January 29, 2016 – Violence, Not Weapons, Is the Issue!

drmaldonado PRESIDENT’S MESSAGE
 Dr. Joseph R. Maldonado
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January 29, 2016
Volume 16, Number 4

Dear Colleagues:

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
MSSNY President

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 comments@mssny.org


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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. 

PHYSICIANS ARE ENCOURAGED TO IMMEDIATELY REGISTER THROUGH THE LINK BELOW TO ATTEND THE MARCH 8TH LOBBY DAY IN ALBANY.
More Information
http://goo.gl/forms/Mw7CX8JfzL              (GOVERNMENTAL AFFAIRS STAFF) 


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!
(AUSTER, DEARS) 


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.
(AUSTER, DEARS) 


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.                                         
(CLANCY, DEARS)
 


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.
(CLANCY, DEARS)


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!
(AUSTER, DEARS)


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.
(AUSTER, DEARS)


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.
(McPARTLON, DEARS)


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.
(McPARTLON)

For more information relating to any of the above articles, please contact the appropriate contributing staff member at the following email addresses:          

pschuh@mssny.org ldears@mssny.org            mauster@mssny.org  
pclancy@mssny.org bellman@mssny.org    

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REMINDER:  All Prescriptions Must Be Sent Electronically Beginning March 27th

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 sbennett@mssny.org).

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 (eskelly@mssny.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.” 


MSSNY/NYS Psychiatric Assn. Present Veterans Mental Health Primary Care Training Initiative

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

For more information, contact Greg Elperin at MSSNY via gelperin@mssny.org or (518) 465-8085; or Donna Gajda at NYSPA via centraloffice@nyspsych.org or at (516) 542-0077.

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.

https://www.health.ny.gov/press/releases/2016/2016-01-22_three_cases_of_zika_virus.htm

Dear Physicians:

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.


Classifieds


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: advocate@medicalpassport.org

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. 212.371.0468drdese@gmail.com.


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 uneyes@verizon.net or call 914-772-5581



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

January 22, 2016 – Yes to Corporate Partnerships?

drmaldonado PRESIDENT’S MESSAGE
 Dr. Joseph R. Maldonado
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January 22, 2016
Volume 16, Number 3

Dear Colleagues:

Yesterday’s Council meeting included a lengthy discussion concerning changes related to the corporate practice of medicine statutes being considered by the New York State Departments of Health and Financial Services. The architects of healthcare reform in the state of New York are seeking to improve how healthcare services are delivered to the residents of the state. There is a prevailing view that in order to improve health outcomes, adjustments need to be made that change how relevant services are delivered.

The current view is that services that are critical to improving outcomes for many costly chronic conditions is delivered in an incomplete and/or fragmented fashion.  In order to improve outcomes, we must improve the coordination of services as well as the modalities and organizations that provide the relevant services. This is where things get wickedly complex and where we, as the highest order licensed healthcare professionals, have the duty to weigh in to insure safe delivery of high quality, evidence-based medical care.

Separation of Physicians and Non-Physicians

We enter into the arena of “wicked problems,” because the healthcare initiatives being considered challenge many of our longstanding beliefs concerning the practice of medicine and the separation of licensed professionals so that non-physicians cannot create professional medical organizations to deliver professional services. These new models do not always seek to create entities that deliver professional physician services. Rather, they seek to allow for the creation of new— perhaps hybrid— entities wherein physicians can deliver professional services that only they can deliver while others—perhaps non-professionals— deliver other services that are critical to the improvement of the physicians’ medical services.

Do we allow room for exploring new delivery models that challenge our views of how we protect the scope of practice of our profession? Do we push the envelope a bit to allow room to explore new models, making sure that physicians have the professional medical and financial control of these new delivery models?  Do we simply draw a line in the ground and raise the standard in the name of protecting our patients while archaic and cumbersome models continue to fail us?  Do we take the risk that our hard stance on the corporate practice of medicine gets railroaded by the political and regulatory machinery to the detriment of our patients because we were unwilling to initiate changes in a manner whereby we could safeguard the health and wellbeing of our patients and our profession?

