new jersey physician january 2012 publication
DESCRIPTION
New Jersey Physician is published monthly by Montdor Medical Media, LLC.,TRANSCRIPT
Also in this Issue• Proposed Legislation Requiring Surgical Practices to be Licensed Passes
House and Senate But Not Signed by Governor Christie
• CMS Releases 2012 Medicare Physician Fee Schedule
• From a Patient’s Point of View-What Doesn’t Kill You Makes You Stronger
Campus Eye GroupVision for LifeThe Only Destination Patients Need to Have for Complete and Continuous Ophthalmic Care
j a n u a r y 2 0 1 2
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Expertise: More than 55,000 New Jersey medical malpractice claims handled
Strength: Over $1 billion in assets and $353 million in surplus as of December 31, 2010
Service: Calls handled personally, specialized legal representation, knowledgeable independentagents, in-office visits by our skilled risk consultants
Knowledge: New Jersey-specific knowledge and decades of experience
Innovation: Three corporate options, specialty reports, practitioner profiles, office practice toolkits, optional data privacy coverage
Publisher’s Letter
Dear Readers,
Welcome to the January issue of New Jersey Physician. Changes are coming soon.
We are hard at work setting up our new website which will have our current issue
featured each month along with an archive of past issues. Additionally there will
be a section for late breaking news, so plan on visiting us often. We will also give
readers the option of receiving our publication either by regular mail in hard
copy, viewing online, or by email. We will soon allow you to communicate with us
regarding how to best provide you with the state’s only voice for physicians.
I have known Tom Touzel for many years. He has shared with me the battle he
waged against his own cancer and the amazing results that have been achieved.
Tom is a very determined person who gives every effort in life his full attention. I
thought this story about him, originally published in a Canadian newspaper, might
prove to be valuable to our physician readers to see serious illness from the other
side. I hope you find it inspiring.
Bollinger Insurance has taken a strong stand in the professional liability community,
recently acquiring Argent Professional Agency as well as The Woodland Group,
Allied Insurance Services Agency, and The Szerlip Agency. These acquisitions will
make Bollinger one of the nation’s leading insurance agencies. They have formed
a new professional liability agency within the company which will be headed by
Henry Kane and Brian Kern of Argent.
Recently, legislation was passed by both the state house and senate requiring
surgical practices to be licensed. The matter is not law yet as Governor Christie has
not signed the ruling, thereby “pocket vetoing” the legislation.
CMS has published the 2012 medicare physician fee schedule, which you will find
inside. Unless there is further action, the new schedule calls for a 27.4% reduction
in reimbursements on March 1. If the past is any indication of the future I wouldn’t
count on these reductions taking place.
We had the pleasure of meeting one of the most comprehensive opthalmic
practices in the state, Campus Eye Group. The vision of Dr. E. Bruce DiDonato, CEG
is a full service vision center, offering the services of many sub-specialists within
opthalmics who practices in one location. State-of-the-art technology includes the
Izon® High Resolution Lenses which are customized to correcting tiny microscopic
irregularities or aberrations.
With warm regards,
Michael GoldbergCo-Publisher
New Jersey Physician Magazine
Published by Montdor Medical Media, LLC
Co-Publisher and Managing EditorsIris and Michael Goldberg
Contributing Writers Iris GoldbergLeon Smith, MDLeslie Thomas, CPAAnthony M. Rainone, Esq.Joseph ConnKeith Roberts, Esq.Debra C. Lienhardt, Esq.John Fanburg, Esq.Mark Manigan, Esq.Joseph Gorrell, Esq.
New Jersey Physician is published monthly by Montdor Medical Media, LLC.,PO Box 257Livingston NJ 07039Tel: 973.994.0068Fax: 973.994.2063
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2 New Jersey Physician
CONTENTS
9 Health Law Update
10
Hospital Rounds
New Jersey cancer docs form network
12
Statehouse
13
Vendor News
Argent Professional Insurance Agency, LLC announces its acquisition by Bollinger, Inc.
14
Patient Point of View
What doesn’t kill you makes you stronger.
Contents
Campus Eye GroupVision for LifeThe Only Desitination Patients Need to
Have for Complete and Continuous Ophthalmic Care
Cover Photo: E. Bruce DiDonato, Founder and President of Campus Eye GroupCOVER STORY
4
September 2011 3
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Procedure type:
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Our knowledge, expertise and access to all of the major NJ markets helps to ensure our clients find the best possible coverage at the lowest available rates.
4 New Jersey Physician
In today’s healthcare arena, patients have
the opportunity to receive treatment from
an ever-growing number of physicians who
have been highly trained in sub-specialized
areas within a particular branch of medicine.
While the benefits of this in terms of the
level of care patients receive is obvious, the
logistics for managing all of the trips to the
various locations that are often required can
be challenging. Comprehensive vision care in
particular, especially as patients grow older,
usually involves treatment from more than one
specialized practitioner.
This was prominently in the mind of E. Bruce
DiDonato, O.D., back in 1981, when he founded
Campus Eye Group. Dr. DiDonato invited
skilled eye care providers from numerous sub-
specialties to practice with him in one location.
Over time, technology was put into place in
order to provide state-of-the-art treatment for
nearly every condition affecting the eye.
“During the 1980s, if you needed anything other
than glasses, contacts or perhaps a cataract
operation or other small procedure, you had
to go to a major university medical center,”
Dr. DiDonato, relates. He shares that often
the patient would have an evaluation on the
first visit and then be required to travel back,
sometimes a considerable distance, days or
even weeks later for the appropriate treatment.
