MSSNY Statement on Excess Medical Liability Insurance Program


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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
February 21, 2020

MSSNY STATEMENT ON EXCESS MEDICAL LIABILITY INSURANCE PROGRAM 

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

“Getting rid of New York’s Excess Medical Liability Insurance program without taking steps to bring down our exorbitant costs will very likely result in not being able to find a physician who will want to practice in New York in future years.

It is well documented how aberrant New York’s liability costs are compared to the rest of the country. The Excess program helps provide a modicum of protection for NY’s Doctors.

Unless the State Legislature decides to enact liability reform, extending this Excess program is essential for preserving patient access to specialized care.”

# # #

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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February 21, 2020

Arthur Fougner MSSNY Presiident

PRESIDENT’S MESSAGE
Arthur Fougner, MD
MSSNY President

MSSNY eNews
February 21, 2020

Vol. 23  Number 8


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Colleagues:

Apparently, Meyer Lansky chose the wrong racket. Case in point – Advanced Gynecology and Laparoscopy of North Jersey, et al v CIGNA Health and Life Insurance.

In summary, the lawsuit alleges that CIGNA accepts the out-of-network provider’s claims at the full billed amount and requests the same amount from the self-insured health plan. However, instead of paying the medical provider or member, CIGNA hires a Repricing Company to try and negotiate a reduction. If the provider refuses to negotiate, CIGNA pays the claim at an exorbitantly low level but appears to keep the difference between what was removed from the self-insured health plan and what was paid to the medical providers. In an attempt to conceal this from the patient and self-insured health plan, CIGNA issued Electronic Remittance Advice or paper Explanation of Benefits forms (collectively, the “EOB”) misrepresent the balance as “Discount” to the members, certifying the member is not responsible for the balance, while simultaneously representing the balance to the Plaintiffs as member liability or “Amount Not Covered”.

Curiously, CIGNA has been actively suing out-of-network physicians for not collecting patient liabilities in full. Moreover, the complaint includes allegations of RICO violations as well. You can read the whole thing at the above link.

Yes, as through this world I’ve wandered
I’ve seen lots of funny men;
Some will rob you with a six gun.
And some with a fountain pen.
–Woody Guthrie, Pretty Boy Floyd

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

Arthur Fougner, MD
MSSNY President


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eNews

Urge Your Legislators to Reject Undermining Physician Due Process
With Part L of Governor’s proposed Health/Mental Hygiene Budget bill containing extremely troubling measures to bypass important due process protections for physicians during disciplinary proceedings, all physicians are urged to continue to contact their legislators to urge that the Legislature reject this unfair proposal, and plan to be in Albany on March 4 for Physician Advocacy Day.

The proposal would, among many other provisions, make it far easier for the Commissioner of Health to disclose to the public that a physician is under disciplinary investigation or summarily suspend a physician with only a minimal finding of risk to the public, as opposed to the much stronger “imminent danger” standard now required for bypassing existing due process protections.  That is particularly troubling given that only a small percentage of complaints to OPMC result in a disciplinary sanction.  MSSNY has indicated that we agree with the importance of acting quickly when it is imperative, but these proposals would completely undermine important and longstanding due process protections. Given that most complaints are dismissed without any sanction or action, this series of proposed changes to bypass these rights would create a substantial possibility of unfairly destroying an innocent physician’s career.   

MSSNY has joined with 16 state specialty societies in a communication to the Legislature setting forth our concerns in greater detail. Moreover, MSSNY President Dr. Art Fougner recently appeared on the WCNY “Capitol Pressroom” radio program to discuss MSSNY’s concerns with this proposal.

Please urge your legislators to reject this proposal from the Budget.


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One-Sided Surprise Bill Proposals Advance in Congress – Contact Your Representatives Today
All physicians are urged to continue to contact New York’s Senators Schumer and Gillibrand, as well as their respective Representative to express strong concerns with the various proposals before Congress that would substantially limit insurer responsibility for coverage of out of network emergency and surprise medical bills.  A letter can be sent here.

While MSSNY supports the goals of legislation to prevent surprise medical bills, most proposals advanced so far are steered heavily to the benefit of insurance companies, and do not have the balance of New York’s law.  Last week the House Ways & Means Committee and Education & Labor Committee advanced separate proposals.  While the Ed & Labor proposal was very similar to Energy & Commerce proposal advanced last year strongly opposed by MSSNY and many other physician organizations, the W&M proposal did make a few marginal improvements including rejecting a benchmark payment and permitting the consideration of many factors.

However, the IDR mechanism identified in the legislation would also prohibit the consideration of physician charge data and require the consideration of median in-network data, which in all certainty will skew the results towards the insurance companies.  In fact, when the proposal was scored by the Congressional Budget Office (CBO), it was noted that “in facilities where surprise bills are likely, average payment rates for both in- and out-of-network care would move toward the median in-network rate.  Moreover, the proposal only provides for a minimal review of insurer networks, which is the major contributing factor to the problem of surprise bills.

Therefore, this proposal remains highly problematic, and MSSNY President Dr. Art Fougner offered this statement supporting efforts to “ensure a fair federal legislative solution to protect patients from surprise out of network bills”, but that “far more balance is needed in what has been put forward so far”, and that the proposal released Friday by the US House Ways & Means “provides a few marginal steps forward but would still hand an enormous gift to already market dominant health insurance companies by tilting the factors in its dispute resolution mechanism towards the insurance industry.”


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“Coronaviruses 2020” CME Webinar on March 18th Registration Now Open
There have been 29 confirmed cases of COVID-19 in the United State as of February 20, 2020.  Learn more about this and other coronaviruses by signing up for Medical Matters: Coronaviruses 2020 on March 18th at 7:30am.  William Valenti, MD, chair of MSSNY Infectious Disease Committee and a member of the Emergency Preparedness and Disaster/Terrorism Response Committee will serve as faculty for this program. Registration is now open for this webinar here.  Please click here to view the flyer for this program.

Educational objectives are:

  • 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

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.Coronavirus Flyer


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Registration Now Open for Steps to Physician Wellness and Resiliency
MSSNY’s Committee on Physician Wellness and Resiliency will hold its first webinar, entitled Steps to Physician Wellness and Resiliency on February 25th from 7:30-8:30am. Jeffrey Selzer, MD will serve as faculty for this webinar.

Educational Objectives are:

  • Review the warning signs that stress, depression, anxiety or substance use may impact work or personal life
  • Identify strategies to increase personal empowerment toward making positive change, including self-assessment tools
  • Recognize self-monitoring strategies for stress related problems and know when to seek professional assistance

Register by clicking here.  Please click here to view the flyer for this program.

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.

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Several NY Counties Pushing Back Against Gov.’s Medicaid Cost-Shifting Plan
The Buffalo (NY) News (2/14) reported, “Officials from Erie County, New York City and elsewhere are pushing back on an additional Medicaid cost-shifting plan that they say could be even worse than what Gov. Andrew M. Cuomo recently proposed in his new budget.” This “latest fight is over millions of dollars counties receive each year from the federal government for additional Medicaid services and costs under the Affordable Care Act.”


 

Dr. Pinto

Saratoga County President Greg Pinto, MD with Assemblywoman Carrie Woerner, Assembly District 113 (Saratoga) at 2-19-2020 Legislative Update meeting of the Saratoga County Medical Society.


NYS DOH Flu Tracker
https://nyshc.health.ny.gov/web/nyapd/new-york-state-flu-tracker


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Unregulated/Deeply Discounted Insulin Sales Common on Craigslist
Reuters (2/17) reports, “Unregulated and deeply discounted sales of insulin are common on Craigslist,” research indicated. Over the course of “a two-week period, researchers turned up 327 ads from private parties selling insulin at a fraction of the retail price,” investigators found. The study’s co-author said, “The take home message from this study is that patients (with diabetes) should not have to go to Craigslist to find affordable insulin.” She added, “There has to be a better way than patients going out on their own and seeking out potentially harmful products.” The findings were published online in a research letter in JAMA Internal Medicine (subscription required).


Grandparents May Be Bad Influence on Children’s Weight
Grandparents can be a bad influence on kids’ weight,” investigators concluded after analyzing data from “23 studies conducted in the United States and eight other countries.” That analysis revealed that children “who were cared for by grandparents had nearly 30% higher odds for being overweight or obese.” The findings of the systematic review and meta-analysis were published online in the journal Childhood Obesity.


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MSSNY Young Physicians, Resident Fellow, Med Student Social
Friday, 2/28/2020, 6pm-9pm
Sessions 73 – 73rd St. and 1st Ave. New York, NY
RSVP for social here


Just One Dose of HPV Vaccine May Help Prevent Cervical Disease

A single dose of human papillomavirus (HPV) vaccine is associated with a significant reduction in cervical disease, according to a retrospective study in Cancer. The CDC generally recommends two doses for those vaccinated between ages 9 and 14, and three doses for those vaccinated later.

Using a U.S. insurance claims database, researchers matched nearly 67,000 females aged 9 to 26 who received at least one dose of the quadrivalent HPV vaccine with 67,000 unvaccinated controls.

The estimated rate of preinvasive cervical disease at 5 years was 2.65% in the unvaccinated group, versus 1.62%, 1.99%, and 1.86% among those who received one, two, and three vaccine doses, respectively, between ages 15 and 19. After multivariable adjustment, one vaccine dose was associated with a 36% risk reduction; two doses, a 28% reduction; and three doses, a 34% reduction.

Editorialists say the findings “add to the growing evidence suggesting that there may truly be no major difference in protection against cervical preinvasive lesions … conferred by 1, 2, or 3 doses of HPV vaccination.”

Cancer article
Background: Prior Physician’s First Watch coverage of single-dose HPV vaccination


Considering a Run for Office for Yourself?
AMPAC Candidate Workshop February 28 – March 1, 2020

Ever wonder how Doctors get elected to Congress or your state legislature? The AMPAC Candidate Workshop will teach you how to run a winning political campaign, just like we taught many of your AMA colleagues over the years.

The Candidate Workshop is designed to help you make the leap from the exam room to the campaign trail and give you the skills and strategic approach you will need to make a run for public office.

Additional details below

This one-and-a-half-day workshop is designed to provide you with the skills and strategic approach you will need to make a run for public office. Some of the topics include: how and when to make the decision to run; the importance of a disciplined campaign plan and message; the secrets of effective fundraising; what kinds of media advertising are right for your campaign; how to handle the inevitable crises that emerge for every campaign; the role of your spouse and your family; and how to become a better public speaker.

Registration is now open. There are still a few spots remaining but don’t delay. The registration fee is $250 for AMA members ($1,000 non-members), spouses and state medical society staff. The fee is waived for students/residents, however, there are limited slots and the AMPAC Board will review and select from the pool of qualified applicants. For more information visit AMPAC online. To apply, simply fill out the online registration form or email your questions to: politicaleducation@ama-assn.org.


Med Schools Recruit LGBTQ Students to Improve Care for LGBTQ Patients
The AP (2/19) reports on efforts to increase the number of LGBTQ physicians, which LGBTQ advocates say should improve the quality of care received by LGBTQ patients. The article says that “when being heterosexual is presumed even in doctors’ offices, those who identify otherwise can feel marginalized and less likely to seek medical care, contributing to health problems” such as mental health issues, alcohol and drug use, and forgone preventive care, according to LGBTQ advocates.

The article adds that some medical schools are pushing to recruit more LGBTQ students citing “research showing that patients often get better care when treated by doctors more like them.” Exact numbers of LGBTQ medical students and doctors are unknown. In 2018, the AMA added sexual orientation and gender identity as an option for members to include in demographic profiles the group compiles.

Of the 15,000 doctors and students who have volunteered that information so far, about 4% identify as LGBTQ. That is similar to Gallup estimates for the general U.S. population, although LGBTQ advocates believe the numbers are higher and rising as more people are willing to “out” themselves. This past fall, Harvard’s entering class of medical students was 15% LGBTQ, a milestone that is no accident.


Bill Correctly for Medicare Telehealth Services
In a recent report, the Office of Inspector General (OIG) determined that the CMS improperly paid practitioners for some telehealth claims associated with services that did not meet Medicare requirements. CMS released the Medicare Telehealth Services video to help you bill correctly.

Additional resources:

·       Telehealth Services (PDF) Medicare Learning Network Booklet

·       Medicare Claims Processing Manual, Chapter 12 (PDF), Section 190

·       Medicare Telehealth Payment Eligibility Analyzer

·       List of Covered Telehealth Services webpage

·       CMS Paid Practitioners for Telehealth Services That Did Not Meet Medicare Requirements OIG Report


 


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

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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.org if you have questions or comments.  Thank you.
(WILKS)


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RENTAL/LEASING SPACE


Office Rental 30 Central Park South
Three exam rooms, consultation, reception and secretarial rooms. Ground floor next to Plaza Hotel.
Elegantly decorated and fully equipped with operating suite on site. Part or full time. $1280/month for each exam plus consultation room.213.371.0468 www.drcenedese.com


Midtown Medical Office for Rent
Beautiful office for rent in midtown Manhattan located opposite Grand Central Station on 42nd Street and Madison avenue. ideal for medical and surgical specialists as there are five spacious exam rooms with an accredited quad a certified operating room with anesthesia services. You can perform procedures and see patients. Rent for three days a week is $3,200 and 4 days a week is $4,100 Interested physicians please email cpmgman@gmail.com or call 914-582-0749.


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We improve the employee and patient experience to help you achieve your goals and grow your practice. How? With strategic processes that support you, your staff, and your patients! We integrate your values into all areas of your practice including hiring, training, communication and operational strategies. Whether you’re independent or part of a group, we have an approach that will work for you. If you’re ready to strengthen your practice, we can help. 

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Furnished Luxury Park Avenue East 70’s Medical Office Rental Available.
Voted most beautiful block on UES. Private Entrance. Central A/C.
Dedicated consultation room, exam room, procedure room, reception and nurse areas in a multispecialty office setting. Suitable for all subspecialties. Walk to Lenox Hill Hospital and NY Cornell. Proximate to Mt Sinai Hospital. Subway 2 blocks away. Full Time/Part Time. No fee.
START SEEING PATIENTS IMMEDIATELY!!!
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JOB OPPORTUNITIES

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Great Career Opportunities for Clinical Physicians
Physicians, are you looking for a change?  Tired of working long shifts with an overwhelming patient load?  Come work at a well-equipped and staffed correctional facility where you can MAKE a difference, working with a smaller number of patients for reasonable hours.

Starting salary is $143,381 – $171,631 *Additional $20,000 geographical differential for Clinton & Franklin CF, and $10,000 for Five Points, Greene and Groveland CFs. We offer full-time, part-time & hourly/per-diem positions.

We have openings in the following counties offering a choice of urban, suburban or rural living:

Clinton*                 Clinton Correctional Facility (sporting and recreational outlets)
Chemung               Elmira and Southport Corrl Facilities (Gateway to the Finger Lakes)
Columbia*             Hudson Correctional Facility (antiquing, arts & collectables)
Dutchess                Green Haven Correctional Facility (Hudson River Valley Beauty)
Franklin*                Franklin & Upstate Corrl Facilities (North Country, 1 hour to Montreal)
Greene*                 Greene Correctional Facility (rural charm yet only 2 hours to NY City)
Livingston*            Groveland Correctional Facility (State Parks, hiking, fishing)
Oneida                   Mohawk Correctional Facility (Cooperstown, breweries)
Orleans                  Albion Correctional Facility (Greater Niagara Region & Canal Town Culture)
Sullivan                  Woodbourne Correctional Facility (mountains, outlets, entertainment)
Seneca*                 Five Points Correctional Facility (heart of wine country)
St. Lawrence          Riverview Correctional Facility (hiking, boating and museums)
Ulster                     Shawangunk and Wallkill Corrl Facility (Catskill Mountains, Casinos)
Washington           Great Meadow Corrl Facility (Between Vermont & Green Mountains)
Westchester           Bedford Hills Correctional Facility (Less than 1 Hour to NYC)
Wyoming               Wyoming Correctional Facility (waterfalls, family farms, natural beauty)

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Inquire with the Facility Personnel Office regarding benefits and anticipated opportunities: http://www.doccs.ny.gov/faclist.html. Contact: www.doccs.ny.gov or DOCCS Personnel Office at (518) 457-8132 for more information and to apply.



 

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

 

MSSNYeNews: Presidents Day – February 14, 2020

Arthur Fougner MSSNY Presiident

PRESIDENT’S MESSAGE
Arthur Fougner, MD
MSSNY President

MSSNY eNews
February 14, 2020

Vol. 23  Number 7


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National Advocacy Conference in Washington DC
National Advocacy Conference in Washington DC Feb. 10-12
MSSNY members in Washington, DC advocating for legislation that puts patients before profits (left to right) Jerome Cohen, MD; MSSNY President-Elect Bonnie Litvack, MD; Purvi Parikh, MD; Jeff Morgan, Legislative Director to NY Rep. Paul Tonko; MSSNY Immediate Past President Tom Madejski, MD; MSSNY President Art Fougner, MD; Daniel Choi, MD; MSSNY Executive VP Phil Schuh; Pratisthe Kiorala, MD


Colleagues:

This Monday, we celebrate Presidents Day. The holiday could not come at a better time. While we agonize over Congress’ inching closer toward awarding insurers the upper hand on surprise bills and, at the same time, worry about Albany’s empowering OPMC, it would be wise to reflect on the lives and examples of America’s Romulus and Remus – George Washington and Abraham Lincoln.

