October 20, 2017

Charles Rothberg, MD - MSSNY President
PRESIDENT’S MESSAGE
Charles Rothberg, MD
October 20, 2017
Volume 17
Number 40

Dear Colleagues:

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

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

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

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

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

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

Sincerely,

Charles Rothberg, MD
MSSNY President

Please send your comments to comments@mssny.org


enews large

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

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

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

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

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

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

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

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


Promo Code: MSSNY


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

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

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

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

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

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


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


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

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

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

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

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

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

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

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

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

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

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

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

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

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

SEMINARS

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

Join Us for a 10/25 Mid-Day Webinar

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

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

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


CLASSIFIEDS

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

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


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

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

PHYSICIAN OPPORTUNITIES


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

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

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

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

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

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

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

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

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

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

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

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


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


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


October 13, 2017 – Executive Order Concerns

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

Dear Colleagues:

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

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

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

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

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

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

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

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

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

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

All donations are tax deductible.

Thank you for helping us to help others.

Sincerely,

Charles Rothberg, MD
MSSNY President

Please send your comments to comments@mssny.org


enews large

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

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

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

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

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

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

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

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

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

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

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

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

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

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



Promo Code: MSSNY


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

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

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

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

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

Survey takers should be at least one of the following:

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

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

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

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

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

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

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

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

For more information on your PQRS feedback report:

For more information on your Annual QRUR:

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

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

Questions:

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


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


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

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

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

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

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

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

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

Source: CMS National Correct Coding Initiative Edits 

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

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

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

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

Educational objectives are:

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

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

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



CLASSIFIEDS

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


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


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

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

PHYSICIAN OPPORTUNITIES


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

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

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

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

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

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

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

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

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

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

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


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


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


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


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

MSSNY


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

Dear Colleagues:

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

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

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

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

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

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

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

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

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

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

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

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

It is time to make America safer.

Sincerely,
Charles Rothberg, MD
MSSNY President

Please send your comments to comments@mssny.org


enews large

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

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

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

Please click here to take the survey.

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

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

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

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

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

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

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

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

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




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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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



Promo Code: MSSNY


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

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

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

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

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

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

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

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

Our top priorities include:

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

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

For More Information

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

Seminars and Webinars

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

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

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

Accreditation Statement

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

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

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

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

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

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

Educational objectives are:

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

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

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



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


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

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

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

Register here.

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

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

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

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

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

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

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

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



CLASSIFIEDS

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


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


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

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

PHYSICIAN OPPORTUNITIES


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

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

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

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

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

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

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

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

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

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

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


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


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


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


September 29, 2017 – Helping to Help Others


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

Dear Colleagues:

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

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

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

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

Thank you for helping us to help others.

Sincerely,
Charles Rothberg, MD
MSSNY President

Please send your comments to comments@mssny.org


enews large

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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



Promo Code: MSSNY


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

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

Please click here to see our 2017 legislative summary.

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

PAL responsibilities include:

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

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

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

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

To continue reading the article, click here.

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

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

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

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

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

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

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

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

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

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

USPSTF recommendations on fall prevention for seniors

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



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


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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

The schedule is as follows:

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

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

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

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

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

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

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

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

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

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

Professional Healthcare Consulting Services that make a difference!

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

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

Transition year (2017) Participation:

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

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

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

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

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

Need Help Participating?

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

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

Key Elements of TPE

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

Provider Tips

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

Related Content


CLASSIFIEDS


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


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


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

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

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

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

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


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


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


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

Dear Colleagues:

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

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

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

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

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

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

Sincerely,
Charles Rothberg, MD
MSSNY President

Please send your comments to comments@mssny.org


enews large

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

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

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

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

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

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

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

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

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

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

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

PAL responsibilities include:

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

Click here to sign up! 

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


Promo Code: MSSNY


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

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

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

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

Educational objectives are:

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

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

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



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


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

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

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

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

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

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

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

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

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

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

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

Detailed guidelines can be found here.

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


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

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

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

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

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

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

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

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

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

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

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

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

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


CLASSIFIEDS


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


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


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

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

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

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


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


September 15, 2017 – QPP for NEWBIES!


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

Dear Colleagues:

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

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

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

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

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

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

Sincerely,
Charles Rothberg, MD
MSSNY President

Please send your comments to comments@mssny.org


enews large


September 14 Council Notes

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


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

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

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



Promo Code: MSSNY



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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

Common Enrollment Questions:

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

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

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

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

Therefore, physicians do not need to complete Section 5.

If you have questions, please call Regina McNally


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



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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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



CLASSIFIEDS



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

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

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

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


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

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

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

PHYSICIAN OPPORTUNITIES

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


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

September 8, 2017 – Insurers Act BADLY!


PRESIDENT’S MESSAGE
Charles Rothberg, MD
September 8, 2017
Volume 17
Number 34

Dear Colleagues:

I need to inform you of recent adverse activities on the part of a few insurers.

Emblem Health appears to have begun notifying a number of participating physicians that they will no longer be in network effective Jan 1, 2018. This is reminiscent of a campaign two years ago, when approximately 700 physicians were not renewed in an apparent attempt to narrow Emblem’s networks.   In its recent letter, Emblem explained to physicians that this non-renewal was not related to quality or performance issues and need not be reported to credentialing bodies.

A few physicians have filed appeals with the company for re-consideration of their non-renewal status. Presently, one physician had his status overturned and will remain “in network” after
January 1.

