| PRESIDENT’S MESSAGE
Dr. Joseph R. Maldonado
January 29, 2016
Volume 16, Number 4
This past week, a family friend was hacked to death in New York by a machete-wielding neighbor.
Mrs. Carmen Torres-Gonzalez was born in my mother’s home town. She had been a caregiver for my mother’s sister several years back during her unsuccessful fight against metastatic Adrenal Cancer. My mother was also the elementary school teacher of one of Mrs. Torres-Gonzalez’s daughters. As I googled the news story of her gruesome death, I found many more stories of other Americans who were victims of machete wielding criminals this month. I was surprised to find so many incidents of fatal assaults with the use of a machete. It made me pause to wonder why I had not previously been aware of the frequent use of machetes in violent deaths.
It seems to me that most of the attention paid to violent death has focused on gun violence. Indeed, guns rank highest as the weapon used in violent deaths. However, the benign neglect of violent deaths due to other weapons seem to me to highlight the political agenda of those who focus on gun violence rather than on the more important issue of deadly violence regardless of the weapon of choice as the more critical issue for the public and our society at large. When we focus attention on gun violence, rather than on the mental illness or drug use which often lies at the core of why perpetrators resort to deadly violence towards others and themselves, we aid and abet political agendas and fail to focus on relevant solutions.
The tragic death of family friend Mrs. Torres-Gonzalez and that of Jessica Parker, an American Physician Assistant brutally murdered in Grenada this past week, highlight the fact that gun violence is not the real problem on which we must focus as a society. While most violent deaths in our country are due to guns, the violent deaths with other instruments of harm highlight the fact that the true area of focus needs to be addressing the mental health needs of the mentally ill. If we fail in this endeavor, we will see that the focus on making guns less accessible will be met with a mounting number of deaths due to the use of other weapons.
We can lead our state and nation in getting the discussion on the right track by refusing to make our public health discussions center on gun violence. Rather we should take the discussion to activism that focuses on addressing the problems of mental illness and drug abuse which underpin behaviors that express themselves in violence and death, be it with a gun or with a machete.
Joseph Maldonado, M.D, MSc, MBA, DipEBHC
In a separate note, last week, we lost a great friend of our Society, Dr. Rufus Nichols, a former longstanding delegate to the House and active committee member from Brooklyn. A scholarship fund has been established in his memory . It is a scholarship established through the National Medical Association that when awarded will pay for the registration fees and section dues of an Ob/Gyn resident or medical student planning to attend the NMA’s Annual Convention and Scientific Assembly. Checks should be made out to: The National Medical Association, Ob/Gyn Section. The mailing address is: Carole West,OB/Gyn Section Administrator, National Medical Association, 80 Jesse Hill Jr. Dr., SE PO Box 26076, Atlanta, Georgia 30303. Please reference the “Rufus A. Nichols Scholarship Fund” in the memo area of your check.
Please send your comments to firstname.lastname@example.org
MSSNY Lobby Day Scheduled for March 8th – Physicians Urged to Attend and Wear Your White Lab Coats
MSSNY’s “Physician Advocacy Day” will be held on March 8th in the Lewis Swyer Theatre in the Egg located at the Empire State Plaza in Albany, New York. If you plan to attend, please register.
A full slate of legislators have been invited to dialogue with Advocacy Day participants including:
- Donna Frescatore, Executive Director, NYS Health Benefit Exchange;
- Troy Oechsner, Executive Deputy Superintendent, Department of Financial Services;
- Legislative Panel: Senate Health Chair Kemp Hannon; Assembly Health Chair, Richard Gottfried; Senate Insurance Chair, James Seward; Assembly Insurance Chair Kevin Cahill.
In addition, Assembly Speaker Carl Heastie, Assembly Majority Leader Joe Morelle and Senate Majority Leader John Flanagan have been invited. A brief informal luncheon to which members of each House are invited to dine and speak with their constituents will follow the morning program. County Medical Societies will be scheduling appointments for physicians to meet with their elected representatives.
