MSSNY COVID-19 Update – March 29, 2020

Physicians are required to report suspect cases to their local department of health.

Microscopic view of COVID-19

March 29 Statistics

New York State: 44,635 confirmed cases, 285 deaths. New York City: 29,766 confirmed cases; 672 deaths, 5,537 Nassau; 4,138 Suffolk; 7,875 Westchester, 1,986 Rockland; 195 Albany.

United States: 124,686; deaths: 2,191; 2,612 recovered. World Count: 716,701 confirmed; 31,882 deaths. 

For a complete NYS county list, click here.



March 28

· Medicare Fee-for-Service (FFS) Response to the Public Health Emergency on the Coronavirus (COVID-19)

· Executive Order of Suspension of Non-Essential Elective Surgeries

· Operationalizing State-Wide Ban on Elective Surgery

· List N: Disinfectants for Use Against SARS-CoV-2

· Psychosocial Impact of COVID-19 (podcast)


Telehealth

· Humana Telehealth Update

· How to Set Up Free Telemedicine for Your Patients – Part I

· Telemedicine in Practice – Part 2

· Emergency Medical Aid and Telemedicine

· Comprehensive Guidance Regarding Use of Telehealth 

· Expansion of Medicare coverage for telehealth (so it is no longer limited to rural areas)

· Assuring physicians can use Facetime and Skype for telehealth without worrying about HIPA

· COVID-19 Physical, Occupational and Speech Therapy Telehealth

· Telehealth Insurance Circular Letter No. 6 (2020)
Reminder that private insurers must cover telehealth services for patients (including those provided through a smartphone) and without patient cost-sharing.

· COVID-19 Telephonic Communication Services
Since Medicare still requires telemedicine to be provided only to patients in a rural setting, you should look at “virtual check in” services under codes  G2010, G2012, 99421, 99422 and 99423.

· State regulated insurers re: required telehealth coverage for all health care services without patient cost-sharing “including technology commonly available on smartphones and other devices”.

· Telehealth Benefits in Medicare are a Lifeline for Patients During Coronavirus


Patients

• Precautions Physicians Should Take (from NYSDOH)

• Evaluating and Reporting Persons Under Investigation (PUI)

• Patient Information on COVID-19 (Podcast)

• Patient precautionary Flyer


Financial

· Trump Administration Approves 34th State Request for Medicaid Emergency Waivers

· Small Business Provisions in Coronavirus Aid, Relief, and Economic Security (CARES) Act

· Tax Day now July 15: Treasury, IRS extends filing deadline and federal tax payments regardless of amount owed


• AMA Letter Urging Federal Assistance for personal protection equipment (PPE) for Physicians

• Medicare Administrative Contractor (MAC) COVID-19 Test Pricing

• FAQs on Essential Health Benefits Coverage and COVID-19

• WC: Laws, Regulations and Decisions

For Medicare fees, go to ngsmedicare.com and do a fee schedule look up for your specific locality (01, 02, 03, 04, or 99).

• Infection Prevention for Self Quarantine

Questions:

• NYS has a coronavirus hotline at 1-888-364-3065.
• The New York State Department of Health has established a provider email account for physicians to ask questions about COVID-19: Covidproviderinfo@health.ny.gov

MSSNYeNews: What Matters – March 27, 2020

Arthur Fougner MSSNY Presiident

PRESIDENT’S MESSAGE
Arthur Fougner, MD
MSSNY President

MSSNY eNews
March 27, 2020

Vol. 23  Number 13



MSSNYPAC Seal

 


Colleagues:

In the midst of pandemics, budget battles, regulations, legislation, resolutions, reality has the nasty habit of jumping into the mix like a collection notice from a bill long since forgotten. Never easy, certainly never pleasant, but there it is. Life told me to pass on its very hard lesson so here goes. Don’t worry, I will keep it short.

We are all here for a blink of the cosmic eye. We live, we laugh, we cry, we dance and then we are gone.

Embrace those around you. Friends and enemies are but two sides of the same coin. What’s important are family, colleagues, and yes, our patients. Everything else is just so much of life’s gift-wrapping – pretty but soon discarded. Embrace those around you – albeit virtually in the Age of Coronavirus – but embrace nonetheless. Remember that it’s what matters that truly matters.

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

Arthur Fougner, MD
MSSNY President



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CORONAVIRUS UPDATE

The state reports 44,635 confirmed cases and 519 deaths statewide, as of Friday morning, including 25,398 cases in New York City, 7,187 in Westchester County, 4,657 in Nassau County, 3,385 in Suffolk County, 1,457 in Rockland County, 910 in Orange County, 225 in Dutchess County, 219 in Erie County, 187 in Albany County, and 160 in Monroe County.
Coronavirus COVID-19 Global Cases by Center for Systems Science & Engineering at Johns Hopkins University


Main Points from Governor Cuomo’s On-going Announcements:

  • Extending the school closures until April 15th, as well as the 180-day mandate waiver.
    – Continuation of distance learning.
  • Additional bed sites / requesting temp hospital from FEMA, 4,000 more over 4 sites:
    – Bronx: NY Expo Center
    – Queens: Aqueduct
    – Brooklyn: Brooklyn Cruise Terminal
    – Staten Island: College of Staten Island
  • Looking at CUNY City College and CUNY Queens College as additional site
  • Looking at Marriott Brooklyn Bridge and Brooklyn Center Nursing Home as additional sites.
  • For a 60-day period, consumers and small businesses experiencing financial hardship due to COVID-19 may defer paying premiums for property and casualty insurance, including auto, homeowners, renters, workers comp, medical malpractice, livery and taxi. No late fees will be assessed and no negative data will be reported to credit bureaus during this time, and late payments will be payable over a one-year period.

NYS Asks Physicians to Volunteer During COVID-19 Pandemic
Governor Andrew Cuomo and the New York State Department of Health is requesting that physicians and other health care providers volunteer during the COVID-19 pandemic. Many MSSNY physicians have inquired about the process and the NYS Department of Health is coordinating volunteers for this effort.  All physicians, even retired physicians, must go through this portal.

There are a series of questions that are asked regarding name, specialties and certification, age, county of residency.  By completing the form, DOH and SED will check that your credentials are up to date and, if needed, recertify the physician.  Out of state physicians and health care providers should also use this portal.  Earlier this week the governor announced civil liability immunity protections for physicians and other health care practitioners in responding to the state’s COVID-19 outbreak.

According to officials from the NYS Department of Health, retired physicians and other health care providers will most likely be redirected to care for patients that are not afflicted with COVID-19.  Activation will be from either the New York State Health Department or the local county health department.

The Department of Health developed the ServNY volunteer registry in partnership with county health departments, the New York City Department of Health and Mental Hygiene, the Medical Society of the State of New York, hospital associations, and other medical professional organizations. Physicians can volunteer through their Health Commerce System Account by going to the ServNY portal at: go to www.health.ny.gov/ServNY

The registry, established in the aftermath of the 9/11 terrorist attacks, is currently used by all local health departments and Medical Reserve Corps for management of volunteer programs.

As New York state climbs the steep face of its COVID-19 curve, Gov. Andrew Cuomo (D) issued an executive order vastly widening the scope of practice for some healthcare providers and absolving physicians of certain risks and responsibilities.

Among the order’s provisions:

  • Eliminating physician supervision of physician assistants (PAs), nurse practitioners (NPs), certified registered nurse anesthetists, and others
  • Enabling foreign medical graduates with at least a year of graduate medical education to care for patients
  • Allowing emergency medical services personnel to operate under the orders of NPs, PAs, and paramedics
  • Allowing medical students to practice without a clinical affiliation agreement, and lifting 80-hour weekly work limits for residents
  • Granting providers immunity from civil liability for injury or death
  • Suspending usual record-keeping requirements
  • Allowing several types of healthcare professionals — including NPs, PAs, nurses, respiratory therapists, and radiology techs — with licenses in other states to practice in New York. However, physicians were not specifically included in the order, as the Department of Health and Human Services has not yet issued the necessary regulation
  • Suspending or revoking hospitals’ operating certificates if they don’t halt elective surgeries

The order, which remains in place through at least April 22, was met mostly with applause, though with some hesitation around work-hour limits. (MedPage, March 27)


What’s in Stimulus Package: Provisions of Interest to Physicians
Late Wednesday night the Senate approved a massive $2 trillion stimulus and COVID-19 relief package. House passage is expected on Friday and the President is expected to sign the bill into law.

Provisions of particular interest to physicians and their practices include the following:

  • Creates a new loan product within the Small Business Administration for loans of up to $10 million to help cover payroll and overhead costs, with expanded loan forgiveness criteria. Physician practices with not more than 500 employees may qualify.
  • $100 billion in direct financial support to hospitals, physician practices, and other health care providers under the Public Health and Social Services Emergency Fund. This support is for costs of treating COVID-19 patients as well as to ease the financial impact on those who lose revenue due reductions in other services as a result of the pandemic. Exact eligibility criteria and application process is not yet defined pending implementation.
  • Suspension of the 2% Medicare sequester in May through December 2020.
  • Limitations on liability for volunteer health care professionals during COVID-19 emergency response.
  • A temporary waiver of the face-to-face visit requirement with home dialysis patients.
  • Authority for the Secretary of HHS to waive telehealth coverage requirements for new patients during a national emergency. Previous legislation provided flexibility only for established patients seen within the past three years.
  • Secretary will also allow for enhanced use of telehealth under Medicare for federally qualified health centers.

Also of interest, the “health extenders” package that was set to expire on May 22 has now been extended to Nov. 30. For a complete summary once the bill is signed into law, visit the AMA COVID-19 website.


WEBINARS

Registration Now Open “Psychosocial Dimensions of Infectious Outbreaks” WEBINAR

April 1st @ 7:30am
REGISTRATION NOW OPEN HERE 

MSSNY’s has expedited the presentation of the next Medical Matters webinar “Psychosocial Dimensions of Infectious Outbreaks” on Wednesday April 1st at 7:30am.  This program provides physicians with vital information to care for patients, staff, family and themselves during this unprecedented pandemic. 

Faculty for this program is Craig Katz, MD.

Educational Objectives are:

  • Understand common human reactions to infectious outbreaks
  •  Explore factors that influence how people react
  • Describe how to apply historical lessons to your own medical practice

This program is a companion piece to the March 18th coronavirus webinar, Coronaviruses 2020: COVID-19 An Evolving Story.  You can go to the MSSNY CME website https://cme.mssny.org to view this and many other free CME webinars that are particularly relevant to the current pandemic situation. 

Medical Matters is a series of Continuing Medical Education (CME) webinars sponsored by MSSNY’s Committee on Emergency Preparedness and Disaster/Terrorism Response.

You can also listen to the podcasts MSSNY has produced about COVID-19 by clicking on the links below:

The Psychosocial Impact of COVID-9
Physician Information on COVID-19
Patient Information on COVID-19

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

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

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


Navigating A Murky Landscape: An Employer’s Guide to Responding To Challenges of COVID-19

Monday, March 30, 2020
2:30 PM – 3:30 PM EDT

The outbreak of the global COVID-19 virus has confronted employers with unprecedented challenges in maintaining their workplaces and operational viability. With ever-increasing speed, new laws are being enacted by the Federal and local governments that are designed to soften the economic and health and safety impacts posed by the COVID-19 virus, but which also, no matter how well intentioned the legislatures, create confusion about available feasible options for employers on how to move forward in sensible, compliant and practicable fashion.

Garfunkel Wild PC will be presenting a webinar designed to assist employers in tackling these steep challenges. The webinar will address such issues as:

  • Highlights of the updated Federal leave laws.
  • Highlights of the updated New York State leave laws.
  • What is the type of “order” that triggers an employee’s entitlement to leave under the new statutes?
  • Who is a healthcare provider?
  • Staff reductions, reduction in hours and terminations.
  • An employer’s obligations under the WARN Act.
  • Practical considerations on dealing with the challenges.

Pain Management, Palliative Care and Addiction Online Program Now Available
The Medical Society of the State of New York Pain Management, Palliative Care and Addiction modules are now available on-line here.

The Medical Society of the State of New York announces an updated series of three one-hour CME webinars on pain management, palliative care and addiction.  New York State statute requires all prescribers, holding a DEA license, to complete three hours of coursework every three years.  Coursework must include the following:

  • New York State and federal requirements for prescribing controlled substances
  • Pain management
  • Appropriate prescribing
  • Managing acute pain
  • Palliative medicine
  • Prevention, screening and signs of addiction
  • Responses to abuse and addiction
  • End of life care

These modules are being offered free of charge to all MSSNY members.  Physicians who are new users to the MSSNY CME site will be required to register as a new user.   Non-MSSNY members will be charged $50 per module.