Some physicians, already renewed by Emblem’s Medicare Advantage plan, still face uncertainty regarding their Emblem Health commercial line participation.

On an unrelated insurance issue, I was made aware that Anthem health, parent of Empire Blue Cross plans in New York, have been improperly collecting personal identifying information belonging to practice employees – including Social Security numbers, birth dates, and home addresses – in conjunction with the Empire Provider Application.

In this matter, Anthem staff appear to have misapplied 42CFR 455.104. that pertains to disclosure requirements for entities that bill various plans for federal funds— such as Medicare and Medicaid.  Individual solo-practices and some physician group practices are specifically excluded from the necessity to disclose a staff member’s personal information.

As a result of a conference call between MSSNY and Anthem, the insurer agreed to revise its application forms and data collection process.   I anticipate that in short time, they will produce an amended Empire Provider Enrollment Application and that they will properly discard any improperly collected information.  In the meantime, physicians in solo and small practices should be aware that the submission of this information is not required.

MSSNY also continues to seek legislation (A.2704/S.3943 – passed the Assembly this year, but not the Senate) that would require health plans to provide physicians with appropriate due process protections before they non-renew a physician’s contract.  You can send a prepared letter to your Senator by visiting MSSNY’s Grassroots Action Center today.

Late Breaking Response to MSSNY from Emblem Health:
“We continuously review our network as it relates to our membership and to reflect our partnerships in value-base arrangements. We emphasize that this change in our network impacted less than .05% of the physicians within our network. Emblem also recommends physicians who received a non-renewal notice have the option to appeal the decision relating to their Medicare agreement.”

For further information, please call VP of Socio-Medical Economics Regina McNally at 561-488-6100 ext. 334.

Sincerely,
Charles Rothberg, MD
MSSNY President

Please send your comments to comments@mssny.org


enews large


Top New York Court Rejects Right to Physician-Assisted Suicide
On September 7, the New York Court of Appeals ruled that physician-assisted suicide is not a fundamental right, and that it would not block the New York Legislature from passing legislation banning physician-assisted death. Physician-assisted suicide is illegal in most states, but in recent years, Colorado, California, Oregon, Vermont, Washington, and the District of Columbia have approved legislation allowing people to request life-ending medication from physicians. No state court, however, has recognized assisted suicide as a fundamental right. (Wall Street Journa l9/7)

The case was brought by three people with terminal illnesses. Two have since died. The plaintiffs had argued that the state’s existing ban on assisting a suicide should not apply to those seeking merciful ends to incurable illnesses.The court disagreed, noting that while state law allows terminally ill patients to decline life-sustaining medical assistance, it does not allow anyone to assist in ending patients’ lives. “The assisted suicide statutes apply to anyone who assists an attempted or completed suicide,” the court wrote in its unanimous decision. “There are no exceptions.”

In their lawsuit, the plaintiffs argued that New York’s prohibition on assisted suicide violated guarantees of equal protection under the law. They alleged the law unlawfully discriminates between terminally ill patients who have the option of dying by declining life-sustaining medical assistance and other terminally ill patients who are unable to hasten their deaths simply by rejecting medical assistance.

MSSNY’s Bioethics Committee is working on an Aid to Dying survey to gather New York physicians’ positions on this topic.

Gov. Reduces Health Insurance Barriers to Substance Abuse Treatment Coverage
New York Governor Andrew Cuomo announced new regulatory guidance this week to better assure New Yorkers can more readily overcome insurance coverage barriers to receiving medications necessary to treat a substance abuse disorder. It was part of a series of initiatives announced this week by the Governor to facilitate new addiction treatment, recovery and support services to residents suffering from substance use disorders in underserved communities throughout New York City and Long Island.

Specifically, a new regulation was issued by the New York Department of Financial Services (DFS) that will require insurers who offer large group coverage to allow consumers to appeal coverage denials for medically necessary addiction medications when they are not on the list of covered drugs.

The regulation calls for an insurer to notify the patient and the prescribing physician within 72 hours of the request and provide coverage of the non-formulary medication for the detoxification or maintenance treatment of a substance use disorder for the duration of the prescription, including refills.  Furthermore, the regulation requires an expedited appeal process for “exigent circumstances” where notification of the determination must be provided to the patient and the prescribing physician no later than 24 hours following receipt of the request.

Moreover, DFS issued a “circular letter”  to New York insurers designed to eliminate impediments to addiction services coverage, “to prevent insurers from excessively reviewing the medical necessity of opioid treatment, and to bar the inappropriate delay of coverage.”

MSSNY Attends DOH: Future of Integrated Care in New York State Workgroup
In 2016, the NYS Department of Health announced that the Fully-Integrated Duals Advantage (FIDA) program received federal approval to be extended until the end of 2019.  The FIDA program is designed to provide managed care coverage to individuals covered by both Medicare and Medicaid.  In response, the DOH workgroup on the Future of Integrated Care in New York State has committed to mapping out a strategy that would help New York State reach its objectives of increasing integration of services, providers, payments, and delivery systems.

The planning committee kicked-off in July where the NYSDOH and CMS presented on the value of integrating Medicare and Medicaid services while sharing insights into models that other states have found success in using. This week’s workgroup focused on target populations, covered services, care coordination/management elements, and assessment and service planning requirements. The Future of Integrated Care in New York State workgroup series will continue on with three additional meetings over the fall in which MSSNY will continue to participate and provide critical input.