Dr. DiDonato remembers that he and others
in the field at the time were frustrated by the
inefficiency of this system and the tremendous
inconvenience for patients. “I wondered why
no one had brought sub-specialty care here
and so we did, with the development of our
retina center in 1989,” he reports. “And for more
than 20 years now, we have been providing
everything right here,” Dr. DiDonato adds,
referring to the addition of virtually all specialty
medical and surgical treatment for the eye as
well as the most innovative optical services
available.
Today, Campus Eye Group has evolved into a
multi-specialty, interdisciplinary eye care prac-
tice, including its own impressive Medicare-cer-
tified, AAAHC-accredited ambulatory surgery
center (ASC), where fellowship-trained sub-
specialized ophthalmic surgeons perform ev-
ery conceivable surgical procedure for the eye.
Campus Eye Group’s ASC was actually
developed in 1985 when Dr. DiDonato realized
the importance of providing the safest and
most technologically advanced environment
for his patients who were having cataract
surgery. “I wanted to have more control over
the outcomes,” he relates, citing concerns
about possible complications.
Since then, the ASC has been continuously
updated with the most sophisticated laser
and computerized equipment in the region,
enabling the surgeons at Campus Eye Group to
perform many advanced eye surgeries as well.
Some of these include corneal transplants,
treatment of diabetic retinopathy, macular
degeneration and glaucoma. Additionally,
eye muscle and eyelid plastic procedures are
performed by Campus Eye Group’s skilled sub-
specialists.
Cover Story
By Iris Goldberg
Campus Eye GroupVision for LifeThe Only Desitination Patients Need to Have for Complete and Continuous Ophthalmic Care
p During LaSIK vision correction, the surgeon creates a precise thin hinged corneal flap that is pulled back to expose the underlying corneal tissue.
January 2012 5
For patients in and around Mercer, Middlesex and numerous other
counties in New Jersey and in fact, many who come from locations
throughout the tri-state area, Campus Eye Group has served as an all-
inclusive hub, providing routine, medical, optical and surgical eye care,
eliminating the need to travel to numerous ophthalmic facilities in order
to address all of their eye care needs.
“We do everything here that is done in tertiary and university care centers
with the exception of oncology,” Dr. DiDonato emphatically states. He
also points out the tremendous savings that are realized when insurance
companies make payments to ASCs as compared to those made to
hospitals as another significant advantage that Campus Eye Group offers.
Brian M. Cohen, O.D. is Director of Clinical Services at Campus Eye
Group. Dr Cohen discusses the comprehensive scope of the practice.
“We have more than 30 doctors on staff here,” he remarks. “In fact, we’re
one of the largest practices in the country,” Dr. Cohen states.
In terms of the services offered, Dr. Cohen emphasizes that from routine
eye care to the most advanced surgeries and treatments and everything
that falls between, Campus Eye Group’s team of experts, equipped with
the most innovative technology, provides it all. “We really are a one-stop
location for complete eye care,” he says. (See Fig. 1)
A great many of the patients who are treated at Campus Eye Group come
for vision correction. In fact, there have been patients who have traveled
from all over the United States and even some who have flown in from
other countries to undergo LASIK laser vision correction surgery with
the renowned experts at the Campus Eye Group. Their vast experience
coupled with the latest LASIK technology has helped countless patients
achieve 20/20 vision or better throughout the years.
p a specialized laser is used to reshape the cornea and the flap is then repositioned onto the underlying cornea without sutures.
• VisionCorrection Cataract Surgery with Premium IOL Implants Lasik Laser Vision Correction PRK Laser Vision Correction Phakic Intraocular Lens (IOL) Surgery
• CorneaServices Corneal Transplants DSEK Pterygia removal with amniotic tissue graft
• RetinaServices Laser treatments, Medical Care and anti-oxidant therapy to slow or reverse progression of Macular Degeneration Use of innovative medications and up-to-the-minute laser technology to treat Diabetic Retinopathy Latest techniques for treatment of Retinal Detachment
• GlaucomaTreatments Advanced technology for early detection Minimally invasive laser therapy Surgical procedures to reduce intraocular pressure and prevent vision loss Shunt Implantation
• Neuro-Ophthamology
• OculoplasticSurgery Blepharoplasty (surgery to correct Ptosis or drooping eye) Surgical correction of Entropian and Ectropian (folding inward or sagging outward of lower eyelid) Eyelid reconstruction
• OcularAesthetics Botox Injectable fillers for wrinkle removal
• OpticalServices Hundreds of fashion and designer frames Advanced extra thin and light lenses Newest progressive bifocals IZON® lenses for high definition Safety and sports glasses Lens treatments including: UV protection, photochromic, polaroid, scratch resistance, anti-glare and fashion tints Prescription and non-prescription sunglasses
• HearingServices Hearing evaluations with leading-edge diagnostic equipment Dual sensory evaluations Sophisticated hearing aids Licensed audiologist on staff
OverviewofServicesProvidedby Campus Eye Group
Fig. 1
6 New Jersey Physician
LASIK eye surgery is appropriate for the
majority of patients who suffer from poor vision
due to myopia (nearsightedness), hperopia
(farsightedness) and/or astigmatism. During
the brief outpatient procedure the surgeon
first creates a precise thin-hinged corneal flap.
Next, the flap is pulled back to expose the
underlying corneal tissue. A highly specialized
excimer laser then gently ablates (reshapes)
the cornea. The flap is then repositioned onto
the underlying cornea without sutures.
At Campus Eye Group custom LASIK is
achieved through wavefront technology that
uses light projected on the back of the retina
to create measurements of each patient’s
individual visual system. The resulting
waveprint is as unique as a fingerprint and
enables the surgeon to customize the LASIK
procedure for each patient based on the
information it provides.
