NY Eliminates Religious Exemption for Vaccinations 


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MEDICAL SOCIETY OF THE STATE OF NEW YORK
865 Merrick Avenue, Westbury, New York 11590-9007
www.mssny.org
Communications Division
Telephone: (516) 488-6100

 

For Immediate Release
June 14, 2019 

NY Eliminates Religious Exemption for Vaccinations 

Statement attributable to:
Arthur Fougner, MD
President, Medical Society of the State of New York

“Yesterday, the New York State Legislature passed a measure that will assure that the only acceptable exception to New York’s vaccination requirements is when there are medical contraindications.   Governor Andrew Cuomo has already signed this measure.  The Medical Society would like to thank all the physicians who took the time to write a letter, make a phone call and take other steps to educate their legislators about the critical importance of this legislation for protecting our public health.

MSSNY would also like to thank the many patient and public health advocacy organizations who also took the time to advocate to their legislators for this needed change.

Most importantly, we thank Assemblymember Jeff Dinowitz, Senator Brad Hoylman and our MSSNY legislative staff Moe Auster and Pat Clancy, for their dogged advocacy in support of this legislation!  Their steadfastness commitment to the measure and to the public health ensures that ALL of New York State children will be protected from vaccine preventable diseases.”

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About the Medical Society of the State of New York
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.

MSSNY Contact:
Roseann Raia
Communications / Marketing
Medical Society of the State of New York
865 Merrick Ave.
Westbury, New York
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rraia@mssny.org

 

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June 14, 2019

Arthur Fougner MSSNY Presiident

PRESIDENT’S MESSAGE<
Arthur Fougner, MD
MSSNY President

MSSNY eNews
June 14, 2019

Vol. 22  Number 23


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Colleagues:

Yesterday, the New York State Legislature passed a measure that will assure that the only acceptable exception to New York’s vaccination requirements is when there are medical contraindications.  Governor Andrew Cuomo has already signed this measure.  The Medical Society would like to thank all the physicians who took the time to write a letter, make a phone call and take other steps to educate their legislators about the critical importance of this legislation for protecting our public health.  MSSNY would also like to thank the many patient and public health advocacy organizations who also took the time to advocate to their legislators for this needed change.

Most importantly, we thank Assemblymember Jeff Dinowitz, Senator Brad Hoylman and our superior MSSNY legislative staff, especially Moe Auster and Pat Clancy, for their dogged advocacy in support of this legislation!  Their steadfastness commitment to the measure and to the public health ensures that ALL of New York State children will be protected from vaccine preventable diseases.

AMA Annual Meeting

Returning from the 2019 AMA Annual House of Delegates, I got in a cab, returned home, picked up my car and drove off to the Northwell Ob-Gyn Resident Graduation Party on Long Island. En route to the affair, I checked off potential topics for this week’s epistle and it dawned on me that the graduating house staff IS the topic. They are the fledglings leaving the nest and flying toward their collective future. Yet are they truly prepared for the world of copays, deductibles, contracts, prior authorizations and medical liability?

There are those in academia who feel that there will be time enough to address these concerns. I am not one of those academics. What is often missing in medical school and postgraduate medical education is advocacy. Yet there is hope for at the AMA meeting, I encountered many medical students, residents and fellows who were eager to familiarize themselves with the issues that would either soon confront them or were engulfing them now. Full of youthful exuberance, they embrace the concerns of medicine with an enthusiastic optimism unencumbered by the vicissitudes of life. Here was the opportunity for continual dialogue, continual reality check, learning the art of negotiation and compromise. And yes, sometimes we all agreed to disagree yet continue to engage.

Sadly, I noted that several health systems in our state were not represented. This is a pity for these students and young physicians are the future. Without the opportunity for mentoring by those who have walked these paths before them, they are thus free to repeat our missteps. We are the ones who must provide the GPS for their careers.

In “The Last Samurai”, Katsumoto says to Algren: “The way of the Samurai is not necessary anymore.”

Algren replies: “Necessary? What could be more necessary?”

Similarly, in these troubled times, what could be more necessary than our Medical Society? And Advocacy is our most important product.

It’s the circle of life
And it moves us all
Through despair and hope
Through faith and love

Till we find our place
On the path unwinding

“Circle of Love,” Tim Rice, lyricist for The Lion King

Arthur Fougner, MD
MSSNY President 

Comments? comments@mssny.org; @mssnytweet; @sonodoc99


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Capital Update

Legislature & Governor Pass Bill to Assure Medical Exemptions Only For Immunization
In a significant move to change public health policy, the New York State Legislature passed a measure that would assure that the only acceptable exception to New York’s vaccination requirements is when there are medical contraindications.   Governor Andrew Cuomo has already signed the bill into law.  The bill is effective immediately, and contains provisions that allow a school age child, who has begun the immunization process to attend school in Fall 2019.  The law becomes fully effective in June 2020.  The measure, A.2371A and S.2994A, was sponsored by Assemblymember Jeffery Dinowitz and Senator Brad Hoylman.  The measure, which the MSSNY strongly supported, passed the Assembly by a vote of 84-61 and the New York State Senate by 36-26.   A copy of the voting record is at click here.

MSSNY led a group of specialty societies, patient and public health advocates to ensure that there was strong support for the bill and helped to activate many physicians, nurses, parents, and other public health organizations in support of the measure.  MSSNY wishes to thank Assemblymember Dinowitz and Senator Hoylman for their dogged advocacy in support of this legislation and for their commitment to public health.   MSSNY recognizes that it will be important to educate the public about the benefits about immunization over the next several months.

There were 33 organizations that joined with the Medical Society in support of the bill:

American Academy of Pediatrics, NYS District II, Chapters 1, 2 & 3, American Nurses Association – New York (ANA-NY),  Associated Medical Schools of New York, Autism Science Foundation, Citizen Committee for Children of New York, Inc., Children’s Defense Fund-New York, Erie County Department of Health, Ithaca Is Immunized, Kimberly Coffey Foundation, Nurses Who Vaccinate, March of Dimes, Meningitis B Action Project,  Nurse Practitioner Association of NYS, NY American College of Emergency Physicians, the NY Chapter American College of Surgeons, NY State Society of Dermatology and Dermatologic Surgery, NYS Society of Orthopaedic Surgeons, NYS Psychiatric Association, NY Chapter American College of Physicians, NYS Academy of Family Physicians, NYS Association of County Health Officials (NYSACHO), NY Occupational and Environmental Medical Association (NYOEMA), NYS Society of Plastic Surgeons,NYS Neurosurgical Society, NYS Ophthalmological Society, NYS Society of Otolaryngology-Head and Neck Surgery, NYS Public Health Association, NYS Society of Anesthesiologists, Inc., The New York State Radiological Society, Schuyler Center For Analysis and Advocacy, The Children’s Agenda, Tompkins County Department of Health and the Tompkins Board of Health.                      (CLANCY) 


All Physicians Urged to Contact Their Legislators to Prevent Huge Increases in Liability Premiums
All physicians are urged to contact their legislators to oppose bills being aggressively pushed  by trial lawyers in the Session’s final days that would drive huge increases in physicians’ and hospitals’ already outrageously high liability premiums, and make it even more difficult for physicians and hospitals to be available to deliver needed patient care.   Physicians are urged to call their local legislators and send a letter clicking here: These bills include:

  • 4006/A.5612, which would greatly expand the possible damages awardable in a wrongful death action. While estimates vary, one actuarial estimate indicated that passage of this legislation could further increase premiums by nearly 50%, which translates to tens of thousands of dollars in new costs for many physicians and could make it impossible for many physicians to stay in practice in New York.
  • 6194/A.2370, which would limit a physician’s ability to defend themselves in liability actions by prohibiting their defense counsel from conducting an interview with the plaintiff’s treating physician.
  • 6081/A.2372, which would require a non-settling co-defendant in a tort action to choose whether to reduce his/her liability exposure by the stated settlement amount or the settling tortfeasor’s equitable share prior to the first opening statement of the trial.

Medical liability payouts in New York State continue to be far out of proportion with the rest of country. A recently released report showed that New York State had far and away the highest number of cumulative medical liability payouts of any state, and that this cumulative number had increased by 11% from 2017 to 2018. Claimants in New York were awarded nearly two times more than the state with the next highest amounts, Pennsylvania, and payments in New York far exceeded states such as California and Florida. Moreover, New York had the highest per capita medical liability payment as well, averaging over $35 per New York resident, more than 20% higher than the second highest state, New Jersey.

Given the extraordinary costs of medical liability insurance that many physicians must pay, combined with the enormous changes in health care delivery and payment that is placing huge new financial pressures on physician practices and hospitals, MSSNY is urging legislators to consider long overdue needed comprehensive reforms, not stand alone pieces of legislation that will harm patient access to care.    (AUSTER)


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Efforts to Legalize Recreational Marijuana Continue as Legislature Nears End; Physician Action Urged
With momentum growing in the New York State Legislature to act on the commercialization of the recreational use of marijuana, physicians are urged to continue to contact their legislators to oppose legislation here  A.1617B/S.1527B sponsored by Assembly Majority Leader Crystal Peoples-Stokes and Senator Liz Krueger, was recently amended.  The Assembly bill is in the Assembly Codes Committee and the Senate bill is in the Senate Finance Committee.  The Medical Society of the State of New York continues to oppose the legalization of recreational/adult use marijuana and continues to work with other advocacy groups that oppose this measure. In particular, MSSNY is concerned with the adverse public health consequences that have occurred in other states that have legalized marijuana.

Additionally, the measure changes the medical use of marijuana and takes the program out of the Department of Health and under the Office of Cannabis.  The measure eliminates “serious condition” and eliminates the list of conditions for certifying patients.   It also would allow any “practitioner” who is authorized to prescribe controlled substances with the state to certify a patient for marijuana. Training requirements for the medical components under the bill have been reduced to two hours.     The measure would also authorize “smoking” as a modality of treatment in the medical component and for recreational use.   (CLANCY,AUSTER)


Opioid Measures Moving in Both Houses
There are several measures that relate to opioid prescribing that are moving forward in the New York State Legislature that would have an impact on prescribing practices for physicians.  The bills are listed below:

  • 8256/S.5867A, sponsored by Assemblymember Richard Gottfried and Senator Gustavo Rivera, has moved from the Assembly Health Committee to the Assembly Rules Committee. This legislation would amend the public health law to require health practitioners before prescribing an opioid medication to consider discussing with the patient and refer or prescribe alternative services such as chiropractic, massage therapy or behavioral therapy. The Medical Society is concerned that this legislation will create confusing requirements for prescribers that will simply deter more physicians from prescribing pain medications for those patients that truly need them.  The Medical Society of the State of New York is opposed to this measure.
  • 5603/S.5150, sponsored by Assemblymember Edward Braunstein and Senator Peter Harckham, has moved to the Assembly Ways and Means Committee and is pending in the Senate Health Committee. This legislation would amend the public health law to require require that prescribers, who prescribe opioids for the first time, also co-prescribe an opioid antagonist with the prescription. MSSNY is concerned that this legislation could potentially create fear within patients that they would be stigmatized as drug addicts.  This fear may very well carry over to the patient’s use of opioids in general – leading those patients to suffer intense pain because of the fear of “addiction”.
  • 7285A/S. 4277A, sponsored by Assemblymember Linda Rosenthal and Senator Peter Harckham, has passed the Senate and is pending in the Assembly Health Committee. This legislation would amend the public health law to require health practitioners who prescribe an opioid or other Schedule II Controlled Substance to discuss with the patient the risks of being prescribed a CSII drug. The measure ignores the principle of informed consent—which essentially means that if a patient needs treatment, the physician gives the patient the information to make an informed decision. This process of understanding the risks and benefits of treatment is known as informed consent.  Additionally, this is duplicative of requirements that currently exist under the ISTOP law, whereby, after the physician prescribes the medication, the pharmacist is required to again inform the patient about the risks of taking a controlled substance.

Physicians are urged to call their member of the New York State Assembly and Senate and to urge them to vote no on these measures. (CLANCY, AUSTER)



Physician Advocacy Needed to Support Important Health Insurance Reforms
With just one week left until the scheduled end of 2019’s legislative session it is vital to continue advocating for legislation to assure patients are more able to receive the timely quality care and medications they need. Physicians may advocate via clicking the links below or calling their legislator’s office. You can call the switchboard and ask to be directed to their office (Senate 518-455-2800, Assembly 518-455-4100). Find your legislator here.

Mid-year formulary changes – Surprisingly, current law does not restrict insurance companies from making substantial changes to their formularies mid-year. This is an egregious practice when you consider the fact that your patients choose insurance plans based on the coverage presented to them – and they generally are not able to switch plans mid-year. Senator Breslin and Assemblymember Peoples-Stokes have introduced legislation (S.2849/A.2969) that would prevent mid-year formulary changes so that patients do not experience removal of a drug or changes in tiering when there is no similarly effective option.  This bill is on the verge of becoming law as it is on the floor calendar in both houses.  However it is being fiercely opposed by health insurers.  Please urge your Assemblymember and Senator to join on as a co-sponsor and support the bill here.

Network due process – There is currently a glaring loophole in New York’s laws that allow insurance companies to terminate physicians by non-renewal without cause or recourse. While they are required to notify physicians when contracts are terminated and physicians are then afforded the opportunity for a hearing, these protections don’t extend to non-renewal. Senator Rivera and Assemblymember Lavine’s bill (S.3463/A.2835) would provide physicians with proper due process upon non-renewal and would enhance the current hearing process by allowing the subject of the hearing (the physician) to choose one of the three members of the panel.  The bill is on the floor of both Houses.

Collective negotiations – Negotiating patient care terms with insurance companies is extremely difficult given many insurers’ overwhelming market share, so we strongly support legislation introduced by Senator Rivera and Assemblymember Gottfried (S.3462/A.2393) that would allow independently physicians to collectively negotiate with insurance companies in certain situations. The bill has been reported out of the Assembly Health Committee and awaits a vote in Ways & Means. Its Senate companion is currently in in the Senate Health Committee. Please urge your Assemblymember and Senator to join on as a co-sponsor and support the bill http://tiny.cc/mssnycollectivenegotation      (AVELLA/AUSTER)


Physician Advocacy Urged to Prevent Congressional Attempts to Undermine New York “Surprise Bill” Law
With several US House and Senate leaders releasing proposals to address the issue of “surprise” out of network medical bills faced by patients, physicians are urged to send a letter (please click here) urging their member of Congress to fight for a law that is consistent with New York’s approach.  Physician advocacy is essential due to a multitude of proposals before Congress that could seriously undermine New York’s proven model and further diminish the ability of physicians to fairly negotiate patient care terms with market dominant health insurers.

Specifically, MSSNY and other physician advocacy organizations have praised a proposal advanced by Representative Joe Morelle (D-Rochester) together with Representative Dr. Phil Roe (R-TN) and Dr. Raul Ruiz (D-CA), that seeks to mirror New York’s law, which uses a “baseball arbitration” Independent Dispute Resolution (IDR) system to determine payment for out of network medical care, and uses charge data collected by an independent database as a leading benchmark to guide the IDR.  MSSNY Board of Trustees member Dr. Andrew Kleinman also recently participated in a meeting with the House Doctors Caucus to educate legislators about New York’s approach.

However, several other proposals have been advanced that would require an insurer determined in-network based default rate for out of network surprise medical bills.  This would give enormous new powers to already market dominant insurers, and fails to recognize the insurance industry’s fault in creating this problem due to their narrow networks.  MSSNY has written to New York’s Congressional delegation praising the approach set forth by Representatives Morelle, Roe and Ruiz, and raising strong concerns with other proposals.

Specifically, New York’s letter raised concerns with the insurance industry’s own notorious history in establishing benchmarks for out of network payment, and the history of then-Attorney General Cuomo’s investigation which found that by using a flawed and conflicted database to determine reimbursement rates for out-of-network care, insurers were increasing profits at the expense of patients and physicians. Moreover, it was noted that New York’s law struck a tenuous balance among various health care stakeholders that protected patients from surprise medical bills and assured that hospital emergency departments had access to needed on-call specialty care.

MSSNY has been working with several other state medical associations and national specialty societies in its advocacy to Congress.  Please see here for a short “Fact Sheet” developed by the Physicians Advocacy Institute that sets forth key principles for Congress to consider in this debate: Fact Sheet   (AUSTER)


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Workers Compensation Board Adopts Regulations to Implement Prescription Medication Formulary
The New York Workers’ Compensation Board (WCB) recently announced it had adopted regulations to implement a prescription drug formulary for injured workers’ medication needs.  To read the final adopted regulation, formulary and summary documents, click here.

Comprehensive Workers Compensation reform legislation enacted by the State Legislature in 2017 directed the WCB to develop and implement a formulary.  The proposed regulation and formulary (Formulary) sets forth a listing of medications that may be prescribed for injured worker patient care needs without prior authorization during the first 30 days after the worker’s injury (Phase A), as well as a listing of medications that may be prescribed and dispensed, up to a 90- day supply, without obtaining Prior Authorization after 30 days following an accident or injury (Phase B).

The regulation also notes that drugs listed as “Perioperative Formulary drugs” may be prescribed without Prior Authorization when prescribed four days before and four days after the patient goes into the hospital, clinic, or doctor’s office for surgery; with the day of surgery being day zero.  When prior authorization is needed for certain medications, the proposed rules require the carrier, employer, or PBM to approve, partially approve or deny a PA request within 4 calendar days of submission by the physician or other care provider.

The regulation also sets forth that new prescriptions must be prescribed pursuant to the Formulary within 6 months of the effective date of the Formulary (December 2019), and that refills and renewals must be prescribed pursuant to the

Formulary within 12 months of the effective date of the Formulary (June   2020). (AUSTER)


Please Complete NYeC Survey to Gauge Physician Hassles with EHR Implementation and Use
MSSNY, in conjunction with other physician associations, has been working with the New York e-Health Collaborative (NYeC) on ways to reduce the hassles associated with the implementation and use of electric health record (EHR) systems.   To that end, they have developed a survey for physicians to complete gauging the challenges of EHR use, including connecting to and using medical information from your local Regional Health Information Organization (RHIO) to enhance patient care delivery.