Topics to be discussed in these future meetings include network adequacy, payment and rate considerations, and geographic scope.  For more information on the FIDA program, click here.



Promo Code: MSSNY


Addiction Medicine Track Offered at ASAP Conference on September 17, 2017
The New York State Office of Alcoholism and Substance Abuse Services (NYS OASAS) and the Alcoholism and Substance Abuse Providers of New York State (ASAP) is now offering the Addiction Medicine Track at a September 17, 2018 conference.

The conference begins on Sunday September 17, 2017 and finishes on Monday September 18, 2017 and is being held at the Buffalo Niagara Convention Center in Buffalo, New York, near Niagara Falls
.  The ASAP conference runs concurrently and will actually finish on Wednesday September 20, 2017 for those who may wish to register for and stay for that.  To register for this program please click here.
This conference track is appropriate for physicians, nurse practitioners, physician assistants and any other staff who may find the material interesting or relevant.  This live activity, Addiction Medicine Track at ASAP’s 18th Annual Conference: Building Bridges, with a beginning date of 09/17/2017, has been reviewed and is acceptable for up to 15.00 prescribed credit(s).


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


Texas Medical Society: Physicians Helping Physicians
The Texas Medical Foundation is soliciting funds to use for grants to help reestablish the delivery of patient care in physician practices in federally designated disaster areas damaged by Hurricane Harvey.

The program will help cover expenses (not covered by insurance or other sources of funding) for relocating or rehabilitating a physician’s medical office. This may include replacing equipment, aiding needed staff, rebuilding patient records, and other similar needs all towards the goal of helping affected physicians once again begin treating their patients. https://www.texmed.org/Harvey

For Members Only: Brooks Brothers Offers 15% Discount
Enroll for your complimentary Brooks Brothers Corporate Membership Card and Save 15%* on full priced merchandise at all Brooks Brothers U.S. and Canadian stores, by phone and online.
TO ENROLL FOR YOUR NEW MEMBERSHIP CARD:

  • Organization ID# 12479 and Pin Code# 19658and enroll at: Membership.BrooksBrothers.com
  • You will need to wait 30 minutes after you enroll before you register to shop online.
    TO SHOP ONLINE:
  • www.BrooksBrothers.com
  • At the top of the page click on My Account & then CREATE AN ACCOUNT.
  • Create new profile and at the bottom click on “I have a Corporate Membership Number”.
  • Enter 12 digit Membership Number.
  • Click on create and you will receive a Welcome Letter.  You are now ready to shop.


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

Sept. 15: 2017 MSSNY Continuing Medical Education Provider Conference
To meet the challenges facing planners, providers and participants of CME, MSSNY recognizes the need for ongoing education and training of its Accredited Providers as well as physicians and other healthcare professionals in NYS.
The conference will take place on Friday, September 15, 2017, at the Westbury Marriott
.  The program is scheduled from 7:30 AM to 3:45 PM.

This conference will inspire participants to explore and interactively address challenges such as self-directed learning for physicians and compliance with the changing accreditation criteria that clearly address practice gaps and practice-based needs while creating opportunities for measurable change in physicians and reinforcing the undeniable link between a successful CME activity and quality improvement for physicians and patients alike.

Registration links and more information are available here.  Featured speakers include Steve Singer, PhD; Vice President of Education and Outreach, Accreditation Council for Continuing Medical Education (ACCME) and Mary Kelly, Project Administrator, AMA PRA Standards and Policy.  MSSNY President Charles Rothberg, MD will deliver the welcome and opening remarks. For more information, please contact Miriam Hardin at mhardin@mssny.org. More information.

Oct. 10-14: Free Vets Health Care Training Program Conference in Niagara Falls
The Medical Society of the State of New York, the New York State Psychiatric Association, and the National Association of Social Workers – New York State Chapter are hosting a two- day conference on
Friday, 10/13 Saturday,10/14 at the Niagara Falls Conference Center, 101 Old Falls St, Niagara Falls, NY.
The conference will consist of interactive seminars and panel discussions focusing on the current and evolving healthcare needs of veterans.

MSSNY and NYSPA will be conducting three CME accredited trainings for primary care physicians and specialists. The CME programs are “Invisible Wounds of War: PTSD, TBI & Combat-Related Mental Health Issues,” “Recognition, Management and Prevention of Veteran Suicide,” and “Substance Use Disorders among Returning Veterans.”


There is no cost, but separate registration will be required for both the trainings and conference. More information will be coming shortly.


Dr. Jerome Adams Sworn in As US Surgeon General
The new Surgeon General of the US, Jerome Adams, an anesthesiologist with a master’s degree in public health, was sworn in on Tuesday, September 5.  Dr. Adams previously served as Indiana’s health commissioner.

At the ceremony Tuesday afternoon, Dr. Adams said his motto as surgeon general will be to create “better health through better partnerships” in an effort to address wide-ranging health issues, such as the opioid epidemic, mental health and childhood obesity. He said that law and healthcare must work together to tackle the opioid fight.

Vice President Pence praised Dr. Adams for his work on cutting Indiana’s infant mortality rate, addressing Ebola and helping curb an HIV outbreak stemming from injection drug use. Dr. Adams said that he is eager to start helping victims of Hurricane Harvey as the “nation’s doctor” and reaffirmed his commitment to “letting the science lead him to facilitating locally-led solutions to difficult health problems.”