Series programs include:

Understanding the Current Legal Landscape in New York State for Prescribing Controlled Substances

Faculty: Patricia Bruckenthal, PhD, APRN-BS, FAAN & Robert Kent, Esq., NYS OASAS General Counsel

Educational Objectives:

  • Understand New York State and Federal Requirements for Prescribing Controlled Substances
  • Discuss Guidelines for Chronic Pain

When to Consider Opioid Therapy for Chronic Non-Cancer Pain & in Palliative Care

Faculty: Charles Argoff, MD
Educational Objectives:

  • Discuss evidence based best practice recommendations for opioid therapy for chronic pain, patient risk assessments and documentation
  • Describe palliative medical care and end-of-life care

Patients with Opioid Use Disorders: Identification, Treatment, and Management of Co-occurring Pain

Faculty: Jeffrey Selzer, MD, Marc Manseau, MD, MPH, NYS OASAS Medical Director
Educational Objectives:

  • Describe the Potential for Addiction, Patient Screening, Diagnosis and Subsequent Treatment or Referral
  • Recommend Tools to Assist in the Identification of High-Risk Patients for Whom Opioids are Indicated and Prescribed
  • Describe Strategies for Treating Pain in Patients with Substance Use Disorders

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

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

Additional information or assistance may be obtained by contacting Melissa Hoffman at mhoffman@mssny.org or 518-465-8085

REGISTER NOW


CMS

Medicaid Allowing Phone Visits Only for Telemedicine
Medicaid is allowing phone, only for telemedicine, during the pandemic.  WC is following Medicaid rules listing the codes as 99441, 99442 and 99443.  I don’t think these codes will result in PAYMENT parity.

But, most plans, including Medicare and Medicaid, are accepting 99211 – 99215, with the GT modifier, which should result in payment parity.  If there is a medical condition, psychiatrists and ophthalmologists should also be able to use these codes, as well.

In addition, with the rules being relaxed including HIPAA rules, use of an iphone or similar equipment with audio/video for telemedicine is being accepted during this pandemic. (Regina McNally, VP MSSNY Socio-Medical Economics Div.)


CMS Call: Lessons from the Front Lines-Saturday, March 28 12noon-2:00 PM
On behalf of CMS Administrator Seema Verma, FDA Commissioner Stephen Hahn, MD, and the White House Coronavirus Task Force, I am writing to invite the physician membership of your organization to the next call in our new series for physicians: Lessons from The Front Lines: COVID-19.

The call will take place on Saturday, March 28th from 12:00 PM – 2:00 PM EST, and the topic of discussion is: COVID-19 Therapeutics. We invite you to join us to share your ideas, strategies, and insights with one another.Please see dial-in details below. Conference lines are limited, so we highly encourage you to join via audio webcast, either on your computer or smartphone web browser.

Participant Dial In: 877-251-0301
Conference ID: 9409959
Audio Webcast https://protect2.fireeye.com/url?k=0d59a9bc-510ca0af-0d599883-0cc47adb5650-9ac2bdf1f2555d1a&u=https://engage.vevent.com/rt/cms2/index.jsp?seid=1738

If you have specific best practices related to COVID-19 therapeutics you are interested in sharing with your peers, please respond to me by 5 PM today and we would be glad to add you to our agenda. 

As always, we appreciate your feedback and collaboration as we address this important issue together.


US Has Fewer Physicians and Hospital Beds Per Capita than Italy and Others
A new analysis and chart collection finds that the U.S. has fewer hospital beds and practicing physicians per capita than many similarly large and wealthy countries with health care systems already strained by the ongoing COVID-19 pandemic.

Compared to Italy and Spain, two countries in which hospitals have already been overwhelmed by an influx of COVID-19 patients, the U.S. has fewer practicing physicians per capita – 2.6 per 1,000 people, compared to 4.0 in Italy and 3.9 in Spain – but more licensed nurses. While the U.S. has a higher number of total hospital employees than most comparable countries, nearly half of that workforce is comprised of non-clinical staff who are not directly involved in delivering care. (KFF-Petersen March 27)


Upstaters Want Downstaters to Stay Away
In an attempt to slow the spread of the novel coronavirus, Upstate counties are warning anyone traveling from New York City to self-quarantine for two weeks or stay away entirely. The requests have no legal backing as only Gov. Andrew Cuomo could give such an order, but they come as the number of cases in New York City continue to grow and upstate health departments predict that they could soon see a similar surge, possibly overwhelming their capabilities. Governors in at least two states have also mandated that anyone who travels from the New York metro area must self-quarantine for two weeks after arriving.

Wednesday evening, county leaders in Rensselaer and Saratoga counties asked Cuomo order that anyone who travels from Westchester or New York City to self-quarantine, following a recommendation from Deborah Birx, the White House coronavirus response coordinator. On Thursday, Rensselaer County Executive Steve McLaughlin asked Cuomo to ban non-essential travel from the same areas. McLaughlin said five Troy residents who tested positive for COVID-19 had recently re-located from New York City. (Times Union, March 27)


Army Field Hospitals to Start Taking Non-COVID-19 Patients in NY on Monday
Three Army field hospitals have begun to deploy to New York and Washington state, the regions hit hardest by the coronavirus, and the facility in New York will start taking non-COVID-19 patients on Monday, according to Army officials.

  • The Army field hospitals will provide 284 beds in New York and 248 in Seattle to relieve stress on hospitals treating patients stricken with the coronavirus, Army Chief of Staff Gen. James McConville told reporters today.
  • The advanced party from the Army’s 531st Hospital Center from Fort Campbell, Ky., and the 9th Hospital Center from Fort Hood, Texas, are already on the ground in New York, McConville said. The main party will arrive at Joint Base McGuire-Dix-Lakehurst, N.J., Friday, and will set up at the Javits Center in Manhattan this weekend, McConville said.
  • The New York National Guard, the Army Corps of Engineers and Javits employees are hard at work converting the Javits Center into a makeshift disaster hospital with 1,000 beds to help with the city’s coronavirus response.
  • In total, roughly 650 personnel are heading to New York and a little over 600 to Seattle to help with the crisis, Army officials said. (Politico Pro 03/26/2020 02:50 PM EDT)

Do Not Bill for Telemedicine Until Further Instruction
I just was on a call with NGS MEDICARE.  They state they have not received direction from CMS on how to process claims for telemedicine.  Therefore, NGS MEDICARE is asking that telemedicine claims NOT BE SUBMITTED until CMS provides NGS with clear instructions regarding telemedicine claims processing procedures.  This is in an effort to avoid unnecessary claim denials.

As soon as NGS MEDICARE hears from CMS, they will advise us.

–From Regina McNally, VP MSSNY’s Socio-Med Economics Div.


Medicaid Guide re Use of Telehealth
An updated version of the Medicaid Update Special Edition – Comprehensive Guidance Regarding Use of Telehealth including Telephonic Services During the COVID-19 State of Emergency, which now includes clarifications for FQHC billing as well as billing for home care providers, has been posted. This guidance was originally issued on March 21, 2020. The Department will be scheduling a webinar shortly to walk through this guidance and a set of FAQs for Medicaid telehealth are under development.

This document will be updated frequently so please continue to check the COVID-19 Guidance for Medicaid Providers webpage and the Medicaid Update webpage  for updates and amendments.


AMA: Ethical Challenges in a Pandemic
The COVID-19 pandemic poses ethical challenges and exceptional demands for physicians in the United States.

While caring for the anticipated surge of seriously ill COVID-19 patients, physicians are very likely to encounter heart-wrenching decisions. Meanwhile, physicians face having to balance the obligation to provide urgent medical care during emergencies, with risks to their own safety, health or life. The current pandemic offers each member of the medical profession a unique opportunity to reflect anew on medical ethical dilemmas that arise in the face of adversity.

During the COVID-19 pandemic, some of these ethical challenges will include:

  • Allocation of limited resource
  • Caring for patients in the face of personal risk
  • Use of quarantine and restrictions of personal liberty

The Code of Medical Ethics offers detailed ethical guidance to physicians on these issues that will help physicians approach the difficult decisions in the days ahead.
For more information, please see the AMA’s list of newly released resources on ethical challenges that arise during pandemics


MLMIC: Staff Ready to Answer Questions 24/7
Due to the minute by minute changes regarding COVID-19, MLMIC is keeping our insureds informed via email blasts, our website, blog, as well as through our social media accounts via Twitter and Linked In.

For those insureds who face challenges to their practice due to COVID-19, MLMIC is offering the following:

  • MLMIC’s toll free 24/7 Legal Hotline – (855) FAKS-LAW (1-855-325-7529) can help address many questions or concerns that may arise.
  • Our staff remains directly available via phone (800) ASK-MLMIC(1-800-275-6564) and every effort will be made to handle inquiries and answer questions regarding claims, coverages and policies on an immediate basis.
  • Blog:  Guidance on Using Telemedicine for Coronavirus – click here

 

This Week’s Legislative Podcast


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SIGN UP TO RECEIVE ALERTS FROM MSSNY’S GRASSROOTS ACTION CENTER

MSSNY Grassroots Banner

When you subscribe to the Medical Society of the State of New York Grassroots Action Center, the Division of Governmental Affairs will alert you when legislation and issues of importance to physicians and patients, either in the NYS legislature or in Congress, are at critical stages.

Accordingly, contact from constituents would be vital to influencing the path and future of that legislation or issue.

Alerts will be accompanied by recommended actions you or your designee can take to have maximum impact such as calling, tweeting and emailing a customizable letter to your legislators.

If you are concerned with health care policy formation in New York State, please subscribe today by texting MSSNY to 52886 and you will be prompted to enter your email address.  When you sign up, it is best to use your NY-based voting address or practice address (if you do not reside in NY) for your alerts.

Contact the Division of Governmental Affairs at 518-465-8085 or albany@mssny.orgThank you. (WILKS)


 

COVID-19 Update March 26, 2020

CORONAVIRUS UPDATE
The state reports 37,258 confirmed cases and 385 deaths statewide, as of Thursday morning, including 21,393 cases in New York City, 5,944 in Westchester County, 3,914 in Nassau County, 2,735 in Suffolk County, 1,197 in Rockland County, 751 in Orange County, 190 in Dutchess County, 171 in Albany County, 139 in Monroe County, and 134 in Erie County. (City and State 3/26/2020)

The U.S. COVID-19 death toll surpassed 1,000, with 1,046 deaths as of 8 a.m. CDT March 26. Nationwide, 69,197 American cases have been reported. Worldwide, 487,648 COVID-19 cases and 22,030 deaths have been reported, while 117,749 people have recovered from the illness.


Governor Cuomo’s Daily Press Conference

  • Governor scouting additional sites for overflow, 1,000 plus overflow in each of the downstate counties, in addition to simultaneously increasing current facility capacity.
    – Queens, Brooklyn, Bronx, Manhattan, Staten Island, Nassau, Suffolk, Westchester, Rockland
  • Approved splitting of ventilators.
    – Converting anesthesia machines into ventilators.
  • Shifting load from downstate hospitals to upstate hospitals, and expanding upstate hospital capacity
  • Lost revenue estimated between $10B and $15B.
  • Fed Stimulus Bill:
    – Unemployment insurance, and small businesses addressed
    – Does not help governmental losses, Governor described this portion as a failure, and irresponsible.
    -NYS gets $5B, only for COVID-19 expenses.
    – Does not know how much revenues are down, do not know the forecast for economic activity, nor additional federal response.
    – State will adjust down revenue projections if needed.
    – Adjust the budget through the years to reflect the actual revenue, and adjust spending down accordingly to match the actual revenue. This will be on a yet-to-be determined schedule. (Moe Auster, Senior VP MSSNY Govt. Affairs)

Frontline Physicians: Are You Available for Media Interviews?
If you are a MSSNY member on the front lines of the COVID-19 pandemic (ideally in emergency or critical care) and are able to make yourself available to do press interviews, please contact Julie Vecchione at jvecchione@mssny.org or 516.488.6100 x340.


Are You a Retired Physician Who Has Signed Up to Serve? Call us!
Are you a retired MSSNY member that has heeded the call to come out of retirement to serve on the front lines of the COVID-19 pandemic? If so and you’re able to make yourself available to do press interviews, please contact Julie Vecchione at jvecchione@mssny.org or 516.488.6100 x340.


NGS Medicare Will Receive Claims for Telemedicine
NGS Medicare can receive claims for telemedicine now. CMS has provided instructions to the Medicare contractor. (Regina McNally (VP Socio-Medical Economics)

MSSNY Members’ Telemedicine Directory: Are You Interested?
As we continue to confront the challenges of the COVID-19 outbreak, and helped by laws ensuring health insurance coverage, a significant number of physicians have incorporated telehealth into their medical practices.

With this growth is a need for physicians to be able to refer their patients to different specialists who may also have incorporated telehealth into their practices. MSSNY is examining the logistical and legal challenges of creating a telehealth “referral” directory. If such a telehealth specialty directory were to be created, would you be interested in being part of such a directory?

If you would like to be part of this directory, please email Steve Sachs at ssachs@mssny.org. Please include your full name and email address.


Cuomo Blasts Federal Relief Package as ‘Terrible’ for New York
Gov. Andrew Cuomo says the emergency deal struck between the U.S. Senate and the Trump administration for coronavirus relief “would be really terrible” for his state, even as his fellow New Yorker, Minority Leader Chuck Schumer, called the package a negotiating victory.