George Washington truly led by example. He took command of a group of rag-tag patriots and led them with spirit, guile and whatever he found at his disposal to victory over the world’s mightiest power. At the height of his military career, he resigned his commission. When offered the scepter of King, he became instead President. After two terms, he retired to private life and left the office to others. George Washington observed that “happiness and moral duty are inseparably connected.” As historian Forest McDonald observed, Washington was “the instrument by which an inconsequential people took the first steps toward becoming a great nation.”

Abraham Lincoln was not a military man yet became the Commander in Chief during the second most important conflict in our history. Lincoln did not attend Harvard or Yale, yet he became arguably the most famous lawyer in our history. Federal judge Herbert George would ask a rhetorical question:

“Would you rather have the edge in the facts of a case, the law of a case or Abraham Lincoln as your lawyer?” Lincoln advised us that a “house divided against itself cannot stand.” We would be wise to heed his counsel.

So, this weekend, take a few moments away from prior authorizations and mouse clicks to reflect on how we got here and, more importantly, where we are going. Remember that another, more recent president pointed the way to that “Shining City on a Hill.”

Remember our patients. Do not despair. We will get there.

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

Arthur Fougner, MD
MSSNY President


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Capital Update

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Please Plan To Be in Albany for MSSNY‘s Annual “Physician Advocacy Day” March 4th
With State Budget discussions beginning to heat up the need for physician advocacy and grassroots involvement is greater than ever. With the Governor’s Budget Proposal teeing up items for potential concern such as Medicaid cuts, cuts to the Excess Medical Liability Insurance Program, and changes to the physician disciplinary process, but also supported reforms such as regulating PBMs and a flavored tobacco ban, it is imperative that physicians be in contact with their local legislators to ensure the physician community’s message is well-represented.One opportunity is to participate in MSSNY’s “Physician Advocacy Day” that will be held on Wednesday, March 4th in the Lewis Swyer Theatre in the Egg located at the Empire State Plaza, Albany NY. Click here to register!

Please join hundreds of your colleagues from all around New York State and come to MSSNY’s Physician Advocacy Day to speak with your legislators and key policymakers to ensure they’re making the right choices for New York’s physicians and their patients.

A brief luncheon to which members of each House are invited to speak with their constituents will follow the morning program. Please work with your County Medical Societies to schedule appointments for physicians to meet with their elected representatives.

If you have any questions/comments, please contact Raza Ali at rali@mssny.org.                                                                   (ALI)


MSSNY Leaders & Staff Hold Key Meetings in DC to Discuss “Surprise Billing” & Other Pressing Issues
On February 10 – 12, MSSNY member leaders, and staff, attended the American Medical Association’s (AMA) National advocacy conference, in Washington, DC., and held meetings with New York’s Congressional delegation. Attendees included the following:

  1. Art Fougner (Current MSSNY President)
  2. Bonnie Litvack-Penn (Incoming MSSNY President)
  3. Jerome Cohen
  4. Dan Choi
  5. Jacqueline Bello
  6. Thomas Madejski (MSSNY Immediate Past-President)
  7. Willie Underwood
  8. Yetunde Olowe
  9. Purvi Parikh

The group discussed several of MSSNY’s most pressing legislative priorities, with a heavy focus on the issue of Surprise Billing, which has multiple bills moving through Congress to try and resolve this issue in a way that serves the needs of both physicians and patients. Among the lawmakers’ offices that MSSNY met with were Senator Chuck Schumer, Senator Kirsten Gillibrand, Representative Paul Tonko (D- Schenectady), Representative Brian Higgins (D- Buffalo), Representative Eliott Engel (D-Westchester/Bronx), Dr. Tom Reed (R-Southern Tier), and Representative Joe Morelle (D-Rochester).

In addition to the “Surprise Billing” issue, MSSNY members discussed the need for federal legislation to reign in the number of services that are subject to prior authorization and a study of the potential public health impact of marijuana for recreational purposes.   (CARY)


 

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One-Sided Surprise Bill Proposals Advance in Congress – Contact Your Representatives Today
All physicians are urged to continue to contact New York’s Senators Schumer and Gillibrand, as well as their respective Representative to express strong concerns with the various proposals before Congress that would substantially limit insurer responsibility for coverage of out of network emergency and surprise medical bills.  A letter can be sent here: Please click here.

While MSSNY supports the goals of legislation to prevent surprise medical bills, most proposals advanced so far are steered heavily to the benefit of insurance companies, and do not have the balance of New York’s law.  This week the House Ways & Means Committee and Education & Labor Committee advanced separate proposals.  While the Ed & Labor proposal was very similar to Energy & Commerce proposal advanced last year strongly opposed by MSSNY and many other physician organizations, the W&M proposal did make a few marginal improvements including rejecting a benchmark payment and permitting the consideration of many factors.

However, the IDR mechanism identified in the legislation would also prohibit the consideration of physician charge data and require the consideration of median in-network data, which in all certainty will skew the results towards the insurance companies.  In fact, when the proposal was scored by the Congressional Budget Office (CBO), it was noted that “in facilities where surprise bills are likely, average payment rates for both in- and out-of-network care would move toward the median in-network rate.  Moreover, the proposal only provides for a minimal review of insurer networks, which is the major contributing factor to the problem of surprise bills.

Therefore, this proposal remains highly problematic, and MSSNY President Dr. Art Fougner offered the following comments in response:

“New York’s dedicated physicians remain anxious to work with all parties to ensure a fair federal legislative solution to protect patients from surprise out of network bills.  However, far more balance is needed in what has been put forward so far.  The proposal released Friday by the US House Ways & Means provides a few marginal steps forward but would still hand an enormous gift to already market dominant health insurance companies by tilting the factors in its dispute resolution mechanism towards the insurance industry.  Even worse, it fails to provide meaningful steps to make sure health insurance physician networks are adequate, to help protect patients from finding themselves in the position in a hospital where they are treated by an out of network physician.

These new proposals remain far different than the comprehensive and balanced measure that was enacted in New York, which not only put in place a balanced dispute resolution system to protect patients, but also put in place new measures to better ensure that health plan networks and out of network coverage was comprehensive.  We urge Congress to revise their proposals to more closely resemble New York’s acclaimed approach, which has had zero adverse premium impact and has saved consumers hundreds of millions of dollars.” (AUSTER, CARY)


Initial Meeting of the MRT 2
This week brought the initial meeting of the second iteration of the Governor’s Medicaid Redesign Team (MRT), charged with recommending $2.5 billion in Medicaid savings as part of an effort to enact a State Budget by April 1.  The meeting generally covered a review of the successes of the previous MRT, a statement of the general charge and activities for the MRT 2, and identifying the highest cost drivers in the Medicaid program that will be under the microscope for revisions.

There will be 3 meetings of the MRT 2, including this week’s, March 2 in NYC and a third meeting to be announced for mid-March.  There will also be a Long Term Care advisory group established.  They will be soliciting public input online as well as through 3 upcoming public forums/evening webinars. The next one will be place on Tuesday February 18th from noon – 3pm, at the Monroe County Community College, High Falls Auditorium, 321 State St., Rochester, NY

In looking at the services for 6.2 million Medicaid enrollees, among the highest cost drivers identified included:

  • LTC and Consumer Directed Personal Care Program (800% growth from 2016 to 2021)
  • Prescription Drugs (36% growth from 2011 to 2019, exceeding 25% medical CPI)
  • Transportation (up 131% from 2011 to 2019)
  • Case management including Health homes
  • Program Integrity (reducing fraud and abuse, and ensuring cost-efficient delivery of care for Medicaid recipients)
  • Distressed Hospitals (160% increase)

It was also noted that, among the 770,000 “dual eligibles” in New York, only 3% are enrolled in managed care programs.

The only area where physician care under Medicaid appeared to be directly implicated was the stated 344% increase in the Patient Centered Medical Home program from 2011 to 2019, which pays physicians a PMPM bonus to help manage the care of certain Medicaid patients.  However, DOH also noted that patients enrolled in PCMH also had significantly lower health costs overall than non-PCMH enrollees.  MSSNY has repeatedly argued to legislators that Medicaid payments to physicians are already among the lowest in the country, represent a good investment in care delivery, and therefore should be spared from future cuts.  MSSNY also continues to raise strong concerns about the lack of a community based physician on the MRT 2.

It was also noted that the public could submit recommendation to the MRT 2 for Medicaid cost-saving suggestions from here: Please click here  (AUSTER, ALI)                                                       


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Please Urge Your Legislators to Reject Unfair Disregarding of Physician Due Process
With Part L of Governor’s proposed Health/Mental Hygiene Budget bill containing extremely troubling measures to bypass important due process protections for physicians during disciplinary proceedings, all physicians are urged to continue to contact their legislators contact here to urge that the Legislature reject this unfair proposal, and plan to be in Albany on March 4 for Physician Advocacy Day.

The proposal would, among many other provisions, make it far easier for the Commissioner of Health to disclose to the public that a physician is under disciplinary investigation or summarily suspend a physician with only a minimal finding of risk to the public, as opposed to the much stronger “imminent danger” standard now required for bypassing existing due process protections.  That is particularly troubling given that only a small percentage of complaints to OPMC result in a disciplinary sanction.  MSSNY has indicated that we agree with the importance of acting quickly when it is imperative, but these proposals would completely undermine important and longstanding due process protections. Given that most complaints are dismissed without any sanction or action, this series of proposed changes to bypass these rights would create a substantial possibility of unfairly destroying an innocent physician’s career.  

MSSNY has joined with 16 state specialty societies in a communication to the Legislature setting forth our concerns in greater detail.  Moreover, MSSNY President Dr. Art Fougner recently appeared on the WCNY “Capitol Pressroom” radio program to discuss MSSNY’s concerns with this proposal.

Please urge your legislators to reject this proposal from the Budget. (AUSTER)


Physician Mandate Bills Begin to Pile Up in Albany
As if physicians needed one more reason to be in Albany on March 4, the State Legislature has been advancing numerous bills through its Committee process that, while well-intended, would place substantial new mandates on physician care delivery at a time when physicians are already drowning in administrative tasks that take time away from patient care delivery.  They also unfairly place the physician at risk of financial penalty or even license sanction by DOH/OPMC if the physician fails to document that they performed the mandated task.  These proposals include:

  • Mandated conspicuous posting in a physician’s office of a patient’s ability to file a complaint with the Office of Professional Conduct (A.7991-A/S.6678-A). Assembly Floor/Senate Health Committee
  • Mandated notification to epileptic patients of the risk of sudden death due to epilepsy (S.5397-A/A.7807-A). On Assembly Floor/On Senate Floor
  • Mandated co-prescribing of naloxone for patients: a) taking 50 mmg per day b) with a history of substance use disorder or c) concurrent use of opioids and benzodiazepine or nonbenzodiazepine sedative hypnotics (S.5150-B/A.5603-B). Passed Senate.  In Assembly Ways & Means
  • Mandated reporting of rescue inhaler prescriptions to the statewide immunization system (S.7337). On Senate floor
  • Mandated dissemination of a pamphlet prior to performance of a pelvic exam (S.7544/A.9600). On Senate floor/In Assembly Health
  • Mandated proof of completion of CME on cultural competency, including paying for an additional fee to SED on top of the bi-ennial $600 registration fee (S.2406-A). Passed Senate/In Assembly Higher Education Committee
  • Mandated seeking of a detailed patient/family member consent for a nursing home resident prior to the receipt of a psychotropic medication, or detailed documentation of the need to provide such medication without consent (A.1033/S.5441). On Assembly Floor/Senate Health Committee.
    (AUSTER, CLANCY

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Rear Seat Belt Measure Passes NYS Assembly; On Senate Calendar for Vote
A measure that would require safety belts for persons 16 years and younger in are back seat passengers in a motor vehicle has passed the New York State Assembly and is pending on the Senate Calendar for a vote.   This measure, Assembly Bill 6163/ S. 4336, is sponsored by Assemblymember Walter Mosely and Senator David Carlucci and the Medical Society of the State of New York supports this measure.

The MSSNY House of Delegates unanimously adopted policy urging that seat belts be required in both front and rear seats.  One of the safest choices drivers and passengers can make is to buckle up and 89.6% of drivers and passengers buckled up in 2018, saving 14,955 lives.   According to the 2015 data from the National Highway Traffic Safety Committee, 4.3% of 22,441 fatalities — or 966 deaths — involved unrestrained people in rear seats.  Research also found that unbuckled rear-seat travelers are eight times as likely as buckled rear-seat passengers to be injured or killed in a crash.

Thirty-eight states have laws that allow police officers to ticket a driver if the driver or the front-seat passenger is not wearing a seat belt, while only 18 states have the same laws for rear-seat riders. Those laws, along with police checks, public education campaigns, and seat-belt reminder systems, have helped increase use of seat belts in all seats.

Rear seating passengers who are older are less likely than front-seat passengers to wear a seat belt, making them more likely to injure themselves and drivers or other passengers in a crash.  Adult rear-row occupants were less likely to use seat belts, with just 70 percent of those ages 20 to 54, and 86 percent of those 55 and older using restraints, according to the Insurance Institute for Highway Safety. According to the Institute for Highway Safety (IHS), adult rear seat passengers are at greater risk for chest injuries and traumatic brain injuries than front seat passengers.                                          (CLANCY)


Register Now for CME Courses at MSSNY House of Delegates April 23 & 24
MSSNY will be offering multiple CME courses on Thursday April 23rd and Friday April 24th at the 2020 House of Delegates in Tarrytown.  Click Please click here to register for as many or few of these offerings as you can.

Thursday April 23, 2020

1:00-2:00pm       Medical Matters: Triage in a Disaster Event

2:00-3:00pm       Veterans Matters: TBI in Returning Veterans

3:00-4:00pm       Steps to Physician Wellness and Resiliency

4:00-5:00pm       The Health of Sexual and Gender Minorities

Friday April 24, 2020

1:00-4:00pm       Pain Management, Palliative Care & Addiction

For more information please contact Melissa Hoffman at mhoffman@mssny.org or call (518) 465-8085. (CLANCY, HOFFMAN)


Registration Now Open for “Steps to Physician Wellness and Resiliency”
MSSNY Committee on Physician Wellness and Resiliency will hold its first webinar, entitled Steps to Physician Wellness and Resiliency on February 25th from 7:30-8:30am. Jeffrey Selzer, MD will serve as faculty for this webinar.

Educational Objectives are:

  • Review the warning signs that stress, depression, anxiety or substance use may impact work or personal life
  • Identify strategies to increase personal empowerment toward making positive change, including self-assessment tools
  • Recognize self-monitoring strategies for stress related problems and know when to seek professional assistance

Register by clicking 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.
(CLANCY, HOFFMAN, ALI)


Registration Now Open for Medical Matters: Virtual Drill: Incident Command System & Crisis Communications
MSSNY’s next Medical Matters will feature a Virtual Drill on the Incident Command System and Crisis Communications on February 19th from 6:00-8:00pm. Faculty for this program are: Arthur Cooper, MD; Pat Anders, MS, MEP; William Valenti, MD and Lorraine Giordano, MD.

With the outbreak of the Wuhan Coronavirus (COVID-19) it is doubly important for physicians to learn about the incident command system and crisis communications from the NYS Department of Health’s perspective.  This program provides physicians with vital information that would be needed to combat a public health emergency.  Be sure to note the format of this webinar includes extended time and takes place in the evening.

Educational Objectives are:

  • Obtain information about local, state and national chain of command in a public health emergency and learn how to access resources
  • Understand the importance of planning for medical surge and triage of patients, as well as staff and family considerations, in the office-based practice setting during a health emergency
  • Develop an understanding that all public health emergencies can potentially have mental health implications for survivors and others connected with the event
  • Acquire skills for the management of patients in a public health emergency

Please note that there are recommended pre-course materials to be viewed prior to this virtual drill. You will be sent a link with your registration confirmation. We encourage all participants to examine these prior to the Virtual Drill.  Register by clicking here:  Please click 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 2.0 AMA/PRA Category 1 credits™.  Physicians should claim only the credit commensurate with the extent of their participation in the activity. (CLANCY, HOFFMAN)


Veterans Matters: PTSD in Returning Veterans Live Seminar at Our Lady of Lourdes Memorial Hospital
The Medical Society of the State of New York is hosting a CME live seminar entitled Veterans Matters: PTSD in Returning Veterans on Thursday, February 27, 2020 at 12:00 pm at Our Lady of Lourdes Memorial Hospital, 169 Riverside Drive, Binghamton, NY 13905.

