Measures Would Cut Down on False Claims, Create Statewide Health Care IT Network, Allow Families to Make Decisions on Medical Research
TRENTON – Five bills sponsored by Senator Joseph F. Vitale aimed at improving Statewide health care programs, protecting against fraud and streamlining services were signed into law by the Governor over the weekend.
“Without constant scrutiny and adaptation, New Jersey’s health care safety net would collapse under its own weight,” said Senator Vitale, D-Middlesex, the Chair of the Senate Health, Human Services and Senior Citizens Committee. “These five measures each address a necessary piece of reform in the State’s response to the medical needs of its citizens. These new laws will ensure a healthier tomorrow for the State’s residents, and a strong health care infrastructure for future generations of New Jerseyans.”
The first bill, S-1757, entitled the “Access to Medical Research Act,” will authorize adult family members or health care representatives empowered by an advance directive for health care to make certain medical decisions for an incapacitated patient in regards to medical research. The law establishes a hierarchy for those people who can give informed consent, depending on whether the patient is receiving non-emergency or emergency room care. Under the law, a family member or authorized representative must exercise substituted judgment based on the wishes and values, to the extent known, of the patient and act in the patient’s best interests.
“Through this law, incapacitated patients will have access to drug trials and other experimental treatments if a family member or other trusted individual signs off,” said Senator Vitale. “It gives voice to the voiceless, and allows their wishes to be followed, even if the patient is unable to let those wishes be known to health care providers.”
The second bill, a Senate Committee substitute for S-360 and S-1829, will allow private individuals in New Jersey to bring a legal action, either by themselves or working with the State Attorney General, against any person who knowingly causes the State to pay a false claim, whether through Medicaid or one of the other State claims programs. If a person is found guilty in court, the law creates civil penalties, between $5,000 and $10,000, for each verified count of a false claim, as well as imposing up to three-times the cost of any losses the public entity sustained because of the false claim.
“Given our limited health care resources, we need to aggressively pursue claims cheats and return those dollars to the State coffers,” said Senator Vitale. “These funds must be used to provide access to those who need it, and we cannot tolerate fraud within the system.”
The third bill, S-2203, will expand the focus of the Disease Management Study Commission to consider the impact that disease management programs can have on health care subsidy programs for New Jersey’s uninsured, such as NJ FamilyCare and Medicaid.
“Nearly 78 percent of the health care costs in the U.S. are related to the treatment of chronic disease,” said Senator Vitale. “With a greater Statewide focus on disease management, and better management of chronic disease, we can maximize the efficiency of NJ FamilyCare and other programs for the uninsured.”
The fourth bill, S-2633, will provide additional revenues to the Catastrophic Illness in Children Relief Fund by increasing the annual surcharge from $1.00 to $1.50 per employee for all employers covered under the New Jersey Unemployment Compensation Law. The Fund provides financial assistance to families for a number of medical-related costs, including: specialty transportation, health insurance premiums, uncovered pharmaceutical costs, specialized pediatric ambulatory care, home modification, home health care, specialty hospital services, or experimental treatments.
“When sudden, catastrophic illness strikes a family, parents are sometimes caught off-guard by the sudden spike in health care expenses related to treating that illness,” said Senator Vitale. “The Catastrophic Illness in Children Relief Fund has been a valuable Statewide safety net for families struggling to meet the uncovered expenses associated with caring for a sick child and we need to provide the resources to allow the Fund to accomplish its mission.”
The final bill, S-2728, known as the “New Jersey Health Information Technology Development, Implementation and Deployment Act,” will create a statewide IT infrastructure for the sharing of medical records among health care professionals. The bill will establish the Office for the Development of Electronic Health Information Technology (e-HIT) within the Department of Banking and Insurance, and charge the Office with establishing and maintaining a secure medical information infrastructure to allow health care professionals to access patient information from a Statewide database.
“With our current technology, there’s absolutely no reason that patients should have to fill out a medical history form at every point of care they visit,” said Senator Vitale. “Requiring patients to update their medical information that many times can lead to mistakes, which could alter the care they’re given by health care professionals. Providing a Statewide, secure database will ensure that doctors and other medical professionals will have quick access to patient information, from High Point to Cape May, and will put a greater focus on treatment over paperwork.”
All five bills were approved earlier in the month, in the final days of the 212th Legislative Session.