Thousands of patients undergo cataract
surgery at Campus Eye Group’s ambulatory
surgery center each year. Leaving the facility
with vision that has been restored or perhaps
is better than it ever was is the outcome for a
great number of patients. “Cataract surgery
today has become a refractive procedure,” Dr.
Cohen explains. “Patients’ expectations today
are much higher than they were even five years
ago,” he adds.
In order to provide the best and most customized
result for each individual patient, the surgeons
at Campus Eye Group offer the latest and
most sophisticated premium intraocular lens
implants (IOLs) to replace the lens that has
become clouded, including ReStor, Technis
Multifocal, Toric and Crystalens.
AcrySof ReStor and Technis are multifocal
IOLs, which restore vision at all distances. The
Toric IOL corrects pre-existing astigmatism and
improves distance vision. The Crystalens is an
accommodating lens implant engineered to
correct presbyopia as well as nearsightedness
and farsightedness.
Before the availability of these premium IOLs
many patients who underwent cataract surgery
still needed to wear eyeglasses at times,
especially for reading. Today, the significantly
growing number of cataract patients who opt
for these upgraded IOLs return for follow-up
visits delighted to report that they no longer
wear glasses at all.
For some patients without cataracts who
may not be good candidates for laser vision
correction surgery, the physicians at Campus
Eye Group can perform surgery to implant
phakic IOLs for vision correction. These
innovative devices, which are similar to
contact lenses, are placed within the eye as
an additional lens. Following this procedure,
which takes less than 30 minutes, most patients
experience improved vision immediately.
In addition to the abundant volume of patients
who are treated at the Campus Eye Group each
year for cataract surgery and vision correction,
many undergo advanced procedures
performed on site by the specialty-trained
ophthalmic surgeons on staff. Dr. Cohen shares,
“What sets us apart from some other practices
is the specialty care we offer. Many conditions
that a general ophthalmologist might refer out,
we treat right here.”
For example, corneal tissue can be affected by
a number of serious eye conditions, such as
keratitis, which is inflammation of the cornea
and keratoconus, in which the eye’s surface
weakens causing the cornea to curve outward.
Fuch’s Dystrophy is a progressive, inherited
corneal disease where the endothelium
becomes less able to control the cornea’s fluid
content. Damage to the corneal tissue can lead
to impaired vision that often cannot be treated
with laser vision correction.
At Campus Eye Group, a fellowship-trained
cornea specialist who has performed thousands
of corneal procedures will do a comprehensive
evaluation to determine the best treatment
p The lens with the cataract is removed
p The new lens is being placed into the eye
January 2012 7
remedy for each individual patient. If surgery is
indicated, it is performed on site in the state-of-
the-art ambulatory surgery center.
Progression of cornea disease may eventually
require a patient to undergo corneal
transplant surgery, during which a cornea
obtained from a donor eye bank is expertly
transplanted to the affected eye. A newer
partial transplant procedure, DSEK, which
stands for Descemet’s Stripping Endothelial
Keratoplasty is now being performed at
Campus Eye Group as well. During DSEK, using
microsurgical techniques, the thin corneal
inner layer called Descemet’s membrane is the
only layer transplanted, along with endothelial
cells, rather than the full corneal thickness as
is done in the traditional transplant procedure.
The remainder of the patient’s healthy cornea
is left in tact. DSEK is less invasive than the
standard corneal transplant and requires less
recovery time.
Many patients seen at Campus Eye Group come
to be treated by its team of retina specialists.
When retinal tissue is damaged by injury or
disease, the ability of the retina to transmit light
may be compromised, leading to vision loss or
even blindness.
For individuals who are over the age of 65,
macular degeneration (AMD), which is a
partial deterioration of the part of the retina
known as the macula, is the leading cause of
blindness. Whether suffering from dry AMD
which is caused by a gradual breakdown of
cells in the macula or the rarer and more
aggressive wet AMD, caused by the abnormal
formation of new blood cells, early detection
and treatment is crucial.
At Campus Eye Group an individualized
treatment plan is developed for each patient
that may include a combination of laser
treatments, Avastin or other drug injections,
and/or vitamin supplements to slow down or
in some cases, even reverse the progression of
macular degeneration. “We are in our fourth
generation of medications that are injected,
which arrest the disease and in 15 percent of
cases, vision actually improves,” Dr. DiDonato
is pleased to report.
Patients with diabetes are at great risk for
developing diabetic retinopathy, a condition
in which the blood vessels in the retina become
damaged and leak blood. Although patients
may be asymptomatic initially, eventually the
swelling of the retina interferes with vision.
Left untreated, diabetic retinopathy can lead to
blindness.
The priority at Campus Eye Group’s retina center
is to closely monitor diabetic patients with
advanced testing in order to detect and treat this
devastating condition as early as possible. With
revolutionary medications and the most current
laser technology, patients who are treated at
Campus Eye Group for diabetic retinopathy are
spared further progression of disease and can
also have a reversal of its severity.
In some patients conditions affecting the retina
can cause the retina to separate or detach from
the underlying tissue. Retinal detachment
can lead to sudden and permanent vision
loss if not treated immediately. Dr. DiDonato is
pleased to inform that Campus Eye Group has
procured the technology to begin performing
retina reattachment on site. This service will
be available imminently and will certainly be
a significant benefit for any patient or referring
physician who suspects a retinal detachment.