Given the wide range of threats physicians face including legislation that would expand the statute of limitations with a broad date of discovery exception potentially increasing physician premiums by 14.5%; legislation to repeal the Trial Lawyers contingency fee limits, potentially increasing premiums by over 10%; significant reductions in eligibility of the Excess Program; legislation that will mandate physicians to take a 4-hour Pain Management CME course every two years; and a move to effectuate statutory and regulatory changes to implement a value-based payment structure under Medicaid and potentially to Medicare and commercial products as well.
MSSNY Testifies Before Joint Senate Finance and Assembly Ways & Means Committee
Earlier this week, MSSNY submitted its testimony of the proposed budget for fiscal year 2016-17. Noting the fact that many physician practices are struggling to remain viable with the significantly decreasing compensation and increasing overhead costs, including medical liability premium costs, they must bear, MSSNY representatives advocated that the Legislature take action to assure that we create and preserve an economically sensible health care delivery system.
First and foremost, in the testimony MSSNY focused on the financial hardship that has been created as a result of the collapse of Health Republic and the need for the creation of a Guarantee Fund or other pool of monies to assure that physicians and other stakeholders will be made whole. MSSNY also encouraged the Legislature to reject the programmatic changes to the Excess program proposed in the budget which would result in the dropping of 55% of physicians who currently have the extra $1M layer of coverage from the program. MSSNY urged the restoration of the $25M funding cut to the historic $127.4M level. MSSNY continues to oppose the establishment by publicly traded corporations of limited-services clinics in pharmacies and other retail establishments, particularly at a time when MACRA and other transformational payment structures reward physicians only if they provide same day access to care, provide for care collaboration and enhanced quality of care. MSSNY expressed its opposition to the sweeping Workers’ Compensation reform proposal contained in the Executive Budget including provisions which would removes the authority of county medical societies to recommend physicians to serve as treating providers or independent medical examiners under Workers Compensation and enable treatment of injured workers and direct payment for care by nurse practitioners and physician assistants, without clarity as to: how non-physicians treating patients with serious health conditions will coordinate patient care delivery with physicians and no new funds to cover this expanded list of care providers. MSSNY also opposed proposed language that would eliminate existing “prescriber prevails” protection for prescriptions for Medicaid patients.
Most importantly, MSSNY urged comprehensive reform of our flawed medical liability adjudication system including reforms which would: place reasonable limits on non-economic damages, which 30 other states have enacted; identifying and assuring qualified expert witnesses; eliminating joint and several liability; strengthening our weak Certificate of Merit requirement; and assuring statements of apology are immunized from discovery. Other important measures we support include alternative systems for resolving Medical Liability claims such as Medical Courts or a Neurologically Impaired Infants Fund that applies to physicians. A copy of the Testimony can be accessed here. (DEARS, AUSTER)
Physicians Urged to Oppose Huge Cuts to Excess Medical Liability Insurance Program
Physicians are urged to continue to contact their legislators to object to the huge cuts contained in the Executive Budget to the Excess Medical Malpractice Insurance program. MSSNY’s strong opposition to these cuts was a major component of MSSNY’s testimony to the joint meeting of the Assembly Ways & Means and Senate Finance Committees this week, as well as in meetings with legislators and key legislative staff. For more information, click here and here.
Specifically, the proposal would cut funding by $25 million, with the effect that 55% of physicians who currently receive this essential coverage being dropped from the program. Across much of upstate New York, only neurosurgeons, bariatric surgeons and OB-GYNs would keep this coverage. That means that in the Capital District, in Northern New York, in Central New York, in western New York and in the Southern Tier every family physician, internist, pediatrician, ophthalmologist, emergency room physician, vascular surgeon, cardiologist, radiologist, pathologist, otolaryngologist, dermatologist and allergist would be automatically dropped. And downstate, many primary care physicians, ophthalmologists, otolaryngologists, pathologists, dermatologists and allergists would be dropped.