Plant-Based Diet As Effective As PPIs in Treating Laryngopharyngeal Reflux
Findings published online in JAMA Otolaryngology-Head & Neck Surgery reports that “a plant-based diet is just as effective as proton pump inhibitors in treating laryngopharyngeal reflux,” researchers found in a six-week study involving “85 patients with an average age of 60 treated with the P.P.I.s Nexium [esomeprazole magnesium] and Dexilant [dexlansoprazole], and 99 treated with alkaline water and the Mediterranean diet, a regimen low in meat and dairy, and rich in olive oil, nuts, fish, beans, fruits and vegetables.”

Garfunkel Wild Hosting 4th Annual Ambulatory Surgery Center Symposium
Garfunkel Wild will be hosting its 4th Annual Ambulatory Surgery Center Symposium on October 20, 2017 at the Crowne Plaza Times Square.  Speakers include representatives from major managed care organizations, CMS, state and national ASC association leaders, hospitals and management company executives, leading consultants and many more. To register or for more information, visit www.nymetroasc.com or call 516-393-2294.

According to CDC Stats, One in Three Americans Are Obese
The Trust for America’s Health and the Robert Wood Johnson Foundation released a report based on statistics from the Centers for Disease Control and Prevention that showed
one in three American adults and one in six children to be obese.
The highest obesity rates are found in West Virginia, Mississippi, Alabama, and Arkansas, although the rates of increase in some states may be stabilizing. Trust for America’s Health President and CEO John Auerbach commented, “The adult rates are showing signs of leveling off and the childhood rates are stabilizing. In our review of the policies and strategies, we found that many (states) show a lot of promise for reversing the trends and improving health if we make them a higher priority.”

The data compiled from the Behavioral Risk Factor Surveillance System, relies on self-reported weight data, “so it likely underestimates true rates.” Despite state obesity statistics leveling off, the data indicates that the nation is “at risk of poor health” if programs to address obesity lose funding, according to the Trust for America’s Health CEO.

District Court: Govt. “All But Ignored” Calls for Insurer Payment Transparency
The US District Court for the District of Columbia has ruled on a motion filed by the American College of Emergency Physicians (ACEP) in regard to its lawsuit against the federal government (ACEP v. Thomas E. Price, MD) that argued a regulation under the Affordable Care Act (ACA) violated Congressional intent.
“This is a clear step in the right direction,” said Rebecca Parker, MD, president of ACEP. “It does not invalidate the federal regulation, but
it supports ACEP’s contention that the federal agencies ignored significant concerns raised by public commenters regarding a lack of transparency by health insurance companies in determining payments.
Congress in the ACA required that reasonable amounts be paid for emergency care, based on an objective standard, when patients receive it outside of a qualified health plan’s network.”

The court remanded the case back to HHS for further explanation, saying that comments during the regulation’s development had been submitted to CMS expressing concerns “for example, that the methods it used to set payments were not transparent and could be manipulated by insurers…The Departments all but ignored these comments and proposals.”

ACEP originally filed suit in May 2016 against then-Secretary Burwell after the federal government did not address the concerns raised to CMS about out-of-network emergency physician payments, which the agency set at the “greatest of three” options: (1) Medicare (which often does not even cover providers’ costs) (2) In-network rates (set without the provider’s input) (3) “Usual and customary” (as determined by the health plans).  As written, this regulation opened the door for insurers to use non-transparent (“black box”) methods to determine these “usual and customary” payment amounts without providing any means to externally verify the data.

CMS Poster for Coding Information for Preventive Services
https://www.cms.gov/Medicare/Prevention/PrevntionGenInfo/medicare-preventive-services/MPS-QuickReferenceChart-1.html


CLASSIFIEDS



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

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

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


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

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

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

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

Council September 14, 2017

AGENDA
Council Meeting
Thursday, September 14, 2017, 9:00 a.m.
Courtyard Marriott, Westbury Long Island
     1800 Privado Road
   Westbury, NY  11590

A.Call to Order and Roll Call

B.Approval of the Council Minutes of June 22, 2017

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

  1. President’s Report
    a.  MSSNY Stress and Burnout Task Force Conference Call Minutes
  2. Board of Trustees Report Dr. Hamlin will present the report (handout)
  3. Secretary’s Report – Dr. Dowling will present the report Nominations for Life Membership and Dues Remissions
  4. MLMIC Update  – Mr. Donald Fager will present a verbal report
  5. AMA Delegation Update– Dr. Kennedy will provide a verbal report
  6.  MSSNYPAC Report –  Dr. Sellers will present the report
    (handout at Council)
  7. Commissioners (All Action Items)
    1. Commissioner of Socio-Medical Economics,
      Howard H. Huang,
      Committee on Interspecialty
      Resolution 2017-157, Development and Promotion of Evidence-based Ultrasound-First Radiation Mitigating Protocols  (For Council Approval)

     

    1. Councilors Reports  (Reports, if any)
      (No items submitted)

D. Reports of Officers (Verbal Reports)
  1. Office of the President – Charles Rothberg, MD
Meetings attended:

  • New York County Annual Meeting
  • NYS Academy of Family Physicians
  • NYSIPP Meeting
  • Integrated Care/NYS Stakeholder Meeting
  • MLMIC Executive Committee @ the Equinox
  • Anthem Provider Teleconference
  • MLMIC Executive Committee
  • Monday, September 11 – Quality Improvement & Innovation Group Roundtable WEBEX

