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New Jersey Physician Magazine
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Also in this Issue• Weinberg-Vitale Bill to Strengthen NJ
Public Health Council Approved in Senate
• New Jersey Receives a Waiver to Carry Out Health Law
• How Reimbursements for Over-The-Counter Medications Will Affect Physicians
• Medicare Financial Incentives are Available-Do You Qualify?
Gartner Plastic Surgery and Laser CenterUtilizing the Latest Technologies to Optimize Results While Minimizing Scarring, Pain and the Need for General Anesthesia
F e b r u a r y 2 0 11
www.HNManagement.com973-660-9334/ext 125Located in Florham Park, NJ
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Publisher’s Letter
Dear Readers,
Welcome to the February edition of New Jersey Physician, providing critical information
to the state’s medical community.
General anesthesia is a problem for some patients. Some health issues make elective
surgical procedures dangerous for patients, others have significant fears related to
being “put under”. Dr. Michael Gartner offers these patients the ability to have elective
surgeries under local anesthesia, giving them a pain free procedure without the
fear or danger associated with the more common methods commonly used. Breast
augmentation and reconstruction, tummy tucks, liposuction and face lifts may now be
done with mild sedation combined with an innovative use of local medication. His
innovative practice also specializes in the use of fat grafting for such procedures as
breast enhancement and “Brazilian butt lifts, giving a more natural result. He also uses
the most innovative techniques to minimize or eliminate visible scarring.
The Obama administration has granted broad waivers to four states including New
Jersey to provide less generous benefits than they would otherwise be required to
provide under the new federal health care bill. This will result in some patients having
less than the minimum required coverage for essential benefits like hospital care,
doctor’s services and prescription drugs.
The New Jersey Assembly Health and Senior Services Committee unanimously
approved a bill that would improve the authorization and prompt payment requirements
under Health Claims Authorization, Processing and Payment Act. Medically necessary
procedures are now classified as covered benefits and would prohibit carriers from
remitting payments to hospitals at a rate lower than the contracted rate.
The 2012 Federal budget proposed by the Obama Administration delays the threatened
28% cut in Medicare payments to doctors for two more years, until after the elections.
Changes to reimbursements for over-the- counter medications have taken place which
subject patients to new rules governing reimbursements. This may require physicians
to provide patients with a prescription for a medically needed OTC drug in order for
reimbursement to occur.
With Warm Regards,
Iris GoldbergPublisher
New Jersey Physician Magazine
Published by Montdor Medical Media, LLC
Publisher and Managing EditorIris Goldberg
PhotographerKen Alswang, At Home Studios
Contributing WritersIris Goldberg Christopher Monaco Robert Pear, Frank Ciesla Deidre Hartmann, CPA Mark Manigan, Esq. Debra Lienhardt, Esq Michael Schoppmann, Esq
New Jersey Physician is published monthly by Montdor Medical Media, LLC.,22 Burnet Hill RoadLivingston New Jersey 07039Tel: 973.994.0068Fax: 973.994.2063
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of NJ Physicians Association
2 New Jersey Physician
Contents
COVER STORY
416 18
F e b r u a r y 2 0 11
Gartner Plastic Surgery and Laser Center
Food forThought
Legal Issues
PHOTO BY KEN ALSwANG, AT HOME STuDIOS
CONTENTS9 Marketing The importance of marketing your
specialty practice
10 Statehouse
13 STATLaw
14 FinanceDo you qualify for available Medicare financial incentives?
16 Food for Thought Tabor Road Tavern
18 Over-the-Counter Medications Reimbursement
How will it affect physicians?
Tabor Road Tavern How Reimbursements for Over-The-Counter Medications Will Affect Physicians patients are now subject to new rules governing reimbursement of the cost of certain over-the-counter (OTC) medications.
February 2011 3
Call for NomiNatioNs
New Jersey Physician Magazineinvites all medical practices to submit nominations for cover stories.
Practices should include a brief description of what makes the practice special.
Please contact Iris Goldberg at [email protected]
4 New Jersey Physician
Cover Story
Most people would like to change something
about their appearance. Some flaws are minor
and more noticeable to the individual in question
than to others. Some are quite significant and
whether as a result of illness, injury or genetics
have a profound affect on the quality of one’s
life. Whatever the case, more and more of us are
opting to undergo cosmetic or reconstructive
surgery in order to improve the way we look and
to maximize a positive self-image.
When planning for an elective procedure
patients and/or referring physicians should
thoroughly investigate the options available
to them in terms of choosing a surgeon and
also evaluating the facility in which he or she
operates. Patients need to be assured of the
surgeon’s skill and beyond that of their safety
and comfort throughout the entire surgical
experience.
With office locations in Paramus and Eatontown,
Michael Gartner, DO, FACS has created the
Gartner Plastic Surgery & Laser Center with the
goal of providing patients with beautiful results
while using the most innovative techniques to
minimize or even eliminate visible scarring,
lessen pain and avoid the use of general
anesthesia for some procedures. In his state-
of-the-art surgery center, Dr. Gartner makes the
comfort and safety of his patients his top priority.
For those procedures that require a hospital
stay or are covered by insurance plans that
consider ambulatory surgery centers to be out
of network, Dr. Gartner is affiliated with both
Valley Hospital and Monmouth Medical Center.
He does anticipate that the Gartner Plastic
Surgery & Laser Center will attain in-network
status from many insurance plans in the not too
distant future.
Patients are seen by Dr. Gartner to undergo
cosmetic procedures for virtually every part
of the body. What sets him apart from some
other plastic surgeons is his determination to
investigate ways to improve upon traditional
techniques in order to achieve the most pleasing
result for each individual patient. For example,
Dr. Gartner has mastered the cosmetic surgery
By Iris Goldberg
Gartner Plastic Surgery & Laser CenterUtilizing the Latest Technologies to Optimize Results While Minimizing Scarring, Pain and the Need for General Anesthesia
p Dr. Michael Gartner created the Gartner Plastic Surgery & Laser Center to provide patients with beauti-ful results while using the most innovative techniques to minimize or eliminate scarring, lessen pain and avoid the use of general anesthesia for some procedures.
p Post mastectomy patients wear an external ex-pander called the brava bra prior to breast reconstruc-tion with fat grafting.
