November 17, 2017

 

Charles Rothberg, MD - MSSNY President
PRESIDENT’S MESSAGE

Charles Rothberg, MD
November 17, 2017
Volume 17
Number 43

Dear Colleagues:

Longtime MSSNY member, Dr. Pat Bomba, has been working enthusiastically on end-of-life issues for well over two decades. The champion of “the tough conversation” has earned  her national recognition for her work; other states have followed New York’s lead. Dr. Bomba created and promoted the end-of-life-care document called MOLST (Medical Orders for Life Sustaining Treatment) for people who are in good health and those who are seriously ill.  MOLST helps fill in the gaps of a living will, and makes sure everyone in the health care system is guided by the patient’s own preferences for care.

According to a recent editorial Dr. Bomba wrote, her family has a Thanksgiving tradition dating back to 1992 that has nothing to do with food or football. Her message is something you may want to think about for yourself, your family, your patients and your practice.

As a health plan medical director with an expertise in geriatrics, palliative care and end-of-life issues, Dr. Bomba knows opening this topic leads to difficult but meaningful conversation. She recommends that everyone 18 years and older complete a Health Care Proxy and then, should share copies with their physician, lawyer and most importantly, their families.

At the Bomba’s annual family turkey dinner, they have an advance care planning discussion whereby they “focus on what makes life worth living at this point in our lives. I encourage every family to embrace our Thanksgiving tradition. Our Thanksgiving and thoughtful MOLST discussions helped our family honor our mom’s wishes at the end of her life.”

As she writes, “Advance care planning is a gift to yourself and your family. Choose the person you trust to make medical decisions if you lose the ability to make medical decisions and share your values, beliefs and what matters most with your family and loved ones.

While at first you might think it’s morbid to discuss such issues at a festive gathering, we’ve found sharing our wishes for end-of-life care actually brings us closer. We gain peace of mind knowing our own wishes will be understood and honored in the event we can’t speak for ourselves.”

As she succinctly puts it, “No pumpkin pie, until you tell me how you want to live until you die.” After dinner, “the adults in our family stay at the table and talk about what matters most in our lives. We review our advance directives to make sure they reflect our current feelings.”

The New York eMOLST Registry is an electronic database centrally housing MOLST forms and CDFs to allow 24/7 access in an emergency. eMOLST allows for electronic completion of the current New York State Department of Health-5003 MOLST form.  By moving the MOLST form to a readily accessible electronic format and creating the New York eMOLST Registry, physicians and EMS professionals, can have access to MOLST forms at all sites of care including hospitals, nursing homes and in the community.

Discussing and documenting each family member’s wishes when they are well will save family turmoil in the future.

For physicians, you can download the doctor-specific information here.

This is not just for your patients. This information is for you and your family.

I wish you and your families a Happy Thanksgiving.

Sincerely,

Charles Rothberg, MD
MSSNY President

Please send your comments to comments@mssny.org



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MSSNY Phone Number for Garfunkel Wild
Our new law firm, Garfunkel Wild, has established a phone number for exclusive use by MSSNY members: 516-393-2230.
  We also have a group of attorneys dedicated to receiving the phone calls to ensure that any MSSNY member who calls will receive prompt service.

They want to hear from you!

DFS Imposes $2 Million Fine on Cigna for Selling Unapproved Health Insurance Policies
This week, New York Department of Financial Services Superintendent Maria Vullo announced the imposition of a $2 million fine on Cigna for violations of New York State Insurance Law involving the illegal sale of stop-loss insurance and unapproved health insurance policies that would otherwise have been part of New York’s small-group market.

According to a consent order entered into with Cigna, DFS found that Cigna improperly sold stop-loss and fully insured health insurance policies outside of New York to New York-based small groups with employees in New York State.  The press release noted that Cigna sold 81 group health insurance policies in violation of New York Insurance Law, including 38 stop-loss insurance policies to New York small groups seeking to self-insure and 43 fully insured health insurance policies to small groups as if they were selling to non-New York small groups.

To read the full press release, click here.

Governor Again Vetoes Legislation to Permit Prescription Refills Longer than Original Prescription
Recently, Governor Cuomo vetoed legislation (A.6731-B/S.5171-B) that would have authorized pharmacists to refill non-controlled substance prescriptions in a quantity greater than that set forth in the prescriber’s original prescription. In effect, it would have enabled pharmacists to provide 90-day refills of particular prescription medication even if the original prescription called for a shorter refill duration, such as 30 days.

While there were some changes to a similar bill that was vetoed last year, Governor Cuomo noted in the veto message his concerns that “the bill retains the provisions that would risk contributing to the distribution of larger quantities of prescription medications than may be necessary for a specific patient”.  Moreover, he noted his concern that “it would still allow the pharmacist to infringe on the physician-patient relationship” because the notification to the prescriber would not occur until after the prescription is filled.



Promo Code: MSSNY

 

 

 

 

 


AHA and ACC Redefine High Blood Pressure Reading
Acting for the first time in 14 years, the American Heart Association, the American College of Cardiology and nine other groups redefined high blood pressure as a reading of 130 over 80, down from 140 over 90.” This “change means that 46 percent of US adults, many of them under the age of 45, now will be considered hypertensive.” The Post points out that “under the previous guideline, 32 percent of US adults had” hypertension.

On its front page, the New York Times (11/14) reports that “under the guidelines…the number of men under age 45 with a diagnosis of high blood pressure will triple, and the prevalence among women under age 45 will double. The guidelines presented at a heart association meeting and published in the Journal of the American College of Cardiology, also spell out exactly how health care providers and people at home should check blood pressure.” For instance, physicians “and nurses are urged to let patients rest five minutes first and then to average at least two readings over two visits.” Meanwhile, “patients are urged to take regular readings at home, with a device checked out by their health care providers.”

Click here to read the AMA statement on the updated guideline for measuring blood pressure.

Tip of the Week: Is it Appropriate to Report Kinesio Taping with Strapping Codes?
By Jacqueline Thelian, CPC, CPC-I, CHCA, Medco Consultants, Inc.

As per Current Procedural Guidelines (CPT), the CPT Assistant and the Centers for Medicare and Medicaid Services (CMS) Local Coverage Determination (LCD) L33631 it is inappropriate to report Kinesio taping with any of the CPT codes for strapping (29200, 29240, 29260, 29280, 29520, 97799, 97039, 29799).

Strapping may be used to treat strains, sprains, dislocations, and some fractures. The strapping codes are intended to be used when the desired effect is to provide total immobilization or restriction of movement.”

Kinesio taping is not utilized for immobilization; rather its function is to provide support and stability to joints and muscles without affecting circulation and range of motion.

The CPT Assistant goes on to state the Kinesio taping is considered to be an inclusive part of neuromuscular re-education or therapeutic exercise and would not be separately reported.

The Centers for Medicare and Medicaid Services (CMS) Local Coverage Determination (LCD) L33631 Outpatient Physical and Occupational Therapy Services under the General Guidelines for Strapping also considers the Kinesio taping to be considered inclusive to CPT codes 97110 and 97112.

Source:

  • National Government Services Inc. Local Coverage Determination (LCD) L33631
  • CPT Assistant March 2012, Surgery Musculoskeletal System

If you have a coding or compliance question you would like to have answered please send your question to MSSNY at eskelly@mssny.org, and complete the subject line with Tip of the Week.


Your membership yields results and will continue to do so. When your 2018 invoice arrives, please renew. KEEP MSSNY STRONG!


What Can I Do?

Help Us Advocate Legislation to Prevent Mid-Year Prescription Formulary Changes
Concerned about changes to health insurer prescription drug formularies that may adversely impact your patients? MSSNY has been working collaboratively with several patient advocacy groups to support legislation (A.2317, People-Stokes/S.5022-A, Serino) that would prohibit health insurers from moving a drug to a higher-cost tier or removing a prescription drug from a formulary during a policy year.  To help facilitate advocacy in support of this legislation, the group New York Health Works has developed a survey to enable physicians and patients to better document the full extent of this problem.  Please take just a few minutes to respond to the survey by clicking here.

Share Your Personal Stories about Challenges You Face as a Physician
MSSNY wants legislators to hear directly from New York Physicians about the challenges they face as medical practitioners.  Personal stories are vital for enhancing our messages on issues of concern to the medical professionals, particularly to legislators who represent the area where those professionals practice.

We plan to gather personalized stories from physicians and medical students to print as flyers and articles that can be distributed to legislators and journalists. Opting in to share your stories is entirely voluntary. We value and respect your privacy, which is why your permission is needed for us to share these stories. Please click here to fill out the brief Physician Questionnaire.

MSSNY to Implement National Diabetes Prevention Program; Physicians Encouraged to Take Diabetes Awareness Survey
The Medical Society of the State of New York has partnered with the American Medical Association to bring its Prevent Diabetes STAT initiative to New York.  MSSNY has developed a short survey to sample physician’s knowledge of the National Diabetes Prevention Program (DPP) and the Prevent Diabetes STATTM program.  This survey can be taken by clicking here.

The AMA previously rolled out the program through partnerships with state medical societies in California, Michigan and South Carolina. New York is one of eight states where the AMA is extending the program. The DPP model encourages physicians to screen patients for prediabetes, a condition in which blood glucose levels are higher than normal but below the threshold for a diabetes diagnosis. Patients identified as pre-diabetic are referred to diabetes prevention programs that meet certain criteria established by the Centers for Disease Control and Prevention.

This initiative will help bridge the gap between the clinical care setting and communities to reduce the incidence of type 2 diabetes by educating and connecting more patients to evidence-based lifestyle change programs that are available in their communities, including programs offered where they work, through community and faith-based organizations, and online.

“MSSNY’s partnership with the AMA is a key step towards making an immediate impact on the health of New Yorkers,” said Dr. Geoffrey Moore, Chair of MSSNY’s Preventative Medicine and Family Health Committee and a lifestyle medicine physician based in Ithaca, NY. “The Centers for Disease Control and the American Medical Association have developed a great educational toolkit and, through our partnership, we seek to extend the benefits of these tools to all physicians and patients throughout New York State.”

In the coming year, MSSNY will be developing education sessions and articles outlining important information about diabetes in the MSSNY Daily and E-News.  Educational webinars and podcasts tailored to both physicians and patients on prediabetes and diabetes are also being developed. MSSNY’s website includes a Diabetes webpage and physicians are encouraged to visit for more information about Type 2 Diabetes and to learn more about MSSNY’s partnership with the AMA.

Please Urge Governor Cuomo to Veto Disastrous Liability Expansion Bill and Work for Comprehensive Reform Instead
With just a few weeks left in 2017, please help us to urge Governor Cuomo to veto legislation (S.6800/A.8516) that would significantly expand the time to bring a medical malpractice lawsuit, in circumstances based upon an “alleged negligent failure to diagnose a malignant tumor or cancer.”  If signed into law it would likely prompt a double digit increase in physician and hospital malpractice premiums.  You can send a letter to the Governor here and call 518-474-8390.

The bill will likely be delivered to Governor within the next few weeks, upon which he will have 10 days to decide to sign it or veto it.  While many physicians have contacted the Governor to urge a veto of this legislation, we need an overwhelming demonstration from physicians regarding how this bill will harm access to care in their communities if this bill is not paired with needed tort reforms to bring down the exorbitant costs of medical liability insurance in New York.

Physicians have been active in warning the public about the patient care access problems this bill will exacerbate if it is signed into law.  Recently Albany radiologist and MSSNY member and Albany radiologist Dr. Robert Rapaport had a commentary published in the Albany Times-Union urging that the Governor veto this bill and instead work for comprehensive reform.  Moreover, a letter to the Editor from MSSNY’s Dr. Rothberg urging a veto was also recently published in the Albany Times-Union (letter).   Similar letters from regional and statewide physician leaders have also appeared in:

MEDICAL STUDENTS

Share Your Personal Stories about Challenges You Face as a Medical Student
MSSNY wants legislators to hear directly from medical students about the challenges they face as future physicians.  Personal stories are vital for enhancing our messages on issues of concern to the medical professionals, particularly to legislators who represent the area where those professionals practice.

We plan to gather personalized stories from physicians and medical students to print as flyers and articles that can be distributed to legislators and journalists. Opting in to share your stories is entirely voluntary. We value and respect your privacy, which is why your permission is needed for us to share these stories. Please click here to fill out the brief Medical Student Questionnaire.

WEBINARS/SEMINARS

CME Webinar on December 6: An Unusual and Highly Resistant Fungus in NYS: An Update on Candida auris for the Practicing Physician:
Upcoming in MSSNY’s Medical Matters continuing medical education (CME) webinar series is: An Unusual and Highly Resistant Fungus in NYS: An Update on Candida auris for the Practicing Physician.  This webinar will take place on Wednesday, December 6, 2017 at 7:30 a.m.  Emily Lutterloh, MD, MPH, Director, Bureau of Healthcare Associated Infections, from the New York State Department of Health will conduct this presentation.  Register for this webinar here.

Additional information or assistance with registration may be obtained by contacting Melissa Hoffman at mhoffman@mssny.org.

Educational objectives are:

  • Provide an update on the emerging multi-drug resistant yeast, Candida auris ( auris), globally and in New York State
  • Describe the risk factors for auris infection and the recommended diagnostic approach
  • Review the recommendations for auris, including infection prevention and control measures

The Medical Society of the State of New York is accredited by the Accreditation Council for Continuing Medical Education (ACCME) to provide continuing medical education for physicians.

The Medical Society of the State of New York designates this live activity for a maximum of 1.0 AMA/PRA Category 1 credits™.  Physicians should claim only the credit commensurate with the extent of their participation in the activity. 

Educate Your Patients About the Flu
It’s flu season!  New York State Department of Health has had reports of seasonal influenza in nearly every county. Encourage your patients to listen to MSSNY’s brief and informative podcast on influenza vaccine here.

MSSNY also has a podcast on the pneumococcal vaccine for patient’s 60 and older here. Or click here listen to all 13 of MSSNY’s podcasts on topics such as the Zika virus, emergency preparedness and a variety of adult vaccines.

Buprenorphine Training to be held in Sullivan County December 2nd
The NYSDOH AIDS Institute and the Sullivan County Public Health Department are hosting a Buprenorphine Eligibility Waiver Training for Clinical Providers on Saturday, December 2,

from 8:00AM to 1:00PM at Catskill Regional Medical Center, 68 Harris-Bushville Rd, Board Room, Harris, NY 12742.

This training is for physicians, nurse practitioners, physician assistants, pharmacists, and medical residents. Sullivan County has some of the highest rates of opioid overdose in New York State. In just the first seven months of 2017, Sullivan County has experienced a reported 20 overdose deaths.  From 2013-2016, there were approximately 75 reported opioid overdose deaths.

DOH is seeking to increase the volume of providers in and around the county that are able to offer medication assisted treatment (MAT) to people using opioids whom could benefit from buprenorphine (or “suboxone”).  Attached is a flyer with further information, including locationonline registration, and more details. Further information will be sent out to confirmed attendees. Light refreshments will be provided. Registration closes on November 29th at 5pm.Trainers: Sharon Stancliff, MD, Harm Reduction Coalition, New York, NY; Bruce Trigg, MD, Harm Reduction Coalition, New York, NY

Please Note: CME Credits will be made available. This is the first half of the minimum required 8 hours of training, and the second half must be completed online after attendance to the live training. Currently NPs & PAs are required to take an additional 16 hours of online training which is available on the PCSS-MAT website (Part 2). For more information about buprenorphine related trainings, mentoring, coaching, technical assistance and more, please contact us at buprenorphine@health.ny.gov or 1-800-692-8528.

Want to Learn More about New York’s New Step Therapy Override Law?
Please click here to view a webinar discussing New York’s new law that gives physicians a stronger ability to override a health insurer’s step therapy protocol when seeking to assure their patients can receive coverage for necessary prescription medications. Among the faculty for the program are MSSNY President-elect Dr. Thomas Madejski and MSSNY Senior Vice President Moe Auster. The webinar, sponsored by the National Psoriasis Foundation, will provide physicians with 0.5 hours of CME credit.

The new law will be applicable to all NY-regulated health plans as of January 1, 2018.  However, since the law applies to health insurance plans “delivered, issued for delivery issued or renewed” after January 1, 2017, many group health insurance plans across the State are already required to follow the new law.

MSSNY has created a template for physicians and their support staff to use in requesting a step therapy protocol override, available here.

Enforcement is the key to assuring that the law is working as intended.  Therefore, please let us know if you see instances where health insurers are not following the law.  Moreover, you can file a complaint with the State here.

MEDICARE/MEDICAID INFORMATION

You Must Enroll In Medicaid FFS to Treat MMC Patients
In September, MSSNY alerted the membership of a new federal regulation resulting from the 21st Century Cures Act.  The regulation requires that any physician treating Medicaid recipients in a Medicaid Managed Care (MMC) plan must now enroll in Medicaid Fee-for-Service (FFS) in order to continue treating MMC patients.  By now, you should have received letters from your MMC plan explaining this requirement.

Some of our members raised concerns about the requirement.  To research the matter, Regina McNally, VP of SME, called the Director of Medicaid provider enrollment at the NYS DOH.  Based on that contact, we have been advised of the following:

Regarding Medicaid Managed Care physicians who want to continue treating Medicaid Managed care recipients, the DOH has no intention of terminating any physician who has his/her application on file before the deadline.  So, if the provider enrollment application is submitted before January 1, 2018, the DOH will work with the physician(s) to ensure that the information is properly on file.  Since the application is submitted to CSC, the Medicaid Intermediary, first for scanning into their system and then forwarded to the NYS DOH for review to ensure accuracy, it would be advisable to have the application filed by December 1, 2017.  This should give sufficient time to ensure that the application is on file.

Note:  Physicians do not have to treat Medicaid fee-for-service recipients even though they have enrolled in the program.  However, physicians do need to enroll in order to continue treating Medicaid Managed care recipients.

New Deadline: Participate in Field Testing of Episode-Based Cost Measures by November 20
The Centers for Medicare & Medicaid Services (CMS) has extended the deadline for feedback on its cost measures field test to November 20, 2017.

As a reminder, CMS is conducting a field test for eight episode-based cost measures before consideration of their potential use in the cost performance category of the Merit-based Incentive Payment System (MIPS) of the Quality Payment Program. During the field test, clinicians may access confidential feedback reports with information about their performance on these new measures. All stakeholders are also invited to comment on the measures and supplemental documents.

The eight episode-based cost measures are:

    1. Elective Outpatient Percutaneous Coronary Intervention (PCI)

  1. Knee Arthroplasty
  2. Revascularization for Lower Extremity Chronic Critical Limb Ischemia
  3. Routine Cataract Removal with Intraocular Lens (IOL) Implantation
  4. Screening/Surveillance Colonoscopy
  5. Intracranial Hemorrhage or Cerebral Infarction
  6. Simple Pneumonia with Hospitalization
  7. ST-Elevation Myocardial Infarction (STEMI) with (PCI) 

Participate in Field Testing through November 20, 2017
The field test is a voluntary opportunity for stakeholders to comment on the measure specifications and the report template for the eight measures in their current stage of development. This feedback will be considered in refining the measures and for future measure development activities.

If you or your clinician group perform(s) or manage(s) the care for one or more of the procedures or medical conditions represented in the measures above, you might have a confidential Field Test Report on the CMS Enterprise Portal. For group practices, reports are available for the TIN of the group practice. Please refer to the “2017-10-cost-measure-field-test-access-guide.pdf” in the zip file linked below for instructions on setting up or activating your EIDM account. The supplemental documentation listed below is included in a zip file on the MACRA page under the “What’s new” section and “Episode-based cost measures” subsection. To download the zip file directly, please click here.

  • Field Test Mock Report
  • Draft Cost Measure Methodology
  • Draft Measure Codes List

Please provide comments through this online survey by 11:59 PM ET on November 20, 2017.

For More Information. You may refer to the fact sheet or FAQs
document for additional information. If you have any questions, please contact QPPCostMeasureTesting@ketchum.com.

New Medicare Card: Provider Ombudsman Announced
The Provider Ombudsman for the New Medicare Card serves as a CMS resource for the provider community. The Ombudsman will ensure that CMS hears and understands any implementation problems experienced by clinicians, hospitals, suppliers, and other providers. Dr. Eugene Freund will be serving in this position. He will also communicate about the New Medicare Card to providers and collaborate with CMS components to develop solutions to any implementation problems that arise. To reach the Ombudsman, contact: NMCProviderQuestions@cms.hhs.gov.

The Medicare Beneficiary Ombudsman and CMS staff will address inquiries from Medicare beneficiaries and their representatives through existing inquiry processes. Visit Medicare.gov for information on how the Medicare Beneficiary Ombudsman can help you.

Summary and Statement: 2018 QPP Final Rule
Last week, CMS issued the long-awaited Medicare Quality Payment Program final regulation for 2018.  PAI’s comments discussed the need for continued physician flexibility and greater simplicity to allow physicians to transition to the program successfully.

The final regulation’s impact on physician practices is a mixed bag, as discussed in PAI’s statement, released earlier this week. PAI applauds CMS for finalizing its policy to increase the low-volume threshold and include an interim final rule to support the needs of those impacted by recent natural disasters.

However, PAI is disappointed that the final regulation includes certain policies that could unintentionally put some patients, physicians, and practices at a disadvantage. One policy of concern will increase the weight of the cost category from 0% in 2017 to 10% in 2018, utilizing the Medicare Spending per Beneficiary (MSPB) and total per capita cost measures, while new episode-based cost category measures that more accurately assess health care service utilization and appropriately attribute costs are still under development and not part of the scoring.

A summary of the final rule provisions is available here; a CMS Fact Sheet is available here. Blood Eosinophil And Neutrophil Concentrations May Predict Lung Function Declines In WTC-Exposed Firefighters, Research Suggests.


CLASSIFIEDS


RENTAL/LEASING SPACE


Want to Work in NYC but Live 100 Yards from the Atlantic Ocean?
Ocean views abound in this beautiful Rockaway Beach 1 family brick home. 5 bedrooms, 3 bathrooms. 60×100, detached 1 car garage, central air, sprinkler, alarm, large rear deck and heated pool. New finished basement, master bedroom on main floor and full bath. Tons of storage, solar panels. Beautiful front porch with ocean views. Located in Rockaway beach on a block 100 yards from the ocean! $1,750,000. Call 718-634-6004.

Upper East Side Plastic Surgery Office Available for Rent or Share
Beautifully equipped Plastic Surgery office available for part-time share along with Quad A-certified OR available for rent. Located in a lovely carriage house on the Upper East Side in close proximity to Lenox Hill Hospital and MEETH and conveniently located near all NYC mass transit. 1 exam room/OR and Recovery room along with large administrative space. Free WIFI. Available for full or half-days. Suits Plastic/Cosmetic Surgeons/ DERM/ ENT/or other Medical MDs. Please contact Kim at Kim@madisonps.com (212) 628-7600.>/div>


Saratoga Springs, NY – Professional Office Space for Lease
Medically oriented building currently occupied by five parties.  The Suite, Suite 700, has 2904 sq. ft., second floor (elevator), excellent off-road parking with drive-thru patient portico in a well maintained and attractive building close to the local hospital.
The lease area has a large waiting room, administrative rooms, lunch room, four examining rooms, one procedure room and one for storage.  Separate staff entrance.  Attractively priced without triple net obligations.  $4,500/month + heat + utilities.  Call Lauren regarding Suite 700 at (518) 587-2020.

Riverdale Medical Office for Sale – Prime Location
Co-op with private entrance features 2 exam rooms, lab, office & bathroom. Must see! Call 718-230-7069


For Rent or Share – Woodbury, Long Island
Beautiful recently renovated Plastic Surgery office available for part-time share and AAAA-certified (by end of summer). OR available for rent. Centrally located
on Long Island.Close to expressways. 3 exam rooms, 1 procedure room /OR.
Waiting room, break room and personal office. Free WIFI. Available for full or half-days. Suits Plastic/Cosmetic Surgeons/Derm/ENT/
ObGyn/Podiatry or other Medical MDs.
Contact Patricia at info@cosmetichg.com
or 631-318-4008

PHYSICIAN OPPORTUNITIES


Medical Director: Binghamton University College Physician (SL-6)
Department: Student Health ServicesLocations:   Binghamton, NYPosted: Oct 24, ’17Type:  Full-timeRef. No.: 49225The Decker Student Health Services Center at Binghamton University (The State University of New York at Binghamton) invites New York State Medical or Osteopathic Board Certified Physicians (Internal Medicine, Family Practice) to apply for a full-time, twelve-month position. This position plans, directs, supervises, and participates in the outpatient medical care of undergraduates and graduate students of a diverse student base.  The person will have excellent, primary care diagnostic skills as well as experience and proficiency in common outpatient surgical procedures, EKG and pulmonary function study interpretation, office laboratory and clinical microscopy.  This position functions as an on-site medical consultant and collaborative physician to the professional staff that includes 10 nurses, 5 nurse practitioners and 7 physicians.

The individual will have five years of clinical experience after residency training and experience with staff oversight and leadership.The Medical Director provides the university campus with infectious disease direction (e.g. meningitis, measles and tuberculosis) and emergency management; participates on the Crisis Response Team; provides direction and consultation to the Dean of Students, University Counseling Center and Residential Life.  This person will be responsible for accreditation activities including; completion of internal and external benchmark studies peer chart review; completion of assessment plans, survey and risk management reports; meeting with site visitors; and following through on recommendations.Requirements: Required qualifications: NYS Board Certified Medical or Osteopathic Physicians (Internal Medicine, Family Practice) from an accredited institution; 5 years of clinical experience after residency; NYS medical license and DEA certificate that are free from special conditions or limitations. Salary: commensurate with qualifications and experience. Preferred qualifications are, but not limited to: college health familiarity; experience with diverse populations; electronic health record navigation; quality assurance, and continuous quality improvement; public health and policy experience. Payroll information can be found on our website http://www.binghamton.edu/human-resources/payroll/Cover letters may be addressed “To the Search Committee.” Postings active on the website accept applications until closure. For information on the Dual Career Program, please visit:
https://www.binghamton.edu/human-resources/dual-career-program/
Application Instructions:Deadline for Internal Applicants:  11/07/2017 Deadline for External Applicants:  Open until filled Review of applications will begin immediately and continue until the vacancy is filled.Persons interested in this position should apply online.Please submit: 1. Resume 2.Cover letter, and 3.Contact information for three professional references You may add additional files/documents after uploading your resume. After you fill out your contact information, you will be directed to the upload page. Please login to check/edit your profile or to upload additional documents: http://binghamton.interviewexchange.com/login.jsp Payroll information can be found on our website http://www.binghamton.edu/human-resources/payroll/
Additional Information:Offers of employment may be contingent upon successful completion of a pre-employment background check and verification of degree(s) and credentials.Binghamton University is a tobacco-free campus.Pursuant to Executive Order 161, no State entity, as defined by the Executive Order, is permitted to ask, or mandate, in any form, that an applicant for employment provide his or her current compensation, or any prior compensation history, until such time as the applicant is extended a conditional offer of employment with compensation.  If such information has been requested from you before such time, please contact the Governor’s Office of Employee Relations at (518) 474-6988 or via email at info@goer.ny.gov

Equal Opportunity/Affirmative Action Employer
The State University of New York is an Equal Opportunity/Affirmative Action Employer.  It is the policy of Binghamton University to provide for and promote equal opportunity employment, compensation, and other terms and conditions of employment without discrimination on the basis of age, race, color, religion, disability, national origin, gender, sexual orientation, veteran or military service member status, marital status, domestic violence victim status, genetic predisposition or carrier status, or arrest and/or criminal conviction record unless based upon a bona fide occupational qualification or other exception.
As required by title IX and its implementing regulations Binghamton University does not discriminate on the basis of sex in the educational programs and activities which it operates.  This requirement extends to employment and admission.  Inquiries about sex discrimination may be directed to the University Title IX Coordinator or directly to the Office of Civil Rights (OCR).  Contact information for the Title IX Coordinator and OCR, as well as the University’s complete Non-Discrimination Notice may be found here. The State University of New York is an Equal Opportunity/Affirmative Action Employer.  As required by title IX and its implementing regulations Binghamton University does not discriminate on the basis of sex in the educational programs and activities which it operates.  This requirement extends to employment and admission.  Inquiries about sex discrimination may be directed to the University Title IX Coordinator or directly to the Office of Civil Rights (OCR).  Contact information for the Title IX Coordinator and OCR, as well as the University’s complete Non-Discrimination Notice may be found here.


Medical Director – AIDS Institute
Minimum Qualifications:
Current license and registration to practice medicine in New York State and board certification AND either a Master’s Degree in Public Health or two years of experience in an HIV program or public health program.Preferred Qualifications:
Master’s Degree in Public Health.  Five years of experience including clinical service in an HIV program or clinical fellowship program (infectious diseases/HIV medicine).  Experience in quality management/quality improvement.  Knowledge of the HIV health care delivery system in New York State. Experience in/knowledge of the New York State Ending the Epidemic initiative.  Experience in STD prevention and care, drug user health, and/or LGBT health.  Experience in health policy development, analysis and evaluation.  Experience with evolving health information technologies.  Experience in health program management and administration.
Responsibilities: The Medical Director, AIDS Institute, plays a significant role in shaping HIV, hepatitis C, and STD care and services, drug user health, and LGBT health care throughout New York State.Please click the link below for more information pertaining to this position and to apply: “https://careers-healthresearch.icims.com/jobs/3742/medical-director—aids-institute/job” Affirmative Action/Equal Opportunity Employer/Qualified Individuals with Disabilities/Qualified Protected Veterans

Multiple Physician Positions with DOHMH Office of School Health
Office of School Health is the largest program of the New York City Department of Health and Mental Hygiene (DOHMH). This bureau is responsible for managing the health issues and promoting the well-being of the over 1.3 million children and adolescents enrolled in New York City’s 1700 school buildings.

Positions with the Office of School Health (OSH) combine clinical skills and public health training.

Adolescent School Health Physician
This position offers to the interested physician the opportunity to help address the clinical and public health needs of adolescents in NYC high schools. The physician will work with the innovative Connecting Adolescents to Comprehensive Health Care (CATCH) Program, which provides select reproductive health services to adolescents in select NYC high schools. In addition, the physician will provide medical care and public health services through additional programs offered to adolescents by the Office of School Health.

Under the supervision of the High School Supervising Physician, the Adolescent School Health Physician’s responsibilities will include but are not limited to:

  • Provide CATCH reproductive health services in select high schools.
  • Perform mandated physical examinations (New Admission Exams, Sports Physicals, and Working Paper Physicals).
  • Function as a liaison for students with community health providers to resolve medical issues that affect school performance.
  • Support the development and implementation of initiatives that promote positive health behaviors and reduce high risk behaviors in the adolescent population.
  • Serve as a consultant to the school nurse and administration on school related health concerns.
  • Provide clinical assistance in the event of an environmental or communicable disease occurrence.
  • Function as a liaison for students with community health providers to resolve medical issues that affect school performance.
  • Support all medical initiatives established by the Office of School Health, e.g. programs and protocols in asthma, reproductive health, obesity and diabetes.
  • Maintain good public relations and communicate effectively within the school community and community-based organizations.
  • Keep abreast of health management policy statements and emerging clinical research related to school health.
  • Participate in OSH research activities.
  • Work within the mandates, policies and protocols of the Office of School Health.
  • Attend all mandated DOHMH and OSH trainings.