Please take just a few minutes to complete the survey here. (AUSTER)                                                                   


                                                 


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Zocdoc Update
Recently, MSSNY expressed concerns with Zocdoc based on physicians expressing discontent with the verbiage of “Dr. XXX has no appointments on Zocdoc right now.”  The site then lists other {Specialists} nearby.  Many physicians viewed this as Zocdoc steering patients away from their practice to practices that have an agreement with Zocdoc.  We asked Zocdoc to reconsider their language.

In an effort of cooperation and in an attempt to address our stated concerns, Zocdoc advised that they are going to adjust the language on these pages as a show of good faith to MSSNY and its members. Zocdoc asked their Product team to update the language to read as follows: “Dr. [NAME] does not participate in Zocdoc to offer online booking at this time.”  This should resolve our specific concern and MSSNY is appreciative of Zocdoc’s consideration.


Our State Fair is a Great State Fair…Don’t Miss It!
Once again the Onondaga County Medical Society will staff the Medical Society of the State of New York/New York State Society of Anesthesiologists booth at the state fair. Medical Society physician members are encouraged to volunteer to work the booth during a time slot. This is a great opportunity to perform public health outreach, and to promote your practice or organization at the NYS Fair, free of charge. Those who work at the booth will receive free admission tickets and free parking (on a limited basis). Feel free to bring handouts about your practice or other timely medical information to share with fairgoers. Please let us know if you have any ideas for exhibits, testing, etc., that you feel will be informative and help advance a positive image of the medical profession.

Contact us for available time slots remaining for the 13-day fair, which runs from Wednesday, August 21 – Monday, September 2, 2019 (Labor Day). You can work as little as two hours or the entire day if you’d like. We need only one physician-member group per time slot. This is being updated daily. Time availability is on a first-come, first-served basis Contact Patty Corasaniti at (315) 424-8118, or send email to corasaniti@oncms.org for more information.


Major City Physician Group Calls for Two-Year Extension of DSRIP Money
Dr. Ramon Tallaj, chairman of Somos Community Care, said Tuesday that the Cuomo administration should work to secure federal funding to continue the Delivery System Reform Incentive Payment program. The DSRIP program provided $7.4 billion for health care providers across the state to implement projects that would lower unnecessary trips to the hospital by 25% over five years. The program is set to end by April.

“We need to extend this for two more years. We have to find together a way to do that,” Tallaj said Tuesday after speaking at a conference hosted by Somos at the New York Academy of Medicine in Manhattan. “We need to be sure the Medicaid money is available to the state to do this transformation.”

Somos Community Care is a network of more than 2,500 physicians who care for more than 700,000 patients in New York City. It is one of 25 Performing Provider Systems, or groups of medical providers that have collaborated on projects to keep patients healthy and out of the hospital. Those projects include increasing care management and integrating medical and behavioral health care.

The money for DSRIP came from an amendment to New York’s 1115 waiver through which the federal government provided New York more than $8 billion. That allowed the state to reinvest some of the $17 billion it had saved through initiatives developed by its Medicaid Redesign Team. To secure additional funding, the state will need to a new amendment to its 1115 waiver, a labor-intensive process that will test New York’s ability to work with the Trump administration. But New York could renew some money from its DSRIP program. Certain parts of DSRIP, known as the state supplemental programs, are distributed through Medicaid managed-care plans and represented more than $1.5 billion in the first five years of the program. The state could allocate a continuation of that money in the next state budget.

Not all leaders in the health care industry think that DSRIP 2.0 is the answer to funding future collaboration among providers and social service organizations. (Crain’s Health Pulse)


NYC DOHMH Conducting Survey on Closure of Pain Clinics
The NYC Department of Health and Mental Hygiene (DOHMH) is involved in emergency preparedness planning in case of the event of a pain clinic closure or other emergency within New York City.  Pain clinic closures in other parts of New York State have led to serious public health consequences.   It is essential to have contingency plans in place in NYC to avoid abrupt interruption of treatment for patients with chronic pain, some of whom receive opioid therapy, and to assure continuity of care.  Physician response to this survey will inform DOHMH’s work and optimize all available resources to protect the health of New Yorkers.

AMA Meeting Highlights

  • AMA And Single-Payer 

The AMA remained opposed Tuesday to proposals for the U.S. to establish a single-payer health care system. At its annual House of Delegates meeting, it voted 53% to 47% against adopting an amendment to remove its formal opposition. The vote follows days of debate between leadership and a group of medical students.

  • AMA: Mature Minors Should Be Able to Provide Informed Consent for Vaccinations

Members voted to express support for “state policies that would allow minors to override their parent’s objections to vaccinations.” AMA board member S. Bobby Mukkamala, M.D., said in a news release, “The prevalence of unvaccinated pediatric patients is troubling to physicians. Many children go unvaccinated as anti-vaccine related messages and advertisements target parents with misinformation. Allowing mature minors to provide informed consent to vaccinations will ensure these patients can access this type of preventive care.”

  • AMA Delegates Vote In Favor of Ethics Council Report On Aid-In-Dying, Physician-Assisted Suicide

Members approved “a report from the AMA’s Council on Ethical and Judicial Affairs (CEJA), which was issued in response to resolutions at the 2016 and 2017 annual meetings that asked the council to ‘study the issue of aid-in-dying with consideration of data collected from the states that currently authorize aid-in-dying, and input from some of the physicians who have provided medical aid-in-dying to qualified patients.’” In the report, “the council had noted that arguments for and against participating in aid-in-dying or physician-assisted suicide were ‘fundamentally unchanged’ since the council’s earlier report on the issue in 1991.” The report also said, “In the council’s view, despite its negative connotations, the term ‘physician-assisted suicide’ describes the practice with the greatest precision.”


Dr. Underwood, Urologist from Buffalo, Elected to AMA Board of Trustees

Dr. Underwood

Willie Underwood, III, M.D., M.Sc., M.P.H., a urologist based in Buffalo was elected to the AMA’s to its Board of Trustees. Dr. Underwood has been an active leader in organized medicine for many years; he has chaired the AMA Council on Legislation and the AMA Resident and Fellow Section, served as president of the Erie County New York Medical Society, and he is an AMA Delegate from the American Urological Association (AUA).

Dr. Underwood is a board-certified urologic surgeon specializing in prostate cancer who has been practicing in the state of New York for the past 11 years. He oversees research focusing on methods to improve early detection and treatment of prostate cancer. In all his advocacy work he is proudest of getting prostate cancer early detection legislation successfully passed in Michigan and Maryland. Dr. Underwood earned his M.D. and M.Sc. from SUNY Upstate Medical University and his M.P.H. from the University of Michigan.


Physician Wellness Committee: 2016 Survey Has Sparked More Attention
Michael Privitera MD, Co-Chair of MSSNY’s Committee for Physician Wellness and Resilience, announced that another publication has come out of the MSSNY Burnout survey we did in the fall of 2016 in collaboration with Federation of State Medical Boards. “Physician Burnout and Mental Health Care Barriers when Reporting on Applications” has been accepted in Journal of Legal Medicine. It expounds upon how asking physicians questions on their state license applications and renewals about previous mental health care is such a large deterrent for physicians getting the care they need and how this backfires in efforts to protect the public.

Dr. Privitera stated, “I am particularly pleased about taking these issues seriously on a national level. There is the terrible perfect storm of an endless list of increasing expectations on physicians and medical students without any single agency overseeing the total expectations of the job. This scenario is then mixed with a culture of silence and endurance prevalent in medical culture that makes them less likely to be aware of how impossible the job has become. It’s not a fair fight  like other challenges in which they have prevailed, so it is important to try to recognize this and  reach out to get help.”


CMS

NGS Medicare Part B Claims Update

Top Reasons for Returning Claims

  • Item 1a Insured ID Number – blank or not valid format
  • Item 21 Diagnosis – No diagnosis code report
  • Item 24b Place of Service – No place of service reported
  • Item 32 – Service Facility location – Blank
  • Item 33a Missing NPI – missing or invalid format reported

JK Timeliness Jan Feb Mar Apr May
JK Claims 977 829 814 2,681 1,627

MIPS 2019: Not Too Late to Avert Future Medicare Pay Penalties
MIPS-eligible physicians who don’t report data may be subject to a 7% Medicare pay penalty in 2021. AMA resources offer help to avoid that outcome

Eligible physicians who fail to report data under Medicare’s 2019 Quality Payment Program (QPP) will be subject to a 7% penalty in 2021. That penalty will rise to 9% the following year.

To avoid such penalties, physicians need to score a minimum of 30 points in this year’s iteration of the QPP’s Merit-based Incentive Payment System (MIPS). The AMA’s expert resources outline what’s new this year under MIPS and how you can avoid potential future pay cuts.

The AMA offers extensive resources to help physicians understand MIPS, including:

Those physicians seeking a positive payment adjustment to their Medicare rates (potentially up to 7%) should have already started collecting data for the MIPS Quality performance category as of Jan. 1. Physicians, however, looking to avoid penalties and receive a neutral Medicare pay adjustment can still do so by collecting 90 days’ worth of data relevant to the MIPS Promoting Interoperability (PI) and Improvement Activities (IA) categories. The latest date to begin collecting data is Oct. 1.


Join CMS for a Public Webinar on Quality Measurement
CMS is pleased to invite the public to attend its upcoming webinar titled Measuring Quality to Improve Quality: Strengths and Challenges of Clinical Quality Measurement. The webinar will provide an engaging and informative overview of key concepts that go into its quality measures. Additionally, the presentation will review current CMS quality measures, explain how they are used, and how they fit into CMS’s quality goals, including the Meaningful Measures initiative. The webinar will be offered twice in June, on Tuesday, June 25th, from 2:00-3:00pm EST (Register here) and Thursday, June 27th, from 2:00-3:00pm EST (Register here). Please register in advance if you can attend as space will be limited. We request that you please only register for events you plan to attend. We hope you can join us and look forward to your questions! For questions, please contact MMSSupport@battelle.org.


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Tasteful, bright, well-maintained medical office in prestigious building on Park Avenue at 94th Street.  Large waiting room and reception area, consultation room and 2 exam rooms available 3 days per week. Room for an assistant or clerical help 5 days per week. Please email abgmdpc@gmail.com or call 987-5000


Medical Office Space for Rent!
Beautiful Newly Renovated Medical Office on the Upper East Side between Madison and Park Avenue! Conveniently located near all public transportation and Mount Sinai Hospital. Consult and Exam room available for rent part time or full time (see pictures). Please call 212-860-0300 or email carnegiehill0062@gmail.com for further information.
Pictures of office space for rent on Madison Ave

 


Fully Renovated Office Space for Part-Time Lease in Hauppauge
Available Tuesdays/Fridays, $450 half session, $750 full session. Elegant office space, beautiful waiting room with new stone and granite reception desk, custom molding, large windows, abundant natural light, TV, and refreshment counter.  Four new exam rooms and dictation room.  New stainless and granite kitchenette.  State-of-the-art network infrastructure meets HIPPA & PCI DSS compliance standards.  Digital X-ray room with PACS in each exam room available as an option.  Located in close proximity to LIE, Northern State Pkwy, and Vets Memorial Hwy. Contact us at (631) 486-8855;  Please see our listing: https://www.loopnet.com/Listing/517-Route-111-Hauppauge-NY/15298633/



Office Rental 30 Central Park South.
Two fully equipped exam, two certified operating, bathrooms and consultation room.  Shared secretarial and waiting rooms. Elegantly decorated, central a/c, hardwood floors. Next to Park Lane and Plaza hotels. $1250 for four days a month.Available full or part-time. 212.371.0468drdese@gmail.com.


 

Rare Find — Great Office Share
Wonderful office share in terrific location at great price. Available Monday, Wednesday, Friday and weekends. Choice of smaller windowed consultation room with adjoining exam room or big windowed consultation room with one or two exam rooms. Beautiful bright rooms, lovely reception area and front . First-rate building on 58th Street between Park and Lexington. Rent by day (about $180). Front desk and office management available if needed, along with many other amenities, including internet, ultrasound, EMG Kitchen, optional C Arm. Willing to make changes for new tenant. Call 646-642-0700.


Are You Trying to Lease Your Medical Office or Sell Your Medical Practice? Trying to Sell New or Used Medical Equipment?
Clineeds, the new online platform designed for medical providers. With Clineeds you can lease your medical officeshared your office spacebuy and sell used medical equipment, or post healthcare job opportunities. LISTING IS FREE! Why wait? Click here to sign-up: www.clineeds.com/sign-up

PHYSICIAN OPPORTUNITIES

Multi-Specialty Medical Office Looking To Bring On More Doctors
New York Medicine Doctors Center is a multi-specialty Medical Agency networking some of the best medical professionals and specialists in the New York Tri-State area. Our offices currently serve both Manhattan and Queens, providing a variety of advanced technological on site testing, imaging, and services for the most rapid results.

We are actively looking to bring on board an array of Doctors specializing in Primary Care, Gynecology, Gastroenterology, ENT, Urology, Podiatry, and Dermatology.

As we continue to broaden our medical services in both locations, we also provide individualized on-boarding contracts with health benefits, tailored in-house marketing and advertising, practice management assistance, and in house team of administration dedicated in serving any and all concerns whether it be credentialing or equipment related tasks.

If you are interested in joining our growing network, please do not hesitate to contact us

at 718-360-9550 or 212-931-8533. Our direct email is drshusterman@gmail.com

Primary Contact: Oksana


 

 


Nurse, RN Utilization Review Full-Time-Westbury, NY (In-office position only)
Excellent opportunity for a RN who is seeking a position performing utilization review.  We require 1-2 years recent experience in hospital and/or insurer utilization review and experience using Interqual criteria and/or MCG Guidelines. Data entry/PC skills a plus. Benefits include 401(k), paid vacation and holidays. Send resume and salary requirements to: Empire State Medical Scientific and Educational Foundation, Inc. Human Resource Department e-mail: chunt@mssny.org  Fax: (1-516) 833-4760 Equal Oppty Employer M/F


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

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 


MSSNYeNews – June 7, 2019 – Get With It! Engage in the Present!

Arthur Fougner MSSNY Presiident

PRESIDENT’S MESSAGE<
Arthur Fougner, MD
MSSNY President

MSSNY eNews
June 7, 2019

Vol. 22  Number 22


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I make my living off the evening news
Just give me something-something I can use
People love it when you lose,
They love dirty laundry  

                    -Dirty Laundry by Don Henley

Colleagues:

As you are probably aware, I spend a considerable amount of time on Twitter. Despite the often intimidating noise to signal ratio, I have found it a useful source of info and breaking news, as well as an opportunity to bring our message to a wider audience. Apparently, Thomas Jefferson University recognized the importance of combatting the rising tide of health misinformation or, dare I say it, fake news. Doctors, meet Austin Chiang MD MPH. Dr. Chiang is the Chief Medical Social Media Executive for Thomas Jefferson Health. With 20,000 Instagram followers, his mission is to combat misinformation with information. Recent events regarding vaccinations demonstrate that this situation requires more than an “Army of One” or a “Few Good Men/Women.”

I recognize that as professionals, we are loathe to expose our reputations or careers to the hordes of internet orcs who would drag us off to a virtual Mount Doom. However, this is the arena that beckons and for the sake of our patients, we must engage. Since my chosen theater of engagement is Twitter, I’ll happily assist you. First, sign up here. Then you put sonodoc99 in the “search twitter” bar and type @sonodoc99. When you see Bones McCoy (my mentor), just click on my name and then hit Follow.

Similarly, do the same with @mssnytweet (MSSNY’s official Twitter handle). Now you are off and running. I would suggest just dipping your toes in the water and lurking to get your bearings. If you see a Tweet by Yours Truly or MSSNY, just click on Retweet and the message will be sent out again. Our organization has about 20,000 members. If only ¼ of the members both followed MSSNY and our leaders, we all would grow in relative influence. Moreover, retweeting our message amplifies the message so that too grows in influence. It’s the old Dallas Cowboy Cheerleader ad come to life – you tell two friends and they tell two friends and so on and so on and so on. If you still have questions, follow @DrDanChoi too. He’ll help you with Instagram as well.

Our message is strong but it often cannot be heard amongst the din of the crowded lounge during happy hour. With a critical mass, we can extend our reach to places we’ve never imagined.

The truth may not be out there yet, but it will be.

Engage!

Arthur Fougner, MD
MSSNY President 

Comments? comments@mssny.org; @mssnytweet; @sonodoc99


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Podcast SymbolThis Week’s Podcast of MSSNY’s Legislative Priorities

Capital Update

NYS Has 889 Confirmed Measles Cases—Physicians Urged to Call Legislators to Demand Action on this Public Health Epidemic
The number of measles cases in New York State has again seen an uptick over the past week with 889 confirmed cases out of the 1,000 plus confirmed nationwide. Physicians throughout the state are encouraged to call their legislators and urge action on a bill that would allow only medical exemptions for immunizations.  The measure, A.2371/S.2994A, is in the Assembly & Senate Health Committees.   The Medical Society of the State of New York has joined 29 other medical organizations, patient advocacy groups and public health organizations, meeting with members of the Legislature to advocate for passage of this measure. MSSNY has participated in several press conferences with the sponsors of this legislation, including one this week organized by the March of Dimes.