Cuomo, who has consistently criticized New York’s allotments of federal aid during the pandemic, said during a press briefing on Wednesday that New York would get roughly $3.8 billion from the $2 trillion package, “a drop in the bucket as to need.”

Schumer’s office characterized the deal differently, saying New York would receive more than $40 billion when totaling unemployment insurance, hospitals and transportation funding. That includes $5.8 billion to local governments in the state — about $1.4 billion for New York City and about $500 million to Long Island.

“Like all compromise legislation, this bill is far from perfect — but it now does much more for this state, its people and its future than where we began,” Schumer said in a release.

It’s not entirely clear which portion the governor was criticizing, but Cuomo seemed to be focused on the expected state share of the expenditure relief. He said he told the state’s congressional delegation “this doesn’t do it.”

Cuomo said the state already has spent roughly $1 billion on its response and will probably spend several billion more by the time the pandemic is over. His budget office predicted on Tuesday that state revenue losses could be as high as $15 billion.

Cuomo said the previous House version of the bill would have given New York about $17 billion, and he is in conversations with representatives in the House about adjustments.

The House is expected to pass the legislation by the end of the week. (3/25 Politico)


Tail Coverage for Physicians Who Come out of Retirement

  1. Q. If I come out of retirement to assist during the COVID-19 pandemic, will it terminate my free tail coverage with MLMIC? Will I be covered for the work I am returning to do under my free tail coverage?
  2. A. If you come out of retirement to assist during the COVID-19 pandemic, it will not terminate your free tail coverage from MLMIC, nor will it alter your ability to report claims from your expired policy. However, you will need new coverage for the work you are returning to do. You can check to see if you have this coverage from your employer or hospital, or if you would like to speak with us about providing this coverage, please call or email us.
    (Regina McNally, VP Socio-Medical Economics)

MSSNY Offers CME Programs-Registration for April 1 Medical Matters
Now Available

The Medical Society of the State of New York is pleased to be able to offer physicians’ on-line programming for Continuing Medical Education (CME). A variety of programs, including a COVID-19 update with the New York State Department of Health and our updated pain management course (free to MSSNY members) are available here.

Physicians who are new to the site will need to establish an account; and physicians who have used the site need only to login in with their user name and password. The majority of courses on the website are free to physicians.

Additionally, MSSNY hosts many “live” webinars and the next one is on Wednesday, April 1, 2020.  

Physicians can register for this program at the link below! 

Psychosocial Dimensions of Infectious Outbreaks”
April 1st @ 7:30am

REGISTRATION NOW OPEN HERE.

MSSNY’s has expedited the presentation of the next Medical Matters webinar “Psychosocial Dimensions of Infectious Outbreaks” on Wednesday, April 1st at 7:30am. 

This program is a companion piece to the March 18th coronavirus webinar.  This program provides physicians with vital information to care for patients, staff, family and themselves during this unprecedented pandemic.

Faculty for this program is Craig Katz, MD.

Educational Objectives are:

  • Understand common human reactions to infectious outbreaks
  • Explore factors that influence how people react
  • Describe how to apply historical lessons to your own medical practice

Medical Matters is a series of Continuing Medical Education (CME) webinars sponsored by MSSNY’s Committee on Emergency Preparedness and Disaster/Terrorism Response.  A copy of the flyer for this program can be accessed here. 

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

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

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

If you missed it last week, Medical Matters: Coronaviruses 2020: COVID-19 An Evolving Story is now available here.

The MSSNY CME website also has a number of free preparedness courses that are invaluable in this time of uncertainty and unprecedented need for preparedness.  Below is a list of just some of the courses that will assist physicians to better prepare:

Medical Matters Courses:

  • Coronaviruses 2020: COVID-19 An Evolving Story
  • Disaster Medicine Every Physician’s Second Specialty
  • Doctor Are You Ready?
  • The Importance of Resilience After a Disaster
  • Principles of Isolation and Quarantine: Epidemiology as a Decision Maker
  • Public Health Preparedness 101
  • Virtual Drill: Incident Command System & Crisis Communications

Emergency Preparedness:

  • Physician’s Electronic Emergency Preparedness Toolkit (Modules 1-4)

Please note, if you do not already have an account there, you will need to create one, this is separate from MSSNY’s home page.

For more information or assistance, please contact Melissa Hoffman at mhoffman@mssny.org or pclancy@mssny.org.


Dr. Fauci: We Should Prepare for “Inevitable” Cycle of Outbreaks
Americans should prepare for “inevitable” cyclic COVID-19 outbreaks, Anthony Fauci, MD, head of the National Institute of Allergy and Infectious Diseases, said during a March 25 White House briefing. Viral patterns in Southern Hemisphere countries suggest a cyclical nature to the illness, meaning it could be seasonal, Dr. Fauci said. (Modern Healthcare 3/26/2020)

Outbreak updates:

  • The Senate passed a $2 trillion relief package, the largest economic stimulus bill in U.S. history, in a unanimous 96-0 vote late March 25, CNBCThe 880-page bill, which now heads to the House, provides funding for hospitals, emergency loans for small businesses, enhanced unemployment insurance and direct checks to Americans.
  • The U.S. wants the United Nations Security Council to declare COVID-19 originated in China, while China seeks recognition in the U.N.’s statement for its response to the outbreak, stalling a global resolution, four U.N. diplomats told NBC News.China’s diplomats are enraged, the diplomats said, as President Donald Trump’s administration increasingly blamed China for the pandemic. However, after reports of racist attacks against Asian Americans, the president tweeted March 23 that it was “NOT their fault” and later said that he would stop calling COVID-19 “the Chinese virus.”
  • Some hospitals are considering do-not-resuscitate orders for all COVID-19 patients, citing the high exposure risk for staff as protective equipment supplies run low, The Washington Post (Becker’s Hospital Review, 3/26)

Regulatory Timeline of COVID-19
William Rinehart, senior research fellow at the Center for Growth and Opportunity at Utah State University, created a timeline to document the major regulatory actions in response to COVID-19.(Modern Healthcare, 3/26/2020.


MSSNY Contracts DrFirst’s “Backline” for Physicians’ Telehealth
DrFirst, a pioneer in healthcare technology offers HIPAA-compliant telehealth and video conferencing as part of its award-winning care collaboration and secure messaging platform, Backline.

Backline is quick to set up and easy to use by both physicians and patients.  Initiate a video session without requiring a patient to download an app, complete a cumbersome registration process, or pay upfront before speaking with their physician. Physicians can use their PC or smartphone to engage with patients. Plus, Backline’s HIPAA security and extensive use cases make it a must-have even after the coronavirus crisis ends.

Also, please remember to add the following link to your call to action https://drfir.st/blt-mssny so that we can track your member registrations and to also enter the Assn Code MSSNY in the Assn box on the registration page.


Cuomo: Social Density Controls May Be Slowing Hospitalization Rate
New York’s social distancing policies may be working to slow the rate of coronavirus-related hospitalizations in the state, Gov. Andrew Cuomo announced Wednesday, though he cautioned the numbers are preliminary.

The governor said new projections suggest that since new density controls enacted over the weekend, hospitalizations have gone from doubling every two days as of Sunday, to doubling every 3.4 days as of Monday, to doubling every 4.7 days as of Tuesday.

There were 30,811 confirmed cases of Covid-19 in New York as of Wednesday morning, Cuomo said. More than 3,800 people are currently hospitalized due to the virus, including 888 who are in intensive care unit beds. Cuomo said the state currently has 53,000 of the 140,000 beds needed to treat patients when the coronavirus reaches its apex in New York — something which is now projected to occur in 21 days. It has identified a total of 119,000 beds it can use through increased capacity at existing hospitals, temporary FEMA and Army Corps of Engineers medical facilities, a Navy hospital ship and dormitories.

The governor said New York will work with hotels and former nursing homes to identify additional beds it can use for coronavirus patients.

Cuomo, who exchanged barbs with President Donald Trump on Tuesday over New York’s access to the national ventilator stockpile, said he’s working with the federal government to procure the 30,000 ventilators the state will need to treat the expected surge in Covid-19 patients. New York has 4,000 of the devices in its current system, received 4,000 more from the federal government and purchased another 7,000, he said.  (Politico, 3/25).


Loss of Smell and Taste: A New COVID-19 Warning Sign?
A pair of ear, nose, and throat doctors (ENTs) in the United Kingdom on Friday published a statement warning doctors that anosmia, or loss of sense of smell, and ageusia, diminished sense of taste, could be symptoms of COVID-19, the disease caused by the new coronavirus. However, the researchers qualified their comments, noting the observations are preliminary. The statement was published by Claire Hopkins, president of the British Rhinological Society, and Nirmal Kumar, president of ENT UK.

In the statement, the authors cited reports from doctors around the world who observed that anosmia was commonly reported among patients who tested positive for the virus.

COVID-19 eNews March 25, 2020

CORONAVIRUS UPDATE:
The state reports 30,811 confirmed cases, and 285 deaths statewide, as of Wednesday morning, including 17,856 cases in New York City; 4,691 in Westchester County; 3,285 in Nassau County; 2,260 in Suffolk County; 968 in Rockland County; 638 in Orange County; 153 in Dutchess County; 152 in Albany County; 122 in Erie County; and 118 in Monroe County.


NYS DOH Update Tomorrow Thursday 1-2 PM
Please join the NYS Department of Health Thursday March 26th at 1-2PM for A COVID-19 Update for Healthcare Providers. To accommodate the large number of participants, our webinar will be streaming via YouTube Live:

For audio only, please dial in: 844-512-2950


TRACKING COVID-19

The CDC’s tracker of US COVID-19 cases. The CDC regularly updates their tracker with newly confirmed cases, including a state-by-state breakdown.

The WHO’s COVID-19 myth busters. This page clarifies common misconceptions about the virus and includes downloadable graphics staff can post on their units.


MSSNY President Dr. Art Fougner’s Editorial Appeared in Yesterday’s Empire Report
As I drove into the parking lot, I couldn’t help noticing the lack of cars. Thanks to the SARS CoV2 virus, hunkering down is now the new normal. Yet through it all, physicians are answering the call, adapting as only they can to the fluid situation. This is not without a cost. As in Italy, the healthcare workers casualties are mounting all too quickly. What hasn’t been emphasized enough is that those professionals are, much like the elderly and the immune-compromised, a very high-risk group for serious complications. And yet, as the FDNY and NYPD on September 11, your physicians, nurses and others are running to the fire while others are running away. Just the other day, one thousand retired medical personnel volunteered to back up beleaguered doctors and nurses on the front lines.

There’s a serious problem, however. We are all short of Personal Protective Equipment. We need this yesterday. Doctors seeing seriously ill patients without adequate protection and supplies is akin to firemen attempting to fight fire without hoses and water. And still, your doctors and nurses are hitting the ground running every day. This indomitable spirit should be an example to us all.

So, when you see a doctor or nurse, give them a hearty Thank You – an air high five or corona forearm bump will do. NY’s Healthcare Team is fighting the good fight for us all. In the words of Winston Churchill, “Never have so many owed so much to so few.” http://empirereportnewyork.com/arthur-fougner-doctor-new-york-our-finest-hour/

Art Fougner, MD
MSSNY President


High Points of Gov. Cuomo’s Announcement
Some points from the on-going Governor’s announcement.

  • NYC currently implementing social distancing plan:
    – closing streets to traffic for pedestrian use.
    – playground density reduction mandates.
    – no close contact sports, such as basketball.
    – if not followed, playgrounds will shut down.
  • Evidence is showing that the density control plan is working.  The doubling of hospitalization rates is spreading out across more days than earlier in the week.
  • As of today, PPE demand is satisfied for the next couple of weeks, but 3 weeks out there will again be a need.
    – Federal Government committed 4,000 ventilators (yesterday, the number was 400).
    – still working with feds for more ventilators, and still looking into splitting ventilators.
    – Governor states that they have purchased everything that can be purchased.
  • 40,000 responses from “Surge Healthcare Force”, the reserve healthcare workforce
    -6,175 mental health professionals signed up (hotline 1-844-863-9314) to provide services.
    – Working with feds to find vendors and using Defense Production Act to maximize production.
    – Working with feds on a rolling deployment plan (mentioned yesterday as a request) to meet needs of hot spots as they arise.  Redeployment of equipment, and personnel as state’s needs decline.
  • Governor described the $2 Trillion bill as “terrible” for NY. $3.8B for NYS, and $1.3B for NYC.

– Told the House to modify the bill.
(Moe Auster, Senior VP MSSNY Govt. Affairs)

Executive Order: Physicians Immune from Civil Liability for COVID-19 Services
As part of an Executive Order,  Governor Cuomo announced physicians and other health care practitioners would be “immune from civil liability for any injury or death alleged to have been sustained directly as a result of an act or omission by such medical professional in the course of providing medical services in support of the State’s response to the COVID-19 outbreak, unless it is established that such injury or death was caused by the gross negligence of such medical professional”.

While this is a very welcome development, at the same time, the Executive Order also contains several very concerning short -term waiving of laws, including physician supervision requirements for Certified nurse anesthetists, physician assistants and nurse practitioners.