To Apply: Please email your resume and cover letter to Dr. Caroline Volel: osh@health.nyc.gov OR  Apply online at https://a127-jobs.nyc.gov/.  In the Job ID search bar, enter: job ID number # 277208. 

School Health Field Physician
Under the direction of the Supervising Physician, the School Health Physician’s will:

  • Improve the health of school children through case management of chronic disease, preventive health screening and counseling, health education, and referrals.
  • Perform mandated physical examination (new entrant, sport physical, working paper physicals.
  • Develop relationships with community health providers in order to optimize medical management of students with health issues.
  • Attend to the health needs of your assigned school community.
  • Utilize the Automated Student Health Record (ASHR) to maintain adequate student health records.
  • Serve as a consultant to the school nurse and administration on school related health concerns.
  • Support the development of school educational and prevention programs promoting the health and wellness of all students.
  • Provide clinical assistance in the event of an environmental or communicable disease occurrence.
  • Develop and maintain professional relationships within the school community.
  • Support all medical initiatives put forth by the Office of School Health, e.g. Asthma, Reproductive health, Obesity and Diabetes initiatives.
  • Provide trainings/presentations to school staff, community organizations, or parents.
  • Stay abreast of health management policy statements and emerging research within the health community related to school health.
  • Participate in School Health research and quality improvement activities.
  • Participate in all mandated DOHMH and Office of School Health trainings and professional development sessions.
  • Attend all program meetings and Continuing Medical Education classes provided by the Office of School Health.

To Apply: Please email your resume and cover letter to Dr. Caroline Volel:osh@health.nyc.gov OR Apply online at https://a127-jobs.nyc.gov/.  In the Job ID search bar, enter: job ID number # 279844. 

Supervising School Health Physician 
Job Description
Under the supervision of the Deputy Medical Director, the Supervising Medical Doctor’s responsibilities will include but not be limited to:

  • Supervise School Health Physicians.
  • Work within the mandates, policies and protocols of the Office of School Health (OSH).
  • Attend to the health needs of a designated school community.
  • Utilize the Automated Student Health Record (ASHR) to maintain accurate student health records.
  • Serve as a consultant to the school nurse and school administrative staff regarding school related health concerns.
  • Support the development of school educational and prevention programs promoting the health and wellness of students.
  • Participate in policy development and revisions as indicated.
  • Provide clinical assistance in the event of an environmental or communicable disease occurrence.
  • Function as a liaison for students with community health providers to resolve health issues that affect school functioning.
  • Develop and maintain professional relationships within the school community and the community at large.
  • Support all medical initiatives put forth by the Office of School Health, e.g. Asthma, Reproductive health, Obesity and Diabetes Initiatives.
  • Keep abreast of health management policy statements and emerging research within the health community affecting school health.
  • Assist with or provide trainings/presentations to school health physicians, nurses, school staff, community organizations or parents
  • Participate in School Health research and quality improvement activities
  • Participate in all mandated DOHMH and Office of School Health trainings and professional development sessions
  • Attend all program meetings and Continuing Medical Education classes provided by the Office of School Health.

To Apply: Please email your resume and cover letter to Dr. Caroline Volel: osh@health.nyc.gov  OR  Apply online at https://a127-jobs.nyc.gov/.  In the Job ID search bar, enter: job ID number # 277026


MEDICAL EQUIPMENT


Retiring from pediatrics. I have medical equipment to donate: examining table, pediatric examining table with a scale, medical scale, examining instruments and miscellaneous office items. Forest Hills. Call 718 275-5858 or email mkolak59@gmail.com


CALL FOR RATES & INFO. CHRISTINA SOUTHARD: 516-488-6100 ext. 355


November 3, 2017 – The Word “Meaningful” & CMS?

Charles Rothberg, MD - MSSNY President
PRESIDENT’S MESSAGE

Charles Rothberg, MD
November 3, 2017
Volume 17
Number 42


Dear Colleagues:

For quite some time, physicians have been rightfully complaining that they are being forced to concentrate and focus on bureaucratic paperwork and trying to fit square pegs in round holes rather than practicing medicine. Regrettably, patients, too, have noted the lack of direct interaction with their physicians during their visits. During office visits, this bureaucratic nonsense has turned face-to-face time into patients looking at their physician’s back while fields on a computer screen are being completed.

Seema Verma, CMS Administrator, said in a speech this week, “We are moving the agency to focus on patients first. To do this, one of our top priorities is to ease regulatory burden that is destroying the doctor-patient relationship. We want doctors to be able to deliver the best quality care to their patients.” She announced that that CMS is “revising current quality measures across all programs to ensure that measure sets are streamlined, outcomes-based and meaningful to doctors and patients.” She then announced the “new” comprehensive initiative named “Meaningful Measures.”

New York physicians welcome the announcement by CMS Administrator Verma of her intention to work to reduce regulatory burdens on physicians including streamlining quality reporting requirements. The time required of physicians to spend on administrative tasks instead of providing patient care is unconscionable. Recent studies show that, for every hour a physician spends delivering patient care, two more hours are spent on administrative tasks.  Much of this overwhelming minutiae is the result of well-intentioned but misguided quality reporting requirements and electronic medical record “meaningful use” standards (including the new MIPS value based payment system) that often disrupt, rather than improve, care delivery.

We look forward to working with CMS on efforts to reduce regulatory burden so that physicians can focus on taking care of their patients, instead of updating their computer systems.

I really want to learn the difference between “Meaningful Use” and “Meaningful Measures.”

Sincerely,

Charles Rothberg, MD
MSSNY President

Please send your comments to comments@mssny.org



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Want to Learn More about New York’s New Step Therapy Override Law?
Please click here to view a webinar discussing New York’s new law that gives physicians a stronger ability to override a health insurer’s step therapy protocol when seeking to assure their patients can receive coverage for necessary prescription medications.  Among the faculty for the program are MSSNY President-elect Dr. Thomas Madejski and MSSNY Senior Vice President Moe Auster. The webinar, sponsored by the National Psoriasis Foundation, will provide physicians with 0.5 hours of CME credit.

MSSNY, together with many other patient advocacy organizations and specialty societies, supported the enactment of this law.  It requires all NY-regulated health insurers to grant an override of that insurer’s step therapy protocol upon receipt of information from the physician “that includes supporting rationale and documentation” which demonstrates that the drug(s) being required by the health insurer:

  • Is contraindicated or will likely cause an adverse reaction by physical or mental harm to the patient;
  • Is expected to be ineffective based on the known clinical history and conditions of the patient and his/her drug regimen;
  • Has been tried by the patient or another prescription drug(s) in the same pharmacologic class or with the same mechanism for action and such drug(s) was discontinued due to a lack of efficacy or effectiveness, diminished effect or an adverse event;
  • Should not be required because the patient is stable on a drug other than the drug being required by the insurer; or
  • Is not in the best interest of the patient because it will likely cause a significant barrier to a patient’s adherence with his/her plan of care, will likely worsen a comorbid condition of a the patient, or will likely decrease the patient’s ability to achieve or maintain reasonable functional ability in performing daily activities.

Health insurers must respond to a step therapy override request within 72 hours of the request.  A health insurer is required to respond within 24 hours if the request is for a patient with a medical condition that places the health of the patient in serious jeopardy without the prescription drug or drugs prescribed by the patient’s physician.  If the health insurer fails to act within these 72 or 24-hour time periods, the request will be granted in favor of the patient.

The new law also requires that health insurers’ step therapy protocols be based upon evidence-based and peer-reviewed clinical criteria that also take into account the needs of atypical patients.  These criteria must be made available to physicians upon request.

The new law will be applicable to all NY-regulated health plans as of January 1, 2018.  However, since the law applies to health insurance plans “delivered, issued for delivery issued or renewed” after January 1, 2017, many group health insurance plans across the State are already required to follow the new law.

MSSNY has created a template for physicians and their support staff to use in requesting a step therapy protocol override, available here.

Enforcement is the key to assuring that the law is working as intended.  Therefore, please let us know if you see instances where health insurers are not following the law.  Moreover, you can file a complaint with the State here.

Council Notes: November 2, 2017

  • Patricia Gagliano, MD, VP of Health Care Quality Improvement for IPRO, provided an overview of the Quality Payment Program (QPP) and the Merit-Based Incentive Payment System (MIPS). Her presentation focused on helping physicians maximize success in the QPP/MIPS programs. Dr. Gagliano noted that there is still time to collect data from 10/2/17-12/31/17 and avoid the negative payment adjustment in 2019. To view the entire presentation, which includes IPRO contact information and links to additional helpful information, click here.
  • MLMIC’s Donald Fager, Esq. reported that the MLMIC/Berkshire deal is still in a holding pattern, and that it will likely happen in early 2018.
  • Council approved the following:
  • MSSNY 2018 Legislative Program
  • Resolution 111 (referred by the 2017 House of Delegates): MSSNY affirms Policy 130.941 and will seek, through legislation and/or regulation, requirements for insurer to accept and reimburse, at in-network level, out-of-network providers willing to provide elective services to patients with no out-of-network benefits as long as the provider meets nationally recognized credentialing criteria.
  • In lieu of Resolutions 62 and 63 (referred by the 2017 House of Delegates), MSSNY re-affirms Policy 130.996 (Single Payor Reimbursement System-Opposition to) and will continue to consider the feasibility of other payment methodology including single payor and continue to work collaboratively with physicians who both support and oppose such proposals to assess the strengths and weaknesses of any such proposals. MSSNY will continue to advocate to assure that physicians have direct input and ongoing involvement on all aspects of any single payer system or other system that may be considered by the NYS Legislature or US Congress.
  • MSSNY Speaker Dr. Geraci announced that Andrew W. Gurman, MD, Immediate Past President of the AMA, will address MSSNY’s 2018 House of Delegates.

Workers’ Comp Board: Physicians Must Register by Dec.29
The Workers’ Compensation Board (Board) has initiated a registration process to update and maintain a current list of medical providers who are authorized to treat injured workers. The goal of this process is to enable an injured worker to easily and accurately identify Board-authorized medical providers.

Registering
You will be notified in November when registration opens for Board-authorized medical providers. Authorized providers are asked to register with the Board and update their office address (es) and contact information by December 29, 2017. This registration process will be an ongoing initiative every two to three years.

Medical providers who have not registered by December 29, 2017 will:

  • be removed from the public directory of Board authorized providers,        and
  • become ineligible for the Board’s disputed bill process.

30 Days Left to Submit an Informal Review Request – Review Your 2016 PQRS Feedback Report and 2016 Annual Quality and Resource Use Report Now


Promo Code: MSSNY


DOH Releases Updated DSRIP Spending Report; Still Very Little Goes to Physicians
The New York Department of Health (DOH) announced this week that New York’s DSRIP Performing Provider Systems (PPS) have substantially increased the amount of funds flowing down to its network partners including physicians.  The announcement noted that “PPS funds distributed to network partners increased by 112% or double the amount of cumulative distributions prior to the DSRIP mid-point.”

It was also noted that, of the $885 million that had been distributed through June 30, 2017, over $38 million had been distributed to primary care providers, of which over $22 million had been distributed since September 30, 2016.  The report also noted that $5 million had been distributed to non-primary care providers, of which $2.3 million had been distributed since September 30, 2016.

However, even with this increase, the funding distribution to health care practitioners is barely more than 5% of the PPS spending, and as such is still woefully insufficient.  MSSNY continues to raise concerns to state officials that funds allocated to many of these PPS across the State are not ultimately being distributed to PPS participating physicians to support their efforts in helping to bring about reductions in potentially preventable readmissions and ER visits.


Your membership yields results and will continue to do so. When your 2018 invoice arrives, please renew. KEEP MSSNY STRONG!


Creating an Account in the New York State Health Commerce System (HCS)The Board will use the existing New York State Health Commerce System (HCS) for this registration process. For the initial registration and for future updates to your practice information, you will need to have an HCS account. If you don’t already have one, you can view directions to create an account on the New York State Department of Health website.

Need Help?
If you are not sure if you already have an HCS account, contact the Commerce Account Management unit (CAMU) at (866) 529-1890 and select option 1. For general questions about health care provider registration, please contact the Board’s Customer Support at (844) 337-6305.

Worker Comp Questions? Email us or call Customer Service at (877) 632-4996

HOW YOU CAN HELP?

Please Urge Governor Cuomo to Veto Disastrous Liability Expansion Bill and Work for Comprehensive Reform Instead
Physicians are urged to continue to contact Governor Cuomo to request that he veto legislation (S.6800/A.8516) that would significantly expand the time to bring a medical malpractice lawsuit, in circumstances based upon an “alleged negligent failure to diagnose a malignant tumor or cancer”.   If signed into law it would likely prompt a double digit increase in physician and hospital malpractice premiums.   You can send a letter here and call 518-474-8390.

While many physicians have made these contacts, we need an overwhelming demonstration from physicians regarding how this bill will harm access to care in their communities if this bill is not paired with needed tort reforms to bring down the exorbitant costs of medical liability insurance in New York.

Physicians have been active in warning the public about the patient care access problems this bill will exacerbate if it is signed into law.  Recently Albany radiologist and MSSNY member and Albany radiologist Dr. Robert Rapaport had a commentary published in the Albany Times-Union urging that the Governor veto this bill and instead work for comprehensive reform.  Moreover, a letter to the Editor from MSSNY’s Dr. Rothberg urging a veto was also recently published in the Albany Times-Union (letter).   Similar letters from regional and statewide physician leaders have also appeared in:

There was also a recent lengthy article in the New York Law Journal highlighting the problems with this bill that included a quote from MSSNY’s Dr. Rothberg.

MSSNY’s CME Provider Conference a Success
On Friday, September 15, 2017, MSSNY held a CME Provider Conference at the Courtyard by Marriott in Westbury, Long Island.  The program was designed to help keep MSSN-accredited CME providers up to date with the latest developments and requirements of the Accreditation Council for Continuing Medical Education (ACCME) and the American Medical Association (AMA).  Speakers included Steve Singer, PhD, ACCME Vice President of Education and Outreach, and Mary Kelly, Project Administrator, AMA PRA Standards and Policy.  Also featured was a panel discussion by James Braun, DO, President, Physicians’ Research Network (PRN); Dorothy Lane, MD, Chair, CME Committee, Suffolk Academy of Medicine; and

Jeffrey Rothman, MD, Director, Department of CME, Staten Island University Hospital.

The panel topic was improving compliance with ACCME accreditation criteria.  In addition, attendees participated in an interactive session on identifying compliance examples for the ACCME’s new criteria for accreditation with commendation.

As an ACCME-Recognized Accreditor, MSSNY is the state/regional accreditor of 34 CME providers in New York State.  Attendees traveled from as far north as Plattsburgh and as far west as Rochester to attend the conference.  MSSNY President Charles Rothberg, MD set the tone for the day with opening remarks that emphasized the importance of continuing medical education. CME professionals shared their strategies and approaches to physician education. The positive feedback of attendees stressed the value of conducting live, in-person conferences.

MSSNY Official: MAT Effective, But Underutilized Treatment for Opioid Use Disorder
On page 16 of the Fall 2017 issue of Behavioral Health News (10/26), Dr. Frank Dowling, a clinical associate professor of psychiatry at SUNY-Stony Brook and the Secretary of the Medical Society of the State of New York, writes that medication-assisted treatment (MAT) is an effective, but underutilized treatment for opioid use disorder. Dowling says that “there is a shortage of access to MAT,” and that many patients and clinicians remain opposed to MAT, because of “well intended but misguided perceptions” that “are often reinforced by drug treatment program staff and by peers in 12-step programs.”

Open Enrollment Opened November 1
Open enrollment for Obamacare plans began November 1 and the Cuomo administration, in an ongoing effort to ignore the negative vibes emanating from the Trump administration, announced Monday that it has expanded its outreach campaign to additional pharmacies. Rite Aid will advertise New York State of Health, the online insurance marketplace created by the Affordable Care Act, joining CVS Pharmacy, Kinney Drugs, ShopRite Supermarkets and TOPS Pharmacies.

NY Physician Accused of Accepting Cash from Patients for Opioid Scrips
Ernesto Lopez, 74, a New York-licensed doctor who operates medical clinics in Manhattan, Flushing, and Franklin Square, is accused, along with his assistant, 49-year-old Audra Baker, of accepting cash payments in exchange for the prescriptions, court papers say.

Dr. Lopez typically charged $200 to $300 in cash for patient visits during which he allegedly performed perfunctory examinations and then prescribed large quantities of oxycodone and fentanyl patches. Since 2015, Dr. Lopez wrote more than 8,000 prescriptions and collected $2 million in fees, prosecutors said.

Dr. Lopez’s assistant at two of his clinics, allegedly steered patients to an individual who could buy the prescriptions and resell the drugs on the street, court papers say.

“As alleged, these defendants acted like drug dealers in lab coats, directly contributing to the glut of highly-addictive opioids flooding the streets of New York City and its surrounding communities,” Acting U.S. Attorney Joon H. Kim said in a statement. The investigation and practitioner-among-three-defendants-charged-manhattan-federal-court”>arrests were conducted by the DEA’s Tactical Diversion Squad comprised of investigators from the DEA, NYPD, and NYC Department of Investigation.

US House Passes IPAB Repeal Legislation
By a 307-111 vote, the US House of Representatives passed legislation that would repeal the Independent Payment Advisory Board (IPAB).  The statutory authority to create the IPAB was established under the ACA, but the Board has never been formally created.  Its purpose is to make recommendations to reduce Medicare spending if it exceeds a certain threshold, which would go into effect if Congress fails to achieve a supermajority vote to override its recommendations.  MSSNY and the AMA support repeal of the IPAB given its potential to significantly and arbitrarily cut physician payments for care to seniors, at a time when overwhelming and rising practice costs require increases, not cuts. It is unclear at this time whether there will be sufficient votes in the US Senate to also pass the bill.

Of New York’s House Delegation, 16 voted “Yes” and 11 voted “no”.   Those voting “Yes” included Rep. Clarke (D-Brooklyn); Rep. Collins (R-Erie County); Rep. Donovan (R-Staten Island); Rep. Engel (D-Bronx/Westchester); Rep. Faso (R-Columbia County); Rep. Higgins (D-Erie County); Rep. Katko (R-Onondaga County); Rep. King (R-Nassau County); Rep. Sean Maloney (D-Westchester); Rep. Meeks (D-Queens County); Rep. Meng (D-Queens); Rep. Reed (R-Southern Tier); Rep. Stefanik (R-North Country); Rep. Suozzi (D-Nassau County); Rep. Tenney (R-Oneida County) and Rep. Zeldin (R-Suffolk County).

Those voting “No” included Rep. Crowley (D-Bronx/Queens); Rep. Espaillat (D-Manhattan); Rep. Jeffries (D-Brooklyn); Rep. Lowey (D-Westchester); Rep. Carolyn Maloney (D-Manhattan); Rep. Nadler (D-Manhattan); Rep. Rice (D-Nassau County); Rep. Serrano (D-Bronx); Rep. Slaughter (D-Monroe County); and Rep. Tonko (D-Albany/Schenectady); and Rep. Velasquez (D-Brooklyn)


WEBINARS/SEMINARS

An Unusual and Highly Resistant Fungus in NYS: An Update on Candida auris for the Practicing Physician

CME Webinar on December 6; Registration Now Open

Upcoming in MSSNY’s Medical Matters continuing medical education (CME) webinar series is: An Unusual and Highly Resistant Fungus in NYS: An Update on Candida auris for the Practicing Physician.  This webinar will take place on Wednesday, December 6, 2017 at 7:30 a.m.  Emily Lutterloh, MD, MPH, Director, Bureau of Healthcare Associated Infections, from the New York State Department of Health will conduct this presentation.  Register for this webinar here.

Additional information or assistance with registration may be obtained by contacting Melissa Hoffman at mhoffman@mssny.org.

Educational objectives are:

  • Provide an update on the emerging multi-drug resistant yeast, Candida auris ( auris), globally and in New York State
  • Describe the risk factors for auris infection and the recommended diagnostic approach
  • Review the recommendations for auris, including infection prevention and control measures 

The Medical Society of the State of New York is accredited by the Accreditation Council for Continuing Medical Education (ACCME) to provide continuing medical education for physicians.

The Medical Society of the State of New York designates this live activity for a maximum of 1.0 AMA/PRA Category 1 credits™.  Physicians should claim only the credit commensurate with the extent of their participation in the activity. 

Preventing Diabetes in Patients: NYS Physicians Encouraged to Attend AMA Webinar
November is National Diabetes Awareness Month and the American Medical Association (AMA) and the Medical Society of the State of New York (MSSNY) has partnered to provide educational information to New York State physicians on how to initiate clinical practice change and prevent diabetes in patient population.  Physicians can participate in a webinar on November 15 from 1-2 p.m.  Click here to register.

The session will review the evidence base for clinical approaches to diabetes prevention and describe how physicians and care teams can implement a diabetes prevention initiative within their practice. Kate Kirley, MD, MS, Director of Chronic Disease Prevention and Janet Williams, MA, Senior Program Manager will be presenters.

Dr. Kirley is director of Chronic Disease Prevention at the American Medical Association.  Prior to joining the AMA, she was a practicing family physician and health services researcher at NorthShore University Health System, and a clinical assistant professor in the Department of Family Medicine at the University of Chicago.  Janet Williams is senior manager of physician and health system engagement at the American Medical Association.  She has more than 30 years public health program and policy development experience.   She manages the AMA’s prediabetes initiative to develop and test clinical tools and resources for engaging health systems, clinicians and health departments in diabetes prevention.

MEDICARE/MEDICAID INFORMATION

2018 MIPS Quality Payment Rule Released by CMS
CMS this week released its final rule implementing the MIPS quality reporting rules for 2018 which will impact Medicare physician payment in 2020.  According to the MACRA statute, Medicare physician payment could be increased or decreased by up to 5% in 2020 based upon physician “performance” in 2018.

To read a comprehensive summary of these changes for 2018, click here.

To read the entire rule, click here.

Among the rule’s highlights:

  • Decreasing the number of physicians required to participate by excluding individual MIPS eligible clinicians or groups with ≤$90,000 in Part B allowed charges or ≤200 Medicare Part B beneficiaries.
  • Permitting the use of 2014 Edition and/or 2015 Certified Electronic Health Record Technology (CEHRT) in Year 2 for the Advancing Care Information (ACI) performance category, and giving a bonus for using only 2015 CEHRT.
  • Adding 5 bonus points to the MIPS final scores of small practices.
  • Adding “Virtual Groups” as a participation option for MIPS for solo or small practice physicians.
  • Awarding up to 5 bonus points on the MIPS final score for treatment of complex patients.
  • 50% of the score will be based on quality reporting; 25% based on ACI reporting (the new “meaningful use”); 15% based on clinical improvement activity reporting; and 10% based on the “cost category”

Review of the 1,653 page rule is ongoing by many across organized medicine.  Physicians can receive free technical assistance in complying with the MIPS program through IPRO, which has a contract with the federal government to provide this assistance.  Please click here more information.  Additional information from the Physicians Advocacy Institute, of which MSSNY is a Board member, is available here.

2018 Medicare Payment Rule Announced – Review Ongoing
This week CMS announced the Medicare Part B payment rule for 2018.  To review a fact sheet about the new rule, click here.

The fact sheet notes the final 2018 conversion factor will be $35.99, a 0.41% increase from the 2017 PFS conversion factor of $35.89.

A specialty by specialty breakdown of the impact of 2018 payment rule for allowed charges is available on p. 1152 of the entire rule.  The chart notes that the 2018 payment rule will have 0% impact for many specialties.  However, it is estimated that there will be 1% increases for cardiology, dermatology, infectious disease, plastic surgery, psychiatry, radiation oncology and rheumatology.  There will be a 1% decrease for anesthesiology, pathology, urology and vascular surgery, a 2% decrease for otolaryngology; and a 3% decrease for allergy/immunology.

MSSNY together with the AMA and the federation of medicine is reviewing the 1,250 page rule and will follow up with a more comprehensive summary.

CMS Unveils MACRA Rule Changes
Modern Healthcare (11/2) reports CMS finalized a proposed rule which would exempt 134,000 providers from complying with MACRA. The rule finalized on Tuesday will exclude “Physician practices with less than $90,000 in Medicare revenue or fewer than 200 unique Medicare patients per year.” As a result of the change, a total of 934,000 providers will be exempt from MACRA’s Merit-based Incentive Payment System, leaving only 39 percent of the 1.5 million clinicians billing under Medicare required to comply with MIPS.

2016 PQRS Feedback Reports Are Ready for Viewing
2016 Physician Quality Reporting System (PQRS) feedback reports and 2016 Annual Quality and Resource Use Reports (QRURs) were released on September 18, 2017. The PQRS feedback reports show your program year 2016 PQRS reporting results, including if you are subject to the 2018 PQRS downward payment adjustment. The 2016 Annual QRURs show how physicians, physician assistants (PAs), nurse practitioners (NPs), clinical nurse specialists (CNSs), and certified registered nurse anesthetists (CRNAs) in groups and solo practitioners performed in 2016 on the quality and cost measures used to calculate the 2018 Value Modifier as well as their practice’s 2018 Value Modifier payment adjustment.

The payment adjustments shown in the reports are based on proposals that were included in the 2018 Medicare Physician Fee Schedule Proposed Rule. If the policies are not finalized as proposed, CMS will provide an update to report recipients.

Access and review your 2016 PQRS feedback report and 2016 Annual QRUR now to determine whether you are subject to the 2018 PQRS downward payment adjustment and your practice’s 2018 Value Modifier payment adjustment.

If you believe your payment adjustment status was made in error, you may request an informal review of your 2016 PQRS results and/or 2018 Value Modifier calculation during the informal review period from now until 8:00 pm Eastern Time (ET) on December 1, 2017. 

An Enterprise Identify Management (EIDM) account with the appropriate role is required for participants to obtain their 2016 PQRS Feedback Reports and 2016 Annual QRURs. Both reports can be accessed on the CMS Enterprise Portal using the same EIDM account. Visit the How to Obtain a QRUR webpage for instructions on accessing both reports.

To find out which reports are available for your practice and your current and past PQRS and Value Modifier payment adjustments, you can use the new Payment Adjustments and Reports Lookup feature on the CMS Enterprise Portal. An EIDM account is not needed to use this feature. Instructions for using this feature are located in the “Guide for Accessing the Payment Adjustment and Reports Lookup Feature”.

For more information on your PQRS feedback report:

For more information on your Annual QRUR:

For the 2016 reporting period, the majority of eligible professionals (EPs) successfully reported to PQRS and avoided the downward payment adjustment. CMS anticipates that successful trend to continue under the new Quality Payment Program. The Quality Payment Program began January 2017 and replaces PQRS, the Value Modifier program, as well as the separate payment adjustments under the Medicare Electronic Health Record (EHR) Incentive Program for EPs. The Quality Payment Program streamlines these legacy programs, reduces quality reporting requirements and offers many flexibilities that allow eligible clinicians to pick their pace for participating in the first year. To prepare for success in the Quality Payment Program, we encourage EPs to review their PQRS feedback report, Annual QRUR, and visit qpp.cms.gov to learn about the Quality Payment Program.

Questions?

  • For assistance with Enterprise Identity Management or PQRS feedback reports, contact the QualityNet Help Desk at 866-288-8912 (TTY 877-715- 6222) or qnetsupport@hcqis.org.
  • For assistance with the QRURs or Value Modifier, contact the Physician Value Help Desk at pvhelpdesk@cms.hhs.gov or 888-734-6433 (select option 3).

CMS: Wants More Flexibility with “Providers” and Increase Competition
CMS Administrator Seema Verma announced the agency’s efforts to streamline quality measures and reduce regulatory burden with a new approach to quality measurement called “Meaningful Measures.”

In addition to focusing on quality measurement, CMS announced in September that it would be moving the Center for Medicare and Medicaid Innovation (Innovation Center) in a new direction to give providers more flexibility with new payment models and to increase healthcare competition.

In September, the agency issued a “request for information” to collect ideas on the best path forward.  On the CMS Innovation Center website, CMS said the Innovation Center’s new direction will promote patient-centered care and test market-driven reforms that empower beneficiaries as consumers, provide price transparency, increase choices and competition to drive quality, reduce costs, and improve outcomes.

In particular, CMS says the Innovation Center is interested in testing models in the following eight focus areas—increased participation in Advanced Alternative Payment Models (APMs); consumer-directed care and market-based innovation models; physician specialty models; prescription drug models; Medicare Advantage (MA) innovation models; state-based and local innovation, including Medicaid-focused models; mental and behavioral health models; and program integrity.

New Medicare Card Project Special Open Door Forum — Nov. 9 from 2 to 3pm ET
This call will educate State Medicaid Agencies, Medicaid providers, Managed Care Organizations, Medicaid partners, and other Medicaid stakeholders about the change from Social Security Number-based Health Insurance Claim Numbers to new Medicare Beneficiary Identifiers (MBIs). A question and answer session follows the presentation.

CMS discusses:

  • Background and implementation
  • MBI format
  • Timeline and milestones, including the transition period
  • Beneficiary outreach and education
  • How to get ready for the new number

To participate:

  • Dial-In Number: 800-837-1935; conference ID #: 49255212

For more information, visit the New Medicare Project website and Transcripts webpage.

MSSNY CME Provider Conference

CMS Opened 30 Day Preview for 2016 Performance
On October 18, CMS opened the 30-Day Preview Period for the 2016 performance information targeted to be publicly reported on Physician Compare starting in December 2017. The preview was scheduled to end on November 17 at 8pm ET. Due to a technical issue preventing the data from properly displaying in the preview portal, the Provider Quality Information Portal (PQIP), all data were not viewable for the first week of preview. This display issue has now been resolved. We are extending preview through Friday, December 1 at 8pm ET to provide more time for clinicians and groups to preview their performance data as a result of this technical issue.

Additionally, the Physician Compare team is currently outreaching to all clinicians and groups that have already accessed PQIP to preview their data to share the information above.  We would appreciate the AMA helping us disseminate the Physician Compare preview extension information to stakeholders.  The Physician Compare team will also be disseminating this information via our listserv.

For more information about preview and the measures available for preview, visit the Physician Compare Initiative page.

For assistance with accessing PQIP, or obtaining your EIDM user role, contact the QualityNet Help Desk at 866-288-8912 or qnetsupport@hcqis.org.

If you have any questions about Physician Compare, public reporting, or the preview period, please contact us at PhysicianCompare@Westat.com.