Advocates against mandatory vaccinations continue to call and meet with legislators and were in Albany again this week.  It is vitally important that physicians call or send messages to their legislators urging action on this measure.  You can help by following these steps:

  • Physicians are strongly urged to contact members of the Assembly Health Committee. Please call 518-455-4100 and ask for the following Assemblymembers: Gottfried, Schimminger, Galef, Dinowitz, Cahill, Paulin, Cymbrowitz, Gunther, L. Rosenthal, Hevesi, Jaffee, Steck, Abinanti, Braunstein, Kim, Solages, Bichotte, Barron, Sayegh, Raia, McDonough, Ra, Garbarino, Byrne, Byrnes and Ashby.  Tell them that you support passage of A.2371/S.2994, which ensures that the only allowable exemption to vaccination will be for medical reasons.
  • Please send a letter to your legislator via the MSSNY Grassroots Action Center (GAC).  Please click here!
  • Physicians are encouraged to call their Senator and Assemblymember’s office to voice support for this legislation. There is strength in numbers! Please click here.

The Medical Society of the State of New York’s memo in support of A.2371/S.2994A can be found here and a copy of the memo produced by physician and public health organizations and parent and patient advocacy groups is available here. 

Governor Andrew Cuomo has publicly stated that he will sign the bill if it comes to his desk.  The question is whether there will be enough votes in support in the New York State Assembly Health Committee and on the Assembly Floor.

Joining the Medical Society in support of repealing religious exemptions are the following groups:  American Academy of Pediatrics, NYS District II, Chapters 1, 2 & 3, American Nurses Association – New York (ANA-NY),  Associated Medical Schools of New York, Autism Science Foundation, Citizen Committee for Children of New York, Inc., Children’s Defense Fund-New York, Erie County Department of Health, Ithaca Is Immunized, Kimberly Coffey Foundation, Nurses Who Vaccinate, March of Dimes, Meningitis B Action Project,  Nurse Practitioner Association New York State, New York American College of Emergency Physicians, New York State Society of Dermatology and Dermatologic Surgery, NY Chapter American College of Physicians, NYS Academy of Family Physicians, NYS Association of County Health Officials (NYSACHO), NY Occupational and Environmental Medical Association (NYOEMA), NY State Neurological Society, NY State Neurosurgical Society, NYS Ophthalmological Society, NYS Society of Otolaryngology-Head and Neck Surgery, NYS Public Health Association, New York State Society of Anesthesiologists, Inc., The New York State Radiological Society, Schuyler Center For Analysis and Advocacy, The Children’s Agenda, Tompkins County Department of Health and the Tompkins Board of Health.    (CLANCY)


Act Now to Prevent Unsustainable Increases in Liability Premiums
There are currently a handful of bills being advanced that would have the effect of significantly increasing already outrageously high medical liability insurance premiums and further erode patient access to needed care. Physicians are encouraged to reach out to their elected officials to let them know how harmful these bills would be for patient care continuity by clicking here.    

  • 4006/A.5612 would greatly expand the possible damages in a wrongful death action which would have the effect of greatly expanding liability insurance premiums. While estimates vary, one actuarial estimate indicated that passage of this legislation could further increase premiums by nearly 50%, which translates to tens of thousands of dollars in new costs for many physicians and could make it impossible for many physicians to stay in practice.
  • 6194/A.2370 would limit a physician’s ability to defend themselves in liability actions by prohibiting their defense counsel from conducting an interview with the plaintiff’s treating physician. This would depart from a long-standing judicial concept that no party has a proprietary interest in a witness, and would further tip the scales of New York’s already one-sided malpractice adjudication system.
  • 6081/A.2372 would require a non-settling co-defendant in a tort action to choose whether to reduce his/her liability exposure by the stated settlement amount or the settling tortfeasor’s equitable share prior to the first opening statement of the trial. It is likely that this bill would enable a plaintiff to be unjustly enriched by collecting more than the jury ultimately determined the non-settling defendants’ equitable share to be if the settling defendant settles for an amount that exceeds their equitable share of the award.

Medical liability payouts and premiums in New York State continue to be considerably out of proportion with the rest of country. A recently released report showed that New York State had far and away the highest number of cumulative medical liability payouts of any state, and that this cumulative number had increased by 11% from 2017 to 2018. Claimants in New York were awarded nearly two times more than the state with the next highest amounts, Pennsylvania, and payments in New York far exceeded states such as California and Florida. Moreover, demonstrating once again why New York has been designated the worst state in the country to be a doctor, New York had the highest per capita medical liability payment as well, averaging over $35 per New York resident, more than 20% higher than the second highest state, New Jersey.

Given the extraordinary costs of medical liability insurance that many physicians must already pay, combined with the enormous changes in health care delivery and payment that is placing huge new financial pressures on physician practices and hospitals, MSSNY is urging legislators to reject these bills, as it could drive many physicians out of New York State.  Instead we urge that comprehensive liability reform be enacted.                (AVELLA)


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Efforts to Legalize Recreational Marijuana Continue As Legislature Nears End; Physician Action Urged
Physicians are urged to continue to contact their legislators to oppose legislation and commercialization of recreational use of marijuana. In the remaining days of the legislative session, advocates on both sides of legalizing the recreational/adult-use of marijuana in New York held joint press conference espousing their view on whether the New York State Legislature should pass the bill.

MSSNY joined Smart Alternatives to Marijuana (SAM), the New York State PTA, the Sheriff’s Association, school superintendents and the New York State Association of County Health Officials (NYSACHO) in opposing passage of the legislation.  A.1617A/S.1527A, sponsored by Assembly Majority Leader Crystal Peoples-Stokes and Senator Liz Krueger, was recently amended and would create the “marijuana regulation and taxation act”.  The Assembly bill is in the Assembly Codes Committee and the Senate bill is in the Senate Finance Committee.

The Medical Society of the State of New York continues to oppose the legalization of recreational/adult use marijuana and continues to work with other advocacy groups that oppose this measure. In particular MSSNY is concerned with the adverse public health consequences that have occurred in other states that have legalized marijuana.  Also pending in both houses is A.7467/S.5657, sponsored by Assemblymember Richard Gottfried and Senator Diane Savino, which would greatly expand New York State’s medical program for certifying patients for the use of marijuana.

The bill eliminates “serious condition” and replaces it with “condition” and further expands the list of conditions eligible for certification.  The measure also expands the list of practitioners who can certify the patient for the use of marijuana and would authorize “smoking” as a modality of treatment.   The bill is pending in the Assembly Codes Committee and the Senate Health Committee.  Physicians throughout New York State are urged to send a letter through MSSNY Grassroots  Action Center opposing legalization of marijuana here.     (CLANCY, AUSTER)


Opioid Prescribing in NYS Down by 37.5% Over Five Year Period
Opioid prescribing by New York State physicians has decreased 37.5% percent between 2013-2018 and opioid prescriptions also decreased by 11.2% from 2017 to 2018 according to data recently released by the IQVIA, Danbury, CT,  a data collection firm within the healthcare industry. The data is available here.

Additionally, the American Medical Association (AMA) has released its 2019 Opioid Progress Report—the third year that the AMA has reported on actions that physicians have taken to help end the nation’s opioid epidemic. The report shows significant decreases in opioid prescribing as well as increases in PDMP use and naloxone prescriptions. In addition to the national data, the AMA also released state-level data for opioid prescribing and PDMP use. New York State physicians and other users of the prescription monitoring program logged 23,931,571 inquiries in 2018, a 42% increase since 2014.

The Medical Society of the State of New York is a member of the AMA Task Force on Opioids which put together the report.   While more can be done to address our opioid abuse epidemic, the report highlights the progress that has been made.  The topline findings from the report are as follows:

  • Nationally, opioid prescriptions decreased 33 percent between 2013-2018 from 251.8M to 168.8M;
  • PDMP use increased to 462M since 2014 (up from 61.4M in 2014);
  • More than 700,000 physicians and other health care professionals completed CME and related trainings or accessed other resources focused on opioid prescribing, pain management, screening for substance use disorders and other areas;
  • Naloxone prescriptions increased to nearly 600,000 in 2018—a 338 percent increase from 2016;
  • More than 66,000 physicians and other health care professionals now have a federal waiver to prescribe buprenorphine in-office for the treatment of opioid use disorder—an increase of more than 28,000 since 2016.

Many states have also taken action to remove prior authorization and other barriers to evidence-based treatment for an opioid use disorder and the AMA has proudly supported those efforts.   New York State is at the forefront by removing the prior authorization for Medicated Assistance Treatment (MAT).  MSSNY strongly supported this measure during the 2019-20 New York State budget process.   (CLANCY)


 


Physician Advocacy Needed in End of Session Push for Insurance Reforms
There are two weeks left until the scheduled end of 2019’s legislative session and in these waning days it is vital to continue advocating for the insurance related bills to assure patients are more able to receive the timely quality care they need. Physicians are urged to help advocate for the advancement of these reforms by conducting outreach to the appropriate legislators to emphasize how important these bills are. Physicians may advocate via clicking the links below or calling their legislator’s office. You can call the switchboard and ask to be directed to their office (Senate – 518-455-2800, Assembly – 518-455-4100). Find your legislator here.

Mid-year formulary changes

Surprisingly, current law does not restrict insurance companies from making substantial changes to their formularies mid-year. This is an egregious practice when you consider the fact that your patients choose insurance plans based on the coverage presented to them – and they generally are not able to switch plans mid-year. Senator Breslin and Assemblymember Peoples-Stokes have introduced legislation (S.2849/A.2969) that would prevent mid-year formulary changes so that patients do not experience removal of a drug or changes in tiering when there is no similarly effective option.

This bill is on the verge of becoming law as it is on the floor calendar in both houses (for the first time in the Senate).  However it is being fiercely opposed by health insurers.  Please urge your Assemblymember and Senator to join on as a co-sponsor and support the bill here. 

Network due process

There is currently a glaring loophole in New York’s laws that allow insurance companies to terminate physicians by non-renewal without cause or recourse. While they are required to notify physicians when contracts are terminated and physicians are then afforded the opportunity for a hearing, these protections don’t extend to non-renewal. Senator Rivera and Assemblymember Lavine’s bill (S.3463/A.2835) would provide physicians with proper due process upon non-renewal and would enhance the current hearing process by allowing the subject of the hearing (the physician) to choose one of the three members of the panel.

The bill is currently eligible for a vote in both the full Senate and Assembly.

Collective negotiations

Negotiating with insurance companies is extremely difficult, especially when monolithic payers control a huge portion (or all) of the market that you practice in. The fact that you are barred from banding together with your colleagues is unfair, so we strongly support legislation introduced by Senator Rivera and Assemblymember Gottfried (S.3462/A.2393) that would allow physicians to collectively negotiate with insurance companies in certain situations. Insurance companies will surely be out fighting against this and so we must ensure grassroots support for this provision that would put you on more even footing with insurers.

The bill has been reported out of the Assembly Health Committee and awaits a vote in Ways & Means. Its Senate companion is currently in the Senate Health Committee. Please urge your Assemblymember and Senator to join on as a co-sponsor and support the bill here.                                    (AVELLA/AUSTER)


Physician Advocacy Results in Scope of Practice Expansion Bills Being Pulled from Committee Agenda
Thank you to the many physicians who responded to our grassroots call to action earlier this week to oppose bills that were on the Assembly Higher Education Committee agenda and would have inappropriately expanded the scope of practice for podiatrists (A.6185) and optometrists (A.1193-A).  With your grassroots assistance, MSSNY worked closely with specialty societies representing Orthopedic Surgery, Radiology and Ophthalmology, lobbying members of the Committee, with the result that the bills were taken off the Committee agenda due to insufficient support by Assemblymembers on the Committee.  However, it is still possible these bills could still return before the end of Session.  Physicians are urged to continue to contact their legislators to express their opposition to these bills.  518-455-4100.    (AUSTER)


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MSSNY Joins Public Health Advocates Urging Passage of Bill to Ban Use of Flavored E-liquids
The Medical Society of the State of New York joined with the American Cancer Society, the American Heart Association, Parents Against Vaping e-cigarettes (PAVe) and other advocates to urge that the New York State Legislature to pass A.47/S.248 which would ban flavored e-liquids for use in e-cigarettes.  PAVe, a grassroots organization founded by parents that seeks to educate parents about the dangers of e-cigarettes and an advocate for the health and safety of young people, joined the bill’s sponsors Assemblywoman Linda Rosenthal and Senator Brad Hoylman in urging the bill’s passage before the close of session.  At a press conference held this week, young people talked to the press about their or their friend’s nicotine addiction stemming from vaping flavored e-cigarettes.  They indicated that they had thought that e-cigarettes were harmless and that all they were inhaling was “flavored” water.  They have since learned that one e-cigarette can contain as much nicotine as 20 cigarettes.

Tobacco companies have a long history of using creative tactics to draw in adolescents and young adults to begin smoking and are now using flavoring to entice young people to begin using e-cigarettes in New York State, the use of electronic cigarette is on the rise-especially among adolescents and young adults.  E-cigarette use poses a significant health risk to young people by increasing the possibility of addiction and long-term harm to brain development and respiratory health. E-cigarette liquid containing nicotine and most are now flavored.  The Medical Society supports this measure.  The bill is currently in the Assembly Codes Committee and is on the floor of the Senate awaiting a vote.                               (CLANCY)


Physician Advocacy Urged to Prevent Congressional Attempts to Undermine New York “Surprise Bill” Law
With several US House and Senate leaders releasing bi-partisan proposals to address the issue of “surprise” out of network medical bills faced by patients that could undermine New York’s acclaimed law, physicians are urged to send a letter (please click here) urging their member of Congress to fight for a law that is consistent with New York’s approach.  Physician advocacy is essential due to a variety of proposals before Congress that would undermine New York’s proven model and further diminish the ability of physicians to negotiate patient care terms with market dominant health insurers.

Recently, Representative Joe Morelle (D-Rochester) joined with Representative Dr. Phil Roe (R-TN) and Dr. Raul Ruiz (D-CA) in releasing a summary of a proposal that seeks to mirror New York’s law, which uses a “baseball arbitration” Independent Dispute Resolution (IDR) system to determine payment for out of network medical care, and uses charge data collected by an independent database as a leading benchmark to guide the IDR.  MSSNY Board of Trustees member Dr. Andrew Kleinman also recently participated in a meeting with the House Doctors Caucus to educate legislators about New York’s approach.

However, several proposals have been advanced that would either require an insurer determined in-network based default rate for out-of-network surprise medical bills, or would create a baseball arbitration system that uses an insurer determined in-network rate as a benchmark.  MSSNY has written to New York’s Congressional delegation praising the approach set forth by Representatives Morelle, Roe and Ruiz, and raising strong concerns with the other proposals.

Specifically, New York’s letter raised concerns with the insurance industry’s own notorious history of establishing benchmarks for out of network payment, and the history of then-Attorney General Cuomo’s investigation which found that by using a flawed and conflicted database to determine reimbursement rates for out-of-network care, insurers were increasing profits at the expense of patients and physicians.   Moreover, it was noted that New York’s law struck a tenuous balance among various health care stakeholders that protected patients from surprise medical bills and ensured that patients receiving care in hospital emergency departments had greater access to needed on-call specialty physician care.    (AUSTER)


Please Complete NYeC Survey to Gauge Physician Hassles with EHR Implementation and Use
MSSNY, in conjunction with other physician associations, has been working with the New York e-Health Collaborative (NYeC) on ways to reduce the hassles associated with the implementation and use of electric health record (EHR) systems.   To that end, they have developed a survey for physicians to complete that will gauge the challenges of EHR use, including connecting to and using medical information from your local Regional Health Information Organization (RHIO) to enhance patient care delivery.

Please take just a few minutes to complete the survey here:                                 (AUSTER)


Commissioner’s Medical Grand Rounds On June 13th On Vaccine Hesitancy
New York State Department of Health Commissioner Howard A. Zucker, MD, JD, will conduct a Commissioner’s Medical Grand Rounds on “Vaccine Hesitancy: An Evolving Public Health Threat” on Thursday, June 13 from 9-11 a.m.  The location of the grand rounds will be: Annenberg Building, Room 13-01, Ichan School of Medicine at Mount Sinai, 1468 Madison Avenue, New York, NY 10029.  For registration information please view the flyer here. There are also continuing medical education credits that are being offered for this program.      (CLANCY)


Measles Outbreak in New York State Continues to Spread
Webinar Available at MSSNY CME Website

The number of measles cases in New York State has again seen an uptick over the past week.  832 of the 981 nationwide cases confirmed in 2019 are in New York State. Year-to-date as of June 6th there have been 509 confirmed cases in New York City and 323 outside of New York City (259 in Rockland; 38 in Orange; 18 in Westchester; 6 in Sullivan; 1 in Suffolk and 1 in Greene counties).  MSSNY conducted a just-in-time Medical Matters webinar entitled “The Continued Public Health Threat of Measles 2018” in December, 2018.  This webinar has now been posted to the MSSNY CME website.

You can also view MSSNY’s latest Medical Matters webinar entitled “What’s Your Diagnosis? Infectious Diseases” which involves a patient with a fever and a rash. Please check these out and keep yourself informed about the growing measles outbreak throughout New York State.  You can also listen to MSSNY’s brief podcast on the Measles, Mumps and Rubella vaccine here.                                                                                                               (HOFFMAN, CLANCY)


                                                     


pschuh@mssny.org mauster@mssny.org  pclancy@mssny.org  mavella@mssny.org
charring@mssny.org

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Medicaid Illegally Paid for NY Sex Offenders’ Erectile Dysfunction Drugs
New York’s publicly funded Medicaid program paid more than $63,000 for erectile dysfunction drugs and other sexual treatments for 47 sex offenders, despite laws banning such expenses. The figures come from an audit released Wednesday by state Comptroller Thomas DiNapoli and first reported by The Associated Press. A state audit revealed that the New York Medicaid system made $993,000 in payments for erectile dysfunction drugs, providing 47 state sex offenders with sexual treatments. While Medicaid will cover such drugs used to treat certain diagnoses, state auditors argued that the cases did not warrant the prescriptions.

Health officials deny the charges, saying auditors “either ignored the law or the facts which undermines any value that can be associated with its findings. State and federal laws prohibit payments for sexual treatments for any Medicaid recipient. Yet auditors found that the state approved such treatments between 2012 and 2018. DiNapoli urged immediate changes to ensure the state isn’t misusing taxpayer money.