Glaucoma, which affects the optic nerve, is
another serious eye condition that requires
immediate treatment to avoid permanent vision
loss. However, glaucoma is a slowly progressing
disease that can be managed quite effectively if
caught early on and provides another example
of the exemplary specialty care available at
Campus Eye Group.
p a multifocal intraocular lens replaces the lens that was clouded.
p Besides his role as President of the practice, Dr DiDonato makes time to treat patients
8 New Jersey Physician
The skilled surgeons offer advanced testing
and effective treatment options to arrest
glaucoma before significant damage can
occur. Depending upon the type and severity
of glaucoma in each individual case, eye drops,
minimally invasive laser therapy and/or surgery
to reduce intraocular pressure are used.
In addition to the comprehensive spectrum of
routine and specialty eye care, patients who
visit Campus Eye Group have access to an
impressive array of optical services. Besides
hundreds of the latest fashion and designer
eyeglass frames, Campus Eye Group offers the
latest technology in lenses and lens treatments.
A revolutionary development in eyewear vision
correction has recently allowed the skilled
opticians at Campus Eye Group to customize
each individual prescription to match every
patient’s unique optical requirements. Izon®
High-Resolution Lenses are produced using
information from measurements obtained in
the traditional way and also a revolutionary
computerized capability to measure tiny
microscopic irregularities or aberrations that
oftentimes distort light as it passes through the
cornea and lens and onto the retina.
These aberrations have a significant impact
on the quality of vision affecting things like
depth perception, crispness, contrast, color
perception and night vision. From this data a
unique “eyeprint” is derived. Like fingerprints,
no two individuals have the same one. In fact,
each eye has its own unique print. Campus Eye
Group patients who are found to be appropriate
candidates for the Izon® technology receive
eyeglasses that provide vision correction
created solely for them that is far superior to
what they were able to have with standard
lenses.
Preserving as well as enhancing the gift of
sight for hundreds of thousands of patients in
New Jersey and beyond has been the mission
at Campus Eye Group since it was founded
three decades ago. Dr. DiDonato and the other
expertly trained specialists who have joined
him throughout the years have continuously
provided the most comprehensive and
technologically advanced eye care available
today. As Campus Eye Group begins another
decade, the vision of a future with endless
possibilities for its patients is crystal clear.
Campus Eye Group is located at 1700
Whitehorse-Hamilton Square Road, Hamilton,
NJ 08690. For more information or to make
an appointment call (609) 587-2020 or visit
www.campuseyegroup.com
p Dr Cohen administers the IZOn® exam
p Izon technology produces unique “eye prints” (top) for each patient, which are used to create customized lenses for vision without aberrations.
January 2012 9
Health Law Update
MedicinalMarijuanaProgramRules TakeEffect;BMEClarifiesPosition onPrescribingMarijuana
CMSReleases2012MedicarePhysician FeeSchedule
HealtH lawUpdateProvided byBrachEichlerLLC,CounselorsatLaw
On December 19, 2011, the rules governing New
Jersey’s Compassionate Use Medical Marijuana
Act went into effect. The adopted rules – origi-
nally proposed by New Jersey’s Department of
Health and Senior Services (DHSS) – are iden-
tical to those proposed by DHSS in February
of 2011.
In addition to DHSS’s rules, the New Jersey
State Board of Medical Examiners (BME) ad-
opted its own rules concerning the prescrip-
tion of medicinal marijuana, which were re-
vised from the BME’s originally proposed rules.
The revisions came in response to controversy
surrounding the Legislature’s interpretation of
the BME’s rule as requiring physicians to pe-
riodically attempt to wean patients off of their
medicinal marijuana. The revised rules retain
a provision requiring physician reassessment
of the patient’s medicinal marijuana use every
three months. However, the new rule makes
clear that physicians can continue to prescribe
medicinal marijuana if it is helping the patient
reach his or her treatment objectives with no
untoward side effects, physical problems or
psychological problems. Notwithstanding this
clarification, if such problems do arise, then the
prescribing physician is required to either (1)
modify the dose of marijuana, (2) undertake a
trial of other drugs or treatment modalities or
(3) discontinue the use of marijuana. Addition-
ally, a physician who is required to take action
must also consider referring the patient for in-
dependent evaluation or treatment in order to
achieve the patient’s objectives.
CMS published the Medicare Physician Fee
Schedule (MPFS) for calendar year 2012 late
last year. Payments under the MPFS are based
upon the Sustainable Growth Rate formula im-
posed under the Balanced Budget Act of 1997.
Based on that formula, the 2012 MPFS provides
that Medicare’s payments to physicians will be
reduced across the board by 27.4%. However,
on December 31, 2011, President Barack Obama
signed legislation which delays the implemen-
tation of the reduction until February 29, 2012.
Unless there is further action, Medicare pay-
ments will be reduced as of March 1, 2012.
Some of the other key provisions of the MPFS
include:
• The Multiple Procedure Payment Reduc-
tion policy currently reduces payment by
50% for the technical component associ-
ated with the second and any subsequent
advanced diagnostic imaging tests per-
formed on the same patient on the same
day. For 2012, this policy is expanded to
apply to the professional component as
well, with payment being reduced by 25%
for the professional component associ-
ated with the second and any subsequent
advanced diagnostic imaging tests, includ-
ing MRI, CT and ultrasound.
• The Geographic Practice Cost Indices will
incorporate different data sources to deter-
mine the various cost differences among
localities in connection with the physician
work RVU, the practice expense RVU and
the malpractice RVU.
• Certain aspects of the Physician Quality
Reporting System, the e-Prescribing incen-
tive program, and the Electronic Health
Records incentive program have been up-
dated and modified to allow for increased
participation.
• The quality and cost measures that will
be used in establishing a new value-based
modifier have been finalized, which will
ultimately be used to reward physicians
for providing higher quality and more effi-
cient care, commencing with specific phy-
sicians and physician groups in 2015 and
expanding to all physicians by 2017.