• Breast Reconstruction
• Scar-less Breast Augmentation
• Scar-less Breast Reduction
• Vertical Breast Reduction and Lift
• Scar-less Breast Lift
• Body Lift After Gastric Bypass Surgery
• Tummy Tuck
• Liposuction
• SmartLipo™ (using laser light technology)
• Brazilian Butt Lift
• Labiaplasty
• Sclerotherapy
• Mesotherapy
• MACS (minimal access cranial suspension) Lift
• Short Scar face Lift
• Rhinoplasty
• Eyelid & Eyebrow Lift
• Blepharoplasty
• Otoplasty
• Cheek/Chin/Lip Augmentation &
Facial Implants
• Neck Liposuction
• Mole Excision
• Injectable Fillers
• Facial peels
An overview of the procedures performed by Dr. Gartner includes the following:
February 2011 5
techniques necessary to perform a “scar-less”
procedure in many cases. Also, Dr. Gartner
feels strongly about taking steps to effectively
control pain during and after surgery.
One exciting newer technique that Dr. Gartner
offers for patients who have undergone
mastectomy is breast reconstruction with
fat grafting. This innovative procedure is
presently being done by only a small minority
of plastic surgeons but offers some significant
benefits for appropriate patients. “This
procedure suits patients who do not wish to
have implants or may not want the morbidity
of some of the other techniques such as a
tram flap, deep flap or free flap,” explains
Dr. Gartner. He is referring to the fact that
these procedures involve extensive surgery
with general anesthesia, muscle trauma and
scarring. “I think this is a good alternative
option for those women who fear traditional
reconstruction,” Dr. Gartner adds.
In order to undergo breast reconstruction
with fat grafting after mastectomy, the patient
first wears an external expander called a
Brava bra for about ten hours a day (usually
while sleeping). This comfortable soft gel-
like bra gradually expands the skin from the
outside, creating an edema-like breast mound
through the expansion of nerves and tissues.
After approximately two months Dr. Gartner
performs minimally-invasive liposuction to
remove fat from an area of the body that has
enough to spare, such as the belly, flank or
thighs and meticulously injects this fat into the
breast site that has been enlarged by the Brava
expansion. After this procedure, the patient
can usually resume normal activity within a
few days.
The transferred fat survives within the matrix of
tissue that has been created by the Brava. The
breasts are restored naturally as this procedure
is repeated three times on average over the
course of several months. If the breast has
been radiated, the process can take up to five
sessions. The patient receives the added bonus
of gaining a more sculpted body as excess
fat is removed from certain areas. (Of course
patients who do not have adequate fat to spare
would not be suitable candidates).
The “new” breast looks and feels like the
patient’s own but contains no breast tissue to
be concerned about and no foreign bodies.
Best of all, the newly constructed breast retains
a more normal sensation. If the healthy breast is
much larger or droopier than the reconstructed
breast, Dr. Gartner can reduce and/or lift the
other breast in order to achieve symmetry.
It is important to note that although
reconstruction after mastectomy is covered by
health insurance, liposuction usually is not.
Dr. Gartner is currently involved in pursuing
proper channels to determine if the present
restrictions can be lifted to allow coverage for
the fat grafting procedure and he is hopeful that
in time this will become an insurance-accepted
alternative to traditional breast reconstruction
methods.
For non-cancer patients who simply want larger
breasts, insurance is not an issue. Dr. Gartner
can use the fat grafting method to increase
breast size for these women and that process
would require only one session since the
patients already have breasts to build upon.
Generally, breasts could be increased by one
to one and a half cup sizes.
Fat grafting has actually been used by Dr.
Gartner for years to enhance the buttocks.
During this procedure, which has recently been
termed the Brazilian butt lift, fat is harvested
from other parts of the body via standard
minimally-invasive liposuction techniques and
then transferred to the buttocks. The result is
buttocks that are firmer and smoother than
they were and other parts of the body (most p Dr. Gartner performs minimally invasive liposuction to remove fat from an area of the body that has enough to spare.
p Fat is collected and placed into syringes for reinjection.
6 New Jersey Physician
commonly the abdomen, waist, back and
thighs) attain a more sculpted appearance.
Another innovative procedure to enhance
breast size that Dr. Gartner has perfected is scar-
less breast augmentation. Minimal incisions
are made in the navel to ensure that scarring is
barely if at all visible after recovery. Dr. Gartner
then inserts saline breast implants through the
navel. With this method, patients report little
or no pain, no loss of nipple sensation and
a speedy recovery. For patients who prefer
traditional breast augmentation, Dr. Gartner is
highly skilled in these procedures as well.
Dr. Gartner also offers women a scar-less
breast reduction involving the latest surgical
techniques that include liposuction of the
breast tissue to reduce size. This method
greatly reduces scarring and recovery time.
For men with gynecomastia caused by
excess glandular tissue and fat, Dr. Gartner
employs a scar-less reduction technique that is
specifically designed for men. This procedure
is also associated with little or no scarring, fast
recovery and minimal pain.
Besides offering patients minimal or no scarring
for the more extensive cosmetic procedures,
Dr. Gartner also excises moles, lipomas and
other growths, skillfully using techniques
that leave the skin virtually unblemished. This
is especially important to patients who are
having excisions on the face and other parts of
the body that are exposed. Dr. Gartner shares
that he sees many individuals who want to
be assured that an excision will not leave an
unsightly scar.
A great many patients come to the Gartner
Plastic Surgery & Laser Center requesting body
contouring, body sculpting and/or liposuction
for the neck, arms, abdomen, hips, thighs and
knees. SmartLipo™ is the most advanced
technology available today to perform these
procedures and removes fat more evenly
and precisely than traditional liposuction. Dr.
Gartner’s considerable skill and experience
with this technology enables him to teach other
surgeons how to become proficient with it as
well.
Dr. Gartner inserts a very small cannula
containing a laser fiber into the skin. The
cannula is moved back and forth delivering
the laser’s energy to the fat cells, causing them
to rupture and easily drain away. SmartLipo™
is a minimally invasive procedure and can be
performed under local anesthesia. The laser
causes blood vessels to coagulate immediately
on contact, resulting in less bleeding, swelling
and bruising.
Although a number of cosmetic procedures
are routinely performed with local anesthesia,
many of the most popular procedures have
traditionally required that the patient receive
general anesthesia. However, for some patients,
anesthesia is not a good option because of
health problems that increase risk. Others are
fearful of being put to sleep and won’t consider
an elective procedure that requires general
anesthesia. Still others experience intractable
nausea as a result of anesthesia, even with pre-
medication.
Dr. Gartner is able to accommodate many
suitable patients by performing some cosmetic
procedures painlessly with local anesthesia
p Dr. Gartner has been using fat grafting for years to enhance the buttocks. During the brazilian butt lift, fat is har-vested from other parts of the body and transferred to the buttocks. The result is buttocks that are firmer and smoother than they were.
p SmartLipo™ is the most advanced technology available today for body contouring body sculpting and/or liposuc-tion for the neck, arms, abdomen, thighs and knees.
p Dr. Gartner is shown injecting local anesthetic prior to SmartLipo™.
