July 21, 2017


PRESIDENT’S MESSAGE
Charles Rothberg, MD
July 21, 2017
Volume 17
Number 28

Dear Colleagues:

The Daily Beast and other publications reported this week that the current Administration and the Department of Health and Human Services used taxpayer money—earmarked for encouraging enrollment in the ACA—on a multi-pronged public relations campaign designed to damage public opinion of Obamacare.

How is it possible that an agency tasked with overseeing the existing health care law and educating the public can instead divert taxpayer dollars to fly people dissatisfied with the ACA to DC from all over the country to produce negative videos?

The ACA website has also been redesigned. Instead of a direct link to access the sign-up portal, the site criticizes the healthcare.gov and encourages people to use private sector web brokers.
Former HHS Secretary Kathleen Sebelius told The Daily Beast: “I’m on a daily basis horrified by leaders at the Department of Health and Human Services who seem intent on taking healthcare away from the constituents they are supposed to serve. We always believed that delivering health and human services was the mission of the department. That seems to not be the mission of the current leadership.”

Governor Awards $76.3 M

Also, this week, Gov. Cuomo awarded $76.3 million (see list below)to support 27 projects that will protect and transform New York’s health care system. More dollars for healthcare is good for patients, good for physicians, and good for our communities.

Sincerely,
Charles Rothberg, MD
MSSNY President

Please send your comments to comments@mssny.org

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MSSNY Objects to UHC Policy Change re Consultation Reimbursement
In the June United Healthcare Bulletin, the plan placed a notice regarding the elimination of reimbursement for consultation codes effective October 1, 2017. UHC indicates that they are adopting a policy that was put forth by CMS for the Medicare program back in 2010. MSSNY is joining with other entities of organized medicine to voice our strong opposition to UHC regarding this egregious policy change.

ACA Repeal/Replacement Could Affect Coverage of Some 370,000 Long Islanders
Newsday (NY) (7/15) reported that nearly 370,000 people in Long Island “could see their access to health coverage directly affected by the possible repeal and replacement of the 2010 Affordable Care Act.” In a statement, Dr. Charles Rothberg, President of the Medical Society of the State of New York, said, ‘While a wholesale review of the flaws of the ACA should be undertaken, we are deeply concerned about potentially significant adverse consequences to New York’s residents and its health care system arising from proposals before the House and Senate.’” Dr. Rothberg said in an interview, “I think New York and Long Island have the potential to be devastated.”

$491 Million Awarded Statewide to Health Care Facility Transformation Program
27 Awards to Support Essential Health Care Services
This week, Governor Cuomo announced $76.3 million to support 27 projects that will protect and transform New York City’s health care system. As part of the $491 million Statewide Health Care Facility Transformation Program, this funding will improve patient care through the development of high-quality medical facilities and programs serving the inpatient, primary care, mental health, substance use disorder and long-term care needs of communities throughout New York State.

“Now, more than ever, we need to protect health care in New York and ensure the system in place is meeting the needs of current and future generations of New Yorkers,” Governor Cuomo said. “While others seek to decimate our hospitals and reduce access to quality healthcare, we are investing to help ensure a stronger, healthier New York for all.”

For more information about the 27 awarded providers, the specific funding awarded, and the details about the awarded projects, click here .



Your membership yields results and will continue to do so. When your 2017 invoice arrives, please renew. KEEP MSSNY STRONG!


AMA Update on Senate Reform Bill
While there was considerable activity in the Senate this week, plans for bringing a health system reform bill to the floor for a vote remain very fluid.  Up until this week, Majority Leader McConnell could only afford to lose two Republican votes to pass an Affordable Care Act (ACA) “repeal and replace” bill, and with the sad news that Senator John McCain’s illness may keep him away from Washington next week that number could be reduced to one.  Nevertheless, under pressure from both from President Trump and a long legislative to-do list, Senator McConnell said he will attempt to bring repeal legislation to the floor next Tuesday.

Process
Senators will be asked on Tuesday to approve a motion to open debate on the House-passed American Health Care Act, H.R. 1628.  At this point, it appears that two substitute amendments for the House-passed text are likely candidates to serve as the basis for Senate debate and amendment:

  • A revised version of the Obamacare Repeal and Reconciliation Act (ORRA), vetoed by President Obama in 2015, that eliminates mandate penalties as well as all premium subsidies and Medicaid expansion funds; or
  • The Better Care Reconciliation Act (BCRA), with modification that include additional funding for opioid addiction treatment and for market stabilization, among other changes.

It is unclear whether there are 50 votes to approve the motion to proceed, let alone for passage of either of these substitute amendments (which could be revised further before Tuesday).  To date, enough Senators have expressed opposition to proceeding to either substitute to block its consideration, though negotiations are ongoing.

Want to Get Involved? AMPAC Campaign School October 27-29
The 2017 AMPAC Campaign School will be taking place Oct. 27-29 at the AMA Office in Washington, DC. The school is targeted to AMA members, their spouses, residents, medical students and medical society staff who want to become more involved in the campaign process. Running an effective campaign can be the difference between winning and losing a race. That’s why the AMPAC Campaign School is designed to give you the skills and strategic approach you will need out on the campaign trail. The AMA  team of political experts will teach you everything you need to know to run a successful campaign or be a sought-after volunteer.

During the two and a half day in-person portion of the program under the direction of  political experts, participants will be broken into campaign staff teams to run a simulated congressional campaign using what they’ve learned from the pre-school workbook activities and videos along with the group sessions on strategy, vote targeting, social media, advertising and more.

NOTE: Faculty, materials (including the pre-school workbooks, videos and all in-person meeting materials) and all meals during the meeting are covered by AMPAC. Participants are responsible for the registration fee ($350 for AMA Members / $1000 for non-members), airfare, and hotel accommodations at the Hyatt Regency Washington on Capitol Hill (AMA has secured a room block for a discounted rate). The registration fee is waived for residents and students, however, space is limited to four slots and the AMPAC Board will review and select qualified participants from the pool of resident and student applicants.

For more information or to apply click here.


CLASSIFIEDS


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

Medical Space Available for Leasing
Currently (last 7 years) occupied by Lab Corp.
2,500 sq. ft. ADA compliant.
25-15 Steinway Street, Astoria, NY 11103
Please contact Landlord: 1-800-283-0602;
e mail: wwwevans@yahoo.com

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



Job Posting – Chief Medical Officer – Cayuga Medical Associates

Cayuga Medical Associates (CMA), a growing multi-specialty group located in the heart of the beautiful Finger Lakes Region in Central New York, is currently seeking a Chief Medical Officer to work within the organization. This newly created senior leadership position is designed to ensure that high quality, service-oriented patient care is delivered by Cayuga Medical Associates’ physicians on a consistent basis. The Chief Medical Officer has primary responsibility for clinical issues pertaining to the delivery of patient care services, patient satisfaction, and quality at the practice level. This position will report to the President of CMA, with an administrative dyad/partnership to the Chief Operating Officer. In this role, the Chief Medical Officer will work in an administrative capacity 2 days a week, and will practice as a physician for the remaining 3 days of the workweek.

This position will require the physician to:

  • Engage in Physician recruitment, engagement and retention, in collaboration with President and Chief Operating Officer
  •  Set and communicate performance, service standards and expectations to  all providers
  •  Exercise professional clinical leadership regarding specific cases or questions of quality or compliance
  • Assist with compensation model refinements and redesign, with specific focus on quality and productivity metrics
  •  Oversee CMA’s Physician Action Council (PAC)
  •  Develop and implements physician peer review system, medical policies, and clinical programs

Qualifications for this position include:

  • Graduate from accredited medical school and appropriate residency training
  • Board certified physician in a primary care or related sub-specialty area
  •  Active NYS medical license
  •  At least 3-5 years of relevant work experience in a physician practice setting, prior experience in physician leadership role preferred
  • Strong leadership skills to develop a close, collaborative working relationship with senior leadership team, physician leaders, and practice  management staff

The Finger Lakes region of New York offers endless opportunities for outdoor adventures, as well as rich support of the arts and diverse cultural opportunities, excellent school districts, and charming villages, towns and small cities to call home.  If you are dedicated to excellence and possess a commitment to patient-centered care, please submit your CV and cover letter to cma_hr@cayugamedicalassociates.org or fax to (607) 277-1415, attention Human Resources. CMA offers a competitive pay and benefits package and is an equal opportunity employer.


Position Available for Critical Care Physician to Join Established Practice in Nassau County, Long Island, NY.
The Physician will join our existing team of Board-Eligible/Board-Certified Intensivists. This is a PT/FT position including both nocturnal and daytime responsibilities. The Physician will work with a dedicated group of highly trained mid-level practitioners, respiratory therapists and nurses to provide Critical Care at St. Francis Hospital in Roslyn, NY. St. Francis was ranked one of the top 10 hospitals in the nation for Cardiac Care and is top rated nationally in seven other adult specialties.
We are expanding our Intensivist Program and are expecting to add an Intensivist to our group.
Nassau Chest Physicians, P.C. was established in 1978 to provide state-of-the-art care to patients with pulmonary diseases on Long Island. We have expanded our practice to include 8 Intensivist/Pulmonologists and 5 pure Intensivists. Since 2006, we have assumed management of Critical Care services at St. Francis Hospital-The Heart Center in Roslyn, NY.
St. Francis Hospital is New York State’s only specialty designated cardiac center and is a nationally recognized leader in cardiology and heart surgery, ear-nose-throat, gastroenterology and GI surgery, geriatrics, neurology and neurosurgery. More cardiac procedures are performed at St. Francis than at any other hospital in New York State. The hospital is located on the North Shore of Long Island; approximately 30 minutes from Manhattan. The hospital combines unrivaled expertise in cardiovascular medicine with top-ranged nursing (AACN Magnet Award) to provide the very best in patient care.
In addition, St. Francis offers excellent Thoracic, Vascular, Oncologic, Neurosurgical, and Orthopedic Surgical Programs. We have a very active Emergency Department. The hospital offers the latest in technologies such as Therapeutic Temperature Modification, Impella, ECMO and LVAD. Our excellent and experienced medical staff supports strong medical and surgical subspecialty programs.

Aside from Certified Critical Care Nurses, many who have more than 20 years of experience and are expert at caring for this complex patient population, we have a growing pool of Intensivist mid-level practitioners who work hand in hand with our Intensivist physicians to coordinate the care of the critically ill patient, minister to them and perform procedures.

Of course, a New York License is required. J1 or H1 VISAS accepted.
Additional Salary Information: Salary and benefits are competitive and commensurate with experience. Interested applicants, send resume to: dr.sorett@nassauchest.com


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

July 14, 2017 – Last Chance to Demand VETO!


PRESIDENT’S MESSAGE
Charles Rothberg, MD
July 14, 2017
Volume 17
Number 27

Dear Colleagues:

Bad week for medicine, law and money. Last week I wrote about the NYS legislature passing an over reaching and defective expansion of medical liability (“Lavern’s Law”) that seriously burdens all providers, but at the same time leaves an unsuspecting public nearly as unprotected as before.

This week, a discredited, convicted legislative leader— perhaps best known as an opponent of liability reforms, had his corruption conviction overturned on appeal.

And, in that leader, the medical connection extends beyond medical liability. Mr. Sheldon Silver was convicted of using his office to provide public money to a medical researcher in exchange for referrals of patients (also possible plaintiffs).  Mr. Silver was in turn paid for those referrals. He did no work—an activity illegal for doctors but—perfectly legal for lawyers.

For this, Mr. Silver was convicted in 2015. But in another case in 2016, the US Supreme Court narrowed the definition of corruption sufficiently to provide the technicality to overturn Mr. Silver’s conviction.

His story of conflicts regarding the legislature, the legal profession, and the medical profession illustrates the difficulty of obtaining a legislative solution to overcome the deficiencies of our medical liability system.  And while a stunning story, there persists within the legislature a cultural barrier to the best solutions.  Last year, in New York State, medical liability payouts were $700 million.  The public deserves better for the money.

When will our elected officials finally examine the adversarial trial process, its distortions, unintended consequences, and inefficiencies in order to institute reforms that return the process to its public purpose?

Meanwhile, I urge the Governor to veto this version of Lavern’s law instead of doubling down on this outrageous charade. Now, more than ever, we need comprehensive reform.

PHYSICIANS MUST CONTINUE TO CALL GOVERNOR CUOMO AT 518-474-8390 and send a letter from here

Sincerely,
Charles Rothberg, MD
MSSNY President

Please send your comments to comments@mssny.org

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We Can Assure the Stability of MLMIC
In today’s marketplace, stability is top-of-mind for many us. And given recent reports from July 6, 2017, by the Albany Times Union and Politico, that New York State has ousted the CEO of the state’s second largest medical malpractice insurance carrier, this is unsurprising.

However, MLMIC, our trusted partner and longstanding endorsed professional liability insurer, continues to maintain a sound financial condition. And for 40+ years, MLMIC has provided exceptional coverage, an unyielding defense, strong risk management programs, and high-quality legal counsel to the physicians of the State of New York.

MSSNY and MLMIC remain unwavering in our commitment to protecting you and your practice.

Please do not hesitate to contact our offices and/or reach out to MLMIC directly at mlmic.com or (888) 412-2012 should you have any questions or need additional information.