2. Office of the President-Elect – Thomas J. Madejski, MD
3. Office of the Vice-President – Arthur C. Fougner, MD
4. Office of the Treasurer – Joseph R. Sellers, MD,
Financial  Statement for the period 1/1/17 – 7/31/17
5.   Office of the Secretary – Frank G. Dowling, MD
6.  Office of the Speaker –  Kira A. Geraci-Ciradullo, MD, MPH

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

F.   Commissioners (Committee Informational Reports/Minutes)
1.  Commissioner of Communications,
      Maria A. Basile, MD, MBA
     Report of the Division of Communications

2.   Commissioner of Governmental Relations,
               Gregory Pinto, MD
      2017 Legislative Summary

3.   Commissioner of Medical Education,
       Mark J. Adams, MD
      (No written report submitted)

 4.  Commissioner of Membership, Parag H. Mehta, MD
        (No written report submitted)

 5.  Commissioner of Science & Public Health,
       Frank G. Dowling, MD
      Public Health and Education Report

 6.  Commissioner of Socio-Medical Economics,
       Howard H. Huang, MD
       Committee on Interspecialty Minutes, June 29, 2017

GReport of the Executive Vice President –
              Philip A. Schuh, CPA, MS

  1.   Membership Dues Revenue Schedules
  2.   Group Institutional Dues Schedule
  3.   PAI Letter to Dr. Price and Recommendations for Regulatory Relief
  4.  Final MOC Sign-On Letter

H.  Report of the Alliance – Valerie Semeran, Co-President                            Alliance Report    

I.   MESF Foundation – Thomas Donoghue, Executive Director                     (No written report submitted)

J. Other Information/Announcements

1. Brookhaven Memorial Hospital Harvest Moon Gala honoring                 Charles Rothberg, MD>
2.  AMA Letter to Alphonso David, Counsel to the Governor re                    Veto of S.6800/A.8516
3.  Times-Union 7-26-17 Gruenthal
       4.   Syracuse P-S Iroquois 8-22-17
       5.   Syracuse PS 8-1-17
       6.   S.6800 letter to the Governor
7.    PoJo 8-21-17
8.    LRANY Letter to Cuomo RE S6800
       9.    Legislative Gazette – 7-27-17
       10.  GNYHA White Paper
       11.  Dunkirk-Oberver-Opinion-July-2017

K. Adjournment

August 25, 2017 – Northwell Out of Insurance Biz


PRESIDENT’S MESSAGE
Charles Rothberg, MD
August 25, 2017
Volume 17
Number 33

Dear Colleagues:

Yesterday, Northwell announced that it will close its insurer, CareConnect, due in large part to the flawed risk adjustment.

While physicians won’t be asked to absorb the losses—as was the case with the shuttering of insurer Health Republic almost two years ago—both of these situations suggest that if we want to encourage new entrants into the insurance market, regulators need to understand what “adjustments” do to the playing field.

Northwell was required to pay almost half its revenue into the pool (even though the ACA requires that 80% of premiums be spent on medical care). Both Congress and the ACA sought to promote new entrants to create a more competitive insurance market—but in attempting to level the playing field it has instead tilted it even further.

The risk adjustment was based on a flawed methodology that absurdly considered factors beyond actual claims experience. It scored non-financial factors like co-morbid disease—which was derived from insurer’s own data and the mining of physician records, but didn’t at all correlate with financial experience. Established, deep-pocketed insurers were able to mine data better to exploit this flawed methodology. New insurers were drained out of business.

This kind of dangerous “misunderstanding” on the part of regulators and policy makers is why I cannot easily welcome so-called “value based payment” reforms.

Sincerely,
Charles Rothberg, MD
MSSNY President

Please send your comments to comments@mssny.org


enews large


Northwell Will Shutter CareConnect Over ACA Uncertainty, Costs
Yesterday, CareConnect, which includes 22 hospitals, including North Shore University Hospital, Northern Westchester Hospital, and Lenox Hill Hospital, reported that they will exit the insurance market in 2018 “because of the uncertainty of the Affordable Care Act’s future” and costs. About 126,000 CareConnect policyholders “would remain covered while they transfer to new health providers.” CareConnect parent Northwell Health highlighted a $112 million payment into the ACA’s risk-adjustment pool this year, which represented 44 percent of CareConnect’s 2016 revenue from its small group health plan. CareConnect faced another such payment and “said it never received $150 million from the federal government in risk-corridor payments.” Newsday (NY) (8/24)

The New York Times (8/24) quotes Northwell CEO Michael Dowling saying in an interview that the politics are “so poisonous at the moment that nobody wants to sit down collectively and, in my view, do their duty to fix the things that need to get fixed…“It has become increasingly clear that continuing the CareConnect health plan is financially unsustainable, given the failure of the federal government and Congress to correct regulatory flaws that have destabilized insurance markets and their refusal to honor promises of additional funding.”