CLASSIFIEDS


MEDICAL EQUIPMENT


Retiring from pediatrics. I have medical equipment to donate: examining table, pediatric examining table with a scale, medical scale, examining instruments and miscellaneous office items. Forest Hills. Call 718 275-5858 or email mkolak59@gmail.com


RENTAL/LEASING SPACE


Upper East Side Plastic Surgery Office Available for Rent or Share
Beautifully equipped Plastic Surgery office available for part-time share along with Quad A-certified OR available for rent. Located in a lovely carriage house on the Upper East Side in close proximity to Lenox Hill Hospital and MEETH and conveniently located near all NYC mass transit. 1 exam room/OR and Recovery room along with large administrative space. Free WIFI. Available for full or half-days. Suits Plastic/Cosmetic Surgeons/ DERM/ ENT/or other Medical MDs. Please contact Kim at Kim@madisonps.com (212) 628-7600.


Saratoga Springs, NY – Professional Office Space for Lease
Medically oriented building currently occupied by five parties.  The Suite, Suite 700, has 2904 sq. ft., second floor (elevator), excellent off-road parking with drive-thru patient portico in a well maintained and attractive building close to the local hospital.
The lease area has a large waiting room, administrative rooms, lunch room, four examining rooms, one procedure room and one for storage.  Separate staff entrance.  Attractively priced without triple net obligations.  $4,500/month + heat + utilities.  Call Lauren regarding Suite 700 at (518) 587-2020.


Riverdale Medical Office for Sale – Prime Location
Co-op with private entrance features 2 exam rooms, lab, office & bathroom. Must see! Call 718-230-7069


For Rent or Share – Woodbury, Long Island
Beautiful recently renovated Plastic Surgery office available for part-time share and AAAA-certified (by end of summer). OR available for rent. Centrally located
on Long Island.Close to expressways. 3 exam rooms, 1 procedure room /OR.
Waiting room, break room and personal office. Free WIFI. Available for full or half-days. Suits Plastic/Cosmetic Surgeons/Derm/ENT/
ObGyn/Podiatry or other Medical MDs.
Contact Patricia at info@cosmetichg.com
or 631-318-4008

PHYSICIAN OPPORTUNITIES


Medical Director – AIDS Institute
Minimum Qualifications:
Current license and registration to practice medicine in New York State and board certification AND either a Master’s Degree in Public Health or two years of experience in an HIV program or public health program.Preferred Qualifications:
Master’s Degree in Public Health.  Five years of experience including clinical service in an HIV program or clinical fellowship program (infectious diseases/HIV medicine).  Experience in quality management/quality improvement.  Knowledge of the HIV health care delivery system in New York State. Experience in/knowledge of the New York State Ending the Epidemic initiative.  Experience in STD prevention and care, drug user health, and/or LGBT health.  Experience in health policy development, analysis and evaluation.  Experience with evolving health information technologies.  Experience in health program management and administration.
Responsibilities: The Medical Director, AIDS Institute, plays a significant role in shaping HIV, hepatitis C, and STD care and services, drug user health, and LGBT health care throughout New York State.Please click the link below for more information pertaining to this position and to apply: “https://careers-healthresearch.icims.com/jobs/3742/medical-director—aids-institute/job” Affirmative Action/Equal Opportunity Employer/Qualified Individuals with Disabilities/Qualified Protected Veterans

Multiple Physician Positions with DOHMH Office of School Health
Office of School Health is the largest program of the New York City Department of Health and Mental Hygiene (DOHMH). This bureau is responsible for managing the health issues and promoting the well-being of the over 1.3 million children and adolescents enrolled in New York City’s 1700 school buildings.

Positions with the Office of School Health (OSH) combine clinical skills and public health training.

Adolescent School Health Physician
This position offers to the interested physician the opportunity to help address the clinical and public health needs of adolescents in NYC high schools. The physician will work with the innovative Connecting Adolescents to Comprehensive Health Care (CATCH) Program, which provides select reproductive health services to adolescents in select NYC high schools. In addition, the physician will provide medical care and public health services through additional programs offered to adolescents by the Office of School Health.

Under the supervision of the High School Supervising Physician, the Adolescent School Health Physician’s responsibilities will include but are not limited to:

  • Provide CATCH reproductive health services in select high schools.
  • Perform mandated physical examinations (New Admission Exams, Sports Physicals, and Working Paper Physicals).
  • Function as a liaison for students with community health providers to resolve medical issues that affect school performance.
  • Support the development and implementation of initiatives that promote positive health behaviors and reduce high risk behaviors in the adolescent population.
  • Serve as a consultant to the school nurse and administration on school related health concerns.
  • Provide clinical assistance in the event of an environmental or communicable disease occurrence.
  • Function as a liaison for students with community health providers to resolve medical issues that affect school performance.
  • Support all medical initiatives established by the Office of School Health, e.g. programs and protocols in asthma, reproductive health, obesity and diabetes.
  • Maintain good public relations and communicate effectively within the school community and community-based organizations.
  • Keep abreast of health management policy statements and emerging clinical research related to school health.
  • Participate in OSH research activities.
  • Work within the mandates, policies and protocols of the Office of School Health.
  • Attend all mandated DOHMH and OSH trainings.

To Apply: Please email your resume and cover letter to Dr. Caroline Volel: osh@health.nyc.gov OR  Apply online at https://a127-jobs.nyc.gov/.  In the Job ID search bar, enter: job ID number # 277208. 

School Health Field Physician
Under the direction of the Supervising Physician, the School Health Physician’s will:

  • Improve the health of school children through case management of chronic disease, preventive health screening and counseling, health education, and referrals.
  • Perform mandated physical examination (new entrant, sport physical, working paper physicals.
  • Develop relationships with community health providers in order to optimize medical management of students with health issues.
  • Attend to the health needs of your assigned school community.
  • Utilize the Automated Student Health Record (ASHR) to maintain adequate student health records.
  • Serve as a consultant to the school nurse and administration on school related health concerns.
  • Support the development of school educational and prevention programs promoting the health and wellness of all students.
  • Provide clinical assistance in the event of an environmental or communicable disease occurrence.
  • Develop and maintain professional relationships within the school community.
  • Support all medical initiatives put forth by the Office of School Health, e.g. Asthma, Reproductive health, Obesity and Diabetes initiatives.
  • Provide trainings/presentations to school staff, community organizations, or parents.
  • Stay abreast of health management policy statements and emerging research within the health community related to school health.
  • Participate in School Health research and quality improvement activities.
  • Participate in all mandated DOHMH and Office of School Health trainings and professional development sessions.
  • Attend all program meetings and Continuing Medical Education classes provided by the Office of School Health.

To Apply: Please email your resume and cover letter to Dr. Caroline Volel:osh@health.nyc.gov OR Apply online at https://a127-jobs.nyc.gov/.  In the Job ID search bar, enter: job ID number # 279844. 

Supervising School Health Physician 
Job Description
Under the supervision of the Deputy Medical Director, the Supervising Medical Doctor’s responsibilities will include but not be limited to:

  • Supervise School Health Physicians.
  • Work within the mandates, policies and protocols of the Office of School Health (OSH).
  • Attend to the health needs of a designated school community.
  • Utilize the Automated Student Health Record (ASHR) to maintain accurate student health records.
  • Serve as a consultant to the school nurse and school administrative staff regarding school related health concerns.
  • Support the development of school educational and prevention programs promoting the health and wellness of students.
  • Participate in policy development and revisions as indicated.
  • Provide clinical assistance in the event of an environmental or communicable disease occurrence.
  • Function as a liaison for students with community health providers to resolve health issues that affect school functioning.
  • Develop and maintain professional relationships within the school community and the community at large.
  • Support all medical initiatives put forth by the Office of School Health, e.g. Asthma, Reproductive health, Obesity and Diabetes Initiatives.
  • Keep abreast of health management policy statements and emerging research within the health community affecting school health.
  • Assist with or provide trainings/presentations to school health physicians, nurses, school staff, community organizations or parents
  • Participate in School Health research and quality improvement activities
  • Participate in all mandated DOHMH and Office of School Health trainings and professional development sessions
  • Attend all program meetings and Continuing Medical Education classes provided by the Office of School Health.


To Apply: Please email your resume and cover letter to Dr. Caroline Volel: osh@health.nyc.gov  OR  Apply online at https://a127-jobs.nyc.gov/.  In the Job ID search bar, enter: job ID number # 277026


CALL FOR RATES & INFO. CHRISTINA SOUTHARD: 516-488-6100 ext. 355


October 27, 2017 – Drugs: Everyone’s Problem

Charles Rothberg, MD - MSSNY President
PRESIDENT’S MESSAGE
Charles Rothberg, MD
October 27, 2017
Volume 17
Number


Dear Colleagues:

Today, as a guest, I will be attending the NYS and NJ Societies of Interventional Pain Physicians Conference in Jersey City. These doctors already have a target on their back.

When drug addiction became everyone’s problem— kids, adults, law and drug enforcement—not just ours, New York stepped up in a meaningful way with ISTOP. We did not like it and thanks to our Government Affairs division, we were able to make the process less draconian than what was proposed. Most of the complaints about using the DOH’s system have died down. Many doctors reported that, to their surprise, yes, some of their patients were doctor shopping because they were either addicted to or diverting their prescribed opioids. Other states have used our comprehensive ISTOP program as a model to treat their own epidemics.

In reality, the epidemic is a failure of public health, public policy, and law enforcement. Blame and remedies should be shared. What about the role various national organizations promoting pain as a vital sign? What about the role of Congress in limiting DEA enforcement of diversion? What about drug makers that misstated the safety of opioids?  What about the role of insurers and PBMs in disfavoring alternatives to opioids? Many drug companies claimed that the opioids they manufactured were not addictive.

This week, President Trump addressed the problem in a somber press conference. His long-awaited public health emergency declaration on the opioid epidemic does not yet contain any new funding to combat the problem. However, federal health agencies will be able to reallocate existing resources and hire educated personnel. The declaration disappointed state officials and public health experts who maintain that a lot more money is needed to respond and confront this deadly epidemic. One of President Trump’s intentions is to break a logjam preventing doctors from treating opioid addiction through telemedicine consults as a way to reach addicts living in rural areas.

The CDC Has released guidelines on how to treat Chronic Pain which includes best practices.  This speaks to something that is often lost when discussing the opioid epidemic—there are still many patients who need pain medication, and there are some concerns that because of new prescribing limits and the fear of feeding addiction, they will have no access.

President Trump’s Commission on Combating Drug Addiction and the Opioid Crisis is set to release its final recommendations on Nov. 1. I expect that they will map out solid short and long term solutions.

Our President stated, “As Americans, we cannot allow this to continue. It is time to liberate our communities from this scourge of drug addiction…..We can be the generation that ends the opioid epidemic. We can do it.”

As physicians, I am confident that we are up to the challenge, too.

Sincerely,

Charles Rothberg, MD
MSSNY President

Please send your comments to comments@mssny.org



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MSSNY’s Statement Re Merger of CVS and Aetna Insurance Company
“The proposed purchase of Aetna by CVS, as reported by the Wall Street Journal, demands an immediate investigation by the federal Departments of Justice and Federal Trade Commissions. Physicians and patients are already often powerless to push back against barriers imposed by market dominant health insurance behemoths that interfere with needed medical care, such as limited choice of doctors and burdensome pre-authorization rules.

At the same time, corporate pharmacy interests are increasingly trying to take away prescribing and health care decision making authority from physicians, thereby interfering with continuity of care for our patients.  These companies need to prove why these problems will not become even worse for our patients if this proposed conglomeration were permitted to go forward.”

NYS Senate Releases Report on Lyme and Tick-Borne Disease
The New York State Senate’s Task Force on Lyme and Tick-Borne Diseases has released a report,” Ticking Time Bomb: An Update on the Lyme and Tick-Borne Disease Epidemic in New York State”.  This report recommends that there be established a comprehensive action plan, developed by the NYS Department of Health, in 2018 to implement a comprehensive approach to surveillance, prevention and detection in Lyme and other tick borne diseases.

Additionally, the report calls for the development of a specific medical protocol and notification for diagnosis and treatment;  that a comprehensive assessment of insurance practices related to tick borne disease; calls for increased testing for children and the use of informational technical technology to inform the public about the dangers of tick-borne diseases.  A copy of the report may be found HERE.

Concerns with Anthem’s New Prior Authorization Policy for Imaging Services
This past week, MSSNY staff joined representatives of the New York State Radiological Society to meet with the New York Department of Financial Services to express strong concerns with Anthem’s new policy imposing new prior authorization requirements as a precondition of patients receiving hospital-based imaging services.  In particular,

MSSNY expressed concerns regarding the additional administrative hassles imposed on referring physicians seeking to assure their patients can receive needed MRIs or CTs in a timely manner.  Moreover, concerns were expressed regarding the likely continuity of care issues for some patients, as well as the fact that such additional criteria for accessing these services of particular radiologists may not be clearly identified when a patient is looking at which physicians participate in a particular health insurer’s network.

To aid in its investigation, DFS representatives asked MSSNY and NYSRS for examples of instances where patients have been unable to receive the care they need, or have had their care unduly delayed, as a result of this new prior authorization requirement.   Please contact rmcnally@mssny.org if you would like to share your story.

Similar prior authorization requirements have been imposed in other states by Anthem.  As a result, the American Medical Association EVP Dr. James Madara wrote a letter to Anthem EVP Dr. Craig Samitt urging Anthem to reconsider this policy given the “potential adverse impact on patients’ timely access to medically necessary care”, and concerns that the “new policy interferes with the patient-physician relationship and may disrupt ongoing care coordination”.

AMA Action Item: IPAB Repeal Moving Ahead in Congress; Be Heard
Legislation to repeal the Independent Payment Advisory Board (IPAB) is moving on Capitol Hill, but Congress needs to hear from America’s physicians in order to push it over the finish line.

The “Protecting Seniors’ Access to Medicare Act of 2017” (H.R. 849) would permanently repeal the IPAB; a panel that puts significant health care payment and policy decisions in the hands of an unelected body with far too little accountability.  Unless the IPAB is repealed, access to care for millions of Medicare patients could be threatened by arbitrary cost-cutting targets year after year.

Getting rid of IPAB will allow physicians and policymakers to focus on long-term efforts to improve care quality, improve health outcomes and make Medicare more sustainable while preserving access to care for seniors now and in the future. Please urge your legislators to support H.R. 849 to repeal the arbitrary and flawed IPAB by calling our toll-free grassroots hotline: (800) 833-6354 or emailing them today! Click this link to log in and send your message.


Promo Code: MSSNYCorporate-Huddle-uQAB4IbD?promo”>


About New York’s New Step Therapy Override Law
This week, MSSNY President-Elect and Medina internist/geriatrician Dr. Thomas Madesjki and MSSNY Senior Vice President Moe Auster participated in a webinar to discuss the provisions of New York’s new law to better regulate health insurers’ use of “step therapy” or “fail first” protocols. The forum was sponsored by the National Psoriasis Foundation.

A “step therapy protocol” is a policy that establishes a specific sequence in which prescription drugs for a medical condition are approved for coverage by a health insurance plan for a patient.  The new law provides that all NY-regulated health insurers shall grant an override of that insurer’s step therapy protocol upon receipt of information from the physician “that includes supporting rationale and documentation” which demonstrates that the drug(s) being required by the health insurer:

  • Is contraindicated or will likely cause an adverse reaction by physical or mental harm to the patient;
  • Is expected to be ineffective based on the known clinical history and conditions of the patient and his/her drug regimen;
  • Has been tried by the patient or another prescription drug(s) in the same pharmacologic class or with the same mechanism for action and such drug(s) was discontinued due to a lack of efficacy or effectiveness, diminished effect or an adverse event;
  • Should not be required because the patient is stable on a drug other than the drug being required by the insurer; or
  • Is not in the best interest of the patient because it will likely cause a significant barrier to a patient’s adherence with his/her plan of care, will likely worsen a comorbid condition of a the patient, or will likely decrease the patient’s ability to achieve or maintain reasonable functional ability in performing daily activities.

Health insurers must respond to a step therapy override request within 72 hours of the request.  A health insurer is required to respond within 24 hours if the request is for a patient with a medical condition that places the health of the patient in serious jeopardy without the prescription drug or drugs prescribed by the patient’s physician.  If the health insurer fails to act within these 72 or 24-hour time periods, the request will be granted in favor of the patient.

The new law also requires that health insurers’ step therapy protocols be based upon evidence-based and peer-reviewed clinical criteria that also takes into account the needs of atypical patients.  These criteria must be made available to physicians upon request.

The new law will be applicable to all NY-regulated health plans as of January 1, 2018.  However, since the law applies to health insurance plans “delivered, issued for delivery issued or renewed” after January 1, 2017, many group health insurance plans across the State are already required to follow the new law.

Enforcement is the key to assuring that the law is working as intended.  Therefore, please let us know if you see instances where health insurers are not following the law.  Moreover, you can file a complaint with the State here  or here. 

Governor Signs Bill into Law to Regulate Biosimilar Substitutions
Governor Cuomo signed into law this week a bill (S.4788-A/A.7509-A) passed by the State Legislature   that would establish rules regarding the substitution of interchangeable biological products.  While New York State law regulates the substitution by pharmacists of generic drugs for their branded counterparts, the existing law has not been updated to set forth the circumstances under which a biologic product can be substituted with a FDA approved interchangeable biologic.

Importantly, it would prohibit a pharmacist from substituting an interchangeable biological product (as defined by the FDA) prescribed by a physician if the physician affirmatively requests that the product be “dispensed as written”.  If the physician does not specify on the prescription that the biological medication should be “dispensed as written”, then the pharmacist may substitute an interchangeable biological product but only if the pharmacist provides notice to the physician within 5 days of the substitution.  The new law provides that this notice from the pharmacist to the physician be conveyed by:

·        making an entry that is electronically accessible to the prescriber through an interoperable electronic medical records system, an electronic prescribing technology or a pharmacy record; ·        using fax, electronic transmission or other electronic means, or ·        by telephone if an electronic means is not available to the pharmacist at the time of communication.  It would also establish a 5-year sunset on all these provisions.


Your membership yields results and will continue to do so. When your 2018 invoice arrives, please renew. KEEP MSSNY STRONG!


Urge Gov. Cuomo to Veto Disastrous Liability Bill; Instead Work for Reform
Physicians are urged to continue to contact Governor Cuomo to request that he veto legislation (S.6800/A.8516) that would significantly expand the time to bring a medical malpractice lawsuit, in circumstances based upon an “alleged negligent failure to diagnose a malignant tumor or cancer”.   If signed into law it would likely prompt a double digit increase in physician and hospital malpractice premiums.   You can send a letter here and call 518-474-8390.

While many physicians have made these contacts, we need an overwhelming demonstration from physicians regarding how this bill will harm access to care in their communities if this bill is not paired with needed tort reforms to bring down the exorbitant costs of medical liability insurance in New York.

Significant pressure is being placed on the Governor to sign the bill by trial lawyers, and by some consumer groups and media outlets.  For example, this past week, a consumer group representative appeared on a statewide political show to urge the Governor to sign the bill. There was also an article in the New York Daily News, which has engaged in a multi-year crusade for this bill, regarding the significant number of groups that supported the bill.  The article did reference concerns from several groups, including MSSNY, the Lawsuit Reform Alliance, and the New York State Radiological Society.  MSSNY President Dr. Charles Rothberg stated “We’re in favor of comprehensive reform. We want to make sure any reforms protect the public, but also that they are reasonable and don’t unfairly burden our hospitals and physicians.”

In response, physicians have been active in warning the public about the patient care access problems this bill will exacerbate if it is signed into law.  Last week Albany radiologist and MSSNY member and Albany radiologist Dr. Robert Rapaport had a commentary published in the Albany Times-Union urging that the Governor veto this bill and instead work for comprehensive reform.  Moreover, a letter to the Editor from MSSNY’s Dr. Rothberg urging a veto was also recently published in the Albany Times-Union (letter).   Similar letters from regional and statewide physician leaders have also appeared in:

There was also a lengthy article in the New York Law Journal this week highlighting the problems with this bill that included a quote from MSSNY’s Dr. Rothberg. 

NYS/NYC Department of Health Report Increase in Hepatitis A Infections
The New York State and New York City Departments of Health are reporting recent increases in hepatitis A infections in men who have sex with men (MSM) in New York City and that state DOH has documented a similar risk profile among individuals with hepatitis A who reside in NYS outside of NYC. Western Europe is also experiencing outbreaks of hepatitis A among men that have sex with men.

The state DOH has sent a letter to all physicians and health care providers requesting that  efforts be intensified to implement existing recommendations for completion of a hepatitis A vaccine series in all men and transgender individuals who have sex with men who are either not previously immunized or who do not know their vaccination or disease status.  There is also information in the letter that physicians can provide to their patients.  A copy of the letter can be found here.

Asian New Yorkers Face Barriers to Mental Health Care
New York City’s diverse and growing Asian population needs dedicated resources to increase access to mental health care, according to a report released by the Asian American Federation.

Suicide was among the 10 leading causes of death for Asian New Yorkers every year between 1997 and 2015, but that was not the case for other racial groups, according to stats from the city’s Department of Health and Mental Hygiene.

Through a series of roundtable discussions, focus groups and interviews conducted with mental health providers and others working with Asian New Yorkers, the federation identified key barriers to accessing mental health care in Asian communities. These include a shortage of providers that are culturally and linguistically competent, a lack of awareness and understanding of mental health issues in some Asian communities, less access to health insurance and a lack of research on alternative services that bear less stigma.

In addition to highlighting the need to develop more culturally appropriate models for addressing mental health issues, the federation faulted the city for not dedicating enough social-services dollars to Asian New Yorkers.

Physicians Needed for Martial Arts Tournament November 4-5 SUNY Old Westbury
The US Muay Thai Open will take place on November 4 and 5, 2017 at SUNY College at Old Westbury. The tournament will feature approximately 400 amateur Muay Thai athletes from around the nation and world. The physicians’ duties will be to observe each bout, permanently stop bouts if in the physicians’ opinion, the competitor is no longer medically fit to compete, and to perform post-bout interviews to assess the competitors’ condition.  They will need physicians for the following dates:

Saturday, November 4, 2017
7:30 a.m. – 1:30 p.m.
7:30 a.m. – 7:30 p.m.

Sunday, November 5, 2017
7:30 a.m. – 1:30 p.m.
7:30 a.m. – 7:30 p.m.

Compensation will be $100/hr for physician services. Call 480-245-0094 or 917-318-7988

MEDICARE/MEDICAID INFORMATION

Tip of the Week
By Jacqueline Thelian, CPC, CPC-I, CHCA, Medco Consultants, Inc. 

Q: What is all this buzz about new Medicare audits?
A:  In an effort to “reduce appeals, decrease provider burden and improve the medical review and education process,” Medicare has expanded the Targeted Probe and Educate (TPE) pilot program to all their Medicare Administrative Contractors (MACs) for Part A, B, HHH and DME.

The TPE program went into effect on Oct. 1, 2017 and it applies to all medical reviews for all MAC lines of business. It is very similar to a pre-payment audit only the TPE has a definitive time line.

The providers/suppliers will have one (1) to three (3) pre- or post-payment rounds of review. After or during each review, the healthcare provider /supplier will be educated based on MACs findings. The educational sessions are offered via webinar or telephone conference by a nurse reviewer. Other educational methods are available if necessary. If the healthcare provider is found to be non-compliant with Medicare, they will be reviewed again.

Failing the third round of reviews can result in dire consequences such as a referral to the Centers of Medicare and Medicaid services (CMS) for additional action. These actions may include “extrapolation, referral to Zone Program Integrity Contractor(ZPIC) or Unified Program Integrity Contractor (UPIC), referral to the RAC or 100% pre-pay review,” etc. (i.e. audit).

If you are targeted the best advice is to take advantage of the education provided by your MAC as well as additional education from an outside certified coder with experience with these types of reviews.

Remember the sooner you get it right, the sooner you will be removed from the TPE.

Sources:
Targeted Probe and Educate (TPE), http://ow.ly/JB5N30fDG7u
CMS PUB 100-20 One-Time Notification, Transmittal 1919, SUBJECT: Targeted Probe and Educate, http://ow.ly/sf9A30fDGjQ
NGS Compliance & Audits, Targeted Probe and Educate http://ow.ly/IshY30fDGyM
Noridian Healthcare Solutions, Targeted Probe & Educate http://ow.ly/s6HN30fDGLX
If you have a coding or compliance question you would like to have answered please send your question to MSSNY at eskelly@mssny.org, and complete the subject line with Tip of the Week.

Medical Provider Direct Deposit FAQs

  • How do I start?
    Visit nysif.com and log in to your online account. If you do not have one, please create a NYSIF account by clicking Login >> Create an Account and choosing “medical provider” as the account type. Visit our Medical Provider Portal page for more information on registration.
    You will need a check received from NYSIF within the last 12 months and a valid email address to begin. When you’ve completed your registration, log into your account and choose “Enroll/Manage Direct Deposit.”
  • What do I need to enroll?
    A valid checking or savings account, the name of your financial institution, your bank routing number and your bank account number. Foreign bank accounts cannot be enrolled in NYSIF direct deposit.
  • How will NYSIF verify my identity?
    Once the application is completed, you will be redirected to DocuSign to authenticate your identity and sign electronically.
  • When will my direct deposit begin?
    Once NYSIF receives a completed direct deposit application, it will take several business days to verify your bank information. Until that time, you will receive your payments by mail.
  • Will I be notified by NYSIF when payments are deposited?
    Once direct deposit begins, you will receive an email every time NYSIF deposits a payment to your account. You can then log in to the medical provider portal to review the associated Explanation of Benefits (EOB) by using the draft number in the payment notification email to “Search Payments by Check Number.” Each direct deposit can contain payment for up to 25 separate bills.
  • Will funds be available on a holiday?
    If your payment date falls on a bank holiday, your payment will post on the next business day.
  • What if I want to change bank accounts?
    If you need to change the bank account for your direct deposit, please log in to your account and choose “Manage/Enroll Direct Deposit” to provide your new bank account information. Please note, you will be directed to DocuSign again to verify your identity. Once NYSIF approves your new application, it will take several business days to process the change to the new account. If a payment is due in the interim, it will be sent by mail.
  • What if I want to cancel direct deposit?
    Log in to your NYSIF online account, visit your Account Management page and click “Unsubscribe” to cancel direct deposit at any time. It may take another cycle of payments to stop this transaction, after which your next scheduled payment will be sent by mail.
  • What if I move?
    Always notify NYSIF if your address changes. However, moving will not affect your direct deposit unless you close or change bank accounts.

Please carefully review the Medical Provider’s Rights and Authorizations, applicable to any NYSIF provider payments.

Attention Managed Care Network Providers: Medicaid Enrollment Requirement
Section 5005(b)(2) of the 21st Century Cures Act amended Section 1932(d) of the Social Security Act (SSA) and requires that effective January 1, 2018, all Medicaid Managed Care and Children’s Health Insurance Program providers must enroll with state Medicaid programs.

The SSA requires that the enrollment include providing identifying information including name, specialty, date of birth, social security number, National Provider Identifier (NPI), federal taxpayer identification number, and the state license or certification number.

For example, if a physician currently participates in a network with a Medicaid managed care plan that provides services to, or orders, prescribes, or certifies eligibility for services for, individuals who are eligible for medical assistance, the physician must enroll with New York State Medicaid.

Common Enrollment Questions:

  • To check on your enrollment status, please call CSRA at 1-800-343-9000. Practitioners may also check the Enrolled Practitioners Search function at: https://www.emedny.org/info/opra.aspx
  • If you are already enrolled as a Medicaid fee-for-service (FFS) provider and are listed as active, you will not have to enroll again.
  • If at one time you were a FFS provider, and your enrollment has lapsed (no longer actively enrolled), you may be able to keep your original Provider Identification Number (PID), also known as MMIS ID, by reinstating.
  • Practitioners who do not wish to enroll as a Medicaid FFS billing provider may enroll as a non-billing, Ordering/Prescribing/Referring/Attending (OPRA) provider.
  • Enrollment in Medicaid FFS does not require providers to accept Medicaid FFS patients.

If you are not actively enrolled, please go here  and navigate to your provider type. Print the Instructions and the Enrollment form. At this website, you will also find a Provider Enrollment Guide, a How Do I Do It? Resource Guide, FAQs, and all forms related to enrollment in New York State Medicaid. 

As a point of information, under 42 CFR 455.104 defines the following providers as excluded from the definition of “disclosing entity”:

  • Solo practitioners such as an individual physician, psychologist, or chiropractor.
  • Group of individual practitioners, such as a group of cardiologists, or a group of radiologists.”



Therefore, physicians do not need to complete Section 5.

If you have questions, please contact Regina McNally at 516-488-6100 ext 332.

SEMINARS

Rebuild Puerto Rico Health Symposium in NYC TOMORROW
The Puerto Rican Studies Association (PRSA) and the Center for Puerto Rican Studies will host several concurrent panels that will discuss various health topics related to rebuilding Puerto Rico.

When:  Saturday, October 28, 2017, 11:30-12:45
Where: Silberman School of Social Work, Hunter College, 2180 Third Avenue (at 119th St)

The panelists will include Irwin Redlener, MD, Director of the National Center for Disaster Preparedness, Columbia University; Sarah Schuyler, Director of Operations, The Afya Foundation; Jodie Roure, JD, PhD, Associate Professor, St. John’s University School of Law. In addition, physicians who have volunteered in Puerto Rico will share their experiences.

If you’re unable to attend in person, click here for the zoom webinar link.

DOH Commissioner Zucker to Speak on Pain Management and Medical Marijuana
As a partner with the New York State Department of Health Medical Grand Rounds Committee, the enclosed information on the first session of the 2017-2018 Commissioner’s Medical Grand Rounds series: Pain Management and Medical Marijuana at Flushing Hospital

Who:     Hosted by DOH Commissioner Howard A. Zucker, MD, JD
When:   Monday, October 30th, 2017
Time:    6:30 PM – 8:30 PM
Where: Flushing Hospital Medical Center – Medical Science Building, 5th Floor, Auditorium
4500 Parsons Blvd (at the corner of 45th Ave and Burling Street)      Flushing, NY 11355

The purpose of this presentation is to enhance the learner’s knowledge of cannabinoids and their pharmacology, demonstrate how medical marijuana may fit into medical practice for pain management, explain safety, potential risks and benefits of medical marijuana use, provide information on the effect marijuana may have on opioid use and opioid related risks, and discuss the regulatory requirements of the Medical Marijuana Program in New York State. Practitioners will have the opportunity to ask questions of the Department and physicians currently using these treatments to help patients.

