Call Your NJ Politicians Now to Vote NO on S4204! Physicians (and everyone else) in NJ will be unable to take side jobs as contractors.

“New Jersey’s law regarding independent contractors [will be] the most restrictive in the nation,” if the State Legislature passes S4204, reports JD Supra in an analysis of a ill-conceived bill ” that could decimate the state’s gig economy.”

The Jersey Conservative puts it this way:

Are you a photographer? A truck driver owner-operator? A freelance writer? A tree trimmer? A dog groomer? A lawyer? A locksmith? A tow-truck driver? A million other things? [e.g. a doctor] Yeah. You’re screwed.

https://www.jerseyconservative.org/blog/2019/11/22/trentonian-the-lives-of-hundreds-of-thousands-of-new-jerseyans-are-about-to-be-destroyed

Spurred by the growth of crowdsourcing apps like Uber and Lyft, this bill “could effectively end independent contract work for many residents in the state if passed,” concurs the Washington Examiner.

California passed a similarly controversial bill earlier this year. But unlike the California bill that exempted a broad array of professionals, including physicians and surgeons, from the law’s prohibition on independent contracting, the NJ bill has only very narrow exemptions.

As written, under the New Jersey bill, “doctors who contract with a health care group, an attorney contracted by a law firm or a political consultant contracted to a political campaign may not be able to [be considered an independent contractor],” concludes JD Supra.

Can such a draconian and un-American bill pass? It is being “fast-tracked for passage in the coming weeks,” according to the Jersey Conservative blog. And JD Supra “predict[s] it will [pass].”

Please speak out TODAY and ask your NJ legislators to oppose S4204: https://www.njleg.state.nj.us/SelectMun.asp

Read more about the implications of this awful bill: https://www.jerseyconservative.org/blog/2019/11/22/trentonian-the-lives-of-hundreds-of-thousands-of-new-jerseyans-are-about-to-be-destroyed

Update: AAFP Should Stand Up for Patient Access to Independent DPC and Withdraw Support for HR 3708

Update: Here is Mr. Shawn Martin’s reply. He granted permission for IP4PI to share it with the understanding that it should not be considered an official statement from the AAFP.

On Oct 25, 2019, at 7:17 AM, Shawn Martin wrote:

Craig-

Thank you for your email. I hope you are doing well. Your email outlines several areas of concern that we share and have been communicating to the various bill sponsors and Committees. We are working to make changes to the bill and I am confident that we will be able to do so.

AAFP policy only speaks to the allowable use of HSA funds for the periodic payment for primary care DPC practice. The bill language meets this objective. We are, however, very concerned with the exclusionary definition of services, specifically pharmaceuticals. Family physicians are not homogenous and the inclusion of a standardized definition and payment rate for “primary care” is concerning. We also are concerned that the allowable periodic payment amount is established irrespective of the patient and their health condition(s).

The other concern we are advancing is the simple fact that the language would apply the permissible use of the HSA to the periodic payment and not the patient themselves. This is nuanced, but basically the permissible amount should apply only to the patient/HSA holder and should have no impact on the practice or the practice’s financial operations.

There are other structural issues, but these are the big items we are working on.

Have a nice weekend – SM

Update 2: From: Shawn Martin, Date: October 25, 2019 at 2:06:39 PM EDT

October 25, 2019 at 2:06:39 PM EDT

I think the challenge in the next few weeks is this – is there a pathway to codify the permissible use of HSA funds for the explicit purpose of periodic membership payments and, if yes, what is the scope of services for such a permissible payment.

The relationship between not permissible (current) and permissible at $x (as proposed in legislation) is not the point in my mind.  The point is providing clarity in statute that an individual may use their HSA funds for a defined purpose – in this case periodic payments to a DPC practice.  Any limitation on the amount of a permissible expenditure is secondary to the permissibility question more generally.  There are defined limits on tax advantage accounts broadly – FSA, CTC, mortgage deduction, SALT, etc.

Its an interesting policy question that I have been kicking around since the ACA.  The HRA is cleaner because it is a defined contribution.  Anyway – look forward to the call with you and others.


10/24/2019 letter from IP4PI founder Craig M. Wax, DO to AAFP Senior Vice President for Advocacy, Practice Advancement and Policy, Shawn Martin:

Dear Shawn

Long time no see, or hear for that matter. I hope you and your family are well and that you landed safely at another entity. I’m writing to express concern about HR 3708 in the House and AAFP support of it. AAFP has been supportive of DPC in recent past and that support is much appreciated, but this bill, as written, would do more harm than good.