• Providers are required to conduct a health
risk assessment as part of the Medicare
patient’s annual wellness visit, and Medi-
care will increase payment for the HCPCS
codes associated with the health risk as-
sessment to take into account the addi-
tional time and paperwork involved.
10 New Jersey Physician
Health Law Update
ProposedLegislationRequiringSurgicalPracticestobeLicensedPassesHouse& SenateButNotSignedbyGovernorChristie
NewJerseyBillWouldRequireCertain AdvertisingDisclosures
On January 9, 2012, legislation that would have
required surgical practices to be licensed by
DHSS as ambulatory care facilities was passed
by both the New Jersey Senate and Assem-
bly. However, Governor Chris Christie did
not sign the bill into law by January 17, 2012,
thereby “pocket-vetoing” the legislation. Un-
der the “Codey Law,” surgical practices are not
required to be licensed. Instead, they are re-
quired to register with DHSS and obtain either
certification by CMS as an ambulatory surgery
provider or ambulatory care accreditation from
an accrediting body recognized by CMS.
This bill would have repealed the registra-
tion requirement and instead mandated that
all surgical practices be licensed by DHSS as
ambulatory care facilities within one year of its
enactment. The bill provided, however, that
surgical practices in operation prior to the date
of enactment would not have been subject to
the ambulatory care facility assessment or to
DHSS regulations pertaining to physical plant
and functional requirements for ambulatory
care facilities.
A bill originally introduced last June in the
New Jersey Legislature, which requires certain
health care professionals, working in an of-
fice, to disclose to patients their name, type of
license and highest level of academic degree
(A4185), was recently reported out of the As-
sembly Regulated Professions Committee. The
bill requires that information must either be
prominently displayed in the office of such a
health care professional or in writing to a pa-
tient on the patient’s first office visit.
The bill requires that:
• A person licensed to practice medicine or
surgery by the State Board of Medical Ex-
aminers, who is also certified in a medical
specialty, must disclose, while working in
an office, the name of the certifying board
or association
• Advertisements by a health care profes-
sional for health care services must include
the professional’s name, type of license and
highest level of academic degree
• Certain health care professionals who pro-
vide information regarding health care ser-
vices on an internet website that is directly
controlled or administered by that profes-
sional or that professional’s office person-
nel, must prominently display on that in-
ternet website their name, type of license
and highest level of academic degree
The bill was not addressed in the last day of the
legislative session held on January 9, 2012.
Hospital Rounds
A group of physician practices in New Jersey
has formed an oncology physician network
that comprises more than 70 cancer-care
specialists and 500 employees at 20 care sites
within the state.
Regional Cancer Care Associates, based in
Hackensack, N.J., expects to treat about 90,000
patients each year, according to a news release.
The network is made up of 10 oncology
physician practices: the Central Jersey
Oncology Center; Hematology Oncology
Associates; Hematology Oncology Associates
of North New Jersey; Hope Community Cancer
Center; Monmouth Middlesex Hematology
Oncology; Northern New Jersey Cancer
Associates; Sparta Hematology Oncology; The
Center for Cancer; and the practices of Dr.
Kenneth Nahum and Dr. Usha Niranjan.
“Regional Cancer Care Associates physicians
and staff accept our responsibility to work
with insurance companies, our hospitals
and referring physicians to provide patients
continued access to the highest-quality
compassionate care, cutting-edge therapies
and clinical trials while reducing the cost of
cancer care,” said Dr. Andrew Pecora, president
of the network.
Pecora is the chief innovations officer and
vice president of cancer services at the John
Theurer Cancer Center, which is part of the
Northern New Jersey Cancer Associates
network, according to a spokesman for
Regional Cancer Care Associates.
N.J.CancerDocsFormNetworkBy Jaimy Lee
January 2012 11
Health Law Update
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NewJerseyBillPhasesOutTaxon CosmeticMedicalProcedures: AwaitingGovernorActionA bill recently passed by the New Jersey legis-
lature would phase out New Jersey’s cosmetic
medical procedure gross receipts tax. The tax,
initially passed in 2004, currently imposes a
6% gross receipts tax on the purchase of cos-
metic medical procedures, defined as those
procedures performed in order to improve an
individual’s appearance where such proce-
dures do not significantly serve to prevent or
treat illness or disease. This includes cosmetic
surgery, hair transplants, chemical peels and
cosmetic dentistry, as well as a host of other
procedures. The tax is paid by the individual
receiving the cosmetic procedure and collect-
ed by those billing for the procedure. The bill
is meant to reduce the cost of such procedures
as well as the administrative burden that the tax
places on providers who are required to collect
the revenue.
The bill (A-3646/S-1988) would begin reduc-
ing the current 6% rate on such procedures
to 4% starting on the first day of the calendar
quarter after the bill is passed. The rate would
then drop to 2% on or after July 1, 2012. The
tax would subsequently be eliminated for pro-
cedures performed after July 1, 2013. During
the final voting day of this legislative session on
January 9, 2012, both the general assembly and
the senate voted to approve the bill, and it has
now been sent to Governor Christie for signa-
ture or veto.
12 New Jersey Physician
Statehouse
NEW JERSEYSTATEHOuSE
Beginning in the fall, medical professionals
who come into contact with patients would
have to get a flu shot under a bill that won final
legislative approval Monday evening.
Health care facilities would have to provide a
vaccination program for its employees by the
start of the next flu season in the fall. Employees
would have to get the vaccine, show proof they
got it on their own, or sign a statement that
testifies to their decision not to get vaccinated,
according to the bill.