This session will be streamed as a live webcast for those unable to attend in person, and it will also be offered on the New York State Department of Health webpage as an archived webinar. This is a free event and participation is encouraged from providers all over the state of New York. Participants are eligible for CME credits whether they view in-person, via the live webcast, or via the archived webcast. Please;

Buprenorphine Training to be held in Sullivan County December 2nd
The NYSDOH AIDS Institute and the Sullivan County Public Health Department are hosting a free Buprenorphine Eligibility Waiver Training for Clinical Providers on Saturday, December 2nd, 2017 from 8:00AM to 1:00PM at Catskill Regional Medical Center, 68 Harris-Bushville Rd, Board Room, Harris, NY 12742. This training is for physicians, nurse practitioners, physician assistants, pharmacists, and medical residents. Sullivan County has some of the highest rates of opioid overdose in New York State. In just the first seven months of 2017, Sullivan County has experienced a reported 20 overdose deaths.  From 2013-2016, there were approximately 75 reported opioid overdose deaths.

DOH is seeking to increase the volume of providers in and around the county that are able to offer medication assisted treatment (MAT) to people using opioids whom could benefit from buprenorphine (or “suboxone”).  Attached is a flyer with further information, including location, online registration, and more details. Further information will be sent out to confirmed attendees. Light refreshments will be provided. Registration closes on November 29th at 5pm.

Trainers: Sharon Stancliff, MD, Harm Reduction Coalition, New York, NY; Bruce Trigg, MD, Harm Reduction Coalition, New York, NY

Please Note: CME Credits will be made available. This is the first half of the minimum required 8 hours of training, and the second half must be completed online after attendance to the live training. Currently NPs & PAs are required to take an additional 16 hours of online training which is available on the PCSS-MAT website (Part 2).
For more information about buprenorphine related trainings, mentoring, coaching, technical assistance and more, please contact us at buprenorphine@health.ny.gov or 1-800-692-8528.

An Unusual and Highly Resistant Fungus in NYS: An Update on Candida auris for the Practicing Physician” CME Webinar on December 6; Registration Now Open
Upcoming in MSSNY’s Medical Matters continuing medical education (CME) webinar series is: An Unusual and Highly Resistant Fungus in NYS: An Update on Candida auris for the Practicing Physician”.  This webinar will take place on Wednesday, December 6, 2017 at 7:30 a.m.  Elizabeth DuFort, MD, Medical Director, Division of Epidemiology from the New York State Department of Health will conduct this presentation.  Register for this webinar here

Additional information or assistance with registration may be obtained by contacting Melissa Hoffman at mhoffman@mssny.org.

Educational objectives are:

  • Provide an update on the emerging multi-drug resistant yeast, Candida auris ( auris), globally and in New York State
  • Describe the risk factors for auris infection and the recommended diagnostic approach
  • Review the recommendations for auris, including infection prevention and control measures

The Medical Society of the State of New York is accredited by the Accreditation Council for Continuing Medical Education (ACCME) to provide continuing medical education for physicians.

The Medical Society of the State of New York designates this live activity for a maximum of 1.0 AMA/PRA Category 1 credits™.  Physicians should claim only the credit commensurate with the extent of their participation in the activity. 

Physicians Encouraged to Attend AMA Webinar Re Preventing Diabetes in Patients
November is National Diabetes Awareness Month and the American Medical Association (AMA) and the Medical Society of the State of New York (MSSNY) has partnered to provide educational information to New York State physicians on how to initiate clinical practice change and prevent diabetes in patient population.  Physicians can participate in a webinar on November 15 from 1-2 p.m.  Click here to register.

The session will review the evidence base for clinical approaches to diabetes prevention and describe how physicians and care teams can implement a diabetes prevention initiative within their practice. Kate Kirley, MD, MS, Director of Chronic Disease Prevention and Janet Williams, MA, Senior Program Manager will be presenters.  Dr. Kirley is director of Chronic Disease Prevention at the American Medical Association.  Prior to joining the AMA, she was a practicing family physician and health services researcher at NorthShore University Health System, and a clinical assistant professor in the Department of Family Medicine at the University of Chicago.  Janet Williams is senior manager of physician and health system engagement at the American Medical Association.  She has more than 30 years public health program and policy development experience.   She manages the AMA’s prediabetes initiative to develop and test clinical tools and resources for engaging health systems, clinicians and health departments in diabetes prevention.

New Alzheimer’s Association Continuing Medical Education (CME) Course Now Available
The Alzheimer’s Association is offering Challenging Conversations about Dementia, a free five-module online CME course intended to meet the educational needs of primary care clinicians — including internists, family physicians, nurse practitioners and physician assistants — who are seeking additional education in the assessment, diagnosis and ongoing health care of patients with cognitive impairment and dementia.

The course takes approximately 75 minutes and upon completion, participants will be able to:

    • Recognize the signs indicative of dementia and mild cognitive impairment versus normal aging.
    • Identify and explain the benefits of early detection and diagnosis of mild cognitive impairment and/or dementia.
    • Discuss next steps in the diagnostic process with patients who fail a cognitive screen in a clinical setting and prompt them to complete the process.
    • Evaluate the behavioral, safety and functional needs of patients with AD as part of the care planning process.

  • Assess patients’ fitness to drive.

CLASSIFIEDS


Saratoga Springs, NY – Professional Office Space for Lease
Medically oriented building currently occupied by five parties.  The Suite, Suite 700, has 2904 sq. ft., second floor (elevator), excellent off-road parking with drive-thru patient portico in a well maintained and attractive building close to the local hospital.
The lease area has a large waiting room, administrative rooms, lunch room, four examining rooms, one procedure room and one for storage.  Separate staff entrance.  Attractively priced without triple net obligations.  $4,500/month + heat + utilities.  Call Lauren regarding Suite 700 at (518) 587-2020.


Riverdale Medical Office for Sale – Prime Location
Co-op with private entrance features 2 exam rooms, lab, office & bathroom. Must see! Call 718-230-7069

Medical Family Practice For Sale – Long Beach, NY
Established 14 years. Newly renovated. Fully equipped ground floor premises. 3 exam rooms. Must see! Call Carol – 516-238-3422


For Rent or Share – Woodbury, Long Island
Beautiful recently renovated Plastic Surgery office available for part-time share and AAAA-certified (by end of summer). OR available for rent. Centrally located
on Long Island.Close to expressways. 3 exam rooms, 1 procedure room /OR.
Waiting room, break room and personal office. Free WIFI. Available for full or half-days. Suits Plastic/Cosmetic Surgeons/Derm/ENT/
ObGyn/Podiatry or other Medical MDs.
Contact Patricia at info@cosmetichg.com
or 631-318-4008

Want to Sell Your Medical Practice? Do You Have Medical Office Space to Sell or Share?
Clineeds is a new online platform designed to help medical providers sell their practice or buy, sell and share medical office space. Listing is FREE! No contracts. No commitments. No fees. Sign up today at  http://www.clineeds.com/sign-up

PHYSICIAN OPPORTUNITIES


Medical Director – AIDS Institute
Minimum Qualifications:
Current license and registration to practice medicine in New York State and board certification AND either a Master’s Degree in Public Health or two years of experience in an HIV program or public health program.Preferred Qualifications:
Master’s Degree in in Public Health.  Five years of experience including clinical service in an HIV program or clinical fellowship program (infectious diseases/HIV medicine).  Experience in quality management/quality improvement.  Knowledge of the HIV health care delivery system in New York State. Experience in/knowledge of the New York State Ending the Epidemic initiative.  Experience in STD prevention and care, drug user health, and/or LGBT health.  Experience in health policy development, analysis and evaluation.  Experience with evolving health information technologies.  Experience in health program management and administration.
Responsibilities: The Medical Director, AIDS Institute, plays a significant role in shaping HIV, hepatitis C, and STD care and services, drug user health, and LGBT health care throughout New York State.Please click the link below for more information pertaining to this position and to apply: “https://careers-healthresearch.icims.com/jobs/3742/medical-director—aids-institute/job” Affirmative Action/Equal Opportunity Employer/Qualified Individuals with Disabilities/Qualified Protected Veterans

Multiple Physician Positions with DOHMH Office of School Health
Office of School Health is the largest program of the New York City Department of Health and Mental Hygiene (DOHMH). This bureau is responsible for managing the health issues and promoting the well-being of the over 1.3 million children and adolescents enrolled in New York City’s 1700 school buildings.

Positions with the Office of School Health (OSH) combine clinical skills and public health training.

Adolescent School Health Physician
This position offers to the interested physician the opportunity to help address the clinical and public health needs of adolescents in NYC high schools. The physician will work with the innovative Connecting Adolescents to Comprehensive Health Care (CATCH) Program, which provides select reproductive health services to adolescents in select NYC high schools. In addition, the physician will provide medical care and public health services through additional programs offered to adolescents by the Office of School Health.

Under the supervision of the High School Supervising Physician, the Adolescent School Health Physician’s responsibilities will include but are not limited to:

  • Provide CATCH reproductive health services in select high schools.
  • Perform mandated physical examinations (New Admission Exams, Sports Physicals, and Working Paper Physicals).
  • Function as a liaison for students with community health providers to resolve medical issues that affect school performance.
  • Support the development and implementation of initiatives that promote positive health behaviors and reduce high risk behaviors in the adolescent population.
  • Serve as a consultant to the school nurse and administration on school related health concerns.
  • Provide clinical assistance in the event of an environmental or communicable disease occurrence.
  • Function as a liaison for students with community health providers to resolve medical issues that affect school performance.
  • Support all medical initiatives established by the Office of School Health, e.g. programs and protocols in asthma, reproductive health, obesity and diabetes.
  • Maintain good public relations and communicate effectively within the school community and community-based organizations.
  • Keep abreast of health management policy statements and emerging clinical research related to school health.
  • Participate in OSH research activities.
  • Work within the mandates, policies and protocols of the Office of School Health.
  • Attend all mandated DOHMH and OSH trainings.

To Apply: Please email your resume and cover letter to Dr. Caroline Volel: osh@health.nyc.gov OR  Apply online at https://a127-jobs.nyc.gov/.  In the Job ID search bar, enter: job ID number # 277208. 

School Health Field Physician
Under the direction of the Supervising Physician, the School Health Physician’s will:

  • Improve the health of school children through case management of chronic disease, preventive health screening and counseling, health education, and referrals.
  • Perform mandated physical examination (new entrant, sport physical, working paper physicals.
  • Develop relationships with community health providers in order to optimize medical management of students with health issues.
  • Attend to the health needs of your assigned school community.
  • Utilize the Automated Student Health Record (ASHR) to maintain adequate student health records.
  • Serve as a consultant to the school nurse and administration on school related health concerns.
  • Support the development of school educational and prevention programs promoting the health and wellness of all students.
  • Provide clinical assistance in the event of an environmental or communicable disease occurrence.
  • Develop and maintain professional relationships within the school community.
  • Support all medical initiatives put forth by the Office of School Health, e.g. Asthma, Reproductive health, Obesity and Diabetes initiatives.
  • Provide trainings/presentations to school staff, community organizations, or parents.
  • Stay abreast of health management policy statements and emerging research within the health community related to school health.
  • Participate in School Health research and quality improvement activities.
  • Participate in all mandated DOHMH and Office of School Health trainings and professional development sessions.
  • Attend all program meetings and Continuing Medical Education classes provided by the Office of School Health.

To Apply: Please email your resume and cover letter to Dr. Caroline Volel:osh@health.nyc.gov OR Apply online at https://a127-jobs.nyc.gov/.  In the Job ID search bar, enter: job ID number # 279844. 

Supervising School Health Physician 
Job Description
Under the supervision of the Deputy Medical Director, the Supervising Medical Doctor’s responsibilities will include but not be limited to:

  • Supervise School Health Physicians.
  • Work within the mandates, policies and protocols of the Office of School Health (OSH).
  • Attend to the health needs of a designated school community.
  • Utilize the Automated Student Health Record (ASHR) to maintain accurate student health records.
  • Serve as a consultant to the school nurse and school administrative staff regarding school related health concerns.
  • Support the development of school educational and prevention programs promoting the health and wellness of students.
  • Participate in policy development and revisions as indicated.
  • Provide clinical assistance in the event of an environmental or communicable disease occurrence.
  • Function as a liaison for students with community health providers to resolve health issues that affect school functioning.
  • Develop and maintain professional relationships within the school community and the community at large.
  • Support all medical initiatives put forth by the Office of School Health, e.g. Asthma, Reproductive health, Obesity and Diabetes Initiatives.
  • Keep abreast of health management policy statements and emerging research within the health community affecting school health.
  • Assist with or provide trainings/presentations to school health physicians, nurses, school staff, community organizations or parents
  • Participate in School Health research and quality improvement activities
  • Participate in all mandated DOHMH and Office of School Health trainings and professional development sessions
  • Attend all program meetings and Continuing Medical Education classes provided by the Office of School Health.


To Apply: Please email your resume and cover letter to Dr. Caroline Volel: osh@health.nyc.gov  OR  Apply online at https://a127-jobs.nyc.gov/.  In the Job ID search bar, enter: job ID number # 277026


CALL FOR RATES & INFO. CHRISTINA SOUTHARD: 516-488-6100 ext. 355


Council November 2, 2017

AGENDA
MSSNY Council Meeting
Thursday, November 2, 2017
Courtyard Marriott
1800 Privado Road
Westbury, NY  11590

A.   Call to Order and Roll Call

B.   Approval of the Council Minutes of September 14, 2017

C.   New Business (All New Action & Informational Items)

1.  President’s Report:
a. Presidential Appointments to the 2018 Nominating
Committee (For Council Approval)
b. Physician Stress and Burnout Task Force
Survey Correlation Analysis Executive Summary
c. Hospital Medical Staff Initiative/Discussion

  1. Board of Trustees Report – Dr. Hamlin will present the report (handout)
  1. Secretary’s Report –  Dr. Dowling will present the report for Nominations for Life Membership & Dues Remissions
  1. MLMIC Update –  Mr. Donald Fager, Esq. will present a verbal report
  1. AMA Delegation Update – Dr. Kennedy will present a verbal report
  1.  MSSNYPAC Report –   Dr. Sellers will present the report  (handout)
  1. MESF Foundation ReportThomas Donoghue, Executive Director
  1.  Councilors/Commissioners  (All Action Items,
    For Council Approval
    )
    Joshua M. Cohen, MD, MPH, Councilor
    (a) New York County Medical Society submitted the following three Action Items:
  1. That the Medical Society of the State of New York (MSSNY) endorse the candidacy of MSSNY/New York County Medical Society Member Stuart Gitlow, MD for a seat on The Board of Trustees of the American Medical Association (AMA) in the upcoming AMA Election.
  2. That the Medical Society of the State of New York Form a Task Force to Study Increasing Membership among Employed and Young Physicians to Encourage Their Active Participation in Membership.
  3. That the Medical Society of the State of New York Benchmark Successful Membership Projects with Other State Societies and Investigate a More Streamlined Vision of Projects (Reducing the Number of Issues MSSNY Tries to Cover by Instead Looking for a Big Win).

Commissioner of Governmental Relations,
           Gregory Pinto, MD, Commissioner

(b)    Legislative and Physician Advocacy Committee,
Paul A. Pipia, MD, Chair

  1. MSSNY’s 2018 Legislative Program
  2. Resolution 62 and 63 2017, New York State Healthcare Delivery System , MSSNY Support Single Payer Health Insurance
  3. Resolution 111-2017, Any Willing Provider with Universal Credentialing

D.   Presentation Introduction to the QPP/MIPS 
    Presented by IPRO Corporate Representatives:
    Mr. Theodore Will, MPA – Chief Executive Officer
    Clare B. Bradley, MD, MPH
    Senior Vice President,  Chief Medical Officer
    Patricia Gagliano, MD – Vice President,
    Health Care Quality Improvement

E.  Reports of Officers
  1. Office of the President- Charles Rothberg, MD
 Meetings attended:

  • MSSNY CME Provider Conference
  • Kings County President’s Dinner
  • Connecticut Annual Meeting
  • Westchester Dinner
  • NYS County & Specialty Executive Director Conference
  • Meeting at Stony Brook Hospital w/Dr. Kaushansky
  • Brookhaven Hospital Gala
  • Legislative & Physician Advocacy Teleconference
  • MESF Leadership Conference
  • Bronx County Gala
  • NY/NJSIPP Meeting
  • Fifth & Sixth District Retreat
  • Queens County Gala – Honoring Dr. Penny Stern
  1. Office of the President-Elect – (Verbal Report)
    Thomas J. Madejski, MD
  2. Office of the Vice-President – (Verbal Report)
    Arthur C. Fougner, MD
  3. Office of the Treasurer – Joseph R. Sellers, MD, Financial Statement for the period 1/1/17 – 9/30/17
  4. Office of the Secretary – (Verbal Report)
    Frank G. Dowling, MD
  5.  Office of the Speaker
    Kira A. Geraci-Ciradullo, MD, MPH

F.   Reports of Councilors  (Informational)

      1.   Kings and Richmond Report – Parag H. Mehta, MD
      2.    Manhattan and Bronx Report
        Joshua M. Cohen, MD,  MPH
      3.   Nassau County Report – Paul A. Pipia, MD
      4.   Queens County Report – Saulius J. Skeivys, MD
      5.   Suffolk County Report – Maria A. Basile, MD, MBA
      6.  Third District Branch Report – Brian P. Murray, MD
      7.   Fourth District Branch Report
        John J. Kennedy, MD
      8.   Fifth District Branch Report –Howard H. Huang, MD
      9.   Sixth District Branch Report – Robert A. Hesson, MD
      10.  Seventh District Branch Report 
        Janine L. Fogarty, MD
      11. Eighth District Branch Report
        Edward Kelly Bartels, MD
      12.   Ninth District Branch Report  – Thomas T. Lee, MD
      13.  Medical Student Section Report – Pratistha Koirala
      14.  Organized Medical Staff Section Report
        Bonnie L.Litvack, MD
        (no written report submitted)
      15. Resident and Fellow Section Report
        Justin Fuehrer, DO
      16.  Young Physician Section Report –
        L. Carlos Zapata, MD  (no written report submitted)

      G. Commissioners (Committee Informational
                   Reports/Minutes
      )

      1.Commissioner of Communications,
      Maria A. Basile, MD, MBA
      a. Report of the Division of Communications

      2. Commissioner of Governmental Relations,
      Gregory Pinto, MD
      a. MSSNY-HCA Task Force Minutes
      b. MSSNY HIT Minutes (includes DOH Power Point)

      3. Commissioner of Medical Education,
           Mark J. Adams, MD
      a. CME Report

      4. Commissioner of Membership, Parag H. Mehta, MD
      (No written report submitted)
      5. Commissioner of Science and Public Health,
                 Frank G. Dowling, MD (No written report submitted)

      H.  Report of the Executive Vice President –
                    Philip A. Schuh, CPA, MS
      1. Membership Dues Revenue Schedule
      2. Group Institutional Dues Schedule

      I.   Report of the General Counsel,
        Barry Cepelewicz, MD, Esq. (Verbal Report)

      J.  Report of the Alliance  Helena Mirza, Co-President
      Alliance Report

      K. Other Information/Announcements
      1.  AMA Letter to President Trump re:
      Interim Opioid Crisis
      2.  Final Sign-on AMA MACRA Letter
      3.  Coalition of State Medical Societies Letter – Asking
      Congress to fully fund the Children’s Health Insurance
      Program (CHIP)

      4.  Final Sign-on PAMA Letter

      L.  Adjournment

October 20, 2017 – MSSNY’s New Law Firm

Charles Rothberg, MD - MSSNY President
PRESIDENT’S MESSAGE

Charles Rothberg, MD

October 20, 2017
Volume 17
Number 40

Dear Colleagues:

I am very excited to announce that the Medical Society State of New York has entered into an agreement with the law firm of Garfunkel Wild P.C. to represent MSSNY as general counsel. Specializing in health care law, they maintain offices in Great Neck (Long Island) and Albany.  In fact, the Albany offices are managed by three partners that have extensive high-level backgrounds within the regulatory and administrative services of the State government. Therefore, all MSSNY members will have access to legal services on a statewide basis.

With over 80 attorneys, Garfunkel Wild will be able to serve all of our members’ needs from medical school to retirement. As part of our agreement, MSSNY members, if eligible, will receive a discount on regular billing rates. 

Our new relationship partners for MSSNY and its members are Barry B. Cepelewicz, M.D., Esq. at 516-393-2579 bcepelewicz@garfunkelwild.com and Andrew E. Blustein, Esq. (516-393-2218; ablustein@garfunkelwild.com. The firm website is at www.garfunkelwild.com.

Garfunkel Wild can help our members negotiate, draft, and review all types of agreements, from employment contracts, wills, and real estate agreements, to shareholder and operating agreements, to managed care/third-party payor participation agreements, to billing and other vendor agreements.  Moreover, the firm’s attorneys can work with our physicians to develop, implement and supervise corporate compliance programs, to prepare for and defend against both routine and more complex audits, investigations, and reimbursement appeals, and to protect our licenses before professional licensing boards.

I look forward to a long-lasting relationship with our new law firm. This is a premier MSSNY member benefit.

It is important to know that we have a firm with decades of health care experience to walk beside us in our good times and times of need.

Sincerely,

Charles Rothberg, MD
MSSNY President

Please send your comments to comments@mssny.org


enews large

Albany Radiologist to Albany T-U: Date of Discovery Bill Could Harm Medicine in NY
Albany radiologist and MSSNY member Dr. Robert Rapaport had a commentary published in the Albany Times-Union  this week urging that Governor Cuomo veto legislation (S.6800/A.8516) passed in the waning hours of the Legislative Session that would significantly expand the time to bring a medical malpractice lawsuit, in circumstances based upon an “alleged negligent failure to diagnose a malignant tumor or cancer”.   If signed into law it would likely prompt a double digit increase in physician and hospital malpractice premiums.

Physicians are urged to continue to contact Governor Cuomo to request that the bill be vetoed, and to instead work for comprehensive medical liability reform. You can send a letter here and call 518-474-8390.

Dr. Rapaport’s letter noted that the bill would “do nothing to improve the identification or treatment of cancer,” but would instead “encourage physicians to leave the state, discourage radiologists from working in the field of mammography, and reduce women’s access to breast cancer screening.”

A Letter to the Editor from MSSNY President Dr. Charles Rothberg urging a veto was also recently published in the Albany Times-Union (letter).  Numerous other letters from regional and statewide physician leaders have appeared in papers across the State urging a veto including the following:  

While many physicians have weighed in, we need an overwhelming demonstration from physicians regarding how this bill will harm access to care in their communities if this bill is signed into law without also providing needed tort reforms to bring down the exorbitant costs of medical liability insurance in New York. This bill is also being strongly opposed by several other medical liability insurers including MLMIC, as well as the Healthcare Association of New York State, the Greater New York Hospital Association and the Lawsuit Reform Alliance of New York.

Urge the Governor to Include E-Cigarettes Under Clean Indoor Air Act
Legislation that would require E-cigarettes be included in the Clean Indoor Air Act is now before Governor Cuomo for his consideration. Physicians are urged to send a letter to him in support of this measure (S.2543A/A.516A), by clicking here  sponsored by Senator Kemp Hannon and Assemblywoman Linda Rosenthal, the bill includes vaping in the definition of smoking, along with the use of e-cigarettes.  It would place the same restrictions on e-cigarettes that already exist on tobacco products under the Clean Indoor Air Act.  MSSNY supports this legislation and urges that it be signed into law.

Electronic cigarettes, commonly known as e-cigarettes, are electronic devices that deliver nicotine to the user.  People are being placed at risk because of the lack of information regarding the chemical makeup of liquid nicotine or the risk to individuals from inhaling the water vapor either directly or through secondhand exposure. Testing done by the FDA shows that electronic cigarettes can be dangerous because users inhale carcinogens and toxic chemicals, such as diethylene glycol, an ingredient found in antifreeze.  Recent studies have suggested that e-cigarettes may contain more carcinogens than traditional cigarettes, in some instances ten times the carcinogens of traditional cigarettes.

NY Health Works Conducting Survey on Medication Switching
Please Complete Survey to Document Problems of Mid-Year Prescription Formulary Changes
MSSNY has been working collaboratively with several patient advocacy groups to support legislation (A.2317, People-Stokes/S.5022-A, Serino) that would prohibit health insurers from moving a drug to a higher-cost tier or removing a prescription drug from a formulary during a policy year.  To help facilitate advocacy in support of this legislation, the group New York Health Works has developed a survey to enable physicians and patients to better document the full extent of this problem.  To respond to the survey, click here.


Promo Code: MSSNY


MSSNY Physician Leaders Participate in Regulatory Modernization Discussions
Several MSSNY physician leaders have been participating in NYS Department of Health Regulatory Modernization Workgroup meetings since the summer.   In response to the changing dynamics in health care delivery, including emerging technologies are allowing for new models of consumer-driven care; and medical advances facilitating a shift towards ambulatory models, these workgroups have examined existing laws, regulations, and policies and make recommendations to assure New York’s regulatory structure reflects these changing dynamics.

This week, past MSSNY Councilor and Brooklyn cardiologist Dr. Robert Frankel and past Albany County Medical Society President and Albany Medical Center Hospital General Director Dr. Fred Venditti participated in a meeting of the Cardiac Need Methodology Workgroup.  Last week, MSSNYSecretary and Suffolk County psychiatrist Dr. Frank Dowling participated in a meeting of the Integrated Primary Care and Behavioral Health Workgroup.  In previous weeks, Richmond County President and internist Dr. Sal Volpe participated in a meeting of the Telehealth Workgroup.

Columbia Dept. of Psychiatry Conference Oct 28-29: “Healing Unexplainable Pain”
The Department of Psychiatry at Columbia University Medical Center & Office of Mental Health of the State of New York present 3rd Columbia Psychosomatics Conference: Healing Unexplainable Pain. Advances in Psychotherapeutic Treatments for Persistent Somatic Distress: Towards Reversing Effects of Early Interpersonal Adversity on the Body will feature lectures lectures and workshops by world experts in research and treatment of psychosomatic disorders. Conference Chairs: Alla Landa, PhD, Harald Gündel, MD, Brian A. Fallon, MD, Philip R. Muskin, MD

When: October 28 – October 29, 2017
Where: New York State Psychiatric Institute at Columbia University Medical Center, 1051 Riverside Drive, NY NY

Advanced registration is encouraged as the number of seats is limited! For more information, complete program and to register please go here.

The Bureau of Psychiatric Services & Research Institute Support (BPSRIS) is accredited by the Medical Society of the State of New York (MSSNY) to provide continuing medical education for physicians. The Bureau of Psychiatric Services & Research Institute Support (BPSRIS) designates this live activity for a maximum of 13.75 AMA PRA Category 1 Credits TM.  Physicians should claim only the credit commensurate with the extent of their participation in the activity


Your membership yields results and will continue to do so. When your 2018 invoice arrives, please renew. KEEP MSSNY STRONG!


NYC Commissioner Bassett:  Lack of Vaccinations Causing Oral HPV
Dr. Mary T. Bassett, commissioner of health for New York City, writes at CNN (10/19), about the recent study finding “an estimated 11 million men in America have oral HPV infections and 7 million men have the high-risk type of HPV that can cause cancers of the mouth and throat.”

She says the reason for this is that people are not being vaccinated, and attributes that to “the health care provider who must recommend it, and the parent who must accept it.” She urges health professionals to “call the vaccine what it is: a vaccine against cancer.” Regarding those already infected, she adds, “early diagnosis and behavioral changes are critical” though “there are no FDA-approved oral HPV tests.” Research published in the Annals of Internal Medicine indicated “11 million men and 3.2 million women in the” US have “oral HPV infections.” Among these individuals, “7 million men and 1.4 million women” have “strains that can cause cancers of the throat, tongue and other areas of the head and neck.”

NY AG Schneiderman Sues Trump Administration to Protect ACA Subsidies
New York Attorney General Eric Schneiderman and 18 other attorneys general filed a lawsuit October 13 arguing that the federal government is required to continue making cost-sharing reduction payments to insurers. The attorneys general argue in the lawsuit, filed in U.S. District Court for the Northern District of California, that the executive branch has “both the authority and the obligation” to make the payments, which help offset copays and deductibles for lower-income people getting coverage on the Affordable Care Act marketplaces. “The loss of funds and financial uncertainty caused by their actions will lead to higher health insurance costs for consumers and to insurers abandoning the individual health insurance market,” the plaintiffs wrote of the Trump administration in the complaint.

The lawsuit followed President Donald Trump’s directives late last week rolling back the Affordable Care Act subsidies and opening the door for businesses to buy health insurance across state lines. State officials warned such actions would destabilize New York’s insurance exchange and create gaps in the state budget.

“I will not allow President Trump to once again use New York families as political pawns in his dangerous, partisan campaign to eviscerate the Affordable Care Act at any cost,” Schneiderman said in a statement.

New York State receives about $870 million to finance the Essential Plan for low income families.

CVS Health and Epic Announce Initiative to Help Lower Drug Costs for Patients
On October 16, CVS Health and Epic today announced a strategic initiative to help lower drug costs for patients by providing prescribers with expanded visibility to lower cost alternatives through enhanced analytics and data sharing. CVS Health will use Epic’s Healthy Planet population health and analytics platform to generate insights surrounding dispensing patterns and behaviors around medication adherence.

The collaboration will bolster prescription decision-making for patients and their physicians, pharmacists and health insurers. Real-time benefit information and facilitated, point-of-prescribing electronic prior authorization will help improve and simplify patient access to necessary medications and ensure their prescribers are aware of prescription insurance formulary status and less expensive alternatives as appropriate. CVS Health currently works with Epic, the most widely used EHR.

MSSNYPAC Physician Family Halloween Party in Staten Island October 29
You’re invited to the home of John Maese, MD & Donna Seminara, MD, for a physician family Halloween party to benefit MSSNYPAC.  Suggested contribution is $175 per family, $10 for medical students and $50 for residents.  Please also consider joining MSSNY’s Councilor’s Club or President’s Circle. Please visit www.mssnypac.org/events to RSVP or learn more.  Location is in Staten Island NY and address to be provided prior to event.

Tip of the Week
By Jacqueline Thelian, CPC, CPC-I, CHCA, Medco Consultants, Inc.

Q:  Is it true I now have to be credentialed with straight Medicaid to remain participating with a Medicaid HMO Plan?

A. This is not only an excellent question but a timely one as well. In the past you were not required to have a Medicaid number to become credentialed with a Medicaid HMO plan such as Healthfirst or Metro Plus. Effective January 1, 2018, Federal law requires that all Medicaid Managed Care and Children´s Health Insurance Program network providers be enrolled with New York State (NYS) Medicaid programs.

For example, if a physician currently participates in a network with a Medicaid managed care plan that provides services to, or orders, prescribes, or certifies eligibility for services for, individuals who are eligible for medical assistance, the physician must enroll with New York State Medicaid.” Physician’s application must be received by CSRA, the Medicaid fiscal agent, by December 1, 2017 or you may be removed from the network. It is important to note enrollment in Medicaid is required to maintain credentialing status with Medicaid HMO plans even if you don’t accept straight Medicaid patients.
Source: https://www.health.ny.gov/health_care/medicaid/program/update/2017/2017-05.htm#requirement

If you have a coding or compliance question you would like to have answered please send your question to MSSNY at eskelly@mssny.org, and complete the subject line with Tip of the Week.