The Excess Medical Liability Insurance Program provides an additional layer of $1M of coverage to physicians with hospital privileges who maintain primary coverage at the $1.3 million/$3.9 million level. The program was created over 30 years ago as a result of the liability insurance crisis of the mid-1980’s to address concerns among physicians that their liability exposure far exceeded available coverage limitations. They legitimately feared that everything they had worked for all of their professional lives could be lost as a result of one wildly aberrant jury verdict. This fear continues today since New York State has failed to enact meaningful tort reform to ameliorate this risk. The size of verdicts in New York State has continued to grow significantly and physician liability premiums remain far out of proportion compared to the rest of the country. Absent meaningful liability reform, full funding for the Excess program is absolutely essential in today’s very challenging practice environment.
At a time when the state is seeking to attract and retain physicians, this proposal deters physicians from wanting to practice in New York State for fear of putting themselves and their families in financial jeopardy for judgements and settlements exceeding the limits of their primary coverage.
Please urge your legislators to reject these cuts and restore full funding for the program!
Contact Your Legislators to Support a Health Republic Guarantee Fund
With the failure of the Executive Budget to include a Guarantee or other fund to cover the likely hundreds of millions in payments due to Health Republic contracted providers, all physicians are urged to continue to contact their legislators and demand that the State Legislature take action to create such Guarantee or other fund. Urging the Legislature to enact a Guarantee fund as part of the State Budget process was a major component of the testimony that MSSNY gave this past week at a joint meeting of the Assembly Ways & Means and Senate Finance Committees. For more information, see here and here.
Moreover, please take the time to complete an updated MSSNY survey (sent out earlier this week) to provide us with updated information regarding the amounts you are due from Health Republic. To complete the survey, click here. This data is critical to our advocacy efforts!
MSSNY has worked with hospital associations to press key State Legislative leaders that it is absolutely imperative for the stability of our health care system that this be addressed soon. We have shared with public officials the results of MSSNY’s earlier survey that concluded that physicians are owed at least tens of millions of dollars in outstanding claims, of which:
- 11% are owed $100,000 or more;
- 20% are owed $25,000 or more; and
- 49% are owed $5,000 or more.
Moreover, we have shared data from 5 large medical practices in the Lower Hudson Valley that together are owed over $12 million.
Remind your legislators that, with physicians facing so many other challenges in seeking to keep their doors open to deliver patient care, including high liability costs, expensive electronic medical record equipment, employee costs, insurance companies dropping physicians from their networks and declining payments from insurers, failure to assure payment for these claims would have serious negative consequences for patient care and employment in your community.
CME Mandate Bill Reported by Senate Health Committee; Now Before Full Senate
Senate Bill 4348A (Hannon), which would create a continuing medical education mandate for practitioners with prescribing privileges was approved by the Senate Health Committee and is now before the full Senate for a vote. Physician action is vitally important.
Physicians are urged to contact their elected representatives to urge that they vote against this mandate! Send an email through MSSNY’s Grassroots Action Center.
4348A, sponsored by Senator Kemp Hannon, authorizes the Commissioner of Health to establish standards and to review requirements for CME on pain management, palliative care and addiction, would require health care professionals authorized to prescribe controlled substances to complete three hours of continuing medical education, prior to renewal of registration to practice, that involves pain management. The curricula must include but is not limited to, I-STOP and drug enforcement administration requirements for prescribing control substances; pain management; appropriate prescribing; managing acute pain; pain; palliative medicine; prevention, screening and signs of addiction; responses to abuse and addiction; and end of life care. The Commissioner may allow for exemptions if the health care professionals meet requirements to the Commissioner’s satisfaction.
The Commissioner must report on the impact of this legislation and any recommendations no later than three years after its enactment. A similar measure, A. 355, sponsored by Assembly Linda Rosenthal, is in the Assembly Health Committee.