CareConnect was started in 2013 as a way for Northwell to direct patients to its hospitals and doctors, promising a simple, limited network of health providers and lower prices. But the business faced the same pressures many other insurers faced in the Affordable Care Act marketplaces. Many misjudged the business, charging too little for premiums and then taking losses as patients used more care than they projected. Bloomberg News (8/24) 

DFS re Careconnect’s Withdrawal from NY Health Insurance Market

“While it is unfortunate that the continued uncertainty across the nation due to the repeated actions of the federal government to undermine the Affordable Care Act at this time in the insurance cycle has caused CareConnect to begin an orderly wind down from the market, we recognize that this decision will help Northwell focus on its core mission to deliver healthcare services to New Yorkers. In spite of recent federal efforts to destabilize markets and threats to dismantle or not enforce the ACA, New York’s healthcare market remains robust and consumers across New York have real choice of coverage.

DFS will work with CareConnect on an orderly transition to ensure that all of its members know their full options and continue to receive healthcare coverage without interruption. Once again we call on the federal government to end this continued uncertainty, immediately act to protect our markets by fully paying the cost-sharing subsidies for good and not piecemeal, making the overdue risk corridor payments, fully enforcing the individual mandate, and stopping once and for all the partisan attacks on healthcare for all Americans. We appreciate that some members of Congress are seeking to turn this corner in a bipartisan manner and to maintain the ACA’s protections to stabilize markets.”

Iroquois Healthcare Alliance to Syracuse Post-Standard: Comprehensive Medical Liability Reform is Needed to Help Recruit Doctors in New York State
Noting that “upstate New York is suffering from a shortage of doctors”, this week Iroquois Healthcare Alliance President Gary Fitzgerald responded to an offensive letter to the editor from NYPIRG Executive Director Blair Horner that had appeared in the Syracuse Post-Standard that had called for the Governor to sign the potentially disastrous medical liability expansion bill that had passed the Legislature prior to the end of Session.

To read the Iroquois letter, click here.  The Iroquois Healthcare Alliance represents numerous hospitals and health systems across upstate New York.  The NYPIRG letter to the editor had been a response to an August 1 op-ed from Onondaga County Medical Society President Dr. Mary Abdulky calling for the Governor to veto this legislation.

The IHA letter noted that “the bill for which Horner advocates is a lone piece of medical malpractice liability legislation, hastily passed in the well-known Albany-style darkness during the end of the legislative session…What makes sense, what is crucially needed and what will result in fewer doctors fleeing this state, is a comprehensive package of medical liability legislation that also addresses the ability to recruit and retain doctors in New York state, especially those in our Upstate rural and underserved areas.

Also this week, an op-ed from Dutchess County President-elect Dr. Jay Jalaj urging Governor Cuomo to veto this legislation was in the Poughkeepsie Journal.

Physicians must continue to contact the Governor at 518-474-8390 to urge that he veto this legislation, as well as sending a letter from here.



Promo Code: MSSNY




DFS Fines MVP $200,000 for Improperly Denying Claims and Charging Co-Pays and Deductibles for Preventative Services
Companies Agree to Pay Restitution to 356 Members and to Correct Problems

Financial Services Superintendent Maria T. Vullo announced the Department of Financial Services (DFS) has fined MVP Health Plan Inc. and MVP Health Insurance Company $200,000 for incorrectly applying cost-sharing to members’ claims and improperly denying some claims for preventive healthcare services.  The companies agreed to pay the fine and to correct claims processing procedures in a consent order reached with DFS.  The companies have agreed to make restitution, including interest, to 356 of its members.

The companies have agreed to make restitution, including interest, totaling approximately $9,000 to 356 of its members.  MVP Health Plan Inc. is a not-for-profit health maintenance organization; MVP Health Insurance Company is a for-profit insurer that sells small group policies and policies to individuals.  The two companies insure approximately 100,000 members in New York’s individual and small group markets.

The violations, which occurred between 2011 and 2013, were uncovered in a DFS examination of the insurers.  The DFS examination found that some members’ claims were improperly denied by the insurers.  In other cases, members were erroneously charged cost-sharing expenses, such as improper co-payments or deductible charges.  The violations involved instances of improperly processing claims involving more than a dozen kinds of healthcare screening or preventive services.  These included screening for breast, cervical and colorectal cancer, depression, hearing loss and obesity in children and adults.

In addition to restitution and the fine, the consent order directs the companies to update their claims processing system, provide training for claims examiners, and explain to providers how to handle certain mandated services under the federal Affordable Care Act and New York law.

The DFS consent order requires the companies to provide DFS with documentation to verify that they have complied with the terms of the order.

More Than 400,000 New Yorkers Paid Penalty for Going Uninsured in 2015
The New York Post (8/21) reports that 405,610 New York tax payers, more than 4 percent of total tax filers in the state, paid a combined “shared responsibility payment” fee of more than $186 million under the Affordable Care Act in 2015. The Post reports the comparatively healthy, uninsured young people are so-called “invincibles.” These tax filers “failed to obtain health insurance in 2015” and were required to pay a tax penalty under the ACA. The article notes that ACA penalty fees are set to rise in 2016 and 2017.

AMA and Physicians’ Advocacy Institute Submits Detailed Comments to CMS to Reduce MIPS Program Hassles
The American Medical Association this week submitted detailed comments to CMS regarding their proposed changes to the MACRA MIPS and APM programs for the 2018 performance year (which will impact payment for care provided to Medicare patients in the year 2020).  The Physicians Advocacy Institute, of which MSSNY is a board member along with 9 other state medical societies, also submitted detailed comments to CMS.

For more information about the AMA comments, click here.   For more information about the MACRA resources the PAI provides for physicians, click here.