SEMINARS

Want to Learn More About New York’s New Step Therapy Patient Protections?

Join Us for a 10/25 Mid-Day Webinar

This Wednesday October 25, from 12:30-1:15, please join MSSNY President-elect Thomas Madejski, and MSSNY Senior VP Moe Auster in an educational webinar organized by the National Psoriasis Foundation (NPF) discussing New York’s new step therapy medication patient protections. To register for the webinar, click here.

While the new requirements on health insurers has been phased in this year, it will become effective for all New York-regulated health insurance plans, including Medicaid Managed Care plans, on January 1, 2018.  The law requires a health insurer to grant a physician’s override request of an insurer step therapy protocol for their patient if the physician can demonstrate that the drug required by the protocol is contraindicated, likely to be ineffective, or if the patient is stable on the medication requested by the physician.

If the physician’s request for an override of the step therapy protocol is denied, the new law would better enable a physician to formally appeal the decision both within the plan’s existing appeal mechanism as well as taking an external appeal.   MSSNY worked together with several other specialty society and patient advocacy organizations to advocate in support of this new law.


CLASSIFIEDS

Riverdale Medical Office for Sale – Prime Location
Co-op with private entrance features 2 exam rooms, lab, office & bathroom. Must see! Call 718-230-7069

Medical Family Practice For Sale – Long Beach, NY
Established 14 years. Newly renovated. Fully equipped ground floor premises. 3 exam rooms. Must see! Call Carol – 516-238-3422


For Rent or Share – Woodbury, Long Island
Beautiful recently renovated Plastic Surgery
office available for part-time share and
AAAA-certified (by end of summer).
OR available for rent. Centrally located
on Long Island.Close to expressways.
3 exam rooms, 1 procedure room /OR.
Waiting room, break room and personal office.
Free WIFI. Available for full or half-days.
Suits Plastic/Cosmetic Surgeons/Derm/ENT/
ObGyn/Podiatry or other Medical MDs.
Contact Patricia at info@cosmetichg.com
or 631-318-4008

Want to Sell Your Medical Practice? Do You Have Medical Office Space to Sell or Share?
Clineeds is a new online platform designed to help medical providers sell their practice or buy, sell and share medical office space. Listing is FREE! No contracts. No commitments. No fees. Sign up today at  http://www.clineeds.com/sign-up

PHYSICIAN OPPORTUNITIES


Medical Director – AIDS Institute
Minimum Qualifications:
Current license and registration to practice medicine in New York State and board certification AND either a Master’s Degree in Public Health or two years of experience in an HIV program or public health program.Preferred Qualifications:
Master’s Degree in in Public Health.  Five years of experience including clinical service in an HIV program or clinical fellowship program (infectious diseases/HIV medicine).  Experience in quality management/quality improvement.  Knowledge of the HIV health care delivery system in New York State. Experience in/knowledge of the New York State Ending the Epidemic initiative.  Experience in STD prevention and care, drug user health, and/or LGBT health.  Experience in health policy development, analysis and evaluation.  Experience with evolving health information technologies.  Experience in health program management and administration.
Responsibilities: The Medical Director, AIDS Institute, plays a significant role in shaping HIV, hepatitis C, and STD care and services, drug user health, and LGBT health care throughout New York State.Please click the link below for more information pertaining to this position and to apply: “https://careers-healthresearch.icims.com/jobs/3742/medical-director—aids-institute/job” Affirmative Action/Equal Opportunity Employer/Qualified Individuals with Disabilities/Qualified Protected Veterans

Multiple Physician Positions with DOHMH Office of School Health
Office of School Health is the largest program of the New York City Department of Health and Mental Hygiene (DOHMH). This bureau is responsible for managing the health issues and promoting the well-being of the over 1.3 million children and adolescents enrolled in New York City’s 1700 school buildings.

Positions with the Office of School Health (OSH) combine clinical skills and public health training.

Adolescent School Health Physician
This position offers to the interested physician the opportunity to help address the clinical and public health needs of adolescents in NYC high schools. The physician will work with the innovative Connecting Adolescents to Comprehensive Health Care (CATCH) Program, which provides select reproductive health services to adolescents in select NYC high schools. In addition, the physician will provide medical care and public health services through additional programs offered to adolescents by the Office of School Health.

Under the supervision of the High School Supervising Physician, the Adolescent School Health Physician’s responsibilities will include but are not limited to:

  • Provide CATCH reproductive health services in select high schools.
  • Perform mandated physical examinations (New Admission Exams, Sports Physicals, and Working Paper Physicals).
  • Function as a liaison for students with community health providers to resolve medical issues that affect school performance.
  • Support the development and implementation of initiatives that promote positive health behaviors and reduce high risk behaviors in the adolescent population.
  • Serve as a consultant to the school nurse and administration on school related health concerns.
  • Provide clinical assistance in the event of an environmental or communicable disease occurrence.
  • Function as a liaison for students with community health providers to resolve medical issues that affect school performance.
  • Support all medical initiatives established by the Office of School Health, e.g. programs and protocols in asthma, reproductive health, obesity and diabetes.
  • Maintain good public relations and communicate effectively within the school community and community-based organizations.
  • Keep abreast of health management policy statements and emerging clinical research related to school health.
  • Participate in OSH research activities.
  • Work within the mandates, policies and protocols of the Office of School Health.
  • Attend all mandated DOHMH and OSH trainings.

To Apply: Please email your resume and cover letter to Dr. Caroline Volel: osh@health.nyc.gov OR  Apply online at https://a127-jobs.nyc.gov/.  In the Job ID search bar, enter: job ID number # 277208. 

School Health Field Physician
Under the direction of the Supervising Physician, the School Health Physician’s will:

  • Improve the health of school children through case management of chronic disease, preventive health screening and counseling, health education, and referrals.
  • Perform mandated physical examination (new entrant, sport physical, working paper physicals.
  • Develop relationships with community health providers in order to optimize medical management of students with health issues.
  • Attend to the health needs of your assigned school community.
  • Utilize the Automated Student Health Record (ASHR) to maintain adequate student health records.
  • Serve as a consultant to the school nurse and administration on school related health concerns.
  • Support the development of school educational and prevention programs promoting the health and wellness of all students.
  • Provide clinical assistance in the event of an environmental or communicable disease occurrence.
  • Develop and maintain professional relationships within the school community.
  • Support all medical initiatives put forth by the Office of School Health, e.g. Asthma, Reproductive health, Obesity and Diabetes initiatives.
  • Provide trainings/presentations to school staff, community organizations, or parents.
  • Stay abreast of health management policy statements and emerging research within the health community related to school health.
  • Participate in School Health research and quality improvement activities.
  • Participate in all mandated DOHMH and Office of School Health trainings and professional development sessions.
  • Attend all program meetings and Continuing Medical Education classes provided by the Office of School Health.

To Apply: Please email your resume and cover letter to Dr. Caroline Volel:osh@health.nyc.gov OR Apply online at https://a127-jobs.nyc.gov/.  In the Job ID search bar, enter: job ID number # 279844. 

Supervising School Health Physician 
Job Description
Under the supervision of the Deputy Medical Director, the Supervising Medical Doctor’s responsibilities will include but not be limited to:

  • Supervise School Health Physicians.
  • Work within the mandates, policies and protocols of the Office of School Health (OSH).
  • Attend to the health needs of a designated school community.
  • Utilize the Automated Student Health Record (ASHR) to maintain accurate student health records.
  • Serve as a consultant to the school nurse and school administrative staff regarding school related health concerns.
  • Support the development of school educational and prevention programs promoting the health and wellness of students.
  • Participate in policy development and revisions as indicated.
  • Provide clinical assistance in the event of an environmental or communicable disease occurrence.
  • Function as a liaison for students with community health providers to resolve health issues that affect school functioning.
  • Develop and maintain professional relationships within the school community and the community at large.
  • Support all medical initiatives put forth by the Office of School Health, e.g. Asthma, Reproductive health, Obesity and Diabetes Initiatives.
  • Keep abreast of health management policy statements and emerging research within the health community affecting school health.
  • Assist with or provide trainings/presentations to school health physicians, nurses, school staff, community organizations or parents
  • Participate in School Health research and quality improvement activities
  • Participate in all mandated DOHMH and Office of School Health trainings and professional development sessions
  • Attend all program meetings and Continuing Medical Education classes provided by the Office of School Health.


To Apply: Please email your resume and cover letter to Dr. Caroline Volel: osh@health.nyc.gov  OR  Apply online at https://a127-jobs.nyc.gov/.  In the Job ID search bar, enter: job ID number # 277026


CALL FOR RATES & INFO. CHRISTINA SOUTHARD: 516-488-6100 ext. 355


October 13, 2017 – Executive Order Concerns

Charles Rothberg, MD - MSSNY President
PRESIDENT’S MESSAGE
Charles Rothberg, MD
October 13, 2017
Volume 17
Number 39

Dear Colleagues:

Yesterday, when we received news regarding President Trump’s Executive Order, we responded quickly about how this may impact our patients. My statements were picked up by today’s Newsday and Politico. My full press statement is as follows: 

“The Medical Society of the State of New York is still assessing the full impact of the President’s Executive Order, and we have many questions regarding how this will be implemented.  We are generally very supportive of efforts to increase the availability of affordable insurance options for our patients. At the same time, we are also very concerned about the possibility that the expanded use of Association Health Plans (AHPs) could remove oversight of health insurance plans away from state governments. Specifically, we are concerned that it could result in more consumers purchasing plans with even more exorbitant out of pocket costs, fewer choices of physicians and a reduction in the ability of patients and physicians to enforce provisions of a health insurance contract.  Of greatest concern, it very well could result in increased costs for those consumers who remain in New York’s health insurance market due to potential adverse selection by these AHPs.”

Opportunity to Donate Your Time and Skill to Hurricane-Ravaged Puerto Rico

MSSNY is continuing to look for ways for physicians to participate in efforts to help repair the hurricane-ravaged medical system in Puerto Rico. We have information to share regarding an opportunity for physicians to donate their time, talent and medical supplies to the relief effort.

Dr. Jodie G. Roure, JD, PhD, a tenured Associate Professor of human rights at John Jay College of Criminal Justice-City University of New York, is coordinating a hurricane relief effort to Puerto Rico.  Dr. Roure is recruiting physicians and nurses to volunteer in Puerto Rico. She is also collecting donations of medications and medical supplies (including oral and topical antibiotics, insulin and GI medications).

Dr. Roure is working with Dr. Jose Joaquin Vargas, who is charged by the Puerto Rican government with heading and coordinating the medical relief efforts, and Attorney Fernando Alarcon, Special Assistant to the President of the Puerto Rican Senate of Puerto Rico for Public Health and Governmental Issues.

Dr. Vargas and Special Assistant Alarcon have developed a protocol regarding medical malpractice and liability and the ability to practice medicine in Puerto Rico without a Puerto Rico license.  Medical malpractice will be covered by the state insurance accreditation after proper registration of each doctor.

Dr. Vargas estimates he will be needing volunteers for the next three to four months. The first trip will depart on JetBlue from JFK NYC airport tomorrow. We will keep you posted as to when the next missions are departing. The government will provide ground transportation and accommodations when the medical personnel arrive in Puerto Rico.

For more information, please contact Prof. Jodie Roure, Latin American Studies Department, John Jay College, NY, NY 10019 (787) 400-2337.

There are other ways to join in the recovery. I encourage you to join me in supporting the work of the MESF with a generous contribution to assist the physicians affected by the storm.

All donations are tax deductible.

Thank you for helping us to help others.

Sincerely,

Charles Rothberg, MD
MSSNY President

Please send your comments to comments@mssny.org


enews large

Urge Congress to Extend CHIP Funding: Contact your Federal Legislators Today
Over 350,000 New York Children are covered through its Child Insurance Program, which receives a substantial portion of its funding from Congress. However, the authorization to provide funding to the states for this essential program expired on September 30. While the Senate and House have each advanced separate bills to continue this program, an agreement remains elusive.

Governor Cuomo on Wednesday warned that inaction by Congress has jeopardized health care for the 350,000 New York children covered under the program and urged an extension of Child Health Funding. Last week, MSSNY and other Health Provider groups sent a letter to Congress urging them to not allow CHIP funding and insurance subsidies to expire.   This week, MSSNY joined the medical societies of Arizona, California, Florida, Louisiana, New Jersey, North Carolina, Oklahoma, South Carolina, Texas in a letter to Congressional leaders urging that legislation be enacted to extend CHIP funding for 5 years.

Please urge our Representatives and Senators to put aside partisan differences and reach an agreement to continue this important funding.  You can contact your federal legislators here.

MedPAC Recommends MIPS Repeal and Replacement with Different VBP Program
Noting that the newly implemented Medicare Merit-Based Incentive Payment System (MIPS) is “extremely complex” and imposes a “$1 billion reporting burden” on physicians and other health care providers, the Medicare Payment Advisory Commission (MedPAC) has recommended that Congress repeal the program.

In lieu of MIPS, MedPAC recommended a different program by which a portion of payments (such as 2%) would be withheld. Clinicians not in an advanced payment model (APM) could join a group of physicians whose claims data is reviewed on certain population-based health measures to see if they qualify to have the withheld funds returned. Clinicians who do not participate in an APM or the new model would forfeit the withheld portion.

MedPAC’s recommendations are not binding on Congress, but sometimes help shape the debate around a particular issue.

Among the concerns articulated by MedPAC is that the program is designed primarily to measure how doctors perform, such as whether they ordered appropriate tests or followed general clinical guidelines, rather than if patient care was ultimately improved by that provider’s actions.

The MIPS program became effective at the start of 2017 and will impact Medicare payments starting in 2019.  Last year, CMS adopted provisions that provided that physicians could avoid Medicare penalties in 2019 if they reported one quality measure or one clinical improvement activity during 2017.

Based upon 2018 performance, however, those not exempted from MIPS participation (if they see 200 or more Medicare patients or have more than $90,000 in Medicare charges) could see their Medicare payments shifted up or down 5% in 2020 based upon how their performance in reporting quality measures, use of EHR and clinical improvement activities compares with other physicians.

Earlier this year, the MSSNY House of Delegates passed a resolution calling upon MSSNY to work with the AMA to advocate to repeal the law that conditions a portion of payment on compliance with the MIPS and APM program, while simultaneously advocating to significantly reduce the administration burdens and penalties with the program.

For more information for how physicians can comply with the MIPS program, please visit the Physicians Advocacy Institute’s MACRA Resource Center.  MSSNY is a board member of the Physicians Advocacy Institute.

Legislation To Require E-cigarettes Be Included in Clean Indoor Air Act Before Governor for Signature
Legislation which would include that e-cigarettes is now before Governor Andrew Cuomo for his consideration and physicians are urged to send a letter to him in support of this measure.  S.2543A/A/516A, sponsored by Senator Kemp Hannon and Assemblywoman Linda Rosenthal, includes vaping in the definition of smoking, along with the use of electronic cigarettes or e-cigarettes.  It would place the same restrictions on e-cigarettes that already exist on tobacco products under the Clean Indoor Air Act.  The Medical Society of the State of New York supports this legislation and urges that it be signed into law.  Physicians are urged to send a letter by clicking here.

Electronic cigarettes, commonly known as e-cigarettes, are electronic devices that deliver nicotine to the user.  People are being placed at risk because of the lack of information regarding the chemical makeup of liquid nicotine or the risk to individuals from inhaling the water vapor either directly or through secondhand exposure.

Testing done by the FDA shows that electronic cigarettes can be dangerous because users inhale carcinogens and toxic chemicals, such as diethylene glycol, an ingredient found in antifreeze.  Recent studies have suggested that e-cigarettes may contain more carcinogens than traditional cigarettes, in some instances ten times the carcinogens of traditional cigarettes.



Promo Code: MSSNY


Medicaid Fee- for- Service Providers Dispense Brand Name Drug when Less Expensive than Generic Program
The latest update for Medicaid FFS providers dispensing brand name drugs when less expensive generic is available. Changes are effective October 19, 2017.

Please visit our website for additional, up-to-date information.

Drug Ads: Too Many Risks Dilutes Larger Risks to the Public
A Study http://go.nature.com/2xDr1Tt published in the journal Nature Human Behaviour found “that when a drug advertisement throws too many risks at you…the less risky a drug is perceived to be by a potential consumer” based on “a psychological phenomenon called ‘the dilution effect.’” The article says advertisements for medications “are required by the Food and Drug Administration to list their risks along with the drug’s benefits,” although “savvy marketers” may have found “that the more risks the commercial or print ad lists, the better for their brand because the smaller side effects dilute the larger risks.”

Make the Voices of Recovery Count in New York State
Friends of Recovery – New York (FOR-NY) needs your help in distributing the FOR-NY Life in Recovery Survey. The survey will help FOR-NY identify current needs, strengths and gaps in addiction and recovery services and supports for individuals and families in recovery.

The critical information we gather will help us pinpoint resources needed by individuals, families, friends and allies to the recovery community so we can make important recommendations to legislators and policy makers to improve the quality of addiction services and recovery supports provided to thousands of New Yorkers.

Survey takers should be at least one of the following:

  • A person in recovery
  • A family member of someone with an addiction
  • A family member who has lost someone to an addiction
  • A professional in the addiction/recovery field

For additional information, please contact Allison Weingarten FOR-NY Director of Policy, by email at aweingarten@for-ny.org or by phone at (518) 487-4395 X22.  

50 Days Left to Submit an Informal Review Request; Review PQRS Feedback Now
Your 2016 Physician Quality Reporting System (PQRS) feedback reports and 2016 Annual Quality and Resource Use Reports (QRURs) were released on September 18, 2017. The PQRS feedback reports show your program year 2016 PQRS reporting results, including if you are subject to the 2018 PQRS downward payment adjustment. The 2016 Annual QRURs show how physicians, physician assistants (PAs), nurse practitioners (NPs), clinical nurse specialists (CNSs), and certified registered nurse anesthetists (CRNAs) in groups and solo practitioners performed in 2016 on the quality and cost measures used to calculate the 2018 Value Modifier as well as their practice’s 2018 Value Modifier payment adjustment.

The payment adjustments shown in the reports are based on proposals that were included in the 2018 Medicare Physician Fee Schedule Proposed Rule (https://federalregister.gov/d/2017-14639). If the policies are not finalized as proposed, CMS will provide an update to report recipients.

Access and review your 2016 PQRS feedback report and 2016 Annual QRUR now to determine whether you are subject to the 2018 PQRS downward payment adjustment and your practice’s 2018 Value Modifier payment adjustment.

If you believe your payment adjustment status was made in error, you may request an informal review of your 2016 PQRS results and/or 2018 Value Modifier calculation during the informal review period from now until December 1, 2017 8:00 pm Eastern Time (ET). 

An Enterprise Identify Management (EIDM) account with the appropriate role is required for participants to obtain their 2016 PQRS Feedback Reports and 2016 Annual QRURs. Both reports can be accessed on the CMS Enterprise Portal using the same EIDM account. Visit the How to Obtain a QRUR webpage for instructions on accessing both reports.

To find out which reports are available for your practice and your current and past PQRS and Value Modifier payment adjustments, you can use the new Payment Adjustments and Reports Lookup feature on the CMS Enterprise Portal. An EIDM account is not needed to use this feature. Instructions for using this feature are located in the “Guide for Accessing the Payment Adjustment and Reports Lookup Feature”.

For more information on your PQRS feedback report:

For more information on your Annual QRUR:

For the 2016 reporting period, the majority of eligible professionals (EPs) successfully reported to PQRS and avoided the downward payment adjustment. CMS anticipates that successful trend to continue under the new Quality Payment Program. The Quality Payment Program began January 2017 and replaces PQRS, the Value Modifier program, as well as the separate payment adjustments under the Medicare Electronic Health Record (EHR) Incentive Program for EPs.

The Quality Payment Program streamlines these legacy programs, reduces quality reporting requirements and offers many flexibilities that allow eligible clinicians to pick their pace for participating in the first year. To prepare for success in the Quality Payment Program, we encourage EPs to review their PQRS feedback report, Annual QRUR, and visit qpp.cms.gov to learn about the Quality Payment Program.

Questions:

  • For assistance with Enterprise Identity Management or PQRS feedback reports, contact the QualityNet Help Desk at 866-288-8912 (TTY 877-715- 6222) or qnetsupport@hcqis.org.
  • For assistance with the QRURs or Value Modifier, contact the Physician Value Help Desk at pvhelpdesk@cms.hhs.gov or 888-734-6433 (select option 3).
  • Both Help Desks are available Monday through Friday from 7:00 a.m. to 7:00 p.m., Central Time.


Your membership yields results and will continue to do so. When your 2018 invoice arrives, please renew. KEEP MSSNY STRONG!


MSSNYPAC Physician Family Halloween Party in Staten Island October 29
You’re invited to the home of John Maese, MD & Donna Seminara, MD, for a physician family Halloween party to benefit MSSNYPAC.  Suggested contribution is $175 per family, $10 for medical students and $50 for residents.  Please also consider joining MSSNY’s Councilor’s Club or President’s Circle. Please visit www.mssnypac.org/events to RSVP or learn more. Location is in Staten Island NY and address to be provided prior to event.

Coding Tip of the Week
By Jacqueline Thelian, CPC, CPC-I, CHCA, Medco Consultants, Inc.

Q: What are the new NCCI edits for orthopedic codes?

A: As you know the National Correct Coding Initiative (NCCI) edits define pairs of CPT/HCPCS codes that should not be reported together for a variety of reasons.

The latest version of NCCI edits V23.3 effective October 1, 2017 targets shoulder procedures. Now CCI will bundle shoulder release code 23020 into arthroplasty 23470-23474 codes. This means it would be inappropriate to report the two codes for the same shoulder. You may however, unbundle and report them on the opposite shoulders.

Additionally, Chapter 4 of the NCCI edits state, “When a fracture or dislocation is repaired, only one fracture/dislocation repair code may be reported. Closed repair codes, percutaneous repair codes, and open repair codes for the same anatomic site are mutually exclusive of one another, and only one of these codes may be reported for the repair of a fracture or dislocation at an anatomic site.”

Once again separate billing would only be appropriate when these services are provided on opposite shoulders.

Source: CMS National Correct Coding Initiative Edits 

If you have a coding or compliance question you would like to have answered please send your question to MSSNY at eskelly@mssny.org, and complete the subject line with Tip of the Week.

The Importance of Herd Immunity” CME Webinar Oct. 18; Registration Still Open

The first of MSSNY’s 2018 Medical Matters continuing medical education (CME) webinar series is: “The Importance of Herd Immunity” on Wednesday, October 18, 2017 at 7:30 a.m.  William Valenti, MD, chair of MSSNY Infectious Disease Committee and a member of the Emergency Preparedness and Disaster/Terrorism Response Committee will serve as faculty for this program. Registration is now open for this webinar here.

Additional information or assistance with registration may be obtained by contacting Melissa Hoffman at mhoffman@mssny.org.

Educational objectives are:

  • Review the epidemiology of vaccine-preventable infectious disease and role of herd immunity.
  • Describe how herd immunity protects vulnerable populations such as newborns, the elderly and those who are too sick to be vaccinated.
  • Discuss the percentage(s) of a population who need to be vaccinated to allow herd immunity to be effective.

The Medical Society of the State of New York is accredited by the Accreditation Council for Continuing Medical Education (ACCME) to provide continuing medical education for physicians.

The Medical Society of the State of New York designates this live activity for a maximum of 1.0 AMA/PRA Category 1 credits™.  Physicians should claim only the credit commensurate with the extent of their participation in the activity



CLASSIFIEDS

Medical Family Practice For Sale – Long Beach, NY
Established 14 years. Newly renovated. Fully equipped ground floor premises. 3 exam rooms. Must see! Call Carol – 516-238-3422


Great Neck – Medical Zoned Condo
2690 Sqft – $699,000 – quick easy access to North Shore University Hospital, Long Island Expressway and Long Island Rail Road. 10 Exam rooms plus waiting room & large secretary area http://bit.ly/2wXCbkQ . Call Chris Pappas, LAB 516-659-6508


For Rent or Share – Woodbury, Long Island
Beautiful recently renovated Plastic Surgery
office available for part-time share and
AAAA-certified (by end of summer).
OR available for rent. Centrally located
on Long Island.Close to expressways.
3 exam rooms, 1 procedure room /OR.
Waiting room, break room and personal office.
Free WIFI. Available for full or half-days.
Suits Plastic/Cosmetic Surgeons/Derm/ENT/
ObGyn/Podiatry or other Medical MDs.
Contact Patricia at info@cosmetichg.com
or 631-318-4008

Want to Sell Your Medical Practice? Do You Have Medical Office Space to Sell or Share?
Clineeds is a new online platform designed to help medical providers sell their practice or buy, sell and share medical office space. Listing is FREE! No contracts. No commitments. No fees. Sign up today at http://www.clineeds.com/sign-up

PHYSICIAN OPPORTUNITIES


Multiple Physician Positions with DOHMH Office of School Health
Office of School Health is the largest program of the New York City Department of Health and Mental Hygiene (DOHMH). This bureau is responsible for managing the health issues and promoting the well-being of the over 1.3 million children and adolescents enrolled in New York City’s 1700 school buildings.

Positions with the Office of School Health (OSH) combine clinical skills and public health training.

Adolescent School Health Physician
This position offers to the interested physician the opportunity to help address the clinical and public health needs of adolescents in NYC high schools. The physician will work with the innovative Connecting Adolescents to Comprehensive Health Care (CATCH) Program, which provides select reproductive health services to adolescents in select NYC high schools. In addition, the physician will provide medical care and public health services through additional programs offered to adolescents by the Office of School Health.

Under the supervision of the High School Supervising Physician, the Adolescent School Health Physician’s responsibilities will include but are not limited to:

  • Provide CATCH reproductive health services in select high schools.
  • Perform mandated physical examinations (New Admission Exams, Sports Physicals, and Working Paper Physicals).
  • Function as a liaison for students with community health providers to resolve medical issues that affect school performance.
  • Support the development and implementation of initiatives that promote positive health behaviors and reduce high risk behaviors in the adolescent population.
  • Serve as a consultant to the school nurse and administration on school related health concerns.
  • Provide clinical assistance in the event of an environmental or communicable disease occurrence.
  • Function as a liaison for students with community health providers to resolve medical issues that affect school performance.
  • Support all medical initiatives established by the Office of School Health, e.g. programs and protocols in asthma, reproductive health, obesity and diabetes.
  • Maintain good public relations and communicate effectively within the school community and community-based organizations.
  • Keep abreast of health management policy statements and emerging clinical research related to school health.
  • Participate in OSH research activities.
  • Work within the mandates, policies and protocols of the Office of School Health.
  • Attend all mandated DOHMH and OSH trainings.

To Apply: Please email your resume and cover letter to Dr. Caroline Volel: osh@health.nyc.gov OR  Apply online at https://a127-jobs.nyc.gov/.  In the Job ID search bar, enter: job ID number # 277208. 

School Health Field Physician
Under the direction of the Supervising Physician, the School Health Physician’s will:

  • Improve the health of school children through case management of chronic disease, preventive health screening and counseling, health education, and referrals.
  • Perform mandated physical examination (new entrant, sport physical, working paper physicals.
  • Develop relationships with community health providers in order to optimize medical management of students with health issues.
  • Attend to the health needs of your assigned school community.
  • Utilize the Automated Student Health Record (ASHR) to maintain adequate student health records.
  • Serve as a consultant to the school nurse and administration on school related health concerns.
  • Support the development of school educational and prevention programs promoting the health and wellness of all students.
  • Provide clinical assistance in the event of an environmental or communicable disease occurrence.
  • Develop and maintain professional relationships within the school community.
  • Support all medical initiatives put forth by the Office of School Health, e.g. Asthma, Reproductive health, Obesity and Diabetes initiatives.
  • Provide trainings/presentations to school staff, community organizations, or parents.
  • Stay abreast of health management policy statements and emerging research within the health community related to school health.
  • Participate in School Health research and quality improvement activities.
  • Participate in all mandated DOHMH and Office of School Health trainings and professional development sessions.
  • Attend all program meetings and Continuing Medical Education classes provided by the Office of School Health.

To Apply: Please email your resume and cover letter to Dr. Caroline Volel:osh@health.nyc.gov OR Apply online at https://a127-jobs.nyc.gov/.  In the Job ID search bar, enter: job ID number # 279844. 

Supervising School Health Physician 
Job Description
Under the supervision of the Deputy Medical Director, the Supervising Medical Doctor’s responsibilities will include but not be limited to:

  • Supervise School Health Physicians.
  • Work within the mandates, policies and protocols of the Office of School Health (OSH).
  • Attend to the health needs of a designated school community.
  • Utilize the Automated Student Health Record (ASHR) to maintain accurate student health records.
  • Serve as a consultant to the school nurse and school administrative staff regarding school related health concerns.
  • Support the development of school educational and prevention programs promoting the health and wellness of students.
  • Participate in policy development and revisions as indicated.
  • Provide clinical assistance in the event of an environmental or communicable disease occurrence.
  • Function as a liaison for students with community health providers to resolve health issues that affect school functioning.
  • Develop and maintain professional relationships within the school community and the community at large.
  • Support all medical initiatives put forth by the Office of School Health, e.g. Asthma, Reproductive health, Obesity and Diabetes Initiatives.
  • Keep abreast of health management policy statements and emerging research within the health community affecting school health.
  • Assist with or provide trainings/presentations to school health physicians, nurses, school staff, community organizations or parents
  • Participate in School Health research and quality improvement activities
  • Participate in all mandated DOHMH and Office of School Health trainings and professional development sessions
  • Attend all program meetings and Continuing Medical Education classes provided by the Office of School Health.


To Apply: Please email your resume and cover letter to Dr. Caroline Volel: osh@health.nyc.gov OR  Apply online at https://a127-jobs.nyc.gov/.  In the Job ID search bar, enter: job ID number # 277026


Child and Adolescent Psychiatrist – Lockport, New York, Eastern Niagara Hospital
Eastern Niagara Hospital is seeking a Full Time Medical Director for its 12 bed Child and Adolescent Psychiatric Unit.  Responsibilities include inpatient care, shared on-call responsibilities and Medical Director duties.  Competitive compensation package.  For more information, please contact David DiBacco at 716-514-5501 or email to physicians@enhs.org.


CALL FOR RATES & INFO. CHRISTINA SOUTHARD: 516-488-6100 ext. 355


October 6, 2017 – Gun Violence: Everyone’s Problem

MSSNY


PRESIDENT’S MESSAGE
Charles Rothberg, MD
October 6, 2017
Volume 17
Number 38

Dear Colleagues:

The motive behind the deadliest mass shooting in modern US history remains a mystery as police try to learn more about the suspected gunman who killed 58 people and injured 500 when he opened fire on concertgoers from the 32nd floor of a Las Vegas hotel last Saturday night.

On Tuesday, New York Governor Andrew Cuomo disputed the notion that now, in the wake of the massacre in Las Vegas, is not the time to discuss gun control.  “All these federal officials they put out press releases, warm wishes. Warm wishes are nice, press releases are nice. You know what’s better? Action,” Cuomo said. He also mentioned banning assault rifles.