Bill to Limit Opioid Prescriptions to Three-Ten Day Supply Poised for Full Senate Vote
Senate Bill 6091A, which would limit the initial prescription of Schedule II or III Controlled Substance to a three to ten day supply, has passed the Senate Health Committee and is now before the NY Senate for a full vote. Sponsored by Senator Kemp Hannon, the bill is intended to encourage patients whose acute pain lasts longer than initially expected to follow up with a physician and it lessens the number of the pills left in medicine cabinets and available for diversion.
The bill does limit the number of co-pays for patients should they need additional prescriptions. The Medical Society of the State of New York is opposed to this measure and believes that having the New York State Legislature place an arbitrary limit on any type of prescriptions interferes with the practice of medicine. Its companion measure, A. 8601, sponsored by Assemblymember John T. MacDonald III, is in the Assembly Health Committee. Physicians are urged to contact senators and urge defeat of this measure. Senators can be reached here.
Disastrous Liability Expansion Bill on Assembly Calendar; Physicians Must Contact Their Legislators to Oppose Now!
All physicians must continue to contact their legislators to urge that they oppose legislation (A.285-A, Weinstein) before the full Assembly that could drastically increase New York’s already exorbitantly high medical liability premiums by changing the medical liability Statute of limitations to a “Date of Discovery” rule. The letter can be sent here.
While the bill currently does not have a Senate sponsor, it is possible that similar legislation could be introduced shortly. At the conclusion of the 2015 Legislative Session, Senate Majority Leader Flanagan noted in response to a question from a Daily News reporter that issues like malpractice reform “have never been done in isolation” and that they would be working with representatives on both sides of this issue. Since that time, MSSNY working together with MLMIC and hospital associations have met with top Senate staff to discuss comprehensive medical liability proposals to work towards legislation that would reduce the outrageous cost of physician medical liability premiums.
As these discussions ensue, you need to let your legislators know that no liability increases can be tolerated! MLMIC’s estimate is that this bill could increase physician liability premiums by an untenable 15%! New York physicians continue to pay liability premiums that are among the very highest in the country. By way of example, a neurosurgeon practicing on Long Island must pay an astounding $338,252 for just one year of insurance coverage and an OB/GYN practicing in the Bronx or Staten Island must pay $186,639. New York far surpasses all other states in terms of total medical liability payouts, per capita payments, and medical liability awards above $1 million.
They also face rapidly increasing overhead costs to remain in practice such as the huge costs associated with implementing expensive and cumbersome electronic medical record systems. At the same time, they face reduced payments from Medicare and commercial insurers, and many practices face losses of tens of thousands, hundreds of thousands and in some cases millions of dollars in losses due to the collapse of Health Republic.
And to make matters even worse, trial lawyers are aggressively pushing the Legislature to consider additional liability expansion bills such as legislation that would eliminate the statutory limitation on contingency fees in medical liability actions, legislation that MLMIC has estimated could have the effect of raising your premiums by over 10%. Physicians need liability reform to bring down these costs, not legislation that increases them!
Physicians Urged to Shared Concerns with Legislators Regarding Workers Compensation Reform Proposals in Executive Budget
MSSNY’s testimony to the Senate Finance and Assembly Ways & Means Committees this week raised significant concerns with the sweeping Workers’ Compensation reform proposal contained in the Executive Budget. Physicians are urged to contact their State Senators and Assemblymembers to express their opposition to these proposals.