Senate Released Revised ACA Repeal/Replace Bill; Possible Floor Consideration Next Week
This week, the Senate released a revised version of the Better Care Reconciliation Act (BCRA), a bill designed to repeal and replace much of the Affordable Care Act (ACA).  While review of the new bill is ongoing, at first glance it does not appear to remediate concerns with the earlier version of this legislation that it could potentially significantly expand the number of New Yorkers who will face higher cost-sharing.

AMA President Dr. David Barbe issued the following statement in response: “The revised bill does not address the key concerns of physicians and patients regarding proposed Medicaid cuts and inadequate subsidies that will result in millions of Americans losing health insurance coverage. The additional funding to address the opioid epidemic is a positive step, however, those suffering from substance use disorder have other health care needs that are not likely to be addressed if they lose coverage through a rollback of the Medicaid expansion. While stabilizing the individual market is an initial step, more bipartisan collaboration is needed in the months ahead to improve the delivery and financing of health care.”

According to the AMA, revised estimates by the Congressional Budget Office on the impact on spending and health insurance coverage are expected to be released on Monday.  Senate floor consideration is likely to begin on Tuesday or Wednesday.    However, Senators Rand Paul (R-KY) and Susan Collins (R-ME) have indicated they would oppose the “motion to proceed” to begin consideration of the bill, putting into question whether there will be enough votes to begin floor consideration.

Please stay alert for further updates.

Upstate Fatality in Case of Powassan Virus
Since 2000, only 24 cases of Powassan virus have been confirmed in New York.  Five of them were fatal. The most recent case was 74-year-old Charles Smith from Gansevoort. His family reported that he was bitten by a tick on April 28. He went to the doctor on May 1 and was sent home. However, by May 11, he had fever and chills and was hospitalized. He died June 6.

“Powassan is a serious illness,” said Bryon Backenson, New York State DOH’s Deputy Director of Communicable Disease Control. There is no cure for Powassan’s, which is deadly about 10-percent of the time because it affects the central nervous system in about half the cases. “You’re trying to do things to reduce swelling in the brain or reduce swelling on the lining of the brain,” explained Backenson. Symptoms of Powassan’s include headache, fever, vomiting, weakness, and confusion, loss of coordination, speech difficulty and seizures.

It can take up to four weeks for Powassan’s to be confirmed by blood and cerebrospinal fluid testing, making early treatment important when it’s suspected. “With a disease like Powassan that tick only has to be on 10 or 15 minutes before it has the potential to transmit what it’s carrying because Powassan is a virus,” warned Backenson.

Unlike Lyme disease which is a bacteria and can take up to 36 hours for infection to occur.

Without a specific treatment, the need to protect against tick bites is key. “This is a very severe illness. It’s an illness that can cause deaths, but it’s also one that’s extremely rare,” explained Backenson. (WNYT, July 12)


 

Your membership yields results and will continue to do so. When your 2017 invoice arrives, please renew. KEEP MSSNY STRONG!


FDA To Implement Stricter Education Requirements for Opioid Makers
FDA Commissioner Scott Gottlieb “announced plans Monday to require manufacturers of painkillers to provide more extensive education for physicians and other health-care professionals who prescribe the drugs.” Previously, only manufacturers of extended-released opioids, which account for ten percent of opioid prescriptions, were required to provide the training. Dr. Gottlieb said the agency would also consider legal action on any drugs that it concludes pose a larger risk than benefit. The FDA did that last month when it concluded that the painkiller Opana ER was linked to injection drug abuse. Its maker, Endo Pharmaceutical, Inc. pulled the drug from the market last week at the FDA’s request. (Wall Street Journal (7/10)

CMS Proposes Medicare Physician Payment Rule for 2018
On July 13, CMS issued a proposed rule to update the Medicare physician fee schedule for 2018.

To read the CMS press release announcing some of the key policy changes proposed in the rule, click here.

To read the entire rule, click here.

A chart listing the specialty by specialty impact of the proposed rule changes is on pp.727-728.   Specifically, the chart notes that, as a result of these proposed changes, the following specialties will see an overall +1% in allowed charges: geriatrics, hand surgery, infectious disease, physical medicine, psychiatry and radiation oncology.

The chart notes that the following specialties could see an overall -1% in permitted charges: colon and rectal surgery, emergency medicine, gastroenterology, general surgery, interventional radiology, neurosurgery, OB-GYN, pathology, radiology, thoracic surgery, and urology.

The chart also notes that the following specialties could see an overall -2% in permitted charges: cardiac surgery, cardiology, otolaryngology and vascular surgery, with a -3% projected for allergy/immunology.

MSSNY, working together with the AMA and the federation of medicine, will be reviewing the rule and will follow up with further analysis.

CMS Proposed Rule for Implementation of Diabetes Prevention Program (MDPP)
On July 13, 2017, CMS issued the Calendar Year (CY) 2018 Physician Fee Schedule (PFS) proposed rule that would make additional proposals to implement the Medicare Diabetes Prevention Program (MDPP) expanded model starting in 2018.

The MDPP expanded model was announced in early 2016, when it was determined that the Diabetes Prevention Program (DPP) model test through the Center for Medicare and Medicaid Innovation’s Health Care Innovation Awards met the statutory criteria for expansion. Through expansion of this model test, more Medicare beneficiaries will be able to access evidence-based diabetes prevention services, potentially resulting in a lowered rate of progression to type 2 diabetes, improved health, and reduced costs.

The Medicare Diabetes Prevention Program expanded model is a structured intervention with the goal of preventing progression to type 2 diabetes in individuals with an indication of pre-diabetes. The clinical intervention, the result of National Institutes of Health-funded research, consists of a minimum of 16 intensive “core” sessions of a Centers for Disease Control and Prevention (CDC) approved curriculum furnished over six months in a group-based, classroom-style setting that provides practical training in long-term dietary change, increased physical activity, and behavior change strategies for weight control.

After completing the core sessions, less intensive follow-up meetings furnished monthly will help ensure that the participants maintain healthy behaviors. The primary goal of the expanded model is at least 5 percent weight loss by participants. 

Long-Term Dietary Improvements Associated with Decreased Risk of Death
The New England Journal of Medicine reports that “long-term improvements in diet were associated with a significantly decreased risk of death,” researchers found. The study revealed that “making mostly healthier choices for 12 years could decrease someone’s risk of death during the next 12 years by 20 percent.”

NGS Claim Submission Changes
Healthcare continues to keep up with technology with the new claim submission changes issued by National Government Services (NGS). Beginning July 10, 2017 NGS will no longer be accepting claim submissions with handwriting on the CMS 1500 form (except in the specified signature boxes). As per the new alert issued on June 29th, handwritten claims received will be returned to the provider with a notice to submit a new claim in the acceptable format.

The CMS Pub. 100-04, Medicare Claims Processing Manual, Chapter 26, Section 30 notes the CMS 1500 form specifications are “required to facilitate the use of image processing technology such as Optical Character Recognition (OCR), facsimile transmission, and image storing.”

NGS currently allows for claims to be submitted online via NGSConnex. If you are currently submitting handwritten claims it is recommended to open a dialogue with your billers and consider alternatives, as many private insurance carriers look towards Medicare and Medicaid for guidance. 

Sources:
http://ow.ly/hM5E30drukU
https://www.cms.gov/Regulations-and-Guidance/Guidance/Manuals/Downloads/clm104c26.pdf
Lorna Simons CPC, Medco Consultants Inc.

Former Suffolk County President Dr. Bernard Lane Dies
MSSNY member Bernard P. Lane, MD, passed away on July 5, 2017 at the age of 79 after a long battle with cancer.  The Brooklyn native—known to friends and colleagues as Bernie—graduated from Brown University and NYU Medical School.

A founding faculty member of Stony Brook University School of Medicine, Dr. Lane contributed over 45 years of service to medical science and education including his faculty years at NYU and Stony Brook medical schools.  In addition to his duties as Professor of Pathology, Dr. Lane also served as Deputy Chairman, Interim Chair, and Director of the Electron Microscopy Laboratory.  He was the Pathology residency program director for 25 years, mentoring scores of pathologists who have gone on to positions in hospitals and academic medical centers both locally and nationally.

Dr. Lane served as President of the Stony Brook University Faculty Senate, and was the Founding Chairman of the Board of Directors of the Clinical Practice Management Plan at the University Hospital, serving in that capacity for nearly 20 years.

An active member of organized medicine, Dr. Lane was a member of MSSNY since 1986 and served as President of the Suffolk County Medical Society in 1990 and 1991.  He was Chair of the National Group on Faculty Practice of the Association of American Medical Colleges, and president of the Suffolk County Pathology Society.

Dr. Lane and his wife, Dr. Dorothy Lane (nee Spiegel), celebrated their 53rd wedding anniversary in August 2016. In addition to his wife, Dr. Lane is survived by his daughter Erika Neil, his sons Dr. Andrew Lane and Matthew Lane, his daughter-in-law Dr. Wendy Lane, and his grandchildren Zachary Lane, Jacob Lane, Rachel Neil and Justin Neil.

A graveside funeral service was held on Friday, July 7, 2017 at the Washington Memorial Park cemetery in Mount Sinai. In lieu of flowers, the family requests that donations be made in his memory to the Stony Brook Cancer Center or the American Cancer Society.


CLASSIFIEDS


Medical Space Available for Leasing
Currently (last 7 years) occupied by Lab Corp.
2,500 sq. ft. ADA compliant.
25-15 Steinway Street, Astoria, NY 11103
Please contact Landlord: 1-800-283-0602;
e mail: wwwevans@yahoo.com

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 – Cayuga Medical Associates
Cayuga Medical Associates (CMA), a growing multispecialty group located in the heart of the beautiful Finger Lakes Region in Central New York, is currently seeking a Medical Director to work within the organization. This senior leadership position is designed to ensure that high quality, service-oriented patient care is delivered by Cayuga Medical Associates’ physicians on a consistent basis. The medical director has primary responsibility for clinical issues pertaining to the delivery of patient care services, patient satisfaction, and quality at the practice level. This position will report to the Chief Operating Officer of CMA, and will serve as an ex-officio board member. In this role, the Medical Director will work in an administrative capacity 2 days a week, and will practice as a physician for the remaining 3 days of the workweek.This position will require the physician to:

  • Engage in Physician recruitment, engagement and retention, in collaboration with Executive Director
  • Set and communicate performance, service standards and expectations to all providers
  • Exercise professional clinical leadership regarding specific cases or questions of quality or compliance
  • Assist with compensation model refinements and redesign, with specific focus on quality and productivity metrics
  • Oversee CMA’s Physician Action Council (PAC)
  • Develop and implements physician peer review system, medical policies, and clinical programs

Qualifications for this position include:

  • Graduate from accredited medical school and appropriate residency training
  • Board certified physician in a primary care or related sub-specialty area
  • Active NYS medical license

At least 3-5 years of relevant work experience in a physician practice setting, prior experience in physician leadership role preferred

vStrong leadership skills to develop a close, collaborative working relationship with senior leadership team, physician leaders, and practice management staff

The Finger Lakes region of New York offers endless opportunities for outdoor adventures, as well as rich support of the arts and diverse cultural opportunities, excellent school districts, and charming villages, towns and small cities to call home.  If you are dedicated to excellence and possess a commitment to patient-centered care, please submit your CV and cover letter to cma_hr@cayugamedicalassociates.org or fax to (607) 277-1415, attention Human Resources. CMA offers a competitive pay and benefits package and is an equal opportunity employer.


Position Available for Critical Care Physician to Join Established Practice in Nassau County, Long Island, NY.
The Physician will join our existing team of Board-Eligible/Board-Certified Intensivists. This is a PT/FT position including both nocturnal and daytime responsibilities. The Physician will work with a dedicated group of highly trained mid-level practitioners, respiratory therapists and nurses to provide Critical Care at St. Francis Hospital in Roslyn, NY. St. Francis was ranked one of the top 10 hospitals in the nation for Cardiac Care and is top rated nationally in seven other adult specialties.
We are expanding our Intensivist Program and are expecting to add an Intensivist to our group.
Nassau Chest Physicians, P.C. was established in 1978 to provide state-of-the-art care to patients with pulmonary diseases on Long Island. We have expanded our practice to include 8 Intensivist/Pulmonologists and 5 pure Intensivists. Since 2006, we have assumed management of Critical Care services at St. Francis Hospital-The Heart Center in Roslyn, NY.
St. Francis Hospital is New York State’s only specialty designated cardiac center and is a nationally recognized leader in cardiology and heart surgery, ear-nose-throat, gastroenterology and GI surgery, geriatrics, neurology and neurosurgery. More cardiac procedures are performed at St. Francis than at any other hospital in New York State. The hospital is located on the North Shore of Long Island; approximately 30 minutes from Manhattan. The hospital combines unrivaled expertise in cardiovascular medicine with top-ranged nursing (AACN Magnet Award) to provide the very best in patient care.
In addition, St. Francis offers excellent Thoracic, Vascular, Oncologic, Neurosurgical, and Orthopedic Surgical Programs. We have a very active Emergency Department. The hospital offers the latest in technologies such as Therapeutic Temperature Modification, Impella, ECMO and LVAD. Our excellent and experienced medical staff supports strong medical and surgical subspecialty programs.