I don’t always agree with our Governor. On this issue, I do.

The Las Vegas shooter had 23 guns, some with scopes. Investigators also found 19 more guns, explosives and thousands of rounds of ammunition at his Nevada home.

The American Medical Association renewed its call for background checks and wait periods for gun ownership. The group first adopted a policy in 2016 calling gun violence a public health issue, shortly after the mass shootings at the Pulse nightclub in Orlando.

The American College of Physicians has also labeled gun violence a public health issue for more than 20 years, and specifically called for legislation that would ban the sale and ownership of automatic and semiautomatic weapons.

Where is New York law on possession of assault weapon? Under the 2013 Safe Act, passed after the 2012 mass murder at Sandy Hook Elementary School, New York prohibits the purchase or possession of large-capacity magazines and assault-style weapons (unless you owned the gun before January 2013). Other semiautomatic weapons, in which the trigger must be pulled to fire each bullet, are legal in New York, but you cannot legally purchase a magazine that holds more than ten rounds.

It is unacceptable to hold the view that absolutely nothing can be done to reverse what appears to be an escalating public health crisis. While the second amendment grants the right to bear arms, most folks surveyed own guns in order to “protect” themselves.

How real the threat or how effective that “protection” is, is a matter of debate.

But I don’t think many hold the view that mass killing or suicide is a proper exercise of second amendment rights. In comparison to other agents guns are sometimes compared to, weapons are a false equivalent because guns are so lethal.

I believe that the reason we don’t have good safety policy is because we lack good data. The Dickey amendment, which threatens CDC funding if its research is used to support gun control, squelches research on firearms safety. Research should be promoted.

Twenty-five years ago, Surgeon General C. Everett Koop published a common sense way to look at gun safety from a public health perspective. It’s time to reread his 1992 recommendation. See Violence in America: A Public Health Emergency: Time to Bite the Bullet Back Koop C, Lundberg GD. JAMA. 1992; 267(22):3075-3076. Published online June 10, 1992.

It is time to make America safer.

Sincerely,
Charles Rothberg, MD
MSSNY President

Please send your comments to comments@mssny.org


enews large

Have a Minute to Take Prompt Payment Survey?
In New York, health insurers that are regulated by the Department of Financial Services (DFS) are required to pay a claim, notify the claimant of the reason for denying a claim, or request additional information within 30 days of submission of an electronically filed claim.

If the claim is a paper submission, the insurer has 45 days.  If a health insurer is found to have violated this law, they could be subject to significant financial penalties. These so-called “Prompt payment complaints” are reviewed by the New York DFS.

We have heard concerns raised by some physicians and practice managers that there have been inordinate delays in resolving otherwise meritorious prompt payment complaints.  Would you please just take a few moments to complete the below survey so that MSSNY has more detailed information about the full scope of this problem.

Please click here to take the survey.

NYS Health Insurance Exchange Announces Updated Enrollment Numbers and Plan Options for 2018
The NY State of Health, New York’s Health Insurance Exchange, issued a press release this week announcing that more than 4 million people have signed up for health insurance coverage through the State Exchange.  Of these 4 million, over 2.8 million were enrolled in Medicaid, with the remaining divided between a Qualified Health Plan (227,796), an Essential Plan (682,800) and Child Health Plus (346,067).

The press release further noted that “Most Marketplace consumers qualify for financial assistance to pay for coverage. Among QHP enrollees who qualify for tax credits, premium costs for the most popular silver plan will be about the same or lower compared to last year.”

Last week, the NY State of Health issued a press release highlighting consumer insurance options for 2018 for the open enrollment that begins on November 1 and will continue on January 31, 2018.  There are 12 insurers offering “Qualified Health Plans” in the individual marketplace, 15 insurers offering “Essential Plan” coverage and 5 insurers offering coverage in the “Small Business Marketplace”.

As a reminder, physicians are urged to review the “NYS Provider & Health Plan Lookup” tool (https://pndslookup.health.ny.gov/) to confirm the accuracy of the network listings of health insurers across the State.  In some cases, physicians have been erroneously listed as participating with certain health insurers or health insurance products.  In other cases, there are inaccurate practice locations listed.  If you see an inaccuracy, click on the “Contact/Report an Error” tab on the site’s home page to report it.

Continue to Urge Governor Cuomo to Veto One-Sided Medical Malpractice Expansion Legislation
Physicians are urged to continue to send letters and call Governor Cuomo’s office to request that he veto legislation (S.6800/A.8516) passed in the waning hours of the Legislative Session that would significantly expand the time to bring a medical malpractice lawsuit, in circumstances based upon an “alleged negligent failure to diagnose a malignant tumor or cancer”.   If signed into law it would likely prompt a double digit increase in physician malpractice premiums.  You can send a letter here and call 518-474-8390.

Recent letters to the editor urging a veto have appeared in the Albany Times-Union  from MSSNY President Dr. Charles Rothberg, as well in the Middletown Times-Herald from Orange County Medical Society President Dr. Stephanie Zeszutek.  Numerous other letters from regional and statewide physician leaders have appeared in papers across the State urging a veto including the following:  

While many physicians have weighed in, we need an overwhelming demonstration from physicians regarding how this bill will harm access to care in their communities if this bill is signed into law without also providing needed tort reforms to bring down the exorbitant costs of medical liability insurance in New York. This bill is also being strongly opposed by several other medical liability insurers, as well as the Healthcare Association of New York State and the Greater New York Hospital Association.

MSSNY and Other Health Provider Groups to Congress: Don’t Let CHIP Funding and Insurance Subsidies Expire
The US House of Representatives and US Senate each advanced their respective bills this week to continue funding for the Child Health Insurance Program and other expiring programs.  Noting that “extending CHIP funding would provide peace of mind for the families of 350,000 New York children that receive their insurance through CHIP, MSSNY joined with several other patient and health provider advocacy groups to urge Congress to put aside peripheral disputes and extend this program as well as continuing the health insurance subsidies for the over 700,000 New Yorkers who receive this assistance, preventing cuts in Disproportionate Share funding for hospitals, and re-authorizing the Health Centers Fund.  Funding for the CHIP program expired on September 30.

While the House Energy & Commerce and the Senate Finance committees are working towards extending this program, there are unresolved disputes delaying enactment of this essential funding relating to additional items to be included in the legislation, as well as proposed “offsets” to pay for continuation of this program.  It should be noted that among the items under discussion is repeal of the Independent Payment Advisory Board (IPAB), the Medicare cost-cutting board enacted as part of the ACA.  Repeal of the ACA is supported by MSSNY, the AMA and many other medical societies across the country.




New York State Withholding $380 Million from New York City’s Public Hospitals
The New York Daily News (9/29) reported New York City’s public hospital system, Health + Hospitals, claims that the state is withholding $380 million in Disproportionate Share Hospital funds. Interim President and CEO of Health + Hospitals Stanley Brezenoff wrote, “In light of the Governor’s recent pronouncements, it is mystifying that approximately $380 million of DSH funds – the majority of which we expected to received months ago – is languishing, awaiting action by the State Department of Health and the Division of Budget.” The letter added that the system has just 18 days’ worth of cash on hand. 

MSSNY, Others Rally to Send Aid to Puerto Rico
Newsday (NY) (10/2, Ricks) reports several Long Island health centers and the Medical Society of the State of New York are preparing medical and humanitarian aid for Puerto Rico, and “scores of doctors and nurses [are] volunteering to go to the storm-devastated U.S. territory.” MSSNY, Northwell Health system, and Stony Brook University are “planning to help by supplying medicine, equipment and monetary aid, officials with the organizations said Monday.”

MSSNY President Dr. Charles Rothberg said, “We are waiting for directions from our counterparts in Puerto Rico,” referring to the medical society in San Juan. He added, “There are a lot of physicians here who want to help, but we don’t want people going there without coordination.” Rothberg explained that he is asking the society’s physicians to donate money to help Puerto Rican doctors with damaged medical practices, adding, “The island has been overcome with loss of life and lack of available medical services due to flooding, isolation and downed communication lines.”

Please Donate to the Hurricane Relief Fund Today!
The Medical Educational and Scientific Foundation (MESF) is MSSNY’s not-for-profit subsidiary. As they have in other times of need, MESF is collecting funds to assist in the recovery efforts. One hundred percent of the funds raised will support the physicians affected practices in Puerto Rico. After Hurricane Sandy, due to your generosity, MESF was able to help many New York physicians rebuild their practices. Donations can be made online here or by sending a check made payable to MESF with the designation “Hurricane Relief Fund” and mailed to MSSNY, 865 Merrick Avenue, Westbury NY 11590. All donations are tax deductible. Help us to help others.

FDA: Require Makers of Immediate-Release Opioids to Train Physicians
The AP reports that the Food and Drug Administration is requiring the makers of fast-acting opioid pain medications to “provide extensive training to doctors in an attempt to stem the ongoing opioid addiction crisis.” According to FDA Commissioner Scott Gottlieb, the agency contacted 74 drug makers informing them that their immediate-release opioids will be subject to the requirement. Although the training “will be offered as voluntary continuing education for healthcare professionals, the agency is also considering some form of mandatory education on opioids.”

Many Employers Pushing For Expansion of Telemedicine
Reuters (10/4) reports a growing number of employers are covering telehealth services through their insurance plans and are also pushing employees to use the services. The article reports that five years ago, only 7 percent of employers covered telehealth visits through their health insurance plans, but today 96 percent of employers do. Usage remains low, however.

The article mentions that the American Medical Association supports telehealth as “an ongoing evolution of new models for the delivery of care and patient-physician interactions,” but that providers should recognize the “limitations of the relevant technologies and take appropriate steps to overcome those limitations.” A March 2017 study in Health Affairs found that the costs of treating bronchitis and similar conditions increased by $45 per user when telehealth was involved – mostly because the availability of telehealth encouraged more doctor care, not less.

Some of those seeking care did not have a regular doctor. Some were using telehealth as a precursor to an office visit, like triage, said Scott Ashwood, an associate policy researcher at the nonpartisan Rand Corporation, who led the study.

Tip of the Week 10/3/17
By Jacqueline Thelian, CPC, CPC-I, CHCA, Medco Consultants, Inc.

Q: How will the new Medicare ID numbers impact my practice?

  1. The new Medicare Beneficiary ID (MBI) numbers will be 11 alphanumeric characters. Starting in April 2018, new beneficiary cards and numbers will be issued. All Medicare cards are expected to be replaced by April 2019. During the transition period healthcare providers will be able to use either patient identifier (HICN or MBI) when submitting claims until December 31, 2019.

The new ID numbers require your practice management systems are updated with the new numbers. Keeping in mind your system will have to be able to identify and handle dual MBI numbers until all claims are paid. Additional concerns occur when a practice submits a claim with an old MBI number and CMS sends back the electronic remittance with the new MBI number. Some practice management systems may not be able to identify the patient.

The biggest challenge will be secondary payers. CMS will notify the secondary payers; however, it is up to the secondary payer to update their systems.

The best way to prepare is to inform and train your front desk staff of the upcoming change and work with your practice management vendor and IT consultant to enlist their aid for a smooth transition.

Source: https://www.cms.gov/Medicare/New-Medicare-Card/index.html

If you have a coding or compliance question you would like to have answered please send your question to MSSNY at eskelly@mssny.org, and complete the subject line with Tip of the Week.



Promo Code: MSSNY


Volunteer Physicians Needed at Long Island Clinic: Malpractice Coverage Provided
RotaCare is a free primary not-for-profit health center in Uniondale, NY. Our mission is to facilitate free health care for the relief of pain and suffering to individuals who have the most need and the least access to primary medical care. RUN ENTIRELY BY VOLUNTEERS, we provide healthcare for individuals who do not have health insurance and are unable to pay for care. Our patients do not qualify for Medicaid or other government programs and are left with little or no access to treatment.

The health center is run entirely by a rotating staff of over 120 volunteer physicians, nurse practitioners, nurses, pharmacists, medication room staff, social workers, translators and administrative staff. We serve the working poor — those in service jobs or part time jobs that do not provide benefits such as landscaping or cleaning services. Patients are screened for financial eligibility and to ensure that RotaCare services are appropriate for their medical needs.

We save lives by facilitating early intervention and disease management for individuals with chronic conditions. We collaborate with and receive support from Mercy Medical Center, Nassau University Medical Center, St. Francis Hospital and specialists in the community who provide free medical care to our patients.

RotaCare also helps patients obtain free prescription medications in order to manage their health conditions. We need active or retired physicians, nurse practitioners or nurses to provide primary care for our patients on-site. Malpractice coverage is provided by HRSA FTCA coverage for free clinics.

Physicians of all specialties are also needed to provide pro-bono care at their own office.

Please contact RotaCare today at 516-539-9834 and visit www.ROTACAREny.org for more information or info@rotacareny.org to let us know how you can help today.

MSSNYPAC Physician Family Halloween Party in Staten Island October 29
You’re invited to the home of John Maese, MD & Donna Seminara, MD, for a physician family Halloween party to benefit MSSNYPAC.  Suggested contribution is $175 per family, $10 for medical students and $50 for residents.  Please also consider joining MSSNY’s Councilor’s Club or President’s Circle. Please visit  mssnypac.org/events to RSVP or learn more.  Location is in Staten Island NY and address to be provided prior to event.

CMS Mailed Letters to Physicians Re New Medicare Cards
CMS, through the Medicare Administrative Contractors (MACs), recently mailed letters to all Medicare fee-for-service providers about our work to assign new numbers known as Medicare Beneficiary Identifiers (MBIs) and issue new Medicare cards to Medicare beneficiaries beginning in April 2018.

Our top priorities include:

  • Ensuring your Medicare patients have continuous access to care; and
  • You have the tools and information you need for a smooth transition. Starting in June 2018, you can look up your patients� new Medicare numbers through your MAC�s secure web portal.

Carefully review the letter and accompanying fact sheet and find out how to prepare to accept the new number beginning in April 2018. Your letter will contain specific information for your MAC. You can also view a sample letter and print-friendly fact sheet.

For More Information

Review the new Medicare card design and press to learn more.

Seminars and Webinars

Register Now for the Veterans Mental Health Training Initiative Conference
The Medical Society of the State of New York, the New York State Psychiatric Association, and the National Association of Social Workers – New York State Chapter are hosting a two day conference on Friday, 10/13 Saturday,10/14 at the Niagara Falls Conference Center, 101 Old Falls St, Niagara Falls, NY. Registration is now open for this free two-day conference here.

Please note registration for the conference is separate from the registration for the educational programs.

The conference will consist of interactive seminars and panel discussions focusing on the current and evolving healthcare needs of veterans. MSSNY and NYSPA will be conducting three CME accredited trainings for primary care physicians and specialists. The CME programs are: Invisible Wounds of War: PTSD, TBI & Combat-Related Mental Health Issues;  Recognition, Management and Prevention of Veteran Suicide; and Veterans Matters: Substance Use Disorders in Returning Veterans  (you can register for each seminar by clicking on the program title[s]).

Accreditation Statement

These activities have been planned and implemented in accordance with the Accreditation Requirements and Policies of the Medical Society of the State of New York (MSSNY) through the joint-providership of the Westchester Academy of Medicine (WAM) and the New York State Psychiatric Association, Inc… WAM is accredited by MSSNY to provide Continuing Medical Education for physicians.

WAM designates this live activity for a maximum of 1.5 AMA PRA Category I Credits™. Physicians should claim only the credit commensurate with the extent of their participation in each activity.

The Medical Society of the State of New York is accredited by the Accreditation Council for Continuing Medical Education (ACCME) to provide continuing medical education for physicians.

The Medical Society of the State of New York designates this live activity for a maximum of 1.0 AMA/PRA Category 1 credits™.  Physicians should claim only the credit commensurate with the extent of their participation in the activity. 

The Importance of Herd Immunity” CME Webinar October 18; Registration Open
MSSNY will begin its 2018 Medical Matters continuing medical education (CME) webinar series with “The Importance of Herd Immunity” on Wednesday, October 18, 2017 at 7:30 a.m.  William Valenti, MD, chair of MSSNY Infectious Disease Committee and a member of the Emergency Preparedness and Disaster/Terrorism Response Committee will serve as faculty for this program. Registration is now open for this webinar here.

Additional information or assistance with registration may be obtained by contacting Melissa Hoffman at mhoffman@mssny.org.

Educational objectives are:

  • Review the epidemiology of vaccine-preventable infectious disease and role of herd immunity.
  • Describe how herd immunity protects vulnerable populations such as newborns, the elderly and those who are too sick to be vaccinated.
  • Discuss the percentage(s) of a population who need to be vaccinated to allow herd immunity to be effective.

The Medical Society of the State of New York is accredited by the Accreditation Council for Continuing Medical Education (ACCME) to provide continuing medical education for physicians.

The Medical Society of the State of New York designates this live activity for a maximum of 1.0 AMA/PRA Category 1 credits™.  Physicians should claim only the credit commensurate with the extent of their participation in the activity. 



Your membership yields results and will continue to do so. When your 2018 invoice arrives, please renew. KEEP MSSNY STRONG!


For Physicians Only: Updates on Naloxone, HIV, & HCV Oct. 13 in Syracuse
This half-day program will discuss clinical updates in Naloxone, and HIV and Hepatitis C testing and treatment.

When:  Friday, October 13, 2017 9:00 am – 12:30pm
Topics: Naloxone: Preventing Opioid Overdose in the Community; The Role of the Primary Care Clinicianin HIV Care; Treatment for Hepatitis C: New Tests, New Drugs, & New Recommendation

Where: SUNY Upstate EMSTAT Training Center
550 E. Genesee St., Syracuse, NY

Register here.

Are You Ready to Eliminate Hepatitis C?
Did you know that Hepatitis C is easy to treat and curable? Join us for an exciting free half day CME program that will review the recently released NYSDOH AI clinical guidelines on the treatment of chronic HCV! This program is sponsored by NYSDOH AI Clinical Education Initiative and Mount Sinai Institute for Advanced Medicine.

“From Screening to Treatment: The Clinician’s Role in Eliminating Hepatitis C in New York State”
Thursday, October 12, 2017
8:00am – 12:00pm
DoubleTree Syracuse
6301 State Rte. 298
East Syracuse, NY 13057

Space is limited, so register for this free training today.   

Not near Syracuse? We’re coming to a city near you!

                                     Rochester, October
  3rd: http://bit.ly/HCVRochester

Buffalo, October 26thhttp://bit.ly/HCVBuffalo

NYC, December 8thhttp://bit.ly/HCVNewYorkCity

Questions? Contact Jessica Steinke at jessica.steinke@mountsinai.org or 212-731-3789
View Flyer Here .



CLASSIFIEDS

Medical Family Practice For Sale – Long Beach, NY
Established 14 years. Newly renovated. Fully equipped ground floor premises. 3 exam rooms. Must see! Call Carol – 516-238-3422


Great Neck – Medical Zoned Condo
2690 Sqft – $699,000 – quick easy access to North Shore University Hospital, Long Island Expressway and Long Island Rail Road. 10 Exam rooms plus waiting room & large secretary area http://bit.ly/2wXCbkQ . Call Chris Pappas, LAB 516-659-6508


For Rent or Share – Woodbury, Long Island
Beautiful recently renovated Plastic Surgery
office available for part-time share and
AAAA-certified (by end of summer).
OR available for rent. Centrally located
on Long Island.Close to expressways.
3 exam rooms, 1 procedure room /OR.
Waiting room, break room and personal office.
Free WIFI. Available for full or half-days.
Suits Plastic/Cosmetic Surgeons/Derm/ENT/
ObGyn/Podiatry or other Medical MDs.
Contact Patricia at info@cosmetichg.com
or 631-318-4008

Want to Sell Your Medical Practice? Do You Have Medical Office Space to Sell or Share?
Clineeds is a new online platform designed to help medical providers sell their practice or buy, sell and share medical office space. Listing is FREE! No contracts. No commitments. No fees. Sign up today at http://www.clineeds.com/sign-up

PHYSICIAN OPPORTUNITIES


Multiple Physician Positions with DOHMH Office of School Health
Office of School Health is the largest program of the New York City Department of Health and Mental Hygiene (DOHMH). This bureau is responsible for managing the health issues and promoting the well-being of the over 1.3 million children and adolescents enrolled in New York City’s 1700 school buildings.

Positions with the Office of School Health (OSH) combine clinical skills and public health training.

Adolescent School Health Physician
This position offers to the interested physician the opportunity to help address the clinical and public health needs of adolescents in NYC high schools. The physician will work with the innovative Connecting Adolescents to Comprehensive Health Care (CATCH) Program, which provides select reproductive health services to adolescents in select NYC high schools. In addition, the physician will provide medical care and public health services through additional programs offered to adolescents by the Office of School Health.

Under the supervision of the High School Supervising Physician, the Adolescent School Health Physician’s responsibilities will include but are not limited to:

  • Provide CATCH reproductive health services in select high schools.
  • Perform mandated physical examinations (New Admission Exams, Sports Physicals, and Working Paper Physicals).
  • Function as a liaison for students with community health providers to resolve medical issues that affect school performance.
  • Support the development and implementation of initiatives that promote positive health behaviors and reduce high risk behaviors in the adolescent population.
  • Serve as a consultant to the school nurse and administration on school related health concerns.
  • Provide clinical assistance in the event of an environmental or communicable disease occurrence.
  • Function as a liaison for students with community health providers to resolve medical issues that affect school performance.
  • Support all medical initiatives established by the Office of School Health, e.g. programs and protocols in asthma, reproductive health, obesity and diabetes.
  • Maintain good public relations and communicate effectively within the school community and community-based organizations.
  • Keep abreast of health management policy statements and emerging clinical research related to school health.
  • Participate in OSH research activities.
  • Work within the mandates, policies and protocols of the Office of School Health.
  • Attend all mandated DOHMH and OSH trainings.

To Apply: Please email your resume and cover letter to Dr. Caroline Volel: osh@health.nyc.gov OR  Apply online at https://a127-jobs.nyc.gov/.  In the Job ID search bar, enter: job ID number # 277208. 

School Health Field Physician
Under the direction of the Supervising Physician, the School Health Physician’s will:

  • Improve the health of school children through case management of chronic disease, preventive health screening and counseling, health education, and referrals.
  • Perform mandated physical examination (new entrant, sport physical, working paper physicals.
  • Develop relationships with community health providers in order to optimize medical management of students with health issues.
  • Attend to the health needs of your assigned school community.
  • Utilize the Automated Student Health Record (ASHR) to maintain adequate student health records.
  • Serve as a consultant to the school nurse and administration on school related health concerns.
  • Support the development of school educational and prevention programs promoting the health and wellness of all students.
  • Provide clinical assistance in the event of an environmental or communicable disease occurrence.
  • Develop and maintain professional relationships within the school community.
  • Support all medical initiatives put forth by the Office of School Health, e.g. Asthma, Reproductive health, Obesity and Diabetes initiatives.
  • Provide trainings/presentations to school staff, community organizations, or parents.
  • Stay abreast of health management policy statements and emerging research within the health community related to school health.
  • Participate in School Health research and quality improvement activities.
  • Participate in all mandated DOHMH and Office of School Health trainings and professional development sessions.
  • Attend all program meetings and Continuing Medical Education classes provided by the Office of School Health.

To Apply: Please email your resume and cover letter to Dr. Caroline Volel:osh@health.nyc.gov OR Apply online at https://a127-jobs.nyc.gov/.  In the Job ID search bar, enter: job ID number # 279844. 

Supervising School Health Physician 
Job Description
Under the supervision of the Deputy Medical Director, the Supervising Medical Doctor’s responsibilities will include but not be limited to:

  • Supervise School Health Physicians.
  • Work within the mandates, policies and protocols of the Office of School Health (OSH).
  • Attend to the health needs of a designated school community.
  • Utilize the Automated Student Health Record (ASHR) to maintain accurate student health records.
  • Serve as a consultant to the school nurse and school administrative staff regarding school related health concerns.
  • Support the development of school educational and prevention programs promoting the health and wellness of students.
  • Participate in policy development and revisions as indicated.
  • Provide clinical assistance in the event of an environmental or communicable disease occurrence.
  • Function as a liaison for students with community health providers to resolve health issues that affect school functioning.
  • Develop and maintain professional relationships within the school community and the community at large.
  • Support all medical initiatives put forth by the Office of School Health, e.g. Asthma, Reproductive health, Obesity and Diabetes Initiatives.
  • Keep abreast of health management policy statements and emerging research within the health community affecting school health.
  • Assist with or provide trainings/presentations to school health physicians, nurses, school staff, community organizations or parents
  • Participate in School Health research and quality improvement activities
  • Participate in all mandated DOHMH and Office of School Health trainings and professional development sessions
  • Attend all program meetings and Continuing Medical Education classes provided by the Office of School Health.


To Apply: Please email your resume and cover letter to Dr. Caroline Volel: osh@health.nyc.gov OR  Apply online at https://a127-jobs.nyc.gov/.  In the Job ID search bar, enter: job ID number # 277026


Child and Adolescent Psychiatrist – Lockport, New York, Eastern Niagara Hospital
Eastern Niagara Hospital is seeking a Full Time Medical Director for its 12 bed Child and Adolescent Psychiatric Unit.  Responsibilities include inpatient care, shared on-call responsibilities and Medical Director duties.  Competitive compensation package.  For more information, please contact David DiBacco at 716-514-5501 or email to physicians@enhs.org.


CALL FOR RATES & INFO. CHRISTINA SOUTHARD: 516-488-6100 ext. 355


September 29, 2017 – Helping to Help Others


PRESIDENT’S MESSAGE
Charles Rothberg, MD
September 29, 2017
Volume 17
Number 37

Dear Colleagues:

Over the past few weeks our mainland has been devastated by hurricanes. Most recently, and most tragically, Puerto Rico has been overcome with loss of life and lack of available medical services due to flooding, isolation and downed communication lines. Hospitals, clinics and nursing homes have been destroyed beyond repair. The entire Puerto Rican medical system has been critically damaged. Local officials have called conditions “a humanitarian crisis.”

The Medical Educational and Scientific Foundation (MESF) is MSSNY’s not-for-profit subsidiary. As they have in other times of need, MESF is collecting funds to assist in the recovery efforts. One hundred percent of the funds raised will support the physicians affected practices in Puerto Rico. After Hurricane Sandy, due to your generosity, MESF was able to help many New York physicians rebuild their practices.  The program will help cover expenses (not covered by insurance or other funding) for relocating or rehabilitating a physician’s medical office. This may include replacing equipment, aiding needed staff, rebuilding patient records, and other similar needs all towards the goal of helping physicians once again treat patients.

I encourage you to join me in supporting the work of the Foundation with a generous contribution.

Donations can be made online here or by sending a check made payable to MESF with the designation “Hurricane Relief Fund” and mailed to MSSNY, 865 Merrick Avenue, Westbury NY 11590. All donations are tax deductible.

Thank you for helping us to help others.

Sincerely,
Charles Rothberg, MD
MSSNY President

Please send your comments to comments@mssny.org


enews large

Assembly Hearing: Labor Community Concern Re Impairment Guideline Proposed Changes
The New York State Assembly Labor Committee held a hearing this week to examine strong concerns expressed by organized labor, groups representing injured workers and trial attorneys with a proposal by the Workers Compensation Board to revise the permanency impairment guidelines.  To watch a re-broadcast of the hearing, click here The testimony and Q&A with the leadership of the New York Workers Compensation Board encompasses approximately the first 2 ½ hours of the hearing.

The labor community, including the NYS AFL-CIO, New York Committee on Occupational Health & Safety (NYCOSH) and the Injured Workers Bar Association expressed concerns with both the proposed changes to the impairment guidelines as well as the regulations implementing the use of these new guidelines.  They are very concerned that the schedule loss of use (SLU) awards will be reduced if the proposed guidelines are permitted to go into effect.  Moreover, they have strong concerns with proposals that would limit the ability of an injured worker to have an independent physician rather than the treating physician determine the degree of the injured worker’s impairment.  Moreover, there are concerns with provisions that would require injured workers to completely answer questionnaires and respond to written interrogatories from Independent medical examiners.

On the opposite side, the Business Council of New York State challenged the assertions that the regulations were unfair to injured workers.  However, they too raised concerns with the proposed guidelines due to “multiple instances where the guidelines fail to be reflective of advances in modern medicine in very key areas, are far too subjective in their determination processes and fail to give employers fair opportunities to cross-examine claimants.”

The proposed revised guidelines were originally drafted by the New York State Society of Orthopedic Surgeons (NYSSOS).  However, they were changed significantly following an August 15 meeting convened by the WCB that included representatives of the NYS AFL-CIO, the New York Business Council, the City of New York and several insurance companies, as well as physicians representing MSSNY and the New York State Osteopathic Medical Society.  NYSSOS President and MSSNY member Dr. John Olsewski as well as orthopedist Dr. Jeffrey Lozman testified at the Assembly hearing this week, expressing concerns with the significant changes to their original proposed guidelines.

To read the testimony of the New York Committee on Occupational Health & Safety, click here.

To read media coverage of the Assembly hearing, click here.

Governor Proposes Legislation to Combat Synthetic Fentanyl Use
Governor Andrew Cuomo announced this week a series of actions to combat the fentanyl crisis in communities across New York State. Specifically, the Governor is proposing legislation to add 11 fentanyl analogs to the state controlled substances schedule.  Moreover, the NY Department of Financial Services issued a circular letter to advise health insurers against placing arbitrary limits on the number of naloxone doses covered by an insurance plan.

The press release noted that, while overdose deaths involving opioids in New York increased nearly 35% between 2015 and 2016, fentanyl-related deaths increased nearly 160%   The release further noted that while Fentanyl proper is a Schedule II synthetic opiate, underground labs have tweaked the molecular structure of fentanyl to create new, unregulated chemicals referred to as fentanyl analogs. These deadly cousins are chemically similar to fentanyl—and often many times more potent—but are not listed on New York State’s schedule of controlled substances, and therefore not subject to the same criminal penalties.

In response,  the legislation proposes to add the following 11 fentanyl analogs to Schedule I of the controlled substance schedules of New York State Public Health Law §3306: AH-7921; Acetyl Fentanyl; Butyryl Fentanyl; Beta-Hydroxythiofentanyl; Furanyl Fentanyl; U-47700; and Acryl Fentanyl (or Acryloylfentanyl); N-(4-fluorophenyl)-N-(1-phenethylpiperidin-4-yl)isobutyramide; Ortho-Fluorofentanyl; Tetrahydrofuranyl Fentanyl; Methoxyacetyl Fentanyl. The 11 substances are already listed on the federal schedule of controlled substances. The legislation will also give the New York State Health Commissioner the authority to add to the state controlled substances schedule any new drugs that have been added to the federal schedule.

Moreover, the new DFS circular letter advised that health insurers “should provide coverage for naloxone on an outpatient basis when prescribed to an insured by an authorized provider, as they would for any other prescribed drug, subject to the terms and conditions of the health insurance policy or contract. In addition, naloxone should also be covered on an inpatient basis when medically necessary.”