“There are clear rules about what conditions Medicaid will cover when it comes to erectile dysfunction drugs. And paying for sex offenders who’ve committed terrible crimes to get these drugs should never be lost in the bureaucratic administration of this program,” DiNapoli said. “Nearly two decades ago this office identified this problem, which led to national and state changes. While the state Department of Health immediately followed up to make corrections during the course of our audit, our auditors found that the problem persisted and needed to be fixed.”


VA Expands Veterans’ Access to Private Physicians
The New York Times (6/5) reports that on Thursday, the Department of Veterans Affairs will start “allowing a broad swath of its nine million enrollees to seek medical care outside of traditional VA hospitals, the biggest shift in the American health care system since the passage of” the ACA. Although “department officials say they are ready, veterans groups and lawmakers on Capitol Hill have expressed concerns about the VA, which has been dogged by problems with its computer systems for years.”

The groups are concerned “the department is not fully prepared to begin its new policy, which Congress adopted last year to streamline and expand the way veterans get care.” The article says “veterans facing a wait of 30 days or more for an appointment at their closest VA health care center could seek private care,” but “under the new policy, that waiting time would be reduced to 20 days, with the goal of 14 days by 2020.”

With respect to “specialty care, they can see private doctors at VA expense if they have to wait longer than 28 days or drive more than an hour to see a VA provider.” Prior to this update, “veterans who had to drive more than 40 miles or wait longer than 30 days could choose to see a private doctor paid for by the VA.”


Physician Wellness and Resilience Committee Sparks Article in Legal Journal
Dr. Michael Privitera, Co-Chair of MSSNY Physician Wellness and Resilience Committee announced that another publication has come out of the MSSNY Burnout survey we did in the fall of 2016 in collaboration with Federation of State Medical Boards. “Physician Burnout and Mental Health Care Barriers when Reporting on Applications” has been accepted in Journal of Legal Medicine.

It expounds upon how asking physicians questions on their state license applications and renewals about previous mental health care is such a large deterrent for physicians getting the care they need and how this backfires in efforts to protect the public. Other MSSNY Co-Authors were Fouad Attalah, Caroline Gomez-DiCesare, Frank Dowling and Arthur Hengerer.


A Spike in Emergency Department Prices: 135% from 2008 to 2017
The average price of an emergency department (ED) visit rose by 135% from 2008 to 2017, leaving patients on the hook for a larger share of the cost, according to a new report from the Health Care Cost Institute. The report also found that ED providers were billing for complex care more often in 2017 when compared with 2008.


Average Cost of Emergency Room in 2017 Is $1389: Up 176% over Last Decade
The nonprofit Health Care Cost Institute (HCCI) examined insurance claims for a decade’s worth of hospital emergency room bills, analyzing millions of insurance claims for people under the age of 65 who get health insurance through an employer.

HCCI found that hospital emergency rooms not only substantially increased prices for care from 2008 through 2017. The hospitals and doctors also billed for more complex care, which allows them to collect more lucrative fees from consumers, employers and private insurers.

The average emergency room visit cost $1,389 in 2017, up 176% over the decade. That is the cost of entry for emergency care; it does not include extra charges such as blood tests, IVs, drugs or other treatments.


CVS to Open 1,500 HealthHub Stores by the End of 2021
After success with its pilot sites in Houston, CVS Health plans to open 1,500 HealthHub stores by the end of 2021, the pharmacy retail giant announced June 4. HealthHubs are CVS’  redesigned health-focused concept stores that have space dedicated to helping customers manage such chronic conditions as diabetes, hypertension and asthma. Each store features an expanded health clinic with a lab for blood testing and health screenings as well as wellness rooms equipped to handle yoga classes and seminars. The stores also have more shelf space for health-focused products, such as medical equipment and supplies for diabetes care and sleep apnea.

CVS opened its first three HealthHub location in Houston. It plans to open more HealthHubs in Houston, Atlanta, Philadelphia, southern New Jersey and Tampa, Fla., this year.

The goal is to have 1,500 of the health-focused stores operating by the end of 2021.

Read the full announcement here. Becker’s Hospital Review Jun 5


Jefferson County Elects New Officers
The Medical Society of Jefferson County met on Tuesday, May 21. The meeting information is below and pictures are attached. On May 21, the Medical Society of Jefferson County hosted a Member Appreciation and New Member Welcome event. Members enjoyed a social gathering in Green Street at the Ramada Inn, Watertown, before adjourning to the Renaissance Room for a light buffet where Dr. Thomas Madejski, Immediate Past President of the Medical Society of the State of New York, led a discussion on current issues of concern to physicians.

Members of Jefferson County Medical Society

Josiree Ochotorena MD, Secretary/Treasurer, MSJC; David O. Van Eenenaam MD, Director, MSJC; Thomas Madejski MD, Immediate Past President of MSSNY; Robert Kimball MD, President, MSJC; Elizabeth Sinclair- Cady (MLMIC), and Howard Huang MD, Director, MSJC & Counselor to the 5th-6th Districts.


AMGA Survey: Physician Benefit Packages Haven’t Changed Much Since 2014
The core discretionary benefits for physicians remained largely unchanged from 2014 to 2018, according to the latest provider benefits survey from medical trade group AMGA. The survey — conducted by AMGA’s subsidiary, AMGA Consulting — also showed that the number of part-time primary care providers who are eligible for employer benefits is increasing.

For instance, in 2018, the most common combination of retirement plans reported by respondents was a 403(b) with a 457(b) plan, which was consistent with the AMGA’s 2014 benefits survey.

The 2014 and 2018 surveys also found that most employers offered some type of life insurance coverage, and that most group physicians become eligible for life insurance the first of the month after their hire date. To compare provider benefits of health systems, researchers examined data from 83 healthcare organizations across 34 states. The research included 2018 benefits package information from AMGA’s 2018 Medical Group Compensation and Productivity survey. AMGA also used a supplemental survey to gain additional information from respondents.

Overall, benefits survey found that core physician benefits, such as retirement plans, medical insurance, income protection, time off, and professional development, remained largely unchanged from 2014 to 2018, said AMGA.

Additionally, 89 percent of the 2018 survey respondents indicated they offer continuing medical education benefits for providers. Also, more than half of the 64 organizations that provided information on provider time-off benefits last year reported more than the typical six holidays guaranteed off, including New Year’s Day, Memorial Day, Independence Day, Labor Day, Thanksgiving Day and Christmas Day.

“The healthcare industry is currently experiencing a physician shortage, especially in primary care,” said Elizabeth Siemsen, AMGA Consulting director, in a news release. “The expanded offerings and lowered FTE [full-time-equivalent] thresholds we saw in this survey indicate short-staffed organizations are looking to fill employment gaps with part-time physicians and are using employee benefits as a way to attract talent.” (Beckers Hospital Review May 29).


Classified

RENTAL/LEASING SPACE


Park Avenue Office Share-3 Days Per Week
Tasteful, bright, well-maintained  medical office in prestigious building on Park Avenue at 94th Street.  Large waiting room and reception area, consultation room and 2 exam rooms available 3 days per week. Room for an assistant or clerical help 5 days per week. Please email abgmdpc@gmail.com or call 987-5000

Medical Office Space for Rent!
Beautiful Newly Renovated Medical Office on the Upper East Side between Madison and Park Avenue! Conveniently located near all public transportation and Mount Sinai Hospital. Consult and Exam room available for rent part time or full time (see pictures). Please call 212-860-0300 or email carnegiehill0062@gmail.com for further information.
Pictures of office space for rent on Madison Ave

 


Fully Renovated Office Space for Part-Time Lease in Hauppauge
Available Tuesdays/Fridays, $450 half session, $750 full session. Elegant office space, beautiful waiting room with new stone and granite reception desk, custom molding, large windows, abundant natural light, TV, and refreshment counter.  Four new exam rooms and dictation room.  New stainless and granite kitchenette.  State-of-the-art network infrastructure meets HIPPA & PCI DSS compliance standards.  Digital X-ray room with PACS in each exam room available as an option.  Located in close proximity to LIE, Northern State Pkwy, and Vets Memorial Hwy. Contact us at (631) 486-8855;  Please see our listing: https://www.loopnet.com/Listing/517-Route-111-Hauppauge-NY/15298633/


Office Rental 30 Central Park South.
Two fully equipped exam, two certified operating, bathrooms and consultation room.  Shared secretarial and waiting rooms. Elegantly decorated, central a/c, hardwood floors. Next to Park Lane and Plaza hotels. $1250 for four days a month.Available full or part-time. 212.371.0468drdese@gmail.com.


 

Rare Find — Great Office Share
Wonderful office share in terrific location at great price. Available Monday, Wednesday, Friday and weekends. Choice of smaller windowed consultation room with adjoining exam room or big windowed consultation room with one or two exam rooms. Beautiful bright rooms, lovely reception area and front . First-rate building on 58th Street between Park and Lexington. Rent by day (about $180). Front desk and office management available if needed, along with many other amenities, including internet, ultrasound, EMG Kitchen, optional C Arm. Willing to make changes for new tenant. Call 646-642-0700.


Are You Trying to Lease Your Medical Office or Sell Your Medical Practice? Trying to Sell New or Used Medical Equipment?
Clineeds, the new online platform designed for medical providers. With Clineeds you can lease your medical officeshared your office spacebuy and sell used medical equipment, or post healthcare job opportunities. LISTING IS FREE! Why wait? Click here to sign-up: www.clineeds.com/sign-up

PHYSICIAN OPPORTUNITIES

Multi-Specialty Medical Office Looking To Bring On More Doctors
New York Medicine Doctors Center is a multi-specialty Medical Agency networking some of the best medical professionals and specialists in the New York Tri-State area. Our offices currently serve both Manhattan and Queens, providing a variety of advanced technological on site testing, imaging, and services for the most rapid results.

We are actively looking to bring on board an array of Doctors specializing in Primary Care, Gynecology, Gastroenterology, ENT, Urology, Podiatry, and Dermatology.

As we continue to broaden our medical services in both locations, we also provide individualized on-boarding contracts with health benefits, tailored in-house marketing and advertising, practice management assistance, and in house team of administration dedicated in serving any and all concerns whether it be credentialing or equipment related tasks.

If you are interested in joining our growing network, please do not hesitate to contact us

at 718-360-9550 or 212-931-8533. Our direct email is drshusterman@gmail.com

Primary Contact: Oksana


 

 


Nurse, RN Utilization Review Full-Time-Westbury, NY (In-office position only)
Excellent opportunity for a RN who is seeking a position performing utilization review.  We require 1-2 years recent experience in hospital and/or insurer utilization review and experience using Interqual criteria and/or MCG Guidelines. Data entry/PC skills a plus. Benefits include 401(k), paid vacation and holidays. Send resume and salary requirements to: Empire State Medical Scientific and Educational Foundation, Inc. Human Resource Department e-mail: chunt@mssny.org  Fax: (1-516) 833-4760 Equal Oppty Employer M/F


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

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 


Medical Society Supports SAM, NYSACHO and NYS PTA in Opposition to Legalized Recreational Marijuana


MSSNY Seal
MEDICAL SOCIETY OF THE STATE OF NEW YORK
865 Merrick Avenue, Westbury, New York 11590-9007
www.mssny.org
Communications Division
Telephone: (516) 488-6100

 

For Immediate Release
June 4, 2019 

Medical Society Supports SAM, NYSACHO and NYS PTA in Opposition to Legalized Recreational Marijuana

Statement attributable to:
Arthur Fougner, MD
President, Medical Society of the State of New York

“The Medical Society of the State of New York remains firm in its opposition to the legalization of recreational marijuana and applauds Smart Approaches to Marijuana (SAM), New York State Association of County Health Officials (NYSACHO), and the NYS PTA for their joint efforts in stopping the bill from moving forward.

“One of our chief concerns is that sufficient research and clinical study necessary for both legislators and voters to make an informed decision are sorely lacking. A major contributing factor is that marijuana continues to have a schedule I classification by the federal government, which significantly limits the comprehensive research that can be performed so that physicians and consumers can make informed decisions. We would therefore support reclassification of cannabis as Schedule II first to facilitate urgently needed further study.”

# # #

About the Medical Society of the State of New York
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.

MSSNY Contact:
Roseann Raia
Communications / Marketing
Medical Society of the State of New York
865 Merrick Ave.
Westbury, New York
516-488-6100 ext 302
rraia@mssny.org

 

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Medical Society Supports March of Dimes Vaccination Efforts


MSSNY Seal
MEDICAL SOCIETY OF THE STATE OF NEW YORK
865 Merrick Avenue, Westbury, New York 11590-9007
www.mssny.org
Communications Division
Telephone: (516) 488-6100

 

For Immediate Release
June 4, 2019 

Medical Society Supports March of Dimes Vaccination Efforts 

Statement attributable to:
Arthur Fougner, MD
President, Medical Society of the State of New York

“More than 60 years ago, the March of Dimes pioneered the vaccine research leading to the eradication of polio. The organization has been a leader in the fight for the health and well-being of mothers and children and has stood firm in their efforts to encourage every individual to be vaccinated.

“The Medical Society of the State of New York is pleased to support the March of Dimes’ efforts to ensure that medical exemptions are the only exemptions that exist in New York State. The health of our patients depends on proper vaccinations. Vaccines are, in fact, the very cornerstone of public health. We must preserve community immunity in order to protect society—especially our most vulnerable: newborn babies, pregnant women, the immune-compromised and those with cancer.

# # #

About the Medical Society of the State of New York
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.

MSSNY Contact:
Roseann Raia
Communications / Marketing
Medical Society of the State of New York
865 Merrick Ave.
Westbury, New York
516-488-6100 ext 302
rraia@mssny.org

 

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State Medical Societies Demand Legislators “Say No” to Recreational Marijuana Legalization


MSSNY Seal
MEDICAL SOCIETY OF THE STATE OF NEW YORK
865 Merrick Avenue, Westbury, New York 11590-9007
www.mssny.org
Communications Division
Telephone: (516) 488-6100

 

For Immediate Release

State Medical Societies Demand Legislators “Say No” to Recreational
Marijuana Legalization

Group comprises seven State Medical Associations with more than 180,000 physician and student members

May 31, 2019, Westbury, NY— With pressure mounting on state legislatures across the country to legalize recreational marijuana, a group of seven state Medical Societies is calling for cooler heads to prevail.“

This is a public health issue, not a tax issue,” said Thomas Madejski, MD, immediate past president of the Medical Society of the State of New York. “It’s ludicrous to prioritize increased state revenue against increased hospital visits. The health of our citizens is at stake here.

”Indeed, data from states that have legalized recreational marijuana shows an increase in car accidents and an increase in teen use.

The American Medical Association (AMA) stands with the states in expressing concern about legalization of cannabis for recreational use. James Madara, MD, executive vice president and CEO of the AMA recently sent a letter to New York State Assembly Speaker Carl Heastie and New York State Senate Majority Leader Andrea Stewart-Cousins urging them to “delay initiating the legalization of cannabis for recreational (non-medicinal) use until further research is completed on the public health, medical, economic and social consequences of its use.”

The group is urging Congress to re-classify marijuana from Schedule I to Schedule II so that necessary research can be performed to better inform states considering these proposals. As a Schedule II drug, government funding can be sought for necessary research that clearly defines the positive and negative elements of marijuana use.

“One of our chief concerns is the lack of sufficient research and clinical study upon which legislators and voters are approaching this issue,” said Dr. Madejski. “A major contributing factor is that marijuana continues to have a schedule I classification by the federal government, which significantly limits the comprehensive research that can be performed to inform physician and consumer decision-making.”

A final concern involves the worsening of the current mental health and substance abuse crisis enveloping the country.

“We have seen a relentless push by wealthy Wall Street Venture Capitalists to create a new addiction industry to extract profits from all our communities but especially those already experiencing socioeconomic challenges,” said Dr. Madejski. “They are particularly devious in hiding their true intentions with legitimate arguments to redress inequities in social justice and health care disparities. Redressing these inequities does not require expanding use of a substance with well documented harms to our vulnerable populations, particularly with regards to accidental deaths, substance abuse disorders and severe mental health issues.”

# # #

About the Medical Society of the State of New York
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.

The state medical societies in the group are New York, New Jersey, Connecticut, Delaware, New Hampshire, Pennsylvania and Ohio.

 

MSSNY Contact:
Roseann Raia
Communications / Marketing
Medical Society of the State of New York
865 Merrick Ave.
Westbury, New York
516-488-6100 ext 302
rraia@mssny.org

 

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MSSNY eNews – May 31, 2019 – WHO YOU GONNA CALL? MSSNY!

Arthur Fougner MSSNY Presiident

PRESIDENT’S MESSAGE<
Arthur Fougner, MD
MSSNY President

MSSNY eNews
May 31, 2019

Vol. 22  Number 21


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Colleagues:

We get asked all the time: “Why MSSNY”? Or perhaps, “What does MSSNY do for me?” For two Bronx physicians, that answer is resoundingly clear— “MSSNY saved our practice.”

Two Bronx doctors received notification from their largest carrier that because of an issue with their Maintenance of Certification (this will be the subject of a future piece), they were about to be dropped from participation. These physicians do not practice in the trendy Hamptons or on the tony Upper West Side. They do primary care for patients of modest means and, I must say, do it well.

So they reached out to us with a cry for help. Right away, our in-house ombudsman Regina McNally contacted the carrier for more information. We also suggested they reach out to Bronx State Senator Gustavo Rivera who now chairs the Health Committee about the problem. We also did the same.

Lo and behold, the physicians received a follow-up letter from the carrier apologizing for a “mistake,” assuring them that they would remain an integral part of their network.

Funny how that works, right?

So the next time anyone asks “Why MSSNY?,” invite them to pull up a chair and tell them the story of the two Bronx physicians.