Adolph Meyer, MD will serve as faculty for this program and the educational objectives are:

  • Identify diagnostic criteria for PTSD
  • Discuss medical and psychiatric comorbidities of military related PTSD
  • Discuss evidence-based treatment modalities for PTSD including medications and psychotherapy
  • Discuss strategies to help veterans overcome stigma to seek and accept treatment for military related trauma

Reservations can be made by contacting Jean Jenkins at jjenkins@ascension.org or (607) 798-5290.

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 each of these live activities 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.
(CLANCY, HOFFMAN)          


 pschuh@mssny.org mauster@mssny.org  pclancy@mssny.org  zcary@mssny.org
rali@mssny.org


eNews

Physicians Are Fighting BCBS Plan Requiring Use of Mail-Order Pharmacies
A group of eight medical societies are pushing back against a proposal from BlueCross BlueShield of Tennessee that the groups fear will hurt patient access to critical drugs. (American Academy of Ophthalmology; American Academy of Dermatology; American College of Rheumatology; American Gastroenterological Association; American Urological Association; Coalition of State Rheumatology Organizations; Alabama Society for Rheumatic Diseases; Tennessee Rheumatology Society)

The proposed policy change would require physicians to use mail-order pharmacies to order drugs that have to be administered in-office, instead of allowing physician offices to bulk-order the drugs and keep them in-house. It would apply to drugs such as those given to rheumatoid arthritis patients that have to be administered by physicians in their offices.

BCBS said the policy changes are designed to save money for Tennessee-based employers and the people covered by their healthcare plans. The medical groups argue that the policy, which would mean physicians can only order the drugs on an as-needed basis for each patient, would delay patient care, reduce access to much-needed drugs, inflate out-of-pocket costs and increase drug waste.

Under the proposal, physicians would have to obtain the drugs from BCBS’ preferred pharmacies and then wait for that pharmacy to ship them, which the groups argue is just a way for BCBS to get rebates from its pharmacy benefit managers.

The groups are also concerned that they won’t be able to ensure the drugs are safe and haven’t been exposed to high temperatures. Additionally, extra doses would be required to be thrown away, increasing drug waste. The new policy could also mean patients have to go to a more expensive hospital outpatient setting if their physician can’t afford to obtain the drugs from the preferred pharmacies, which could be a significant barrier to access for some patients.

“We’re not asking members to see a different doctor or receive care at a different facility,” BCBS said on its website. The company added that the changes apply to only 5,500 of its 3.5 million members.  In a letter to BCBS, Ellen Gravallesse, MD, said: “We have had an alarming number of practices reporting they have been denied the ability to use therapies currently available in their offices to administer patient care quickly.” (Becker’s Healthcare Feb. 13)


If You’re a Physician under 40, Don’t Miss Feb. 28 Meeting in Manhattan!
For all medical students, residents, fellows, and new attendings starting practice in the last 8 years in the NY Metro Area and Long Island, don’t miss the upcoming Medical Society of the State of New York Joint Section Annual Meeting on February 28th from 8:30am-12:30pm at the New York Academy of Medicine, 1216 5th Avenue. New York, NY. More information and registration available at: www.mssnyconference.org Earn CME and learn from experts on how to succeed when starting practice and how to best advocate for your patients outside of the hospital and clinic. Limited space available. 3.0 AMA PRA Category I CME Credits available.

Program:

1.     Keynote speaker: The Evolving Healthcare Landscape: Challenges and Opportunities for Young Physicians by Jesse Ehrenfeld, Current AMA Board of Trustees Chair.

2.      “How to Avoid Malpractice Lawsuits in the First 5 Years of Practice” by William Hassett, Esq. from Fager, Amsler, Keller & Schoppmann, LLP.

3.      Millennials in Private Practice: Is It Even Possible? A Panel Discussion by Millennial Independent Physicians with Sonia Bahlani; Dhaval Bhanusali, MD, FAAD; Purvi Parikh, MD; Saya Nagori, MD. Moderated by: Daniel E. Choi, MD #doctor #medicalstudent #SoMeDocs



CDC Confirms 15th Case of Coronavirus Disease (COVID-19)
Yesterday, CDC confirmed another infection with Coronavirus Disease (COVID-19) in the United States. The patient is among a group of people under a federal quarantine order at JBSA-Lackland in Texas because of their recent return to the U.S. on a State Department-chartered flight that arrived on February 7, 2020.

All people who lived or traveled in Hubei Province, China, are considered at high risk of having been exposed to this virus and are subject to a temporary 14-day quarantine upon entry into the United States. This is the first person under quarantine at JBSA-Lackland who had symptoms and tested positive for COVID-19. The individual is currently isolated and receiving medical care at a designated hospital nearby.

This brings the total number of COVID-19 cases in the United States to 15. There will likely be additional cases in the coming days and weeks, including among other people recently returned from Wuhan. While 195 people were discharged from quarantine on Tuesday, more than 600 people who returned on chartered flights from Wuhan remain under federal quarantine and are being closely monitored to contain the spread of the virus.

For the latest information on the outbreak, visit CDC’s Novel Coronavirus 2019 website(Thursday, February 13, 2020 CDC release)


Yale New Haven Hospital Sued Over Exam Policy for Employees 70+ Years
The U.S. Equal Employment Opportunity Commission is suing Yale New Haven Hospital, alleging its policy mandating eye and neuropsychological exams for employees age 70 or older who seek medical privileges violates two federal antidiscrimination laws.

Yale New Haven implemented its late career practitioner policy about four years ago. The policy requires employees 70 and older who apply for or seek to renew staff privileges to take both medical exams. Employees under the age of 70 are not required to take the exam.

In the lawsuit, filed Feb. 11, EEOC claims that the individuals required to be tested are singled out solely because of their age, instead of a suspicion that their cognitive abilities may have declined.

As a result, Yale New Haven’s policy violates the Age Discrimination in Employment Act, the lawsuit says. “While Yale New Haven Hospital may claim its policy is well-intentioned, it violates antidiscrimination laws,” said Jeffrey Burstein, a regional attorney for the EEOC’s New York District office. “There are many other nondiscriminatory methods already in place to ensure the competence of all of its physicians and other healthcare providers, regardless of age.”

In addition, the EEOC charges that the policy also violates the Americans with Disabilities Act because it subjects employees to medical examinations that are not job-related. (Becker’s Hospital Review Feb 12)



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Lawsuit: Juul Bought Ad Space on Kids’ Websites Including Cartoon Network
E-cigarette maker Juul Labs Inc bought online advertisements on teen-focused websites for Nickelodeon, Cartoon Network and Seventeen magazine after it launched its product in 2015, according to a lawsuit filed on Wednesday by the Massachusetts attorney general’s office.

The allegations in the lawsuit, stemming from a more than year-long investigation, contradict repeated claims by Juul executives that the company never intentionally targeted teenagers, even as its products became enormously popular among high-school and middle-school students in recent years. (Reuters Business News 2/12)


Two States Have Each Reported 200+ Vaping-Related Illnesses
As of Feb. 4, a total of 2,758 hospitalized EVALI cases have been reported to CDC, an increase of 47 since the last CDC update Jan. 21.

Four updates:

  1. Sixty-four EVALI deaths have been confirmed in 28 states and the District of Columbia, up from 60 reported Jan. 21.
  2. The most EVALI cases have been in Texas and Illinois, with each state reporting between 200 and 249 illnesses as of Feb. 4.
  3. Vitamin E acetate, an additive in some THC-containing e-cigarette or vaping products, has been strongly linked to the outbreak.
  4. The recent decline in EVALI cases is due in part to a reporting lag. More deaths are currently under investigation, according to the CDC. Beckers Hospital Review, Feb 12

The outbreak of lung injury associated with vaping has slowed but it has not stopped. CDC data released Tuesday show 2,758 hospitalized individuals (three new) and 64 deaths.


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Would You Like to Be a Judge?
If you’re coming to the House of Delegates meeting – or just live in the neighborhood – please consider participating as a poster judge at this year’s Symposium. The event will take place in Tarrytown on Friday, April 24, 2020. Judging occurs between 1:30 and 3:30 pm. Each judge evaluates approximately 8 – 10 posters and is generally done in an hour. Contact sbennett@mssny.org


Register Now!  Young Physicians/Resident Fellow/Medical Students Meeting

When: Saturday, February 29, 2020
Time: 8:30 am – 12:30 pm
Where: New York Academy of Medicine, 1216 Fifth Avenue, Manhattan.
Why: Guest speakers, panel program “Is Private Practice Even Possible?”, important updates on how to avoid malpractice lawsuits in early practice. Webinar available.

Click here for required preregistration and details.


 


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

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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.org if you have questions or comments.  Thank you.
(WILKS)


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Three exam rooms, consultation, reception and secretarial rooms. Ground floor next to Plaza Hotel.
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Midtown Medical Office for Rent
Beautiful office for rent in midtown Manhattan located opposite Grand Central Station on 42nd Street and Madison avenue. ideal for medical and surgical specialists as there are five spacious exam rooms with an accredited quad a certified operating room with anesthesia services. You can perform procedures and see patients. Rent for three days a week is $3,200 and 4 days a week is $4,100 Interested physicians please email cpmgman@gmail.com or call 914-582-0749.


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Great Career Opportunities for Clinical Physicians
Physicians, are you looking for a change?  Tired of working long shifts with an overwhelming patient load?  Come work at a well-equipped and staffed correctional facility where you can MAKE a difference, working with a smaller number of patients for reasonable hours.

Starting salary is $143,381 – $171,631 *Additional $20,000 geographical differential for Clinton & Franklin CF, and $10,000 for Five Points, Greene and Groveland CFs. We offer full-time, part-time & hourly/per-diem positions.

We have openings in the following counties offering a choice of urban, suburban or rural living:

Clinton*                 Clinton Correctional Facility (sporting and recreational outlets)
Chemung               Elmira and Southport Corrl Facilities (Gateway to the Finger Lakes)
Columbia*             Hudson Correctional Facility (antiquing, arts & collectables)
Dutchess                Green Haven Correctional Facility (Hudson River Valley Beauty)
Franklin*                Franklin & Upstate Corrl Facilities (North Country, 1 hour to Montreal)
Greene*                 Greene Correctional Facility (rural charm yet only 2 hours to NY City)
Livingston*            Groveland Correctional Facility (State Parks, hiking, fishing)
Oneida                   Mohawk Correctional Facility (Cooperstown, breweries)
Orleans                  Albion Correctional Facility (Greater Niagara Region & Canal Town Culture)
Sullivan                  Woodbourne Correctional Facility (mountains, outlets, entertainment)
Seneca*                 Five Points Correctional Facility (heart of wine country)
St. Lawrence          Riverview Correctional Facility (hiking, boating and museums)
Ulster                     Shawangunk and Wallkill Corrl Facility (Catskill Mountains, Casinos)
Washington           Great Meadow Corrl Facility (Between Vermont & Green Mountains)
Westchester           Bedford Hills Correctional Facility (Less than 1 Hour to NYC)
Wyoming               Wyoming Correctional Facility (waterfalls, family farms, natural beauty)

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Inquire with the Facility Personnel Office regarding benefits and anticipated opportunities: http://www.doccs.ny.gov/faclist.html. Contact: www.doccs.ny.gov or DOCCS Personnel Office at (518) 457-8132 for more information and to apply.



 

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

 

MSSNY Raises Strong Concerns with New Surprise Billing Proposals Coming Out of Washington


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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
February 10, 2020

MSSNY Raises Strong Concerns with New Surprise Billing Proposals Coming Out of Washington

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

“New York’s dedicated physicians remain anxious to work with all parties to ensure a fair federal legislative solution to protect patients from surprise out of network bills.  However, far more balance is needed in what has been put forward so far.  The proposal released Friday by the US House Ways & Means provides a few marginal steps forward, but would still hand an enormous gift to already market dominant health insurance companies by tilting the factors in its dispute resolution mechanism towards the insurance industry.  Even worse, it fails to provide meaningful steps to make sure health insurance physician networks are adequate, to help protect patients from finding themselves in the position in a hospital where they are treated by an out of network physician. 

These new proposals remain far different than the comprehensive and balanced measure that was enacted in New York, which not only put in place a balanced dispute resolution system to protect patients, but also put in place new measures to better ensure that health plan networks and out of network coverage was comprehensive.  We urge Congress to revise their proposals to more closely resemble New York’s acclaimed approach, which has had zero adverse premium impact and has saved consumers hundreds of millions of dollars.”

# # #

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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MSSNYeNews: Open Letter on OPMC – February 7, 2020

Arthur Fougner MSSNY Presiident

PRESIDENT’S MESSAGE
Arthur Fougner, MD
MSSNY President

MSSNY eNews
February 7, 2020

Vol. 23  Number 6


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Colleagues:

On January 13, The Medical Society of the State of New York met with Health Commissioner Dr. Howard Zucker as well as Keith Servis and Paula Breen of the Office of Professional Medical Conduct. It was by all accounts a cordial meeting. We were there to share our thoughts on Physician Wellness, what the stressors were for NY’s doctors and to explore potential solutions. Dr. Zucker offered that government mandates might be one of the stressors. We voiced some fears raised by the “State of the State” about OPMC but were reassured by Ms. Breen that our concerns were largely unfounded. We left optimistic and agreed to continue our dialog.

Despite this collaborative dialogue, we then saw what was being proposed within the legislative proposal for the Health and Mental Hygiene section of the Budget to unfairly malign physicians. The first element is to lower the threshold for the Commissioner of Health to summarily suspend a physician’s license. As the result of a physician’s inappropriate use of disposable syringes, the Medical Society had worked with the Department of Health to add the ability of the Commissioner to suspend the license of any physician felt to be an imminent threat to public health. We feel that the summary suspension of license without due process is such a significant matter that the threshold should be as high as possible as the ramifications of acutely severing longstanding patient-doctor relationships are enormous. Any lowering of this bar should be undertaken only after serious study of all its effects and therefore not as part of the budget process.

The second has to do with removing the OPMC Board’s oversight of the Executive Secretary and substitute oversight only by the Health Commissioner. On its face, this appears again to remove a level of due process from the system as the Board would discuss and deliberate more thoroughly than one individual could. We wonder if the governor views due process as a bug not a feature of the system.

Finally, the third and perhaps most inimical is the proposal to publicize complaints, valid or not, before any real evaluation is undertaken. OPMC complaints would then become the equivalent of a bad Yelp review on steroids. As an example, consider the case of a drug-seeking patient whose physician would not accede to her wishes. In retaliation, she files complaint with OPMC that the physician sexually assaulted her. Or how about an insurance company trying to teach a physician a lesson for making too many complaints to a government body? Ultimately, the physician was found not guilty of any misconduct. Had an allegation of sexual assault become public, his career would have been over. Former Labor Secretary Raymond L Donovan once famously asked, “Which office do I go to get my reputation back?” That office did not exist then and it doesn’t exist now.

New York State has been labeled the worst state for doctors by Wallethub. NY’s high cost of living along with its decidedly unfriendly malpractice climate have driven over half of the young physicians who train in New York out of the state. If government officials wish to know what NY stressors lead to physician burnout, they need only look to the current budget proposal. We would only hope that everyone awakens to the realization that as far as NY physician stress and burnout are concerned, Albany has not been the solution to the problem. Thus far, Albany IS the problem.

But we are not without recourse.  Your MSSNY has been hard at work, in the halls of the Capitol, and in the media, pushing back against this and other adverse Budget proposals.  We need to keep it up. 

I do have two asks. The first is for all reading this who haven’t already done so to text MSSNY to 52886 to get our grassroots alerts which will generate a letter sent to our elected officials on this and other issues of concern. The second is to arrange to join us on March 4 on Lobby Day to let Albany know exactly how we feel.

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

Arthur Fougner, MD
MSSNY President


 

Capital Update


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Plan to Be in Albany on March 4th for MSSNY’s “Physician Advocacy Day”
With so many issues of concern in the Governor’s Budget, the need for physician advocacy and grassroots involvement is greater than ever. Items of concern Medicaid cuts, legalized marijuana and changes to the physician disciplinary process, while supporting reforms such as include regulating PBMs and a flavored tobacco ban. Therefore, it is imperative that physicians be in contact with their local legislators to ensure the physician community’s message is well-represented.

One opportunity is to participate in MSSNY’s “Physician Advocacy Day” that will be held on Wednesday, March 4th in the Lewis Swyer Theatre in the Egg located at the Empire State Plaza, Albany NY. Click here to register!

Join your colleagues from all around New York State and come to MSSNY’s Physician Advocacy Day to speak with your legislators and key policymakers to ensure they’re making the right choices for New York’s physicians and their patients.

A brief luncheon to which members of each House are invited to speak with their constituents will follow the morning program.  Please work with your County Medical Societies to schedule appointments for physicians to meet with their elected representatives.

If you have any questions/comments, please contact Raza Ali at rali@mssny.org. (ALI)


MSSNY Continues to Push Back Against Troubling Proposal to Bypass Disciplinary Due Process
With Part L of Governor’s proposed Health Budget bill containing extremely troubling measures to bypass important due process protections for physicians during disciplinary proceedings, all physicians are urged to contact their legislators contact here to urge that the Legislature reject this unfair proposal.