February 2011 7
along with an oral sedative. The “awake”
breast augmentation and the “awake”
face lift are examples of procedures that Dr.
Gartner offers. Some of these surgeries can
also be performed by Dr. Gartner without any
oral sedation if this is what the patient prefers.
Another advantage of this method for some,
especially when affordability is an issue, is that
the significant cost of anesthesia is deducted
from the total price of the procedure.
The key to the success of these “awake”
procedures is the use of pre-emptive
anesthesia. Dr. Gartner has learned through
scientific research and while performing his
own procedures, that if a local anesthetic is
injected into the skin and the muscle area a
few minutes before the incision is made, the
patient will have considerably less pain after
the procedure is completed.
As a result, Dr. Gartner routinely uses
pre-emptive anesthesia for his breast
augmentations. Recovery room nurses have
consistently reported to Dr. Gartner that his
patients who received pre-emptive anesthesia
had significantly less pain upon awakening.
Anesthesiologists have also shared that these
patients generally require less anesthesia and
wake up feeling more comfortable than others.
It was for this reason that a couple of years
ago, when a patient came to see him for breast
augmentation and shared her tremendous fear
of being put to sleep, that Dr. Gartner agreed
to perform her hour-long procedure with pre-
emptive local anesthesia and oral sedation.
Since that time he has done many others in
the same manner. “After each and every one
of these I ask the patient if she would do it
without general anesthesia again and without
exception they all have said they definitely
would,” Dr. Gartner reports.
“Leslie” is one of Dr. Gartner’s patients who
underwent “awake” breast augmentation
not too long ago. She is someone who does
not do well with general anesthesia. “I get
extremely nauseous,” Leslie shares. In fact, she
remembers being ill for days afterwards. When
asked how it felt to be awake for her breast
augmentation Leslie responds, “It was the
most comfortable procedure I’ve ever had!” Dr.
Gartner and his staff were so terrific,” she adds.
“I felt no pain at all and the next day I was up
and cooking breakfast,”
Leslie happily reports. Most importantly, Leslie
is thrilled with her new breasts. Although she
really wanted the augmentation, Leslie confides
that she might not have gone ahead if general
anesthesia was involved. “But I would definitely
do this again,” she emphatically states.
At 54, “Grace” had wanted to have her breasts
made larger for many years. When the
opportunity finally presented itself, Grace opted
to be awake during her implant procedure.
She had heard about people who had adverse
reactions to general anesthesia and also she
didn’t like the idea of being put to sleep. “I
like to be aware of what’s going on,” Grace
admits. “This was the simplest procedure I’ve
ever gone through,” raves Grace. “Dr. Gartner
and his wonderful staff made me feel so
comfortable and secure,” she wants to share.
“If I could be aware and have no pain and know
this is a good thing that I’m doing – that’s my
option,” Grace states. “Also, I picked the right
doctor,” she emphatically adds. “Dr. Gartner
is a sweetheart! Nothing is a silly question for
him. He wants to know his patient’s concerns
and he really makes you feel great,” Grace says
with delight.
In fact, the “awake” procedures have been
so successful that Dr. Gartner now performs
an “awake” breast augmentation with
lift and a mini-tummy tuck during a three
hour procedure that is performed under local
anesthesia. He explains that with any of the
procedures done with the patient being awake,
while there is no real pain, patients may feel
slight pulling, tugging or similar sensations
while Dr. Gartner is working.
More recently, Dr. Gartner has expanded his
“awake” procedures to include face lifts for
appropriate patients. He shares the case of a
patient who was absolutely terrified of having
general anesthesia. Somehow she learned
that Dr. Gartner performed some cosmetic
procedures with local anesthesia and came
to see him, not too long ago, with a request
that he perform a face lift for her without
putting her to sleep. He felt confident that in
her case the procedure could be safely and
successfully completed without the need for
general anesthesia. He is happy to report that
all went well and the patient was delighted with
the experience and the results.
For some older patients, especially, general
anesthesia could present a problem. While they
might be cleared for anesthesia with surgery
for emergent, life-threatening conditions, many
internists and/or cardiologists could hesitate
to approve anesthesia for a totally elective
cosmetic procedure. Some of these patients
would, however, have medical clearance to
undergo a face lift that does not entail general
anesthesia. For them, Dr. Gartner offers a way
to look younger and therefore, feel better.
Dr. Gartner is careful however to point out that
at the present time most board-certified plastic
surgeons do not perform these procedures
under local anesthesia. As a result, some
patients who want cosmetic surgery but can
p before and after breast augmentation. For some patients, Dr. Gartner can perform this procedure with local anesthesia and oral sedation.
8 New Jersey Physician
or will not undergo general anesthesia, will
seek the services of physicians who are not
board certified plastic surgeons or who are
possibly specialists in other related fields.
Some of these physicians are willing to perform
certain cosmetic procedures with the patient
remaining awake and being administered
local anesthesia. Additionally concerning to
Dr. Gartner is the fact that when only a local
anesthetic is used, some procedures can legally
be performed within a physician’s office.
For patients who cannot tolerate general
anesthesia, for whatever reason, Dr. Gartner
wants to emphasize the importance of finding
a board-certified plastic surgeon such as
himself, who is highly skilled in the specialized
techniques necessary for a successful cosmetic
surgery outcome. Furthermore, he knows
that it is crucial that patients undergo these
procedures in a safe and sterile setting such as
the one at the Gartner Plastic Surgery & Laser
Center. “I have a sterile, Medicare-certified
operating room equipped with everything
that would be available in a regular hospital
setting,” Dr. Gartner emphasizes.
Electing to have plastic surgery is an important
decision. Whether for a minor imperfection or
a significant problem that drastically affect’s
one’s appearance a potential patient should
get all of the facts before proceeding. Dr.
Gartner spares no effort to ensure that every
patient who consults with him leaves his
office with a complete understanding of what
his or her procedure will entail. Then patients
who choose to go ahead can be assured that
Dr. Gartner is impressively trained and highly
skilled in the most advanced cosmetic surgical
techniques that will produce the beautiful
results each individual patient desires. With
every appearance-enhancing procedure he
performs, Dr. Gartner has the distinct pleasure
and satisfaction of knowing that he has
transformed someone’s life for the better.
Gartner Plastic Surgery & Laser Center is located at 3 Winslow Place, Paramus NJ. For more information or to make an appointment, please call (201) 546-1890.