All health care facilities would have to report its
annual compliance rate to the state Department
of Health and Senior Services, according to the
bill, (A3920).
The bill passed, despite calls from anti-vaccine
groups urging people to tell lawmakers to
oppose any vaccine mandate. “This opens
the door for vaccine mandates for adults.
Records will be maintained regarding who has
received this vaccine and who has declined
it,’’ according to an email sent Friday by the
New Jersey Coalition for Vaccine Choice to its
members.
The Senate passed the bill 36-3 just before 6
p.m.; the Assembly passed the bill last month.
NJBillWouldRequireHealthCareWorkersto Get Flu ShotsBy SusanK.Livio
Legislation sponsored by Senator Robert Singer
(R-30) which would require the Commissioner
of Health and Senior Services to convene a
planning summit to examine an expected
shortage of physicians practicing in New Jersey
has been approved by the Senate Health,
Human Services & Senior Citizens Committee.
“A recently completed report predicts that
within the next decade, New Jersey will face a
shortage of thousands of physicians practicing
in family care and important specialties,” said
Singer. “Unless we get to work now to prevent
that shortage, many New Jerseyans may soon
find themselves without doctors or unable to
obtain appointments or treatments when they
need them.”
Singer’s legislation, S-173, was introduced in
response to a report issued by the Physician
Workforce Policy Task Force in 2010 which
predicts a shortfall of nearly 3,000 doctors
in the Garden State by 2020, including 1,000
primary care physicians and 1,800 specialists.
The legislation seeks to address that shortage
by requiring the Commissioner of Health and
Senior services to convene a strategic planning
summit comprised of relevant State agencies,
boards and key stakeholders, including
representatives of medical schools and
teaching hospitals in the state.
The summit would be charged with analyzing
the state’s physician workforce supply,
discussing the redistribution or expansion
of residency slots to address shortages in the
state and investigating ways to include more
community hospitals in resident rotations
in family medicine, internal medicine and
pediatric medicine.
“The summit proposed by this legislation
would bring together experts from across
the state to determine the most effective way
to prevent or minimize the looming doctor
shortage,” added Singer. “Once we have their
recommendations, we will be able create and
enact a plan to ensure that New Jersey trains
and retains enough doctors to meet all of our
residents’ needs.”
SingerBilltoRequireStudyofLoomingDoctorShortageinNJApprovedbySenate Health Committee
January 2012 13
Vendor News
Argent Professional Insurance Agency, LLC
announces its acquisition by one of the nation’s
leading insurance agencies, Bollinger, Inc.
“Bollinger is a leader in virtually every area of
the insurance industry, and with the acquisition
of Argent, we feel we have solidified our place
on top of the professional liability market as
well,” remarked Jack Windolf, CLU, CPCU,
Bollinger Chairman and CEO. This acquisition
will make Bollinger one of the largest
professional liability insurance agencies in the
nation, combining Argent’s vast network and
seasoned leadership, with Bollinger’s extensive
resources and national presence.
Bollinger has formed a new professional
liability division within its agency in recognition
of its new role as a leader in the niche. In
addition to acquiring Argent, Bollinger has
also recently acquired other agencies with
professionalliability expertise, including
The Woodland Group and Allied Insurance
Services Agency. “We are excited by the
prospect of creating one professional liability
division within Bollinger, and are honored to
be tasked to lead it,” commented Henry Kane,
ARM, President, Argent.
The acquisition also comes at a time when
many professionals – particularly in healthcare
– are experiencing widespread consolidation
and regionalization. “As the clients we serve
throughout a number of professions continue
to expand geographically, and diversify into
new areas with new exposures, we are thrilled
to be able to partner with Bollinger . Having
access to Bollinger’s
resources helps ensure that our clients’ needs
will be met for many years into the future,”
noted Brian Kern, Esq., Co-Founder of Argent.
Argent Professional Insurance Agency, LLC,
was founded in 2009 by Henry Kane, ARM,
and Brian Kern, Esq., and has grown rapidly to
become one of New Jersey’s leading writers of
professional liability insurance for physicians
and healthcare facilities, accountants and
attorneys.
Bollinger, Inc. is headquartered in Short
Hills, NJ with branch offices in Greenwich CT,
New York NY, Monticello NY, Philadelphia PA
and additional NJ locations in Moorestown,
Sparta, Vineland and Wall. The firm has over
440 employees and is currently ranked as the
nation’s 17th largest insurance broker.† It is one
of the 2009 Best Places to Work in Insurance.††
Bollinger provides business and personal
insurance and employee benefit programs to a
wide range of customers, as well as specialty
insurance programs for golf and country clubs,
amateur sports, and schools and colleges.
For more information on Bollinger, Inc.
www.BollingerInsurance.com
† As reported
ArgentProfessional InsuranceAgency,LLC Is Acquired by Bollinger
14 New Jersey Physician
Patient Point-of-View
WhatDoesn’t Kill You,Makes You Stronger
Tom Touzel learned one of life’s most
important lessons, perhaps unintentionally,
after deciding several years ago that he would
not succumb to bladder cancer, chose to fight
it, and won.
Touzel, who lives in Vankleek Hill but travels
abroad on a regular basis, said despite having
to undergo regular checkups for his health, he
lives a relatively fit and active lifestyle - and he
feels good.
His advice? Take your care into your own
hands and be relentless.
“No matter what you’re dealing with, especially
with cancer, the proactive are the survivors,”
he said. “When you sort of walk in and say, ‘Do
what you need to do,’ that’s when you lose.
“It’s important to get involved in your own
care and be involved with doctors and nurses
and technicians and so on, so that you
understand what’s going on and you can better
communicate to them what’s going on.”