The proposal would, among many other provisions, make it far easier for the Commissioner of Health to disclose to the public that a physician is under disciplinary investigation or summarily suspend a physician with only a minimal finding of risk to the public, as opposed to the much stronger “imminent danger” standard now required for bypassing existing due process protections.

That is particularly troubling given that only a small percentage of complaints to OPMC result in a disciplinary sanction.  MSSNY has indicated that we agree with the importance of acting quickly when it is imperative, but these proposals would completely undermine important and longstanding due process protections. Given that most complaints are dismissed without any sanction or action, this series of proposed changes to bypass these rights would create a substantial possibility of unfairly destroying an innocent physician’s career.    

MSSNY has joined with 16 state specialty societies in a communication to the Legislature setting forth our concerns in greater detail. Moreover, this week, MSSNY President Dr. Art Fougner appeared on the WCNY “Capitol Pressroom” radio program to discuss MSSNY’s concerns with this proposal.

Please urge your legislators to reject this proposal from the Budget.   (AUSTER)


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MSSNY: Community Physician Perspective Needs to Be Considered on Medicaid Redesign Recommendations
MSSNY has raised strong concerns that the newly appointed Medicaid Redesign Team charged with identifying $2.5 billion in State Budget savings has not included any community-based treating physicians. For the full list of appointees, click here.

The MRT2, chaired by Northwell CEO Michael Dowling and former SEIU Chair Dennis Rivera, includes state agency commissioners who are MDs, including Health Commissioner Dr. Howard Zucker and Mental Health Commissioner Dr. Ann Sullivan.  However, MSSNY is very concerned that the recommendations may lack the perspective of a physician in practice regularly treating patients, particularly those covered by Medicaid. The Committee is expected to consider further cuts to Medicaid payments, as well as possible revisions to the Excess Medical Malpractice Insurance Program.

After the MRT2 composition was announced, MSSNY President Dr. Art Fougner offered a public statement noting that: “It is perplexing that despite the hundreds of thousands of patients insured by Medicaid who are treated by a physician, and the tens of thousands of physicians who deliver care to these patients every year, not a single community-based physician has been appointed to the MRT 2.

We are further perplexed that some parts of the health care system actually have multiple representatives on this group. A $2.5 billion Medicaid savings target is almost certainly going to examine programs that impact patient access to community-based physician care, so it is very important that these physicians’ perspectives are represented on this Group.

To ignore or marginalize physicians’ perspective on our health care system is wholly unfair, not only to New York’s dedicated physicians but to all New Yorkers—the patients we serve.  We will of course continue to work with the Legislature and Administration on identifying responsible ways to address our State Budget deficit.”

Media articles reporting on the appointment of the MRT2 have noted similar concerns about lack of representation raised by Senate Health Committee Chair Gustavo Rivera, Assembly Health Committee Chair Richard Gottfried, and representatives of various provider associations such as clinics and home care associations.     (AUSTER)


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Physicians Urged to Support Efforts to Enact Ban on Flavored Vaping Products; MSSNY Meets with Governor to Discuss Vaping Epidemic
Physicians are urged to send a letter to the governor and to their member of the New York State Legislature urging enactment of provisions in the New York State budget that would prohibit the sale or distribution of flavored e-cigarettes or vaping products.  MSSNY strongly supports the proposed budget provision and urges physicians to take action here.

This week, MSSNY joined other patient advocacy organizations in a meeting with Governor Andrew Cuomo, NYS Department of Health Commissioner Howard Zucker, MD, and gubernatorial staff to discuss the continued vaping epidemic in New York State and ways to combat it including discussion of passage of the governor’s language within the context of the budget.  MSSNY joined with other health groups such as the New York State Association of County Health Officials, (NYSACHO), the NYS PTA, the NYS American Academy of Pediatrics, Chapters 1, 2 & 3, the American Heart Association, the American Cancer Society and the Coalition for Tobacco Free Kids.  (CLANCY)


NY AG Appeals Judges Order to Strike Down Emergency e-Cigarette Flavor Ban
On Friday New York State Attorney General Letitia James appealed a Supreme Court Justices order that struck down New York’s emergency ban on flavored e-cigarettes. Acting Supreme Court Justice Catherine Cholakis ruled that Governor Andrew Cuomo and health officials had exceeded their authority in approving the temporary ban last fall and that it should be left to the legislature to develop the law and policy around the issue. James’s office has asked the court of appeals to clarify how the ‘separation of powers doctrine’ applies to the issue over the emergency vaping flavor ban.

MSSNY supports the packages of bills brought forth in the legislature by Senator Brad Hoylman and Assemblywoman Bichotte to combat the vaping epidemic, as well as a package of proposals being advanced by the Governor.         (ALI) 


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Surprise Bill Resolution Heats Up in Congress – Contact Your Representatives Today
With new legislation to address the issue of surprise medical bills likely to receive a “mark-up” by the US House Education & Labor Committee next week, all physicians are urged to contact New York’s Senators Schumer and Gillibrand, as well as their respective Representative, to request that they enact a fair surprise bill law similar to New York’s highly acclaimed law.

A letter can be sent from here.  With Congress under pressure to find new revenue sources to help fund the federal Budget once the existing Budget resolution expires on May 22, the Congressional Budget Office has erroneously identified grossly unfair surprise billing legislation sponsored by Rep. Pallone and Sen. Alexander (H.R. 3630/S.1895) as one revenue source.  Unfortunately, this proposal would give insurers the power to pay for surprise out of network bills based upon insurers’ self-determined in-network rates, with little power to meaningfully to seek a more fair payment.

This would give enormous new powers to already market dominant insurers to drop physicians from their networks, or to significantly drop in-network payments.  Moreover, this is significant contrast to New York’s law, which sought to strike a fair balance to ensure that on-specialty care in hospital emergency departments was not jeopardized.

New York physician leaders will be having meetings with key members of New York’s Congressional delegation on Capitol Hill the week of February 10th.  Their message will be that physicians very much agree with the goal of the legislation to protect patients from facing these bills but disagree strongly with the solutions being offered.

Please contact your representatives today.    (AUSTER, CARY)


Senate Sets Recommendations to Combat Heroin and Opioid Abuse; DOH Releases Opioid Annual Report
The week the New York State Senate released its opioid abuse report setting forth recommendations for legislation to further respond to the opioid and heroin abuse epidemic.  The recommendations include some measures that MSSNY opposes such as S.5150-B, mandatory co-prescribing of naloxone for certain pain patients.  It does include measures that MSSNY worked to improve (S.7102-A, expanding the topics to be covered in the mandatory 3-hour pain course) and measures that MSSNY supports such as S.7115 which would permit “partial fills” of controlled substances.

All of these measures have passed in the NYS Senate.  On the other hand, the report did not include legislation imposing significant requirements on physicians such as mandatory notification to patients of the many risks associated with prescribing opioids (S.4277), and mandatory consideration of alternatives to opioid medications (S.5867).  These measures remain in the Senate Health Committee.  The report does discuss the importance of prescribers “Discussing risks and alternatives with patients” as a priority issue. A copy of the report can be found here.

This week the NYS DOH also released its New York State Opioid Annual Report 2019.  This report reflects the work of many programs within the New York State Department of Health, in partnership with other agencies which have worked collaboratively to address the opioid epidemic. The report provides an overview of opioid-related mortality, morbidity, naloxone distribution and administration, controlled substance prescriptions, and opioid use disorder treatment, including medication assisted treatment across New York State. It also summarizes new and expanded initiatives, and collaborative cross-disciplinary efforts implemented by the NYSDOH and partners. A copy of the report can be found here.           (CLANCY) 


MSSNY Joins Public Health Partners to Urge Restoration of Governor’s Cuts to Crucial State Programs Focused on Healthcare Workforce
On Tuesday, February 4th, MSSNY staff joined partners with the Workforce Advisory Group (WAG), for a full day of meetings in Albany with key policymakers, urging restoration of proposed cuts by Governor Cuomo to programs that support the healthcare related workforce. These programs include the Empire Clinical Research Investigator Program (ECRIP), Area Health Education Center (AHEC), the Center of Health Workforce Studies, Rural Health Access Development, and the Diversity in Medicine Scholarship Program. WAG is comprised of stakeholders in the health care field across New York, has advocated for and works closely with the Department of Health (DOH) on a variety of programmatic and funding issues related to Doctors Across New York (DANY), of which MSSNY is also a member.

The DANY program was established in 2008 to assist with the recruitment and retention of physicians in areas of need across New York State that lack the capacity to meet community needs by providing funding in exchange for loan repayment and practice support. DANY is a valued player in the recruitment and retention of physicians in underserved areas across the state, but the number of placements has not kept pace with the growing physician shortage.

MSSNY will continue to work with WAG as budget negotiations heat up and will share new information as it becomes available.   (CARY)


MSSNY Presents Testimony Raises Concerns with a Number of State Budget Proposals
On Wednesday January 29th, MSSNY Senior Vice President Moe Auster presented testimony to a joint Senate-Assembly Committee hearing Budget hearing .examining the proposed State Budget for Fiscal Year 2020-2021.  Among the issues he raised on MSSNY’s behalf:

  • Strong objections to proposals that would permit the bypassing of long-standing physician due process when a complaint is filed is OPMC;
  • Strong objections to the recent 1% cut to physician Medicaid payments, as well as concerns regarding even deeper cuts that could be imposed to meet a $2.5 Billion Medicaid savings target based upon recommendations of the revised Medicaid Redesign Team;
  • Support for funding to extend the Excess Medical Malpractice Insurance program, but strong objections to the failure to include historical language extending the program
  • Strong objections to a proposal to permit the sale of recreational or “adult use” marijuana
  • Strong objections to the significant expansion of the existing physician-pharmacist collaborative drug program to include nurse practitioners and physician assistants.
  • Support for proposals to regulate PBMs
  • Support for proposals to limit the sale of flavored tobacco products and to help prevent the health risks associated with vaping
  • Support for health insurance reforms, including creation of an administrative simplification task force and health claims denial transparency report.

To view a video of the testimony, click here. You can either advance to the 8:04 mark, or scroll to the direct link to Mr. Auster’s testimony.        (AUSTER)


Registration now open for “Steps to Physician Wellness and Resiliency”
MSSNY Committee on Physician Wellness and Resiliency will hold its first webinar, entitled Steps to Physician Wellness and Resiliency on February 25th from 7:30-8:30am. Jeffrey Selzer, MD will serve as faculty for this webinar.

Educational Objectives are:

  • Review the warning signs that stress, depression, anxiety or substance use may impact work or personal life
  • Identify strategies to increase personal empowerment toward making positive change, including self-assessment tools
  • Recognize self-monitoring strategies for stress related problems and know when to seek professional assistance

Register by clicking 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.
(CLANCY, HOFFMAN, ALI)


Registration now open for Medical Matters: Virtual Drill: Incident Command System & Crisis Communications
MSSNY’s next Medical Matters will feature a Virtual Drill on the Incident Command System and Crisis Communications on February 19th from 6:00-8:00pm. Faculty for this program are: Arthur Cooper, MD; Pat Anders, MS, MEP; William Valenti, MD and Lorraine Giordano, MD.

Educational Objectives are:

  • Obtain information about local, state and national chain of command in a public health emergency and learn how to access resources
  • Understand the importance of planning for medical surge and triage of patients, as well as staff and family considerations, in the office-based practice setting during a health emergency
  • Develop an understanding that all public health emergencies can potentially have mental health implications for survivors and others connected with the event
  • Acquire skills for the management of patients in a public health emergency

Please note that there are recommended pre-course materials to be viewed prior to this virtual drill. You will be sent a link with your registration confirmation. We encourage all participants to examine these prior to the Virtual Drill.  Register by clicking 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 2.0 AMA/PRA Category 1 credits™.  Physicians should claim only the credit commensurate with the extent of their participation in the activity. (HOFFMAN)


Veterans Matters: PTSD in Returning Veterans Live Seminar at The Brooklyn Hospital
The Medical Society of the State of New York, along with the Medical Society of County of Kings & Medical Society of Bay Ridge are hosting a CME live seminar entitled Veterans Matters: PTSD in Returning Veterans on Wednesday, February 12, 2020 at 7:00 pm at The Brooklyn Hospital Center, Conference Room 2a/2b, 121 DeKalb Avenue, Brooklyn, NY 11201.

Adolph Meyer, MD will serve as faculty for this program and the educational objectives are:

  • Identify diagnostic criteria for PTSD
  • Discuss medical and psychiatric comorbidities of military related PTSD
  • Discuss evidence-based treatment modalities for PTSD including medications and psychotherapy
  • Discuss strategies to help veterans overcome stigma to seek and accept treatment for military related trauma

Reservations can be made by contacting Dr. Lisa Eng at DrEng@NewLifeWellnessny.com or call (917) 952-8814. All participants must RSVP to receive parking accommodations.

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 each of these live activities 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.     (SHERPA)     

 pschuh@mssny.org mauster@mssny.org  pclancy@mssny.org  zcary@mssny.org
rali@mssny.org
eNews

FDA Grants Emergency Use Approval for Coronavirus Testing Kits
The FDA “on Tuesday granted emergency use approval for state public health laboratories to start testing for the new flu-like coronavirus…using kits developed by the Centers for Disease Control and Prevention (CDC).” Under the approval, “state public health labs can order test kits and also start the work of validating the tests within their own labs to make sure their scientists are using it correctly, Scott Becker, the executive director of the Association of Public Health Laboratories (APHL), said. “CDC reports highest pediatric flu death toll in 17 years.” (Reuters )If flu activity continues to rise in the same trajectory, the U.S. could see one of the worst flu seasons in decades, Anthony Fauci, MD, director of the National Institute of Allergy and Infectious Diseases, told CNN in a separate report.


71% of Physicians Say Electronic Records Contribute to Burnout
More than half of physicians reported symptoms of burnout in a 2014 study, and while that rate dropped to 43 percent in a 2017 follow-up, it is still much higher than the rate for all US workers, which stayed essentially flat in those years. What has gone wrong with our once beloved profession?

A report in The American Journal of Medicine last year looked at this question. It defined burnout as 1) lacking a sense of accomplishment, 2) cynicism, and 3) lack of enthusiasm for our work. It found that the one thing in medicine that seemed to correlate with the rise of burnout was the electronic medical record, introduced in 2008. A Stanford study showed that 71 percent of doctors say that electronic health records contribute to burnout.


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Rep. Clarke Brings Primary Physician Dr. Donald Moore to State of the Union Address
U.S. Rep. Yvette D. Clarke (D- Brownsville, Crown Heights, East Flatbush, Flatbush, Kensington, Park Slope, Prospect Heights, Midwood, Sheepshead Bay, Marine Park, Gerritsen Beach, Prospect Lefferts Gardens) attended this week’s State of the Union and brought MSSNY member  (Kings County) Donald E. Moore MD a primary care physician from Brooklyn and champion for Medicare for All, as her guest.

Democrats brought more than 80 patients, doctors and health care advocates from across the country to this year’s State of the Union. “I was honored to bring Brooklyn physician Dr. Donald Moore who is well known in our community and is one of the greatest advocates for Medicare for All. The time is now to prioritize health care as a right, not a privilege, and Dr. Moore walks this walk every day in his medical practice,” she added.


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Fewer People Are Regularly Visiting Their Primary Care Physicians
Visits to primary care physicians are on the decline, according to new research. Previous research has suggested that patients who regularly see PCPs tend to be healthier, but insurance claims data from one insurer from 2008-2016 reveal that regular visits to PCPs have declined by nearly 25%. The share of adults who didn’t have any visits with their PCP in a given year rose from around 38% to 46%, while visits to other settings — such as urgent care centers — also increased.

Young adults, those with chronic conditions, and those living in low-income areas were least likely to have visited their PCP. The authors of the study suggest that these declines in PCP visits may be because people perceive regular checkups as unnecessary, and because of rising costs — the average cost per visit increased by around $10 over the study period.


First Peanut Allergy Treatment Approved
The FDA has approved Palforzia to reduce the risk for allergic reactions in children with confirmed peanut allergies. Patients aged 4 to 17 years can start the oral treatment, and its continued use is approved for those ages 4 and up. After the initial dose, 11 increasing doses are given over several months. The first time a higher dose is given, it is administered in a supervised healthcare setting where allergic reactions can be managed. After tolerating all the up-dosing levels, the patient enters a maintenance phase, where the 300-mg dose is given at home daily.

A study of roughly 500 people with peanut allergy found that after 6 months of treatment, 67% of Palforzia recipients could tolerate a single 600-mg dose of peanut protein with only mild allergic symptoms, compared with 4% of those receiving placebo. Common side effects include abdominal pain, vomiting, mouth tingling, itching, hives, wheezing, and anaphylaxis. The treatment is contraindicated in patients with uncontrolled asthma.