Aside from Certified Critical Care Nurses, many who have more than 20 years of experience and are expert at caring for this complex patient population, we have a growing pool of Intensivist mid-level practitioners who work hand in hand with our Intensivist physicians to coordinate the care of the critically ill patient, minister to them and perform procedures.

Of course, a New York License is required. J1 or H1 VISAS accepted.
Additional Salary Information: Salary and benefits are competitive and commensurate with experience. Interested applicants, send resume to: dr.sorett@nassauchest.com


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

July 7, 2017 – PRI Oust & Urge Gov Veto


PRESIDENT’S MESSAGE
Charles Rothberg, MD
July 7, 2017
Volume 17
Number 26

Dear Colleagues:

Today’s press has reported the Department of Financial Services (DFS) findings following a yearlong audit of PRI, the second largest malpractice carrier in the state.  As a result of their findings the CEO of PRI has been ousted. The superintendent of the DFS, Maria Vullo, stated, “…, the examination determined that AFP (PRI’s management company) and its top executives, including its CEO and owner, Anthony J. Bonomo, disregarded sound actuarial principles when setting PRI’s loss reserves, and then tried to cover it up by seeking to silence outside auditors and employees who objected to this misconduct.”

The board of PRI voted yesterday to void the company’s management contract with Administrators for the Professions, a subsidiary of AJB Ventures, which Mr. Bonomo owns. The new management contract will be given to PRIMMA, LLC, and a wholly-owned subsidiary of PRI. PRIMMA will be run on an interim basis by The Princeton Partnership, a firm that specializes in turnaround and runoff management. Read more here.

More importantly, this information comes at a volatile time for New York’s malpractice industry, especially in view of the Expansion of Liability bill that will be delivered to the Governor. He needs to make a decision whether or not this is the appropriate time to sign such legislation into law. This does not appear to be the optimal time to further destabilize the climate of the malpractice industry in New York.

Expansion of Liability Bill

New York has a reputation of being a difficult place to be a doctor.  Yet the legislature in Albany has potentially made this problem far worse.  It passed a “one-sided” bill that, if enacted, will drastically increase health care costs by radically increasing the number of lawsuits that could be brought against our doctors and hospitals. But the law ignores much of the problem illustrated by the story of Lavern.

Voice your opposition here!

The bill is a hastily conceived legislative response to the sad case of Lavern Wilkinson.  Ms. Wilkinson, treated at a public hospital, was not informed of a cancerous lesion present on an x-ray.  Sometime later, when Ms. Wilkinson ‘discovered’ the cancer, it had already spread.  She was unable to sue for medical negligence owing to the short 15-month statute of limitations that applies to public hospitals like the one that treated her.  Had she been treated elsewhere in New York, with the standard 30-month statute, Lavern would have been able to sue.  Sadly, she succumbed to this cancer.

The legislature could have solved Lavern’s medical liability ‘problem’ by simply extending the shortened statute against public hospitals to 30 months (like in non-public hospitals). Instead, they unreasonably extended the statute to date of discovery (as long as 7 years from treatment) to all venues. If this law is enacted, despite the unnecessary burden on all physicians and hospitals, patients presenting to public hospitals might still find themselves unable to sue.  For example, a patient presenting to a public hospital for evaluation following a motor vehicle accident, not informed of an aneurysm on x-ray, would still be unable to sue after 15 months’ time. This bill, that would increase liability costs for physician practices by 15%, would not provide a remedy for many patients like Lavern!

We are not alone in this fight. HANYS and the Greater New York Hospital Association are equally opposed. Ken Raske, in a letter to the Governor, stated that they are “deeply disappointed with the Senate leadership—whom we have repeatedly supported—for putting this onerous, extremely damaging bill forward… At the very least, it will lead to more litigation, as parties seek to take advantage of the bill’s drafting ambiguities.” Specialty societies were against it, too.

But if there is a need to expand the time to bring lawsuits; it must be balanced with legislation to address the numerous flaws of our medical liability system that drive our excessive costs – “comprehensive” reform.  Unfortunately, the Legislature, with its hasty one-sided remedy, ignored the risk of harm to our already fragile care delivery infrastructure.

Governor Cuomo must veto this bill and instead work for comprehensive medical malpractice reform effort that address deficiencies raised by all sides – patients, lawyers and doctors. New York is already the worst state to be a doctor largely because our medical liability costs and premiums far exceed any other state.  Many other states such as California, Texas and Florida, along with the majority of others, have put reasonable controls on liability awards to preserve some stability in their health care systems.

What do our legislators not see?

Governor Cuomo must insist on fair balance by vetoing this bill and pushing for comprehensive reform instead.

Voice your opposition here!

Sincerely,
Charles Rothberg, MD
MSSNY President

Please send your comments to comments@mssny.org


Your membership yields results and will continue to do so. When your 2017 invoice arrives, please renew. KEEP MSSNY STRONG!


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Please Contact Gov. to Urge Veto to Prevent More Lawsuits and Increased Costs
All physicians are urged to contact Governor Andrew Cuomo to veto legislation (S.6800/A.8516) that would prompt significant increases in medical malpractice lawsuits and premiums at a time when no further increases can be tolerated.  Please call at (518) 474-8390, and send a letter here: Take Action

This week, MSSNY President-elect Dr. Thomas Madejski and Erie County Medical Society President Dr. Willie Underwood authored an op-ed that appeared in the Buffalo News urging the Governor to veto the bill, and press for comprehensive medical liability reform instead.  Read the op-ed here.

Introduced in the final days and passed in the final hours of the 2017 Legislative Session over the strong objections of MSSNY, the specialty societies, the hospital industry and medical liability insurers, S6800/A8516 would expand the medical liability statute of limitations for cases involving “alleged negligent failure to diagnose a malignant tumor or cancer”.   The bill would permit lawsuits 2.5 years from the “date of discovery” of such alleged negligence, up to an outside limit of 7 years from the date of the alleged negligent act.

While it is likely that a more narrowly focused bill will reduce somewhat the premium increase needed from the 15% projected increase for an earlier version of this bill, there is great ambiguity in the legislation as to which cases the 7-year limit would apply.  Moreover, the bill does not just apply to treatment that occurs after the proposed effective date of the bill but has a very significant retroactive impact, subject to numerous interpretations, for which insurance companies have not reserved premium dollars (another reason to veto the bill!).  These errors and/or ambiguities are likely the result of the bill being “rushed into print” to meet the constitutional “3-day aging” requirement before a bill can be considered by the Legislature.

Of greatest concern, the bill fails to include needed tort reforms to help bring down our already exorbitant medical liability costs.

While it is not known when the bill will be officially delivered to the Governor for his consideration, it could be sent at any time.  Please take action and urge your colleagues to do the same.

DOH Announces Additional Four-Hour Medical Marijuana Course
The New York State Department of Health announced the availability of an additional four-hour medical use of marijuana course. Practitioners who wish to register with the Department and certify their patients for the Medical Marijuana Program must complete one of the available approved courses.  The Department also streamlined the process for practitioners to register with the program. See the following press release for additional information on these enhancements to the program.

CDC: Opioid Prescribing Down Since 2010, But Varies Widely
The amount of opioids prescribed in the United States decreased each year between 2010 and 2015, according to a Vital Signs report released this week by the CDC. The amount of opioids prescribed per capita fell from a peak of 782 morphine milligram equivalents in 2010 to 640 MME in 2015, but remains about three times higher than in 1999 and varies widely by county, with some counties prescribing six times as much as others.

“This variation highlights the need for health care providers to consider evidence-based guidance when prescribing opioids,” said Deborah Dowell, M.D., chief medical officer for CDC’s Division of Unintentional Injury Prevention. Between 2010 and 2015, MME per capita decreased in half of US counties and increased in 23% of counties.

NAM Collaborative Calls for Research to Address Clinician Burnout
The National Academy of Medicine Action Collaborative on Clinician Well-Being and Resilience, whose sponsors include the AHA, yesterday issued a discussion paper calling for research to identify the organizational and health system factors that place physicians, nurses and other health care professionals at increased risk for burnout; the implications for health care outcomes; and effective interventions to improve clinician well-being.

“The U.S. health care system is rapidly changing in an effort to deliver better care, improve health, and lower costs while providing care for an aging population with high rates of chronic disease and co-morbidities,” notes the paper, whose co-authors include AHA Chief Medical Officer Jay Bhatt, D.O. “…Navigating these changes are health care professionals, whose daily work is critical to the success of health care improvement.

Unfortunately, as a result of these changes and resulting added pressures, many HCPs are burned out, a syndrome characterized by a high degree of emotional exhaustion and high depersonalization (i.e., cynicism), and a low sense of personal accomplishment from work.” On July 14, the collaborative will host its first public meeting to solicit feedback and highlight research and examples of promising approaches to promoting clinician well-being. To attend in person or via webcast, register here.

In July: Pilot for Office-Based Surgery Practitioners New Online Practice Report
To assist in the promotion of patient safety and quality of care for patients undergoing procedures in the office-based setting, the NYS Department of Health (NYS DOH) Office-Based Surgery (OBS) Program has developed a new online Practice Report. This Report will assist in providing context for the interpretation of Adverse Event information received by the NYS DOH. Public Health Law provides the NYS DOH with authority to require OBS practices to report additional data for the interpretation of adverse events.[1] Beginning in January 2018, all NYS OBS practice sites will be required to complete an annual Practice Report.

In July of 2017, the NYS DOH will conduct a pilot with OBS practices to ensure practitioners and practices are aware of the report content and are able to complete the Practice Report. They are requesting practices complete the pilot Practice Report using information from January 1 through December 31, 2016. Practices newly accredited in 2017, may provide available 2017 data. The NYS DOH has contacted OBS practices with details regarding the pilot by email.

In late Fall 2017, the NYS DOH will share feedback received from the pilot and any subsequent changes to the report. The NYS DOH is hopeful the pilot Practice Report will assist OBS practices in preparing for the first annual Practice report in January of 2018.  If you have any questions, please contact the Office-Based Surgery Program at 518-408-1219 or obs@health.ny.gov.
[1]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”

Athenahealth: The Case for Staying Independent
Join online on Wednesday, July 12, at 2pm ET
Reserve your spot
If you think that merging your independent practice with a larger healthcare system is the only way for it to survive, this webinar is for you. On the heels of Independence Day, this free one-hour presentation takes a close look at topics such as:

  • Why it’s so overwhelming for independent practices to operate today
  • The measurable advantages independent practices have over larger systems
  • 3 case studies of once-struggling independent practices that are thriving today

Know what athenahealth knows about helping you run your practice your way.                                    REGISTER TODAY


Less Expensive Hearing Devices May Work as Well as Traditional Hearing Aids
Some over-the-counter sound amplification devices are nearly as effective as prescription hearing aids, according to a small JAMA study.

Researchers compared five personal sound amplification products with one hearing aid in 40 older adults with mild-to-moderate hearing loss. Speech understanding improved with the hearing aid and four of the amplification products. For three of the products (Sound World Solution sCS50+, Soundhawk, Etymotic BEAN), the improvement in speech understanding was within 5 percentage points of that of the hearing aid.

The authors conclude: “Results lend support to current national initiatives … requesting that the US Food and Drug Administration create a new regulatory classification for hearing devices meeting appropriate specifications to be available over the counter.”
JAMA research letter

New Web Page for Doctors Working in Small, Rural, or Underserved Areas
CMS announced the launch of a new section on the Quality Payment Program on https://qpp.cms.gov/about/small-underserved-rural-practices  dedicated to doctors and other clinicians working in small or rural practices as well as those treating patients in underserved areas. This page serves as a single point of reference to help physicians prepare for, and actively participate in, the Quality Payment Program, especially, for those of you participating under the Merit-based Incentive Payment System (MIPS) track.

Physicians can quickly locate contact information for the organizations providing assistance to practices through the Small, Underserved, and Rural Support initiative using a simple interactive map. These local, experienced, community-based organizations provide hands-on training to help thousands of small practices, especially those that practice in historically under-resourced areas including rural areas, health professional shortage areas, and medically underserved areas.

The training and education resources are available nationwide and will be provided at no cost to eligible clinicians and practices. Physicians can also review the flexibilities to help reduce the participation and reporting burden on small practices for 2017. We anticipate adding more features and information over time and will continue to keep the lines of communication open, as CMS values physician feedback in helping to improve their experience in the Quality Payment Program.