For an appointment at Dr. Gartner’s Eatontown office, located at 44 Monmouth Road, Eatontown NJ, please call (732) 389-0909.
p The state of the art operating room at the Gartner Plastic Surgery & Laser Center is Medicare certified and equipped with everything that would be available in a regular hospital setting.
p Shown here, is how a patient looked before Dr. Gartner performed her facelift and after. again, for suitable patients Dr. Gartner can perform this procedure while the patient is awake, with local anesthesia and oral sedation.
February 2011 9
Marketing
Today’s healthcare marketplace is more
competitive than it was just last year. Every year
there are more and more practices popping up
in and around your community. You may or
may not be aware, but your competitors are
probably doing some type of marketing. They
may be running ads in the local paper, taking
family docs out to dinner, internet advertising
or maybe they even have their office manager
dropping off business cards at local PCP
offices. If they are not already doing one or all
of the above, rest assured, they will be doing
something soon.
For specialty physicians, developing
relationships with area PCPs and their office
staff is critical to growing, strengthening and
protecting your referral base. If you are like
most specialty practices, you are so busy that
you don’t take the time to adequately track your
referring docs, let alone visit them. If you are
planning to have a successful practice, long
term, you need to take a serious look at these
things.
Which docs are referring patients to me? How
many patients are they referring on a weekly
basis? Is it more or less than it was last year?
Which docs are not referring to me? Why are
they not? Do they know me? Do they know
what I offer? Did something happen? Did we
do something to upset them? Do they have my
information readily available in their office? Is
there something else they might need from me?
These are just some of the questions you need
to ask yourself and more importantly, address.
The PCPs have all of the new patients that you
want and need. Communication, personal
attention and accommodation will help you get
them.
Can referral patterns really be changed?
They absolutely can. You, as a specialist, may
believe that there are such strong relationships
between physicians in your area. You think that
must be the reason, because those referrals are
not going to you, they are going to someone
else. The truth of the matter is, there are very
few strong personal relationships among
physicians. Those referrals go to someone
else for no other reason than that’s where they
have always gone. And until you do something
about it, they’ll continue to go there.
Submitted by Christopher G. Monaco,
Executive Director – Marquis Medical Practice
Marketing, LLC
For more information visit www.MarquisHBA.com
The Importance ofMarketing Your Specialty Practice In Today’s Competetive Healthcare Environment
Top 5 Reasons to market your practice:1. You’ve been in practice for years, but most physicians in your area do not refer
to you.
2. You are new to the area and referring physicians don’t know anything about you or your practice.
3. You want to secure and protect your current referral base from new or existing competition in your area.
4. You are looking to add more providers.
5. You are looking to see a different kind of patient.
Submitted by Christopher G. Monaco, Executive Director – Marquis Medical Practice Marketing, LLC
10 New Jersey Physician
Statehouse
NEW JERSEYSTATEHOuSE
Weinberg-Vitale Bill to Strengthen NJ Public Health Council Approved in SenateMeasure Would Ensure Broader Representation, Direct Council to Identify Health Funding Available to the StateTRENTON – A bill sponsored by Senate Health, Human Services and Senior
Citizens Committee Chairwoman Loretta Weinberg and Committee Vice
Chair Joseph F. Vitale which would strengthen the role and membership
of the New Jersey Public Health Council was approved today by the Senate
by a vote of 29-10.
“Considering that New Jersey’s public health dollars are stretched to the
absolute limit, we need a public agency with broad representation of all
facets of the health care industry to seek out funding wherever it may
exist,” said Senator Weinberg, D-Bergen. “Under this bill, the Public Health
Council will not only serve to advise State policy and regulation-makers
about the science of health care, but will also be called upon to identify
untapped federal and private funding sources for which the State can
apply. It would make the Public Health Council relevant to the needs and
demands of a 21st Century public health care system.”
“Since it was scaled back in 2005, the Public Health Council has acted on
the periphery of New Jersey’s public health programs, providing limited
advice on the direction of health policy in the State,” said Senator Vitale,
D-Middlesex. “Through this bill, we wanted to empower the agency to
once again make important policy and funding recommendations to make
sure that we take the politics out of health care and apply for all the funds
for which New Jersey qualifies. At a time when the health care picture
nationally is in a state of flux, we absolutely need the Public Health Council
to make sure New Jersey’s health programs are meeting the shifting health
care needs of our people.”
The bill, S-2659, would revise the Public Health Council’s membership,
and restore the functions, powers and duties of the Council. Under the bill,
the Council’s membership would be amended in order to better reflect a
broader representation of public health interests. Specifically, the revised
Council would include:
• a dentist licensed to practice in New Jersey, appointed by the
Governor;
• a person who is knowledgeable by way of education or professional
experience in health-related aspects of terrorism, appointed by the
Governor;
• a dean of a school of public health, or a regionally accredited institution
of higher education in New Jersey, appointed by the Governor;
• a health insurance carrier licensed to do business in New Jersey;
appointed by the Governor;
• a physician who specializes in infections disease, appointed by the
Senate President;
• a State-licensed public health officer, appointed by the Senate
President;
• someone who represents a philanthropic foundation that funds
research on public health issues, appointed by the Senate President;
• a licensed pediatrician, appointed by the Assembly Speaker;
• a person with a demonstrated expertise in maternal and child health,
appointed by the Assembly Speaker; and
• a licensed health care professional with a demonstrated knowledge
and interest in public health, appointed by the Assembly Speaker.
Under the bill, each member would serve for a term of four years, as
opposed to the seven-year terms prescribed for under current law. The
members of the Public Health Council serving on the effective date of the
bill would continue to serve until the expiration of their respective terms.
“Under the terms of the current law, many of these specialized areas of
health care have little to no representation on the Public Health Council,”
said Senator Vitale. “We want an organization which can provide
comprehensive advice and represent a broad set of interests. Through this
bill, we can transform the Public Health Council into an advisory agency
which represents and reflects the many varied areas of interest within the
public health arena – from pediatric to insurance providers, dentists to
anti-terror experts.”
The bill would also direct the Public Health Council to resume some of the
duties it had prior to an executive reorganization which took place in 2005
and essentially relegated it to a diminished advisory role. The revamped
Public Health Council would be responsible for identifying public and
private grants and other funding sources for public health purposes that
may be available to the State, and advise the Commissioner of Health of its
findings. It would also report annually to the Governor and the Legislature
on its activities and include in its report such recommendations for
legislative or administrative action as it deems appropriate.
“At a time when more and more people depend on some level of public
assistance to access health care, we cannot afford to leave any money
on the table, whether its in the form of federal grants or private research
dollars,” said Senator Weinberg. “In addition to restoring the Public Health
Council to its former responsibilities, we need the Council to be creative
February 2011 11
NEW JERSEY STATEHOuSE about finding funding solutions for our many
publicly-funded health care programs. At the
end of the day, this will allow State health care
administrators to do more with less, and help
the greatest number of people possible access
decent, quality health care.”