Among the proposals of greatest concern to physicians and their injured worker patients:
- Enables treatment of injured workers and direct payment for care by nurse practitioners and physician assistants, without clarity as to: how non-physicians treating patients with serious health conditions will coordinate patient care delivery when specialized care is needed; whether new funds will be allocated or whether existing fees will need to be cut to cover this expanded list of care providers; and whether a non-physician can perform an IME of an injured worker to review the care provided by a physician to an injured worker;
- Removes the requirement for a referral by a physician for an injured worker as a pre-condition to receive psychological care;
- Expand the circumstances when a physician or other health care provider can have their authorization removed and empowers the Board to impose a $5,000 fine on a physician or any other Board-authorized health care provider for violating a Workers Compensation rule;
- Prohibits an injured worker not subject to a collective bargaining agreement from seeking medical treatment from outside a Workers Compensation PPO before 120 days after his or her first visit to a preferred provider organization provider; and
- Removes the authority of county medical societies to recommend physicians to serve as treating providers or independent medical examiners under Workers Compensation, which is currently an important peer review function provided by county medical societies to assure physician applications are complete and physician applicants are appropriately qualified to deliver this needed care to injured workers.
Exacerbating these concerns is that the proposal also does not meaningfully address the many excessive administrative hassles identified by physicians that have caused many physicians to withdraw from participation in the Workers Compensation program. While there have been some modestly positive actions taken by the WCB in recent years to encourage physician participation in the WC program through removal of arbitration fees and development of an electronic portal for facilitating authorizations from carrier, the Budget proposals if enacted could further chase physicians away from the program.
MSSNY has reached out to labor organizations and attorneys for injured workers to coordinate its advocacy in opposition to these adverse proposals. MSSNY has also been working closely with county medical society leadership from across the State to encourage their outreach to their local Senators and Assemblymembers to request that these proposals be jettisoned from the Budget.
Contact Your Legislators to Oppose the Expansion of Retail Clinics
With the inclusion of language to permit public corporations to own and operate retail clinics, or “”limited service clinics”, throughout NYS in the Governor’s Proposed Budget and with introductions of one house bills in both the Assembly & Senate all physicians are urged to contact their legislators and demand that the State Legislature prevent the proliferation of publicly-traded corporations practice of medicine.
While various versions of legislation exist, each seeks to allow publicly traded corporations to establish health clinics without need for certificate of need for review—for the first time in New York State. By permitting this practice, NYS will infringe upon the independence of medical decision-making and the integrity of the doctor-patient relationship. Furthermore, corporately owned and operated retail clinics will open the floodgates to conflicts of interest posed to exist as retail clinics directly profit from the very prescriptions they write, and treatments they recommend—all under the very same roof.
At a time when we in NYS are working hard to ensure and expand primary care and medical home capacity, retail clinics threaten the very viability of primary care physician’s practices. Contact your legislator today, and urge them to oppose the expansion of Retail Clinics in New York State.
DOH Files HCA-Proposed Flexibility in Signed M.D. Order Rules, Billing Deadlines for Home Care
The Home Care Association of New York State (“HCA”), working together with MSSNY’S Long-Term Care Subcommittee, has succeeded in urging the NYSDOH to examine its proposal to provide flexibility in signed physicians-order and Medicaid billing deadlines for home care services under Medicaid, allowing a full year to obtain physician orders and then bill. When implemented, the proposed regulations will positively impact collaboration between home care agencies and physicians.
DOH officials reported that the proposed regulations were filed on January 22nd, and they expect the regulations to be published in the February 10th State Register for a 45-day comment period.
Several months ago, HCA obtained an initial agreement from the state to consider HCA-drafted regulatory language to align state deadlines for signed physician orders with the broader time constraints allowed by Medicare, replacing the current 30-day limit for signed orders (and 90-day deadline to bill Medicaid) with a one-year outside window for signed orders and billing.
Of important note is that this does not change the requirements for having physician orders for start of care or revisions in care plans. The rule change applies specifically to the signed order requirements, which form the basis for the state’s current 30-day and 90-day billing compliance standards.
MSSNY will notify Long-Term Care Subcommittee members once the proposed regulations are published.
For more information relating to any of the above articles, please contact the appropriate contributing staff member at the following email addresses:
Tell your patients NOW that you will NOT be issuing papers scripts as of March 27. With the e-prescribing mandate quickly approaching, we at MSSNY are concerned about the lack of preparedness expressed by New York doctors. Our recent survey showed that more than 40% of responding physicians are not yet prepared to meet the e-prescribing mandate.