As a postscript, the following week, I met up with Sen. Rivera at an event and he told me that after speaking with those same doctors, he was introducing legislation on this whole “MOC business.”

Stay tuned.

Get up, Stand up. Stand up for your right.
Get up, Stand up. Don’t give up the fight.

Bob Marley

Arthur Fougner, MD
MSSNY President 

Comments? comments@mssny.org; @mssnytweet; @sonodoc99


MSSNY Physician Burnout Banner


Podcast SymbolThis Week’s Podcast of MSSNY’s Legislative Priorities


 

Capital Update


Wrongful Death Bill Reported Out of Judiciary Committees
All physicians are urged to contact their legislators to oppose a bill that would cause enormous increases in medical liability premiums by expanding damages awarded in wrongful death actions. Senator Hoylman and Assemblyman Weinstein’s S.4006/A.5612, which was reported out of the Senate and Assembly Judiciary Committees on Thursday,  which will now be considered in the Senate Finance and Assembly Codes committees, would expand the possible award in a wrongful death action to include compensation for grief or anguish, the loss of love and companionship, loss of services and support and the loss of nurture and guidance.

Current law allows the family and/or estate of a decedent to sue for both economic damages and for pain and suffering that the decedent may have experienced prior to death. They also may sue for economic loss incurred due to the death. This bill would greatly expand the permissible compensation and would likely lead to drastic increases in already outrageously high liability insurance premiums.  An Actuarial estimate released by the NY Lawsuit Reform Alliance indicated that passage of this legislation could increase premiums by nearly 50%!!

With New York consistently being ranked as the worst state in the country in which to practice medicine, in large part due to its overwhelming liability exposure as compared to other states in the country, passage of this legislation would likely exacerbate these issues, making the practice environment even worse. Physicians are urged to contact their legislators and let them know how harmful this bill would be by going here.  (AVELLA) 


NYS Has 845 Confirmed Measles Cases—Physicians Urged to Call Legislators to Demand Action on this Public Health Epidemic
As of May 24, 2019, there are 940 confirmed cases of measles nationally—with 845 of them here in New York State.   Physicians throughout the state are encouraged to call their legislators and urge action on a bill that would allow only medical exemptions for immunizations.  The measure, A.2371/S.2994A, is in the Assembly & Senate Health Committees.   The Medical Society of the State of New York has joined 29 other medical organizations, patient advocacy groups and public health organizations, meeting with members of the Legislature to advocate for passage of this measure.

Advocates against mandatory vaccinations continue to call and meet with legislators and were in Albany again this week.  It is vitally important that physicians call or send messages to their legislators urging action on this measure.  You can help by following these steps:

  • Physicians are strongly urged to contact members of the Assembly Health Committee. Please call at 518-455-4100 and ask for the following Assemblymembers: Gottfried, Schimminger, Galef, Dinowitz, Cahill, Paulin, Cymbrowitz, Gunther, L. Rosenthal, Hevesi, Jaffee, Steck, Abinanti, Braunstein, Kim, Solages, Bichotte, Barron, Sayegh,Raia, McDonough, Ra, Garbarino, Byrne, Byrnes, Ashby.  Tell them that you support passage of A.2371/S.2994, which would repeal the religious exemption, ensuring that the only allowable exemption to vaccination will be for medical reasons.
  • Please send a letter to your legislator via the MSSNY Grassroots Action Center (GAC).  Please click here !
  • Physicians are encouraged to work with their local county medical society to schedule a local legislative meeting with your with local legislators! Please call your State Senator and Assembly Member’s office to voice your support of this legislation. There is strength in numbers! Please click here

The Medical Society of the State of New York’s Memo in support of A.2371/S.2994A can be found here and a copy of the memo produced by physician and public health organizations and parent and patient advocacy groups’ memo is available here.

Senate Majority Leader Andrea Stewart-Cousins has indicated that she has enough votes to pass this measure in the Senate and Governor Andrew Cuomo has publicly stated that he will sign the bill if it comes to his desk.  The question is whether there will be enough votes in support in the New York State Assembly Health Committee.

Joining the Medical Society in support of repealing religious exemptions are the following groups:  American Academy of Pediatrics, NYS District II, Chapters 1, 2 & 3, American Nurses Association – New York (ANA-NY),  Associated Medical Schools of New York, Autism Science Foundation, Citizen Committee for Children of New York, Inc., Children’s Defense Fund-New York, Erie County Department of Health, Ithaca Is Immunized, Kimberly Coffey Foundation, Nurses Who Vaccinate, March of Dimes, Meningitis B Action Project,  Nurse Practitioner Association New York State, New York American College of Emergency Physicians, New York State Society of Dermatology and Dermatologic Surgery, NY Chapter American College of Physicians, NYS Academy of Family Physicians, NYS Association of County Health Officials (NYSACHO), NY Occupational and Environmental Medical Association (NYOEMA), NY State Neurological Society, NY State Neurosurgical Society, NYS Ophthalmological Society, NYS Society of Otolaryngology-Head and Neck Surgery, NYS Public Health Association, New York State Society of Anesthesiologists, Inc., The New York State Radiological Society, Schuyler Center For Analysis and Advocacy, The Children’s Agenda, Tompkins County Department of Health and the Tompkins Board of Health.(CLANCY)


Rural Health Care Hearing Highlights Roots of Rural Access Issues
On Friday the Assembly Health Committee held a hearing to discuss issues surrounding access to care in rural communities. The committee heard testimony from a wide array of individuals, including those representing physicians, hospitals, home care organizations and other providers. The theme was consistent as those testifying spoke to the need to increase reimbursement to rural areas.

Dr. Chris Kjolhede, a pediatrician from Cooperstown and MSSNY delegate, testified on behalf of MSSNY and addressed the variety of issues challenging communities in rural areas. These include the need for more adequate reimbursement for services provided to Medicaid members; enhanced ability to incentivize physicians to practice in rural areas through increased funding for programs like Doctors Across New York (DANY); innovation through a carefully planned and quality-controlled telemedicine system; understanding how social determinants of health impact communities in order to craft localized solutions; and supporting evidence-based public health measures. Dr. Kjolhede and others also stressed the strong willingness on the behalf of physicians and other stakeholders to work together to improve access to quality care in rural areas.   (AVELLA)



Physician Advocacy Needed in End of Session Push for Insurance Reforms
With only three weeks remaining until the scheduled end of session, strong advocacy is needed on a variety of insurance related bills that MSSNY is supporting in order to bring about positive reforms to the health insurance system in New York. Physicians are urged to help advocate for the advancement of these reforms and emphasize how important these bills are. 

Collective negotiationsNegotiating with insurance companies is extremely difficult, especially when monolithic payers control a huge portion (or all) of the market that you practice in. The fact that you are barred from banding together with your colleagues is unfair, so MSSNY strongly supports legislation introduced by Senator Rivera and Assemblymember Gottfried (S.3462/A.2393) that would allow physicians to collectively negotiate patient care terms with insurance companies such as prior authorizations and network participation rules. Insurance companies have been fighting against this fiercely so we must ensure strong grassroots support for this legislation that would put physicians on more even footing with insurers.

The bill has been reported out of the Assembly Health and Codes Committees and awaits a vote in Ways & Means. Its Senate companion is currently in in the Senate Health Committee. Please urge your Assemblymember and Senator to join on as a co-sponsor and support the bill click here. 

Mid-year formulary changesSurprisingly, current law does not restrict insurance companies from making substantial changes to their formularies mid-year. This is an egregious practice when you consider the fact that your patients choose insurance plans based on the coverage presented to them – and they generally are not able to switch plans mid-year. Senator Breslin and Assemblymember Peoples-Stokes have introduced legislation (S.2849/A.2969) that would prevent mid-year formulary changes so that patients do not experience removal of a drug or changes in tiering when there is no similarly effective option.

The bill is currently on the Senate calendar eligible for a vote and has been reported out of the Assembly Insurance Committee; it currently awaits a vote in the Assembly Codes Committee. Please urge your Assemblymember and Senator to join on as a co-sponsor and support the bill click here.

Prior authorizationsPrior authorizations continue to be a major roadblock to care and cause endless hassles for you and your staff. The burdens caused by excessive and often unjustified prior authorization requirements take away from the time that you should be spending with your patients and lead to far too many hours being spent on paperwork. Senator Breslin and Assemblymember Gottfried have introduced an “omnibus bill” (S.2847/A.3038) that would help physicians in a variety of ways, including reducing prior authorization burdens, updating UR standards and patient protections for prescription drug coverage continuity.

The bill is has been reported out of the Senate Insurance Committee and is on the floor calendar eligible for a vote. Its Assembly companion awaits consideration in the insurance committee. Please urge your Assemblymember and Senator to join on as a co-sponsor and support the bill click here.

Network due processThere is currently a glaring loophole in New York’s laws that allow insurance companies to terminate physicians from their networks by non-renewal without cause or recourse. While they are required to notify physicians when contracts are terminated and physicians are then afforded the opportunity for a hearing, these protections don’t extend to non-renewal. Senator Rivera’s and Assemblymember Lavine’s bill (S.3463/A.2835) would provide physicians with proper due process upon non-renewal and would enhance the current hearing process by allowing the subject of the hearing (the physician) to choose one of the three members of the panel.

The bill is currently eligible for a vote on the Senate Floor. It was recently reported out of the Assembly Codes Committee and will be eligible for a vote in the Assembly next week.  (AVELLA)


MSSNY Testifies at Single Payor Hearing
MSSNY President Dr. Art Fougner testified at a 13-hour long Assembly-Senate hearing this week (click here) examining legislation (S.3577, Rivera/A.5248, Gottfried) that would create a single payor system in New York State.  Dr. Fougner’s testimony praised the sponsors for their efforts to ensure New Yorkers have coverage for the care they need, as well as the efforts to revise the legislation to address concerns that physicians have raised with the legislation.   These improvements include provisions to reduce prior authorization requirements and additional mechanisms to help physicians more fairly negotiate with a monolithic bureaucratic structure.  MSSNY has a long-standing position in opposition to a single payor insurance system, though many physicians across the State have expressed support for such a system.

Dr. Fougner noted that while there are aspects of such a system that are appealing, such as the potential for administrative simplification, MSSNY remains concerned that the good intentions of the sponsors of this proposal may not be how the NY Health system will ultimately operate, particularly when they must respond to situations where anticipated tax revenues do not meet spending projections. He also noted that continued promotion and expansion of the varied programs to provide health insurance coverage for New York’s uninsured and underinsured is MSSNY’s preferred approach.

There will be more hearings on this issue later in the year.   (AUSTER)


Efforts to Legalize Recreational Marijuana Continue as Legislature Nears End
Advocates for legalizing the recreational/adult-use of marijuana in New York are strongly pressing members of the New York State Legislature to pass legislation.   A. 1617A/ S 1527A, sponsored by Assembly Majority Leader Crystal Peoples-Stokes and Senator Liz Krueger, which was recently amended, would create the “marijuana regulation and taxation act”.   The amended bill would expunge lower level marijuana convictions reduce the amount of marijuana that can be possessed to three ounces, and tax marijuana at a higher level.  Additionally, the new bill calls for the state to train police to recognize impaired drivers and establishes an Office of Cannabis Management which would oversee the growth, sale and distribution of hemp and medical marijuana as well as recreational/adult-use marijuana.  The Assembly bill is in the Assembly Codes Committee and the Senate bill is in the Senate Finance Committee.  The Medical Society of the State of New York continues to oppose the legalization of recreational marijuana and continues to work with other advocacy groups that oppose this measure.

Also pending in both houses is A.7467/S.5657, sponsored by Assemblymember Richard Gottfried and Senator Diane Savino, which would greatly expand New York State’s medical program for certifying patients for the use of marijuana.   The bill eliminates “serious condition” and replaces it with “condition” and further expands the list of condition eligible for certification.  The measure also expands the list of practitioners who can certify the patient for the use of marijuana and would authorize “smoking” as a modality of treatment.   The bill is pending in the Assembly Codes Committee and the Senate Health Committee.   (CLANCY, AUSTER)


Bill to Assess Ways to Improve Physician Loan Repayment Program Passes Both Houses
Senator Rivera and Assemblymember Gottfried’s S.4269/A.5425 has passed both the Senate and Assembly and will be sent to the Governor for signature. The bill, which was supported by MSSNY, will require an assessment of the impact of requiring individual applicants for grants from the Doctors Across New York physician loan repayment and physician practice support programs to use the New York State Grants Gateway.

Doctors Across New York (DANY) is a successful recruitment and retention tool that helps attract physicians to underserved areas across New York. This is achieved by offering loan forgiveness and practice start-up financial support from the state. This year, the application has been moved from the Department of Health to the New York Grants Gateway. The process to obtain a grants gateway account and the method via which applicants access the RFA is more rigorous and difficult than the previous process and there is some fear that this will reduce the number of physicians that are able to take advantage of this program.  MSSNY has been working with the NY Chapter of ACP in advocating for this legislation.

The workgroup established by this legislation will gather information on the results of the new application process and will work to ensure that the number of applicants is not negatively impacted by the increased administrative steps needed to apply.       (AVELLA)


Varying Proposals to Address Surprise Medical Bills Contain Positive and Concerning Elements
With several US House and Senate leaders releasing bi-partisan proposals to address the issue of “surprise” patient out of network medical bills that could undermine New York’s acclaimed law, physicians are urged to send a letter (please click here) urging their member of Congress to fight for a law that is consistent with New York’s approach, and to oppose legislation that would undermine New York’s proven model.

Importantly, last week Representative Joe Morelle (D-NY) together with Representative Dr. Phil Roe (R-TN) and Dr. Raul Ruiz (D-CA) released a proposal that seeks to mirror New York’s law, which uses a “baseball arbitration” Independent Dispute Resolution (IDR) system to determine payments for out of network medical care, and uses charge data collected by an independently controlled database as a leading benchmark to guide the IDR.  MSSNY Board of Trustees member Dr. Andrew Kleinman also recently participated in a meeting with the House Doctors Caucus to educate legislators about New York’s approach.

However, several proposals have been advanced that would either require an insurer determined in-network based default rate for out of network surprise medical bills, or create a baseball arbitration system that uses an insurer determined in-network rate as a benchmark.   MSSNY has written to New York’s Congressional delegation praising the approach set forth by Representatives Morelle, Roe and Ruiz, and raising strong concerns with other proposals.

Specifically, New York’s letter raised concerns with the insurance industry’s own notorious history establishing benchmarks for out of network payment, and the history of then-Attorney General Cuomo’s investigation which found that by using a flawed and conflicted database to determine reimbursement rates for out-of-network care, insurers were increasing profits at the expense of patients and physicians.   Moreover, it was noted that New York’s law struck a tenuous balance among various health care stakeholders that protected patients from surprise medical bills and assured that hospital emergency departments had access to needed on-call specialty care.

With so much interest in this issue, there will be likely be Congressional action this year, so physician grassroots advocacy is essential.  (AUSTER)


Expansion of Scope of Practice Legislation Pending on Senate Calendar For A Vote
There are several bills that are now on the Senate Calendar and ready for a vote that would expand the scope of practice for many providers.  The Medical Society opposes the following measures:

  • 5395/A.6185, which is sponsored by Senator Robert Jackson and Assemblymember Gary Pretlow, would inappropriately expand the scope of practice of podiatrists the following ways: by reducing certification requirements for podiatrists seeking to have advanced surgical privileges; Removing the requirement that a podiatrist seeking either standard ankle surgery or advanced ankle surgery privileges be directly supervised by a podiatrist with an advanced license from the NYSED or a physician; and enabling podiatrists to treat wounds that are not contiguous with structures of the foot or ankle.
  • 5092/A.3867, sponsored by Senate Health Chair Gustavo Rivera and Assemblymember John McDonald. This would add pharmacists to the list of licensed health care professionals authorized under public health law to perform non-invasive laboratory tests as an adjunct to their professional services, without an order from a physician to provide such services.
  • 5227/A.6511A, sponsored by Senator Rachel May and Assemblymember Amy Paulin. The bill would allow pharmacists to provide ALL immunizations on the Advisory Committee on Immunizations Practices (ACIP) list recommended for adults, this would more than double the number of immunizations pharmacists would be permitted to provide.
  • 4975/A.6486, sponsored by Senator Neil Breslin and Assemblymember John McDonald, would authorize a pharmacist to administer vaccines for hepatitis A, hepatitis B, and human papillomavirus

to adults via a patient or non-patient specific script.

Please urge your legislators to oppose these measures.  Assembly 518-455-4100, and Senate 518-455-2800.    (CLANCY, AUSTER)     


AMA Opioid Task Force Issued 2019 Report
The AMA Opioid Task Force this week issued an updated report containing recommendations focusing on tangible actions that can help to end the opioid epidemic. In 2014-15, the Task Force issued six recommendations focused on ways in which physicians could take specific actions to help reverse the nation’s opioid epidemic. While there has been   demonstrated progress in each of these areas, it is clear that much more work remains, and policymakers have an increasing role to play. The new recommendations:

  1. Remove prior authorization, step therapy and other inappropriate administrative burdens or barriers that delay or deny care for FDA-approved medications used as part of medication-assisted treatment for opioid use disorder.
  2. Support assessment, referral and treatment for co-occurring mental health disorders as well as enforce state and federal laws that require insurance parity for mental health and substance use disorders.
  3. Remove administrative and other barriers to comprehensive, multimodal, multidisciplinary pain care and rehabilitation programs.
  4. Support maternal and child health by increasing access to evidence-based treatment, preserving families, and ensuring that policies are non-punitive.
  5. Support reforms in the civil and criminal justice system that help ensure access to high quality, evidence-based care for opioid use disorder, including medication-assisted treatment.