The bill now heads to the Assembly for
consideration.
Four States Get Waivers to Carry Out Health LawBy Robert Pear, Sourced from the NY Times
The Obama administration said that it had
granted broad waivers to four states allowing
health insurance companies to continue
offering less generous benefits than they would
otherwise be required to provide this year under
the new federal health care law.
The states are Florida, New Jersey, Ohio and
Tennessee, the administration told Congress.
Lawmakers said that many other states, insurers
and employers needed similar exemptions from
some of the law’s requirements and would seek
waivers if they knew of the option.
Steven B. Larsen, a top federal insurance
regulator, said the waivers would allow many
consumers to keep the coverage they had, a
goal often espoused by President Obama.
Under the law and rules issued by the
administration, health plans this year must
generally provide at least $750,000 in coverage
for essential benefits like hospital care, doctor’s
services and prescription drugs. In states
granted the waivers, many health plans with
much lower annual limits on coverage may
continue to operate.
“Unfortunately, limited benefit plans, or mini-
med plans, are often the only type of insurance
offered to some workers,” said Mr. Larsen, who
is director of the federal Center for Consumer
Information and Insurance Oversight. It was to
protect such coverage that the administration
granted the waivers, he said.
Mr. Larsen said the administration had granted
temporary waivers t the four states and to more
than 900 health plans covering 2.4 million people
, or fewer than 2% of all those with employer
sponsored insurance
Delay In Physician Pay ReductionPosted by Frank Ciesla
The 2012 Federal budget proposed by the
Obama Administration delays the threatened
28% cut in Medicare payments to doctors for two
(2) more years, until after the elections. This
approach continues kicking the can down the
road, and does not permanently resolve the
situation. At a hearing on Tuesday, February 15,
2011, both Senate Finance Committee Chair Max
Baucus, a Democrat, as well as Orrin G. Hatch,
the Republican ranking member, challenged
Health and Human Services Secretary Kathleen
Sebelius to come up with a permanent overhaul
of the Medicare physician pay formula. The lack
of a permanent solution continues to put at risk
doctor compensation for providing services to
Medicare beneficiaries. It also does not address
the need to reduce Medicare expenditures so
as not to continue growing the national deficit.
As Senator Alan Simpson co-chair of the Debt
Reduction Commission, stated on cable news, it
is necessary to reduce physician compensation
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12 New Jersey Physician
NEW JERSEY STATEHOuSE if we intend to have a handle on the Medicare expenditures going forward.
Regrettably, the math is simple. If there are more beneficiaries, as there
will be with the baby boomers, and society does not want to or cannot
afford to increase the Medicare expenditures, the alternatives are to reduce
payment to providers or ration care.
Assembly Committee Passes Insurance Reform Bill and Bill to Improve EMS SystemBy Mark Manigan Esq and Debra Lienhardt, Esq of Brach Eichler
On January 20, 2011, the New Jersey Assembly Health and Senior Services
Committee unanimously approved a bill (A3247) that would improve the
authorization and prompt payment requirements under the Health Claims
Authorization, Processing and Payment Act (HCAPPA). The bill would
require insurance carriers to classify medically necessary procedures as
covered benefits and would prohibit carriers from remitting payments
to hospitals at a rate lower than the contracted rate for patients awaiting
transfers to a lower level of care.
Under the current system, carriers that receive a request for authorization
from a health care provider are only required to respond to the request
with a determination as to whether the health care service is medically
necessary under the member’s insurance plan. This bill requires that
carriers that provide authorization determine that the service is medically
necessary and that it is a covered benefit under the insured’s plan.
The bill also provides that, while a patient remains in the hospital awaiting
authorization from the insurance carrier to be transferred to another
facility to receive medically necessary services that are not rendered by
the hospital, the carrier must remit payment to the hospital in connection
with the contracted acute care rate until the patient is transferred to
another health care facility.
On the same day, the committee also approved a second bill (A2095)
that would improve New Jersey’s Emergency Medical Services (EMS)
system. This bill would require all ambulances to become licensed by
the New Jersey Department of Health and Senior Services (DOH), and
also establishes an Emergency Medical Care Advisory Board to study and
improve the EMS program in New Jersey.
The bill will require licensure of the following individuals: 1) a paramedic
to staff a mobile intensive care unit; 2) an EMT to staff a licensed
ambulance; and 3) an emergency medical responder to respond to 9-1-1
calls. Paramedics, EMTs and emergency responders would be required to
undergo criminal history background checks as a condition of licensure.
DOH would be required to make available to the public a current list of
licensed paramedics and EMTs on its website.
Pursuant to the bill, DOH must ensure or arrange for the provision
of advanced life support pre-hospital care in response to 9-1-1 calls.
Paramedics would be able to perform advanced life support services
provided they 1) maintain direct voice communication with and are
taking orders from a licensed physician or physician directed registered
professional nurse, both of whom are affiliated with a mobile intensive care
service; or 2) operate under standing orders from a licensed physician that
were developed or approved by a mobile intensive care program.
We will continue to monitor the progress of these bills. Both will now go
to the Assembly floor and await posting for a full vote.
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February 2011 13
Legal Issues
Strike Force Sweep Charges 111 Persons with Health Care FraudThe Medicare Fraud Strike Force, on February
17th, charged 111 persons-including doctors,
nurses, and health care companies and
executives-in nine cities for their alleged
participation in Medicare fraud schemes
involving more than $225 million in false
billing tied to criminal false claims, kickbacks,
money laundering and aggravated identity
theft (see http://www.justice.gov/opa/pr/2011/
February/11-ag-202.html). The multi-agency
team of federal, state, and local investigators
uses Medicare data analysis and community
policing to find and prosecute fraud. The
defendants included three physicians and
one physical therapist in Brooklyn, and the
schemes involved DME, home health, physical
therapy, chiropractic, podiatry, psychotherapy,
diagnostic testing, and prescription drugs.
Two days earlier, twenty persons in Florida,
including three physicians, were charged with
over $200 million in health care fraud involving
mental health services and sleep studies.
OIG Launches Most Wanted ListJust two weeks prior to the government’s
massive health care fraud takedown, the U.S.
Dept of Health & Human Services’ (HHS)
Office of Inspector General (OIG) launched its
Most Wanted Fugitives List, at http://oig.hhs.
gov/fugitives/, to highlight to the public those
individuals sought by authorities on charges of
health care fraud and abuse. The list includes
a photo and profile of each fugitive, with an
online tip form and 24 hour hotline number
for reporting information related to a fugitive.
