Sponsored by:
Assemblyman TROY SINGLETON
District 7 (Burlington)
SYNOPSIS
Establishes "The Patient Safety and Provider Incentive Program;" makes an appropriation.
CURRENT VERSION OF TEXT
As introduced.
An Act establishing "The Patient Safety and Provider Incentive Program," supplementing chapter 9 of Title 45 of the Revised Statutes, and making an appropriation.
Be It Enacted by the Senate and General Assembly of the State of New Jersey:
1. The State Board of Medical Examiners in the Department of Law and Public Safety, hereinafter the board, shall establish "The Patient Safety and Provider Incentive Program."
a. The Patient Safety and Provider Incentive Program, hereinafter the program, shall enable participating healthcare providers to use guidelines established pursuant to this section as the treatment protocol in the provision of healthcare services. The guidelines approved by the program shall:
(1) be based on a systematic review of existing evidence, including the National Guideline Clearinghouse, an initiative of the Agency for Healthcare Research and Quality, United States Department of Health and Human Services;
(2) be developed by a knowledgeable, multidisciplinary panel of experts and representatives from key affected groups;
(3) consider appropriate patient subgroups and patient preferences;
(4) be based on an explicit and transparent process that minimizes distortions, biases, and conflicts of interest;
(5) provide a clear explanation of the relationship between various care options and health outcomes and provide ratings of both the quality of evidence and the strength of the recommendations;
(6) be reconsidered and revised as warranted when new medically significant evidence emerges; and
(7) clearly identify any exceptions to their application.
b. The program shall initially be a pilot program for a minimum of three years, and shall:
(1) include, at a maximum, 150 participating health care providers, who shall be located throughout the entire State and shall include, at a maximum, 50 providers representing Southern New Jersey, 50 providers representing Central New Jersey, and 50 providers representing Northern New Jersey; and
(2) include an evaluation of the program's effect on medical and litigation costs for providers after the conclusion of the pilot program.
c. The program shall include a system of financial incentives for providers who reduce Medicaid costs by at least two percent, reduce patient injuries by at least five percent, and meet performance goals on the quality of care that is subject to the guidelines adopted by the board. The financial incentives shall be funded through appropriations from the General Fund to the board for this purpose, of which, no more than five percent may be used for administrative expenses.
d. Physicians who participate in guideline development for the program shall publicly disclose all financial interests, and they and their family members shall not have any financial conflicts of interest. Guideline development shall not be funded by any sectors of the health care industry, including medical imaging, durable medical equipment, or pharmaceutical companies.
2. The board shall establish and implement a mechanism for providing a patient, who receives treatment from a healthcare provider who is participating in the program, and is injured by that treatment, with no-fault compensation for injuries sustained by the patient without regard to negligence, liability or fault.
3. There is appropriated from the General Fund to the board $5 million for the purposes of this act.
4. This act shall take effect on the first day of the month next following the date of enactment by at least 180 days, but the board may take such administrative action in advance thereof as shall be necessary for the implementation of this act.
STATEMENT
This bill directs the State Board of Medical Examiners in the Department of Law and Public Safety to establish, on a pilot basis, "The Patient Safety and Provider Incentive Program" for a minimum of three years and makes a $5 million appropriation to fund incentives available pursuant to this pilot program.
"The Patient Safety and Provider Incentive Program" is a pilot program that enables participating healthcare providers to use established guidelines as the treatment protocol in the provision of healthcare services. The use of established guidelines is intended to decrease the practice of defensive medicine and decrease the health care costs associated with unnecessary testing to protect physicians from future litigation based on the provision of care. The program includes a system of financial incentives for providers who meet certain objectives and the bill provides a $5 million appropriation from the General Fund for those financial incentives.
The bill establishes the program as a pilot program and restricts the program to a maximum of 150 participating healthcare providers throughout the State. Furthermore, the bill requires that of the 150 providers, up to 1/3 must come from Southern New Jersey, 1/3 from Central New Jersey and 1/3 from Northern New Jersey.
The bill directs the board to establish and implement a mechanism for providing a patient of a participating provider with no-fault compensation for injuries sustained by the patient without regard to negligence, liability or fault.