The FDA requires that prescribers be educated on the risk for anaphylaxis. Patients should still take steps to avoid ingesting peanuts and have injectable epinephrine on hand. FDA news release; Palforzia prescribing information (PDF).


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NY Doctor Sentenced for Accepting Bribes/Kickbacks in Exchange for Prescribing Fentanyl
Geoffrey S. Berman, the United States Attorney for the Southern District of New York, announced today that Alexandru Burducea, a doctor who practiced in Manhattan, was sentenced in Manhattan federal court to 57 months in prison for conspiring to violate the Anti-Kickback Statute, in connection with a scheme to prescribe Subsys, a potent fentanyl-based spray, in exchange for bribes and kickbacks from Subsys’s manufacturer, Insys Therapeutics.  Burducea pled guilty on February 14, 2019 and was sentenced by United States District Judge Kimba M. Wood.

U.S. Attorney Geoffrey S. Berman said: “Before September 2014, Alexandru Burducea, a doctor who practiced in Manhattan, had never prescribed Subsys, a potent fentanyl-based spray.  By the second quarter of 2015, however – in exchange for bribes and kickbacks from Subsys’s manufacturer, Insys Therapeutics – Burducea became approximately the 14th-highest prescriber of Subsys in the country. Burducea sacrificed the safety of his patients to satisfy his own greed and will now spend time in federal prison for his reckless prescribing of this highly addictive and deadly drug.” 

The Insys Speakers Bureau

Subsys, which is manufactured by Insys, is a powerful painkiller approximately 50 to 100 times more potent than morphine. The FDA approved Subsys only for the management of breakthrough pain in cancer patients.  Prescriptions of Subsys typically cost thousands of dollars each month, and Medicare and Medicaid, as well as commercial insurers, reimbursed prescriptions written by Burducea.

In or about August 2012, Insys launched a “Speakers Bureau,” a roster of doctors who would conduct programs (“Speaker Programs”) purportedly aimed at educating other practitioners about Subsys.  In reality, Insys used its Speakers Bureau to induce the doctors who served as speakers to prescribe large volumes of Subsys by paying them Speaker Program fees.  Speakers were supposed to conduct an educational slide presentation for other health care practitioners at each Speaker Program.  In reality, many of the Speaker Programs were predominantly social affairs where no educational presentation about Subsys occurred.  Attendance sign-in sheets for the Speaker Programs were frequently forged by adding the names and signatures of health care practitioners who had not actually been present.

Burducea’s Participation in the Scheme

Dr. Burducea, certified in pain management and anesthesiology, was an Assistant Professor of anesthesiology at a large Manhattan hospital.  He also practiced at an anesthesiology and pain management office associated with the hospital.  From in or about September 2014 until in or about June 2015, BURDUCEA received approximately $68,400 in Speaker Program fees from Insys in exchange for prescribing large volumes of Subsys.

In addition, Insys hired BURDUCEA’s then-girlfriend, now wife, to work as BURDUCEA’s sales representative, and the company paid her large commissions based on the volume of Subsys prescribed by her assigned doctors, which included Dr. Burducea. Dr. Burducea, who had never prescribed Subsys before in or about September 2014, became approximately the 14th-highest prescriber of Subsys nationally in the second quarter of 2015, accounting for total net sales of the drug of approximately $621,345 in that quarter. (Press release from Department of Justice U.S. Attorney’s Office Southern District of New York)


WORKERS COMP

New Drug Formulary FAQs
To support the successful implementation of the New York Workers’ Compensation Formulary (NY WC Formulary), the Board continues to educate medical providers and payers about the Formulary and prior authorization process. This includes providing timely responses to frequently asked questions and requests for clarification. This week, the Board published a new round of frequently asked questions (FAQs). Please visit the Board’s Drug Formulary Overview webpage for the latest FAQs as well as:

  • An overview of the NY WC Formulary and the prior authorization process
  • The latest version of the NY WC Formulary
  • A Quick Guide to the NY WC Formulary
  • NY WC Formulary Dashboard Guides for Providers and Payers/TPAs

More Information

For more information, visit the Drug Formulary Overview Page

General NY WC Formulary questions: WCBFormularyQuestions@wcb.ny.gov

Technical support questions: WCBCustomerSupport@wcb.ny.gov

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MEDICARE

Medicare Provider Enrollment
A new Medicare Provider Enrollment Educational Tool is available. Learn about:

  • Eligibility and process
  • Application fee for institutional providers
  • Revalidation
  • Provider Enrollment, Chain and Ownership System (PECOS)

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

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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.org if you have questions or comments.  Thank you.
(WILKS)


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Looking for a tutor for Initial Pediatric Board Exam
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Great Career Opportunities for Clinical Physicians
Physicians, are you looking for a change?  Tired of working long shifts with an overwhelming patient load?  Come work at a well-equipped and staffed correctional facility where you can MAKE a difference, working with a smaller number of patients for reasonable hours.

Starting salary is $143,381 – $171,631 *Additional $20,000 geographical differential for Clinton & Franklin CF, and $10,000 for Five Points, Greene and Groveland CFs. We offer full-time, part-time & hourly/per-diem positions.

We have openings in the following counties offering a choice of urban, suburban or rural living:

Clinton*                 Clinton Correctional Facility (sporting and recreational outlets)
Chemung               Elmira and Southport Corrl Facilities (Gateway to the Finger Lakes)
Columbia*             Hudson Correctional Facility (antiquing, arts & collectables)
Dutchess                Green Haven Correctional Facility (Hudson River Valley Beauty)
Franklin*                Franklin & Upstate Corrl Facilities (North Country, 1 hour to Montreal)
Greene*                 Greene Correctional Facility (rural charm yet only 2 hours to NY City)
Livingston*            Groveland Correctional Facility (State Parks, hiking, fishing)
Oneida                   Mohawk Correctional Facility (Cooperstown, breweries)
Orleans                  Albion Correctional Facility (Greater Niagara Region & Canal Town Culture)
Sullivan                  Woodbourne Correctional Facility (mountains, outlets, entertainment)
Seneca*                 Five Points Correctional Facility (heart of wine country)
St. Lawrence          Riverview Correctional Facility (hiking, boating and museums)
Ulster                     Shawangunk and Wallkill Corrl Facility (Catskill Mountains, Casinos)
Washington           Great Meadow Corrl Facility (Between Vermont & Green Mountains)
Westchester           Bedford Hills Correctional Facility (Less than 1 Hour to NYC)
Wyoming               Wyoming Correctional Facility (waterfalls, family farms, natural beauty)

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Inquire with the Facility Personnel Office regarding benefits and anticipated opportunities: http://www.doccs.ny.gov/faclist.html. Contact: www.doccs.ny.gov or DOCCS Personnel Office at (518) 457-8132 for more information and to apply.



 

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

 

MSSNY Calls for Physician Representation on the MRT 2

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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
February 5, 2020

MSSNY CALLS FOR PHYSICIAN REPRESENTATION ON THE MRT 2

Statement attributable to:
Art Fougner, MD

President, Medical Society of the State of New York

“It is perplexing that despite the hundreds of thousands of patients insured by Medicaid who are treated by a physician, and the tens of thousands of physicians who deliver care to these patients every year, not a single community-based physician has been appointed to the MRT 2.

We are further perplexed that some parts of the health care system actually have multiple representatives on this group. A $2.5 billion Medicaid savings target is almost certainly going to examine programs that impact patient access to community-based physician care, so it is very important that these physicians’ perspectives are represented on this Group.

To ignore or marginalize physicians’ perspective on our health care system is wholly unfair, not only to New York’s dedicated physicians but to all New Yorkers—the patients we serve.  We will of course continue to work with the Legislature and Administration on identifying responsible ways to address our State Budget deficit.”

# # #

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.

Media Contact:
Roseann Raia
Medical Society of the State of New York
516.488.6100 x 302
rraia@mssny.org

 

MSSNYeNews: Child Abuse, Physician Abuse – January 31, 2020

Arthur Fougner MSSNY Presiident

PRESIDENT’S MESSAGE
Arthur Fougner, MD
MSSNY President

MSSNY eNews
January 31, 2020

Vol. 23  Number 5


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Colleagues:

Wisconsin Drs. John Cox and Sadie Dobrozsi had their adopted infant daughter taken away – apparently because a Nurse Practitioner with the hospital Child Abuse Team mistook what Pediatric Dermatologists felt were birthmarks for bruises. Additionally, the baby had a bruise on her heel – the same heel where blood was taken. Although the test results were available for the Nurse Practitioner, she missed that they pointed in the direction of a possible bleeding and clotting disorder which could easily lead to that bruise. Dr. Dobrozsi was especially upset since she is a Pediatric Hematologist-Oncologist. Yet, there you are and the case is now wending its way through the courts as the couple now face criminal charges.

For the sake of brevity, I am oversimplifying but the issue here is clear – despite the opinions of fifteen medical experts, their child is now a ward of the state.

But wait, there’s more.  In another case a Nurse Practitioner accused an employed Indiana Ob-Gyn of rendering patient care while being under the influence. Despite the hospital’s not following its own substance protocol, including due process, the employed physician’s medical group suspended her with partial pay and she had to enter into a five year treatment program with Indiana’s version of CPH in order to keep her license. Though this physician is still in the treatment program, she filed suit against the hospital, the medical group and the Nurse Practitioner and won a $4.75 M verdict.

So, if anyone who’s reading this still doesn’t understand the problem of independent practice by “NotExactlies ®” or the threat to your career from a government agency’s overreacting to an allegation without due process, please feel free to contact me. And do come to Albany March 4 and let them hear from all of us. After all, it’s only your career.

Take your place on The Great Mandala
As it moves through your brief moment of time.
Win or lose now you must choose now
And if you lose you’re only losing your life


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

Arthur Fougner, MD
MSSNY President


Get Updates for Healthcare Providers on the Novel Coronavirus from DOH – Monday, February 3, 2020 4:00 pm
The NYC DOHMH and the NYS DOH will present updates on the outbreak,
review new guidance from the Centers for Disease Control, and discuss infection control considerations.


Capital Update


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Plan to Be in Albany on March 4th for MSSNY’s “Physician Advocacy Day”
As we begin to unpack the Governor’s budget proposal and the legislative work at the Capitol continues, the need for physician advocacy and grassroots involvement is greater than ever. With the Governor’s budget proposal teeing up items for potential concern such as huge Medicaid cuts, legalized marijuana and unfair changes to the physician disciplinary process, while also supporting reforms such as regulating PBMs and a flavored tobacco ban, it is imperative that physicians be in contact with their local legislators to ensure the physician community’s message is well-represented.

One opportunity is to participate in MSSNY’s “Physician Advocacy Day” that will be held on Wednesday, March 4th in the Lewis Swyer Theatre in the Egg located at the Empire State Plaza, Albany NY. Click here to register!

Join your colleagues from all around New York State and come to MSSNY’s Physician Advocacy Day to speak with your legislators and key policymakers to ensure they’re making the right choices for New York’s physicians and their patients.

A brief luncheon to which members of each House are invited to speak with their constituents will follow the morning program.  Please work with your County Medical Societies to schedule appointments for physicians to meet with their elected representatives.

If you have any questions/comments, please contact Raza Ali at rali@mssny.org.                                                                (ALI)


Wuhan Coronavirus (2019-nCoV) Response & Preparation Efforts
With the World Health Organization declaring the Wuhan Coronavirus a global health emergency, MSSNY is participating in a bi-weekly conference call with the New York State Department of Health regarding preparation and response efforts.  Gov. Andrew Cuomo said that test results for seven suspected cases of the new coronavirus came back negative and the state is still waiting for results on three other cases.  DOH has issued guidance on January 17, 2020 and a copy of that guidance is at:  Please Click Here

The DOH also has a website dedicated to the corona virus : Please Click Here.

MSSNY will be conducting two webinars regarding public health emergencies.  The first is a virtual drill scheduled for Feb. 19, 2020 and is entitled, “Incident Command System and Crisis Communications”.  The webinar is scheduled for 6-8 p.m. and its main objective is to obtain information about local, state, and national chain of command in a public health emergency and to understand the importance of planning for medical surge.  On March 18, 2029, there will be a webinar on Wuhan coronavirus (2019-nCoV), conducted by William Valenti, MD, chair of MSSNY Infectious Disease Committee.  More information will be available shortly on this.

MSSNY Medical Matters on February 19th from 6:00 – 8:00pm is a virtual drill on the “Incident Command System and Crisis Communications”.   While this drill uses another biological scenario, it does provide essential information from NYS DOH on the incident command system and communications that will be employed should the coronavirus outbreak becomes much larger.

Faculty for this program are: Arthur Cooper, MD; Pat Anders, MS, MEP; William Valenti, MD and Lorraine Giordano, MD.

Educational Objectives are:

  • Obtain information about local, state and national chain of command in a public health emergency and learn how to access resources
  • Understand the importance of planning for medical surge and triage of patients, as well as staff and family considerations, in the office-based practice setting during a health emergency
  • Develop an understanding that all public health emergencies can potentially have mental health implications for survivors and others connected with the event
  • Acquire skills for the management of patients in a public health emergency

Please note that there are recommended pre-course materials to be viewed prior to this virtual drill. You will be sent a link with your registration confirmation. We encourage all participants to examine these prior to the Virtual Drill.  Register by clicking here:

Please Click 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 2.0 AMA/PRA Category 1 credits™.  Physicians should claim only the credit commensurate with the extent of their participation in the activity.
(CLANCY, HOFFMAN)


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MSSNY Presents Testimony Raises Concerns with a Number of State Budget Proposals
MSSNY Senior Vice President Moe Auster presented testimony to a joint Senate-Assembly Committee meeting examining the proposed State Health Budget proposals for Fiscal Year 2020-2021.  Among the issues MSSNY raised:

  • Strong objections to proposals that would permit the bypassing of long-standing physician due process when a complaint is filed is OPMC;
  • Strong objections to the recent 1% cut to physician Medicaid payments, as well as concerns regarding even deeper cuts that could be imposed to meet a $2.5 Billion Medicaid savings target;
  • Support for funding to extend the Excess Medical Malpractice Insurance program, but strong objections to the failure to include historical language extending the program
  • Strong objections to a proposal to permit the sale of recreational or “adult use” marijuana
  • Strong objections to the significant expansion of the existing physician-pharmacist collaborative drug program to include nurse practitioners and physician assistants.
  • Support for proposals to regulate PBMs
  • Support for proposals to limit the sale of flavored tobacco products and to help prevent the health risks associated with vaping
  • Support for health insurance reforms, including creation of an administrative simplification task force and health claims denial transparency report.

To view a video of the testimony, click here: Please Click Here.  You can either advance to the 8:04    mark or scroll to the direct link to Mr. Auster’s testimony.    (AUSTER)


MSSNY Continues to Push Back Against Troubling Proposal to Bypass Disciplinary Due Process
With Part L of Governor’s proposed Health Budget bill containing extremely troubling measures to bypass important due process protections for physicians during disciplinary proceedings, all physicians are urged to contact their legislators Please Click Here to urge that the Legislature reject this unfair proposal.

The proposal would, among many other provisions, make it far easier for the Commissioner of Health to disclose to the public that a physician is under disciplinary investigation or summarily suspend a physician without going through existing due process protections.

That is particularly troubling that only a small percentage of complaints to OPMC result in a disciplinary sanction. MSSNY has indicated that we agree with the importance of acting quickly when it is imperative, but these proposals would completely undermine important and longstanding due process protections. Given that most complaints are dismissed without any sanction or action, this series of proposed changes to bypass these rights would create a substantial possibility of unfairly destroying an innocent physician’s career. 

Please urge your legislators to reject this proposal from the Budget.   (AUSTER)


                                                                  

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Surprise Bill Resolution Heats Up in Congress – Contact Your Representatives Today
With key US House of Representatives Committees likely to present a new draft to address the issue of surprise medical bills, all physicians are urged to contact New York’s Senators Schumer and Gillibrand, as well as their respective Representative, to request that they enact a fair surprise bill law similar to New York’s highly acclaimed law. A letter can be sent from here.

With Congress under pressure to find new revenue sources to help fund the federal Budget once the existing Budget resolution expires on May 22, the Congressional Budget Office has erroneously identified grossly unfair surprise billing legislation sponsored by Rep. Pallone and Sen. Alexander (H.R. 3630/S.1895) as one revenue source.  Unfortunately, this proposal would give insurers the power to pay for surprise out of network bills based upon insurers’ self-determined in-network rates, with little power to meaningfully to seek a more fair payment.

This is significant contrast to New York’s law, which sought to strike a fair balance to ensure that on-specialty care in hospital emergency departments was not jeopardized and would not eliminate incentives for insurers to put together comprehensive physician networks.

New York physician leaders will be having meetings with key members of New York’s Congressional delegation on Capitol Hill the week of February 10th.  Their message will be that physicians very much agree with the goal of the legislation to protect patients from facing these bills, but disagree strongly with the solutions being offered.