Two of the fugitives, including a physician,
have been captured since being identified on
the website. The OIG is seeking more than
170 fugitives on health care fraud and abuse
charges.
HHS Adopts Enrollment Rules Targeted at FraudThe title of new HHS rules that become
effective March 25, 2011, says it all: Medicare,
Medicaid, and Children’s Health Insurance
Program: Additional Screening Requirements,
Application Fees, Temporary Enrollment
Moratoria, Payment Suspensions and
Compliance Plans for Providers and Suppliers.
Among other things, the new rule categorizes
providers and suppliers by level of “risk”, with
additional screening activities conducted at each
level, such as unannounced site visits to those
labeled as “moderate” risk. Although intended
to target those who are unqualified to enroll,
all providers and suppliers should be aware of
the new rules, including provisions allowing
for payment suspension during an investigation
of a “credible allegation of fraud.” For more
information, see: http://www.federalregister.
gov/articles/2011/02/02/2011-1686/medicare-
medicaid-and-childrens-health-insurance-
programs-additional-screening-requirements.
New QIO Notice Requirement ProposedThe Centers for Medicare & Medicaid Services
has proposed a rule that would require most
providers and suppliers that participate in
Medicare, including clinics and ASCs, to provide
beneficiaries with written notice of their right
to contact a Quality Improvement Organization
with concerns about the quality of care they
received. More information is available at:
http://www.cms.gov/qualityimprovementorgs/.
Employment and Ignorance No DefenseIn an unpublished opinion, the New Jersey
Appellate Division has upheld the Board of
Chiropractic Examiners in its disciplinary
action against a chiropractor who conducted
sensory nerve conduction threshold testing.
The chiropractor argued that he was not
prohibited from performing the tests, only from
billing for them and, as a per diem employee
of another chiropractor, did not actually bill
for the services and, in fact, was unaware that
the billing was prohibited. The Court agreed
with the Board that a licensee is held to the
same professional standards and obligations
whether or not employed by another
licensee. By certifying for billing purposes
that he performed the tests and that they were
reasonably necessary, the employee violated
the Board’s diagnostic testing rule. Both the
Chiropractic Board and the State Board of
Medical Examiners have comprehensive
diagnostic testing rules.
Find more information on the above items at
www.drlaw.com.
STATLawProvided by Kern, Augustine Conroy & Schoppmann, PC
14 New Jersey Physician
Finance
Keeping up with the constant changes going
on these days in the healthcare field can be
a full time job. Physicians and their practices
need to be aware of the Medicare and Medicaid
incentives available to them and take advantage
while the opportunities exist. This article
aims to make you aware of programs that are
available and what actions you need to take so
you don’t leave money on the table.
Primary Care Incentive Payment
Program (PCIP)
The 2011 Final Physician Fee Schedule which
was published in the Federal Register on
November 29, 2010 provides for a 10% bonus
payable to primary care providers. A primary
care provider is defined as either a physician
who is enrolled in Medicare with a primary
specialty designation of family practice,
internal medicine, pediatrics or geriatrics.
Non-physician practitioners can also qualify if
they are enrolled in Medicare with a specialty
designation of nurse practitioner, certified
clinical nurse specialist or physician assistant.
The provider allowable charges for primary
care services must represent at least 60% or
more of their Medicare allowed charges in
the prior year. To be eligible for the PCIP the
primary care physician must submit the claim
for primary care services indicating his or her
National Provider Number (NPI) as rendering
physician on the line item for the primary care
service provided. The bonus will be paid
quarterly in 2011 by the Medicare intermediary
automatically if the provider has met the above
criteria.
HPSA Surgical Incentive Payment
Program (HSIP)
The 2011 Final Physician Fee Schedule also
provides for a 10% bonus payable to general
surgeons when they furnish a major surgical
procedure in a location defined by Medicare
as a Health Professional Shortage Area
(HPSA). For a listing of zip codes eligible for
the automatic payment of the HPSA physician
bonus payment go to http://bhpr.hrsa.gov/
shortage/. Qualifying general surgeons would
be identified on a claim for a major surgical
procedure based upon his or her NPI. If the
claim is submitted by a physician’s group
practice, the rendering physician’s NPI must
be included on the line item for the major
surgical procedure in order to determine if
the procedure is eligible for payment under
the HSIP program. The bonus will be paid
quarterly in 2011 by the Medicare intermediary
automatically if the provider has met the above
criteria.
Medicare and Medicaid Electronic
Health Record (EHR) Incentive
Programs
The Medicare and Medicaid EHR Incentive
programs will provide incentive payments
to an eligible professional who becomes a
meaningful user of EHR technology. The
incentive payments are based upon individual
practitioners. If you are part of a group practice,
each eligible professional in the group can
qualify for up to $44,000 from the Medicare
program or up to $63,750 from the Medicaid
Program.
• Eligibility - For the Medicare program
an eligible professional is a doctor of
medicine, osteopathy, dental surgery or
dental medicine, podiatry, optometry or
chiropractor. For the Medicaid program an
eligible professional is a physician, nurse
practitioner, certified mid-wife, dentist or
physician assistant.
• Certified EHR technology – To receive the
incentive payments, make sure the EHR
technology you’re using or are considering
purchasing has been certified by the Office
of the National Coordinator for Health
Information Technology. See http://healthit.
hhs.gov for a listing of products that have
been certified. Register as soon as possible.
You can register before purchasing a system.
• Meaningful User – You have to successfully
demonstrate “meaningful use” for a
consecutive 90-day period in your first
year of participation (and a full year in
all subsequent years) to receive the EHR
incentive.
• Attestation – You must legally attest through
Medicare or Medicaid’s website that you have
met all of the eligibility criteria to qualify for
the incentive payments. Attestation begins
in April 2011, with the first EHR incentive
payments being paid in May 2011.
Although these are only some of the programs
available, keeping you informed can help you
achieve financial benefits. Wishing everyone a
Happy and Prosperous New Year!
Deirdre M. Hartmann is CPA and Manager
of Nisivoccia LLP, a multi-dimensional CPA
firm with offices in Mt. Arlington and Newton,
New Jersey. The firm offers traditional tax,
accounting and audit services, and maintains
practice specialties in sectors including
healthcare, technology, municipal government,
and education, nonprofit and financial services.
Contact her at [email protected].
(973) 328-1825.
Medicare Financial Incentives Are Available Do you Qualify?Provided by Deirdre Hartmann, CPA and Manager Nisivoccia LLP
February 2011 15
The program kicks off with a networking luncheon at 12 noon. It concludes with a wine tasting and an opportunity to network. In between, you will have the chance to hear the perspectives of two leaders in New Jersey healthcare and meet and mingle with other professional women in healthcare.