The Executive Order also contains provisions that directs the Health Commissioner to cancel all elective surgeries and procedures, in “all general hospitals, ambulatory surgery centers, office-based surgery practices and diagnostic and treatment centers to increase the number of beds available to patients”.


State/Federal Agencies Encourage PTs to Receive Treatment Via Telehealth
There have been a number of important steps taken over the last week to better enable physicians to treat their patients via telemedicine. This week, CMS announced it was implementing rules to temporarily waive the limitations on providing telemedicine for their Medicare patients.

Also, very importantly, the federal Office of Civil Rights announced it was relaxing enforcement of HIPAA rules such that a physician “that wants to use audio or video communication technology to provide telehealth to patients during the COVID-19 nationwide public health emergency can use any non-public facing remote communication product that is available to communicate with patients”, and that OCR will “not impose penalties for noncompliance with the HIPAA Rules in connection with the good faith provision of telehealth using such non-public facing audio or video communication products during the COVID-19 nationwide public health emergency.”

This follows important steps taken by the New York State Department of Financial Services reminding insurers to cover telehealth services for patients including basic smart phone technology and waiving patient cost-sharing.  They also noted they would be strongly encouraging self-insured plans operating in New York State not subject to state regulation to follow these coverage and cost-sharing rules.  Moreover, a similar announcement was made by the New York State Department of Health including ensuring there is Medicaid and Medicaid Managed Care coverage for telephone visits.

In light of the COVID-19 nationwide public health emergency, the HHS Office for Civil Rights (OCR) is exercising its enforcement discretion and, effective immediately, will not impose penalties on physicians using telehealth in the event of noncompliance with the regulatory requirements under the Health Insurance Portability and Accountability Act (HIPAA). 

Physicians may seek to communicate with patients and provide telehealth services through remote communications technologies. Some of these technologies, and their use, may not fully comply with the requirements of the HIPAA Rules. However, the announcement means that physicians who want to use audio or video communication technology to provide telehealth to patients during the COVID-19 nationwide public health emergency can use any non-public facing service that is available to communicate with patients. This exercise of discretion applies to telehealth provided for any reason, regardless of whether the telehealth service is related to the diagnosis and treatment of health conditions related to COVID-19.

For example, a physician using their professional judgement may request to examine a patient exhibiting COVID-19 symptoms, using a video chat application connecting the physician’s or patient’s phone or desktop computer in order to assess a greater number of patients while limiting the risk of infection of other persons who would be exposed from an in-person consultation. Likewise, a physician may provide similar telehealth services in the exercise of their professional judgment to assess or treat any other medical condition, even if not related to COVID-19, such as a sprained ankle, dental consultation or psychological evaluation, or other conditions.

Under this Notice, physicians may use popular applications that allow for video chats, including Apple FaceTime, Facebook Messenger video chat, Google Hangouts video, or Skype to provide telehealth without risk that OCR might seek to impose a penalty for noncompliance with the HIPAA Rules.

Physicians should not use Facebook Live, Twitch, TikTok or other public-facing communication services. Physicians are encouraged, but not required, to notify patients of the potential security risks of using these services and to seek additional privacy protections by entering into HIPAA business associate agreements (BAA). HHS also noted that while it hasn’t confirmed such statements, Skype for Business, Updox, VSee, Zoom for Healthcare, Doxy.me, and Google G Suite Hangouts have said that their products will help physicians comply with HIPAA and that they will enter into a HIPAA BAA.

Additional information can be found at this notice from Department of Health and Human Services (HHS).


Emergency Medical Aid and Telemedicine


Amendment to Allow Telemedicine for Social Distancing
New York State Workers’ Compensation Board sent this bulletin at 03/16/2020 03:00 PM EDT

Emergency Adoption of Amendments to 12 NYCRR 325-1.8, 329-1.3, 329-4.2, 333.2, and 348.2 (COVID-19 Telemedicine)


New Emergency Regulation Requiring Insurance Companies to Waive Cost-Sharing for In-Network Telehealth Visits
New Regulatory Actions State New Yorkers Do Not Have to Pay Copayments, Coinsurance, or Annual Deductibles for In-Network Telehealth Services


AMA: COVID-19 Physician Practice Resources
The COVID-19 physician and practice resources released by the AMA include:

  • A Physicians Guide to COVID-19, to help physicians prepare their practices, address patient concerns, and provide answers to physicians’ top questions;
  • An AMA COVID-19 online resource center, and a COVID-19 FAQ that are updated each day with the latest information on the COVID-19 epidemic;
  • A Quick Guide to Telemedicine in Practice, a new resource to help physicians implement remote care which can help achieve a dramatic increase in the nation’s telemedicine capacity;
  • The AMA Journal of Medical Ethics published ethical guidance for physicians to help them in making determinations about how to combat COVID-19;
  • The JAMA Network COVID-19 Resource Center for evidence-based, actionable resources, plus videos of firsthand accounts from physicians on the front lines;
  • CME for physicians through the JAMA Network’s JN Learning website, including COVID-19 epidemiology, infection control and prevention recommendations

Executive Order of Suspension of Non-Essential Elective Surgeries
A directive was sent out by DOH to hospitals, ambulatory surgery centers, and office-based surgery centers to implement the Executive Order to suspend all non-essential elective surgeries.


Garfunkel Wild Webinar Operationalizing NYS Ban on Elective Surgery
New York State is banning elective procedures at hospitals and ASCs for the unforeseeable future. This webinar explored what the scope of these bans and some suggestion on how to operationalize.


AMA Releases Special Coding Advice Related to COVID-19
New guidance from the AMA provides special coding advice during the COVID-19 public health emergency. One resource outlines coding scenarios designed to help health care professionals apply the best coding practices. The scenarios include telehealth services for all patients.

Examples specifically related to COVID-19 testing include coding for when a patient: comes to the office for E/M visit, and is tested for COVID-19 during the visit; receives a telehealth visit re: COVID-19 and is directed to come to physician office or physician’s group practice site for testing; receives a virtual check-in/online visit re: COVID-19 (not related to E/M visit), and is directed to come to physician office for testing; and more. There is also a quick-reference flowchart that outlines CPT reporting for COVID-19 testing. A new web page on the AMA site also outlines CMS payment policies and regulatory flexibilities related to COVID-19. Check the AMA COVID-19 resource center to stay up to date and for additional resources.


CDC: Clinician Outreach and Communication Activity (COCA)

Emergency Preparedness and Response

COCA prepares clinicians to respond to emerging health threats and public health emergencies by communicating relevant, timely information related to disease outbreaks, disasters, terrorism events, and other health alerts.

COCA Call: March 27, 2020 – Underlying Medical Conditions and People at Higher Risk for the Coronavirus Disease 2019 (COVID-19)


FDA Expedites Treatment of Seriously Ill COVID-19 PTs with Experimental Plasma
In an unusual move, the Food and Drug Administration today announced that is making it easier for doctors to try an experimental treatment for COVID-19 patients that uses plasma from people who had the disease and recovered. There is scant evidence it works in people infected with the coronavirus, but the approach has been tried for other illnesses.

The idea is that this so-called convalescent plasma will contain antibodies to the virus that allowed the donor to recover to disease, and therefore should help patients who are sick.

Convalescent plasma been used in the past to treat outbreaks polio, measles, and mumps before a vaccine was available. More recently it’s has been used with some effectiveness to treat patients with SARS and Ebola.

In guidance to doctors, the FDA stated, “Given the public health emergency that the expanding COVID-19 outbreak presents, while clinical trials are being conducted, FDA is facilitating access to COVID-19 convalescent plasma for use in patients with serious or immediately life-threatening COVID-19 infections.” Doctors will still have to get FDA approval for individual patients to use the treatment, but if doctors need an answer in less than four hours, they can call the FDA Office of Emergency Operations for a verbal authorization.

The idea for using convalescent serum to treat COVID-19 has been championed by Arturo Cassadeval of the Johns Hopkins Bloomberg School of Public Health and Liise-anne Pirofski from the Albert Einstein College of Medicine.

Cassadeval has been interested in the use of convalescent serum to treat outbreaks of viral diseases throughout his career. In February, he wrote an op-ed piece for The Wall Street Journal suggesting it be used in the current outbreak. He followed that up with a scientific paper and then started hearing from doctors all over the country asking if they could participate in a clinical trial of the approach.

Cassadevall was hoping to hear from the FDA that it would give him approval to start a trial. The broader usage granted by FDA was a surprise.

“The FDA just opened the floodgates,” wrote Jeffrey Henderson, associate Professor of Medicine and Molecular Microbiology at Washington University School of Medicine in St. Louis in an email to NPR. “Our institution is scrambling to be ready to use this, as are many others, I’m sure.”

As with any unproven therapy, there are risks with the approach. The worst is that it could actually make patients sicker, a response known as antibody-dependent enhancement where the virus is actually helped to proliferate by a patient’s own immune system.

“I think we need to be cautious about using convalescent serum,” says Martin Zand, professor in the department of medicine and co-director of the Clinical & Translational Science Institute at the University of Rochester Medical Center. (NPR Mar 24 5:35PM)


Update on President Trump Expands Telehealth Benefits for Medicare Beneficiaries During COVID-19 Outbreak

CMS Outlines New Flexibilities Available to People with Medicare

On March 17, 2020,  CMS announced that Fee For Service (FFS) Medicare is expanding coverage for Telehealth services, with an effective date of March 6, 2020. MLN Connects® Special Edition for Tuesday, March 17, 2020. Previously covered Telehealth services are now available to beneficiaries in their home environments, regardless of geographic location.

Our sole intent is to make the claim process as seamless as possible for the providers we serve. While we do not anticipate claim rejections and denials relative to these Telehealth claims, we urge providers to notify us immediately if any such problems are identified. We also advise providers that the NGS Provider Call Center does not have any further information on this issue at present.

NGS keenly recognizes the challenges providers are facing as the country deals with this current emergency and we assure you of our full support as we navigate through this time.

NGS remains fully committed to a prompt and successful implementation of the telehealth benefits as a result of these changes.  Please continue to monitor this website (www.ngsmedicare.com) for additional information from CMS or NGS as it becomes available.


OIG Warns of COVID-19 Fraud Schemes
The US Department of Health and Human Services Office of Inspector General (OIG) released a fraud alert warning Medicare beneficiaries of potentially fraudulent schemes that take advantage of the fears surrounding the COVID-19 public health emergency. The OIG warns that fraudsters are targeting Medicare beneficiaries through telemarketing, social media and even in-person, door-to-door contact. According to the OIG, the fraudulent schemes often involve an offer of a COVID-19 test in exchange for an individual providing personal information.  More on COVID-19 Fraud Schemes Here.


AMA Releases Special Coding Advice Related to COVID-19
New guidance from the AMA provides special coding advice during the COVID-19 public health emergency. One resource outlines coding scenarios designed to help health care professionals apply the best coding practices.

The scenarios include telehealth services for all patients. Examples specifically related to COVID-19 testing include coding for when a patient: comes to the office for E/M visit, and is tested for COVID-19 during the visit; receives a telehealth visit re: COVID-19 and is directed to come to physician office or physician’s group practice site for testing; receives a virtual check-in/online visit re: COVID-19 (not related to E/M visit), and is directed to come to physician office for testing; and more. There is also a quick-reference flowchart that outlines CPT reporting for COVID-19 testing. A new web page on the AMA site also outlines CMS payment policies and regulatory flexibilities related to COVID-19. Check the AMA COVID-19 resource center to stay up to date and for additional resources.


CVS To Waive Co-Pays for Aetna Member Coronavirus Hospitalizations
CVS Health said it will waive co-payments and related out-of-pocket cost-sharing of commercially insured Aetna members’ inpatient admissions related to the Coronavirus strain COVID-19. The move is among the more significant thus far among health insurance companies that are expanding coverage and eliminating plan member cost-sharing for everything from doctor office visits for Coronavirus tests to telehealth consultations for screening of the disease. (Forbes, March 25)

 

 

COVID-19 eNews – March 24, 2020 5:30 PM

A List of all New York State resources for Physicians Has Been Compiled by MSSNY and is Available Here.


Gov. Cuomo Demands Supplies from President
Gov. Andrew Cuomo voiced alarm and frustration with the Trump administration’s response to the growing coronavirus crisis Tuesday, estimating that New York is just two weeks away from hitting the apex of its outbreak.  “The president said it’s a war … then act like it,” Cuomo said, raising his voice during a morning news conference at the Javits Center in Manhattan. “They’re doing the supplies? Here’s my question: Where are they?”

New York has procured just 7,000 of the 30,000 ventilators required to treat the expected surge in hospitalized Covid-19 patients. Cuomo repeated his call for the Trump administration to use the federal Defense Production Act to contract with American companies so more of the vital machines can be manufactured in the coming weeks. “There is no other way for us to get these ventilators, we’ve tried everything else,” he said. “The only way we can obtain these ventilators is from the federal government, period. … If we don’t have the ventilators in 14 days it does us no good.”