Please contact your representatives today: Please Click Here. (AUSTER, CARY)


MSSNY Joins Radiologists to Oppose Proposed Changes to Scope-of-Practice for Physician Assistants Operating Fluoroscopy Imaging Technology
MSSNY Albany staff recently joined leaders of the NYS Radiological Society for a day of meetings with key lawmakers, in Albany, to express concerns over a bill (S1812/A2982) that would allow physician assistants (PAs) who complete a brief training program to operate fluoroscopy imaging technology as part of a diagnostic or treatment procedure.

Fluoroscopy is an x-ray-based technique that allows continuous imaging of an instrument, a body part, or dye as each is used during a diagnostic or treatment procedure. In a fluoroscopy procedure, an e-ray is passed through the body and the images are transmitted to a monitor so that movement can be detected and evaluated, It is used in cardiac, orthopedic, and other surgeries, as well as in diagnostic studies, among other medical procedures. Concerns over medical radiation exposure has grown in recent years, with the issue earning national attention.

MSSNY opposes this legislation as it does not require adequate time for training or appropriate supervision by a qualified physician. We will continue to monitor the issue and share updates as they happen.   (CARY)


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MSSNY Staff Participates in Final Session of Department of Health (DOH) Workforce Workgroup
MSSNY Albany staff recently attended the latest session of one of the DOH’s workgroups charged with examining the workforce aspects related to the Delivery System Reform Incentive Payment (DSRIP) program. DSRIP is the main mechanism by which New York State implemented its Medicaid Redesign Team (MRT) in 2014.

DSRIP´s charge since then has been to fundamentally restructure the state’s health care delivery system by reinvesting in the Medicaid program, with the primary goal of reducing avoidable hospital use by 25% over 5 years. Up to $6.42 billion was allocated to the program, with payouts based on results in system transformation, clinical management and population health. The project included extensive work by the following subcommittees of the workforce workgroup:

·        Barriers to Effective Care Coordination

·        Care Coordination Curriculum

·        Care Coordination Training Guidelines

·        Health Care Data

·        Primary Care and Behavioral Health Integration

·        Workforce Compendium

Leaders from each subcommittee provided detailed updates on their most recent work, as well potential next steps as the move on to the next phase of the project. MSSNY Albany staff is a member of the main workgroup and will continue to participate and ensure the physician perspective is included in all discussions, as well as report back developments as they happen.       (CARY)


Registration now open for “Steps to Physician Wellness and Resiliency”
MSSNY Committee on Physician Wellness and Resiliency will hold its first webinar, entitled Steps to Physician Wellness and Resiliency on February 25th from 7:30-8:30am. Jeffrey Selzer, MD will serve as faculty for this webinar.

Educational Objectives are:

  • Review the warning signs that stress, depression, anxiety or substance use may impact work or personal life
  • Identify strategies to increase personal empowerment toward making positive change, including self-assessment tools
  • Recognize self-monitoring strategies for stress related problems and know when to seek professional assistance

Register by clicking here:

Please Click 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.
(CLANCY, HOFFMAN, ALI)
                                                                                              

 pschuh@mssny.org mauster@mssny.org  pclancy@mssny.org  zcary@mssny.org
rali@mssny.org
eNews

Get Updates for Healthcare Providers on the Novel Coronavirus from DOH – Monday, February 3, 2020, 4:00 pm
The NYC DOHMH and the NYS DOH will present updates on the outbreak,
review new guidance from the Centers for Disease Control, and discuss infection control considerations.


Council Notes-January 30, 2020

  • MSSNY Commissioner of Public Health and Education Dr. Joshua Cohen reported the following:
  • MSSNY is participating in a bi-weekly conference call with the New York State Department of Health regarding Wuhan coronavirus. MSSNY will be conducting two webinars: “Incident Command System and Crisis Communications” is a virtual drill and is scheduled for February 19, 6 pm – 8 pm. On March 18, Dr. William Valenti, Chair of MSSNY’s Infectious Disease Committee, will conduct a webinar on Wuhan coronavirus.
  • MSSNY will launch its educational program on Physician Wellness in February. The educational program “Steps to Physician Wellness and Resiliency” webinar will be held on February 25 at 7:30 am. A live seminar will also be available at the House of Delegates meeting in Tarrytown on April 23, 3-4 pm.
  • In February, MSSNY will select 4-7 practices interested in improving their practice operations and professional satisfaction through the AMA/Physician Foundation Practice Transformation. This opportunity is open to all types of physician practices and specialties and requires a 16-18-month commitment. Single and multispecialty groups with at least 30 physicians are welcome to submit a statement of interest. If interested, email Pat Clancy, MSSNY Senior VP of Public Health and Education at pclancy@mssny.org.
  • Steven Schwalbe, MD, was presented with a Certificate of Appreciation for his many years of dedicated service as Chair of MSSNY’s Interspecialty Committee. Dr. Schwalbe is Associate Professor of Anesthesiology and Associate Director, Department of Anesthesiology at Mount Sinai.
  • Marina Caskey, MD, was presented with the Albion Bernstein Award, which was endowed by the late Morris Bernstein in memory of his son, a physician who died in an accident while answering a hospital call in 1940. Dr. Caskey is an Associate Professor of Clinical Investigation at The Rockefeller University. Her research focuses on the development and testing of a promising new strategy that uses broadly neutralizing antibodies to prevent or treat HIV infection.
  • MSSNY Speaker Dr. Latrielle announced that March 11 at 5 pm is the hard deadline for House of Delegates (HOD) Resolution submissions. After the March 11 deadline, resolutions will have to be reviewed by the Rules Committee. The HOD will be held at the Tarrytown Marriot April 24-26, 2020.
  • Young Physicians Section (YPS) announced two upcoming events:
  • YPS Annual Meeting: 2/29/20, 8:30 am -12:30 pm at the New York Academy of Medicine, 1216 5th Ave, NYC. Keynote speaker AMA Board of Trustees Chair Jesse Ehrenfeld, MD will present “The Evolving Healthcare Landscape: Challenges and Opportunities for Young Physicians.”
  • MSSNY Young Physicians, Resident, Med Student Social: 2/28/20, 6 pm-9 pm at Sessions 73, 73rd St and 1st Ave, NYC. All physician trainees and attendings up to eight years in practice are invited. Come network with other medical trainees and young physicians.

State Department Advisory: DO NOT TRAVEL TO CHINA
Last night, the State Department issued a travel advisory telling Americans not to travel to China because of the public health threat posed by coronavirus. New York hospitals have stepped up preparations for the possibility that a patient with this year’s novel strain of coronavirus would walk into a local emergency room, as the U.S. Centers for Disease Control and Prevention reported the first case Thursday of person-to-person transmission within the United States.

A special page has been created at NEJM.org with a collection of articles and other resources on the 2019 Novel Coronavirus outbreak, including clinical reports, management guidelines, and commentary.
Visit NEJM.org/coronavirus today >>


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Novel Coronavirus Cases in China Pass SARS at Its Peak
Nearly 6000 confirmed cases of the novel coronavirus (2019-nCoV) have been reported in China, according to World Health Organization numbers released on Wednesday. The outbreak has officially surpassed the 2002–2003 outbreak of severe acute respiratory syndrome (SARS) coronavirus, which totaled 5327 cases in China, the Associated Press reports.

Over 9200 additional novel coronavirus cases in China are suspected, the WHO reports. There have been 132 related deaths, all in China. Outside of China, 68 cases have been confirmed. A WHO committee will reconsider whether to declare a Public Health Emergency of International Concern on Thursday.

Meanwhile in the Lancet, researchers report on a genomic analysis of 2019-nCoV from nine patients in Wuhan, China, all of whom had a connection to the Huanan seafood market. Genetic sequences from the patients’ samples were almost identical, which indicates that the virus emerged in humans very recently, the researchers note. Additionally, the virus appears most similar to two SARS-like coronaviruses that originated in bats. The researchers say that taken together, their findings suggest that bats are the original host and an animal sold at the market might have served as an intermediate host that facilitated transmission to humans.

Also in the Lancet, researchers report on a cluster of 99 patients with 2019-nCoV at a Wuhan hospital. Roughly half had exposure to the market. Overall, 11 patients died — all from multiple organ failure following acute respiratory distress syndrome.


Low-Dose CT Scans Can Reduce Lung Cancer Death in Smokers, Ex-Smokers
 A study of smokers and ex-smokers in the Netherlands and Belgium is confirming that widespread screening using low-dose CT scans can dramatically lower the lung cancer death rate.” Researchers found that “after 10 years, the mortality rate for men who received regular screening was reduced by 24% compared to men who got no screening.” Reuters adds that “although women were under-represented in the study, the research team found that screening lowered their risk of dying from lung cancer by 33%.” The findings were published in the New England Journal of Medicine. Also covering the story are the Wall Street Journal (1/29) and CHEST Physician (1/29).


US Life Expectancy Increased for First Time in Four Years In 2018, Data Indicate
The New York Times (1/30) reports that “life expectancy increased for the first time in four years in 2018, the federal government said Thursday, raising hopes that a benchmark of the nation’s health may finally be stabilizing after a rare and troubling decline that was driven by a surge in drug overdoses.” According to the Times, “Improvements in cancer mortality rates represented the single largest share of the life expectancy gain in 2018, about 30 percent.” The Times adds, “Next came the decline in so-called unintentional injuries, which include deaths from car accidents and drug overdoses.”

“Life expectancy in the United States in 2018 was 78.7 years – an increase of 0.1 year compared with life expectancy of 78.6 years in 2017, the” US Centers for Disease Control and Prevention’s National Center for Health Statistics reported https://www.cdc.gov/nchs/products/databriefs/db355.htm



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Doctor Must Pay $1.1M to Settle Kickback and False Claim Allegations
An otolaryngologist in New York agreed to pay the federal government $1.1 million to settle allegations that he paid kickbacks and submitted false claims to Medicare for services provided in adult residential facilities, the Justice Department announced. Rajendra Bhayani allegedly paid cash tips, high rents, and other payments to medical management companies for exclusive access to facility residents — many of whom had disabilities or mental illnesses — so he could bill for allergy testing and other medical procedures that prosecutors said were unnecessary.


Barbershops Could Offer a Community Setting for Diabetes Testing
Having Black men tested for diabetes at barbershops could be a way to ensure more timely diagnoses, according to new research. Previous studies have shown that barbershops, as trusted community places among Black men, can be spots to diagnose high blood pressure by removing barriers to care — such as insurance and cost — that this population may face.

In the new study, researchers approached around 900 men who frequented one of eight barbershops in Brooklyn, N.Y. — a third of these men agreed to be tested, and almost 10% had blood sugar levels that would have resulted in a diabetes diagnosis in a doctor’s office.

Nearly 30% had prediabetes, which, with proper lifestyle changes, can be prevented from progressing. Although these results are promising, the small study group and its location could mean the findings are not generalizable.  (STAT, Jan.28)


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FL Surgeon Files Whistleblower Suit re Requiring in House Referrals
A Florida surgeon filed a whistleblower lawsuit against his former employer, Orlando Health, claiming it violated federal law by requiring him to perform surgeries and refer patients within the network’s facilities — and firing him when he did not obey. Ayman Daouk, MD, an orthopedic surgeon in Orlando, alleged in a lawsuit filed in early January that he was fired for performing surgeries at Florida Hospital, a facility unaffiliated with Orlando Health, and for referring patients to radiologists outside of the health system’s network.

Daouk sued Orlando Health and three of its subsidiaries — claiming that mandatory self-referrals violate “Stark law” and anti-kickback statutes, the lawsuit stated. The complaint said that because Orlando Health owns the facilities that it requires physicians to refer to, “there exists an unbroken chain of financial relationships that renders these referrals as violations” of Stark law, which prohibits doctors from referring patients to entities where they have financial interests.

Daouk also claimed that physicians received payments and benefits for referring to Orlando Health facilities, a direct violation of the federal anti-kickback statute.

Daouk was employed by Physician Associates for three years when it was acquired by Orlando Health in 2012. In the complaint, Daouk said that at the start of his employment, physician referrals in-network were highly suggested, but not required.

Daouk, too, was contacted by administration officials for performing surgeries at Florida Hospital. In November 2014, Daouk was informed that his employment would be terminated if he continued performing surgeries at other hospitals, the complaint stated. When Daouk objected to this restriction, Dennis Buhring, president of Physician Associates, allegedly said that he was “sending a very negative message to [his] employer.”

There are a number of reasons why hospitals may require referrals to be made within network, said Mollie Gelburd, JD, associate director of government affairs at the Medical Group Management Association. One reason may be promoting care coordination, as referring patients to doctors exclusively within network makes the transfer of medical records and information easier.

However, she said, there is concern that hospitals require doctors to practice medicine and make referrals in network for a profit motive.

Jay Wolfson, PhD, a health policy expert at the University of South Florida in Tampa, said this case “goes to the heart of physician clinical autonomy.” (Medpage 1/29/20)


Number of Smokers— 14%– at All-Time Low
The percentage of Americans who smoke — 14%, or 34 million people — is at an all-time low, but smoking still remains the number one cause of preventable disease, death, and disability, and doctors could be doing more to help patients quit, Surgeon General Jerome Adams, MD, MPH, said Thursday.

“Forty percent of smokers who see their physician aren’t advised by the provider to quit,” Adams said at a press conference announcing the release of a 700-page report on smoking cessation. “So why are 40% of our health providers out there not advising smokers to quit?”…”I often say you come into the orthopedist’s office because you’ve got a broken ankle, but you’re more likely to die from the fact that you’re smoking,” so even the orthopedist should be talking to that patient about quitting, Adams continued. “At every touchpoint, everyone should be. The tools that the CDC has put out are designed to help empower more people to know what they can do to help folks quit.”

Examples of tools physicians can look at include the Million Hearts protocol and the smokefree.gov website.

Adams also chided health insurers who require prior authorization or high copays for smoking cessation treatments, calling such policies “penny-wise and pound-foolish.” “According to the report, comprehensive, barrier-free coverage and promotion can increase the use of proven treatments and lead to higher rates of successful quitting,” he said.


AMA Foundation Launches New Initiative to Address LGBTQ Health Disparities
American Medical Association Foundation (AMAF) today announced that John D. Evans, telecommunications pioneer, internationally-recognized business executive and philanthropist, will lead a unique and innovative initiative designed to dramatically shape the future of LGBTQ health.

The new initiative will create a cadre of LGBTQ health specialists through the AMA Foundation LGBTQ Fellowship Program – a national fellowship program to promote best practices and shared outcomes, while exponentially improving the quality of LGBTQ health care across the nation.

“A key social determinant of health affecting sexual and gender minorities is a shortage of health care providers who are knowledgeable and culturally competent in LGBTQ health. This shortage underscores the immediate need for the AMA Foundation’s LGBTQ Fellowship Program which will train physicians to become LGBTQ Health Specialists,” said former AMAF president and founding donor of its LGBTQ endowment fund,  and MSSNY Councilor Joshua M. Cohen, MD, MPH, FAHS. Moreover, policies that permit the denial of services to LGBTQ people are linked to a 46 percent increase in the proportion of gay, lesbian, and bisexual adults who report mental distress and gay men account for more than two thirds of all people diagnosed with HIV each year in the United States, despite comprising only 2 percent of the general population. Establishing a national network of LGBTQ health specialist physicians who are formally trained to serve sexual and gender minorities will have a dramatic and positive impact on this community. The LGBTQ Fellowship cohort provides a transformative opportunity to:

  • Decrease LGBTQ health disparities;
  • Increase cultural and clinical competence amongst physicians in LGBTQ health;
  • Build capacity of LGBTQ health services sector to better identify and address the unique health needs of the LGBTQ community, such as the effects of anesthesia on transgender patients undergoing gender affirming surgery due to medications;
  • Improve basic quality of life (health and well-being) of LGBTQ communities;
  • Understand and address social determinants of health faced by this community through the promotion of research and supporting the dissemination of research findings across mediums such as medical journals; and,
  • Provide safe entry point to link individuals to broader health and wellness services.

2020 MSSNY Young Physicians Section Annual Meeting
Join us for the premiere annual meeting attended by your medical trainee and physician colleagues from across NY state. Earn CME* and learn from experts on how to succeed when starting practice and how to best advocate for your patients outside of the hospital and clinic.

WHEN: Feb 29, 8:30 AM – 12:30 PM
WHERE: New York Academy of Medicine, 1216 5th Ave, New York, NY 10029, USA

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

MSSNY designates this live activity for a maximum of 3.0 AMA PRA Category 1 Credits™. Physicians should claim only the credit commensurate with the extent of their participation in the activity. Limited space available. Preregistration required. Register here.
MSSNY Members FREE. Non-members $75
Click here for information on how to become a MSSNY member


MSSNY Young Physicians, Resident Fellow, Med Student Social
WHEN:   Friday, 2/28/2020, 6pm-9pm
WHERE: Sessions 73 – 73rd St. and 1st Ave. New York, NY
All physician trainees and attending physicians up to 8 years in practice are invited. Come network with other medical trainees, young physicians and learn about how you can impact the future of medicine in New York.
RSVP for social here


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

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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.org if you have questions or comments.  Thank you.
(WILKS)


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Midtown Medical Office for Rent
Beautiful office for rent in midtown Manhattan located opposite Grand Central Station on 42nd Street and Madison avenue. ideal for medical and surgical specialists as there are five spacious exam rooms with an accredited quad a certified operating room with anesthesia services. You can perform procedures and see patients. Rent for three days a week is $3,200 and 4 days a week is $4,100 Interested physicians please email cpmgman@gmail.com or call 914-582-0749.