The task force consists of American Medical Association, American Osteopathic Association, and 25 specialty and state medical societies as well as the American Dental Association.   The Medical Society of the State of New York is a member of the task force.    The original task force recommendations, issued in 2015, focused on actions that physicians could take to help end the epidemic and are now regularly being followed by New York physicians:

  • Register for and use the state prescription drug monitoring program;
  • Enhance education and training on effective, evidence-based treatment;
  • Support comprehensive care for patients in pain and those with a substance use disorder;
  • Remove stigma. Patients with pain and with a substance use disorder deserve comprehensive care and compassion, not judgment;
  • Expand access to naloxone in the community and through co-prescribing; and
  • Encourage safe storage and disposal of opioids and all medications. (CLANCY)

Measles Outbreak in New York State Continues to Spread
Webinar Available at MSSNY CME Website

The number of measles cases in New York State in 2019 has again seen an uptick over the past week.  806 of the 940 confirmed cases nationwide are in New York State. In 2019 there have been 493 confirmed cases in New York City and 313 outside of New York City (254 in Rockland; 37 in Orange; 17 in Westchester; 3 in Sullivan; 1 in Suffolk and 1 in Greene counties) confirmed cases as of May 30th.  MSSNY conducted a just-in-time Medical Matters webinar entitled “The Continued Public Health Threat of Measles 2018” in December, 2018.  This webinar has now been posted to the MSSNY CME website. https://cme.mssny.org/ . You can also view MSSNY’s latest Medical Matters webinar entitled “What’s Your Diagnosis? Infectious Diseases” which involves a patient with a fever and a rash. Please check these out and keep yourself informed about the growing measles outbreak throughout New York State.  You can also listen to MSSNY’s brief podcast on the Measles, Mumps and Rubella vaccine here.          (HOFFMAN, CLANCY)


Registration Now Open for Veterans Matters CME Webinar on June 5th
Register now for MSSNY’s next Veterans Matters webinar June 5th at 7:30am. This webinar is entitled Substance Use Disorders in Veterans.  Register for this program here .

Veterans Matters: Substance Use Disorders in Veterans

When:  Wednesday June 5 2019 at 7:30am – Register here

Faculty: Frank Dowling, MD

Educational Objectives

  1. Define Substance Use Disorders (SUDs), symptoms, warning signs, comorbidities
  2. Explore evidence-based intervention and treatment options for SUDs among veterans
  3. Identify barriers to diagnosis and treatment and methods to overcome them

Additional information or assistance with registration can be obtained by contacting Melissa Hoffman at mhoffman@mssny.org or (518)465-8085

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

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


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pschuh@mssny.org mauster@mssny.org  pclancy@mssny.org  mavella@mssny.org
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eNews

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SURVEY: What are Your Challenges with EHR?
MSSNY, in conjunction with other physician associations, has been working with the New York e-Health Collaborative (NYeC) on ways to reduce the hassles associated with the implementation and use of electric health record (EHR) systems.

To that end, they have developed a survey for physicians to complete gauging the challenges of EHR use, including connecting to and using medical information from your local Regional Health Information Organization (RHIO) to enhance patient care delivery.

Please take just a few minutes to complete the survey here.


Opioids Prescribed in 1 of 6 ED Visits by Young People
One in six emergency department visits by adolescents and young adults resulted in an opioid prescription, according to a Pediatrics study.

Using 2005 to 2015 data from two national health surveys, researchers examined 47,000 visits to emergency departments and 31,000 visits to outpatient clinics among patients aged 13 to 22. Among the findings:

  • Nearly 15% of emergency department visits and 3% of clinic visits resulted in an opioid prescription.
  • Opioid prescriptions in the ED decreased slightly over time.
  • The prescribing rate surpassed 40% for dental problems in all ages and clavicle fracture in adolescents.

A commentator writes: “This study’s findings reflect many of the unique attributes of health care use by young adults. … Young adults seek care for acute conditions and injuries, chronic conditions, and reproductive care and receive a greater proportion of their care at emergency departments than any age group except for the elderly.”

Pediatrics article


MSSNY Council Notes—May 30. 2019

  • MLMIC has filed for a no rate increase and a “claims free” discount with DFS. The decision is expected at the end of June. MLMIC will let MSSNY know immediately when the decision is made and we will inform membership.
  • MLMIC has contributed $50,000 to MSSNY’s Physician Wellness Committee, which is chaired by Dr. Charles Rothberg.
  • On behalf of MSSNYPAC, Dr. Thomas Lee reported very successful fundraising events in Erie County and Staten Island, and encouraged each county in New York to develop a local fundraising effort to bring new members into MSSNYPAC. Contact Jennifer Wilks at jwilks@mssnypac.org or 518.465.8085 to get started.
  • The Medical, Educational and Scientific Foundation of New York (MESF) will run a final Physician Leadership Seminar June 21-22 at the Hyatt Regency in Hauppauge on Long Island. Contact Tom Donohue at tdonoghue@mssny.org for more info.
  • 40 MSSNY Delegates and Alternates will attend the annual AMA meeting June 8-12 in Chicago.
  • Hayden S. Wool, a partner with Garfunkel Wild, presented “Key Considerations in Informing Ancillary Services through a Group.” He provided an overview of the key regulatory compliance issues related to patient referrals and the performance of ancillary services by Group Practice. The presentation focused on an overview of physician consolidation/service expansion; structural changes; and regulatory compliance issues.
  • Onondaga County Medical Society hired Erika Barry as their new executive director.

Westchester Medical Center Locked in Contract Dispute
Empire BlueCross BlueShield has notified its members that Westchester Medical Center Health Network will become out-of-network on June 1 unless the two sides reach an agreement. The health network’s contract with Empire expired April 1, but discussions have continued during a two-month “cooling off” period. “We have a strong desire for Westchester Medical Center to be in-network, but we have to provide affordable products,” Alan Murray, Empire’s CEO, told Crain’s. “That’s a constant balance we’re challenged with.”

The insurer sent a letter describing the potential network changes to members last month; it was obtained this week by The Journal News. The hospitals affected are Westchester Medical Center and Maria Fareri Children’s Hospital in Valhalla; Bon Secours Community Hospital in Port Jervis, Orange County; Good Samaritan Hospital in Suffern, Rockland County; St. Anthony Community Hospital in Warwick, Orange County; and MidHudson Regional Hospital in Poughkeepsie, Dutchess County. The insurer told members that Empire would cover WMCHealth facilities as in-network during emergencies, when services have been previously authorized or where another provider is not within 30 miles of a patient’s home. (Crain’s Health Pulse)


Some Measles Patients Are Asked Not to Travel by Air
Five states, including New York, have advised people who may have measles that public health officials could stop them from boarding airplanes, the Washington Post reports.

State officials can request that the CDC put measles patients on a Do Not Board List that could prevent them from getting on aircraft. All eight people given the warnings by officials in New York, California, Illinois, Oklahoma and Washington State canceled their flights.

The CDC reported 971 cases of measles in the United States so far this year, the highest number in over a quarter-century an increase of 91 cases in the past week. CDC Director Robert Redfield pleaded with hesitant parents to vaccinate their children, reiterating that measles and other vaccines are safe and do not cause autism. Maine and New Mexico have joined the list of 26 states that have confirmed measles. https://www.cdc.gov/measles/travelers.html; CDC measles outbreak surveillance;  NEJM Journal Watch Infectious Diseases coverage of U.S. measles outbreak in 2019


Growing Number of Cancer Patients Are Using Electronic Cigarettes
Findings published in a research letter in JAMA Oncology report that “research shows a growing number of cancer patients are using electronic cigarettes.” Investigators found that “e-cigarette use by cancer patients rose from 8.5% in 2014 to nearly 11% in 2017.” The data indicated that “among patients younger than 50, the rate of use rose from 23% in 2014 to 27% in 2017.”


CDC: Decline of Diagnosed Diabetes in US, Yet Overall Numbers High
Even though “rates of diagnosed diabetes in the United States may finally be declining…overall numbers remain high,” Stephen R. Benoit, MD, and colleagues from the Division of Diabetes Translation, Centers for Disease Control and Prevention (CDC) concluded after analyzing “data for an almost 40-year period (1980-2017) from the National Health Interview Survey.” The findings were published online in BMJ Open Diabetes Research and Care. https://drc.bmj.com/content/7/1/e000657


Weed Killer May Be Linked to Liver Disease, Study Suggests
An article published online in Clinical Gastroenterology and Hepatology reported that research suggests “the popular weed killer Roundup might be linked to liver disease.” Researchers found that “a group of patients suffering from liver disease had elevated urine levels of glyphosate, the primary weed-killing ingredient in Roundup.” Lead researcher Paul Mills said, “We found those patients who had more severe disease had higher levels of [glyphosate] excretion, which means they had higher levels of exposure, presumably through their diet.”


Dr. Madejski Debates Legalization of Recreational Marijuana
Immediate Past President Dr. Tom Madejski debates recreational marijuana with author, screenwriter, former editor-in-chief/Publisher at High Times and convicted drug smuggler Richard Stratton on the podcast Morano Whenever. Highlights of the debate will also air this Sunday morning on AM 970 THE ANSWER, which is broadcast in the New York metropolitan area.


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RENTAL/LEASING SPACE


Medical Office Space for Rent!
Beautiful Newly Renovated Medical Office on the Upper East Side between Madison and Park Avenue! Conveniently located near all public transportation and Mount Sinai Hospital. Consult and Exam room available for rent part time or full time (see pictures). Please call 212-860-0300 or email carnegiehill0062@gmail.com for further information.
Pictures of office space for rent on Madison Ave


Park Avenue Medical Office for Sale
On Park Ave, for sale is a large medical office, in a beautiful full service co-op with two entrances, one of which is an impressive doorman in lobby entrance.The office has high ceilings, easily adaptable to any specialty and priced to sell. Three good size rooms easily converted to five exams, plus consult, bathroom, reception and large waiting room. Outstanding location. A must see. View floorplan http://ow.ly/kKOI30o6MjI. Call Jeff Tanenbaum,  646-234-2226 or email jtanenbaum@halstead.com for showings and more information.


Fully Renovated Office Space for Part-Time Lease in Hauppauge
Available Tuesdays/Fridays, $450 half session, $750 full session. Elegant office space, beautiful waiting room with new stone and granite reception desk, custom molding, large windows, abundant natural light, TV, and refreshment counter.  Four new exam rooms and dictation room.  New stainless and granite kitchenette.  State-of-the-art network infrastructure meets HIPPA & PCI DSS compliance standards.  Digital X-ray room with PACS in each exam room available as an option.  Located in close proximity to LIE, Northern State Pkwy, and Vets Memorial Hwy. Contact us at (631) 486-8855;  Please see our listing: https://www.loopnet.com/Listing/517-Route-111-Hauppauge-NY/15298633/


Office Rental 30 Central Park South.
Two fully equipped exam, two certified operating, bathrooms and consultation room.  Shared secretarial and waiting rooms. Elegantly decorated, central a/c, hardwood floors. Next to Park Lane and Plaza hotels. $1250 for four days a month. Available full or part-time. 212.371.0468drdese@gmail.com.


5th Ave Medical Office for Share
Facing Central Park in exclusive building, ground floor, separate entrance.
Perfect for psychiatrist, physiatrist, osteopath, or other.
880 5th Avenue (between 69th and 70th Sts.), New York, N.Y.
Please call 917-715-2464


Rare Find — Great Office Share
Wonderful office share in terrific location at great price. Available Monday, Wednesday, Friday and weekends. Choice of smaller windowed consultation room with adjoining exam room or big windowed consultation room with one or two exam rooms. Beautiful bright rooms, lovely reception area and front . First-rate building on 58th Street between Park and Lexington. Rent by day (about $180). Front desk and office management available if needed, along with many other amenities, including internet, ultrasound, EMG Kitchen, optional C Arm. Willing to make changes for new tenant. Call 646-642-0700.


Are You Trying to Lease Your Medical Office or Sell Your Medical Practice? Trying to Sell New or Used Medical Equipment?
Clineeds, the new online platform designed for medical providers. With Clineeds you can lease your medical officeshared your office spacebuy and sell used medical equipment, or post healthcare job opportunities. LISTING IS FREE! Why wait? Click here to sign-up: www.clineeds.com/sign-up

PHYSICIAN OPPORTUNITIES

Multi-Specialty Medical Office Looking To Bring On More Doctors
New York Medicine Doctors Center is a multi-specialty Medical Agency networking some of the best medical professionals and specialists in the New York Tri-State area. Our offices currently serve both Manhattan and Queens, providing a variety of advanced technological on site testing, imaging, and services for the most rapid results.

We are actively looking to bring on board an array of Doctors specializing in Primary Care, Gynecology, Gastroenterology, ENT, Urology, Podiatry, and Dermatology.

As we continue to broaden our medical services in both locations, we also provide individualized on-boarding contracts with health benefits, tailored in-house marketing and advertising, practice management assistance, and in house team of administration dedicated in serving any and all concerns whether it be credentialing or equipment related tasks.

If you are interested in joining our growing network, please do not hesitate to contact us

at 718-360-9550 or 212-931-8533. Our direct email is drshusterman@gmail.com

Primary Contact: Oksana


 

 


Nurse, RN Utilization Review Full-Time-Westbury, NY (In-office position only)
Excellent opportunity for a RN who is seeking a position performing utilization review.  We require 1-2 years recent experience in hospital and/or insurer utilization review and experience using Interqual criteria and/or MCG Guidelines. Data entry/PC skills a plus. Benefits include 401(k), paid vacation and holidays. Send resume and salary requirements to: Empire State Medical Scientific and Educational Foundation, Inc. Human Resource Department e-mail: chunt@mssny.org  Fax: (1-516) 833-4760 Equal Oppty Employer M/F


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

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 


MSSNY eNews – May 24, 2019 – Memorials and Decorations

Arthur Fougner MSSNY Presiident

PRESIDENT’S MESSAGE<
Arthur Fougner, MD
MSSNY President

MSSNY eNews
May 24, 2019

Vol. 22  Number 20


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Colleagues:

This is Memorial Day weekend. We celebrate the unofficial beginning of summer with barbecues, sitting in traffic en route to newly opened pools and beaches, or perhaps strolling in lower Manhattan for the Fleet Week celebration. Maybe you take care of that long delayed yard work and sit on the back porch, sipping lemonade or something stronger, enjoying the weather. But really, is this what Memorial Day is about?

Memorial Day began as separate remembrances in 1866 in both the North and the South. In the town of Waterloo, NY, a ceremony was held to honor the local veterans. (This was later recognized by President Lyndon Johnson as the birthplace of Memorial Day.) In 1868, Gen. Logan declared May 30 Decoration Day for the official placing of florals on the graves of the Union War Dead. As America entered World War I, Decoration Day became today’s Memorial Day to honor those who died in all America’s wars.

One of the earliest of those was a physician. Gen. Joseph Warren was a Boston physician who once saved a young John Quincy Adams finger from amputation. A prominent member of the Sons of Liberty, Warren had enlisted Paul Revere and William Dawes to take that famous ride. Though a General, he chose to fight with the enlisted men who stood their ground on Breed’s Hill (Yes, the Battle of Bunker Hill was actually fought on Breed’s Hill.) Dr. Warren gave his all for what would become our United States in the British troops final assault.

We should also remember one of our own – Dr. Ralph Schlossman. Although he did not die in battle, he served our country honorably and was perhaps the first US physician to fly jets. Dr. Schlossman’s cause was and remains our cause – the good of all patients and their doctors.

So as you enjoy that last hot dog, perhaps washing it down with an adult beverage or two, do remember those who served and gave their all for their cause – us.

The torch; be yours to hold it high.
If ye break faith with us who die
We shall not sleep, though poppies grow
In Flanders fields.  – John McCrae, Flanders Fields

Arthur Fougner, MD
MSSNY President 

Comments? comments@mssny.org; @mssnytweet; @sonodoc99


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Capital Update


Physician Action Needed to Help Stop Measles Outbreak, NYS Has 810 Confirmed Cases!
There are 810 confirmed measles cases in New York State and the number continues to grow.  The Medical Society of the State of New York continues to advocate for passage of legislation that would allow only medical exemptions for immunizations.  The measure, A.2371/S.2994A, is in the Assembly & Senate Health Committees.   MSSNY, along with 28 other medical organizations, patient advocacy groups and public health organizations, have been meeting with members of the Legislature to advocate for passage of this measure. The Medical Society of the State of New York’s Memo in support of A.2371/S.2994A can be found here and a copy of the memo  produced by physician and public health organizations, and parent and patient advocacy groups memo is available here.

Physicians are strongly urged to contact members of the Assembly Health Committee.  Please call them at 518-455-4100 and ask for the following Assemblymembers: Gottfried, Schimminger, Galef, Dinowitz, Cahill, Paulin, Cymbrowitz, Gunther, L. Rosenthal, Hevesi, Jaffee, Steck, Abinanti, Braunstein, Kim, Solages, Bichotte, Barron, Sayegh,Raia, McDonough, Ra, Garbarino, Byrne, Byrnes,Ashby.  Tell them that you support passage of A.2371/S.2994, which would repeal the religious exemption, ensuring that the only allowable exemptions to vaccination will be for medical reasons.  Additionally, please send a letter via the MSSNY Grassroots Action Center (GAC) to your legislator!   Please click here..