We DO NOT expect an extension of the deadline, and urge you to ACT NOW to ensure you are compliant with the law.
Do Not Wait until March; Buy E-Prescribing Software NOWAs a MSSNY member benefit, you qualify for a substantial discount on DrFirst’s industry-leading Rcopia® with EPCS GoldSM. The cost is $500 for a one-year license (a $299 discount) and includes e-prescribing for both legend drugs and controlled substances, as well as the DEA-required identity proofing and two-factor authentication soft token.
If you buy now, you’ll be ready when the deadline arrives, and DrFirst will extend your software license from now until March 27, 2017 at no additional charge. To purchase online, visit www.drfirst.com/MSSNY and use coupon code MSSNY, or call the MSSNY E-prescribing Hotline at 866-980-0553.
Shortcut to Apply for Medicare EHR Incentive Program Hardship Exception
Prior to adjourning for the holidays, MSSNY worked with the AMA and other state medical associations in support of a measure passed by Congress to direct CMS to make changes to the Medicare EHR Incentive Program hardship exception process that allows physicians to avoid a Meaningful Use (MU) penalty in 2017. The AMA has developed a short document that details the steps physicians should take to apply for this hardship. The AMA is encouraging ALL physicians subject to the 2015 Medicare MU program to apply for the hardship. According to the AMA, applying for the hardship will not prevent a physician from earning an incentive. It simply protects a physician from receiving an MU penalty. Therefore, physicians who believe that they met the MU requirements for the 2015 reporting period should still apply for the hardship protection. Note that the program operates on a two-year look-back period, meaning that physicians who are granted an exception for the 2015 program will avoid a financial penalty for 2017.
Young Physicians Section Annual Meeting
Saturday, February 27, 2016
8:00 am – 1:00 pm
865 Merrick Avenue, Westbury (MSSNY HQ) and Hilton Garden Inn (across street)Don’t miss this essential leadership presentation by Richard Popovic, a highly experienced consultant in the fields of physician leadership, strategy, management and patient safety. CME available, no charge:
- Learn tips on how to take an active role in shaping public policy on healthcare
- Increase your ability to make decisions in the best interest of quality care and patient safety
- Find the right balance between clinical and administrative duties
- Identify barriers to physician leadership and advocacy
- Define goals and assess needs of your organization – and achieve results!
MSSNY’s three sections, YPS, RFS, and MSS will gather for the presentation at the Hilton. If you wish to stay overnight, the Hilton is offering a corporate room rate (contact email@example.com).
YPS will start at MSSNY HQ with business and breakfast, then proceed to the Hilton for the presentation. Lunch will follow back at MSSNY.
This activity has 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 MSSNY and the Medical Educational & Scientific Foundation of New York, Inc. (MESF). MSSNY 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 1.5 AMA PRA Category 1 CreditsTM. Physicians should claim only the credit commensurate with the extent of their participation in the activity.
Want to Join MSSNY’S Task Force for Independent Physicians?
At the 2015 House of Delegates of the Medical Society of the State of New York, Resolution 210 was passed calling for the creation of a Task Force on Independent Practice. The purpose of the taskforce is two-fold. First, the Taskforce would explore viable options for independent physicians to collaborate and create practice models to achieve the goals of “diversity of service, economy of scale and collective negotiations.” Second, consult experts and examine successful independent practice models in NY and elsewhere that will facilitate the preservation of independent practice in the State of New York. We need your help!
I am looking to assemble the MSSNY team to tackle this work. This calls for physicians who have developed innovative business models of private practice as well as those who have working knowledge of practice models that can accomplish the goals of the committee. This is NOT a committee for those who want to learn on the job. Rather, it is a team of individuals who have working experience both at the individual practice level establishing new medical business ventures as well as those who have expertise through academic, business and health policy endeavors.