CLASSIFIEDS


Medical Space Available for Leasing
Currently (last 7 years) occupied by Lab Corp.
2,500 sq. ft. ADA compliant.
25-15 Steinway Street, Astoria, NY 11103
Please contact Landlord: 1-800-283-0602;
e mail: wwwevans@yahoo.com

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 – Cayuga Medical Associates
Cayuga Medical Associates (CMA), a growing multispecialty group located in the heart of the beautiful Finger Lakes Region in Central New York, is currently seeking a Medical Director to work within the organization. This senior leadership position is designed to ensure that high quality, service-oriented patient care is delivered by Cayuga Medical Associates’ physicians on a consistent basis. The medical director has primary responsibility for clinical issues pertaining to the delivery of patient care services, patient satisfaction, and quality at the practice level. This position will report to the Chief Operating Officer of CMA, and will serve as an ex-officio board member. In this role, the Medical Director will work in an administrative capacity 2 days a week, and will practice as a physician for the remaining 3 days of the workweek.This position will require the physician to:

  • Engage in Physician recruitment, engagement and retention, in collaboration with Executive Director
  • Set and communicate performance, service standards and expectations to all providers
  • Exercise professional clinical leadership regarding specific cases or questions of quality or compliance
  • Assist with compensation model refinements and redesign, with specific focus on quality and productivity metrics
  • Oversee CMA’s Physician Action Council (PAC)
  • Develop and implements physician peer review system, medical policies, and clinical programs

Qualifications for this position include:

  • Graduate from accredited medical school and appropriate residency training
  • Board certified physician in a primary care or related sub-specialty area
  • Active NYS medical license

At least 3-5 years of relevant work experience in a physician practice setting, prior experience in physician leadership role preferred

vStrong leadership skills to develop a close, collaborative working relationship with senior leadership team, physician leaders, and practice management staff

The Finger Lakes region of New York offers endless opportunities for outdoor adventures, as well as rich support of the arts and diverse cultural opportunities, excellent school districts, and charming villages, towns and small cities to call home.  If you are dedicated to excellence and possess a commitment to patient-centered care, please submit your CV and cover letter to cma_hr@cayugamedicalassociates.org or fax to (607) 277-1415, attention Human Resources. CMA offers a competitive pay and benefits package and is an equal opportunity employer.


Position Available for Critical Care Physician to Join Established Practice in Nassau County, Long Island, NY.
The Physician will join our existing team of Board-Eligible/Board-Certified Intensivists. This is a PT/FT position including both nocturnal and daytime responsibilities. The Physician will work with a dedicated group of highly trained mid-level practitioners, respiratory therapists and nurses to provide Critical Care at St. Francis Hospital in Roslyn, NY. St. Francis was ranked one of the top 10 hospitals in the nation for Cardiac Care and is top rated nationally in seven other adult specialties.
We are expanding our Intensivist Program and are expecting to add an Intensivist to our group.
Nassau Chest Physicians, P.C. was established in 1978 to provide state-of-the-art care to patients with pulmonary diseases on Long Island. We have expanded our practice to include 8 Intensivist/Pulmonologists and 5 pure Intensivists. Since 2006, we have assumed management of Critical Care services at St. Francis Hospital-The Heart Center in Roslyn, NY.
St. Francis Hospital is New York State’s only specialty designated cardiac center and is a nationally recognized leader in cardiology and heart surgery, ear-nose-throat, gastroenterology and GI surgery, geriatrics, neurology and neurosurgery. More cardiac procedures are performed at St. Francis than at any other hospital in New York State. The hospital is located on the North Shore of Long Island; approximately 30 minutes from Manhattan. The hospital combines unrivaled expertise in cardiovascular medicine with top-ranged nursing (AACN Magnet Award) to provide the very best in patient care.
In addition, St. Francis offers excellent Thoracic, Vascular, Oncologic, Neurosurgical, and Orthopedic Surgical Programs. We have a very active Emergency Department. The hospital offers the latest in technologies such as Therapeutic Temperature Modification, Impella, ECMO and LVAD. Our excellent and experienced medical staff supports strong medical and surgical subspecialty programs.

Aside from Certified Critical Care Nurses, many who have more than 20 years of experience and are expert at caring for this complex patient population, we have a growing pool of Intensivist mid-level practitioners who work hand in hand with our Intensivist physicians to coordinate the care of the critically ill patient, minister to them and perform procedures.

Of course, a New York License is required. J1 or H1 VISAS accepted.
Additional Salary Information: Salary and benefits are competitive and commensurate with experience. Interested applicants, send resume to: dr.sorett@nassauchest.com


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

Press coverage of MSSNY’s statement on Surgeon General Nominee

Health Medicine Network – 06/30/17
Trump Nominates Indiana Health Commissioner as Surgeon General
(MSSNY President Dr. Charles Rothberg, MD quoted)

USA Today – 06/30/17
Trump nominates Indiana doctor for surgeon general
(MSSNY statement included)

The Tennessean – 06/30/17
Trump nominates Indiana doctor for surgeon general

The Commercial Appeal – 06/30/17
Trump nominates Indiana doctor for surgeon general

Springfield News-Leader – 06/30/17
Trump nominates Indiana doctor for surgeon general

Democrat and Chronicle   – 06/30/17
Trump nominates Indiana doctor for surgeon general

My Northshore NOW   – 06/30/17
Trump nominates Indiana doctor for surgeon general

Lake Country NOW  – 06/30/17
Trump nominates Indiana doctor for surgeon general

The Asbury Park Press (AP)  – 06/30/17
Trump nominates Indiana doctor for surgeon general

HometownLife.com  – 06/30/17
Trump nominates Indiana doctor for surgeon general 

Courier-Journal  – 06/30/17
Trump nominates Indiana doctor for surgeon general

Central Florida Future – 06/30/17
Trump nominates Indiana doctor for surgeon general 

Post-Crescent  – 06/30/17
Trump nominates Indiana doctor for surgeon general

The Newark Advocate  – 06/30/17
Trump nominates Indiana doctor for surgeon general

WaukeshaNow  – 06/30/17
Trump nominates Indiana doctor for surgeon general

The Californian – 06/30/17
Trump nominates Indiana doctor for surgeon general

LoHud.com  – 06/30/17
Trump nominates Indiana doctor for surgeon general 

Northwest Now  – 06/30/17
Trump nominates Indiana doctor for surgeon general

Ruidoso News  – 06/30/17
Trump nominates Indiana doctor for surgeon general

The News Leader (AP) – 06/30/17
Trump nominates Indiana doctor for surgeon general

Chambersburg Public Opinion  – 06/30/17
Trump nominates Indiana doctor for surgeon general

Tallahassee Democrat  – 06/30/17
Trump nominates Indiana doctor for surgeon general

June 30, 2017 – Fix Insurance System NOT Healthcare System


PRESIDENT’S MESSAGE
Charles Rothberg, MD
June 30, 2017
Volume 17
Number 25

Dear Colleagues:

According to the Washington Post, Senate Majority Leader Mitch McConnell (R-KY) “intends to send a revised version of his health-care bill to the Congressional Budget Office today according to Capitol Hill aides and lobbyists.” This timeline points to McConnell’s attempt to hold a vote before the August recess.

We need to promote a message, by July 3, to Mitch McConnell and all the federal legislators, while they are home in their districts, that what is needed is to fix the health insurance system— not healthcare.

If we get them to rethink patient costs related to premiums, deductibles, co-insurance and/or co-payments, then affordable, usable quality healthcare can be provided to patients with medical needs.  (A $6000 deductible is not usable to most people.) Both political parties will need to work together to get this done.

To help make America greater, we must put away party politics and get health insurance reform back on track. Outrageous deductible amounts are unaffordable to working families with health care needs.  High deductibles mean high out-of-pocket cost to insureds, who (despite high premium costs) are left with paying for office visits as though they don’t have insurance.  This is not right.

For example, an individual insurance premium of $10K+ annually, whereby that individual pays $140 in co-payments for TWO specialist visits and $80 for TWO PCP visits, while the health plan pays just $20 for all FOUR visits is not right either.  Before Obamacare, this ‘feature’ of managed care was a deplorable hurdle and it still is.  It was not right then, it is not right now.  Current proposals don’t appear to address this issue at all.

The insurance industry is to blame and that is where more focus should be. There is far too much talk about perverse ‘incentives’ and ‘payment reform’ for providers of medical services such as physicians and hospitals.  That, too, is wrong.  Insurance reform is what is needed to fix the ills in the system.

Now – Senate, House, Republican and Democrat, how do you propose do fix the system?

Sincerely,
Charles Rothberg, MD
MSSNY President

Please send your comments to comments@mssny.org


Your membership yields results and will continue to do so. When your 2017 invoice arrives, please renew. KEEP MSSNY STRONG!


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US House Passes Medical Liability Reform Bill
By a largely party line 218-210 vote the US House of Representatives passed legislation to expand patient access to care by reducing the exorbitant cost of medical liability insurance.  Among other provisions, the bill contains a provision that would limit to $250,000 the amount of non-economic damages that could be awarded in cases where the patient is enrolled in a Government-subsidized program like Medicare, Medicaid or an Exchange plan.    It would also define federal standards for attorney contingency fees, statutes of limitations, certificates of merit and prohibiting apologies from being introduced into evidence.

After the bill was passed, MSSNY President Dr. Charles Rothberg issued the following statement praising the action of the US House:

“We have long maintained that medical liability reform is an essential component of health reform.  We commend the House of Representatives for passing legislation (HR 1215) that if enacted could help to reduce some of the extraordinary costs faced by our physicians and hospitals and restore some balance to our medical liability system.

New York State was recently designated as the worst state in the country to practice medicine, in large part due to our excessive liability exposure as compared to all other states.  Indeed, physicians in New York City, Long Island and the Lower Hudson Valley pay some of the highest liability premiums in the country.  New York not only far exceeds all other states in terms of total medical liability payouts, we also spend more on a per capita than any other state in the country.

The actions of the US House of Representatives to address this huge problem stands in stark contrast to the New York State Legislature, which despite New York’s exorbitant costs, just passed legislation that would actually expand lawsuits against doctors and hospitals and impose huge new costs.  MSSNY and many other health care provider associations are urging Governor Cuomo to veto this legislation.

As efforts continue to be undertaken to fix the flaws of the Affordable Care Act, we urge that comprehensive medical liability reform be included in these efforts.”

All 9 Republican members of New York’s Congressional delegation (Collins, Donovan, Faso, Katko, King, Reed, Stefanik, Tenney and Zeldin) voted in favor of the bill.  All 18 Democrat members of New York’s Congressional delegation (Clarke, Crowley, Engel, Espaillat, Jeffries, Higgins, Lowey, C. Maloney, S.P. Maloney, Meeks, Meng, Nadler, Rice, Serrano, Slaughter, Suozzi, Tonko, and Velasquez) voted against the bill.

At this point, it is not clear what the Senate will do with this legislation.  It has been reported that some US Senators are seeking to include medical liability reform provisions within the broader health care reform debate.

Tell Governor Cuomo to Reject Medical Liability Expansion Bill and Call for Comprehensive Liability Reform
All physicians are urged to call Governor Cuomo at 518-474-8390 and send a letter here urging that he veto a so-called “cancer only” medical liability statute of limitations expansion bill (S.6800/A.8516) that passed the Legislature over the strong objections of MSSNY, the specialty societies, the hospital industry and MLMIC.  Please urge that legislation be enacted instead that provides for comprehensive medical liability reform.

This ambiguously drafted bill, introduced in the final days and passed in the final hours of the 2017 Legislative Session, would expand the medical liability statute of limitations for cases involving “alleged negligent failure to diagnose a malignant tumor or cancer”.   The bill would permit lawsuits 2.5 years from the “date of discovery” of such alleged negligence, up to an outside limit of 7 years.

While it is likely that a more narrowly focused bill will reduce somewhat the premium increase needed from the 15% projected increase for an earlier version of this bill, there is great ambiguity in the legislation as to which cases the 7-year limit would apply that will undoubtedly generate significant litigation.    Moreover, the bill does not just apply to treatment that occurs after the proposed effective date of the bill but has a very significant retroactive impact, subject to numerous interpretations, for which insurance companies have not reserved premium dollars (another reason to veto the bill!).  These errors and/or ambiguities are likely the result of the bill being “rushed into print” to meet the constitutional “3-day aging” requirement before a bill can be considered by the Legislature.

Besides the bill’s drafting errors, of greatest concern, the bill completely ignores the exorbitant medical liability costs that New York physicians already pay, which was reflected in MSSNY President Dr. Rothberg’s statement about the failings of this bill:

“New York’s physicians are extremely concerned about the ultimate impact to New Yorkers’ access to care if the statute of limitations expansion bill (S.6800/S.8516) considered by the Legislature today is ultimately signed into law.  Many New York hospitals and physicians are already struggling to keep their doors open.

New York State has already earned the dubious distinction as the absolute worst state in the country in which to practice medicine, in large part due to its overwhelming liability costs.  The bill will add significantly to these costs that have already driven physician after physician out of private practice, and in many cases driving them out of New York altogether.  It will also discourage countless others from coming here to practice.  We urge Governor Cuomo to veto this legislation and bring parties together to pass comprehensive, not one-sided, medical liability reform. New Yorkers’ access to health care is at stake.”

Again, please urge the Governor to veto this bill and encourage your colleagues to do the same! Please let the Governor know how this bill will harm patient care and exacerbate existing physician shortage issues in your community. 

MSSNY President Issues Statement Expressing Deep Concerns US Senate Health Reform Legislation, Communicates to NY Congressional Delegation
As the US Senate was deciding this week whether to begin floor debate on its proposal to repeal and revise much of the Affordable Care Act, MSSNY President Dr. Charles Rothberg issued the following statement expressing deep concerns about the legislation’s impact to New York:

“While a wholesale review of the flaws of the ACA should be undertaken, we are deeply concerned about potentially significant adverse consequences to New York’s residents and its health care system arising from proposals before the House and Senate. 