The challenges facing us are great.  Many of us do not like the changes being proposed. Nonetheless, our Oath, when we entered the profession, requires us to rise above long-held beliefs, and rethink these beliefs in light of changes.

We Must Lead the Way

We must consider these changes and create the mechanisms that improve the delivery of care while we stand firm in the defense that it is the MEDICAL PROFESSION that must lead and control these novel delivery systems in order to insure evidence-based quality and safety outcomes that provide the desired value for our money.

Short of these, the most advanced healthcare system in the world is doomed to collapse or fall into mediocrity.

Joseph Maldonado, M.D, MSc, MBA, DipEBHC
MSSNY President

Please send your comments to comments@mssny.org


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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.  Please register here if you plan to attend.

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, Special Assistant to the 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 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.

PHYSICIANS ARE ENCOURAGED TO IMMEDIATELY REGISTER TO ATTEND THE MARCH 8TH LOBBY DAY IN ALBANY.                                            
(GOVERNMENTAL AFFAIRS STAFF)


Physicians Urged to Oppose Huge Cuts to Excess Medical Liability Insurance Program
Physicians are urged to contact their legislators to object to the huge cuts contained in the Executive Budget to the Excess Medical Malpractice Insurance program.  If permitted to go forwarded, it would unfairly result in more than half of the physicians currently enrolled being dropped.   MSSNY’s strong opposition to these cuts will be a major component of MSSNY’s testimony to the joint meeting of the Assembly Ways & Means and Senate Finance Committees this Monday examining the proposed Health Budget.

Specifically, the proposal would prioritize funding for those physicians who practice in higher risk specialties and in more litigious regions of the State.  However, by cutting the funding by $25 million, it would mean that 55% of physicians who currently receive this essential coverage would be dropped from the program.  In upstate communities north and west of Greene and Columbia counties, coverage would continue only for neurosurgeons, bariatric surgeons and OB-GYNs. 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.  Even in some downstate communities including in the Bronx, Kings, Queens, Westchester, Sullivan and Orange counties, 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!
(AUSTER, DEARS)


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 will be a major component of the testimony that MSSNY will give this Monday at a joint meeting of the Assembly Ways & Means and Senate Finance Committees. 

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 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.

Please be on the lookout early next week for a new survey that seeks updated information from you whether this amount has grown since our initial survey was sent in November.  Please take the time to complete this survey, as the data is critical to our advocacy efforts.

And please take the time to send a letter to your legislators at this link.

Remind them 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.
(AUSTER, DEARS) 


Disastrous Liability Expansion Bill Back on Assembly Calendar; Physicians Must Contact Their Legislators to Oppose Now!
All physicians must continue to contact their Senators and Assembly members to urge that they oppose legislation (A.285, Weinstein) 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.

With the bill having passed the Assembly in 2015, but not the Senate, it resumed a place on the Assembly Calendar, where it could be voted on by the full Assembly at any time.   The bill was brought up for initial consideration on Monday 1/11, but was “laid aside” by the Assembly Republican Conference.

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 A.285 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.  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!
(AUSTER, DEARS)


CME Mandate Bill Taken Off NYS Assembly Health Committee Agenda; Senate Bill Moving in Health Committee
Assembly Bill 355 (Rosenthal) and Senate Bill 4348A (Hannon) which would create a continuing medical education mandate for practitioners with prescribing privileges was taken off the agenda of the Assembly Health Committee on Thursday but a slightly different Senate version of the legislation is on the Senate Health Committee agenda for next week.  Physician action is vitally important.  They are urged to contact their elected representatives to urge that they vote against this mandate!  Send an email through MSSNY’s Grassroots Action Center.

  1. 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, is on the Senate Health Committee agenda for Tuesday, January 26th. It 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; preventative, 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.

