NEW JERSEY PIP FEE LAWS UPDATE

NEW JERSEY PIP FEE LAWS UPDATE

Our collective efforts delayed the implementation of the new PIP Fee Schedule down in Trenton for more than 3 ½ years. However, today the Supreme Court of New Jersey declined to hear our appeal of the Appellate Division's August decision to uphold the NJ PIP Fee Schedule. The litigation component of this battle is over. The war to reverse this injustice to the manipulation under anesthesia procedure and other procedures continues in the Legislature.

You may recall that we started fighting this fight at the agency level during the summer of 2005 in New Jersey. DOBI wanted to set fees across the board at 115% of Medicare and to have these rates in place by January 1, 2006. Due to our vigorous lobbying efforts, the New Jersey physician fees were increased to generally 130% of Medicare, with many adjustments in the 130% to 800% of Medicare range, and ASC fees were increased to approximately 325% of Medicare by the time DOBI proposed the rule in 2007.

When DOBI adopted the proposal, we obtained a stay from the Appellate Division on behalf of our clients the Alliance for Quality Care, the Orthopedic Surgeons of New Jersey, the New Jersey Association of Osteopathic Physicians and Surgeons, the New Jersey Interventional Pain Society, Atlantic Orthopedic Associates, the Medical Society of New Jersey, the New Jersey Association of Ambulatory Surgery Centers and the New Jersey State Society of Anesthesiologists. The stay prevented the PIP Fee Schedule from becoming effective during the two years we litigated before the Appellate Division and thus not changing the manipulation under anesthesia reimbursement rates

We are aggressively pursuing corrective legislation. We have significant support for a bill that would require the PIP Fee Schedule to be based on actual amounts paid by PIP carriers to medical providers, as opposed to the hodge-podge of data upon which DOBI allegedly relied. The bill would require the new fee schedule to be based on paid fee data from 2007 -- rates in place before the current fee schedule went into effect and keeping the MUA payments the same.