Among the comments raised in the AMA and PAI letters to CMS:

  • The AMA and PAI letters express support for the proposed expansion of the low-volume threshold from 100 annual Medicare patients and $30,000 in annual allowed Medicare Part B Charges to 200 patients and $90,000, and urges CMS to notify individuals and groups as soon as possible that they qualify for the low-volume threshold exemption;
  • The AMA and PAI letters express support for CMS’ proposal to maintain the cost category weight at zero for the 2018 performance period, similar to 2017. The AMA letter noted that it believes CMS needs additional time to develop, test, and refine new episode-based cost measures prior to including them in the MIPS program in future years.
  • The AMA and PAI letters express support for CMS’ proposal within the Advancing Care Information (ACI) category of MIPS to extend certified electronic health record technology (CEHRT) flexibility for performance year 2018 and the proposed hardship exemption for small practices.
  • The AMA and PAI letters express support for CMS proposal to maintain the data completeness criteria for quality category measures at 50% for the 2018 MIPS performance period, and express concerns with a proposal to increase this threshold to 60% for the 2019 MIPS performance period.
  • The AMA letter notes its opposition to including items or services beyond the physician fee schedule, especially Part B drugs, when determining MIPS eligibility, applying the MIPS payment adjustment, and in cost score calculations.
  • The AMA letter contains a number of recommendations to simplify the overall MIPS scoring methodology, including setting a low performance threshold, maintaining the 70-point additional performance threshold, eliminating bonus points from the calculation of future performance thresholds, maintaining stability in program requirements in future years, and increasing the reliability threshold.

AMA President Dr. David Barbe said in a statement. “CMS has been a good partner in smoothing out the bumps but the program still needs to be more understandable and less burdensome. The complexity is an obstacle to the goal of promoting innovative approaches to encourage higher value care. We applaud CMS’ decision to allow for another transition year for MIPS, recognizing the challenges physicians face both bureaucratic and technological. The willingness to compromise will help physicians and patients alike.”

NYC Public Hospitals Treating Larger Share of Mental Health Patients
The New York Times (8/22) reports that mental health patients are being increasingly treated by the city’s strained public health system, as private hospitals divert patients and close psychiatric beds. Public hospitals’ share of psychiatric beds was more than three times those in private hospitals, according to the Independent Budget Office report released last month. Anthony Feliciano, director of the Commission on the Public’s Health System, a citywide health advocacy organization, said, “The public hospitals are taking care of a lot more of the most vulnerable population, while the private hospitals get away with not doing it.”


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



High School Hours Begin Too Early in Day; 8:30 AM Is Optimal Start Time
A recent report by the National Center for Education Statistics found that “only a fraction of high schools are starting later than 8:30AM, which is what the American Academy of Pediatrics recommends.”

Pediatricians have argued that early school start times can result in sleep deprivation for teenagers and, “in turn, a decline in academic performance, an increased risk of car accidents and physical and mental health issues.” The average start time for US high schools is 7:59AM, according to the study. Only 13 percent of high schools start later than 8:30AM, while 46 percent start before 8AM.


For Members Only: Brooks Brothers Offers 15% Discount
Enroll for your complimentary Brooks Brothers Corporate Membership Card and Save 15%* on full priced merchandise at all Brooks Brothers U.S. and Canadian stores, by phone and online.
TO ENROLL FOR YOUR NEW MEMBERSHIP CARD:

  • Organization ID# 12479 and Pin Code# 19658and enroll at: Membership.BrooksBrothers.com
  • You will need to wait 30 minutes after you enroll before you register to shop online.
    TO SHOP ONLINE:
  • www.BrooksBrothers.com
  • At the top of the page click on My Account & then CREATE AN ACCOUNT.
  • Create new profile and at the bottom click on “I have a Corporate Membership Number”.
  • Enter 12 digit Membership Number.
  • Click on create and you will receive a Welcome Letter.  You are now ready to shop.

JAMA: Hospital Should Do More for Patients Admitted for Heroin Overdoses
study published Tuesday in JAMA stated that not enough is being done “during hospital encounters” to intervene in patients’ opioid addictions. The study found that “among people who had overdosed on heroin, the filling of opioid prescriptions fell by 3.5 percent, while medication-assisted treatment increased by only 3.6 percent,” following their hospitalizations.

The study covered “more than 6,000 people who survived an overdose from an opioid.” The study’s lead author, Julie Donahue, said, “Forty percent of those with a heroin overdose and 60 percent of those with a prescription opioid overdose filled a prescription in the six months after overdose for the very kind of medication that contributed to the overdose in the first place.”

Survey: Physicians Are Warming Up to Single-Payer Model
In a recent Merritt Hawkins survey, 56 percent of doctors were found to support single-payer healthcare. The results represent a big change from those of the same survey in 2008, where 58 percent of respondents opposed a single-payer system.

The change is due to three main reasons, according to Merritt Hawkins, a physician recruitment firm who spoke to more than 1,000 doctors for the survey. First, doctors seek clarity and stability in healthcare reform. Next, it’s a generational issue, as young doctors come up, there is less resistance to a single-payer format. And lastly, there is a feeling of resignation among doctors who believe single-payer is inevitable so it should be adopted sooner rather than later.