With nearly 26,000 confirmed cases of coronavirus, New York is the epicenter of the crisis, nationally. The governor said the state is now expected to need 140,000 hospital beds when the virus reaches its peak — which he estimates will occur in the next 14 to 21 days. Cuomo has ordered New York hospitals to increase their total capacity from 53,000 beds to at least 75,000 — with the goal of creating 110,000 beds.

The governor said he “will turn this state upside down to get the number of beds we need.” He said he’s in touch with hotel owners to take over their locations and has no problem turning dorms at state colleges into makeshift hospitals.

But, Cuomo argued, that means nothing if New York does not have the staff or equipment needed to treat those beds. (Politico 3/24)


Notes from Gov. Cuomo’s Press Conference

– Apex is forecasted for 5/1, but the curve is increasing, new apex is forecasted for 14 to 21 days.
– New projected needed beds are at 140k, with 40k ICU beds.
– NYC expected to have a density reduction plan in place by noon today.
– Hydroxychoroquine and Zithromax trials will start today.
– DOH still pursuing Plasma Injection as well as Antibody test.
– Cuomo will speak with all hospital administrators today on increasing capacity.
– Cuomo is speaking with hotel owners to discuss conversion of locations.  He will use SUNY and CUNY dorms, as well.
– Experimenting with splitting ventilators in order to cover two people simultaneously.
Still pushing feds to use of federal Defense Production Act.  Not using power is inexplicable to Cuomo.
– The Governor is urging HHS Secretary Azar to release 20,000 ventilators to the State.
– FEMA is reportedly sending 400 ventilators, but the need is projected to be 30,000.
– The Governor will take personal responsibility for transporting federal stockpile ventilators to the next region where needed, once state crests over apex.
– Governor discussing bringing lower risk people back into the workforce, and recovered people.
-Ramp up the economy with available workers.  Reiterates that the crisis facing the state today is hospital capacity.

FEMA has sent just 400 ventilators to New York — an amount which Cuomo said misses “the magnitude of the problem.”

The federal government could use its authority to provide businesses start-up capital and guaranteed contracts to build more ventilators in 14 days. Companies volunteering services — something the president has pointed to in recent days — is not enough, Cuomo said.

He compared the current push to World War II when the U.S. contracted directly for military supplies.

“When we went to war we didn’t say, ‘Any company out there want to build a battleship?'” he said, mocking the federal government’s current stance.

He argued business would welcome such an order.

“You know what business wants? They want to make money … let them open their factory and make money, help them do that by ordering the supplies you need,” Cuomo said. “That’s what the Defense [Production] Act was all about and at the rate they are going — it is not happening. FEMA says we’re sending 400 ventilators. Really? What am I going to do with 400 ventilators when I need 30,000?”

https://www.governor.ny.gov/news/no-20210-continuing-temporary-suspension-and-modification-laws-relating-disaster-emergency
No. 202.10: Continuing Temporary Suspension and Modification of Laws Relating to the Disaster Emergency | Governor Andrew M. Cuomo

No. 202.10. EXECUTIVE ORDER. Continuing Temporary Suspension and Modification of Laws Relating to the Disaster Emergency. WHEREAS, on March 7, 2020, I issued Executive Order Number 202, declaring a State disaster emergency for the entire State of New York; WHEREAS, both travel-related cases and community contact transmission of COVID-19 have been documented in New York State and …

www.governor.ny.gov
https://www.governor.ny.gov/news/no-20210-continuing-temporary-suspension-and-modification-laws-relating-disaster-emergency

As part of an Executive Order Governor Cuomo announced physicians and other health care practitioners would be “immune from civil liability for any injury or death alleged to have been sustained directly as a result of an act or omission by such medical professional in the course of providing medical services in support of the State’s response to the COVID-19 outbreak, unless it is established that such injury or death was caused by the gross negligence of such medical professional”.  While this is a very welcome development, at the same time, the Executive Order also contains several very concerning short -term waiving of laws, including physician supervision requirements for Certified nurse anesthestists, physician assistants and nurse practitioners.

The Executive Order also contains provisions that directs the Health Commissioner to cancel all elective surgeries and procedures, in “all general hospitals, ambulatory surgery centers, office-based surgery practices and diagnostic and treatment centers to increase the number of beds available to patients”.


Medicaid Guide re Use of Telehealth
An updated version of the Medicaid Update Special Edition – Comprehensive Guidance Regarding Use of Telehealth including Telephonic Services During the COVID-19 State of Emergency, which now includes clarifications for FQHC billing as well as billing for home care providers, has been posted. This guidance was originally issued on March 21, 2020. The Department will be scheduling a webinar shortly to walk through this guidance and a set of FAQs for Medicaid telehealth are under development.

This document will be updated frequently so please continue to check the COVID-19 Guidance for Medicaid Providers webpage and the Medicaid Update webpage for updates and amendments.


PODCAST ”The Psychosocial Impact of COVID-19″
Available at :https://www.buzzsprout.com/51522/3095743

The COVID-19 physician and practice resources released by the AMA include:

  • A Physicians Guide to COVID-19, to help physicians prepare their practices, address patient concerns, and provide answers to physicians’ top questions;
  • An AMA COVID-19 online resource center, and a COVID-19 FAQ that are updated each day with the latest information on the COVID-19 epidemic;
  • A Quick Guide to Telemedicine in Practice, a new resource to help physicians implement remote care which can help achieve a dramatic increase in the nation’s telemedicine capacity;
  • The AMA Journal of Medical Ethics published ethical guidance for physicians to help them in making determinations about how to combat COVID-19;
  • The JAMA Network COVID-19 Resource Center for evidence-based, actionable resources, plus videos of firsthand accounts from physicians on the front lines;
  • CME for physicians through the JAMA Network’s JN Learning website, including COVID-19 epidemiology, infection control and prevention recommendations

Guidance on How to Protect Yourself and Your Family from COVID-19 When Enjoying the Outdoors


NYS has a Coronavirus Hotline at 1-888-364-3065.
The New York State Department of Health has established a provider email account for physicians to ask questions about COVID-19: Covidproviderinfo@health.ny.gov


Chloroquine in Short Supply As Hospitals Buy in Bulk
Providers have been purchasing significant amounts of chloroquine and hydroxychloroquine in anticipation that they will be used to treat COVID-19, drastically depleting available supply, according to a new report from Premier.

While the U.S. Food and Drug Administration is still investigating whether the inexpensive, old anti-malaria drugs can tame symptoms and limit the spread of the highly contagious virus, hospitals have responded to clinical trials in other countries that have shown promising results.

Orders of chloroquine spiked 3,000% in March, according to data from Premier, the group purchasing and consulting organization. From January 2019 through February 2020, hospitals ordered an average of 149 units a month. More than 2,300 units were ordered through March thus far.

Its variant hydroxychloroquine experienced a 260% surge in demand, Premier data show. Hospitals typically used about 8,800 units a month, jumping to 16,110 units ordered in March. Chloroquine phosphate tables and hydroxychloroquine sulfate tablets went into shortage on March 9 and March 19, respectively, according to the American Society of Health System Pharmacists.

All major wholesale distributors put hydroxychloroquine and chloroquine on allocation this week, which limits ordering to prevent hoarding, Premier said.

Chloroquine, which is also used to treat lupus and rheumatoid arthritis, isn’t typically well stocked by hospitals, if at all, said Erin Fox, a drug shortage expert and senior director of drug information and support services at University of Utah Health.

Some of the manufacturers of chloroquine and related products have lowered prices and donated millions of doses to the U.S. government.

Last month, the National Institutes of Health began a randomized controlled trial for the treatment of COVID-19 patients with Gilead Sciences’ antiviral drug remdesivir. It is one of several drugs that are being tested for COVID-19 treatment, but quality and pricing questions remain.

“We understand and recognize the urgency with which we are all seeking prevention and treatment options for COVID-19. FDA staff are working expeditiously on that front,” FDA Commissioner Dr. Stephen Hahn, said in prepared remarks. “We also must ensure these products are effective; otherwise we risk treating patients with a product that might not work when they could have pursued other, more appropriate, treatments.”

The drug supply chain is already working around restricted access to pharmaceutical ingredients. The Indian government is limiting the export of 26 ingredients, some of which are used in widely used antibiotics, to protect its domestic supply amid the pandemic.

Much of the world’s supply of generic drugs comes from India, which relies heavily on China for their active pharmaceutical ingredients. (Modern Healthcare Mar. 23)


Florida Governor Orders New York Travelers to Quarantine
Florida Gov. Ron DeSantis said Monday he is issuing an executive order mandating that anyone arriving on a flight from New York City and the surrounding area submit to self-quarantine for two weeks. DeSantis said in an address from his Tallahassee office that more than 100 such flights arrive daily in the state and he believes each contains at least one person infected with the new coronavirus.

He said he has been in contact with federal officials about curtailing such flights, but has not yet received a response. He said people will be screened when they arrived and told they must self-quarantine. He said those travelers will not be allowed to stay with family or friends, because that is one way the virus is spread.

He did not say specifically how the self-quarantine would be enforced, but said “it is actually a criminal offense if you violate the quarantine order.” Florida law says it is a second-degree misdemeanor to violate a quarantine order that could result in a 60-day jail sentence.


Update on President Trump Expands Telehealth Benefits for Medicare Beneficiaries During COVID-19 Outbreak; CMS Outlines New Flexibilities Available to People with Medicare

On March 17, 2020,  CMS announced that Fee For Service (FFS) Medicare is expanding coverage for Telehealth services, with an effective date of March 6, 2020. MLN Connects® Special Edition for Tuesday, March 17, 2020. Previously covered Telehealth services are now available to beneficiaries in their home environments, regardless of geographic location.

Our sole intent is to make the claim process as seamless as possible for the providers we serve. While we do not anticipate claim rejections and denials relative to these Telehealth claims, we urge providers to notify us immediately if any such problems are identified. We also advise providers that the NGS Provider Call Center does not have any further information on this issue at present.

NGS keenly recognizes the challenges providers are facing as the country deals with this current emergency and we assure you of our full support as we navigate through this time.

NGS remains fully committed to a prompt and successful implementation of the telehealth benefits as a result of these changes.  Please continue to monitor this website (www.ngsmedicare.com) for additional information from CMS or NGS as it becomes available.


CMS Eliminated Reporting for Jan. to June of 2020
CMS eliminated much of the need for reporting in the first six months of 2020. For the Merit-based Incentive Payment System, eligible clinicians who have not submitted any MIPS data by April 30, 2020 will receive a neutral payment adjustment for the 2021 MIPS payment year, according to the press release.

For the Ambulatory Surgical Center Quality Reporting Program, any data from January 1, 2020 through March 31, 2020 submitted will be used for scoring in the program.

Programs with data submission deadlines in April and May 2020 will be given exemptions based on the facility’s choice to report.

The CMS stated in the press release that it “recognizes that quality measure data collection and reporting for services furnished during this time period may not be reflective of their true level of performance on measures such as cost, readmissions and patient experience during this time of emergency and seeks to hold organizations harmless for not submitting data during this period.”

Modern Healthcare Mar 23


University of Washington Doctors Share Findings of COVID-19 Cases
In a research letter published in JAMA on Thursday, doctors at the University of Washington revealed what they called “the first description of critically ill patients infected with COVID-19 in the U.S.,” describing them as having a high rate of acute respiratory distress syndrome and a high risk of death.

The research shows “poor short-term outcomes among patients requiring mechanical ventilation.”
A total of 21 cases, ranging in age from 43 to 92, with 52% of them male were admitted to the ICU at Evergreen Hospital between February 20, 2020, and March 5, 2020, were included. Evergreen Hospital is a 318-bed public hospital with a 20-bed ICU serving approximately 850 000 residents of King and Snohomish counties in Washington State.

Comorbidities were identified in 18 cases, with chronic kidney disease and congestive heart failure being the most common. (7:40 PM CT on 3/19/2020 Modern Healthcare 3/19)


AMA: Ethical Challenges in a Pandemic
The COVID-19 pandemic poses ethical challenges and exceptional demands for physicians in the United States.

While caring for the anticipated surge of seriously ill COVID-19 patients, physicians are very likely to encounter heart-wrenching decisions. Meanwhile, physicians face having to balance the obligation to provide urgent medical care during emergencies, with risks to their own safety, health or life. The current pandemic offers each member of the medical profession a unique opportunity to reflect anew on medical ethical dilemmas that arise in the face of adversity.

During the COVID-19 pandemic, some of these ethical challenges will include:

  • Allocation of limited resource
  • Caring for patients in the face of personal risk
  • Use of quarantine and restrictions of personal liberty

The Code of Medical Ethics offers detailed ethical guidance to physicians on these issues that will help physicians approach the difficult decisions in the days ahead.
For more information, please see the AMA’s list of newly released resources on ethical challenges that arise during pandemics


Scientists Warned re China as a “Time Bomb” for Viruses 13 years Ago
In a 2007 study published by Clinical Microbiology Reviews.scientists warned that a penchant for eating exotic mammals in southern China was a “time bomb” waiting to happen.