Is your practice unique in what it offers? Have you created an IPA? Have you written a master’s thesis on collective negotiations and messenger model negotiations? Are you a physician offering concierge services or a telemedicine based practice? Are you a physician with a law degree or an MBA that has innovated healthcare delivery for your practice in a non-traditional manner or in an innovatively thriving traditional practice? This taskforce can use your skills.
Please contact Eunice Skelly at MSSNY (firstname.lastname@example.org) with a short bio and letter expressing your interest, expertise and what you intend to bring to the taskforce to advance the mission of the project. I will be looking for diversity of practice location as well as types of innovations that may contribute to a robust and comprehensive report and plan of action for preserving independent practice in New York.
USPSTF Calls for Routine Depression Screening of All Adults
The guidelines from the USPTF were published online Jan. 26 in JAMA that recommended that general physicians screen all adults for depression and treat those affected by the mood disorder with antidepressant medication, refer them to psychotherapy or do both. In a previous recommendation made in 2009, the USPSTF “had recommended screening adults for depression only when mental health services were available.” An accompanying editorial
observed that primary care professionals “should screen people with a history of depression at every visit.”
NEJM: One Percent of Physicians Account for 32% of Paid Claims
A study published Thursday in the New England Journal of Medicine that found “the more often a doctor is sued, the more likely he or she will be sued again,” based on the past ten years of claims listed in the National Practitioner Data Bank.
The study found “one percent of all doctors account for 32 percent of all paid malpractice claims.” Neurosurgeons and orthopedic surgeons were more likely to have a paid claims, while “pediatricians were 30 percent less likely to have one.”
“Approximately 1% of all physicians accounted for 32% of paid claims. Among physicians with paid claims, 84% incurred only one during the study period (accounting for 68% of all paid claims), 16% had at least two paid claims (accounting for 32% of the claims), and 4% had at least three paid claims (accounting for 12% of the claims). In adjusted analyses, the risk of recurrence increased with the number of previous paid claims. For example, as compared with physicians who had one previous paid claim, the 2160 physicians who had three paid claims had three times the risk of incurring another (hazard ratio, 3.11; 95% confidence interval [CI], 2.84 to 3.41); this corresponded in absolute terms to a 24% chance (95% CI, 22 to 26) of another paid claim within 2 years. Risks of recurrence also varied widely according to specialty — for example, the risk among neurosurgeons was four times as great as the risk among psychiatrists.”
When: Friday, February 5, 2016, 8:00 a.m. to 9:00 a.m.
Where: Niagara Falls Conference Center, 101 Old Falls Street, Niagara Falls, New York
Topic : PTSD and TBI In Returning Veterans: Identification and Treatment
Presented By Frank Dowling, M.D.
Program Summary: The Medical Society of the State (MSSNY) and NYSPA (NYSPA) welcome primary care physicians and providers, including those in internal medicine, family practice, emergency medicine, and OB/GYN, to attend this one hour training. The objectives:
(1) Explain the two most common disorders facing returning veterans today, their prevalence, risks, costs, and comorbidities.
(2) Identify common symptoms and causes of PTSD and Traumatic Brain Injury (TBI), especially those that affect returning veterans the most.
(3) Outline proven treatment options in psychotherapy and pharmacotherapy, from concept to implementation.
(4) Outline the process of recovery and post-traumatic growth.
(5) Discuss barriers to treatment, including those unique to military culture, and how to overcome them.
Following the training physicians are welcome to attend a panel discussion hosted by MSSNY, NYSPA, and the National Association of Social Workers – New York State Chapter, starting at approximately 9:15 a.m. regarding the post deployment experiences and challenges veterans have faced, specifically focusing on treatment.
REGISTRATION REQUIRED: Click Here
Accreditation Statement: 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.
Disclosure Statement: The Medical Society of The State of New York relies upon planners and faculty participants in its CME activities to provide educational information that is objective and free of bias. In this spirit and in accordance with the guidelines of MSSNY and the ACCME, all speakers and planners for CME activities must disclose any relevant financial relationships with commercial interests whose products, devices or services may be discussed in the content of a CME activity, that might be perceived as a real or apparent conflict of interest. None of the planners and presenters has any relevant financial relationships to disclose.