Admission is complimentary.
New Jersey Women in Healthcare (NJWH) is a new networking group for leading women in healthcare in New Jersey, such as healthcare providers, including physicians and dentists, and key executives in hospitals, nursing homes and other healthcare facilities.
Sponsored by
Keynote speakers:
Poonam Alaigh, M.D. Commissioner
Department of Health and Senior Services
Elizabeth A. Ryan, Esq.President & CEO
New Jersey Hospital Association
RSVP to
973.364.8389
www.bracheichler.com
Health Law Practice Group Women Partners
Lani M. Dornfeld Carol Grelecki Debra C. Lienhardt
973.403.3136 973.403.3140 973.364.5203
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Join us for NJWH’s inaugural event, which will bring together
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16 New Jersey Physician
Food for Thought
If there are readers
who actually follow
Food For Thought on
a monthly basis, they
would have noticed
that I did not submit an
article for last month’s
issue. The reason is
one I am sure many can identify with. A painful back ailment that
began last July became progressively worse and had kept me away
from restaurants and most other places since mid-December. On
January 4th I reluctantly underwent a necessary fusion procedure to
correct the significant problems that were causing the horrific pain.
For the next six weeks I gradually healed from the extensive surgery
but the original pain was gone immediately. I will be forever grateful
for the excellent care and treatment I received.
Although complete recovery takes from three to six months, I am
slowly returning to normal life. One of the enjoyable parts of life that
I have been able to re-claim is dining out. Last night Michael and I
visited the Tabor Road Tavern, right off of Route 10 in Morris Plains.
We had never been there but were eager to try it because it is owned
by the same group as the Huntley Taverne in Summit, which we
always enjoy.
As we entered I felt as if I were in a huge ski chalet in the mountains,
complete with a high wood-beamed ceiling and wood-burning
fireplace. The ambience was warm and welcoming. I thought it was
odd, however, for the hostess to ask for our name since there was a
table available which we were escorted to without having to wait. We
were somewhat disappointed once we were seated because our table
was in between two other tables, each only inches away. We clearly
heard the conversations at both tables – distracting to say the least.
We asked the server if one of the lovely booths was available but he
responded that the empty booths were reserved.
Determined not to let this slight annoyance ruin our first dinner out in
months, we explored the menu. We were intrigued by an appetizer for
two consisting of a sampling of Maryland crab cakes, tuna tartare and
vegetable spring roll with assorted sauces. This arrived beautifully
arranged on a large platter. The spring roll was crisp on the outside
with a stuffing of delicately cooked veggies. The crab cakes were not
as crisp but the crab filling was delicious. Last but not least, the tuna
was fresh and presented interestingly with tortilla chips to scoop with.
By Iris Goldberg
Tabor Road TavernMorris Plains, New Jersey
February 2011 17
At this point we couldn’t help but notice the
over-attentive service. Two different people
had come over to ask if the appetizer was
okay. Michael finished his plate first and it was
removed. The moment I put my fork down my
plate was whisked away as well. I was starting
to feel cranky and couldn’t decide if perhaps
I had ventured out too soon or if things were
really not going as well as they might.
I decided to reserve judgment until after the
entrees were served. I had selected char-broiled
hangar steak, rare with Cuban style Yukon Gold
potatoes and a salad of watercress. The steak
was fabulous. It was seasoned and cooked to
perfection. The potatoes were cooked well –
crisp on the outside and tender on the inside
but I could not eat more than one because of
the excessive amount of garlic. In fact, I fed one
to Michael so that he might be able to tolerate
being close to me. (If you both eat it, the odor
isn’t noticeable. This is an undisputed fact).
The seasoning on the watercress was off as
well. It was so salty that again, I could not eat
more than one bite.
Michael thoroughly enjoyed his dish of honey
and spice roasted Long Island duck breast
served over quinoa with escarole, raisins and
pine nuts. I tasted a slice of the duck and had
to agree it was perfectly cooked and seasoned.
Again, we were asked more than once if
everything was alright and again the plates
were removed promptly. In fact, although I had
put my fork down, there was still food left on
my plate but it was removed without asking if I
was done eating.
I wasn’t imagining it. Tabor Road Tavern
needs to address certain issues. I do think,
however, that the potential is definitely there.
The atmosphere is lovely and some of the food
we sampled was excellent. It’s a bit pricey but
with a little effort this could be a great place
for a casual meal that’s a step above a burger
and fries. For me, even though the meal was
less than perfect, the evening was greatly
appreciated. I felt so fortunate to be out and
about. Sometimes we take even the simplest of
pleasures for granted.
Tabor Road Tavern is located at 510 Tabor
Road, Morris Plains, NJ. (973) 267-7004
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18 New Jersey Physician
As part of the Patient Protection and Affordable
Care Act and the Health Care and Education
Reconciliation Act of 2010, patients are now
subject to new rules governing reimbursement
of the cost of certain over-the-counter (OTC)
medications. These rules affect reimbursements
under employer-sponsored health plans, health
flexible spending arrangements (health FSAs),
and health reimbursement
arrangements (HRAs),
as well as health savings accounts (HSAs)
and Archer medical savings accounts (Archer
MSAs).
Presently, the cost of OTC medicines and
drugs are deemed “medical expenses” that are
eligible for reimbursement from group health
plans (and are “qualified medical expenses”
eligible for distribution from HSAs and Archer
MSAs). However, the changes in the law amend
the definition of what is considered a “medical
expense” and restrict the reimbursement of
funds used to purchase OTC medicine and
drugs going forward after December 31, 2010.
Under these new changes, “a distribution
from an FSA, HRA, HSA or an Archer MSA
for a medicine or drug is a tax-free qualified
medical expense only if (1) the medicine or
drug requires a prescription, (2) is an over-the-
counter medicine or drug and the individual
obtains a prescription, or (3) is insulin.
As patients seek to utilize these reimbursement
vehicles, this will seriously affect the potential
liability of physicians who are now frequently
asked to provide the documentation required
for their patients to be reimbursed. Although,
according to the IRS, the patient simply needs to
obtain a receipt of payment, the physician must
provide documentation which (other than for
insulin) is nothing short of an actual prescription
, regardless of the fact that OTC medications do
not require a prescription for purchase.
In responding to recent requests from the
medical community for clarification of the
need to provide prescriptions for OTC drugs,
the IRS has posted a very specific response to
this frequently asked question (“FAQ”) on its
website:
“If your employer’s health FSA or HRA
reimburses these expenses, you would provide
the prescription (or a copy of the prescription or
another item showing that a prescription for the
Howfor
By Michael J. Schoppmann, Esq. Kern Augustine Conroy & Schoppmann, P.C.