Touzel was first diagnosed with bladder cancer
in the spring of 2005, when he visited his
primary physician in Fort Lauderdale, Florida.
At the time, he was taking a blood thinner
(Coumadin) after suffering a stroke about a
decade earlier - and wrongly assumed the
blood in his urine was linked to the medication.
“I never thought to discuss it with my doctor
until one time, when I was in Korea and the
bleeding started and I stopped taking Coumadin
and it kept on bleeding,” he recalled. “Within a
week, I was in the hospital.”
His first surgery took place in Miami in April
2005, and Touzel recalls his doctor coming
in post-operation and uttering a few simple
sentences.
“He said, ‘So Tom, can you hear me and
understand me?’ I said, ‘Sure.’ He said, ‘Well,
it’s not pretty. What you need to do is go home
and get your s--t together.’ That’s literally what
he said - and he walked out of the room.”
Touzel decided right then and there that the
diagnosis would not control his life. He began
researching cancer care centres that deal
with bladder cancer and decided on the M.D.
Anderson Cancer Center in Houston, Texas.
The surgeon he would see was Dr. Colin
Dinney, though the latter didn’t know it yet.
“I went into the clinic and they told me they
weren’t taking any new patients,” said Touzel.
“So I went back to admissions and said, ‘I know
there’s a great turnover in patients. I will sit here
and wait until Dr. Dinney comes to me.’
“The next morning I went back there, and
around 11 o’clock, he came over and said, ‘Mr.
Touzel, I understand you’re pretty persistent.’
I said, ‘I am, because I want a winner. I don’t
intend to lose this battle and I want you on my
team.’”
By JustinBromberg
January 2012 15
Touzel had with him his MRIs, scans and
reports, but nevertheless was scoped again at
M.D. Anderson. The clinic would not offer a
definite prognosis, only saying its team would
do the best it can do - along with robotic
surgical procedures and drugs.
“I just started with treatments there, including
two surgeries, and was rendered clean and
declared clean,” he said. “A couple of years
ago, I reached my five-year point of being clean
and [Dinney] said, ‘Okay, are you ready for a
prognosis? If you keep doing exactly what we
tell you to do, I can promise you will not die of
bladder cancer.’”
One year into the treatment, Dr. Dinney asked
him to serve as a patient advocate for bladder
cancer. Touzel said he was initially concerned
it would be “like giving people ice and water,”
but he quickly learned it meant being part of
“a very complex group of people that acts as
referees between doctors and patients.”
“It’s not about battles but translating what
they’re feeling and thinking, making sure their
questions are answered, their needs are met,
no bulls--t, up front and honest,” he said. “I’ve
been doing that for five years now and I’ve
become involved with other advocates and
many other disease sites.”
Stayingpositive
Bladder cancers is one of the cancers of which
there is no cure, meaning it requires regular
care and management. Touzel continues to be
examined every three months and will likely do
so for the rest of his life - as there’s always the
chance it’ll “pop up” again.
“We all have cancer cells floating around in our
systems and one of the great mysteries is: what
triggers them to grow and become tumours
and metastize and spread?” he noted.
But what gives him such a positive outlook on
his condition, Touzel was asked.
“There are some truths that are absolute,”
he stated. “The proactive are the survivors.
The people that engage their own illness and
treatment are the ones that come out on top.
That’s all I know but I’m grateful that I’m happy
and healthy and have a great family and live a
great life.”
This week, Touzel also celebrates a noteworthy
milestone: once an alcoholic, he is now 38
years clean in Alcoholics Anonymous. Asked
about what inspires him to be so forthcoming
- and public - about his disease, he says being
involved in that group and abstaining from
alcohol taught him an important lesson that he
readily referred to after his battle with cancer.
“I learned very early in AA that the key to
survival is sharing,” said Touzel. “Sharing, not
being afraid to share you story and your fears
and I’ve always done it. That’s sort of the way
it is with cancer, too. The fact that I’m cancer
free today is something that can give hope to
someone, someday, who is just embarking on
this journey.
“They say, ‘Look, an old fart with wrinkled hair
has beat it’ and they have hope then. They also
see patients walking around with no colour in
their face and that’s frightening - so we need
to keep the hope up for all these people.
Everybody is entitled to hope and faith.”
Wordsofadvice
Touzel’s advice, again, is to be proactive - and
don’t assume you can just sit back and let the
system take care of you.
“Whether you’re in Canada or the U.S. - both
medical systems work - you still need to learn
how to work the system,” he said. “You can’t
just sit back and let the system work you. When
you have an issue that needs special attention,
you need to demand special attention from
primary physicians - and you’re entitled to it.
“It’s the same thing down here [in the U.S.]
with Medicare and insurance; most companies
have restrictions on the doctors themselves,
on who’s included in their plan, and you have
to make demands. Speak up and say, ‘I am a
human, I am covered by you and that is what I
want - and I want the best.’”
Touzel refers to that approach as “speaking up
and attacking the system, making it do what it’s
supposed to do for you.”
“I am not a religious guy, but I’m pretty spiritual,”
he continued. “I’m not a Sephardic Jew or a
born-again Christian or a radical Buddhist, but
we have to somehow develop a sense of faith...
and that’s really where the freedom for all of us
comes, is engaging and embracing the faith -
wherever we find it.
“We are powerless over all kinds of things in
this world, and cancer is one of them, but we’re
not powerless in dealing with it. People need to
search out the optimum in treatment and care
and go for it.”
Those are the so-called words of wisdom from
a man who, at an age where most people
settle into retirement, now travels the world
as a judge for dog shows. Touzel relocated to
Vankleek Hill several years ago after operating
a kennel in Pointe-Fortune for 20 years, noting
“this area is really home.”