The House and Senate bills will replace the low cost coverage hundreds of thousands of New Yorkers currently have with tax credits that for many will be insufficient to purchase coverage. Patients may face huge new out of pocket costs or worse, they may not purchase any coverage at all. In addition, we also have strong concerns about the bill’s long-term impact on funding for New York’s health care system. 

We look forward to working with the members of New York’s Congressional delegation and urge that they work towards enactment of legislation that enhances rather than reduces affordable and comprehensive coverage options for our patients. We also urge that they work proactively with physicians and physician advocacy associations to ensure that proposed remedies will truly address patient care and coverage needs.”

This week, MSSNY also joined on to a letter to New York’s Congressional delegation along with over 30 other New York health care advocacy organization that noted that “By eliminating the cost-sharing reduction payments in 2020, and pegging tax credits for consumers to the very low actuarial value Bronze Plan, the Senate bill will significantly reduce funding for our state’s Essential Plan, jeopardizing coverage for 700,000 low-income New Yorkers. These changes will also lead to higher prices in our state’s individual insurance market, especially for older New Yorkers. And the bill hits providers hard by imposing cuts at the same time as the number of uninsured people seeking care will rise.”  Specifically, the letter called on New York’s Congressional delegation to:

  • Ensure uninterrupted health insurance coverage for the 24 million Americans, including the 850,000 New Yorkers, who gained coverage under the Affordable Care Act (ACA);
  • Do not harm New York State’s budget and do not shortchange New York’s Medicaid program by repealing the expansion under the ACA and profoundly restructuring it into a per capita cap program;
  • Protect the more than 700,000 New Yorkers who gained coverage under the ACA’s Essential Plan;
  • Do not harm health care consumers and providers;
  • Maintain and improve our insurance markets for individuals, families, and small employers


MSSNY/County Society Physician Leaders Participate in Regional ACA Town Hall Forums
This week MSSNY and county society physician leaders participated in forums organized by the Cuomo Administration designed to highlight concerns to the public with the legislation before the Congress that would repeal and revise much of the Affordable Care Act (ACA).  MSSNY Treasurer and Cobleskill internist/pediatrician Dr. Joseph Sellers participated at the forum in Hudson, and Erie County Medical Society President and Roswell Park urologist Dr. Willie Underwood participated at the forum in Buffalo (along with former MSSNY House of Delegates Speaker and AMA President Dr. Nancy Nielsen).

Both Dr. Sellers and Dr. Underwood noted that it was appropriate for Congress to examine and seek to fix the flaws of the ACA, given the increasing use of health plans with narrow networks and high deductibles.  However, both Dr. Sellers and Dr. Underwood noted MSSNY’s concerns “with proposals before Congress that would replace provisions that may cause New Yorkers who currently have low cost, “first dollar” coverage through the Essential Plan or expanded Medicaid to lose this coverage.  Instead they will have to purchase coverage with tax credits where they may only be able afford policies with high deductibles and other high cost sharing responsibilities.

Or worse yet, they may not purchase any coverage at all.” Moreover, both articulated to the Governor’s top health care staff at these forums the importance of including medical liability reform within ACA reform discussions, given New York’s recent designation as the worst state in the country to be a physician, in large part due to its excessive liability costs.

AG: Would Sue Federal if Provision Affecting NY Medicaid Spending Became Law
Crain’s New York Business (6/27) reports New York Attorney General Eric Schneiderman said on Tuesday that he would “sue the federal government if Senate Republicans pass their bill to repeal the Affordable Care Act.” Schneiderman said the measure unconstitutionally interfered in the governance of New York by shifting Medicaid costs from counties to the state government.

MSSNY President Charles Rothberg, MD with Jerome Adams, MD
MSSNY President Charles Rothberg, MD with Jerome Adams, MD

MSSNY Supports Dr. Jerome M. Adams’ Nomination as US Surgeon General
Indiana State Health Commissioner Jerome Adams, MD, MPH, has been nominated as Surgeon General of the US by President Donald Trump.

Trained as an anesthesiologist, Adams has been outspoken about the risks of prescription opioid painkillers and the need to address the opioid epidemic. Dr. Adams took the helm at the Indiana Health Department in October 2014. Just a month later, the first cases of what would later be recognized as a full-blown HIV outbreak were detected in the community of Austin in southeastern Indiana.

The virus was being spread primarily by intravenous drug users sharing needles to inject the prescription opioid oxymorphone. In 2015, Dr. Adams worked to persuade then Governor Michael Pence to authorize an emergency needle exchange for 30 days, although Governor Pence was morally against needle sharing.

MSSNY President Charles N. Rothberg, MD, stated, “Dr. Adams has a proven track record to make public health a priority despite political hurdles. He is reminiscent of  Dr. C. Everett Koop (US Surgeon General, 1982-1989), who was a champion of public health.  Dr. Adams is in touch with the public needs.”

Dr. Adams wrote in May 2015, “We are building a model for prevention and response should this type of outbreak happen in other communities in the US. I would like nothing better than to tell you this unprecedented HIV epidemic will never happen anywhere else. But I can’t do that.”

In July of 2016, Indiana joined the list of states with standing orders for naloxone, the antidote to revive people who overdose on opioids. Subsequently, Indiana, residents can go to registered pharmacies, nonprofit organizations, and health centers and get naloxone without needing a prescription.

In 2016, Dr. Adams gave a presentation on fighting the spread of hepatitis C and HIV at the National Rx Drug Abuse & Heroin Summit in Atlanta.  He said in his presentation, “Speak to your audience in their language. To change behavior, public health program workers need to confront ignorance and denial, conduct small pilot programs, and use successes to gain support.”

Dr. Adams earned bachelor’s degrees in biochemistry and biopsychology from the University of Maryland in 1997. He then earned a master’s degree in public health from the University of California at Berkley, and a medical degree from the Indiana University Medical School. He has been a researcher at medical schools in both the Netherlands and Zimbabwe and has worked under Nobel Prize winner Dr. Tom Cech.

Dr. Adams is married and has three children.

Click here to read press coverage of MSSNY’s support of Dr. Adams’ nomination. 

NYS Provider & Health Plan Look-Up
The New York State Department of Health, together with the NY State of Health, this week announced the launch of the NYS Provider & Health Plan Look-Up, an online tool that consumers can use to research those health insurance plans with which a physician (and other health care practitioners) participates.  It also lists practice locations for each physician.  Previously, a consumer would have to go to the website of each health insurance company to determine if a physician participated with a particular plan.

Physicians should take the opportunity to go to the website to see with which health plans they are listed to participate to determine if there are inaccuracies in their listings. The most efficient way to report an error is for the physician or someone on his or her behalf to select the  Contact Us button on the website. Then select the health plan and the reason for the contact. The issue will be routed electronically to the DOH and to the selected health plan(s) for review and follow-up.

CDC Working on New Approach for Early-Stage Lyme Disease Detection
STAT (6/28) reports that the number of Lyme disease cases is rising, and given that the current FDA-approved laboratory test does not consistently detect the disease in its early stages, the CDC is focusing on creating a new Lyme test using “metabolomics,” which measures “metabolite biosignatures” rather than the body’s immune response. The article extensively quotes CDC microbiologist Claudia Molins, who says, “We want a test that can be used within the first two weeks of infection and that does not rely on antibody production.” STAT adds that by using metabolomics, “the CDC aims to create a Lyme ‘signature’ of small molecules in the blood – an approach that, in early testing, catches a dramatically higher share of early infections.”

2018 EHR Hardship Exemption
July 1 is the deadline for avoiding the 2018 penalty imposed by the federal government’s Electronic Health Record (EHR) Incentive Program in its final year if you were not successful in reporting Meaningful Use in 2016 (the performance year for the 2018 penalty).  If you think you might not have reported sufficient data please review the following links:

Instructions
Hardship Application

The deadline for the hardship application is 11:59 PM on Saturday, July 1, 2017

Social Security Number Removal Initiative (SSNRI)
As we reported previously, beginning in April 2018, CMS will start mailing new Medicare cards with Medicare Beneficiary Identifier (MBIs) to people with Medicare. CMS is figuring out the best way to mail the cards. CMS will keep clinicians and beneficiaries posted about critical information so everyone can be ready to ask Medicare patients at the time of service if they have a new card with an MBI.

Beginning in October 2018, through the transition period, when physicians submit a claim using the patient’s valid and active Health Insurance Claim Number (HICN), NGS Medicare will return both the HICN and the MBI on every remittance advice. The MBI will be in the same place you currently get the “changed HICN.” The new MBI format is explained at the following website: https://www.cms.gov › Regulations and Guidance › EHR Incentive Programs

Important Modification on E&M Exam for Expanded Problem and Detailed Levels
The originally planned differentiation in examination requirements for Expanded Problem Focused (2-5) and Detailed (6-7) levels of service will no longer be considered mandatory for providers as of 7/1/2017. NGS developed these suggestions in response to multiple provider queries on the original levels (both EPF and Detailed at 2-7), and has received strong provider support for delineating the two levels as a means of more accurately coding a service.

We will not, however, mandate the changes as previously announced; all medical records reviewed will be subject to the original standard of 2-7 or the newly suggested levels of 2-5 and 6-7, in whatever manner is more beneficial to our providers. These suggestions apply to services coded as per the CMS 1995 Documentation Guidelines for Evaluation and Management Services; suggestions do not apply to services coded as per the CMS 1997 Documentation Guidelines for Evaluation and Management Services.

The posted NGS Evaluation & Management Documentation Training Tool reflects the 2-7 exam component standard for both coding levels, and will remain unchanged.


CLASSIFIEDS


Medical Space Available for Leasing
Currently (last 7 years) occupied by Lab Corp.
2,500 sq. ft. ADA compliant.
25-15 Steinway Street, Astoria, NY 11103
Please contact Landlord: 1-800-283-0602;
e mail: wwwevans@yahoo.com

Office Space Available within Beautiful Medical Spa in Woodbury NY
Seeking an MD that is looking to rent space in Woodbury, NY within a beautiful, state-of-the-art Medical Spa. Located in the Woodbury Common with high profile brands such as Soul Cycle, Athleta, Chop’t and more, this area is exclusive, elite and high-traffic. Rental space can include from 1 – 4 rooms with office space, shared reception and retail area. Size of area and price are negotiable. Great opportunity to share like-minded patients. ssoni@becomemedspa.com.

Manhasset Suite
Medical Suite to share- located at 1201 Northern Blvd, Manhasset. The medical space includes 4 exam rooms and consultation rooms. Direct access to office-  NO STEPS. Conveniently located between St.Francis Hospital and NS/LIJ Hospitals. For more information, please call 516-365-4616 or email RSwe777@aol.com


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


Position Available for Critical Care Physician to Join Established Practice in Nassau County, Long Island, NY.
The Physician will join our existing team of Board-Eligible/Board-Certified Intensivists. This is a PT/FT position including both nocturnal and daytime responsibilities. The Physician will work with a dedicated group of highly trained mid-level practitioners, respiratory therapists and nurses to provide Critical Care at St. Francis Hospital in Roslyn, NY. St. Francis was ranked one of the top 10 hospitals in the nation for Cardiac Care and is top rated nationally in seven other adult specialties.
We are expanding our Intensivist Program and are expecting to add an Intensivist to our group.
Nassau Chest Physicians, P.C. was established in 1978 to provide state-of-the-art care to patients with pulmonary diseases on Long Island. We have expanded our practice to include 8 Intensivist/Pulmonologists and 5 pure Intensivists. Since 2006, we have assumed management of Critical Care services at St. Francis Hospital-The Heart Center in Roslyn, NY.
St. Francis Hospital is New York State’s only specialty designated cardiac center and is a nationally recognized leader in cardiology and heart surgery, ear-nose-throat, gastroenterology and GI surgery, geriatrics, neurology and neurosurgery. More cardiac procedures are performed at St. Francis than at any other hospital in New York State. The hospital is located on the North Shore of Long Island; approximately 30 minutes from Manhattan. The hospital combines unrivaled expertise in cardiovascular medicine with top-ranged nursing (AACN Magnet Award) to provide the very best in patient care.
In addition, St. Francis offers excellent Thoracic, Vascular, Oncologic, Neurosurgical, and Orthopedic Surgical Programs. We have a very active Emergency Department. The hospital offers the latest in technologies such as Therapeutic Temperature Modification, Impella, ECMO and LVAD. Our excellent and experienced medical staff supports strong medical and surgical subspecialty programs.

Aside from Certified Critical Care Nurses, many who have more than 20 years of experience and are expert at caring for this complex patient population, we have a growing pool of Intensivist mid-level practitioners who work hand in hand with our Intensivist physicians to coordinate the care of the critically ill patient, minister to them and perform procedures.

Of course, a New York License is required. J1 or H1 VISAS accepted.
Additional Salary Information: Salary and benefits are competitive and commensurate with experience. Interested applicants, send resume to: dr.sorett@nassauchest.com


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

MSSNY Supports Dr. Jerome M. Adams’ Nomination as US Surgeon General

 
Above: MSSNY President Charles Rothberg, MD with Jerome Adams, MD

For Immediate Release

June 29, 2017

MSSNY Supports Dr. Jerome M. Adams’ Nomination as US Surgeon General

Indiana State Health Commissioner Jerome Adams, MD, MPH, has been nominated as Surgeon General of the US by President Donald Trump.