Lack of hygienic environments and crowded, wet markets selling wild game plus the common presence of coronaviruses in China was a “time bomb” for a dangerous virus outbreak.

“The small reemergence of SARS in late 2003 after the resumption of the wildlife market in southern China and the recent discovery of a very similar virus in horseshoe bats, bat SARS-CoV, suggested that SARS can return if conditions are fit for the introduction, mutation, amplification, and transmission of this dangerous virus,” the authors said. 6:09 PM CT on 3/23/2020 Modern Healthcare, 323


MLMIC: Offering 24/7 Legal Hotline for Insureds
Due to the minute by minute changes regarding COVID-19, MLMIC is keeping our insureds informed via email blasts, our website, blog, as well as through our social media accounts via Twitter and Linked In.

For those insureds who face challenges to their practice due to COVID-19, MLMIC is offering the following:

  • MLMIC’s toll free 24/7 Legal Hotline – (855) FAKS-LAW (1-855-325-7529) can help address many questions or concerns that may arise.
  • Our staff remains directly available via phone (800) ASK-MLMIC(1-800-275-6564) and every effort will be made to handle inquiries and answer questions regarding claims, coverages and policies on an immediate basis.
  • Blog:  Guidance on Using Telemedicine for Coronavirus – click here

 

 

COVID-19 eNews – March 24, 2020

Podcast:

Psychosocial Impact of COVID-19


Webinar:

“Psychosocial Dimensions of Infectious Outbreaks”
April 1st @ 7:30am

REGISTRATION NOW OPEN HERE 

MSSNY’s has expedited the presentation of the next Medical Matters webinar “Psychosocial Dimensions of Infectious Outbreaks” on Wednesday April 1st at 7:30am. 

This program is a companion piece to the March 18th coronavirus webinar.  This program provides physicians with vital information to care for patients, staff, family and themselves during this unprecedented pandemic.

Faculty for this program is Craig Katz, MD.

Educational Objectives are:

  • Understand common human reactions to infectious outbreaks
  • Explore factors that influence how people react
  • Describe how to apply historical lessons to your own medical practice

Medical Matters is a series of Continuing Medical Education (CME) webinars sponsored by MSSNY’s Committee on Emergency Preparedness and Disaster/Terrorism Response.  A copy of the flyer for this program can be accessed here

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

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

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

COVID-19 eNews Update – March 18

As of March 18 Statistics:

In light of the COVID-19 nationwide public health emergency, the HHS Office for Civil Rights (OCR) is exercising its enforcement discretion and, effective immediately, will not impose penalties on physicians using telehealth in the event of noncompliance with the regulatory requirements under the Health Insurance Portability and Accountability Act (HIPAA). 

For example, a physician using their professional judgement may request to examine a patient exhibiting COVID-19 symptoms, using a video chat application connecting the physician’s or patient’s phone or desktop computer in order to assess a greater number of patients while limiting the risk of infection of other persons who would be exposed from an in-person consultation.

Likewise, a physician may provide similar telehealth services in the exercise of their professional judgment to assess or treat any other medical condition, even if not related to COVID-19, such as a sprained ankle, dental consultation or psychological evaluation, or other conditions.

Additional information can be found at this notice from Department of Health and Human Services (HHS).


Emergency Medical Aid and Telemedicine

Importantly, yesterday Medicare announced that it has temporarily limited its limitations on telehealth coverage. And the New York Department of Financial Services put out another statement reminding state regulated insurers about required telehealth coverage for all health care services without patient cost-sharing “including technology commonly available on smartphones and other devices”


Navigating Telehealth Reimbursement; Garfunkel Wild Presents Tomorrow Noon
While telehealth has become an acceptable means of delivering health care, how third-party payers reimburse telehealth services vary depending on the payer. This one-hour webinar will explore the rules and regulations impacting telehealth reimbursement by the Medicare and Medicaid programs and highlight the reimbursement policies of national commercial health plans.

Click here to Register
Thursday, March 19, 2020
12:00 PM – 1:00 PM EDT


Join the New York State Department of Health and New York City Department of Health & Mental Hygiene for a call about COVID-19 – Tomorrow, March 19, 1:00 PM


19% of New York’s 1,374 Coronavirus Cases Required Hospitalization
New York has 53,000 hospital beds, including 3,000 beds in intensive care units which have ventilators and other equipment needed to treat the coronavirus, the governor said. That capacity, he said, is much lower than the 55,000 to 110,000 hospital beds, and 18,600 to 37,200 ICU beds public health and epidemiological experts estimate New York will need when the virus hits its peak in the state. Estimates suggest that will happen in about 45 days.

Gov. Cuomo said 264 of the state’s 1,374 coronavirus cases, about 19 percent, required hospitalizations as of Tuesday morning.

“The expected peak is somewhere between 55,000 and 110,000 positives — the low range, 55,000, is a problem because we have people now in 80 percent of the 53,000 hospital beds — it’s not like they’re vacant,” he said. “One hundred and ten thousand is a problem because it’s double your capacity, if every bed was empty. The real problem is the ICU beds because that’s what people are going to need.”

State Health Commissioner Howard Zucker added that New York has around 4,000 ventilators, and hundreds more in a stockpile, which can be deployed in response to the coronavirus outbreak. (Politico 3/17)


MSSNY’s HOD Meeting Scheduled for April 24-26 in Tarrytown Cancelled
The MSSNY HOD in Tarrytown has been canceled but will moved to an alternative format. When we have finalized the details, we will inform all attendees and members.


Additional COVID-19 Information

COVID-19 Update March 22, 2020

How to Set Up Telehealth for Free

Doctor on Videoconference

Dr. Tom Madejski and Dr. Danial Choi have easy to follow directions on how to set up telemedicine in your office.

Since HIPAA has removed its requirement that all telehealth programs be HIPAA qualified, this do-it-yourself system is free. All you need is your cellphone or tablet.

Please see this video for more information.


Information for Insurers and Providers on Coverage for Telehealth Services click here.


Some points From the On-Going Governor’s Announcement:

– Calling on feds to nationalize medical supply acquisition. States unable to manage procurement, and costs, and are competing against other states.

– Governor thinks use of Defense Production Act at the federal level is appropriate for producing PPE and ventilators.  Use would resolve competitive price gouging, and interstate competition.

– Urges federal money be disbursed directly to individuals, then governments and both before corporate subsidies.  Referred to stock buy-backs with federal bailout money in 2008, and seeks to avoid it.

– Requesting temp hospitals from Army Corps of Engineers:

– Stony Brook
– Westbury
– Westchester
– Javits Center
– Temp hospitals are helpful, but they don’t come with supplies, nor staff – problematic

– Governor given approvals at state level, construction can start tomorrow.

– Asking FEMA to erect 4 federal hospitals at Javits Center – they come with staff and supplies

– Still requesting the federal government waive the 25% share of FEMA disaster money – wont be able to pay it.  Governor also asking on behalf of all states.

– State implementing trial (on Tuesday) of Hydroxychloroquine (70k), Zithromax (10k), Chloroquine (750k).

– Requesting serological testing for Coronavirus antibodies ASAP.  Possibly get people back to work quicker (especially medical staff).

– Requesting hospitals double their existing capacity. Waiving applicable regulations.
– Hospitals must provide plan to increase beds by at least 50%, this will be a mandate, DOH emergency order.

– Elective, non-critical surgeries cancelled on Wednesday.  Should provide 25-30% more beds.

– Repurposing existing health care facilities to provide more beds. 

 

MSSNYeNews: Trying Times – March 20, 2020

Arthur Fougner MSSNY Presiident

PRESIDENT’S MESSAGE
Arthur Fougner, MD
MSSNY President

MSSNY eNews
March 20, 2020

Vol. 23  Number 12


MSSNYPAC Seal

 


Colleagues:

The other night, after finally catching up with email, hospital alerts, and various text messages, I fell asleep during a story about physicians’ reporting shortages of Personal Protective Equipment (PPE)

While dreaming about life during wartime, who should show up but Rudyard Kipling. Kipling was sharing a few beers with some British soldiers, having a grand old time. He turned to me and whispered, “You docs have quite a bit in common with our unsung heroes here, you know.” At that, I awoke with a start and found a copy of his poem Tommy on my desk. I knew what I had to do. The result, you see below.

Please share.

Tommy D.

Went to the local grocery to fetch a loaf of bread
Counterman yelled “Stand far away, I’m ‘fraid of being dead.”
Customers talked among themselves, seeing only an empty shelf
I turned around, went outside and mumbled to myself.
It’s greedy this, rent seeker that, old one percenter guy
But it’s thank you Dr Thomson when the baby’s fever’s high

Mocking folks in white coats who treat you when you’re ill
Is cheaper than those white coats, cheaper than that pill.
And calling out tired doctors when they can hardly stand
Seems better for campaigning than giving them a hand.
So it’s greedy this, rent seeker that, old one percenter guy
But it’s savior of the country when pandemic time is nigh.

We don’t feel we’re heroes and not your villains to fear.
We’re merely human beings, just like your neighbors here.
If something that we do rubs folks the wrong way
Remember fellow humans, this isn’t All Saints Day.

So it’s greedy this, rent seeker that, old one percenter guy
But it’s savior of the country when the body count is high.
It’s greedy this, rent seeker that, say anything you please
Your doctor’s not a bloody fool, you bet your doctor sees.

Please make no mistake. We will continue answering the call. It’s what we do. Like the FDNY on September 11, we run into the burning buildings. The difference is that we are fighting fires often without respirators, without hoses and without water. We don’t ask for praise. That’s not why we’re here. We do ask for society’s support without having to keep one eye elsewhere. If we all pull together, I’ve no doubt we’ll pull through. We have no choice. All our lives depend on it.

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

Arthur Fougner, MD
MSSNY President




MLMIC Insurance Banner Ad


Details from Governor Cuomo’s Announcement
Summary of Governor’s Press Conference today, including cancelation of non-critical elective surgeries next week and 100% work at home requirement for businesses that are not essential.

When out in public, New Yorkers will be required to “practice social distancing of at least six feet from others. This is the most drastic action we can take,” Cuomo said today.

  • Planning to cancel all elective, non-critical surgeries. Setting date next week.
  • Hospitals instructed to double room capacity (current capacity is 50k).
  • NYS will pay a premium for Personal Protective Equipment (PPE). Governor asking companies to get creative on production in order to meet PPE needs.  Governor is looking at state production as well.  Governor cannot mandate but will offer financial incentives – Companies to contact NYS.
  • For Funding to start up PPE Production – 212-803-3100
  • For Sales – 646-522-8477
  • Expansion of hand sanitizer production.
  • Asking closed medical offices to offer their PPE to needed areas.
  • Regulated health facility ordered by DOH to make ventilators. Will purchase, but asking for donations call DOH
  • NYS On Pause – Executive Order will be issued today. Only essential business will be functioning with in-person staff.  100% of the workforce must stay home.
  • Remain inside. “This is the most drastic action we can take.”
  • Specific Rules for personal conduct of vulnerable people:

-Remain indoors
-Go outside for solitary exercise
-Pre-screen visitors by taking temperature
-Don’t visit households with multiple people
-All vulnerable people should wear masks when in company of others
-Everyone in presence of vulnerable people should wear mask
-Stay six feet away from others
-Do not take public transport unless necessary

  • These provisions are legal and will be enforced. Civil fines and mandatory closure for businesses not in compliance

NYS has a coronavirus hotline at 1-888-364-3065.
The New York State Department of Health has established a provider email account for physicians to ask questions about COVID-19: Covidproviderinfo@health.ny.gov

COVID-19 Elective Surgeries and Non-Essential Procedures Recommendations
Earlier today at the White House Task Force Press Briefing, the Centers for Medicare & Medicaid Services (CMS) announced that all elective surgeries, non-essential medical, surgical, and dental procedures be delayed during the 2019 Novel Coronavirus (COVID-19) outbreak.

A copy of the press release is here.

A copy of the guidance is here.


Check COVID-9 Websites Regularly for Updates
This is a rapidly changing situation. Please regularly check the NYSDOH COVID-19 website and the CDC COVID-19 website for updates.

Others:


How to Set Up Telehealth for Free
Dr. Tom Madejski and Dr. Danial Choi have easy to follow directions on how to set up telemedicine in your office. Since HIPAA has removed its requirement that all telehealth programs be HIPAA qualified, this do it yourself system is free. All you need is your cellphone or tablet.

Please see this video for more information.


NYSDOH Seeking Retired Physicians if Crisis Worsens
In the event that the novel coronavirus crisis worsens, we need the help of qualified retired health professionals and related professionals to supplement our hospital capacity on a temporary basis to treat seriously ill coronavirus patients including those that may need to be intubated. The NYS Dept. of Health will recertify you for the purpose.  The forms are available here.

MEDICAL CORPS: One thousand retired doctors and nurses signed up to join the city’s medical reserve corps, joining 9,000 existing members, as part of preparation for a wave of Covid-19 hospitalizations, the New York Post reported.