Among the many public officials quoted in the press release is Suffolk County legislator and Past-President of the Suffolk County Medical Society Dr. William Spencer who stated:  “Fentanyl represents a dangerous new front in the devastating opioid crisis, and I am grateful that Governor Cuomo recognizes this challenge and is stepping up to address it head on. The Governor’s multi-pronged effort to stop the spread of fentanyl will literally save lives. So I want to thank Governor Cuomo for spearheading this effort and making a difference here and all across the state.”

Continue to Urge Gov. Cuomo to Veto One-Sided Medical Malpractice Expansion Legislation
Physicians are urged to continue to send letters and call Governor Cuomo’s office to request that he veto legislation (S.6800/A.8516) passed in the waning hours of the Legislative Session that would significantly expand the time to bring a medical malpractice lawsuit, in circumstances based upon an “alleged negligent failure to diagnose a malignant tumor or cancer”.   You can send a letter here and call 518-474-8390.

This week MSSNY President Dr. Charles Rothberg had a letter published in the Albany Times Union calling for comprehensive, not piecemeal, reform of NY’s dysfunctional medical malpractice adjudication system.  Dr. Rothberg’s letter recommends that, “Cuomo must veto this well-intentioned, but one-sided, destructive legislation. Instead, he should empanel a blue ribbon commission to develop legislation that both assures the rights of patients to bring actions for negligence while preserving the availability of timely and quality medical care.”  The article referenced by Dr. Rothberg’s letter can be found here.

Last week, Orange County Medical Society President Dr. Stephanie Zeszutek had a letter published in the Middletown Times-Herald urging the Governor to veto this bill.   Dr. Zeszutek’s letter noted that “The state has a dangerous doctor shortage and future doctors are already being deterred from certain specialties or medicine altogether due to malpractice liability concerns. This bill sets a dangerous precedent for liability across the country. We urge Gov. Cuomo to reject this bill in favor of more sensible legislation.”

Numerous other letters from regional physician leaders have appeared in papers across the State urging a veto including the following:  Buffalo NewsSyracuse Post-Standard, Rochester Business Journal, Poughkeepsie Journal, Albany Times Union

While many physicians have weighed in, we need an overwhelming demonstration from physicians regarding how this bill will harm access to care in their communities if this bill is signed into law without also providing needed tort reforms to bring down the exorbitant costs of medical liability insurance in New York.



Promo Code: MSSNY


MSSNY’s 2017 Legislative Summary Now Available Online
Many of you are aware that a statute of limitations expansion bill (S.6800/A.8516) passed over the strong objections of MSSNY, the specialty societies, the hospital industry and MLMIC.  However, working together with specialty societies and other health care advocacy groups, MSSNY was successful in advocating for several public health bills passed both houses.

Moreover, MSSNY’s advocacy together with its allies resulted in scores of adverse bills being rejected by the New York State Legislature included those that would have expanded the scope of practice for various professions and those that would have imposed unworkable mandates on physician delivery of patient care.

Please click here to see our 2017 legislative summary.

Sign Up To Become a Physician Advocacy Liaison Today
Your participation is essential to continue a strong grassroots effort to address all of the issues facing physicians.  We encourage you to remain active and reach out to your elected officials to make sure our voices and health care expertise are heard.

PAL responsibilities include:

    • Educating other members on issues facing physicians, such as at local county medical society or medical staff meetings
    • Working as appropriate with your county medical society, be available to meet with your members of the legislature at least twice a year
    • Being responsible for calling or writing letters to members of the legislature on issues that impact physicians
    • Attend training programs in regard to legislative issues
  • Enlisting other member to support our action plans and mobilize them to action
  • Joining and recruiting others to join MSSNYPAC

Please join the many other physicians who have signed up to become a Physician Advocacy Liaison.

Michael Dowling: The Issue of Ill-Conceived Regulation and How it Led to CareConnect’s Demise
Becker’s Hospital Review/Written by Michael J. Dowling, President & CEO, Northwell Health 

One of the greatest frustrations among many healthcare leaders today is the federal government’s increasing addiction to micro-management. Whether it’s a soccer match, or a football, hockey or basketball game, the referees set the rules and then allow the players to compete, stopping the game only when the rules are broken. Rather than let the players play, today’s federal regulators have set the rules and often enter the game themselves. On occasion, they’re even changing the rules during the middle of the game.

To continue reading the article, click here.

US Senate Decides to Shelf Cassidy-Graham Legislation
This week the United States Senate failed to garner the necessary support to bring the “Cassidy-Graham” ACA repeal and replace legislation to a vote of the full US Senate.  As reported last week, MSSNY joined with numerous other New York healthcare provider associations in a letter to New York’s Congressional delegation expressing its strong objections to the Cassidy-Graham proposal because of its potentially significant adverse consequences to New Yorkers’ insurance coverage as well as to our State finances.

As reported in Politico-NY, after Senate Majority Leader Mitch McConnell announced that the bill would not be considered, MSSNY President Dr. Charles Rothberg stated: “Once again, another unworkable ACA repeal bill failed to secure a majority of Senate votes. Now is the time for Republicans and Democrats to work together to find common ground to address the many pressing health care issues of anxious patients and their physicians.

These include continuation of the Child Health Insurance Program, continuation of essential cost-sharing subsidies and yes, addressing fundamental flaws of the ACA such as inadequate physician networks and exorbitant deductibles.” 

Constitutional Convention Debate
Every 20 years, New Yorkers have the chance to vote whether they want to hold a constitutional convention to amend or change the New York State Constitution.  As reported last week, while some advocacy groups support a Constitutional Convention, many groups oppose it.  Professor Gerry Benjamin moderated a recent NYS Constitutional Convention forum with former counsel to former Governor Mario Cuomo, Evan Davis and Chris Ludlow, Hudson Valley Legislative and Political Action Coordinator for the Civil Service Employees Association.

Click here to listen to the pros and cons of holding a NYS Constitutional Convention.  Voters will decide on whether they want to hold a convention on Election Day, November 7, 2017.

USPSTF: Vitamin D Not Recommended Fall Prevention in Seniors
The U.S. Preventive Services Task Force is recommending against vitamin D supplementation to prevent falls in community-dwelling adults aged 65 and older (grade D recommendation). The draft statement is a change from its 2012 recommendation in favor of supplementation.

In a new analysis, the group found evidence that vitamin D supplementation did not reduce fall risk in patients who were not vitamin D deficient.

The USPSTF continues to recommend exercise to reduce the risk for falls in community-dwelling elders (grade B), and multifactorial interventions may be offered to high-risk seniors (grade C).

In a separate draft recommendation statement, the task force maintained its 2013 position on vitamin D and calcium supplementation to prevent fractures in men and premenopausal women. There is still not enough evidence to recommend for or against the practice (grade I).

The group again recommends against postmenopausal women taking 400 IU or less of vitamin D and 1000 mg or less of calcium daily because there’s no effect on fracture prevention (grade D). There was less certainty about higher doses (grade I).

USPSTF recommendations on fall prevention for seniors

USPSTF draft recommendations on Vitamin D, calcium supplementation for fracture prevention.



Your membership yields results and will continue to do so. When your 2018 invoice arrives, please renew. KEEP MSSNY STRONG!


Register Now for the Veterans Mental Health Training Initiative Conference
The Medical Society of the State of New York, the New York State Psychiatric Association, and the National Association of Social Workers – New York State Chapter are hosting a two day conference on Friday, 10/13 Saturday,10/14 at the Niagara Falls Conference Center, 101 Old Falls St, Niagara Falls, NY. Registration is now open for this free two-day conference here.

Please note registration for the conference is separate from the registration for the educational programs.

The conference will consist of interactive seminars and panel discussions focusing on the current and evolving healthcare needs of veterans. MSSNY and NYSPA will be conducting three CME accredited trainings for primary care physicians and specialists. The CME programs are: Invisible Wounds of War: PTSD, TBI & Combat-Related Mental Health Issues;  Recognition, Management and Prevention of Veteran Suicide; and Veterans Matters: Substance Use Disorders in Returning Veterans  (you can register for each seminar by clicking on the program title[s]).

Accreditation Statement
These activities have been planned and implemented in accordance with the Accreditation Requirements and Policies of the Medical Society of the State of New York (MSSNY) through the joint-providership of the Westchester Academy of Medicine (WAM) and the New York State Psychiatric Association, Inc. WAM is accredited by MSSNY to provide Continuing Medical Education for physicians. WAM designates this live activity for a maximum of 1.5 AMA PRA Category I Credits™. Physicians should claim only the credit commensurate with the extent of their participation in each activity. The Medical Society of the State of New York is accredited by the Accreditation Council for Continuing Medical Education (ACCME) to provide continuing medical education for physicians.

The Medical Society of the State of New York designates this live activity for a maximum of 1.0 AMA/PRA Category 1 credits™.  Physicians should claim only the credit commensurate with the extent of their participation in the activity.

“The Importance of Herd Immunity” CME Webinar October 18; Register Now!
MSSNY will begin its 2018 Medical Matters continuing medical education (CME) webinar series with “The Importance of Herd Immunity” on Wednesday, October 18, 2017 at 7:30 a.m.  William Valenti, MD, chair of MSSNY Infectious Disease Committee and a member of the Emergency Preparedness and Disaster/Terrorism Response Committee will serve as faculty for this program. Registration is now open for this webinar here.

Additional information or assistance with registration may be obtained by contacting Melissa Hoffman at mhoffman@mssny.org.

Educational objectives are:
Review the epidemiology of vaccine-preventable infectious disease and role of herd immunity.
Describe how herd immunity protects vulnerable populations such as newborns, the elderly and those who are too sick to be vaccinated.
Discuss the percentage(s) of a population who need to be vaccinated to allow herd immunity to be effective.

The Medical Society of the State of New York is accredited by the Accreditation Council for Continuing Medical Education (ACCME) to provide continuing medical education for physicians. The Medical Society of the State of New York designates this live activity for a maximum of 1.0 AMA/PRA Category 1 credits™.  Physicians should claim only the credit commensurate with the extent of their participation in the activity.

Are You Ready to Eliminate Hepatitis C?
Did you know that Hepatitis C is easy to treat and curable? Join us for an exciting free half day CME program that will review the recently released NYSDOH AI clinical guidelines on the treatment of chronic HCV! This program is sponsored by NYSDOH AI Clinical Education Initiative and Mount Sinai Institute for Advanced Medicine.

“From Screening to Treatment: The Clinician’s Role in Eliminating Hepatitis C in New York State”
Thursday, October 12, 2017
8:00am – 12:00pm
DoubleTree Syracuse
6301 State Rte. 298
East Syracuse, NY 13057

Space is limited, so register for this free training today – http://bit.ly/HCVSyracuse      

 Not near Syracuse? We’re coming to a city near you!

Questions? Contact Jessica Steinke at jessica.steinke@mountsinai.org or 212-731-3789
View Flyer Here .

NYSDOH AIDS Institute Started Naloxone Co-payment Assistance Program (N-CAP) in August
For individuals with prescription coverage through their health insurance plans, this program will cover the cost of co-payments for naloxone up to $40 so there are no or lower out-of-pocket expenses when accessing naloxone at participating pharmacies.  All Medicaid Managed Care Plans cover at least one formulation of naloxone, and the vast majority of private insurance plans also cover naloxone.

Additional information as well as the ability to order promotional materials on N-CAP can be found at:  www.health.ny.gov/overdose. There are 2,000 pharmacies throughout the State who dispense naloxone with a physician standing order.  Individuals getting naloxone at these pharmacies do not need a prescription. They simply need to ask for it at the pharmacy counter and present their insurance information as they do for any other medicine.  They do not need to enroll in N-CAP.  Maximizing pharmacy distribution will allow individuals increased access to naloxone.

Pharmacies are open evening hours and weekends, and have multiple locations. Refills can also be obtained from any of the 2,000 participating pharmacies.  A directory of pharmacies with standing orders can be found here.

Individuals who cannot access naloxone from pharmacies will continue to access naloxone through registered opioid overdose prevention programs including individuals using naloxone in the line of duty and people who are uninsured.  If you have questions, please contact Lyla Hunt at:  lyla.hunt@health.ny.gov.

As you are aware, CMS has been working on our Handwritten Paper Claims Reduction Initiative since July.  As we move to the Downstate New York regions, I am once again asking if you can help us communicate this important update to your Members and colleagues.

Handwritten Paper Claims Reduction Initiative
On July 10, 2017, NGS began returning any paper claims that include handwriting in fields other than the allowed signature fields (Items 12, 13, or 31).

We are rolling this out on a State/Locality basis and by November, all handwritten claims will be returned to the provider.

The schedule is as follows:

November 13, 2017New York (Downstate: Localities 01, 02, and 04)New York Locality/Area and County Information

Date we will start to return handwritten paper claims State/Locality County listing
August 7, 2017 New York (Upstate: Localities 03 and 99) New York Locality/Area and County Information

The CMS Internet-Only Manual (IOM) Publication 100-04, Medicare Claims Processing Manual, Chapter 26, Section 30, “Printing Standards and Print File Specifications Form CMS-1500” (700 KB) contains the printing specifications for the CMS-1500 claim form. These printing specifications do not provide instructions to submit handwritten claims. Please use this CMS IOM reference to ensure you are completing paper claims correctly.

Alternatives to Handwritten Paper Claims
We understand this may require some substantial changes to your office practices and we at NGS have two alternatives to handwritten paper claims that would be of little cost to your practice.

  1. NGSConnex is our web-based self-service portal, free of charge, and available through Internet access. You can login to NGSConnex and submit claims to us. In addition to claims submission, NGSConnex has other useful functions like verifying Medicare entitlement, submitting appeals on claims, and viewing and downloading your remittance advice. Take this opportunity to get started on NGSConnex today!
  1. Electronic claim submission and other transactions submitted electronically process considerably faster than paper submission. The Electronic Data Interchange (EDI) page on our website, explains how to enroll and what capabilities your office needs to be able to submit electronic claims.  In addition, NGS can provide you with no cost claim submission software, PC-ACE.  Visit our web site at PC-ACE to learn more.

All providers with access to the Internet should have the capability to download this billing software free of charge. However, if that is not the case, this software will continue to be available on CD for a $25 nonrefundable fee.

To learn more about PC-ACE visit the Electronic Data Interchange software tab on our web site at www.NGSMedicare.com  and choose Claims & Appeals

For assistance, please contact the EDI Help Desk or submit an EDI E-mail Inquiry Form for assistance. If it is determined that you are not capable of downloading the software, you will be provided with the appropriate form to request the PC-ACE software on CD.

Tip of the Week
By Jacqueline Thelian, CPC, CPC-I, CHCA, Medco Consultants, Inc. 

Due to HIPAA-HITECH requirements, please do not send any Protected Health Information (PHI) via email. Please contact Medco to obtain secure file transfer instructions.

Professional Healthcare Consulting Services that make a difference!

Certified Coding, Remote Coding, Coding education, Coding Certification Prep Course, and discounted coding products. If you have a coding or compliance question you would like to have answered please send your question to MSSNY at eskelly@mssny.org, and complete the subject line with Tip of the Week.

MIPS Milestone: Begin Data Collection by October 2nd for 90 Consecutive Days of Participation
It’s not too late to participate in the first year of the Merit-based Incentive Payment System (MIPS)—one of the two tracks in the Quality Payment Program. The transition year of MIPS has been underway since January 1, 2017 and runs until December 31, 2017.

Transition year (2017) Participation:

For 2017, you can participate in one of three ways:

  • Submit data covering a full year, or
  • Submit data covering at least a consecutive 90-day period, or
  • Submit a minimum amount of data (<90 days)

Remember: You should begin data collection no later than October 2, 2017, to report 90 consecutive days of data for the transition year. For example: If you are planning to submit 90 days or more of your quality data via your claims, you would need to begin adding the applicable quality data codes to your claims no later than October 2nd. If you submit data for at least 90 days, you avoid the negative payment adjustment, and may be eligible for a positive payment adjustment.

Are you planning to submit less than 90 days of data? If so, you can begin data collection as late as Dec 31st and still avoid the negative payment adjustment. However, more data increases your likelihood of earning a positive payment adjustment.

When is data submission? This listerv is a reminder to begin data collection. You will begin submitting your 2017 MIPS performance data on January 2 through March 31, 2018.  If you are eligible to participate but choose not to submit data, you’ll get a negative 4% payment adjustment which will go into effect on January 1, 2019.

Need Help Participating?

  • Contact the Quality Payment Program at QPP@cms.hhs.gov or 1-866-288-8292 (TTY: 1-877-715-6222).

Targeted Probe and Educate
Effective 10/1/2017, the CMS is expanding the existing Targeted Probe and Educate (TPE) pilot to include all MACs. TPE will include targeted medical review and education along with an option for potential elevated action, up to and including referral to other Medicare contractors including the ZPIC, UPIC, RAC, etc. The goal of TPE is to reduce/prevent improper payments. The purpose of this expansion is to reduce appeals, decrease provider burden, and improve the medical review and education process.

Key Elements of TPE

  • All current NGS medical record reviews are replaced with three rounds of pre-payment or post-payment TPE. If the provider’s error rate remains high upon completion of the first round, then the provider is retained for the second and, potentially, a third round of review.
    • Automated reviews and prior authorization directed by CMS are outside of the TPE strategy.
    • Note that any reviews or pilots otherwise mandated by CMS are excluded from this change.
  • Providers with a continued high error rate after three rounds of TPE will be referred to CMS for additional action
  • NGS will select the topics for review based upon existing data analysis procedures.
  • The claim sample size for each round of probe review is limited to a minimum of 20 and a maximum of 40 claims
    • Note that the sample is per provider, per topic, and per round.
  • The TPE process includes provider specific education that will focus on improving specific issues without allowing other problems to develop along with an opportunity for the provider to ask questions. Education will be offered after each round of 20 to 40 claims reviewed.   We urge all to take advantage of the education.
    • In addition, there is an opportunity for intra-round education as well if the nurse reviewer identifies a common theme that can be easily corrected during the review phase.

Provider Tips

  • Providers targeted for TPE will receive a notification letter about the upcoming review and ADRs will be used for the specific claims selected for review.
  • Providers should ensure that medical records are submitted promptly upon request.
    • Reminder: ADRs must be responded to prior to the 45 day deadline (based on the date of the ADR) for each claim selected.
    • Providers are highly encouraged to respond to the ADR by sending all applicable medical records prior to day 45
  • Provider nonresponse to medical records requests will count as an error.
  • MACs may conduct a “related claim review” of services related to a denied claim and such reviews may be conducted outside of the TPE process.
  • The TPE process does not replace or change appeal rights.
    • The educational sessions are not an appeals forum nor do the result letters and/or the educational sessions extend the appeal period.

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Medical Family Practice For Sale – Long Beach, NY
Established 14 years. Newly renovated. Fully equipped ground floor premises. 3 exam rooms. Must see! Call Carol – 516-238-3422


Great Neck – Medical Zoned Condo
2690 Sqft – $699,000 – quick easy access to North Shore University Hospital, Long Island Expressway and Long Island Rail Road. 10 Exam rooms plus waiting room & large secretary area http://bit.ly/2wXCbkQ . Call Chris Pappas, LAB 516-659-6508


Beautiful, Fully-Equipped Medical Suite for Rent or Share – Glen Oaks, NY
For Rent or Share – Glen Oaks, NY
(border of Queens & Long Island)
Available for full or half-days.
Beautiful, recently renovated office
available for part-time share
OR available for rent.
Centrally located /Close to expressways.
The practice is 5 minutes from LIJ/Northwell Hospital.
8 exam rooms/procedure rooms. Waiting room, break room and
personal office with private bathroom.
(~2500 sqft) Free WIFI.
6 parking spots for patients and 2 for doctor.
The previous tenant, a full-time primary care
physician with a part-time cardiologist coming
in turned it over to an associate a year ago
but has been here for about 10 years. He needed more space
and bought a building about 20 minutes away. Our building gets a lot of drive-by traffic and pedestrian traffic from the mall across the street. Weekly we have patients walk in inquiring about the practice.
The dental practice next door sees over 2500 patients per year and refers actively to the medical suite.Follow the link for a video of the space (all furnishings, exam tables, chairs, oxygen, orthoscope included in lease – about $500k in value): https://youtu.be/f9gr62fKaVsContact Haresh at hareshshah54@hotmail.com or 516-220-3297

Upper East Side Medical Office for Rent
East 68th Street full or part-time, 1 consult room, 2 exams rooms, large waiting room, high ceilings, central A/C, carpeted throughout , window in every room, X-Ray facility in-house.  Also for Rent- Large furnished room ideal for Psychiatrist/Psychologist. Please call 212-639-1800

For Rent or Share – Woodbury, Long Island
Beautiful recently renovated Plastic Surgery
office available for part-time share and
AAAA-certified (by end of summer).
OR available for rent. Centrally located
on Long Island.Close to expressways.
3 exam rooms, 1 procedure room /OR.
Waiting room, break room and personal office.
Free WIFI. Available for full or half-days.
Suits Plastic/Cosmetic Surgeons/Derm/ENT/
ObGyn/Podiatry or other Medical MDs.
Contact Patricia at info@cosmetichg.com
or 631-318-4008

Want to Sell Your Medical Practice? Do You Have Medical Office Space to Sell or Share?
Clineeds is a new online platform designed to help medical providers sell their practice or buy, sell and share medical office space. Listing is FREE! No contracts. No commitments. No fees. Sign up today at http://www.clineeds.com/sign-up

PHYSICIAN OPPORTUNITIES
Child and Adolescent Psychiatrist – Lockport, New York, Eastern Niagara Hospital
Eastern Niagara Hospital is seeking a Full Time Medical Director for its 12 bed Child and Adolescent Psychiatric Unit.  Responsibilities include inpatient care, shared on-call responsibilities and Medical Director duties.  Competitive compensation package.  For more information, please contact David DiBacco at 716-514-5501 or email to physicians@enhs.org.


CALL FOR RATES & INFO. CHRISTINA SOUTHARD: 516-488-6100 ext. 355


September 22, 2017 – Graham-Cassidy: No Good for NY


PRESIDENT’S MESSAGE
Charles Rothberg, MD
September 22, 2017
Volume 17
Number 36

Dear Colleagues:

Graham-Cassidy Proposal Is Not Good for New York
This week, MSSNY joined with numerous other New York healthcare provider associations in a letter to New York’s Congressional delegation expressing its strong objections to the Cassidy-Graham proposal before the US Senate. This proposal could be coming up for a vote in the US Senate week next week.

As MSSNY has  stated regarding earlier proposals to profoundly restructure the Affordable Care Act (ACA), we are very concerned with the possibility that hundreds of thousands of New Yorkers could lose access to insurance programs that currently provide “first dollar” coverage.  We are also very concerned about the potentially huge adverse budgetary impacts to the State of New York.   One report has New York losing over $50 billion as a result of this bill. 

New York’s Senators Charles Schumer and Kirsten Gillibrand, are strongly opposed to it.  Moreover, some of the Republican members of New York’s Congressional delegation who supported earlier “ACA repeal and replace” proposals are now expressing strong objections to Cassidy-Graham, including Reps. John Faso, Peter King and Claudia Tenney. 

What we need are targeted reforms to fix the flaws of the ACA, instead of proposals that strip away coverage to New Yorkers who rely upon this availability to help pay for their health care needs.  We need to assure more comprehensive physician networks for our patients and to reduce the exorbitant insurer-imposed deductibles they face.   Therefore, we are also very concerned with the increasing attention being placed on “single payor” proposals as the primary alternative to these faulty ACA “repeal and replace” proposals, at a time when enactment of such a proposal in Washington is highly unlikely. 

We badly need compromise, not a further digging in of our heels.   Republicans and Democrats need to come together to find common ground and work towards the enactment of legislation that enhances rather than reduces affordable and comprehensive coverage options for our patients.”

MSSNY has signed onto the following letter: https://www.hanys.org/government_affairs/federal/docs/2017-09-19_letter_to_nys_congressional_delegation.pdf

Sincerely,
Charles Rothberg, MD
MSSNY President

Please send your comments to comments@mssny.org


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New Law to Prohibit Medical Record Charges When Needed to Support a Patient’s Government Benefit Application
As reported last week, the Governor has signed into law legislation (S.6078, Valesky/A.7842, Gottfried) that now expressly prohibits health care providers and facilities from charging patients for copies of medical records when such records are needed “for the purpose of supporting an application, claim or appeal for any government benefit or program.”

While the previous law had already prohibited charging for medical records when a patient was unable to pay, the purpose of this new law is to respond to numerous complaints lodged by patients where they were charged for medical records necessary to assist applications and appeals for government programs assisting lower income patients such as Social Security Disability Insurance (SSDI) and the Supplemental Nutritional Assistance Program (SNAP), or other government benefit program such as those for 9/11 first responders.

While noting that it did not condone the actions of health care providers who were charging low-income patients for medical records, MSSNY did express concerns that the terminology “any government benefit or program” in the legislation was too broad, and suggested that the bill be amended to specifically enumerate in the law those low-income government benefit programs to which this fee charge prohibition should apply.  However, that change was not made.

Multiple Op-Eds this Week Urge Gov. to Veto One-Sided Medical Malpractice Expansion Legislation
Physicians are again reminded that, if they have not done so, to contact Governor Cuomo to urge that he veto legislation that would trigger double digit increases in liability premiums by significantly expanding the time to bring a medical malpractice lawsuit, in circumstances based upon an “alleged negligent failure to diagnose a malignant tumor or cancer”.  Physicians can send a letter here  and by calling 518-474-8390.

This past week, Orange County Medical Society President Dr. Stephanie Zeszutek had a letter published in the Middletown Times-Herald urging the Governor to veto this bill.   Dr. Zeszutek’s letter noted that “The state has a dangerous doctor shortage and future doctors are already being deterred from certain specialties or medicine altogether due to malpractice liability concerns. This bill sets a dangerous precedent for liability across the country. We urge Gov. Cuomo to reject this bill in favor of more sensible legislation.”

Moreover, Adam Morey of the Lawsuit Reform Alliance of New York had a lengthy op-ed published in the Albany Times Union  noting that  “Before any drastic changes are made to the statute of limitations, Gov. Cuomo and the Legislature should instead work with all stakeholders to overhaul the entire medical liability apparatus. New York’s current system is in dire need of reform.”

Numerous other letters to the editor and op-eds have appeared in papers across the State over the last few months urging Governor Cuomo to veto this bill, including in the Buffalo News, Poughkeepsie Journal, Rochester Business Journal and Syracuse Post-Standard.

While many physicians have weighed in, we need an overwhelming demonstration from physicians regarding how this bill will harm access to care in their communities if this bill is signed into law without also provided needed tort reforms to bring down the exorbitant costs of medical liability insurance in New York.

The Physician Advocacy Liaison Network
Do you want to play a critical role in protecting the future of medical care delivery?

MSSNY is building an even more powerful grassroots infrastructure to increase physicians’ contacts to their local legislators.  To reach and energize our membership, we are expanding the ways by which we communicate with physicians to greatly increase our activist network, which is critical to our grassroots activity.  We must mobilize physicians to better assure the enactment of favorable legislation and the defeat of proposals that will adversely impact the care that you provide to your patients.  We must make certain that our elected officials remain committed to championing the issues that matter most to MSSNY members and their patients.

There has never been a greater need for physicians to become active.  With so many changes occurring in our health care system, and other opposition interests seeking to marginalize the physician’s role as leader of the health care team, we must make up for it with an overwhelming presence in grassroots activity that will make it impossible for legislators to ignore.

PAL responsibilities include:

  • Educating other members on issues facing physicians, such as at local county medical society or medical staff meetings
  • Working as appropriate with your county medical society, be available to meet with your members of the legislature at least twice a year
  • Being responsible for calling or writing letters to members of the legislature on issues that impact physicians
  • Attend training programs in regard to legislative issues
  • Enlisting other member to support our action plans and mobilize them to action
  • Joining and recruiting others to join MSSNYPAC

Click here to sign up! 

Thank you to the many physicians who have already answered the call and added their name to the list!


Promo Code: MSSNY


Please Urge Your Legislators to Support Due Process Protections for Physicians Dropped from Health Insurer Networks
Emblem Health Plan’s latest dropping of hundreds of physicians from its network without any due process for these physicians is a clarion call to legislators of the need to enact legislation (A.2704, Lavine/S.3943, Hannon) that assures physicians have some ability to appeal when their contracts are non-renewed.

These due process protections are required for Medicare managed care networks but not similarly required for commercial health insurance plans.  There is no good reason for this discrepancy.  This legislation passed the Assembly overwhelmingly earlier this year, but died on the floor of the State Senate.  Please take the time to contact your legislators to urge that they enact this legislation when they return to Albany in January.

Medical Matters: “Herd Community” Protects Vulnerable Populations
MSSNY will begin its 2018 Medical Matters continuing medical education (CME) webinar series with “The Importance of Herd Immunity” on Wednesday, October 18, 2017 at 7:30 a.m.  William Valenti, MD, chair of MSSNY Infectious Disease Committee and a member of the Emergency Preparedness and Disaster/Terrorism Response Committee will serve as faculty for this program. Registration is now open for this webinar here.

Additional information or assistance with registration may be obtained by contacting Melissa Hoffman at mhoffman@mssny.org.

Educational objectives are:

  • Review the epidemiology of vaccine-preventable infectious disease and role of herd immunity.
  • Describe how herd immunity protects vulnerable populations such as newborns, the elderly and those who are too sick to be vaccinated.
  • Discuss the percentage(s) of a population who need to be vaccinated to allow herd immunity to be effective.

The Medical Society of the State of New York is accredited by the Accreditation Council for Continuing Medical Education (ACCME) to provide continuing medical education for physicians.

The Medical Society of the State of New York designates this live activity for a maximum of 1.0 AMA/PRA Category 1 credits™.  Physicians should claim only the credit commensurate with the extent of their participation in the activity. 



Your membership yields results and will continue to do so. When your 2018 invoice arrives, please renew. KEEP MSSNY STRONG!


What Is the Constitutional Convention?
Every 20 years, New Yorkers have the chance to vote whether they want to hold a constitutional convention to amend or change the New York State Constitution.  Voters will decide on whether they want to hold a convention on November 7, 2017.  In 1997, voters overwhelmingly rejected a convention.  The last constitutional convention held in 1967.  If voters approve a convention, delegates would be elected in 2018, with the convention held the next year.