Trained as an anesthesiologist, Adams has been outspoken about the risks of prescription opioid painkillers and the need to address the opioid epidemic. Dr. Adams took the helm at the Indiana Health Department in October 2014. Just a month later, the first cases of what would later be recognized as a full-blown HIV outbreak were detected in the community of Austin in southeastern Indiana. The virus was being spread primarily by intravenous drug users sharing needles to inject the prescription opioid oxymorphone. In 2015, Dr. Adams worked to persuade then Governor Michael Pence to authorize an emergency needle exchange for 30 days, although Governor Pence was morally against needle sharing.

MSSNY President Charles N. Rothberg, MD, stated, “Dr. Adams has a proven track record to make public health a priority despite political hurdles. He is reminiscent of  Dr. C. Everett Koop (US Surgeon General, 1982-1989), who was a champion of public health.  Dr. Adams is in touch with the public needs.”

Dr. Adams wrote in May 2015, “We are building a model for prevention and response should this type of outbreak happen in other communities in the US. I would like nothing better than to tell you this unprecedented HIV epidemic will never happen anywhere else. But I can’t do that.”

In July of 2016, Indiana joined the list of states with standing orders for naloxone, the antidote to revive people who overdose on opioids. Subsequently, Indiana, residents can go to registered pharmacies, nonprofit organizations, and health centers and get naloxone without needing a prescription.

In 2016, Dr. Adams gave a presentation on fighting the spread of hepatitis C and HIV at the National Rx Drug Abuse & Heroin Summit in Atlanta.  He said in his presentation, “Speak to your audience in their language. To change behavior, public health program workers need to confront ignorance and denial, conduct small pilot programs, and use successes to gain support.”

 

Dr. Adams earned bachelor’s degrees in biochemistry and biopsychology from the University of Maryland in 1997. He then earned a master’s degree in public health from the University of California at Berkley, and a medical degree from the Indiana University Medical School. He has been a researcher at medical schools in both the Netherlands and Zimbabwe and has worked under Nobel Prize winner Dr. Tom Cech.

Dr. Adams is married and has three children.

# # #

Founded in 1807, the Medical Society of the State of New York is the state’s principal non-profit professional organization for physicians, residents and medical students of all specialties. Its mission is to represent the interests of patients and physicians to assure quality healthcare services for all.

Press Contact:
Roseann Raia
Media and Marketing Relations
Medical Society of the State of New York
865 Merrick Avenue
Westbury, New York 11590
Phone:  516-488-6100 ext. 302
email: rraia@mssny.org

US House of Representatives Seeking to Reduce Medical Liability Costs

For Immediate Release



June 28, 2017

MSSNY Applauds US House of Representatives for Seeking to Reduce Medical Liability Costs 

Statement from Charles Rothberg, MD, President, Medical Society of the State of New York:

“We have long maintained that medical liability reform is an essential component of health reform.  We commend the House of Representatives for passing legislation (HR 1215) that if enacted could help to reduce some of the extraordinary costs faced by our physicians and hospitals and restore some balance to our medical liability system.

New York State was recently designated as the worst state in the country to practice medicine, in large part due to our excessive liability exposure as compared to all other states.  Indeed, physicians in New York City, Long Island and the Lower Hudson Valley pay some of the highest liability premiums in the country.  New York not only far exceeds all other states in terms of total medical liability payouts, we also spend more on a per capita than any other state in the country.

The actions of the US House of Representatives to address this huge problem stands in stark contrast to the New York State Legislature, which despite New York’s exorbitant costs, just passed legislation that would actually expand lawsuits against doctors and hospitals and impose huge new costs.  MSSNY and many other health care provider associations are urging Governor Cuomo to veto this legislation.

As efforts continue to be undertaken to fix the flaws of the Affordable Care Act, we urge that comprehensive medical liability reform today be included in these efforts.”

# # #

Founded in 1807, the Medical Society of the State of New York is the state’s principal non-profit professional organization for physicians, residents and medical students of all specialties. Its mission is to represent the interests of patients and physicians to assure quality healthcare services for all.

Press Contact:
Julie Vecchione
Manager, Communications Division
Medical Society of the State of New York
865 Merrick Avenue
Westbury, NY 11590
516.488.6100 x 340
jvecchione@mssny.org

June 23, 2017 – Operating in Obscurity-Wrong, Wrong, Wrong!


PRESIDENT’S MESSAGE
Charles Rothberg, MD
June 23, 2017
Volume 17
Number 24

Dear Colleagues:

On Thursday, a medical liability expansion bill, fast-tracked by a select group of New York State Republican Senators was delivered to their peers amid a totally unacceptable veil.  While quite early to deconstruct this ‘failure’ for the house of medicine, some important lessons are evident.

Healthcare is such a vital issue to the people of our nation that any legislative endeavor regarding this complicated topic deserves to be thoroughly scrutinized to assure it provides the highest standards possible prior to its enactment.

In that spirit, I must question how it is that any bill be considered if it has not been made available for public review and comment prior to its presentation on the floor of the Senate, or worse—after it has been voted into law?

To operate in obscurity is wrong. The public wants to know what doctors think. With rare exception, the public still trusts us to protect their interests—especially their health.

In that spirit, the MSSNY Council considered the manner in which the United States Senate has been crafting its ACA replacement – behind closed doors!  While the Senate did (finally) release the language of the bill just yesterday, it plans to vote as early as next week, an unreasonably short time for public—let alone expert comment.  It was the consensus of the MSSNY Council to advise Congress and the public of our desire to review and comment on health legislation, and to recommend that a similar position be taken by the American Medical Association.

Political Not Medical

I should say that at certain times, such as deliberations regarding investigations or national security, “closed door” deliberation may be appropriate. But in health care deliberations, the motive of closed-door deliberation is purely political. The result will be a political rather than a medical solution—not likely the best service to our sector or to the public we serve.

Our objections to the closed door manner of the Senate proceedings on health care is being disseminated to our entire physician membership, our patient population, and all media to advise the population-at-large of our concerns for their health and welfare—today and in the future.

Expansion of Liability Issue

Our position on the statute of limitations expansion bill that was passed on Wednesday is that it is a poor solution. We still require comprehensive laws to serve all stakeholders in the long term.

Lavern Wilkinson (of Lavern’ Law) was treated at a public hospital, a venue that enjoys a shortened 15-month statute of limitations.  The remedy for Laverne could have extended the statute for public hospitals to 30 months (like all non-public venues).  But instead, the new law unnecessarily expands liability for all physicians and all hospitals. There is major dysfunction operating here

You may recall that in 2008-2009, the New York Medicaid Redesign Team delivered 79 recommendations, including medical liability reform. Originally, MRT was to be enacted as a package up or down.  But ultimately only one provision was excluded, tort reform. The other 78 became law and the genesis of DSRIP!

Both the Senators in Washington and those in the New York legislature cross paths in their exclusion of input from the major healthcare stakeholders—physicians and hospitals.

1) We urge Governor Cuomo to veto this legislation and to then bring parties together to pass comprehensive, not one-sided medical liability reform.   

2) We urge congress to solicit, not exclude input from the local health care experts – our physicians.

Sincerely,
Charles Rothberg, MD
MSSNY President

Please send your comments to comments@mssny.org



Dear Physicians: 

As you may be aware, the State Legislature ended its formally scheduled 2017 Legislative Session late Wednesday (though it is possible for them to return to Albany on a limited basis).  Despite being besieged with numerous adverse proposals in the final weeks of Session, we are happy to report that the Session ended with MSSNY, working together with many other allies, able to assure that the scores of the adverse legislative proposals were rejected, including legislation that would have:

  • Enabled corporate-owned Retail Clinics staffed by physician extenders
  • Significantly expanded the information required to be included in the Physician Profile
  • Limited injured worker choice of physician in Workers Compensation, expanded the role of Non-Physicians under Workers Compensation, and eliminated the county medical society role in processing applications
  • Imposed burdensome new requirements on the prescribing of pain medications to patients;
  • Required urgent care  office –based surgery centers to use electronic health records
  • Expanded the scope of practice of numerous non-physicians, including podiatrists, Nurse-anesthetists, optometrists, psychologists, chiropractors, and naturopaths; and
  • Formally permitted non-physicians to perform laser hair removal with virtually no physician oversight. 

Moreover, working with many other public health groups, we scored an important public health victory by assuring that e-cigarettes are regulated similar to other tobacco products. 

However, as you will note below, we are very disappointed that the Legislature chose to pass a one-sided liability expansion bill at a time when physicians and hospitals already face exorbitant liability costs, and potentially significant cuts from Washington.  With Governor Cuomo waging on aggressive public campaign to warn the public about the threat to our health care system and New Yorkers generally if cuts arising from various proposals to repeal the ACA are enacted, please let him know that further increases in liability costs would make these health care access problems even worse. 

We thank the many of you who responded to our call throughout the Session to contact your legislators when requested. 

Sincerely,

Your MSSNY Division of Government Affairs Team

Tell Governor Cuomo to Reject Medical Liability Expansion Bill and Call for Comprehensive Liability Reform
All physicians are urged to call Governor Cuomo at 518-474-8390 and send a letter here Click Here:

urging that he veto a purported “cancer only” medical liability statute of limitations expansion bill (S.6800/A.8516) that passed the Legislature over the strong objections of MSSNY, the specialty societies, the hospital industry and MLMIC.  Please urge that instead he work towards enacting comprehensive medical liability reform.

The bill, introduced in the final days and passed in the final hours of the 2017 Legislative Session, would expand the medical liability statute of limitations for cases involving “alleged negligent failure to diagnose a malignant tumor or cancer”.   The bill would permit lawsuits 2.5 years from the “date of discovery” of such alleged negligence, up to an outside limit of 7 years.

While it is likely that a more narrowly focused bill will reduce the premium increase needed for this legislation (if signed) from the 15% projected to be needed for an earlier version of this bill, there is great ambiguity in the language that could generate significant litigation as to which cases it would apply.    Moreover, the bill does not just apply to cases that may arise in the future but has a retroactive impact. The ambiguities are likely the result of the bill being “rushed into print” late Sunday night to meet the constitutional “3-day aging” requirement before a bill can be considered by the Legislature, as the Legislature was planning to adjourn its 2017 Session Wednesday.

The bill passed the State Senate by a 56-6 vote (those voting no included Senators Hannon, Klein, Murphy, Ortt, O’Mara, and Valesky) and the Assembly by a 112-27 vote (to see how your Assembly member voted, Click Here:

In response to the passage, Dr. Rothberg issued the following statement (Click Here) expressing MSSNY’s great concerns with proposals to expand liability when are in desperate cost decreases:

“New York’s physicians are extremely concerned about the ultimate impact to New Yorkers’ access to care if the statute of limitations expansion bill (S.6800/S.8516) considered by the Legislature today is ultimately signed into law.  Many New York hospitals and physicians are already struggling to keep their doors open.

New York State has already earned the dubious distinction as the absolute worst state in the country in which to practice medicine, in large part due to its overwhelming liability costs.  The bill will add significantly to these costs that have already driven physician after physician out of private practice, and in many cases driving them out of New York altogether.  It will also discourage countless others from coming here to practice.  We urge Governor Cuomo to veto this legislation and bring parties together to pass comprehensive, not one-sided, medical liability reform. New Yorkers’ access to health care is at stake.”

  • Rothberg’s concerns here noted in both the Daily News and Crains Health Pulse.

We thank all of you who took the time to contact their legislators over the last several days to oppose these and the myriad of other liability expansion bills that were also being aggressively pushed by the Trial Bar in the Session’s final days (for example, the attorney contingency fee limit removal was also under serious consideration but was defeated: Click Here.

Again, please urge the Governor to veto the bill and encourage your colleagues to do the same! Please let the Governor how patient access to care will be harmed if this bill were to be enacted.   (DIVISION OF GOVERNMENTAL AFFAIRS) 

New York State Legislature Approves Bill Banning E-Cigarettes From Bars, Restaurants
The New York State Legislature has approved A. 516A/S. 2543A expanding the state’s Clean Indoor Air Act so that it now bans e-cigarettes from bars and restaurants.  Assembly member Linda Rosenthal and Senator Kemp Hannon were the sponsors of the measure.  The Medical Society of the State of New York strongly supported this measure and worked with other health organizations on the bill’s passage.  Governor Andrew Cuomo, who proposed the measure in his budget earlier this year, is expected to sign the bill.        (CLANCY)

Legislature Does Not Take Up Retail Clinic Legislation
The Legislature ended its regularly scheduled session Wednesday night without taking action on legislation strongly opposed by MSSNY (A.958, Paulin) that would permit corporate-owned retail clinics, which would have veered New York away from its long history of opposition to corporately owned care delivery.    Big box store interests were aggressively pursuing this legislation.  The bill advanced from the Assembly Health Committee to the Assembly Codes Committee earlier this year, but moved no further. This legislation was also opposed by the New York State Nurses Association.
(AUSTER)                 


Your membership yields results and will continue to do so. When your 2017 invoice arrives, please renew. KEEP MSSNY STRONG!


Anti-Physician Workers Compensation “Reform” Proposals Not Taken Up
The Legislature left Albany without taking action on legislation (A.8387, Pretlow and S.6349, Alcantara)   that could have significantly impaired injured workers access to care from WC-authorized physicians including giving greater discretion to the Board to penalize physicians, expanding the scope of numerous non-physicians to treat injured workers without requiring coordination with a physician, and limiting the ability of your county medical society to assist physicians in completing applications to become WC-authorized.