MSSNY has strongly opposed this measure in previous legislative sessions. Continuing Medical Education is valuable to physicians in keeping up-to-date on new clinical information, and physicians throughout the state voluntarily take continuing medical education for continued professional development in those areas that pertain to their individualized practice.  However, this bill fails to recognize that the Medical Society of the State of New York, the specialty societies, the American Board of Medical Specialties, and the American Osteopathic Association have all been aggressively promoting voluntary CME on pain management and that there is other course work that addresses many of the above issues. (CLANCY, DEARS)


Concerns with One-Sided Workers Compensation Reform Proposals to be an Important Component of MSSNY’s Budget Testimony
MSSNY’s testimony to the Senate Finance and Assembly Ways & Means Committees to be presented this Monday will raise significant concerns with the sweeping Workers’ Compensation reform proposal contained in the Executive Budget.  Among the proposals of greatest concern to physicians and their injured worker patients:

  • 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;
  • 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 with physicians; 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 as a pre-condition for an injured worker 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; and
  • 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.

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 choose to not participate 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 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.
(AUSTER, DEARS)


Physicians Encouraged to Register for Opioid Prescribing Webinar on January 26
Physicians and other prescribers are encouraged to register for the first free webinar on opioid prescribing which will take place on Tuesday, January 26th at 12:30 p.m.  at the following link.

Click on the upcoming tab and select the programs. Physicians will need to register for each webinar.

The Medical Society of the State of New York and New York State Office for Alcoholism and Substance Abuse Services are jointly providing this free,  four part webinar series on opioid prescribing.  Entitled, “Revisiting the Role of Opioid Analgesics for Simple and Complex Patients with Chronic Pain”, the series will begin on Tuesday, January 26, 2016.

The first webinar will be conducted by Charles Morgan, MD, FASAM, FAAFP, DABAM and Patricia Bruckenthal PhD, APRN-BC, ANP, FAAN and the educational objectives are:

  • Compare and contrast the dual epidemics of chronic pain and opioid abuse and the implications on public health
  • Understand requirements of New York State laws/regulations with regard to prescribing of controlled substances.

The remaining webinar series will be held on:

Wednesday, February 10, 2016, 7:30 a.m. Faculty:  Charles E. Argoff, MD.  The educational objective:  Discuss evidence based best practice recommendations for opioid therapy for chronic pain, patient risk assessment and documentation.

Tuesday, February 23, 2016, 7:30 a.m.  Faculty:  Jeffrey Selzer, MD and the educational objective:    Describe potential for patient addiction, screening, diagnosis and subsequent treatment or referral.

Thursday, March 10, 2016, 7:30 a.m. Faculty: Charles E. Argoff, MD and Charles Morgan, MD, FASAM, FAAFP, DABAM and the educational objectives:  Recommend tools to assist in the management of patients for whom opioids are indicated and prescribed; discuss strategies to reduce risk of treating pain in patients with substance use disorders.

Opioid abuse is a national epidemic that physicians and other prescribers have the power to help prevent.  This series will provide information on managing pain, understanding the potential for patient addiction, and determining best practices for safe, responsible opioid prescribing.

Physicians and other prescribers can take one or all of the webinars; each webinar has been accredited for one hour of continuing medical education credits.

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.

For further information or assistance in registering for the program, please contact Pat Clancy at pclancy@mssny.org or Terri Holmes at tholmes@mssny.org.
(CLANCY, DEARS)


Bill to Limit Opioid Prescriptions to Three-Ten Day Supply on Senate Health Agenda
Senate Bill 6091A, which would limit the initial prescription of Schedule II or III Controlled Substance to a three to ten day supply, is on the Senate Health Committee agenda for Tuesday, January 26th.   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 on the Health Committee and urge defeat of this measure.  Senate Health Committee members are:   Senators Kemp Hannon, Hugh Farley, Simcha Felder, Martin Golden, Ruth Hassell-Thompson, Brad Hoylman, William Larkin, Betty Little, Jack Martins, Velmanette Montgomery, Terrence Murphy, Roxane Persaud, Gustavo Rivera, James Seward, Toby Stavisky, David Valesky, and Catharine Young.  
(CLANCY, DEARS)