The New York State AFL-CIO, CSEA, NYSUT and many other unions and elected officials have come out in opposition of a constitutional convention fearing that pensions could be cut and workers’ rights could be in danger.  Various nonprofit good government groups like Citizens Union have come out in favor of a convention in hopes of fixing campaign finance laws and ethics reform.  Additionally, the New York State Bar Association have also come out in support of holding a constitutional convention.
Please click below to see who is opposing the constitutional convention?
Constitutional Convention Oppose List
Please click below to see who is supporting the constitutional convention?
Constitutional Convention Support List

Emblem Signs Major City Medical Group
EmblemHealth has agreed to a new value-based contract with Corinthian Medical IPA, the two sides jointly announced Thursday. With the deal Emblem adds to its network Corinthian’s 1,750 “providers,” many of them serving immigrant communities in Brooklyn, the Bronx, Queens and Upper Manhattan. Corinthian, led by Dr. Ramon Tallaj, has demonstrated a willingness to manage patients’ health through value-based contracts. That approach matches Emblem’s shifting of more of its business in that direction. If the physicians keep patients’ costs low, through preventive care and management of chronic diseases, Corinthian can share in Emblem’s savings.

Dr. Tallaj is also chairman of Advocate Community Providers, one of the state’s largest DSRIP Performing Provider Systems.

Radiologists: “New Anthem Imaging Policy Will Harm Patient Access to Care”
The new Anthem cost-cutting policy of not covering computed tomography (CT) and magnetic resonance imaging (MRI) performed in hospital outpatient departments is arbitrary and unwise.

Economically motivated steerage of patients compromises the physician-patient relationship and undercuts integrated health care efforts.

Denying patients covered access to care at such a vast number of facilities will delay care, increase wait times and force many patients to travel outside of their communities to get advanced imaging. The policy may particularly impact patients in inner city and rural areas. In many areas, the local hospital outpatient setting may be the only immediate access point for advanced imaging outside of the main hospital.

The ACR is concerned that Anthem’s policy will force patients to locate an ever-declining number of freestanding imaging centers and/or physician’s offices to access imaging services. If patients do find local, freestanding imaging centers, such facilities may not be immediately prepared to care for an influx of patients now denied covered access to hospital outpatient imaging. Also, by steering all patients out of the hospital, odds of these facilities caring for a patient that may experience complications is increased.

Forcing all advanced imaging out of hospital outpatient departments may prompt many of these facilities to cut back on standard imaging (X-ray, etc.) or close altogether. This may be particularly true in areas where hospitals care for many indigent patients. Moreover, this policy will impact negatively the ability to train the next generation of radiologists. The preponderance of radiology training programs occur in hospitals and hospital-owned imaging facilities.

We urge Anthem to reconsider their approach and work with providers and hospitals to achieve better coverage policy.

Students/Residents Can Submit Abstracts for 13th Annual Poster Symposium at HOD
MSSNY is very pleased to announce the 13th Resident/Fellow/Medical Student Poster Symposium to be held on Friday, March 23, 2018 at the Adam’s Mark Hotel in Buffalo, from 2:00 pm – 4:30 pm. Deadline for abstract submission is 4:00 pm, Friday, January 5, 2018. Participants must be MSSNY members. Membership is free for first-time resident members and nominal for medical students. Join online.

Detailed guidelines can be found here.

Please pass this on to any New York State residency program directors you may know, or anyone involved with a NYS medical school. 


MSSNY Travel Discount Program
MSSNY is pleased to offer an exclusive worldwide travel discount service to our members. Savings average 10-20% below-market on all hotels and car rental suppliers around the world.
Save time and money. Let us negotiate the best deals and comparison price for you.
Any hotel, any car, anywhere, anytime.
Click here to save on your next trip.

State Offers Loan Repayments for Primary Care Clinicians
The state Department of Health is requesting applications for its Primary Care Service Corps Loan Repayment Program, which aims to increase the supply of clinicians in underserved areas.

The program will pay back up to $60,000 in education loans for physicians and other health practitioners In return, the program requires that these primary-care clinicians commit to work for at least two years in a state-designated Health Professional Shortage Area or at a state correctional facility.

This is the third funding round for the program. The state has allocated up to $1 million for fiscal 2017 to 2018 for renewals of existing contracts and for new awards.

Practitioners must demonstrate that they are or will be working in primary care or behavioral health and in an outpatient or other eligible setting. Applications get higher scores based on their site’s HPSA score. Applicants also get extra points for practicing in sites that encourage a diverse work environment and support patients of diverse ethnicities, people with disabilities and other underserved populations. Assuming funding continues, practitioners can extend their contract for three renewal periods of one year each. Questions must be submitted by 4 p.m. Sept. 28, and final applications are due at 4 p.m. Nov. 1.>/span>

AMA Webinar: Thriving Under MIPS – Where to start? Breaking down the complexity of MIPS
With many feeling overwhelmed by the complexity of the Quality Payment Program (QPP), physicians struggle to answer one key question – Where do I start? To help assuage this issue, the AMA has released a new customizable resource – the MIPS Action Plan – that breaks down the complexity of the Merit-based Incentive Payment System (MIPS) track of QPP into specific actionable steps. In this 1-hour webinar, attendees will learn how to use this tool to create and/or validate their strategies for MIPS implementation in 2017. Chris Botts, AMA Care Delivery and Payment Manager will be the presenter. Click here to register.

When: Wednesday, October 18, 2017
1:00PM to 2:00PM ET

Attention Managed Care Network Physicians: Medicaid Provider Enrollment Requirement
Section 5005(b)(2) of the 21st Century Cures Act amended Section 1932(d) of the Social Security Act (SSA) and requires that effective January 1, 2018, all Medicaid Managed Care and Children’s Health Insurance Program providers must enroll with state Medicaid programs. The SSA requires that the enrollment include providing identifying information including name, specialty, date of birth, social security number, National Provider Identifier (NPI), federal taxpayer identification number, and the state license or certification number.

For example, if a physician currently participates in a network with a Medicaid managed care plan that provides services to, or orders, prescribes, or certifies eligibility for services for, individuals who are eligible for medical assistance, the physician must enroll with New York State Medicaid. To check on your enrollment status, please call CSRA at 1-800-343-9000. Practitioners may also check the Enrolled Practitioners Search function here:  If you are already enrolled as a  fee-for-service (FFS) provider and are listed as active, you will not have to enroll again.

If at one time you were a FFS provider, and your enrollment has lapsed (no longer actively enrolled), you may be able to keep your original Provider Identification Number (PID), also known as MMIS ID, by reinstating.

Practitioners who do not wish to enroll as a Medicaid FFS billing provider may enroll as a non-billing,

Ordering/Prescribing/Referring/Attending (OPRA) provider. Enrollment in Medicaid FFS does not require providers to accept Medicaid FFS patients. If you are not actively enrolled, please go to: https://www.emedny.org/info/ProviderEnrollment/index.aspx and navigate to your provider type. Print the Instructions and the Enrollment form.

At this website, you will also find a Provider Enrollment Guide, a How Do I Do It? Resource Guide, FAQs, and all forms related to enrollment in New York State Medicaid. Providers who are not enrolled with New York State Medicaid by January 1, 2018 will not be able to provide services for Medicaid managed care program members. For additional information, please see the May 2017 NYS Medicaid Update available online.


CLASSIFIEDS


Great Neck – Medical Zoned Condo
2690 Sqft – $699,000 – quick easy access to North Shore University Hospital, Long Island Expressway and Long Island Rail Road. 10 Exam rooms plus waiting room & large secretary area http://bit.ly/2wXCbkQ . Call Chris Pappas, LAB 516-659-6508


Beautiful, Fully-Equipped Medical Suite for Rent or Share – Glen Oaks, NY
For Rent or Share – Glen Oaks, NY
(border of Queens & Long Island)
Available for full or half-days.
Beautiful, recently renovated office
available for part-time share
OR available for rent.
Centrally located /Close to expressways.
The practice is 5 minutes from LIJ/Northwell Hospital.
8 exam rooms/procedure rooms. Waiting room, break room and
personal office with private bathroom.
(~2500 sqft) Free WIFI.
6 parking spots for patients and 2 for doctor.
The previous tenant, a full-time primary care
physician with a part-time cardiologist coming
in turned it over to an associate a year ago
but has been here for about 10 years. He needed more space
and bought a building about 20 minutes away. Our building gets a lot of drive-by traffic and pedestrian traffic from the mall across the street. Weekly we have patients walk in inquiring about the practice.
The dental practice next door sees over 2500 patients per year and refers actively to the medical suite.Follow the link for a video of the space (all furnishings, exam tables, chairs, oxygen, orthoscope included in lease – about $500k in value): https://youtu.be/f9gr62fKaVsContact Haresh at hareshshah54@hotmail.com or 516-220-3297


Upper East Side Medical Office for Rent
East 68th Street full or part-time, 1 consult room, 2 exams rooms, large waiting room, high ceilings, central A/C, carpeted throughout , window in every room, X-Ray facility in-house.  Also for Rent- Large furnished room ideal for Psychiatrist/Psychologist. Please call 212-639-1800

For Rent or Share – Woodbury, Long Island
Beautiful recently renovated Plastic Surgery
office available for part-time share and
AAAA-certified (by end of summer).
OR available for rent. Centrally located
on Long Island.Close to expressways.
3 exam rooms, 1 procedure room /OR.
Waiting room, break room and personal office.
Free WIFI. Available for full or half-days.
Suits Plastic/Cosmetic Surgeons/Derm/ENT/
ObGyn/Podiatry or other Medical MDs.
Contact Patricia at info@cosmetichg.com
or 631-318-4008

Want to Sell Your Medical Practice? Do You Have Medical Office Space to Sell or Share?
Clineeds is a new online platform designed to help medical providers sell their practice or buy, sell and share medical office space. Listing is FREE! No contracts. No commitments. No fees. Sign up today at http://www.clineeds.com/sign-up

PHYSICIAN OPPORTUNITIES
Child and Adolescent Psychiatrist – Lockport, New York, Eastern Niagara Hospital
Eastern Niagara Hospital is seeking a Full Time Medical Director for its 12 bed Child and Adolescent Psychiatric Unit.  Responsibilities include inpatient care, shared on-call responsibilities and Medical Director duties.  Competitive compensation package.  For more information, please contact David DiBacco at 716-514-5501 or email to physicians@enhs.org.


CALL FOR RATES & INFO. CHRISTINA SOUTHARD: 516-488-6100 ext. 355


September 15, 2017 – QPP for NEWBIES!


PRESIDENT’S MESSAGE
Charles Rothberg, MD
September 15, 2017
Volume 17
Number 35

Dear Colleagues:

Finally, there is a user-friendly video that shows physicians, in a straight and forward manner, how to avoid 4% Medicare Payment Penalties in 2019. IT’S SURPRISINGLY QUICK.  IT’S SURPRISINGLY EASY.  AND it is available at: https://www.ama-assn.org/qpp-reporting

The Quality Payment Program (QPP) is the new physician payment system created by the Medicare Access and CHIP Reauthorization Act (MACRA) and is administered by CMS. Because the QPP is new this year, MSSNY and the AMA want to make sure physicians know what they have to do to participate and the QPP’s “Pick your Pace” options for reporting. This is especially important for those physicians who have not participated in past Medicare reporting and programs and may be less FAMILIAR WITH the steps they can take to avoid being penalized under the QPP.

This SHORT  video developed by the AMA, titled “One Patient, One Measure, No Penalty: How to Avoid a Medicare Payment Penalty with Basic Reporting ,” offers step-by-step instructions on how to report so physicians can avoid a negative 4% payment adjustment in 2019.  Under the “Pick-Your-Pace” mode,  this is the TEST component.  DESPITE CMS CHARACTERIZATION OF ” one-patient, one-measure” on one claim, our VP of MSSNY’s Socio-Medical Economics Division  Regina McNally ADVISES PHYSICIANS THAT, “Just to be safe, file three or four measures on three or four patients just to makes sure the government gets it.”

The AMA and the Federation stressed to CMS the importance of establishing a transition period to QPP and, as a result, physicians need only to report on at least one quality measure for one patient during 2017 in order to avoid a payment penalty in 2019 under the Merit-based Incentive Payment System (MIPS). On this website , there are also links to CMS’ quality measure tools and an example of what a completed 1500 billing form looks like.

Regina McNally, strongly urges our members who are “lost” and want no part of MIPS to view this video. “This is the first video I have seen that simplifies the process, explains the process clearly and succinctly, and could help physicians from paying penalties,” she said.

Please visit: https://www.ama-assn.org/qpp-reporting

Sincerely,
Charles Rothberg, MD
MSSNY President

Please send your comments to comments@mssny.org


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September 14 Council Notes

  • MSSNY’s VP of Legislative and Regulatory Affairs John Belmont presented information on Physician Advocacy Network (PAL), an initiative aimed at getting MSSNY’s message out to legislators in an innovative new way. MSSNY recognizes that many physicians have relationships with various legislators and others activists.  The goal would be to have at least two or three members assigned as a liaison to each state legislator and for these PALs to meet personally with their assigned legislator at least twice a year to develop or further solidify relationships with elected officials. MSSNY is currently in the process of updating and retooling our key contact list to assist in our legislative advocacy and is looking for assistance from members in reaching out and identifying physicians who have close relationships with legislators. For more information, contact John Belmont at jbelmont@mssny.org or 518-465-8085.
  • Speaker Kira Geraci-Ciardullo, MD announced key information and deadlines for the House of Delegates meeting, which will begin on Friday, March 23, 2018 and will adjourn on Sunday, March 25, 2018. All activities will take place at the Adam’s Mark Hotel in Buffalo. The window for submitting Resolutions is January 22, 2018-February 9, 2018 at 5 pm.
  • A letter was sent by 41 state medical societies (including MSSNY), and 33 National Medical Specialty Societies, to Dr. Nora of the American Board of Medical Specialties regarding the ongoing contentious issue of MOC. The letter informed ABMS about both a high-level summit that recently took place regarding MOC, and an upcoming meeting in December with the ABMS, the Council of American Specialty Societies and state medical societies to share physician views and seek agreement on how to reshape the MOC process. Dr. Madejski will represent MSSNY at the December meeting.
  • Council reconsidered Resolution 2017-157: Development and Promotion of Evidence-based Ultrasound –First Radiation Mitigating Protocols, and voted to Not Adopt Resolution 157.
  • MESF will present Physicians Leadership Seminar on October 20-21, 2017 at the Albany Hilton. Topics include Where the NYS Legislature is Leading Us in Health Care; Strategic Leadership of the Health Care Enterprise: Creating Value in Turbulent Times; and Blue Ocean Thinking: Focusing on Where the Fish are Swimming. Featured speakers include Jon Chilingerian, Ph.D, Carole Carlson, MBA.


New Law to Prohibit Medical Record Charges When Needed to Support a Patient’s Government Benefit Application
Governor Cuomo has signed into law legislation (S.6078, Valesky/A.7842, Gottfried) that prohibits health care providers and facilities from charging patients for copies of medical records when such records are needed “for the purpose of supporting an application, claim or appeal for any government benefit or program”.  While existing law already prohibits charging for medical records when a patient is unable to pay, the purpose of the new law is to respond to numerous complaints lodged by patients where they were charged for medical records necessary to assist applications and appeals for government programs assisting lower income patients such as Social Security Disability Insurance (SSDI) and the Supplemental Nutritional Assistance Program (SNAP), or other government benefit program such as those for 9/11 first responders.  While noting that it did not condone the actions of health care providers who were charging low-income patients for medical records, MSSNY did express concerns that the terminology “any government benefit or program” in the legislation was too broad, and suggested that the bill be amended to specifically enumerate in the law those low-income government benefit programs to which this fee charge prohibition should apply. However, that change was not made. S6078 letter to the Governor

Centene to Buy New York’s Fidelis Care For $3.75 Billion
The Wall Street Journal (9/12) reported that Centene Corp. announced Tuesday that it will buy nonprofit health insurer Fidelis Care in a $3.75 billion deal. The deal adds 1.6 million members in New York to Centene. Centene is a leader in Medicaid managed care business and Medicare, and is also active in Affordable Care Act exchange plans. The deal is expected to close in the first quarter, according to the Journal.

Unlike its competitors Aetna, Anthem, UnitedHealth Group, and Humana, Centene is expanding into new markets and “has been able to successfully manage the costs of sick uninsured Americans buying individual policies on the ACA’s public exchanges. Centene had nearly 1.1 million customers enrolled in ACA marketplaces as of June 30 this year, compared to 617,700 at this time last year. Fidelis, the article says, is “an established player in New York’s Obamacare, Medicaid and Medicare Advantage markets.” Forbes (9/12)



Promo Code: MSSNY



The Law: Pharmacy Providers Cannot Demand Copays from Those Who Cannot Pay
The NYS Medicaid Pharmacy Program has been notified that some pharmacies are refusing to dispense medications to patients for their inability to pay the copayment. Social Security Act §1916 specifies that no Medicaid enrolled provider may deny care or services to an individual eligible for such care or services on account of such individual’s inability to pay a deduction, cost sharing, or similar charge. The September 2011 Special Edition Medicaid Update cover-page and the March 2012 Medicaid Update page 15, confirm this Federal law applies to all Medicaid providers, both fee-for-service and managed care. Providers may attempt to collect outstanding copayments through methods such as requesting the co-payment each time the member is provided services or goods, sending bills or any other legal means

Dr. Rosenblatt: Desperately Seeking Physician Support for Proposed Office-Based Surgery Guidance Changes
The NYS Department of Health has an Office Based Surgery (OBS) Advisory Committee, of which I have been a member since 2006.  In July of 2017, the NYS DOH decided it would conduct a voluntary pilot with OBS practices requiring them to report the number of cases they perform and the AMA-CPT codes of these cases via the Health Commerce System (HCS).

The first foray by the DOH to mine data was meant to be voluntary.  However, starting January 2018, the DOH wants to make the provision of this information mandatory by all NYS OBS practices. They feel that they have the authority to require this because of the following wording in the OBS law:

Reference: PHL § 230-d, 4. (b): “The department may also require licensees to report additional data such as procedural information as needed for the interpretation of adverse events.” http://www.health.ny.gov/professionals/office-based_surgery/law/docs/230-d.pdf

As a plastic surgeon, and MSSNY’s representative on the OBS Advisory Committee, I am only one of   a few practicing office-based physicians on the DOH Committee.  We practicing OBS physicians are outnumbered by the significant number of state employees and full-time hospitalists on the Committee. I have been speaking against this requirement for the following reasons:

  • Much of the data that the DOH is seeking and asking to be reported is publicly available. For example,  AAAASF already provides the number of cases done per 6-month period to the DOH.The law already requires an OBS physician or center to report certain types of adverse events (AE).
  • This kind of regular health record reporting requirement would be burdensome and not needed to develop policies to protect patients in office-based surgical facilities.
  • This proposed requirement represents an unfunded time consuming mandate for practicing physicians
  • I don’t agree that the law allows the DOH to require all OBS facilities to regularly report this information

For many plastic surgeons who provide OBS, the vast majority of our procedures are not reimbursed by insurance.  Therefore, AMA-CPT codes are not used for recording those procedures.

In NYS there are over 990 OBS facilities. https://www.health.ny.gov/professionals/office-based_surgery/practices/.  To locate a specific OBS site, click on Number of accredited practices by county and select the county of your choice.

Effective July 14, 2009, physician offices that perform surgical or invasive procedures using more than mild sedation or liposuction over 500cc under straight local must be accredited by one of these agencies:

There are about 650 OBSs that are certified by AAAASF, which provides the NYS DOH with the number of cases done. Neither AAASF nor the Joint Commission ask their facilities for those numbers; and therefore, doesn’t supply that information to the NYS DOH.  If the DOH wants the number of cases, they should ask the two other certifying agencies to provide them the data and not hassle the doctors.

So far during the voluntary reporting, only 179 of the over 900 OBS facilities in NYS have reported.   When the DOH leaders were asked what will occur if facilities do not report in 2018, their answer was that the OBS sites would be reported to the OPMC.  Can you imagine what the OPMC would do with the report of hundreds of non-reporting facilities?  They are overburdened by their current workload.

MSSNY and I are looking for support from all the NYS OBS facilities.  We need to mobilize the NYS Plastic Surgical Society, NY Regional Society of Plastic Surgery, Gastroenterology, invasive radiology and all other specialists who work in their own accredited office-based surgical facilities to urge the NYS DOH to obtain the data they seek from the OBS certifying agencies.

If you feel that the DOH is overstepping their charge, as I do, please call the DOH or Rosemarie Casale  (518) 408-1219) (Rosemarie.Casale@health.ny.gov) and express your displeasure at having to fill out more forms.

If you have any more ideas, I will be glad to speak to any of you.

William Rosenblatt MD
Past President of MSSNY
Vice-President AAAASF
wbrosenblattmd@verizon.net

Managed Care Network Physicians: Medicaid Provider Enrollment Requirement
Section 5005(b)(2) of the 21st Century Cures Act amended Section 1932(d) of the Social Security Act (SSA) and requires that effective January 1, 2018, all Medicaid Managed Care and Children’s Health Insurance Program providers must enroll with state Medicaid programs. The SSA requires that the enrollment include providing identifying information including name, specialty, date of birth, social security number, National Provider Identifier (NPI), federal taxpayer identification number, and the state license or certification number.

For example, if a physician currently participates in a network with a Medicaid managed care plan that provides services to, or orders, prescribes, or certifies eligibility for services for, individuals who are eligible for medical assistance, the physician must enroll with New York State Medicaid.

Common Enrollment Questions:

  • To check on your enrollment status, please call CSRA at 1-800-343-9000. Practitioners may also check the Enrolled    Practitioners Search function at: https://www.emedny.org/info/opra.aspx
  • If you are already enrolled as a Medicaid fee-for-service (FFS) provider and are listed as active, you will not have to enroll again.
  • If at one time you were a FFS provider, and your enrollment has lapsed (no longer actively enrolled), you may be able to keep your original Provider Identification Number (PID), also known as MMIS ID, by reinstating.
  • Practitioners who do not wish to enroll as a Medicaid FFS billing provider may enroll as a non-billing, Ordering/Prescribing/Referring/Attending (OPRA) provider. The enrollment form for this function is attached.
  • Enrollment in Medicaid FFS does not require providers to accept Medicaid FFS patients.

If you are not actively enrolled, please go to: https://www.emedny.org/info/ProviderEnrollment/index.aspx  and navigate to your provider type. Print the Instructions and the Enrollment form. At this website, you will also find a Provider Enrollment Guide, a How Do I Do It? Resource Guide, FAQs, and all forms related to enrollment in New York State Medicaid.

As a point of information, under 42 CFR 455.104 defines the following providers as excluded from the definition of “disclosing entity”:

  • Solo practitioners such as an individual physician, psychologist, or chiropractor.
  • Group of individual practitioners, such as a group of cardiologists, or a group of radiologists.”

Therefore, physicians do not need to complete Section 5.

If you have questions, please call Regina McNally


Your membership yields results and will continue to do so. When your 2018 invoice arrives, please renew. KEEP MSSNY STRONG!



Donate to AMA’s Physician Disaster Fund
MSSNY Councilor Josh Cohen, MD, MPH is also President, AMA Foundation Board sent a letter providing information as to how New York physicians can aid fellow physicians affected by the recent storms.

The physician community rallied together to help our peers in Texas who were adversely affected by Hurricane Harvey. Now, as a result of the havoc caused by Hurricane Irma, more of our colleagues are experiencing the same devastation in Florida and need our support. It is vital for doctors to quickly rebuild their medical practices to continue serving their communities. The AMA Foundation created the Physician Disaster Recovery Fund to offer relief to doctors in this time of great need.

Your gift today to the AMAF’s Physician Disaster Recovery Fund will directly support Texas and Florida to help to reestablish delivery of patient care by physician practices impacted by Hurricane Harvey and Hurricane Irma.

Join us and please make a gift to the AMAF’s Physician Disaster Recovery Fund. Let’s work together to enable our fellow physicians to get back to the vital work of caring for their patients.

If you have already made a gift – thank you for your generosity!

Coding Tip of the Week
By Jacqueline Thelian, CPC, CPC-I, CHCA Medco Consultants, Inc.

Q: I have been denied by many insurance carriers for invalid radiology orders. What am I doing wrong?

A:  Diagnostic tests are currently under scrutiny from many insurers. To be sure your orders are in good order make sure they include the following:

  • The patient’s name
  • The test requested
  • Clinical indications for the test (diagnosis)
  • The legible name, signature and date of the ordering provider
  • Signature stamps are not acceptable
  • The Medicare Claims Processing Manual (Chapter 23, Section 10.1.2) states that the ordering physician must provide the diagnostic information at the time the study is ordered.

Also keep in mind insurance carriers are also verifying the orders with the ordering provider to make sure the medical necessity for ordering the test is documented. In some cases, the insurance carrier is leaving that responsibility up to the servicing provider.

The source document frequently referenced by the carriers is the DOH Medicaid Update May 2006 Vol.21, No 5, Documentation Requirements for Ordered Services. Check it out https://www.health.ny.gov/health_care/medicaid/program/update/2006/may2006.htm

If you have a coding or compliance question you would like to have answered please send your question to MSSNY at eskelly@mssny.org, and complete the subject line with “Tip of the Week.”

Feds: NY Paid $1.4B to Providers with Medicaid Compliance Problem
The AP (9/12) reports that New York State paid $1.4 billion in Medicaid funds in 2014 to long-term care providers who did not comply with state rules for the program, according to federal Office of the Inspector General report published Tuesday. The report “revealed a large number of providers who failed to document patient assessments, provide community-based services or provide written care plans to patients, all requirements spelled out in their contracts with the state.” New York Medicaid Director Jason Helgerson disagreed with the report’s conclusions, stating that many are “simple paperwork problems” and “wouldn’t be sufficient reason to demand full refunds from the providers.”

Many of the deficiencies outlined in the report amount to simple paperwork problems, he said, and wouldn’t be sufficient reason to demand full refunds from the providers, a move he likened to the “death penalty.” He said the report’s conclusion that $1.4 billion could have been saved is “a complete mischaracterization.”

“They’re suggesting that if any (provider) plan has any clerical error – if they have any deficiencies – we should recoup entire years of reimbursement,” he said. “If we were to basically ding them for a full year’s reimbursement, no one would ever sign that contract.”

He said the agency is looking at using fines as a way to ensure providers are complying with the rules.

“We want full compliance,” he said, “but at the same time we have to have a measured response.”

MSSNY President to Be Honored at Harvest Moon Ball in Glen Cove
MSSNY President Charles N. Rothberg is being honored at the Brookhaven Hospital Harvest Moon Ball at the Nassau Country Club in Glen Cove (Long Island) on Saturday, October 14, 2017 from 6PM to 10PM. Dr. Rothberg will be receiving the Dr. Jacob Dranitzke Award.  For tickets, to donate or be a sponsor, please go here.

Monroe County Joins ABMS Multi-Specialty Portfolio Program
The Monroe County Medical Society (MCMS) has joined the American Board of Medical Specialties’ (ABMS) Multi-specialty Portfolio Program. The program, functioning in the quality collaborative segment of the Society, will assist the organization in providing basic guidelines for clinical care across the region.

Based in Rochester, the Monroe County Medical Society covers Livingston, Monroe, Ontario, Steuben, Seneca, Wayne and Yates counties, advocating for betterment of health care in the region.

“As an ABMS Portfolio Program Sponsor, MCMS will ensure that we provide meaningful QI [quality improvement] project opportunities to the physicians in our region, bringing expertise of the Quality Collaborative and physician leadership oversight to the program,” said Christopher Bell, executive director of MCMS, in a statement. “We will encourage physicians to be innovative in their project designs or participate in projects developed within the Quality Collaborative and will welcome their feedback during the process to ensure they have input throughout it.”

In the early hours of the program, the MCMS expects 250 primary care physicians to participate. The result, as Bell stated, is intended to be a push for better quality control for health care in the region.

“MCMS’ participation in the Portfolio Program provides additional recognition of the valuable efforts these physicians and their teams are undertaking to improve the care of not only their current patient population, but through their various collaborations, even more patients and families throughout the state,” said David Price, executive director of the Portfolio Program.

Utilized nationwide, the Portfolio Program, to date, has initiated over 2,000 improvement efforts to health care systems.



CLASSIFIEDS



Great Neck – Medical Zoned Condo
2690 Sqft – $699,000 – quick easy access to North Shore University Hospital, Long Island Expressway and Long Island Rail Road. 10 Exam rooms plus waiting room & large secretary area http://bit.ly/2wXCbkQ . Call Chris Pappas, LAB 516-659-6508

Beautiful, Fully-Equipped Medical Suite for Rent or Share – Glen Oaks, NY
For Rent or Share – Glen Oaks, NY
(border of Queens & Long Island)
Available for full or half-days.
Beautiful, recently renovated office
available for part-time share
OR available for rent.
Centrally located /Close to expressways.
The practice is 5 minutes from LIJ/Northwell Hospital.
8 exam rooms/procedure rooms. Waiting room, break room and
personal office with private bathroom.
(~2500 sqft) Free WIFI.
6 parking spots for patients and 2 for doctor.
The previous tenant, a full-time primary care
physician with a part-time cardiologist coming
in turned it over to an associate a year ago
but has been here for about 10 years. He needed more space
and bought a building about 20 minutes away. Our building gets a lot of drive-by traffic and pedestrian traffic from the mall across the street. Weekly we have patients walk in inquiring about the practice.
The dental practice next door sees over 2500 patients per year and refers actively to the medical suite.

Follow the link for a video of the space (all furnishings, exam tables, chairs, oxygen, orthoscope included in lease – about $500k in value): https://youtu.be/f9gr62fKaVs

Contact Haresh at hareshshah54@hotmail.com or 516-220-3297


Upper East Side Medical Office for Rent
East 68th Street full or part-time, 1 consult room, 2 exams rooms, large waiting room, high ceilings, central A/C, carpeted throughout , window in every room, X-Ray facility in-house.  Also for Rent- Large furnished room ideal for Psychiatrist/Psychologist. Please call 212-639-1800

For Rent or Share – Woodbury, Long Island
Beautiful recently renovated Plastic Surgery
office available for part-time share and
AAAA-certified (by end of summer).
OR available for rent. Centrally located
on Long Island.Close to expressways.
3 exam rooms, 1 procedure room /OR.
Waiting room, break room and personal office.
Free WIFI. Available for full or half-days.
Suits Plastic/Cosmetic Surgeons/Derm/ENT/
ObGyn/Podiatry or other Medical MDs.
Contact Patricia at info@cosmetichg.com
or 631-318-4008

Want to Sell Your Medical Practice? Do You Have Medical Office Space to Sell or Share?
Clineeds is a new online platform designed to help medical providers sell their practice or buy, sell and share medical office space. Listing is FREE! No contracts. No commitments. No fees. Sign up today at http://www.clineeds.com/sign-up

PHYSICIAN OPPORTUNITIES

Child and Adolescent Psychiatrist – Lockport, New York, Eastern Niagara Hospital
Eastern Niagara Hospital is seeking a Full Time Medical Director for its 12 bed Child and Adolescent Psychiatric Unit.  Responsibilities include inpatient care, shared on-call responsibilities and Medical Director duties.  Competitive compensation package.  For more information, please contact David DiBacco at 716-514-5501 or email to physicians@enhs.org.


CALL FOR RATES & INFO. CHRISTINA SOUTHARD: 516-488-6100 ext. 355

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