Researchers Say Digestive Symptoms Are Common in Patients with Coronavirus
Researchers from the Wuhan Medical Treatment Expert Group for COVID-19 say that digestive symptoms, including diarrhea, are common in patients infected with coronavirus, according to a study in the American Journal of Gastoenterology. The researchers also found that “patients without digestive symptoms were more likely to be cured and discharged than those with digestive symptoms (60% versus 34%).”


People May Hesitate to Seek Treatment for Coronavirus Due to Cost
The New York Times (3/19) reports that the federal government has passed legislation that would eliminate out-of-pocket costs for patients seeking coronavirus testing, and many states, insurers, and employers are also taking action to limit patients’ costs for testing or treatment for coronavirus. However, even if the cost of testing is covered for everyone, experts say people may be reluctant to seek treatment if they are concerned that treatment may be costly.


Recently Released Guidance Documents Related to Home Care

Dear Prevention Partners: Home Care Guidance Documents
Please see several recently released guidance documents related to home care. 

  1. Dear Administrator Letter (DAL): DHCBS 20-08, COVID-19 Guidance for Home Health Care Agencies and Hospice Providers – March 14, 2020

The purpose of this letter is to provide guidance from the New York State Department of Health (NYSDOH) to certified home health agencies, long term home health care programs, hospices, and licensed home care services agencies pertaining to the current novel coronavirus (COVID-19) outbreak.

  1. Interim Guidance for Home Care Services Regarding COVID-19 – March 16, 2020

This document provides agencies and organizations with information about home and community-based services as it relates to the 2019 novel coronavirus disease (COVID-19). Includes an Appendix for Recommended Screening Questions.

  1. Guidance on the Contacts of a Close or Proximate Contact of a Confirmed or Suspected Case of COVID-19

MSSNY: How Telehealth Helps Prevent the Spread of COVID-19
The time for telehealth is now. Healthcare and government leaders have both advocated for the use of telehealth in the fight against the coronavirus.

Through virtual visits, clinicians can remotely screen those who may be infected with COVID-19 without the risk of exposing other patients and providers.

MSSNY endorses the use of telehealth and secure messaging technologies to assess and treat patients remotely, including Backline by DrFirst. Use Association Code MSSNY when registering for Backline Telehealth.

About Backline

Backline makes telehealth and care collaboration easy. A simple text from the provider using Backline goes straight to the patient’s mobile phone to initiate a secure, HIPAA-compliant virtual visit. There’s no patient registration process or app for patients to download. There are no limits on usage or per-session fees.  Plus, Backline gives you communication features you won’t find in other telemedicine offerings.

Please join us in combatting the spread of the coronavirus.  Switch to virtual visits powered by Backline.

Register for Backline Today
Use Association Code MSSNY when registering for Backline Telehealth. 


URGENT TELEMEDICINE UPDATE: Able to Conduct Tele-Visits Now
The CMS has announced that additional emergency measures have been put into place to temporarily expand the use of telemedicine. These measures will include allowing providers to conduct telemedicine visits with patients who are located in their homes. The provider must use an interactive audio and video telecommunications system that permits real-time communication between the distant site (i.e., physician’s office or other location) and the patient at home. “SEE MSSNY WEBSITE FOR EASY DO-IT-YOURSELF INSTRUCTIONS or SIGN UP WITH BACKLINE ABOVE AT $300 PER USER. (See article above)


Small Business Loans Available in Five Counties
There are Small Business Administration loans available for the counties of Bronx, New York, Orange, Rockland, Westchester. Other counties may also qualify as the disease progresses. The loans are available for businesses impacted by COVID-19. The loan is called Economic Injury Disaster Loan Assistance.  Loans have an interest rate of 2.75% with long term repayments in order to keep payments affordable, terms are determined on a case by case basis.  Additional SBA disaster assistance customer service is: 1-800-659-2955 or email at disastercustomerservice@sba.gov or by going to https://disasterloan.sba.gov/ela


“Psychosocial Dimensions of Infectious Outbreaks” WEBINAR April 1st @ 7:30am
REGISTRATION NOW OPEN HERE

MSSNY’s has expedited the presentation of the next Medical Matters webinar “Psychosocial Dimensions of Infectious Outbreaks” on Wednesday April 1st at 7:30am.  This program is a companion piece to the March 18th coronavirus webinar.  This program provides physicians with vital information to care for patients, staff, family and themselves during this unprecedented pandemic.

Faculty for this program is Craig Katz, MD.

Educational Objectives are:

  • Understand common human reactions to infectious outbreaks
  •  Explore factors that influence how people react
  • Describe how to apply historical lessons to your own medical practice

Medical Matters is a series of Continuing Medical Education (CME) webinars sponsored by MSSNY’s Committee on Emergency Preparedness and Disaster/Terrorism Response. A copy of the flyer for this program can be accessed here. To register, please: click here.

For more information, contact: Melissa Hoffman at mhoffman@mssny.org or call (518) 465-8085
Additional information or assistance with registration may be obtained by contacting Melissa Hoffman at mhoffman@mssny.org.

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

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


MSSNY COVID-19 Podcast by Dr. Valenti, Chair of Infectious Disease Committee
Dr. William Valenti, Clinical Associate Professor of Medicine (Infectious Diseases)
University of Rochester School of Medicine Senior Vice-President Chair of MSSNY’s Infectious Diseases Committee, discusses the current coronavirus outbreak.



“Coronaviruses 2020: COVID-19 An Evolving Story” CME Webinar Recorded on March 18th Now Available Online
Medical Matters: Coronaviruses 2020: COVID-19 An Evolving Story recorded on March 18th is now available at https://cme.mssny.org .  William Valenti, MD, chair of MSSNY Infectious Disease Committee and a member of the Emergency Preparedness and Disaster/Terrorism Response Committee along with Elizabeth DuFort, MD, Medical Director in the Division of Epidemiology at the New York State Department of Health served as faculty for this program. And Marcus Freidrich, MD, MBA, Chief Medical Officer – Office of Quality of Patient Safety – New York State Department of Health offered additional information.

If you do not already have an account at the MSSSNY CME website, you will need to create one.

Educational objectives:

  • Become familiar with the epidemiology and clinical features of coronaviruses
  • Understand the physician’s role int eh public health response to an infectious disease outbreak
  • Identify the circumstances that have contributed to the rapid spread of COVID-19

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

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

* Please note that while the recording time of this webinar is approximately two hours, there is only one credit available.  The second hour is an extra question and answer period.


Use the Right Codes for Telemedicine
Billing for telemedicine can be somewhat confusing due to the vast variety of codes.  For simplicity, please be aware that most plans, including Medicare and Medicaid, will accept the normal E&M AMA-CPT codes (99201-99215) with the GT modifier to reflect telemedicine.  Keep it simple. (Be sure to get your patient’s consent to provide your service in this way and note their agreement in their medical record.

Note, during this national state of emergency/pandemic, CMS has expanded telemedicine rules to allow the use of non-public face-to-face technology such as an iPhone or similar equipment.  Additionally, the Office of Civil Rights has relaxed the HIPAA regulations during this event.

If more information is required, email Regina McNally at rmcnally@mssny.org.


UPDATED CASE NUMBERS
TODAY, Governor Cuomo confirmed 1,008 new cases of coronavirus in New York State, bringing the statewide total to 2,382 positive cases.

• We now have 46 deaths

• Today, the Governor announced new cases in Chenango, Essex, Hamilton, Warren and Washington

• Here is the geographic breakdown in NYC and 32 counties:

o   4,408 NYC (695 new)

o   1,091 Westchester (158 new)

o   754 Nassau (52 new)

o   371 Suffolk (32 new)

o   61 Albany (13 new)

o   84 Orange (17 new)

o   101 Rockland (8 new)

o   36 Dutchess (4 new)

o   32 Monroe (4 new)

o   24 Saratoga (5 new)

o   21 Schenectady (9 new)

o   12 Ulster (1 new)

o   31 Erie (same)

o   8 Rensselaer (3 new)

o   7 Tompkins (1 new)

o   7 Putnam (same)

o   2 Allegany (same)

o   2 Greene (same)

o   2 Montgomery (1 new)

o   2 Onondaga (same)

o   2 Broome (same)

o   1 Delaware (same)

o   2 Herkimer (same)

o   1 Tioga (same)

o   3 Ontario (same)

o   2 Wyoming (same)

o   2 Clinton (same)

o   8 Sullivan (same)

o   2 Chenango (1 new)

o   1 Essex (1 new)

o   2 Hamilton (1 new)

o   1 Warren (1 new)

o   1 Washington (1 new)

• New York is still the most impacted state in the nation with 34% of all cases in the U.S. There are 201 deaths in the U.S.

• To date, there are 272,367 positive cases around the world and 11,375 deaths. So far, there are 87,966 total recoveries and 113,913 pending cases worldwide.

• Current Hospitalization Count: 549 out of 2,382 positive cases are currently hospitalized (23% of cases).

• Recovered: 108 people with coronavirus have been discharged from the hospital.

• Testing: 14,597 people have been tested statewide.

• Governor Cuomo’s messages to all New Yorker’s today:

o   “We are fighting a war against this pandemic and we know that two of the most effective ways to stop it is by reducing density and increasing our hospital capacity, so our healthcare system is not overwhelmed.” 

o   “The deployment of the USNS Comfort to New York is an extraordinary but necessary step to help ensure our state has the capacity to handle an influx of patients with COVID-19 and continue our efforts to contain the virus.”

o   Partnering with the private sector to require nonessential employees to work from home will also go a long way toward bending the curve. My number one priority is protecting the public health so that a wave of new cases doesn’t crash our hospital system, and we will continue taking any action necessary to achieve that goal.”


TODAY’S ANNOUNCEMENT

NAVY HOSPITAL SHIP: Today Governor Cuomo announced the Navy hospital ship USNS Comfort will be deployed to New York harbor and is expected to arrive in April.

o   The 1,000-bed hospital ship has 12 fully-equipped operating rooms and will significantly increase New York’s hospital surge capacity.

EXECUTIVE ORDER FOR BUSINESSES: The Governor also announced he will issue an executive order directing non-essential businesses to implement work-from-home policies effective Friday, March 20.

o   Businesses that rely on in-office personnel must decrease in-office workforce by 50 percent.

o   The executive order exempts essential service industries, including shipping, media, warehousing, grocery and food production, pharmacies, healthcare providers, utilities, banks and related financial institutions, and other industries critical to the supply chain. 

o   The Governor also recognized the following partners in this effort:

    • The Business Council of NY
    • Retail Council of NYS
    • ABNY
    • Partnership for New York City

REGIONAL APPROACH: Today the Governor announced that Pennsylvania has joined New York, New Jersey and Connecticut in a regional approach to the combating COVID-19.

o   Governor Cuomo, Governor Murphy, Governor Lamont and Governor Wolf directed temporary closure of all indoor portions of retail shopping malls, amusement parks & bowling alleys – effective by 8 PM Thursday.

STATE GOVERNMENT EMPLOYEES: On Monday, Governor Cuomo directed nonessential state employees statewide to work from home.

o   The Governor also directed local governments to reduce their overall workforce by 50 percent and allow nonessential employees to work from home.

ARMY CORPS OF ENGINEERS: The Governor is meeting with leadership of the Army Corp of Engineers today to discuss ways to increase hospital capacity in New York. 

ACTION PLAN: Today the Governor outlined the State’s ACTION PLAN components:

o   1- Flatten Curve thru Density Reduction

o   2-Increase Current Hospital Capacity

o   3-Identify New Hospital Beds

o   And do all three simultaneously

ID NEW HOSPITAL BEDS: Governor met yesterday with hospital administrators to increase bed capacity and…

o   Waive DOH regulations related to hospital beds

o   Discuss ways to add more staff, including reserve staff

o   And bring in staff from nursing schools, medical schools, retired healthcare workers; and,

o   Convert available facilities into extra hospital space.

DENSITY REDUCTION: Gov. Cuomo reiterated the following density reduction actions:

o   VOLUNTARY: work from home

o   MANDATORY: closed schools statewide

o   MANDATORY: reduce state and local workforce

o   MANDATORY: new 4-state regional agreement to close bars, restaurants and gyms

ESTIMATED VIRUS PEAK: Experts estimate the coronavirus will peak in about 45 days. 

DRIVE-THROUGH TESTING: continues in locations including New Rochelle in Westchester County, Jones Beach in Nassau County…Staten Island and Rockland County.

o   Drive-through mobile testing facilities help keep people who are sick or at risk of having contracted coronavirus out of healthcare facilities where they could infect other people.

o   These facilities are a critical part of the Governor’s nation-leading program to test thousands of people per day for COVID-19 by this week.


YESTERDAY’S ANNOUNCEMENTS

• THREE-WAY AGREEMENT / PAID SICK LEAVE: Governor Cuomo announced a three-way agreement with the Legislature on a bill guaranteeing job protection and pay for New Yorkers who have been quarantined as a result of novel coronavirus, or COVID-19.

o   The program bill also includes the permanent comprehensive paid sick leave policy first advanced in the Governor’s FY 2021 Executive Budget proposal.

o   This follows the Governor’s announcement last week that the state will guarantee two full weeks of paid leave for all state workers who are subject to a mandatory or precautionary order of quarantine as a result of the novel coronavirus.