He doesn’t spend much time in the gym, but
calls himself “fairly fit and active” as well as
grateful to live the lifestyle he does - and when
he’s tired of flying on airplanes, to be nestled
comfortably in eastern Ontario.
“Be proactive - if not, you’re giving up.”
Take your care into your own hands and be relentless.
16 New Jersey Physician
Food for Thought
Michael and I have been attending Super Bowl par-
ties since we moved to New Jersey. Back then, as
many as ten couples, each with anywhere from one
to three children in tow, gathered at one particular
home in Livingston every year. They had a big play-
room down in the basement where all the kids could
go (be banished to is more accurate), leaving the
adults upstairs to enjoy the game, each other and the
food and drink. While this would seem to be a fine
plan on paper, it actually played out like this:
It would take about five minutes until a fight broke
out downstairs, requiring at least two moms to ref-
eree. The men were already congregated in the den
in front of the television, never to be seen or heard
from again until it was time to collect the kids and
go home. The women would sit around the kitchen
table, snacking and commiserating. Every so often,
one or two moms would run downstairs to negotiate
a settlement. Also, a child or two would find his or
her way upstairs now and then to complain or to just
get some TLC.
When the women did have a chance to talk, the topic
was almost always something about their children.
Toilet training, the “terrible twos,” sibling rivalry,
intellectual development (most of us were former
teachers), pre-school programs, etc., were the most
common subjects. In the days when the kids had not
yet started school, we were all stay-at-home moms
so this was truly our main focus. I must admit, there
were many years when I didn’t even know which
teams were playing.
Now for the food! The fare was always the same. Our
hostess, Barbara found a way to make Super Bowl
Sunday a charitable event. She purchased “sloppy
Joes” and all of the sides from a deli that contributed
part of their profit to a cancer-fighting organization.
The only items that varied were the nibbles. Usually,
each couple contributed something. Whatever there
was – nachos, miniature franks in blankets, crudite –
everything tasted delicious, especially when accom-
panied by a bloody Mary or a glass of wine. I remem-
ber I particularly enjoyed the tangy buffalo wings that
were a tradition on this special Sunday.
Fast forward to Super Bowl 2012. Giants vs. Patriots.
Even I am excited. Friends who live in Roseland have
taken on the annual event. There are five couples.
Two are from the original group. We are now “ma-
ture” adults ranging in age from late 50s to early 60s.
The moment we arrive, Michael heads straight for the
den where the other men are already settled. I take
my spot at the kitchen table. Does this sound famil-
iar? Wait, it gets better.
I sit next to a lovely woman who I like very much but
only see from time to time at various events – wed-
dings and funerals mostly. She has a full-time career
as do I. She immediately pulls out her cell phone to
show me a picture of her granddaughter and I re-
spond by sharing every detail of my daughter’s preg-
nancy. Next, a third woman reveals the plans for her
son’s upcoming “destination” wedding.
By this time the game has started and the men are
screaming every few minutes. We are watching on
a smaller TV in the kitchen which has a time delay
so we hear the mens’ shouts before we actually see
what has occurred. It doesn’t really matter because
we are only half-watching. While we are conversing
we are feasting on a variety of scrumptious delights.
Someone has made a multi-layered creation of gua-
camole, bean dip, salsa, Monterey Jack, shredded let-
tuce and other ingredients that I’m sure I am forget-
ting. There was a lovely crudite with a tangy dressing
and a variety of chips, nuts, cheeses, etc. Our contri-
bution was the wings.
Michael had spent most of the afternoon preparing
about 40 of these beauties. They were a hit! Just the
right amount of heat and the meat was perfectly
seasoned and cooked. I was so proud of him that I
glanced toward the den hoping to catch his eye. No
such luck. He was caught up in the excitement of the
game and the camaraderie of other men.
I suddenly remembered one Super Bowl Sunday
many years before, when I did not join Michael and
the kids at the usual party. I was in the hospital re-
covering from surgery. I had encouraged him to go
without me, thinking it would be good for him to
spend an enjoyable few hours away from the hospi-
tal, watching the game in the company of his pals. I
was surprised to see him walk into my hospital room.
It was only half-time. “Why are you here?” I asked. “I
couldn’t enjoy it without you,” he answered with a
straight face and the utmost sincerity.
I am looking forward to attending many more Su-
per Bowl parties with Michael in the years to come.
Wherever and with whomever we find ourselves seat-
ed, Super Bowl Sunday has come to be about good
people, good food and this year- a team that brought
us all to our feet. Although I have to say, I kind of
missed the kids.
Michael’sSuperBowlSundayBuffaloWingsIngredients:
Chicken wings - separated into two main
pieces, and toss out the tip
Salt, Pepper, Garlic Powder, Flour
Oil for frying in a sauté pan
1 cup of Frank’s Original Flavor Hot Sauce
(must be Frank’s, do not substitute)
One stick of butter
Celery
Good blue cheese dressing such as Marie’s
In a large bowl, place the chicken, gener-
ously add the salt, pepper and garlic powder,
mix together. Put enough flour into bowl to
lightly coat the wings by stirring. Heat the oil
to about 375º and cook the wings to a golden
brown. Place them in a heat proof bowl, Mix
the Frank’s Hot Sauce in a separate pan with
the melted butter and stir until combined. Pour
the sauce over the cooked wings. Serve with
the celery and blue cheese dressing on the side.
Can be cooked ahead and warmed in the oven
when ready to serve.
Super Bowl Sunday Buffalo WingsRoseland, New JerseyBy Iris Goldberg