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Pediatric Board Tutor
Looking for a tutor for Initial Pediatric Board Exam
Flexible hours, Negotiable rate. If interested please email at: pedboardhelp@gmail.com


 

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Great Career Opportunities for Clinical Physicians
Physicians, are you looking for a change?  Tired of working long shifts with an overwhelming patient load?  Come work at a well-equipped and staffed correctional facility where you can MAKE a difference, working with a smaller number of patients for reasonable hours.

Starting salary is $143,381 – $171,631 *Additional $20,000 geographical differential for Clinton & Franklin CF, and $10,000 for Five Points, Greene and Groveland CFs. We offer full-time, part-time & hourly/per-diem positions.

We have openings in the following counties offering a choice of urban, suburban or rural living:

Clinton*                 Clinton Correctional Facility (sporting and recreational outlets)
Chemung               Elmira and Southport Corrl Facilities (Gateway to the Finger Lakes)
Columbia*             Hudson Correctional Facility (antiquing, arts & collectables)
Dutchess                Green Haven Correctional Facility (Hudson River Valley Beauty)
Franklin*                Franklin & Upstate Corrl Facilities (North Country, 1 hour to Montreal)
Greene*                 Greene Correctional Facility (rural charm yet only 2 hours to NY City)
Livingston*            Groveland Correctional Facility (State Parks, hiking, fishing)
Oneida                   Mohawk Correctional Facility (Cooperstown, breweries)
Orleans                  Albion Correctional Facility (Greater Niagara Region & Canal Town Culture)
Sullivan                  Woodbourne Correctional Facility (mountains, outlets, entertainment)
Seneca*                 Five Points Correctional Facility (heart of wine country)
St. Lawrence          Riverview Correctional Facility (hiking, boating and museums)
Ulster                     Shawangunk and Wallkill Corrl Facility (Catskill Mountains, Casinos)
Washington           Great Meadow Corrl Facility (Between Vermont & Green Mountains)
Westchester           Bedford Hills Correctional Facility (Less than 1 Hour to NYC)
Wyoming               Wyoming Correctional Facility (waterfalls, family farms, natural beauty)

NYS Corrections Personnel Ad

Inquire with the Facility Personnel Office regarding benefits and anticipated opportunities: http://www.doccs.ny.gov/faclist.html. Contact: www.doccs.ny.gov or DOCCS Personnel Office at (518) 457-8132 for more information and to apply.



 

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

 

MSSNYeNews: Richard Jewell and Scarlet Letters – January 24, 2020

Arthur Fougner MSSNY Presiident

PRESIDENT’S MESSAGE
Arthur Fougner, MD
MSSNY President

MSSNY eNews
January 24, 2020

Vol. 23  Number 4


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Colleagues:

No doubt you’re heard that the Governor’s proposed budget legislation is out.  In the Health and Mental Hygiene Section, there are many helpful proposals, among them reducing maternal mortality, regulation of PBMs, and removing flavored tobacco products. There are some that are unhelpful such as requiring more information in the physician profiles. Ironically, in the fiscal year 2015 budget, the Governor had actually proposed eliminating the profile website altogether. Quite a turnaround, no? 

But then we come to the poison pill –  Section L. Here, the Office of Professional Medical Conduct (OPMC) is further empowered to allow for “immediate publication of charges upon investigative requests.” Let that sink in for a moment. As if that isn’t enough, the powerful position of OPMC Executive Secretary is now removed from the Board Chair’s oversight and now overseen by the Commissioner directly. This similarly could shred due process.  

As I’ve previously shared, less than 3% of complaints to OPMC result in significant actions. Publication of charges prior to thorough investigation would effectively end a physician’s career. In 1976, Richard Jewell found a suspicious package in the Atlanta Olympic Park and alerted police, saving countless lives. For his effort, Jewell was hounded by the press and he became a person of interest. His life was ruined while attention was diverted from the real bomber.  Perhaps we could ask our Governor, as Raymond Donovan famously asked, to which office do physicians go to get their reputations back?  

I don’t know about you, but I feel that an MD or DO degree is a badge of honor. Section L of the Budget could turn your badges of honor into Scarlet Letters.  

Concerned? Upset? Outraged? Then, go here right now and tell Governor Cuomo and your legislators how you feel. Also, Lobby Day is March 4. Albany believes it’s a crisis ONLY when physicians act like it’s a crisis. Physicians, make no mistake – this IS a crisis. We need to pack the house. We need you. 

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

Arthur Fougner, MD
MSSNY President


Capital Update

The Week’s Legislative Podcast


Please Plan to Be in Albany for: MSSNY‘s Annual “Physician Advocacy Day” (3/4)
As we begin to unpack the Governor’s budget proposal and the legislative work at the Capitol continues, the need for physician advocacy and grassroots involvement is greater than ever. With the Governor’s budget proposal teeing up items for potential concern such as Medicaid cuts, legalized marijuana and changes to the physician disciplinary process, while also supporting reforms such as regulating PBMs and a flavored tobacco ban, it is imperative that physicians be in contact with their local legislators to ensure the physician community’s message is well-represented.

One opportunity is to participate in MSSNY’s “Physician Advocacy Day” that will be held on Wednesday, March 4th in the Lewis Swyer Theatre in the Egg located at the Empire State Plaza, Albany NY. Click here to register!

Join your colleagues from all around New York State and come to MSSNY’s Physician Advocacy Day to speak with your legislators and key policymakers to ensure they’re making the right choices for New York’s physicians and their patients.

A brief luncheon to which members of each House are invited to speak with their constituents will follow the morning program.  Please work with your County Medical Societies to schedule appointments for physicians to meet with their elected representatives.

If you have any questions/comments, please contact Raza Ali at rali@mssny.org.       (ALI)


Governor Announces Proposed Budget
Governor Cuomo this week released his proposed $178 Billion Budget for the 2020-21 State Fiscal year, including measures to close a $6.1 billion Budget deficit, through creating a new Medicaid Redesign Team (MRT) to recommend $2.5 Billion in Medicaid savings, assuming an additional $2 billion in new tax revenue, and $1.8 billion in reduced payments to localities.  While we are still poring through the tens of thousands of pages of Budget bills, among the most notable items for physicians upon initial review:

Items of Significant Concern Include:

  • As previously announced, expanding the ability of the Commissioner of Health to notify the public that a physician is under investigation and to make it easier for the Commissioner to summarily suspend a physician license during a disciplinary investigation.  Send a letter to your legislators here: Please click here
  • Expanding the information on the physician profile to include office hours, whether accepting new patients, insurance participation information, and mandatory completion of a workforce survey.
  • Legalizing, regulating and taxing the production, distribution, transportation, and sale of recreational or “adult-use” marijuana.
  • Expanding the list of adult immunizations that can be provided by pharmacists to all those recommended by the ACIP.
  • Expanding the existing physician-pharmacist collaborative drug therapy program to include nurse practitioners and physician assistants 

Positive Items Under the Proposed Budget

  • Require the regulation of Pharmaceutical Benefit Managers (PBMs) with the Department of Financial Services (DFS) and to disclose financial incentives they receive
  • A comprehensive anti-smoking package including: prohibiting the sale or distribution of e-cigarettes or vapor products that have a characterizing flavor; prohibiting the sale of tobacco products  in all pharmacies; expanding the definition of “place of employment” to define indoor space and limit second hand smoke exposure;  restricting the advertising of vapor products;  requires manufacturers of vapor products to disclose to the DOH Commissioner and the public, information regarding the ingredients, by-products, or contaminants in vapor products; bans coupons and manufacturer discounts and displays in shops; and increases penalties for illegally selling tobacco products to minors.
  • Creating an administrative simplification work group to address health insurance hassles and to expedite physician credentialing applications.
  • Establishing the Behavioral Health Parity Compliance Fund for the collection of penalties imposed on insurance carriers who violate New York’s Behavioral Health Parity laws, which will be used to support the Substance Use Disorder and Mental Health Ombudsman program
  • Significantly reduce the interest rate on medical malpractice and other court judgments, from 9% to a market-based rate
  • Reduce the business income tax rate from 6.5% to 4% for businesses with 100 or fewer employees and with net income below $390,000 that file under Article 9-A.
  • $14.2 million in funding to ensure access to a full array of reproductive services for women due to the loss of Title X funding.
  • $8 million to improve maternal health outcomes and for the implementation bias training and incentives for an expansion of community health workers related to Maternal Mortality.
  • Continuation of funding for the Excess Medical Malpractice Insurance Program
  • Continuation of funding for the Committee for Physicians’ Health

Other Items of Note

  • Expanding the scope of New York surprise bill law to include in-patient services following an emergency admission.
  • Convene a new Medicaid Redesign Team (MRT) to come up with $2.5 billion in savings
  • DFS will be authorized to investigate pricing of any prescription drug if the price of such drug has increased by more than 100% within a one-year time period.
  • Capping the co-payments required of insured patients at $100 for a one-month supply of insulin.
  • Development of “NYHealthCareCompare”, a website that will allow New Yorkers to look up charges for medical services, the quality of services provided, and access information about financial assistance programs, as well as what to do about a surprise medical bill.
  • Local governments will be required to stay within 2% property tax increase, or be held accountable for excess growth in Medicaid costs

Several items of concern from previous Budgets, proposed but rejected, such as cuts to Medicaid payments for treating dual eligible patients, elimination of “prescriber prevails” under Medicaid, and expansion of CRNA scope of practice WERE NOT included (but could be brought up under the new MRT).
(DIVISION OF GOVERNMENTAL AFFAIRS)


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Marijuana Legalization Gains Additional Support in State Senate; MSSNY Continues to Raise Strong Concerns with Public Health Impacts
In a press conference held on Thursday Senator Pete Harckham (D-Westchester County) announced his support behind an amended recreational or ‘adult use” marijuana legalization bill sponsored by Senator Liz Krueger (D- Manhattan). Senator Harckham, thought to be one of the Senators that had previously opposed the legalization of marijuana, explained his support is the result of a key provision of the bill which would allocate roughly 25% of the revenue generated from the legalization to mental health and substance abuse prevention and treatment. Senator Harckham is the chair on the Senate Alcoholism and Substance Abuse committee.

Senator Krueger also indicated during the press conference that, if a consensus was not reached between lawmakers and the governor, she would be willing to put the issue aside until after the budget was passed.

MSSNY continues to oppose the legalization of recreational marijuana and we urge our members to send a letter to the legislature and to the governor opposing this legislation (please click here).  Last week, MSSNY joined with the New York State Association of County Health Officials in a statement (please click here ) re-iterating our groups opposition to the legalization of recreational or “adult use” marijuana given the recent CDC report confirming a direct link between legally obtained adult use cannabis and the nation’s outbreak of vaping related illnesses and deaths.   (ALI)


MSSNY Statement by Dr. Art Fougner on the Release of the State Budget
“The proposed Budget importantly advances several positive steps to promote public health, including restricting the sale of flavored tobacco products, regulating PBMs, and facilitating the ability of physicians to be more quickly approved into plan networks.

However, we are extremely concerned about the scope of the Budget proposals that would essentially strip physicians of important due process rights when a complaint has been filed with the Office of Professional Medical Conduct. We agree with the importance of acting quickly when it is imperative, but these proposals would completely undermine important and longstanding due process protections. Given that most complaints are dismissed without any sanction or action, this series of proposed changes to bypass these rights would create a substantial possibility of unfairly destroying an innocent physician’s career.

Due to our enormous liability costs and excessive regulations, New York already has the dubious reputation of being the worst state in the country to be a physician. Proposals like this will make it even more unattractive for physicians to choose New York to deliver patient care.

We welcome discussions to improve our disciplinary system to address gaps to help protect the public. However, these proposed changes are startling. We urge the Senate and Assembly to take a critical eye towards these overreaching proposals to assure patients can continue to receive the care they need.”                                                       (AUSTER)


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Forum Examines Prescription Drugs & Health Care Costs
On Wednesday, January 22, MSSNY Albany staff attended a forum hosted by the New York Health Plan Association (HPA), at the Empire State Plaza Convention Center, in Albany. The event, “Access to Innovation: How are States Addressing Prescription Drug Costs?”, looked at current spending trends associated with prescription drugs, and health care, and outlined potential policy options to address a range of issues. Among them were the use of comparative effectiveness in measuring the value and pricing of prescription drugs.

Leading the discussion was HPA”s President & CEO, Eric Linzer, who was joined by panelists Sarah Emond, from the Institute for Clinical and Economic Review (ICER), Assemblyman Daniel Rosenthal, Chair of the Subcommittee on Intergenerational Care, Helen Schaub from 1199SEIU, Charles Bell with Consumer Reports, and Eileen F. Wood, representing Capital District Physicians’ Health Plan.

Governor Cuomo has introduced several proposals in his budget for 2021 related to prescription drugs, which the MSSNY Albany staff is reviewing, including a requirement that Pharmaceutical Benefit Managers (PBMs) disclose financial incentives received to the Department of Financial Services (DFS) and giving the Department of Financial Services power to investigate sudden large jumps in drug prices. We will update members as budget discussions move forward in the coming weeks.         (CARY)


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Partial Fill Prescribing on Senate Calendar
A measure that would enable the dispensing of a partially filled controlled substances prescription, is now on the Senate calendar for a vote.  The measure, S. 7115/A.9034, sponsored by Senator Gustav Rivera and Assemblymember John McDonald, would allow a prescriber to issue a partially filled prescription for a Controlled Substance II, III, IV, V to a patient.

The prescription would be recorded in the same manner as a refill and the remaining quantity of the prescription may be dispensed separately.   In 2016, Congress passed legislation that would enable partial fill prescription under the Comprehensive Addiction and Recover Act (CARA).  This state measure would allow New York State to conform to what is allowable under federal law.

A similar measure had passed during the 2019 legislative session, but was vetoed by Governor Andrew Cuomo.  This new bill addresses concerns expressed by the administration.  The Medical Society supports this measure and believes that it will help to reduce the amount of unused pain medication that can accumulate in home medicine cabinets and will allow prescribers to help patients balance the need to relive pain with an adequate supply of medication.    (CLANCY)


NYS DOH Issues Guidance on 2019 Novel Coronavirus (2019-nCoV)
The New York State Department of Health issued guidance on the 2019 novel coronavirus (2019-nCoV) and this includes healthcare providers and facilities collecting a travel history for patients presenting with febrile illness and remain aware of current outbreaks overseas. Patients who meet either of the following criteria should be evaluated as a person under investigation (PUI) in association with the 2019-nCoV outbreak.

Fever AND symptoms of lower respiratory illness (e.g., cough, shortness of breath) and in the last 14 days before symptom onset had:

▪ A history of travel from Wuhan City, China OR  Close contact with a person who is under investigation for 2019-nCOV while that person was ill. Fever OR symptoms of lower respiratory illness (e.g., cough, shortness of breath) and in the last 14 days before symptom onset:

▪ Had close contact with an ill laboratory-confirmed 2019-nCoV patient. A copy of the NYS DOH guidance is here.

MSSNY is planning to conduct a webinar on 2019 Novel Coronavirus (2019-nCov) in March.  More information will be available shortly.          (CLANCY)


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Registration Now Open for Steps to Physician Wellness and Resiliency
MSSNY is proud to announce our first webinar entitled Steps to Physician Wellness and Resiliency on February 25th from 7:30-8:30am. Jeffrey Selzer, MD will serve as faculty for this webinar.

Educational Objectives are:

  • Review the warning signs that stress, depression, anxiety or substance use may impact work or personal life
  • Identify strategies to increase personal empowerment toward making positive change, including self-assessment tools
  • Recognize self-monitoring strategies for stress related problems and know when to seek professional assistance

Register by clicking 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.     (HOFFMAN)


Registration Now Open for Medical Matters: Virtual Drill: Incident Command System & Crisis Communications
MSSNY’s next Medical Matters will feature a Virtual Drill on the Incident Command System and Crisis Communications on February 19th from 6:00-8:00pm. Faculty for this program are: Arthur Cooper, MD; Pat Anders, MS, MEP; William Valenti, MD and Lorraine Giordano, MD.