• SUPPLEMENT HEALTHCARE PERSONNEL: The state is reaching out to qualified former doctors, nurses and other healthcare professionals to supplement the personnel at hospitals.

o   The State Department of Health and the State Education Department have sent letters to retired health care professionals and all schools of nursing, public health and medicine encouraging qualified health care personnel to sign up for on-call work during the COVID-19 crisis.

o   Healthcare professionals who wish to volunteer can contact the State Department of Health at health.ny.gov/assistance.

• CHILD CARE: Governor Cuomo also directed the Greater New York Hospital Association and the Healthcare Association of New York State to work with 1199 SEIU to develop a plan to create drop-in childcare opportunities and expand childcare facilities at their hospitals to ensure childcare for hospital workforce. They will submit a joint plan to the state by Friday.

• EMPLOYEE PROTECTIONS: To address the immediate need of employees affected by COVID-19 who are subject to mandatory or precautionary orders of quarantine or isolation, the Governor’s legislation will provide the following:

o   Employers with 10 or fewer employees and a net income less than $1 million will provide job protection for the duration of the quarantine order and guarantee their workers access to Paid Family Leave and disability benefits (short-term disability) for the period of quarantine including wage replacement for their salaries up to $150,000.

o   Employers with 11-99 employees and employers with 10 or fewer employees and a net income greater than $1 million will provide at least 5 days of paid sick leave, job protection for the duration of the quarantine order, and guarantee their workers access to Paid Family Leave and disability benefits (short-term disability) for the period of quarantine including wage replacement for their salaries up to $150,000.

o   Employers with 100 or more employees, as well as all public employers (regardless of number of employees), will provide at least 14 days of paid sick leave and guarantee job protection for the duration of the quarantine order.

• TIMING OF PROVISIONS: The provisions of the quarantine legislation are set to take effect immediately upon passage, ensuring that New York workers will be able to take advantage of these benefits.

• MORE ON PAID SICK LEAVE: The legislation also includes the comprehensive paid sick leave proposal that was advanced by the Governor as part of his State of the State and FY 2021 Executive Budget, which will be effective 180 days after enactment. Specifically, the legislation provides:

o   Employers with 4 or fewer employees and a net income less than $1 million will provide at least 5 days of unpaid sick leave each year.

o   Employers with 5-99 employees and employers with 4 or fewer employees and a net income greater than $1 million will provide at least 5 days of paid sick leave each year.

o   Employers with 100 or more employees will provide at least 7 days of paid sick leave each year.

• HALT ON STUDENT DEBT: Governor Cuomo and Attorney General Letitia James announced that — effective immediately — the state will temporarily halt the collection of medical and student debt owed to the State of New York and referred to the Office of the Attorney General for collection, for at least a 30-day period, in response to growing financial impairments resulting from the spread of 2019 novel coronavirus, or COVID-19.

o   In an effort to support these workers and families and ease their financial burdens, the OAG will halt the collection of medical and student debt owed to the State of New York and referred to the OAG for collection from March 16, 2020 through April 15, 2020.

o   After this 30-day period, the OAG will reassess the needs of state residents for a possible extension.

o   Additionally, the OAG will accept applications for suspension of all other types of debt owed to the State of New York and referred to the OAG for collection.


ADDITIONAL INFORMATION / PREVIOUS ANNOUNCEMENTS

• HOSPITAL CAPACITY: Governor Cuomo issued an Executive Order allowing the state to increase hospital capacity to prepare the state’s healthcare system to handle the potential influx of patients suffering from COVID-19.

o   The State will organize the National Guard and work with building unions and private developers to find existing facilities — such as dormitories and former nursing homes — that can most easily be converted to medical facilities, with the goal of creating an additional 9,000 beds.

o   The Governor also asked local governments, especially those in the most impacted areas, to help identify available facilities for this purpose.

o   The State Department of Health is also suspending regulations to allow existing hospitals to increase space and capacity.

• HOSPITAL SURGE CAPACITY COUNCIL: The Governor has asked the Greater New York Hospital Association President Ken Raske and Northwell Health President Michael Dowling to lead a council to develop hospital surge capacity.

• ELECTIONS DELAYED: Governor Cuomo issued an executive order delaying village elections statewide until the April 28 primary election.

o   Delaying village elections will help ensure poll workers and voters are not potentially exposed to the virus and at the same time maintain integrity in our election system.

• SCHOOL CLOSINGS UPDATE: Governor Cuomo signed an executive order directing all schools in New York to close by Wednesday, March 18 for two weeks ending April 1.

o   At that time, the state will reassess whether to extend the school closures further and continue to suspend the 180-day instructional requirement. Schools that exceed the closure period without state authorization will not be exempted from the 180-day rule.

o   About 86% of all schools in the state have closed already.

• LOCAL GOVTS: The Governor also directed local governments to reduce their overall workforce by 50 percent and allow nonessential employees to work from home. But local governments must keep a minimum 50 percent capacity to deal with community response efforts.

• PARK FEES WAIVED: The Governor also announced New York State will waive all fees for state, local and county parks.

• SUPPORTING CHILDREN and PARENTS:  The Governor also called on 1199 SEIU, NYSNA, Greater New York Hospitals Association and United Federation of Teachers to work together to ensure children who rely on school breakfast and lunch programs will continue to receive that support.

• DMV: The Governor also directed DMV to move to appointment only to limit person to person contact and revert to regular hours rather than the extended hours the state implemented in recent weeks to help reduce lines.

• WORKING WITH COUNTIES: The Governor also tasked SUNY Empire State College President Jim Malatras with working with counties to develop contingency plans in preparation for school closings, including how to provide meals to food insecure children and ensuring families have adequate access to childcare.

• NYS COURT SYSTEM:  Governor Cuomo asked Chief Judge Janet DiFiore to develop a plan to reduce density in the court system, including limiting nonessential proceedings, without disrupting criminal justice system.

• ELECTION PETITIONS: In an effort to keep New Yorkers safe during the COVID-19 pandemic, Governor Andrew M. Cuomo today signed an executive order temporarily modifying election procedures to help reduce the spread of the novel coronavirus.

o   Governor Cuomo said: “This executive order modifies the election process in a way that both protects public health and ensures the democratic process remains healthy and strong regardless of the ongoing pandemic.”

o   The executive order suspends the candidate petitioning process — effective 5PM on Tuesday — for the June primaries for Congressional, State Senate, State Assembly and Judicial races.

o   The executive order also modifies the signature requirements for ballot access; candidates will only need to collect 30 percent of the statutory threshold.

o   For Congress, candidates would need 375 signatures rather than 1,250.

o   For State Senate, candidates would need 300 signatures rather than 1,000.

o   For State Assembly, candidates would only need 150 signatures rather than 500.

o   The executive order also modifies deadlines and procedures to better allow New Yorkers to vote absentee for the Queens Borough President special election on March 24. It extends the current deadline to register to vote absentee to March 23, the day before the special election. Absentee votes must be postmarked or delivered in person up until the day of the election on March 24.

• TELEMEDICINE: Governor Cuomo today announced the State Department of Financial Services will require insurance companies to waive co-pays for telehealth visits.

o   This action will encourage New Yorkers to seek medical attention from their homes rather than visit a hospital or doctor’s office — ultimately reducing strain on the healthcare system and preventing further spread of the virus.

• INCREASING TESTING CAPACITY: The addition of a mobile testing facility on Long Island is part of the State’s initiative to replicate the New Rochelle Mobile Testing Center model at other locations, helping the state to run at least 6,000 tests per day starting next week — six times the state’s target goal when this outbreak first came to New York.

o   This is on top of the testing that will be conducted at the 28 public and private labs across the state and the out of state labs that New York is already contracting with.

o   All of this is a result of the proactive steps taken by Governor Cuomo and the Department of Health to get as many New Yorkers tested as possible.

• TESTING GUIDANCE: We have received lots of questions around testing guidance and who can or should get tested now. Here’s an excerpt from the current guidance.

• Testing for COVID-19 shall be authorized by a health care provider when:

o   An individual has come within proximate contact (same classroom, office, or gatherings) of another person known to be positive; or

o   An individual has traveled to a country that the CDC has issued a Level 2 or Level 3 Travel Health Notice, and shows symptoms of illness; or

o   An individual is quarantined (mandatory or precautionary) and has shown symptoms of COVID-19 illness; or

o   An individual is symptomatic and has not tested positive for any other infection; or

o   Other cases where the facts and circumstances warrant as determined by the treating clinician in consultation with state and local department of health officials.

• NURSING HOMES: There are new limits on visitations to nursing homes – Only Medically Necessary Visits Will Be Allowed to Protect Most Vulnerable.

o   All staff are required to wear masks.

o   All staff will be monitored for symptoms.

o   No non-medical/staff personnel may enter unless there’s an exigent circumstance. In such a case, visitors must then wear protective clothing including masks.

o   NYS DOH sent updated guidance to all nursing home administrators around the state. That guidance is posted on the State Department of Health’s COVID-19 website.

• UNEMPLOYMENT ASSISTANCE: As part of the Governor’s Executive Order, the state will waive the 7-day waiting period for workers in shared work programs to claim unemployment insurance for those that have been put out of work by COVID-19

• SUPPLIES: Local governments seeking to obtain additional stocks of hand sanitizer or other supplies should work with their County’s emergency Manager and local Health Department to submit requests directly into NY RESPONDS, the state’s web-based system which enables both local governments and state agencies to submit and share vital emergency-related information and resource requests.

• STATE GUIDANCE: We are continually updating guidance for our communities, local governments, schools, health care providers, businesses, other institutions, and the public at large.

o   In the last few days, we have provided – and posted to our websites – updated guidance for schools, nursing homes, home care agencies, hospice and more.

o   We have also posted guidance on testing, cleaning & disinfecting, large gatherings and public spaces, and for employees with exposure concerns.

• NEW MASS GATHERING REGULATIONS: Public health experts agree mass gatherings with people making sustained close contact are a place where the novel coronavirus can easily infect many people quickly and continue its spread.

o   So in response, events with 500 or more individuals in attendance will be cancelled or postponed.

o   From zero to 500, we’re reducing the occupancy by 50%. So 50% of your seated capacity is the new capacity for a facility.

o   Those new rules will go into effect five o’clock on Friday, except for the Broadway theaters in Manhattan, which closed as of five o’clock yesterday.

o   Large gatherings and public spaces within the scope of this guidance include, but are not limited to: • Theaters, • Auditoriums, • Concerts, • Conferences, • Worship services, • Sporting events, • Restaurants, • Bars, • Gaming establishments, and • Physical fitness centers.

o   This guidance is not intended for governmental, medical, educational, retail spaces, or mass transportation facilities, including but not limited to: • Schools, • Libraries, • Government Buildings, • Hospitals, • Residential Health Care Facilities, • Retail Establishments, including: o Grocery Stores, o Pharmacies, • Public Transit Facilities: o Trains/Railway Stations, o Subway Terminals, and o Buses and Bus Terminals.

• PUBLIC UTILITIES: The Governor also directed the New York State Department of Public Service to suspend public utilities from cutting off service – including power and heat – to customers affected by COVID-19. The State’s major utilities will take immediate action to suspend service shutoffs to households during the COVID-19 outbreak and will continue to offer deferred payment plans for customers struggling financially due to the outbreak.

• NATIONAL GUARD: At the direction of Governor Cuomo, the New York National Guard has mobilized Army and Air National Guard members in State active duty status to assist in New York State’s efforts to contain the spread of the COVID-19 virus.

o   The soldiers come from units located across New York.

o   The soldiers will be on duty as long as required and are assisting in the distribution of food supplies and state-provided hand sanitizer, aiding with the cleaning and disinfecting of public spaces, and helping with transportation and logistical needs.

• DOCCS: The New York State Department of Corrections and Community Supervision has suspended visitation at facilities statewide.


RESOURCES

• WEBPAGE: That NYS DOH dedicated coronavirus webpage is: (https://www.health.ny.gov/diseases/communicable/coronavirus/). That’s the best place for updated case numbers, guidance, press releases, and additional information.

• HOTLINE: NYS DOH maintains a Coronavirus Hotline (1-888-364-3065) where New Yorkers with questions about the coronavirus can speak with public health experts in their preferred language.


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MSSNY Asks, “Who Will Fight for the Doctors?”


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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
March 19, 2020

MSSNY Asks, “Who Will Fight for the Doctors?”

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

“It is outrageous that while physicians across the State are putting their own health on the line responding to the coronavirus outbreak, the MRT2 is seeking to impose a new $52 million cost on the backs of the nearly 17,000 physicians enrolled in the Excess Medical Malpractice Insurance Program. This essential program has been in existence for over 30 years to ameliorate the outrageous liability costs we face in New York. We thank the Assembly and Senate for their commitment to the program and urge them to continue to fight to ensure full funding for this program as they work to finalize a State Budget. As New York’s doctors are on the front lines of this outbreak fighting for their patients, our public officials should fight for our doctors.”

# # #

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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