Moreover, MSSNY expressed concerns that the bill does nothing to address the myriad of administrative hassles that physicians have experienced with the Workers Compensation system that have forced many physicians to leave the program.  Similar legislation was considered during negotiations of the State Budget, but was ultimately rejected.   Discussions on this topic are likely to continue over into next year.
(AUSTER, BELMONT)

Legislature Does Not Take Up Bill to Empower Non-Physicians to Perform Laser Hair Removal
The Legislature left Albany without taking action on legislation (S.6088-A, Savino/A.7977-A, Paulin) to expressly permit estheticians and others to perform laser hair removal with only minimal physician oversight.  The bill, strongly opposed by MSSNY and other specialty societies, had advanced from the Senate Consumer Protection to the Rules Committee, but moved no further. 

MSSNY has adopted policy that vigorously opposes certification of non-physicians (including non-medical personnel) to perform laser and intense pulsed light source skin enhancement procedures.   That is because lasers have the potential to cause painful burns and permanent scarring if not used properly.  With laser hair removal largely unregulated in New York, legislation to provide strong physician oversight of this process would be appropriate.   However, the only physician oversight this legislation would have required is a once per year audit of policies and procedures.
(AUSTER)

Legislature Rejects Scope of Practice Changes
Working together with the affected specialty societies MSSNY was successful in convincing the legislature to reject various bills that would have expanded the scope of practice for various professions.  These bills include:

  • Certification of Certified Registered Nurse Anesthetists (CRNAs)

A.442 (Paulin) / S.1385 (Gallivan) – This measure would provide for the certification by the education department of certified registered nurse anesthetists (CRNAs).  Because this bill fails to define a scope of practice we had conserns that it could have given the Education Dept authority to enable independent practice for CRNA’s.

  • Broadens scope of practice of dentistry

A.4543 (Morelle) / S.3551 (Golden) – This measure would permit dentists to perform a wide range of medical surgical procedures involving the oral and maxillofacial area. This bill would expand the current scope of practice for dentist which is currently limited to the oral and maxillofacial area relating to restoring and maintaining dental health.

  • Podiatric Scope of Practice

A.1880 (Pretlow) – This bill would expand the scope of practice of podiatrists to allow podiatrists to “diagnose, treat, operate or prescribe for cutaneous conditions of the ankle to the level of the distal tibial tuberocity” (knee).

  • Allows PA’s to Operate Fluoroscopy Imaging Technology

A.4716 (Gottfried) -This bill would allow physician assistants (PAs) who have completed a training program approved by the Department of Education to operate fluoroscopy imaging technology as part of a diagnostic or treatment procedure.      

  • Psychologists Prescribing

A.2851(Mcdonald) / S.4498 (Lanza) – would permit Psychologists to prescribe medications
(BELMONT)

Assembly and Senate Pass Legislation Designed to Regulate Biosimilar Substitutions
The Assembly and Senate passed legislation (S.4788-A/A.7509-A) this week 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 products 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 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.  It would also establish a 5-year sunset on these provisions.
(AUSTER)

New York State Legislature Approves Bill Allowing Medical Marijuana For Treatment Of PTSD
The New York State Senate approved legislation A.7006/S.5629, sponsored by Assembly member Richard Gottfried and Senator Diane J. Savino, that allows medical marijuana to be used to treat post-traumatic stress disorder [PTSD].  The Assembly had passed the bill in May.  The measure now heads to Gov. Andrew M. Cuomo for signature.  The Medical Society of the State of New York opposes the use of marijuana in treatment for PTSD.  Furthermore, MSSNY has expressed concerns about the law due to possible federal prosecution of physicians.
(CLANCY)  

Public Health Issues
Sepsis Awareness Program –   The New York State Legislature has passed a bill which would establish a sepsis awareness, prevention and education program to educate students, parents and school personnel about sepsis awareness on sepsis has passed the state Assembly.

This measure, A. 6053/S.4971, sponsored by Assemblywoman Catherine Nolan and Senator Carl Marcellino, also amends New York State’s amends Public Health Law to require that information on  sepsis  be part of course work in infection control practices already taken by all healthcare providers and would require that this coursework be completed on or before July 1, 2022. 

Raise the Age for Tobacco Purchase—S.3978/A.273, which would increase the purchasing age for tobacco products from eighteen to 21 years of age remained in the Assembly Codes Committee and the Senate Finance Committee.   MSSNY continues to support this measure. 

Three Day Limitation on Pain Medication— There was no action taken on A. 7741/S.6246, sponsored by Assemblyman John McDonald and Senator Kemp Hannon, which would have limited the initial prescription of a Schedule II or III for the alleviation of acute pain from a seven-day supply to a three-day supply for someone suffering from acute pain.  Most importantly, patients throughout New York State who are suffering acute pain, such as acute postoperative pain; acute back or chest pain; acute pain related to an injury, post-herpetic neuralgia, or acute pain related to disease or condition, could be significantly impacted. The Medical Society of the State of New York continues to strongly oppose this measure.

Conversion Therapy—A.3977/S.263, sponsored by Assemblywoman Deborah Glick and Senator Brad Hoylman, would prohibit mental health professionals from engaging in sexual orientation change efforts with a patient under the age of eighteen years and expands the definition of professional misconduct with respect to mental health professionals.   The measure had passed the New York State Assembly, but remained in the in the Senate’s Mental Health and Development Disabilities Committee.    (CLANCY)  

Bill Passes to Prohibit Medical Record Charges When Needed to Support a Patient’s Government Benefit Application
The Senate and Assembly passed legislation (S.6078, Valesky/A.7842, Gottfried) that would prohibit health care providers and entities 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”.

The purpose of the legislation 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), despite provisions in existing law that prohibit charging a fee for medical records where a patient is unable to pay.

MSSNY had expressed concerns that the terminology “any government benefit or program” was too broad, and suggested that the bill be amended to identify specifically those low-income government benefit programs to which this fee prohibition should apply.  However, that change was not made.                                                                                                              (AUSTER)

US Senate Releases Its Own Health Care Reform Proposal
The US Senate this week released its own proposal to repeal substantial portions of the Affordable Care Act, entitled the “Better Care Reconciliation Act of 2017”, with a vote possibly before the July 4 recess.

While the framework of the legislation mirrors the American Health Care Act (AHCA) passed in May by the US House of Representatives, there are some important differences, including with respect to the length of time for the existing Medicaid expansion to be phased out, as well as the distribution of the tax credits to be provided to subsidize the cost of health insurance coverage.

The bill would continue the current tax credit structure provided under the ACA through 2019.  Beginning in 2020, advanceable refundable tax credits would be available for those with incomes up to 350% FPL, down from the existing 400% FPL.  It would not base the size of the tax credit on a person’s age, as was proposed in the House’s AHCA bill.  The benchmark for determining the subsidy would be based on 58% of a health insurance plan’s actuarial value.

Similar to the House’s AHCA legislation, it would contain provisions supported by MSSNY to eliminate the current limitations on a person’s contribution to their HSA, as well as delaying until 2026 enforcement of the “Cadillac Tax” on comprehensive health insurance coverage.

However, of significant concern, it would repeal existing cost-sharing subsidies similar to the AHCA.  That would have the effect of repealing funding for New York’s Essential Plan, which provides low out -of-pocket cost coverage for over 600,000 New Yorkers who make between 138-200% FPL.  It would also phase out from 2021-2024 the existing option to have Medicaid cover individuals who make unto 138% FPL.

Moreover, the bill also contains the “Faso-Collins amendment” contained in the AHCA that would shift $2.3 billion in county Medicaid costs to New York State, which could result in additional cuts or an expansion of risk-based payments in Medicaid to make up the difference.

Next week, Governor Cuomo will host a series of regional forums across New York State to discuss the potential impact of these proposals on New York’s health care system and its citizens. MSSNY Treasurer and Cobleskill Internist/Pediatrician Dr. Joseph Sellers will participate at the forum on Monday, June 26 in Hudson.  The Governor issued a statement on Thursday expressing great concerns with the US Senate’s proposal. MSSNY working together with the AMA and state medical societies across the country are continuing their review of this proposal and will follow up with more detailed information about this proposal and whether the Senate will be able to pass it.
(AUSTER)

CMS Proposes Simplifications to the MIPS Program to Ease Physician Compliance
This week CMS proposed a revised rule implementing the Medicare Quality Payment Program (QPP) as required under MACRA.  According to a summary provided by the AMA, CMS is proposing a number of policies to help small practices,  including a significant expansion of the “low-volume” exemption  threshold to $90,000 (up from $30,000) or less in Medicare Part B allowed charges OR 200 or fewer Medicare Part B patients (up from 100 patients).

CMS estimates that, under this proposed rule, more than 94% of eligible clinicians would earn either a positive or neutral payment adjustment.

In addition to increasing the low volume exemptions, other highlights articulated by the AMA include:

Additional accommodations for small practices

  • Creates virtual groups to assist small practices;
  • Adds 5 bonus points to the final MIPS scores for practices of 15 or fewer clinicians; and
  • Adds a hardship exception from the Advancing Care Information (previously Meaningful Use) category for practices of 15 or fewer clinicians.

Advancing Care Information Category

  • Allows the use of 2014 edition certified electronic health records technology (CEHRT) past 2017 – CMS will not mandate that physicians update their EHRs in 2018;
  • Permits physicians to continue to report on Modified Stage 2 measures in 2018 instead of new Stage 3 measures.

Quality Category

  • Increases the quality performance category weight to 60% in 2018 (due to the Cost category weight remaining at zero in 2018);
  • No additional cross-cutting measure requirements added in 2018;

Cost Category

  • CMS proposes a zero weight for costs again in the 2018 performance/2020 payment year, which would rise to 30% for 2019/2021.
  • Physicians will receive information on how they would have scored under the two current value-based modifier measures (total costs per beneficiary and spending from 3 days before to 30 days after hospital admission)

Improvement Activities (IAs)

  • CMS continues to allow physicians to report on IAs through simple attestation;
  • The proposed rule creates stability in program requirements by not changing the number of IAs physicians must report; and
  • It also develops additional IAs, including adding two activities related to diabetes prevention programs, and clarifies existing IAs to be inclusive of additional activities.
    For more information, Click Here.
    (AUSTER)


DOH Attestation Process for Pain Management CME Must Be Completed by July 1, 2017! One WEEK LEFT!
The New York State Department of Health has announced the attestation process for prescribers required to complete Pain Management CME. Prescribers must attest to the completion of the pain management, palliative care and addiction course work or training by July 1, 2017, and again every three years thereafter. The prescriber should only attest after completion of at least three hours of course work or training covering all eight topics.

A prescriber with a Health Commerce System (HCS) account will attest online using the Narcotic Education Attestation Tracker (NEAT) application.  Complete the steps to access the NEAT (Narcotic Education Attestation Tracker) application in the NYS Health Commerce System (HCS):

  1. Log into the HCS
  2. Under “My Content” click on “All Applications”
  3. Click on “N”
  4. Scroll down to NEAT (Narcotic Education Attestation Tracker) and double click to open the application. You may also click on the “+” sign to add this application under “My Applications” on the left side of the Home screen.

Complete the steps to ATTEST to the completion of the education requirement.   A full set of instructions can be found here.

Prescribers that do not have access to a computer can request a paper attestation form by calling the Bureau of Narcotic Enforcement (BNE) toll-free at 1-866-811-7957. They may then complete the form and return it by mail to the address provided in the form. The Bureau of Narcotic Enforcement has also released a Frequently Asked Questions (FAQs) on the prescriber mandate.   A copy of the FAQs can be found here. 

In certain limited circumstances, the New York State Department of Health may grant an exemption to the required course work or training to an individual prescriber who clearly demonstrates to the department that there is no need to complete such training.  Exemptions will be granted only in very limited circumstances, and not solely on the basis of

Economic hardship, technological limitations, prescribing volume, practice area, specialty, or board certification.

Prescribers may apply for an exemption through the Health Commerce System. Further information may be obtained by contacting BNE at 1-866-811-7957 or narcotic@health.ny.gov.  (CLANCY)

Physicians Have One Week To Meet the  Pain Management Mandatory Education By July 1, 2017
The Medical Society of the State of New York Pain Management, Palliative Care and Addiction modules are now available on-line here.  These modules are being offered free of charge to all MSSNY members.  Physicians who are new users to the MSSNY CME site will be required to register as a new user.

As a new user, physicians and non-physicians will be required to enter fields that include: position; name (the name should be what you want to appear on the CME certificate); email  address; and then create a password.  MSSNY members who encounter a payment page or have difficulty registering, please email cme@mssny.org for technical support.  Directions for creating a new account/or logging in can be found here.   Non-MSSNY physicians will be charged $50 per module. 

The MSSNY CME is a new site and while many MSSNY members have an account with mssny.org a MSSNY member may not necessary have an account with cme.mssny.org   If in doubt, try to create an account and if it tells you that the email address is unavailable or in use,  an account exists.   Passwords can be reset if you don’t know it. 