Educational Objectives are:

  • Obtain information about local, state and national chain of command in a public health emergency and learn how to access resources
  • Understand the importance of planning for medical surge and triage of patients, as well as staff and family considerations, in the office-based practice setting during a health emergency
  • Develop an understanding that all public health emergencies can potentially have mental health implications for survivors and others connected with the event
  • Acquire skills for the management of patients in a public health emergency

Please note that there are recommended pre-course materials to be viewed prior to this virtual drill. You will be sent a link with your registration confirmation. We encourage all participants to examine these prior to the Virtual Drill.  Register by clicking here:  please click 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 2.0 AMA/PRA Category 1 credits™.  Physicians should claim only the credit commensurate with the extent of their participation in the activity.   (HOFFMAN)                                                                                                                                                                                                  

 pschuh@mssny.org mauster@mssny.org  pclancy@mssny.org  zcary@mssny.org
rali@mssny.org
eNews


Transplant Policy That Will Help New Yorkers Clears Legal Hurdle 
A federal judge has denied a second motion for a preliminary injunction that would have halted a new liver transplant policy from taking effect. The policy, which could now be implemented in as soon as days barring an appeal from the plaintiffs, prioritizes the sickest patients over geographic location when it comes to organ allocation.  

“This is a big deal because it allows patients all over the country to be prioritized based on how sick they are, not on where they live,” said Motty Shulman, a partner at Boies Schiller Flexner, who has championed fair-organ allocation and spearheaded litigation to that end. “It’s consistent with the law, but it’s also fair. It removes any barriers for equitable allocation.” Plaintiffs that have challenged the policy’s implementation include a number of major hospitals and transplant centers in the South and Midwest that have benefited from the existing system.  

The court’s order denying the plaintiffs’ motion for a preliminary injunction noted that the Organ Procurement and Transplantation Network, which put forth the new policy, is not an agency subject to the Administrative Procedure Act. The act oversees federal agencies’ issuance of regulations.  

Proponents have remained steadfast that the new policy is a much-needed reform that helps to ensure every patient in need of an organ stands an equal chance of receiving one. A 2018 lawsuit that was led by Shulman and spurred the new policy included a plaintiff who lived in New York City and lacked the financial means to travel outside the area to transplant centers that historically have had much shorter wait times.
(Crain’s Health Pulse, Jan. 2)


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One More Vaping Death: Now, There Are Four
The NYSDOH has confirmed two more deaths in New York from vaping-associated illness: a woman in her 20s from the city and a woman in her 50s from Ontario County. To date, Gov. Andrew Cuomo said in a statement, that brings the number of vaping-related deaths in New York to four. He added that the department and its Wadworth Center Laboratory are working to get to the bottom of the situation, and that the state “will continue using every tool at our disposal until these illnesses and deaths stop.”


Deadline for abstract submission is 4 pm, Monday, February 3, 2020
MSSNY is very pleased to announce the 15th Resident/Fellow/Medical Student Poster Symposium. 

When:   Friday, April 24, 2020
Where:  Westchester MarriottTarrytown, New York
Time:     1:30 pm – 4:00 pm 

Click here for detailed guidelines 

We welcome the participation of residents and fellows. Participants must be MSSNY members, and membership is free for first-time resident members. Join online.


Many Physicians Would Give Up $20K+ for Better Work-Life Balance
Almost half of physicians would take a pay cut to work fewer hours, according to a survey conducted by Medscape. The top three factors physicians cited as contributing to burnout were bureaucratic tasks like charting and paperwork; spending too many hours at work; and lack of respect from administrators, employers, colleagues or staff. The online survey was conducted among more than 15,000 physicians in 29 specialties. Respondents represented three main age groups: millennials (ages 25-39), Generation X (ages 40-54), and baby boomers (ages 55-73). More than a quarter of physicians in each age group would give up between $20,000 and $50,000 per year in salary to work 20 percent fewer hours. Another third in each age group said they would give up $10,000 to $20,000 a year to work fewer hours.  

Medscape writes that these results are “a powerful statement” on behalf of physicians, suggesting that they want greater balance.  

This desire for more balance may partially contribute to the relatively high rates of burnout in the profession, experienced by 42 percent of survey respondents. Burnout was highest among Generation X physicians (48 percent), compared to millennials (38 percent) and baby boomers (39 percent). Read more here 



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Poor Glycemic Control in Childhood May Be Tied to T1D-Related Premature Death in Young Adulthood
Medwire News (1/23) reports, “People who die in young adulthood from acute complications of type 1 diabetes [T1D] are characterized by poor glycemic control during childhood,” researchers concluded in a study of 12,652 patients. The study revealed that “overall, people with diabetes were nearly three times more likely to die before the age of 30 years than those without.” The findings were published online in Pediatric Diabetes


Unhealthy LCD/LFD Scores May Be Associated with Higher Total Mortality in US
Clinical Endocrinology News (1/22) reports, “The health consequences of diet don’t largely depend on whether a person eats a high or low level of carbohydrates or a diet high or low in fat,” research suggests. What appears to be “more important is where the carbs and fats come from, according to an analysis that related diet and mortality rates in more than 37,000 American adults.” The study revealed that “unhealthy low carbohydrate diet [LCD] and low-fat diet [LFD] scores were associated with higher total mortality, whereas healthy LCD and LFD scores were associated with lower total mortality.” The findings were published online in JAMA Internal Medicine.  



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CMS

New Medical Narrative Report Template for Form CMS-1500 Submissions
To further assist medical providers in the implementation of the CMS-1500 for workers’ compensation patients, the Board has created a medical narrative report template that can be used to create the medical narrative that must accompany all CMS-1500 submissions. 

The top of the template includes the three elements most narratives require: the patient’s work status, the causal relationship of the injury to the patient’s work activities, and the patient’s percentage of temporary impairment. A medical narrative report may be found legally defective if these elements are missing. Medical providers must also include examination findings within their narrative, including the history of the injury/illness, objective findings based on the clinical evaluation, the patient’s plan of care and the diagnosis(es)/assessment of the patient. 

A link to the new template, as well as line-by-line instructions, can be found on the CMS-1500 section of the Board’s website at http://www.wcb.ny.gov/CMS-1500/requirements.jsp. A chart outlining the specific narrative requirements for each specialty is located on the same page.  

If you have any questions regarding use of the medical narrative report template, please write to the CMS-1500 mailbox at CMS1500@wcb.ny.gov.(  Jan.22,2020)


New 2019 Data Submission Resources Now Available on QPP Resource Library
CMS has posted the following new Quality Payment Program (QPP) resources to the QPP Resource Library to help eligible clinicians submit their 2019 Merit-based Incentive Payment System (MIPS) data until the submission period closes at 8:00 p.m. EDT on March 31, 2020.  

  • 2019 Data Submission FAQs – Answers commonly asked questions about data submission for the 2019 performance period. 
  • 2019 Data Submission Demonstration Videos 
  • Manual Attestation of Improvement Activities – Provides an overview of how a third-party intermediary can report MIPS data on behalf of a group within the QPP portal and how to modify the Improvement Activity score by manually attesting to measures. 
  • Manual Attestation of Promoting Interoperability Measures – Shows how a third-party intermediary can submit MIPS data on behalf of a group within the QPP portal and how to modify the Promoting Interoperability score by manually attesting to measures. 

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

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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.org if you have questions or comments.  Thank you.
(WILKS)


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RENTAL/LEASING SPACE

Midtown Medical Office for Rent
Beautiful office for rent in midtown Manhattan located opposite Grand Central Station on 42nd Street and Madison avenue. ideal for medical and surgical specialists as there are five spacious exam rooms with an accredited quad a certified operating room with anesthesia services. You can perform procedures and see patients. Rent for three days a week is $3,200 and 4 days a week is $4,100 Interested physicians please email cpmgman@gmail.com or call 914-582-0749.


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Furnished Luxury Park Avenue East 70’s Medical Office Rental Available.
Voted most beautiful block on UES. Private Entrance. Central A/C.
Dedicated consultation room, exam room, procedure room, reception and nurse areas in a multispecialty office setting. Suitable for all subspecialties. Walk to Lenox Hill Hospital and NY Cornell. Proximate to Mt Sinai Hospital. Subway 2 blocks away. Full Time/Part Time. No fee.
START SEEING PATIENTS IMMEDIATELY!!!
Please call or text 929 316-1032

JOB OPPORTUNITIES

NYS Job opportunity headline

ANNOUNCEMENT OF ANTICIPATED JOB OPPORTUNITY
Open to the Public Community Health Program Manager 3 – 24123 $109,956 – $138,763 / M-4
NEGOTIATING UNIT Management Confidential (06)
LOCATION Division of Family Health Corning Tower, Empire State Plaza Albany, NY 12237
MINIMUM QUALIFICATIONS TRANSFER: Current NYS employee with one year or more of contingent-permanent or permanent competitive service in a title at or above Grade 29/M-3 and eligible for transfer under Section 52.6 of the Civil Service Law.
PROVISIONAL*: a bachelor’s degree AND seven years professional public health experience in a governmental public health agency or public health program* that receives funding from a public health governmental agency. Of the seven years required experience, three years must include supervision of professional staff and the following management responsibilities: program planning and implementation, AND program evaluation and monitoring, AND development and implementation of policies and procedures.
The required professional experience must include either:

  1. Designing or implementing a public health outreach, promotion, or disease prevention program; OR
  2. Conducting disease surveillance or a disease control

For the purposes of this recruitment, a public health program focuses primarily on the prevention of disease through outreach and public health education or health promotion, including population-based plans of care, not just plans of care for individual patients, or the study of the prevalence or causes of disease through population-based studies. Examples of non-qualifying experience include, but are not limited to: Read More


Pediatric Board Tutor
Looking for a tutor for Initial Pediatric Board Exam
Flexible hours, Negotiable rate. If interested please email at: pedboardhelp@gmail.com


 

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Great Career Opportunities for Clinical Physicians
Physicians, are you looking for a change?  Tired of working long shifts with an overwhelming patient load?  Come work at a well-equipped and staffed correctional facility where you can MAKE a difference, working with a smaller number of patients for reasonable hours.

Starting salary is $143,381 – $171,631 *Additional $20,000 geographical differential for Clinton & Franklin CF, and $10,000 for Five Points, Greene and Groveland CFs. We offer full-time, part-time & hourly/per-diem positions.

We have openings in the following counties offering a choice of urban, suburban or rural living:

Clinton*                 Clinton Correctional Facility (sporting and recreational outlets)
Chemung               Elmira and Southport Corrl Facilities (Gateway to the Finger Lakes)
Columbia*             Hudson Correctional Facility (antiquing, arts & collectables)
Dutchess                Green Haven Correctional Facility (Hudson River Valley Beauty)
Franklin*                Franklin & Upstate Corrl Facilities (North Country, 1 hour to Montreal)
Greene*                 Greene Correctional Facility (rural charm yet only 2 hours to NY City)
Livingston*            Groveland Correctional Facility (State Parks, hiking, fishing)
Oneida                   Mohawk Correctional Facility (Cooperstown, breweries)
Orleans                  Albion Correctional Facility (Greater Niagara Region & Canal Town Culture)
Sullivan                  Woodbourne Correctional Facility (mountains, outlets, entertainment)
Seneca*                 Five Points Correctional Facility (heart of wine country)
St. Lawrence          Riverview Correctional Facility (hiking, boating and museums)
Ulster                     Shawangunk and Wallkill Corrl Facility (Catskill Mountains, Casinos)
Washington           Great Meadow Corrl Facility (Between Vermont & Green Mountains)
Westchester           Bedford Hills Correctional Facility (Less than 1 Hour to NYC)
Wyoming               Wyoming Correctional Facility (waterfalls, family farms, natural beauty)

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Inquire with the Facility Personnel Office regarding benefits and anticipated opportunities: http://www.doccs.ny.gov/faclist.html. Contact: www.doccs.ny.gov or DOCCS Personnel Office at (518) 457-8132 for more information and to apply.



 

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

 

Council January 30, 2020

AGENDA
MSSNY Council Meeting
Thursday, January 30, 2020 at 9:00 a.m.
Courtyard Marriott, Westbury Long Island
1800 Privado Road
Westbury, NY  11590

A.  Call to Order and Roll Call

B. Council Minutes of November 7, 2019

C.  New Business (All Informational/Action Items)

1 President’s Report:

a. Appointment of Mark Jajkowski, MD, New Eighth District Councilor to complete Dr. Bartels term which ends in 2021. (For Council Approval)

b. Honoring Dr. Steven Schwalbe with a Certificate of Appreciation for his many years of dedicated service as Chair of MSSNY’s Interspecialty Committee

c. Honoring Dr. Marina Caskey with the Albion Bernstein Award

Dr. Caskey is an Associate Professor of Clinical Investigation at The Rockefeller University. Her research focuses on the development and testing of a promising new strategy that uses broadly neutralizing antibodies to prevent or treat HIV infection. Dr. Caskey graduated from medical school at the Federal University of Sergipe, Brazil, in 1998. She then completed an internal medicine residency at Saint Luke’s Roosevelt Hospital, in New York, followed by fellowship training in infectious diseases at New York Presbyterian-Weill Cornell Medical Center.

Dr. Caskey has led a series of early-phase clinical studies to evaluate the safety and efficacy of broadly neutralizing anti-HIV antibodies. These antibodies were isolated and characterized from patient blood cells by sophisticated cloning methods developed in the laboratory of Dr. Michel Nussenzweig.  The studies led by Dr. Caskey have revitalized this area of HIV research, which had been abandoned after first-generation antibodies failed to show significant effects in humans.  Broadly neutralizing antibodies are now considered one of the most promising strategies to achieve HIV remission, as well as potential alternatives to antiretrovirals for both therapy and prevention. Her seminal studies have shaped this new area of research and several groups in the US and abroad are now studying the antiviral and immune modifying effects of these molecules in combination with other strategies.

Dr. Caskey is also an attending physician in infectious diseases at New York Presbyterian-Weill Cornell Medical Center. She was recently elected for membership in the American Society of Clinical Investigation.

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

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

4. MLMIC Update – Dr. John Lombardo will present the report (verbal)

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

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

7. County Federation Report – Dr. Aaron Kumar will present the report

D.  Reports of Officers  

  1. Office of the President  – Arthur C. Fougner, MD
  2. Office of the President Elect – Bonnie L. Litvack, MD
  3. Office of the Vice President – Joseph R. Sellers, MD
  4. Office of the Treasurer – Mark J. Adams, MD
    Financial Statement for the period 1/1/19 to 1/3019
    (For Council Approval)
  5. Office of the Speaker – William R. Latreille, Jr., MD

E.  Presentation

Mr. Tom D’Angelo, President-Elect of the Pharmacists Society of the State of New York
Verbal Discussion – “Pharmacy Benefit Managers and How They Affect the Capability to Fill Prescriptions”

F.  Reports of Councilors (Informational Items)

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

G.  Commissioners (Informational Items)

  1. Commissioner of Continuing Medical Education, Mark J. Adams, MD
    a) Report from the Office of CME
  1. Commissioner of Communications, Maria A. Basile, MD, MBA
    a) Report from the Division of Communications
  1. Commissioner of Governmental Relations, Gregory Pinto, MD
    a)Scope of Practice Minutes, November 20, 2019
    b)Report from the Division of Governmental Affairs
  1. Commissioner of Membership, Parag H. Mehta, MD
    a) Membership Presentation
  1. Commissioner of Science & Public Health, Joshua M. Cohen, MD
        (no written report submitted)
  1. Commissioner of Socio Medical Economics, Howard H. Huang, MD
       a) Interspecialty Minutes, October 24, 2019

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

I.  Report of the General Counsel, Garfunkel Wild, P.C. Andrew Zwerling, Esq.
    (no written report submitted)

J. Report of the Alliance, Barbara Ellman, AMSSNY Co-President
Alliance Report

K. Other Information/Announcements
1. Scope of Practice Letters

L.  Adjournment

 

 

 

 

MSSNY Calls on NYS Legislature to Ensure Due Process For Innocent Physicians  

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

 

For Immediate Release
January 22, 2020

MSSNY CALLS ON NYS LEGISLATURE TO ENSURE DUE PROCESS FOR INNOCENT PHYSICIANS
 

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

“The proposed Budget importantly advances several positive steps to promote public health, including restricting the sale of flavored tobacco products, regulating PBMs, and facilitating the ability of physicians to be more quickly approved into plan networks.

However, we are extremely concerned about the scope of the Budget proposals that would essentially strip physicians of important due process rights when a complaint has been filed with the Office of Professional Medical Conduct. We agree with the importance of acting quickly when it is imperative, but these proposals would completely undermine important and longstanding due process protections. Given that most complaints are dismissed without any sanction or action, this series of proposed changes to bypass these rights would create a substantial possibility of unfairly destroying an innocent physician’s career.

Due to our enormous liability costs and excessive regulations, New York already has the dubious reputation of being the worst state in the country to be a physician. Proposals like this will make it even more unattractive for physicians to choose New York to deliver patient care.

We welcome discussions to improve our disciplinary system to address gaps to help protect the public. However, these proposed changes are startling. We urge the Senate and Assembly to take a critical eye towards these overreaching proposals to assure patients can continue to receive the care they need.”

# # #

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.

 

Media Contact:
Roseann Raia
Medical Society of the State of New York
516.488.6100 x 302
rraia@mssny.org

 

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