The New Jersey State Spine Society has called an emergency meeting for Feb. 15 to address major state legislative issues to reduce reimbursement rates for spine procedures and gather support for advocacy efforts, according to an ISASS news release.
The NJSSS has been working for the past six months to prevent a personal injury protection fee schedule overhaul, which would reduce acceptable fee schedules. The society fears two proposed bill would jeopardize current work and the ability to practice either "in-network" or "out-of-network" in delivering spine surgical care to patients.
Key changes in the proposed bill would:
• Alter a carrier or entity's power to determine whether a physician or facility has committed a pattern of violations concerning waivers of payment;
• Allow a carrier or entity to exempt the physician or facility from the provision of law, which gives an out-of-network healthcare provider the right to receive payment for reimbursement directly through an assignment of benefits;
After meeting with members of NJSSS last year, legislators decided to terminate both bills. However, the bills have been re-introduced in the 2012 legislative session, making it necessary to advocate again for current out-of-network privileges, according to the report.
NJSSS has also been working to remove spine codes from the Department of Banking and Insurance's changes to the Personal Injury Protection Fee Schedule, which will be released later this month. The changes would decrease reimbursement for spine surgeons by up to 50 percent, negatively impacting on-call coverage and delivery of emergency spine care. The change was proposed last August and subsequent advocacy efforts focused on removing spine codes from the change; however, if they are not removed, the society will maintain its current position during the 60-day comment period.
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Key changes in the proposed bill would:
• Alter a carrier or entity's power to determine whether a physician or facility has committed a pattern of violations concerning waivers of payment;
• Allow a carrier or entity to exempt the physician or facility from the provision of law, which gives an out-of-network healthcare provider the right to receive payment for reimbursement directly through an assignment of benefits;
After meeting with members of NJSSS last year, legislators decided to terminate both bills. However, the bills have been re-introduced in the 2012 legislative session, making it necessary to advocate again for current out-of-network privileges, according to the report.
NJSSS has also been working to remove spine codes from the Department of Banking and Insurance's changes to the Personal Injury Protection Fee Schedule, which will be released later this month. The changes would decrease reimbursement for spine surgeons by up to 50 percent, negatively impacting on-call coverage and delivery of emergency spine care. The change was proposed last August and subsequent advocacy efforts focused on removing spine codes from the change; however, if they are not removed, the society will maintain its current position during the 60-day comment period.
Sign up for our FREE Spine E-Weekly for more coverage like this sent to your inbox!
Related Articles on Spine Procedure Reimbursements:
10 Evolving Issues for Hospitals, Health Systems, Physicians & ACOs
ISASS Urges Members to Support Reimbursement for Spinal Fusions
Pain Physicians: What is the Biggest Factor Contributing to Your Practice's Profitability?