Physicians who have previously had an account at the MSSNY CME site will need to log into the site using their email and password. The MSSNY CME site provides the ability for physicians and other prescribers to view the archived webinar at their leisure, take the required test, and download their certificate. The online program covers all eight topics required in the New York State statute. MSSNY developed the program with the NYS Office of Alcoholism and Substance Abuse Services (OASAS).  MSSNY is listed as an accrediting organization by the NYS DOH Bureau of Narcotic Enforcement.   Information on the three CME modules is available here.  Additional information or technical support may be obtained by contacting cme@mssny.org.
(CLANCY)

pschuh@mssny.org mauster@mssny.org
pclancy@mssny.org jbelmont@mssny.org

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Council Notes from June 22, 2017

  • Discussion of the effects in the near future of hospitals and physicians regarding the expansion of liability law
  • MSSNY Council Don Moy advised physicians that they should keep medical records dating back 10 years
  • MLMIC reported that the Berkshire Hathaway deal was moving forward without problems
  • MSSNY won two contested elections at the AMA –Dr. Robert Goldberg , DO, AMA Council on Medical Education; Jerry Cohen MD was reelected to the AMA Council on Constitution and Bylaws;and Meena Davaluri, MD was elected to the Resident slot on the Council on Medical Service. MSSNY now has seats on all AMA Councils that provide guidance on the policies being adopted. AMA Delegation Chair Dr. John Kennedy thanked the 38 delegates and alternates who came to the AMA Annual Meeting in Chicago.
  • Joe Sellers, MD, PAC Chairman said “too many doctors remain on the sidelines with fewer giving even more support” to the PAC. He said that “Doctor to Doctor” solicitation is the most effective was to recruit new PAC members and that the PAC would be happy to meet with small groups throughout the state in an effort to increase PAC membership.
  • Donald Moy, Lawrence Kobak and Thomas Gallo from Kern Augustine will be serving as MSSNY General Counsel.
  • MSSNY Task Force on Physician Stress and Burnout Chair Michael Privitera, MD, made recommendations on the Task Force’s findings for further research collaboration for data analysis
  • Parag Mehta, MD, Commissioner of Membership, presented a resolution about alternate types of memberships for Nonaffiliated Groups of Physicians

Anthem: Minor Conditions No Longer Covered in ED as of July 1
Anthem recently announced that as of July 1, it will no longer cover emergency department visits for most instances of minor conditions that could “safely [be] treated in less acute facilities.” Jay Moore, CMO for Anthem Blue Cross Blue Shield (BCBS) Missouri, said the policy has long been part of coverage contracts, but it has not always been enforced.

A spokeswoman for the insurer, Said its goal was to control costs by steering patients away from expensive ER services and toward doctor offices or urgent care clinics when those are more appropriate settings for treatment. She said the policy wouldn’t apply when the patient is 14 or younger, an urgent care clinic isn’t located within 15 miles, or the visit occurs on a Sunday or holiday. She said it’s aimed at manifestly minor ailments — “If you had cold symptoms; if you have a sore throat. Symptoms of potentially more serious conditions, such as chest pains, could be seen at the ER even if they turn out to be indigestion.” (CBS News & LA Times)

Buffalo Health Centers: ACA Will “Strip People of Their Health Insurance”
The Buffalo (NY) News (6/21) reports that “leaders of Kaleida Health, Erie County Medical Center and the University at Buffalo issued a joint statement this week warning that the bill, known as the American Health Care Act, ‘will ultimately make health care more expensive for patients, doctors and hospitals’” or “strip people of their health insurance, ‘either through prohibitively high premiums for people with pre-existing conditions, elimination of the Medicaid safety net or forcing patients into severely underfunded high-risk pools.’”

The group also said that two key areas of western New York’s economic recovery are medical education and biomedical research, to which “potential cutbacks that stem from the legislation will pose a challenge.”


MSSNY Members Only: Unpaid Claims
We Can Help!
In 2016, MSSNY’s Ombudsman Program was successful in recovering $89,815.79 for physicians who had reached a stalemate regarding unpaid claims. From January to June of 2017, the program recovered $121,441.68 for our members who availed them of the Ombudsman service.If you are a member in good standing, this service is available to you for FREE!For further information, call 516-4886100 ext. 334 or 332.



AMA: New Video Shows Physicians How to Avoid Medicare Payment Penalties
The AMA and the M are looking to help physicians avoid a negative Medicare payment adjustment in 2019—an effort that may be particularly relevant to physicians who have not previously participated in Medicare reporting programs, and/or physicians in smaller practices. The AMA has designated the week starting June 26, 2017 as Pick Your Pace Week, and will broadly disseminate simple instructions on how to report “one patient, one measure, no penalty.” The new materials, available on the AMA website, include:

  • A short video: One patient, one measure, no penalty: How to avoid a Medicare payment penalty with basic reporting.
  • A sample CMS-1500 claim form
  • Links to quality measures on the CMS website

A link to the CMS MIPS eligibility tool

Important Notice Regarding Handwriting on Claims Submitted to Medicare
Beginning 7/1/2017, NGS will return to the provider any paper claim submitted with handwriting on the face of the claim that is not a signature field, (i.e., Items 12, 13, or 31). A notice will be attached to the front of the returned claim and you will need to submit a new claim.

The Centers for Medicare & Medicaid Services (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.

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:

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!

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.

$7M in Overpayments on Electronic Submissions; Recovery Attempt Expected
In the attachment please find the latest report from the Dept. of Health and Human Services, Office of the Inspector General, regarding their recently completed analysis of the Electronic Health Record Incentive Program. The report basically outlines their approach in reviewing the program through which participants received billions in incentive payments for adoption of electronic health records.

They are now asserting that upwards of $729,424,395 (amount reached through extrapolation) of those payments could have been made in situations that did not actually meet the necessary requirements of the program. Therefore, you should be aware that a recovery attempt might be undertaken to get back some of those funds previously paid out to early adopters.  More information here.

Only 25% of Youth with Opioid Use Disorder Receive Buprenorphine or Naltrexone
According to a JAMA Pediatrics study, only 25% of youth with opioid use disorder receive buprenorphine or naltrexone. Guidelines from the American Academy of Pediatrics recommend that clinicians consider offering pharmacotherapy to adolescents with opioid use disorder. Using a health insurance database, researchers tracked the treatment of youth aged 13 to 25 who were diagnosed with opioid use disorder between 2001 and 2014.

The proportion of patients with opioid use disorder who received buprenorphine or naltrexone increased from 3% in 2002 to 32% in 2009, but by 2014 it had fallen to 28%. Meanwhile, prevalence of opioid use disorder in this age group rose more than fivefold.

The authors and editorialists both note that few pediatricians have the necessary waiver to prescribe buprenorphine. “These findings suggest that provision of [buprenorphine and naltrexone] is not keeping up with the growing need for these treatments among youth.”

Physicians Invited to Meaningful Use MIPS Webinar
Physicians are invited to CAPG Educational Series 2017 webinar with CMS, Advancing Care Information: How to Implement the New Meaningful Use Component of MIPS, on July 7. Space is filling quickly, so please make sure to reserve your place – register now! CMS will provide an overview of the substantive changes to the program from meaningful use to ACI. Additionally, CMS will answer audience questions on the specific ACI component of the Quality Payment Program.

CAPG will have its members cover key implementation steps for physicians and physician organizations starting on this important transition. Our members will tell the audience about the rationale behind their strategy and any implications this will have on their organization.

Please visit our Educational Series web page to learn more and register here for July’s webinar.

Register: CMS Webinar on Proposed Rule for Year 2 of the Quality Payment
Join CMS Webinar on Proposed Rule for Year 2 of the Quality Payment Program

On Monday, June 26 at 1:00 p.m. ET, the Centers for Medicare & Medicaid Services (CMS) will host an overview webinar on the Medicare Quality Payment Program Year 2 proposed rule.

Join the webinar to hear CMS policy experts provide an overview of proposed participation requirements for the second year of the Quality Payment Program.

Webinar Details:

  • Title: Medicare Quality Payment Program Year 2 Proposed Rule Overview
  • Date: Monday, June 26
  • Time: 1:00 – 2:30 p.m. ET
  • Registration page, click here.

Please note:

  • Space for this webinar is limited. Register now to secure your spot. After you register, you will receive a follow-up e-mail with step-by-step instructions about how to log-in to the webinar.
  • The audio portion of this webinar will be broadcast through the web. You can listen to the presentation through your computer speakers. If you cannot hear audio through your computer speakers, please contact CMSQualityTeam@ketchum.com.
  • There will be a Q&A session if time allows. However, CMS must protect the rulemaking process and comply with the Administrative Procedure Act. Participants are invited to share initial comments or questions, but only comments formally submitted through the process outlined by the Federal Register will be taken into consideration by CMS. See the proposed rule for information on how to submit a comment.


CLASSIFIEDS


Office Space Available within Beautiful Medical Spa in Woodbury NY
Seeking an MD that is looking to rent space in Woodbury, NY within a beautiful, state-of-the-art Medical Spa. Located in the Woodbury Common with high profile brands such as Soul Cycle, Athleta, Chop’t and more, this area is exclusive, elite and high-traffic. Rental space can include from 1 – 4 rooms with office space, shared reception and retail area. Size of area and price are negotiable. Great opportunity to share like-minded patients. ssoni@becomemedspa.com.


Manhasset Suite
Medical Suite to share- located at 1201 Northern Blvd, Manhasset. The medical space includes 4 exam rooms and consultation rooms. Direct access to office-  NO STEPS. Conveniently located between St.Francis Hospital and NS/LIJ Hospitals. For more information, please call 516-365-4616 or email RSwe777@aol.com


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


Position Available for Critical Care Physician to Join Established Practice in Nassau County, Long Island, NY.
The Physician will join our existing team of Board-Eligible/Board-Certified Intensivists. This is a PT/FT position including both nocturnal and daytime responsibilities. The Physician will work with a dedicated group of highly trained mid-level practitioners, respiratory therapists and nurses to provide Critical Care at St. Francis Hospital in Roslyn, NY. St. Francis was ranked one of the top 10 hospitals in the nation for Cardiac Care and is top rated nationally in seven other adult specialties.
We are expanding our Intensivist Program and are expecting to add an Intensivist to our group.
Nassau Chest Physicians, P.C. was established in 1978 to provide state-of-the-art care to patients with pulmonary diseases on Long Island. We have expanded our practice to include 8 Intensivist/Pulmonologists and 5 pure Intensivists. Since 2006, we have assumed management of Critical Care services at St. Francis Hospital-The Heart Center in Roslyn, NY.
St. Francis Hospital is New York State’s only specialty designated cardiac center and is a nationally recognized leader in cardiology and heart surgery, ear-nose-throat, gastroenterology and GI surgery, geriatrics, neurology and neurosurgery. More cardiac procedures are performed at St. Francis than at any other hospital in New York State. The hospital is located on the North Shore of Long Island; approximately 30 minutes from Manhattan. The hospital combines unrivaled expertise in cardiovascular medicine with top-ranged nursing (AACN Magnet Award) to provide the very best in patient care.
In addition, St. Francis offers excellent Thoracic, Vascular, Oncologic, Neurosurgical, and Orthopedic Surgical Programs. We have a very active Emergency Department. The hospital offers the latest in technologies such as Therapeutic Temperature Modification, Impella, ECMO and LVAD. Our excellent and experienced medical staff supports strong medical and surgical subspecialty programs.

Aside from Certified Critical Care Nurses, many who have more than 20 years of experience and are expert at caring for this complex patient population, we have a growing pool of Intensivist mid-level practitioners who work hand in hand with our Intensivist physicians to coordinate the care of the critically ill patient, minister to them and perform procedures.

Of course, a New York License is required. J1 or H1 VISAS accepted.
Additional Salary Information: Salary and benefits are competitive and commensurate with experience. Interested applicants, send resume to: dr.sorett@nassauchest.com


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

STATUTE OF LIMITATIONS EXPANSION BILL

For Immediate Release

June 21, 2017

STATEMENT FROM MEDICAL SOCIETY OF THE STATE OF NEW YORK PRESIDENT, CHARLES ROTHBERG, MD
RE: STATUTE OF LIMITATIONS EXPANSION BILL

“New York’s physicians are extremely concerned about the ultimate impact to New Yorkers’ access to care if the statute of limitations expansion bill (S.6800/S.8516) considered by the Legislature today were ultimately signed into law.  Many New York hospitals and physicians are already struggling to keep their doors open.

New York State has already earned the dubious distinction as the absolute worst state in the country in which to practice medicine, in large part due to its overwhelming liability costs.  The bill will add significantly to these costs that have already driven physician after physician out of private practice, and in many cases driving them out of New York altogether.  It will also discourage countless others from coming here to practice.  We urge Governor Cuomo to veto this legislation and bring parties together to pass comprehensive, not one-sided, medical liability reform. 

New Yorkers’ access to health care is at stake.”

# # #

Founded in 1807, the Medical Society of the State of New York is the state’s principal non-profit professional organization for physicians, residents and medical students of all specialties. Its mission is to represent the interests of patients and physicians to assure quality healthcare services for all.

Press Contact:

Roseann Raia
Media and Marketing Relations
Medical Society of the State of New York
865 Merrick Ave.
Westbury, New York
516-488-6100 ext 302
rraia@mssny.org