The Veterans Mental Health – Primary Care Training Initiative is supported by a grant provided by the New York State Legislature and administered through the New York State Office of Mental Health.
Seven New York Residents Diagnosed with Zika Virus
Dr. Mary T. Bassett, the city’s health commissioner, and Dr. Herminia Palacio, New York City’s deputy mayor for health and human services, held a news conference at City Hall on Thursday, saying that at least seven people in the state of New York have been diagnosed with Zika virus. The officials announced plans to build on the “robust infrastructure” created in response to West Nile virus and other mosquito-borne illnesses as a way to prevent Zika from entrenching itself in the city
The NYS-DOH reported that two Zika patients have been confirmed in New York City, one in Orange County, one in Nassau County, and one in upstate Monroe County. All of them contracted the virus abroad.
The U.S. Centers for Disease Control and Prevention has said pregnant women or those who may become pregnant, should try to avoid travel to 24 countries and territories, mostly in Latin America and the Caribbean, where Zika virus has been spreading.
The CDC travel alert names the following countries and territories where pregnant women in any trimester should consider staying away, and all visitors should take care to protect against mosquitoes, CBS News reported:
- In Latin America: Bolivia, Brazil, Colombia, Ecuador, El Salvador, French Guiana, Guatemala, Guyana, Honduras, Mexico, Panama, Paraguay, Suriname and Venezuela.
• In the Caribbean: Barbados, the Dominican Republic, Guadeloupe, Haiti, Martinique, St. Martin, Puerto Rico, the U.S. Virgin Islands.
• Cape Verde, off the coast of western Africa.
• Samoa in the South Pacific.
TELL YOUR PATIENTS NOW THAT YOU WILL NOT BE GIVING PAPER SCRIPTS AS OF MARCH 27.
CMS-1500 Claim Form ICD Indicators
The National Government Services Mail and Distribution department has noticed an increase of claims returned as unprocessable due to an invalid diagnosis code indicator. The CMS-1500 Claim Form ICD Indicators news article explains the details of reporting the ICD indicator and shows exactly where the indicator should be added.
Check Out Doctors Without Borders’ LIVE Recruitment Webinar
All interested MEDICAL AND NON-MEDICAL aid workers are invited to join us for a live teleconference and webinar to learn how you can be a part of Doctors Without Borders’ field work.
Thursday, February 25, 2016 @ 7:00PM EST Register here.
Human Resources Officers will discuss requirements and the recruitment process, a Doctors Without Borders aid worker will talk about life in the field, and participants will be able to ask questions.
SPACE IS LIMITED. PLEASE REGISTER.
Click here for more information.
OFFICE SPACE – Sutton Place
Newly renovated medical office. Windows in every room looks out to a park like setting on the plaza level. 2-4 exam rooms/offices available, possible procedure room or gym. Separate reception and waiting area, use of 3 bathrooms and a shower. Central air and wireless. All specialties welcome. Public transportation nearby. Please call 212-772-6011 or e-mail: email@example.com
Office Rental 30 Central Park South
Two fully equipped exam rooms, two certified operating rooms, bathrooms and consultation room. Shared secretarial and waiting rooms. Elegantly decorated, central a/c, hardwood floors. Next to Park Lane and Plaza hotels. $1250 for four days a month. Available full or part-time. 212.371.0468 / firstname.lastname@example.org.
Office Near UN for Rent
Modern, 3000 sq. ft. medical office to rent near the United Nations. Located at 340 East 49th Street, this ground level office is handicapped accessible. Private reception area; secretarial area available; 6 exam rooms. Ideal for ophthalmologist/optometrist. Could suit other specialties. Available for full or part time. $1300 per month for one day per week. Please contact Dr. Weissman at email@example.com or call 914-772-5581