Physicians are also encouraged to work with local county medical society to schedule a legislative meeting within your area with! Or call your State Senator and Assembly Member’s office to voice your support of this legislation.     There is strength in numbers! Please look them up here: Please click here

MSSNY President Arthur Fougner, MD and M. Monica Sweeney, MD, a member of the MSSNY’s Committee on Infectious Disease and Health Disparities participated in a press conference this week with the bill sponsors, calling upon the NY State Legislature to pass this vital bill.  Joining the Medical Society in support of repealing religious exemptions are the following groups:  American Academy of Pediatrics, NYS District II, Chapters 1, 2 & 3, American Nurses Association – New York (ANA-NY),  Associated Medical Schools of New York, Autism Science Foundation, Citizen Committee for Children of New York, Inc., Children’s Defense Fund-New York, Erie County Department of Health, Ithaca Is Immunized, Kimberly Coffey Foundation, Nurses Who Vaccinate, March of Dimes, Meningitis B Action Project,  Nurse Practitioner Association New York State, New York American College of Emergency Physicians, New York State Society of Dermatology and Dermatologic Surgery, NY Chapter American College of Physicians, NYS Academy of Family Physicians, NYS Association of County Health Officials (NYSACHO), NY Occupational and Environmental Medical Association (NYOEMA), NY State Neurological Society, NY State Neurosurgical Society, NYS Ophthalmological Society, NYS Society of Otolaryngology-Head and Neck Surgery, NYS Public Health Association, New York State Society of Anesthesiologists, Inc., The New York State Radiological Society, Schuyler Center For Analysis and Advocacy, The Children’s Agenda, Tompkins County Department of Health.      (CLANCY)


Wrongful Death Bill on Senate Judiciary Agenda
A bill to authorize additional compensation in wrongful death actions will be considered in the Senate Judiciary Committee on Thursday. Senator Hoylman and Assemblyman Weinstein’s S.4006/A.5612 would expand the possible award in a wrongful death action to include compensation for grief or anguish, the loss of love and companionship, loss of services and support and the loss of nurture and guidance.

Current law allows the family and/or estate of a decedent to sue for both economic damages and for pain and suffering that the decedent may have experienced prior to death. They also may sue for economic loss incurred due to the death. This bill would greatly expand the permissible compensation and would likely lead to drastic increases in already outrageously high liability insurance premiums. Actuarial estimates have indicated that passage of this legislation could increase premiums by over 50%.

With New York consistently being ranked as the worst state in the country in which to practice medicine, in large part due to its overwhelming liability exposure as compared to other states in the country, passage of this legislation would likely exacerbate these issues, making the practice environment even worse. Physicians are urged to contact their legislators and let them know how harmful this bill would be by going here. (AVELLA)



Advocating to Reduce Health Insurer Hassles – Take Action Now!
As we progress toward the end of session, it is vital that physicians let legislators know how they feel about a variety of insurance-related legislative measures that would impact physicians and their patients’ relationships with insurance companies. The following three bills would help patients to be able to receive timelier treatment with greater choice of physician.  Please take action by contacting your legislators and asking them to support these bills. 

Collective negotiations – Negotiating with insurance companies is extremely difficult, especially when monolithic payers control a huge portion (or all) of the market that you practice in. The fact that you are barred from banding together with your colleagues is unfair, so we strongly support legislation introduced by Senator Rivera and Assemblymember Gottfried (S.3462/A.2393) that would allow physicians to collectively negotiate patient care terms with insurance companies in certain situations.

The bill is currently in the Assembly Ways and Means Committee and in the Senate Health Committee. Please urge your Assemblymember and Senator to join on as a co-sponsor please click here

Mid-year formulary changes – Surprisingly, current law does not restrict insurance companies from making substantial changes to their formularies mid-year. This is an egregious practice when you consider the fact that your patients choose insurance plans based on the coverage presented to them – and they generally are not able to switch plans mid-year. Senator Breslin and Assemblymember Peoples-Stokes have introduced legislation (S.2849/A.2969) that would prevent mid-year formulary changes so that patients do not experience removal of a drug or changes in tiering when there is no similarly effective option.

The bill is on the Senate floor, and advanced this week from the Assembly Insurance Committee to Codes Committee.  Please urge your Assemblymember and Senator to join on as a co-sponsor please click here

Prior authorizations – Prior authorizations continue to be a major roadblock to care and cause endless hassles for you and your staff. The burdens caused by excessive and often unjustified prior authorization requirements take away from the time that physicians can spend with their patients and lead to far too many hours being spent on paperwork. Senator Breslin and Assemblymember Gottfried have introduced an “omnibus bill” (S.2847/A.3038) that would reduce the hassles in a variety of ways, including updating UR standards and reducing the need for repeat prior authorizations.

The bill is advanced from the Senate Health Committee to the Senate floor this week, and is in the Assembly Insurance Committee. Please urge your Assemblymember andSenator to join on as a co-sponsor please click here (Avella, Auster)


Varying Proposals to Address Surprise Medical Bills Contain Positive and Concerning Elements
US House and Senate leaders have each released bi-partisan proposals this week to address the issue of “surprise” out of network medical bills received by patients.    While the House and Senate proposals have some similarities to New York’s law, there are also important differences which raise serious concerns.  Physicians are urged to send a letter from here (please click here) urging their member of Congress to fight for a law that is consistent with New York’s approach, and to oppose legislation that would undermine New York’s proven model.

The American Medical Association testified this week at a hearing of the House Ways and Means Committee examining this issue.  Moreover, Representative Joe Morelle (D-NY) together with Representative Van Taylor (R-TX) and Raul Ruiz (D-CA) released a summary of a proposal that seeks to mirror New York’s law, though the actual legislative text has not been released yet.

Last week, a bipartisan working group led by Dr. William Cassidy (R-LA) released a proposal that attempts to address several issues that cause patients to have surprise bills in the first instance, including increasing insurer transparency of patient cost-sharing requirements, of networks for the varying plans offered by a particular insurer, and annual reporting to HHS of the out of network services it has paid in the previous year.  Moreover, for “surprise” medical bills, it preserves state approaches to addressing surprise bills for patients insured in state-regulated plans.

With regard to ERISA regulated plans, it recommends using New York’s “baseball” arbitration approach, but of great concern, the IDR benchmark would be “commercially reasonable rates (which must be based on in-network rates and not charges) for that geographic area” This approach could greatly undermine New York’s law and eliminate any incentive for a health insurer to negotiate fairly with a physician.  To read more, click here: please click here.

Another proposal, from House Energy & Commerce Chair Frank Pallone (D-NJ) and Ranking Member Greg Walden (R-OR) would also prohibit balance billing for all emergency services and patients would only be held responsible for the amount they would have paid in-network.  It also preserves a state’s ability to determine their own payment standards for plans regulated by the state.   But of great concern, it would establish a minimum payment standard set at the median contracted (in-network) rate for the service in the geographic area the service was delivered. Again, this approach could greatly undermine New York’s law and eliminate any incentive for a health insurer to negotiate fairly with a physician. To read more, click here: please click here.

MSSNY has written to the New York Congressional delegation to raise concerns with the Cassidy and Pallone proposals, as well as to highlight approaches such as the Morelle-Ruiz-Taylor proposal that would mirror New York’s law for ERISA plans. Again, physicians are urged to send a letter to their members of Congress urging that they follow NY’s approach.   (AUSTER)                                                   


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Bill Requiring Physicians to Maintain Excessive Documentation of Discussion of Risks of Prescribing Opioids Moves to Senate Floor; Action Needed!
Physicians are urged to contact their legislators in opposition to legislation (S.4277-A/A.7285-A) which would require physicians and health practitioners who prescribe an opioid or other Schedule II Controlled Substance to discuss with patients’ the risks prior to prescribing the medications. The Medical Society is opposed to this measure and encourages physicians to send a letter to their legislator at the MSSNY Grassroots Action Center (GAC) please click here.

The bill is on the Senate floor and can be voted on at any time.  This legislation would require physicians to discuss (and by extension document that such discussions took place) the following: a) the risks of addiction and overdose associated with opioid medications; b) the reason why the prescription is necessary; c) alternative treatments that may be available; and, d) the risks associated with the use of these medications. Moreover, it would require the physician to counsel the patient on the risks of overdose and the availability of an opioid antagonist each year.

While this legislation is well intended, it ignores existing Public Health Law that essentially requires the patient’s informed consent. This means that when a patient needs treatment, their physician must give them information regarding risks so that they can make an informed decision. Additionally, this is duplicative of requirements that currently exist under other laws mandating that after a physician prescribes the medication, the pharmacist is required to again inform the patient about the risks of taking a controlled substance.

Moreover, for their patients who are on opioid medications longer than 90 days, physicians are required to have a written treatment plan that includes discussing with patients the risks of these medications and possible alternatives to these medications.  MSSNY is also concerned that such requirements will further discourage physicians from prescribing pain medications for patients who need them – already a growing concern – and could potentially scare patients who truly need pain medication away from taking this medication. (CLANCY, AUSTER)


MSSNY Raises Substantial Concerns with Legislation to Expand List of Conditions for Medical Marijuana Program and Allows Smoking of Marijuana
Assembly Bill A7467, sponsored by Assemblymember Richard Gottfried, has moved from the Assembly Health Committee to the Codes Committee.  This measure would greatly expand New York State medical program for certifying patients for use of marijuana. The bill would expand the medical program for use of marijuana by eliminating “serious condition” and its definition of debilitating or condition to just “condition” and further expands the list of conditions.

Conditions currently eligible include: cancer,  positive  status  for  human  immunodeficiency virus or acquired immune deficiency syndrome, amyotrophic lateral sclerosis,  Parkinson’s  disease,  multiple  sclerosis, damage to the nervous tissue of the spinal cord  with  objective  neurological  indication  of intractable  spasticity,  epilepsy, inflammatory bowel disease, neuropathies, Huntington’s disease, post-traumatic stress disorder,  pain  that degrades health and functional capability where the use of medical marijuana is  an  alternative  to  opioid  use,  substance  use  disorder.  The bill would add Alzheimer’s, muscular dystrophy, dystonia, rheumatoid arthritis, autism or any other conditions to the list of conditions that the practitioner may certify.

There is a lack of scientific study regarding the use of marijuana to treat many of these conditions and using marijuana has the potential to exacerbate certain medical conditions.  This legislation would also authorize the “smoking” of marijuana as a modality for treatment.   Furthermore, the list of individuals who can certify the patient for use of marijuana would be expanded to include dentists and podiatrists.   It requires that the practitioner undergo a two hour course as determined by the commissioner of health. The Medical Society of the State of New York is opposed to this measure as we have serious concerns about government legitimizing in statute that a particular treatment is suitable without an appropriate level of scientific review.

This is yet another reason why MSSNY supports rescheduling of marijuana at federal level so that necessary research can be done.  While there is increasing evidence that shows marijuana may be a beneficial treatment for some conditions, there are also significant personal and public health risks related to its use.  The measure also encompasses many of the concepts contained in the 2019-20 Executive Budget proposals to legalize recreational marijuana.   This legislation is an attempt to further expand the use of marijuana under the guise of a “medical” program.  Senator Diane Savino is carrying the bill S. 5657 in the Senate and that bill is currently in the Senate Health Committee.      (CLANCY)


Senate Health Committee Approves Allowing Pharmacists to Use CLIA-Waived Tests; Bill On the Senate Calendar For A Vote

  1. 5092/ A. 3867, sponsored by Senate Health Chair Gustavo Rivera and Assemblymember John McDonald, has moved from the Senate Health Committee to the Senate Floor. The measure would add pharmacists to the list of licensed health care professionals authorized under public health law to perform non-invasive laboratory tests as an adjunct to their professional services. The Medical Society of the State of New York is opposed to this measure. This measure runs contrary to the continuum of integrated care that has become essential and is expected in today’s medical practice and would lead to siloed care. The present system recognizes that CLIA-waived testing of patients by pharmacists must occur under an established protocol and the supervision of a physician who can help to interpret the test results, provide needed context and most importantly set forth a care plan for the patient.   MSSNY has serious concerns that this legislation is a back-door attempt to allow for the establishment of retail clinics within pharmacies.  Additionally, there is absolutely no demonstrated need for not continuing the present system of how a CLIA-waived test is conducted in the pharmacy.  Having physician oversight of this process is an important step in protecting the continuum of health care. (CLANCY, AUSTER)

Bill to Expand Pharmacists Immunization Authority on Senate Calendar
A bill to allow pharmacists to administer all vaccines to adults is on the New York State Senate Calendar awaiting a vote.  Sponsored by Senator Rachel May and Assemblymember Amy Paulin, S. 5227/A. 6511-A would allow pharmacists to provide ALL immunizations on the Advisory Committee on Immunizations Practices (ACIP) list recommended for adults.  This bill significantly expands on legislation enacted in 2008 and 2012 which provided pharmacists only very limited ability to administer vaccinations to adults.

The bill would lift the sunset provision enacted in the 2012 legislation and make permanent the pharmacist’s authority to administer vaccinations to adults.  This law would expand a pharmacists’ current authority to provide seven vaccines to 16 vaccines that are on the ACIP schedule. Many of these immunizations are given as a series with specific time parameters, and calling back a patient within a physician’s office, where contact information available, is at times difficult.  Calling back an individual to a pharmacy to get the additional immunizations may be beyond the capability of that pharmacy.

More importantly, this legislation prevents a review by the NY Legislature as to whether pharmacists should be performing any additional immunizations that may be recommended by ACIP in the future as ACIP reviews newer vaccines.    The measure is currently pending in the Assembly Higher Education Committee.  The Medical Society opposes this bill and urges physicians to call their legislator regarding this measure.   (CLANCY)


Partial Fill Legislation on Senate Health Committee
Senate Bill S1813, sponsored by Senator Gustavo Rivera, is on the Senate Health Committee next week.   This measure allows a prescriber to issue a prescription to a patient for a Controlled Substance II, III or IV that can be filled partially.  It also allows them to prescribe up to a 30-day supply of Controlled Schedule II, III, and IV with a notation to the pharmacist that he/she should only dispense the agreed to amount. Each partial filling would be dispensed and recorded in the same manner as a refilling (i.e., date refilled, amount dispensed, initials of dispensing pharmacist, etc.).

The total quantity dispensed in all partial fillings may not exceed the total quantity prescribed. Partial fills of prescriptions for Controlled Substance II are allowable under federal law but are currently prohibited in New York State. Its companion measure, Assembly Bill 3918, sponsored by Assemblymember John McDonald, has passed the NYS Assembly.  The Medical Society of the State of New York supports this measure.    (CLANCY)


AMA Urges Delay in Marijuana Legalization Efforts
With the New York State Legislature still actively considering legislation to legalize “recreational” or “adult use” marijuana, the American Medical Association this week sent letters to Governor Cuomo, Senate Majority Leader Stewart-Cousins and Assembly Speaker Heastie urging New York State “to delay initiating the legalization of cannabis for recreational (non-medicinal) use until further research is completed on the public health, medical, economic and social consequences of its use.”

Specifically, the AMA letters raised concerns regarding “the effect of recreational cannabis legalization on public health, as well as the impact of its use particularly in high-risk populations such as youth, pregnant women and women who are breastfeeding.”  The letter also noted that “Early data from jurisdictions that have legalized cannabis demonstrate concerns particularly around unintentional pediatric exposures resulting in increased calls to poison control centers and emergency department visits, as well as an increase in traffic deaths due to cannabis-related impaired driving.”  The AMA also raised concerns that “experiences with other legal drugs (i.e., alcohol and tobacco) suggest that for-profit corporations will attempt to weaken regulations intended to protect health in order to maximize profits—resulting in significant public health harms.”

Recognizing that the State Legislature is also looking at proposals to expand the medical marijuana program for various health conditions without adequate scientific justification, the letter noted that importance of facilitating ongoing research to assure health care providers and legislators make informed decisions.  Specifically, the letter noted “the AMA believes that scientifically valid and well-controlled clinical trials conducted under federal investigational new drug applications are necessary to assess the safety and effectiveness of all new drugs, including potential cannabis products for medical use. The AMA supports efforts to ease current barriers to research by encouraging valid scientific and clinical research, expanding sources of research-grade cannabis and facilitating the commercial production of FDA-approved cannabinoid-based drugs.”  (AUSTER, CLANCY)


MSSNY and Specialties Oppose Change to Podiatric Scope of Practice
MSSNY working together with the New York State Society of Orthopedic Surgeons (NYSSOS) and other specialty societies are opposing legislation (S.5395, Jackson) that would inappropriately expand the scope of podiatrists.  The legislation advanced this week from the Senate Higher Education Committee to the Senate floor, with several Senators, including Senators Amedore, Breslin, LaValle and Robach voting without recommendation.  While purporting to be a “technical” correction of the podiatry scope statute, there are several substantive and concerning changes this legislation would make including:

  • Reducing certification requirements for podiatrists seeking to have advanced surgical privileges
  • Removing the requirement that a podiatrist seeking either standard ankle surgery or advanced ankle surgery privileges be directly supervised by a podiatrist with an advanced license from the NYSED or a physician; and
  • Would enable the treatment of wounds that are not contiguous with structures of the foot or ankle

Identical legislation (A.6185, Pretlow) remains in the Assembly Higher Education Committee.  Physicians are urged to contact their legislators to express their opposition to this proposed scope change.                                                         (AUSTER)


Veterans Matters: Military Culture: Everything Physicians Need to Know About Veterans as Patients Live Seminar in Saratoga

When: Tuesday May 28 2019 at 6:45pm (Reception at 6:00pm)

Where: Jacob & Anthony’s « 38 High Rock Road « Saratoga, NY  12866

Faculty: Lt. Col Lance Allen Wang (Ret)

Educational Objectives

  1. Describe the unique aspects of military culture and how they impact patients who are veterans
  2. Explain the Dwyer Peer-to-Peer program as a resource to assist veteran patients re-acclimating from a group to an individual mentality
  3. Review and identify resources to improve physician’s ability to fully treat veterans who are transitioning back into civilian life

For more information, contact Gregory Pinto, MD at Gregory685@aol.com or call (518) 587-0772 ext. 12

* Note: There is no charge for MSSNY members and their spouses, but there will be a $40.00 dinner charge for non-MSSNY members

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

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


Registration Now Open for Veterans Matters CME Webinar on June 5th
Register now for MSSNY’s next Veterans Matters webinar June 5th at 7:30am. This webinar is entitled Substance Use Disorders in Veterans.  Register for this program here .