Enacting an aggregate cap on patient use of HSA funds for access to value-based care would be a bad precedent and the proposed prohibition on the ability of physicians to include medications in a DPC agreement is contrary to the best interests of patients.

In addition, all specialties, not just primary care, should be permitted to arrange innovative direct payment arrangements with the patient, eliminating the middleman and optimizing care with reduced cost.  HR 3708 appears to preclude the ability of a patient with diabetes from using HSA funds to pay for a monthly arrangement with an endocrinologist, for instance.

The bill also seems to risk the potential for States and others to misclassify DPC as an insurance plan by not properly and clearly defining DPC as medical care.

In its current form, this bill is unacceptable and I am disappointed that AAFP is supporting it. The previous Primary Care Enhancement Act from 2017 (HR 365) was an excellent template, while HR 3708 is flawed.

Please let me know what can be done to revoke AAFP support for this harmful legislation, and work for better options to support DPC and empower both physician and patient independence.

Best wishes for good health,
Craig M. Wax, DO
Family Physician
Independent physicians for patient independence
National Physicians Council on Healthcare Policy member
Host of Your Health Matters
Rowan Radio 89.7 WGLS FM
Twitter @drcraigwax 


The New Jersey #APN Bill is back… please call your #legislators and tell them you oppose the S-1961/A854 Bill TODAY!

Dear friends of IP4PI,

Please read this important alert from the NJ Association of Osteopathic Physicians and Surgeons and TAKE ACTION!

CLICK HERE TO READ ALERT ONLINE

Independent Practice for APN’s “Consumer Access to Healthcare” **Call your Legislators now! – Request that they Oppose S-1961/A854 if posted for a vote**
New Jersey’s Current APN Scope of Practice

In New Jersey APNs are currently required to work in “collaboration” with a licensed physician. Collaboration is the ongoing process by which an APN and a physician engage in practice, consistent with agreed upon parameters. APNs must have a written joint protocol with their collaborating physician in order to prescribe medications and devices. An APNs ability to write prescriptions was a “legislative privilege” and therefore some protections, including the joint protocol with a physician, were put in place. Joint protocols can be as expansive or narrow as the parties agree; and typically is very personal to the experience of the APN and their working relationship with the collaborating physician. There are also NJDHSS regulations addressing the time period required for the collaborating physician’s review of a patient’s’ chart and records when seen by an APN. All of these safeguards will go away under this legislative proposal. 

Other State’s APN Practice Requirements

According to the American Academy of Nurse Practitioners, only 22 states allow APNs to practice completely independent of any physician involvement. These states tend to be more rural states (Alaska, Oregon, Washington, Idaho, Montana, North Dakota, Wyoming, Arizona, New Mexico, Iowa, Hawaii, and Colorado) with the only Northeastern states being Vermont, New Hampshire, Maine and Rhode Island. None of New Jersey’s neighboring states or states similarly situated geographically or demographically permit the independent practice of APNs. For more information, please access the following resources:

Time to Educate the Public on the Difference Between Physician Extenders and Physicians

NJ Physicians Mark Nemiroff, MD, George Petruncio, MD and IP4PI’s Craig M Wax, DO say the difference matters and believe it is time that the public knows the risks of having non-doctors imply that they have the same qualifications as physicians.

They have introduced Resolution 6-2019 at the Medical Society of New Jersey House of Delegates:

Title: Investigation of the autonomous practice of physician extenders in New Jersey and education of the public regarding the differences between physician extenders and physicians.

Sponsored by: Camden County Medical Society

Whereas, physician assistants (PAs) and nurse practitioners (NPs) in the State of New Jersey must have supervising physicians; and

Whereas, there appear to be PAs and NPs practicing semi-autonomously or autonomously in New Jersey with practice names implying they are “Certified Physicians,” and

Where as, physician extender and mid-level practitioner advertisements appear to fraudulently indicate medical licensure, putting public health at risk, and therefore be it

Resolved, the Medical Society of New Jersey call on the New Jersey licensure and regulatory agencies to investigate the legitimacy, guidelines and regulations pertaining to physician extender advertisements and autonomous practice, and be it further

Resolved, the Medical Society of New Jersey educate the public on the difference in education, ability and licensure requirements of physician extenders versus physicians.