Influenza Vaccine Payment Allowances Annual Update for 2017-2018 Season



Why I Joined MSSNY


CLASSIFIEDS


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

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

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

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

S.1297 – Student Athletes Cardiac Arrest

May 23, 2017

Hon. Catherine T. Nolan
Chair, Assembly Education Committee
Room 836 Legislative Office Building
Albany, New York 12248

Dear Assemblywoman Nolan:

The Medical Society of the State of New York wishes to express its significant concerns regarding Assembly Bill 3452 which would require cardiac screening of student athletes and Assembly Bill 6050/S. 1297, which requires the development of regulations for the treatment and monitoring of students who exhibit signs of sudden cardiac arrest.  Both of these bills were on the Assembly Education Committee agenda for May 23.  While we of course agree with the goals of these bills to prevent sudden cardiac arrest in student athletes, these bills have some flaws which we are urging be addressed.

Sudden death in young athletes is a rare but tragic event which MSSNY wants to work with all interested parties to help to prevent.  The possibility that young, well-trained athletes at the high school, college, or professional level could die suddenly seems incomprehensible.  It is a dramatic and tragic event that devastates families and the community.  Physical exertion associated with competitive sports and other physical athletic activities can exacerbate a pre-existing condition and can result in an untimely death of a student.  However, experts have concluded that to require a cardiac screening for every individual who seeks to in any school sponsored athletic activity poses a potential unnecessary emotional toll on the student athlete and could also incur a significant financial burden on the family as cardiac screenings in young people, without a family history, may not be covered under insurance.

In this regard, the Medical Society of the State of New York supports Assembly Bill 6538, sponsored by Assemblymember Michael Cusick.   A. 6538 has already passed the New York State Assembly and is on its companion measure, S. 3149, sponsored by Senator Andrew J. Lanza, is advancing in the New York State Senate.  This measure adds to the existing Health Care and Wellness Education and Outreach Program within the New York State Department of Health. The bill would require DOH to provide educational materials for students and their parents and guardians regarding sudden cardiac arrest. The materials would be developed in conjunction with the Commissioner of Education, the Medical Society of the State of New York, the New York Chapter of the American Academy of Pediatrics, and the American Heart Association.  The materials would include an explanation of sudden cardiac arrest, a description of early warning signs, and an overview of options that are presently available for screening.   The State of New Jersey currently has a similar program where brochures are sent home to parents and guardians.  We believe this is a positive legislative approach for addressing this difficult issue.

Regarding A.3452, we are concerned that experts have recommended against mandatory cardiac testing.  While competitive sports are associated with an increase in the risk of sudden cardiovascular death (SCD) in susceptible adolescents and young adults with underlying cardiovascular disorders, the United States Preventive Services Task Force does not recommend universal screening with Electrocardiography for any individual, let alone children under the age of 18.  The USPSTF recommends against screening with resting or exercise electrocardiography (ECG) for the prediction of coronary heart disease (CHD) events in asymptomatic adults at low risk for CHD events.  The USPSTF ranks this as D—which means that the USPSTF recommends against this service and that there is a moderate or high certainty that the service has no benefit or that the harms may outweigh the benefits.   Additionally, the USPSTF concludes that the current evidence is insufficient to assess the balance of benefits and harms of screening with resting or exercise ECG for the prediction of CHD events in asymptomatic adults at intermediate or high risk for CHD events.  The USPSTF has concluded that the current evidence is insufficient to assess the balance of benefits and harms of the service.   Evidence is lacking, of poor quality, or conflicting, and the balance of benefits and harms cannot be determined.

Instead, the American Heart Association recommends that pre-participation screening of athletes include a history and physician exam and A complete and careful personal and family history and physical examination designed to identify (or raise suspicion of) those cardiovascular lesions known to cause sudden death or disease progression in young athletes is the best available and most practical approach to screening populations of competitive sports participants, regardless of age.

Regarding A. 6050/S. 1297, we agree with the concept of requiring course instruction for coaches, physical education teachers, nurses and athletic trainers on the signs and symptoms of sudden cardiac arrest.  However, we are concerned that the bill”s language does not specifically include medical personnel, such as pediatric or family physicians, cardiologists, emergency department physicians or organizations representing these groups of individuals in the development of such educational program.   Additionally, it should be noted that the most important way to effectively treat sudden cardiac arrest with student athletes is for schools to have and to have individuals trained to use an automated external defibrillator (AED). An AED is a portable electronic device that automatically diagnoses the life-threatening cardiac arrhythmias of ventricular fibrillation and pulseless ventricular tachycardia in a patient, and is able to treat them through defibrillation, the application of electrical therapy which stops the arrhythmia, allowing the heart to reestablish an effective rhythm.  Having individuals trained within the school systems to use AEDs would be a significant step forward.

We very much want to work with you to assure that individuals who work with student athletes are properly trained in recognizing the signs and symptoms of cardiac arrest.  However, at the same time, we do not want to subject patients to what often are unnecessary tests that have been recommended against by national experts.  Moreover, we believe it is very important that physician experts be involved in the development of educational materials for families and school personnel involved in overseeing student athletes.   Working together, we can all help to prevent these tragic incidents in the future.

Thank you for your consideration of our comments.   Please do not hesitate to contact us if there are any questions.

Sincerely,
Morris Auster, Esq.
Pat Clancy
Hon.  Kemp Hannon
Hon. Carl Marcellino
Hon.  Richard Gottfried
Hon.  Jeffrion L. Aubry
Members:  Assembly Education Committee