Veterans Matters: Substance Use Disorders in Veterans

When:  Wednesday June 5 2019 at 7:30am – Register here

Faculty: Frank Dowling, MD

Educational Objectives

  1. Define Substance Use Disorders (SUDs), symptoms, warning signs, comorbidities
  2. Explore evidence-based intervention and treatment options for SUDs among veterans
  3. Identify barriers to diagnosis and treatment and methods to overcome them

Additional information or assistance with registration can be obtained by contacting Melissa Hoffman at mhoffman@mssny.org or (518)465-8085

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

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


pschuh@mssny.org mauster@mssny.org  pclancy@mssny.org  mavella@mssny.org
charring@mssny.org

eNews

Garfunkel Ad


Bloomberg Editorial Board: A Wise Pause on Marijuana Legalization
Bloomberg’s Editorial Board wrote a strong opinion (5/19) on the slick road to marijuana legalization pointing out the downsides in Colorado—spiking of emergency room visits and rise of fatal car accidents. MSSNY’s Immediate Past President, Dr. Tom Madejski, has led the charge to have marijuana moved from Schedule I to Schedule II so it can receive funded research on its negative and positive effects. The piece asks for more research on the long and short term effects of marijuana before rushing to legalize it.


New Yorkers Spend Less on Health Care than Other Americans
New York families with employer-sponsored coverage had the second-lowest annual spending on health insurance premiums and out-of-pocket costs among workers in the 50 states and the District of Columbia, according to a new analysis from the Commonwealth Fund.

The median New York family with a job-based plan spent a combined $2,320 on premiums and out-of-pocket costs. The median in the nation was $3,700. The data come from the two most recent editions of the Current Population Survey, which is produced by the U.S. Census Bureau. The analysis covers information reported based on insurance costs in 2016 and 2017. When isolating premiums and out-of-pocket costs, the median New York family contributed $1,300 to their plan’s premiums and spent $500 on out-of-pocket costs, such as copays and deductible payments. That compares with $2,200 and $800, respectively, nationwide. There were also a smaller percentage of families in New York for whom premium contributions represented at least 10% of household income—9.6% compared with 11.6% nationally.

The data present a vastly different picture from a December analysis by the Commonwealth Fund of employers’ benefit plans. That report noted that employer-sponsored plans in New York had some of the highest premiums in the country and fast-growing deductibles.


NY Nursing Homes’ Report Cards Average 3.19 of 5.0
The scores of New York’s nursing homes dipped to an average of 3.19 out of 5 stars in the federal government’s latest Nursing Home Compare report card, down from 3.33 in January.

However, the national average dropped even further, from 3.35 stars to 3.06. New York’s standing improved from 31st to 27th among the 50 states.

The New York City area, with 300 nursing homes rated, had the best regional average at 3.82. The 31 rated homes in the North Country had the lowest regional average at 2.16.

New York’s middling statewide performance comes in spite of high costs. The median price of a semi-private room, at $141,000 per year, was the fifth highest in the country, according to a 2018 survey by the long-term insurance firm Genworth.

The state’s per capita spending on nursing homes was 29 percent above the national average in 2014, according to National Health Expenditures data.

The state’s nursing home industry gets much better grades, as a group, than its hospitals – which collectively ranked 50th out of 50 states in the most recent Hospital Compare report card.

Individual nursing homes can be searched by state, city and ZIP code at Center for Medicare & Medicaid Services’ Nursing Home Compare website. (NY Torch Public Policy)


NYFD Backing Bill Allowing Insurance Reimbursement for Medical Services
The four largest groups representing New York firefighting organizations presented their case to state lawmakers on Monday in favor of a bill, S.3685/A.1778 that would allow fire departments to be paid for medical services by insurers. Currently, “firefighters are prohibited from charging patients for medical care provided through emergency and ambulance services,” which “differs from private ambulance companies and volunteer ambulance corps, which are able to bill patients’ insurers.” The legislation “has met resistance from insurers.” Crain’s New York Business (subscription only) (5/21)


Nassau County Medical Society to Hold Annual Meeting on May 29
Nassau County Medical Society will hold its annual membership meeting at the Westbury Manor on May 29th.  The evening will honor members who have been in the practice of medicine for fifty years and will include presentations on Legal Services: Member Benefits by Jay Silverman, Esq. and An Overview of the NYS Sexual Harassment Law by Nicole Della Ragione, Esq.  Registration and dinner begin at 6:30 pm. Click here for more informationTo reserve a seat, email chris.nassaumed@gmail.com.


CPC® CERTIFICATION PREP COURSE
BECOME A PROFESSIONAL CODING EXPERT (CPC®)
August 10th – December 7th 2019 | 9am – 5:30pm
Exam Date: December 14th, 2019 | 9am -3pm | Book Check at 8am
Includes One Year AAPC Membership (New Enrollments Only)
& Coding Books! REGISTER TODAY


Study: 5.2% of New Cancer Cases in Adults May be Attributable to Poor Diet
Researchers analyzed data from the National Health and Nutrition Examination Survey and concluded that “an estimated 80,110 new cancer cases among adults 20 and older in the United States in 2015 were attributable simply to eating a poor diet.” The study’s first author, Dr. Fang Fang Zhang of Tufts University, said, “This is equivalent to about 5.2% of all invasive cancer cases newly diagnosed among US adults in 2015,” which “is comparable to the proportion of cancer burden attributable to alcohol.” The findings were published in JNCI Cancer Spectrum. https://academic.oup.com/jncics/advance-article/doi/10.1093/jncics/pkz034/5492023


 

CMS

QPP Tip of the Month: Navigating the QPP
With annual updates to the Quality Payment Program (QPP), and especially for the Merit-based Incentive Payment System (MIPS) pathway, it can be difficult for physician practices to track year-to-year changes and integrate them into their MIPS planning. PAI’s MACRA QPP Resource Center has several resources that can help you navigate the QPP for 2019:


Classified

RENTAL/LEASING SPACE


Medical Office Space for Rent!
Beautiful Newly Renovated Medical Office on the Upper East Side between Madison and Park Avenue! Conveniently located near all public transportation and Mount Sinai Hospital. Consult and Exam room available for rent part time or full time (see pictures). Please call 212-860-0300 or email carnegiehill0062@gmail.com for further information.
Pictures of office space for rent on Madison Ave


Park Avenue Medical Office for Sale
On Park Ave, for sale is a large medical office, in a beautiful full service co-op with two entrances, one of which is an impressive doorman in lobby entrance.The office has high ceilings, easily adaptable to any specialty and priced to sell. Three good size rooms easily converted to five exams, plus consult, bathroom, reception and large waiting room. Outstanding location. A must see. View floorplan http://ow.ly/kKOI30o6MjI. Call Jeff Tanenbaum,  646-234-2226 or email jtanenbaum@halstead.com for showings and more information.


Fully Renovated Office Space for Part-Time Lease in Hauppauge
Available Tuesdays/Fridays, $450 half session, $750 full session. Elegant office space, beautiful waiting room with new stone and granite reception desk, custom molding, large windows, abundant natural light, TV, and refreshment counter.  Four new exam rooms and dictation room.  New stainless and granite kitchenette.  State-of-the-art network infrastructure meets HIPPA & PCI DSS compliance standards.  Digital X-ray room with PACS in each exam room available as an option.  Located in close proximity to LIE, Northern State Pkwy, and Vets Memorial Hwy. Contact us at (631) 486-8855;  Please see our listing: https://www.loopnet.com/Listing/517-Route-111-Hauppauge-NY/15298633/


Office Rental 30 Central Park South.
Two fully equipped exam, two certified operating, bathrooms and consultation room.  Shared secretarial and waiting rooms. Elegantly decorated, central a/c, hardwood floors. Next to Park Lane and Plaza hotels. $1250 for four days a month. Available full or part-time. 212.371.0468drdese@gmail.com.


5th Ave Medical Office for Share
Facing Central Park in exclusive building, ground floor, separate entrance.
Perfect for psychiatrist, physiatrist, osteopath, or other.
880 5th Avenue (between 69th and 70th Sts.), New York, N.Y.
Please call 917-715-2464


Rare Find — Great Office Share
Wonderful office share in terrific location at great price. Available Monday, Wednesday, Friday and weekends. Choice of smaller windowed consultation room with adjoining exam room or big windowed consultation room with one or two exam rooms. Beautiful bright rooms, lovely reception area and front . First-rate building on 58th Street between Park and Lexington. Rent by day (about $180). Front desk and office management available if needed, along with many other amenities, including internet, ultrasound, EMG Kitchen, optional C Arm. Willing to make changes for new tenant. Call 646-642-0700.


Are You Trying to Lease Your Medical Office or Sell Your Medical Practice? Trying to Sell New or Used Medical Equipment?
Clineeds, the new online platform designed for medical providers. With Clineeds you can lease your medical officeshared your office spacebuy and sell used medical equipment, or post healthcare job opportunities. LISTING IS FREE! Why wait? Click here to sign-up: www.clineeds.com/sign-up

PHYSICIAN OPPORTUNITIES

Multi-Specialty Medical Office Looking To Bring On More Doctors
New York Medicine Doctors Center is a multi-specialty Medical Agency networking some of the best medical professionals and specialists in the New York Tri-State area. Our offices currently serve both Manhattan and Queens, providing a variety of advanced technological on site testing, imaging, and services for the most rapid results.

We are actively looking to bring on board an array of Doctors specializing in Primary Care, Gynecology, Gastroenterology, ENT, Urology, Podiatry, and Dermatology.

As we continue to broaden our medical services in both locations, we also provide individualized on-boarding contracts with health benefits, tailored in-house marketing and advertising, practice management assistance, and in house team of administration dedicated in serving any and all concerns whether it be credentialing or equipment related tasks.

If you are interested in joining our growing network, please do not hesitate to contact us

at 718-360-9550 or 212-931-8533. Our direct email is drshusterman@gmail.com

Primary Contact: Oksana


Seeking Executive Director of the Onondaga County Medical Society
Concept:
 An exciting opportunity for the right person to provide leadership for physicians Salary: Commensurate with experience Job Description: Direct day-to-day operations of the Onondaga County Medical Society Some evening meetings, travel required. RequirementsExperience with leading political advocacy; political sophistication. Must know how to interface with government officials. Good networking and communication skills. Conversant with budgets and finance. Excellent media relations skills, including electronic, social media, and written communications. Familiar with medical issues and comfortable discussing them. Education: BA/BS required.  MPH or MBA desirable. We expect innovation and project initiation. The Executive Director will receive a contract that increases remuneration commensurate with membership growth. Application Instructions: Please direct your application to: Dr. Brian Johnson, johnsonb@upstate.edu.


Nurse, RN Utilization Review Full-Time-Westbury, NY (In-office position only)
Excellent opportunity for a RN who is seeking a position performing utilization review.  We require 1-2 years recent experience in hospital and/or insurer utilization review and experience using Interqual criteria and/or MCG Guidelines. Data entry/PC skills a plus. Benefits include 401(k), paid vacation and holidays. Send resume and salary requirements to: Empire State Medical Scientific and Educational Foundation, Inc. Human Resource Department e-mail: chunt@mssny.org  Fax: (1-516) 833-4760 Equal Oppty Employer M/F


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

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 


Council May 30, 2019

AGENDA
MSSNY Council Meeting
Thursday, May 30, 2019, 9:00 a.m.
Courtyard Marriott, Westbury Long Island
1800 Privado Road
Westbury, NY  11590

A. Call to Order and Roll Call

B. APPROVAL of the Council Minutes of Sunday, April 14, 2019 (HOD)

C. New Business (All Action & Informational Items)

1. President’s Report
a. 2019 HOD Resolutions referred to Council (For Council Approval)
b. Presidential Appointments to MSSNY’s Executive Committee of the Council:
 (For Council Approval)
Parag H. Mehta, MD (At-Large-Member)
Gregory L. Pinto, MD (At-Large-Member)

2. Board of Trustees Report –  Dr. Sam Unterricht will present the report                         (handout)

3. Secretary’s Report – Dr. Frank Dowling will present the report

4. MLMIC Update  – Mr. Michael Schoppmann, Esq. will present the report

5. AMA Report – Dr. John Kennedy will present the report

6. MSSNYPAC Report – Dr. Thomas Lee will present the report (handout)

7. MESF Update – Dr. Thomas Madejski will present the report (handout)

8. CME Update – Dr. Mark Adams will present the report

9. County Federation Report – Aaron Kumar, MD will present the report

10. Councilors’ Action Reports
   (No written reports submitted)

11. PresentationOverview of Stark and the Anti-Markup Rule
             Presented by Hayden Wool, Esq. Partner Director, Garfunkel Wild

D. Reports of Officers (Verbal Reports)   

  1. Office of the President – Arthur C. Fougner, MD
  2. Office of the President Elect – Bonnie L. Litvack, MD
  3. Office of the Vice President – Joseph R. Sellers, MD
  4. Office of the Treasurer – Mark J. Adams, MD
    Financial Statement for the period 1/1/19 – 4/30/19
  5. Office of the Speaker – William R. Latreille, Jr., MD

E. Reports of Councilors (Informational)

  1.   Kings & Richmond Report – Adolph B. Meyer, MD
  2.   Manhattan & Bronx Report – Joshua M. Cohen, MD
  3.   Nassau County Report – Paul A. Pipia, MD
  4.   Queens County Report – Saulius J. Skeivys, MD
  5.   Suffolk County Report – Linda S. Efferen, MD
  6.   Third District Branch Report – Brian P. Murray, MD
  7.   Fourth District Branch Report – Gregory Pinto, MD
    (no written report submitted)
  8.   Fifth District Branch Report –Howard H. Huang, MD
  9.   Sixth District Branch Report – Robert A. Hesson, MD
  10. Seventh District Branch Report – Janine L. Fogarty, MD
  11. Eighth District Branch Report – Edward Kelly Bartels, MD
  12. Ninth District Branch Report  – Thomas T. Lee, MD
  13. Medical Student Section Report – Peter Joo
    (no written report submitted)
  14. Organized Medical Staff Section – Stephen F. Coccaro, MD
  15. Resident & Fellow Section Report – Catherine E. Steger, DO
    (no written report submitted)
  16. Young Physician Section Report – L. Carlos Zapata, MD
    (no written report submitted)

F. Commissioners (Committee Informational Items)

  1. Commissioner of Communications, Maria A. Basile, MD, MBA
    a. Report from the Division of Communications
  2. Commissioner of Governmental Relations, Gregory Pinto, MD
    a. Collective Negotiation & Integration Minutes, May 17, 2019
             b. Governmental Affairs Report
  3. Commissioner of Membership, Parag H. Mehta, MD
        (No written report submitted)
  4. Commissioner of Science & Public Health, Joshua M. Cohen, MD
    a. Legislation Efforts on Medical Exemptions Due to the Measles Outbreak
    Presented by:
    Patricia Clancy, Vice President for Public Health & Education
    xx
    b. “ The Measles outbreaks in Orthodox Jewish Communities”
    Presented by:
    Dr. Awi Federgruen
    Charles E. Exley Professor of Management, Columbia University
    xx
    Dr. Daniel Berman
    Infectious Disease Specialist, Montefiore Medical Center & a member of          MSSNY
    xx

  5. Commissioner of Socio Medical Economics, Howard H. Huang, MD
    (No written report submitted)

G. Report of the Executive Vice President, Philip Schuh, CPA, MS

  1. Membership Dues Revenue Schedule
  2. Group Institutional Dues Comparison Report 

HReport of the General Counsel, Barry Cepelewicz, MD, Esq.
    Garfunkel Wild, P.C.
    (No written report submitted)

I. Report of the Alliance, Joan Cincotta, Co-President
 1. Alliance Report

JOther Information/Announcements

  1. MSSNY Executive Committee Minutes, April 11, 2019
  2. Sign On Letter – QPP Experience Report & Appendix
  3. PAI Letter – QPP Experience & Report
  4. AMA Letters – Concern about legalization of cannabis for recreational use

K. Adjournment

 

 

 

 

MEDIA ADVISORY – Demand Action to Remove Non-Medical Exemptions for School Attendance 


MSSNY Seal
MEDICAL SOCIETY OF THE STATE OF NEW YORK
865 Merrick Avenue, Westbury, New York 11590-9007
www.mssny.org
Communications Division
Telephone: (516) 488-6100

 

For Immediate Release
May 20, 2019

MEDIA ADVISORY

With Nearly 800 Cases of Measles in New York,
Lawmakers, Physicians, Nurses and Public Health Groups to Demand Action on
Bill to Remove Non-Medical Vaccine Exemptions for School Attendance 

When: Tuesday, May 21st 2:00 pm
Where: Assembly Staircase, 3rd Floor Capitol Bldg. outside Assembly chamber

Speakers at the press conference will be:

  • Assemblyman Jeffrey Dinowitz, sponsor of A.2371 and other members of the Assembly Health Committee
  • Senator Brad Hoylman, sponsor of S.2994 and other senators
  • Arthur Fougner, MD, MSSNY President
  • Monica Sweeney, MD, Internal Medicine Physician, Member, MSSNY Infectious Disease Committee
  • Shetal Shah, MD, FAAP, NYS AAP, District II, Vice President of Chapter 2, Chair of the Chapter 2
  • Sarah Ravenhall, MHA, CHES, Executive Director, New York State Association of County Health Officials (NYSACHO)
  • Erin E. Jones, Regional Director of Advocacy and Government Affairs, March of Dimes
  • Other supportive organizations representing physicians, nurses and patient/ public health interests 

Why:  According to the State and City Health Departments there were 772 measles cases in New York alone, as of May 14th.  NY State is seeing sharp increases in diagnoses with each week of inaction, and cases have been diagnosed in Brooklyn and six counties outside NYC.

The time for action is now.  Medical experts, together with state legislators and public health organizations, will call for immediate action to address a major barrier to “herd immunity” in order to begin to stem the tide of this highly contagious disease in the state.

# # #

About the Medical Society of the State of New York
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.

MSSNY Contact:
Pat Clancy
Senior Vice President, Public Health and Education/Managing Director
Medical Society of the State of New York
pclancy@mssny.org 518-465-8085

 

 

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