Submitted by:

Dr. Mark Nemiroff, President Camden County Medical Society

Dr. George Petruncio

Dr. Craig M. Wax

Be There! New Jersey Doctor-Patient Alliance Inaugural Summit

You will not want to miss this summit on February 8-9, 2019!

IP4PI’s own Craig M. Wax, D.O. will join an all star lineup as a featured speaker. Dr. Wax will share reform priorities that will help put doctors and patients back in the driver’s seat. It is time to put and end to the shenanigans politicians pull to hand advantages to their crony buddies in the hospital industrial complex. Patients and their physicians must team up to reclaim their rights, increase the availability, and slash the cost of high quality care.

Rowan Univ. School of Osteopathic Medicine Remembers Dr. Robert Maurer’s 39 Years of Service

Dear Faculty, Staff, Residents, and Students,

With sadness, we share the news of the passing of Dr. Robert Maurer on September 11, 2016.

Dr. Maurer served as a faculty member in the Department of Family Medicine with the School of Osteopathic Medicine (SOM) for 39 years. During his time of service, he held a number of administrative and clinical roles. He retired from active employment at SOM in 1997, but continued in a volunteer role as an adjunct associate professor until his passing. Continue reading

R.I.P. Dr. Robert Maurer – a gentleman, a statesman, a renaissance man of Osteopathic medicine

Colleagues,

It is with a sad heart that I write to inform you that my longtime mentor, personal friend and friend to the Osteopathic profession passed away yesterday evening. Robert “Bob” Maurer DO died after a prolonged battle with cancer over the last few years. He was a gentleman, a statesman, and an osteopathic physician, through and through. He brought a kind, commonsense approach to his patient care and the professions fight for recognition and excellence. He was a PCOM graduate 1962, practiced family medicine and rheumatology, and was part of the team that established the school of osteopathic medicine at UMDNJ that became Rowan SOM. He worked for the school in the Department of family practice and established the Sicklerville healthcare center. In his career of that spanned more than four decades, he was a champion of the philosophy and politics of osteopathic physicians and their patients, tirelessly, until his final day. He spoke truth firmly to power, which is virtually unheard of nowadays.

He was described by his longtime friend Albert Talone DO:

“Dr. Bob was the most dedicated man to the profession, I know. His intellect, leadership and integrity were a rarity these days. I will surely miss him   We have truly lost a good friend; a renaissance man of Osteopathic medicine and letters.”

The funeral will be at Temple Emanuel, 100 James Street, Edison, NJ 08820 at 12:30 pm on Thursday.

Internment Beth Israel cemetery 2:15pm.

An In Memoriam from NJAOPS includes more info about Dr. Maurers accomplished lifetime of service:

Born in Brooklyn, he completed his undergraduate education at the University of Pennsylvania in 1953 and received his doctor of osteopathic medicine at the Philadelphia College of Osteopathic Medicine in 1962. Between degrees, he served in the U.S. Navy from 1953-1958.

Dr. Maurer joined NJAOPS in 1963, and served as the 1976-1977 president. He also served the osteopathic profession as a long-time officer of the Middlesex County Osteopathic Society, the NJAOPS House of Delegates, the AOA House of Delegates and the New Jersey Osteopathic Foundation. He was recognized for his contributions as the NJAOPS 1990 Physician of the Year and Life Membership in 2002.

An outspoken advocate for osteopathic physicians and their patients, he ran for the New Jersey Senate in 1983 and the New Jersey General Assembly in 1987.

Beyond New Jersey, in 1970 he became the youngest member ever elected to the PCOM alumni board, provided long-time leadership to the American Osteopathic College of Rheumatology, and secured financial support for osteopathic medical school scholarships and continuing education as a member of the Area VII Physicians Review Organization.

Continuing his advocacy on behalf of his colleagues long after his retirement from practicing medicine, Dr. Maurer has spent the last several years pressing for a reevaluation and reform of physician evaluation and testing unless it can be proven to improve patient care.

Best wishes for good health,
Craig M. Wax, DO
Family Physician
National Physicians Council on Healthcare Policy member
Host of Your Health Matters
Rowan Radio 89.7 WGLS FM
http://wgls.rowan.edu/?feed=YOUR_HEALTH_MATTERS
Twitter @drcraigwax

maurer2

AROC conference spring 2016. (above)
Craig M Wax DO, Robert Maurer DO, Albert Tallone DO

maurer