Legal Issues
Reimbursements Over-the-counter MedicationsWill affect physicians: (NewRules and Requirements)
February 2011 19
item has been issued) and the customer receipt
(or similar third-party documentation showing
the date of the sale and the amount of the charge).
For example, documentation could consist of
a customer receipt issued by a pharmacy that
reflects the date of sale and the amount of the
charge, along with a copy of the prescription; or it
could consist of a customer receipt that identifies
the name of the purchaser (or the name of the
person for whom the prescription applies), the
date and amount of the purchase and an Rx
number.”
For purposes of the new rule, a prescription
is defined as “a written or electronic order
for a medicine or drug that meets the legal
requirements of a prescription in the state in
which the medical expense is incurred and
issued by an individual who is legally authorized
to issue a prescription in that state.”
However, the new rule does not apply to items that
are not medicines or drugs, including equipment
(e.g., crutches), supplies (e.g., bandages), and
diagnostic devices (e.g., blood sugar test kits).
These items will continue to qualify, if they
otherwise meet the definition of medical care,
which includes expenses for the diagnosis, cure,
mitigation, treatment, or prevention of disease,
or for the purpose of affecting any structure or
function of the body.
In light of these new requirements, patients will
likely seek reimbursement for OTC medications
on a more frequent basis. Therefore, physicians
should be prepared for a dramatic increase in
the number of “prescriptions” they are asked
to issue. This is also the area where the risk of
potential liability exists. Before simply issuing
such documents as “claim documents” or
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20 New Jersey Physician
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• Musculoskeletal pain
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“reimbursement forms,” physicians and medical
practices must not issue what will still be legally
considered a prescription, thereby intended to
treat a known medical condition without having
first seen and fully examined the
patient for that condition. That also
requires properly documenting the
propriety and medical necessity
of that “prescription.” Further, an
additional problem may well arise
when an established patient requests
that numerous “OTC prescriptions”
be written, yet is also already taking
prescribed medications which may
interact negatively with the OTC
medications, and result in patient
injury and a lawsuit. Such a situation clearly
requires the prescribing physician be aware
of and assess the possible interaction of all the
medications and drugs, both OTC and non-OTC,
which the physician has now “prescribed” for the
patient.
There may also be additional ramifications for
those physicians who contemplate charging
for the initial prescription. They may well face
regulatory problems at a later date. A physician
should not write a prescription without first
examining and evaluating the patient,
unless this is an established patient
and the physician reasonably believes
a new examination is not required to
write the new prescription. Further,
if the physician wants to charge
the patient to write the initial OTC
prescriptions, this charge would likely
be in addition to the fee for the office
visit. However, if the patient complains
to a regulatory agency or insurer, such a
combination of fees may well be viewed
as “excessive.” This could trigger an investigation
into the documentation about the prescription
with subsequent disciplinary action.
Therefore, as a result of this new rule, we anticipate
that both new and established patients will want
to come to see the physician at least once a year
and have as many of their OTC prescriptions
written at that office visit as possible, with as
many refills as can be legitimately written. Some
practices which have provided advance notice
of such a policy are already charging patients for
writing prescription refills between visits, in order
to encourage patients to adhere to a “once a year”
protocol.
Looking ahead, every physician and practice
must be strongly cautioned not to casually “back-
date”, “re-write” or “post-date” prescriptions
to ease the burdens imposed upon them by
passage of these new rules. Whatever issues
may later arise, the falsification of a prescription,
whether for OTC or non-OTC medications, will
take greater precedence in disciplinary or other
regulatory investigations and proceedings and
pose a far greater threat to the practice than any
other underlying issues.
Michael J. Schoppmann, Esq., is a principal in the firm of Kern Augustine Conroy & Schoppmann P.C., which is solely devoted to the representation of healthcare professionals. He may be contacted at 1-800-445-0954 or via email at [email protected].
HELP SAVE THE PRACTICE OF MEDICINE!CALL 888-806-5362
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More than 22,000 healthcare professionals across the country depend on medical malpractice insurance from ProMutual Group for protection and peace of mind.
• We have the long-term vision and financial resources to provide the coverage you need today and in the future. • We proactively partner with you to minimize risk, increase patient safety and improve patient care.• And if you do face a claim, we will aggressively defend good medicine and provide the emotional support you need to rest assured.
To learn more about ProMutual Group, call us at (800) 225-6168 or visit us online at www.promutualgroup.com.
PROTECT, PREVENT, DEFEND.
ProMutual Group Agents:Michael R. Bernal-SilvaMBS InsuranceBoonton, NJ – 800-347-3417
John BisbeeBoynton & BoyntonRed Bank, NJ – 800-822-0262
Kevin ByrneAcorn Professional ServicesWest Conshohocken, PA – 800-454-2429
William CareyHealthcare Risk SolutionsFort Washington, PA – 800-215-2707
Bob CottoneRUE InsuranceTrenton, NJ – 800-272-4783
Yvonne DiLauroBollinger InsuranceMoorestown, NJ – 856-273-8100
Mary DonohueBrown & Brown MetroMt. Laurel, NJ – 856-552-6330
Tim HooverThe Woodland GroupSparta, NJ – 800-253-1521
Henry S. KaneArgent Professional InsuranceWarren, NJ – 908-769-7400
Steven KlingerProfessional Consulting ServicesLivingston, NJ – 973-597-0400
Shawn KnechtelWiderman & CompanyHaddonfield, NJ – 800-220-3434
Carol MaselliConner Strong CompaniesPhiladelphia, PA – 267-702-1375
Jennifer M. MoserBrown & BrownBethlehem, PA – 610-974-9490
Richard PetryGlenn InsuranceAbsecon, NJ – 609-641-3000
William A. ReillyJoseph A. Britton AgencyMountainside, NJ – 800-462-3401
Rory RineerProfessional Liability AgencyHarrisburg, PA – 800-375-3056
Don RobertsUSI MidAtlanticPlymouth Meeting, PA – 482-351-4600
Patty SchaefferAON/Affinity InsuranceHatboro, PA – 215-773-4600
Kim SoricelliArthur J. Gallagher AssociatesMontclair, NJ – 973-744-8500
Burt C. SzerlipBC Szerlip Insurance AgencyLittle Silver, NJ – 800-684-0876
Robin VoorheesThe NIA GroupSomerset, NJ – 800-669-6330
Chris ZuccariniCornerstone Professional Liability ConsultantsRadnor, PA – 800-508-1355
101 Arch Street, Boston, Massachusetts 02110 | 1.800.225.6168 | www.promutualgroup.com