Governor Nominates Vullo for DFS Superintendent
Governor Andrew Cuomo this week nominated Maria T. Vullo to serve as the Superintendent of the New York State Department of Financial Services. She is currently of counsel at Paul, Weiss, Rifkind, Wharton & Garrison LLP, where she was a partner for 20 years, and previously oversaw the Economic Justice Division in the Office of the New York State Attorney General.   DFS has had multiple Interim Superintendents since the previous Superintendent, Benjamin Lawsky, left the position last spring.  To read more about Ms. Vullo’s background, click here.
(AUSTER)


Centerlight Healthcare Settles for $47 Million in Medicaid Fraud Case
On Thursday, January 21st, Attorney General Eric Schneiderman announced a $47 million settlement with CenterLight Health Care and Centerlight Health System stemming from allegations of fraudulent Medicaid billing for unrendered services to 1,200 Medicaid recipients. As part of the settlement agreement CenterLight admitted that it enrolled ineligible Medicaid beneficiaries in its Managed Long Term Care Plan (“MLTCP”), which was contracted by NYS DOH to provide long-term community based health care; and that it used adult day care centers to provide community-based MLTCP personal care services that did not qualify as personal care services. In addition to its $47 million settlement, CenterLight agreed to additional monitoring for two-years by an independent compliance monitor and the A.G.’s Medicaid Fraud Control unit, and if necessary to revise its compliance policies.
(MCPARTLON) 


Inside Correctional Facilities—Increase in Staff Training on Inmate Mental Health
On January 21st, the New York State Senate passed a one-house bill sponsored by Senator Carlucci (D- Rockland/Westchester) which clarifies the eight-hour annual requirement for training of residential mental health treatment unit staff, as well as security, program services, mental health and medical staff with direct contact of inmates with mental illnesses. The bill was passed unanimously by the Senate, as it contains the language of a previously negotiated chapter amendment to a bill signed into law by Governor Cuomo last month. Current NYS Correction Law similarly requires that new corrections staff receive initial training in mental health treatment upon recruitment. The training topics include: types and symptoms of mental illnesses, the goals of mental health treatment, the prevention of suicide and training in how to effectively and safely manage inmates with mental illness. While a same-as bill has yet to be introduced in the Assembly, it will likely do so shortly.                                                                                            (MCPARTLON)


CMS Posts Information Regarding How Physicians Can Apply for Meaningful Use Hardship
The Center for Medicare and Medicaid Services (CMS) today posted information regarding changes to Medicare EHR Incentive Program hardship exception process.  Medicare is implementing these modifications as a result of the recently passed Patient Access and Medicare Protection Act, which established that the Secretary may consider hardship exceptions for “categories” of EPs, eligible hospitals, and CAHs that were identified on CMS’ website as of December 15, 2015.  Prior to this law, CMS was required to review all applications on a “case-by-case” basis.   The AMA had advised that it will review CMS’ materials and begin to educate physicians about how they can best apply for the exception.  Here is a link to the information CMS posted.

For more information relating to any of the above articles, please contact the appropriate contributing staff member at the following email addresses:          

pschuh@mssny.org ldears@mssny.org            mauster@mssny.org  
pclancy@mssny.org bellman@mssny.org    


Council Meeting Notes: January 21, 2016

  • MLMIC’s Vice President, Don Fager, announced a 20% dividend for policyholders who are insured by May 1, 2016, and maintain continuous coverage through July 1, 2016.
  • Council approved the Board of Trustees report, which included approval of $100/day for delegates at the 2016 House of Delegates and approval for a MSSNY financial audit for 2015.
  • Council discussed MSSNY’s approach regarding the corporate practice of medicine as being proposed within the DSRIP program and agreed to enable leadership to carry on discussions with appropriate parties.
  • Dr. Maldonado stressed the importance of Legislative Day this year, which will be held on March 8 in Albany. He called on physicians to help ensure a large turnout to demonstrate the importance of our issues to legislators.
  • MSSNY will partner with the American Cancer Society and the American Cancer Society Action Network in a new anti-smoking campaign, 2016 New York is Kicking Butts Quit Smoking Campaign. The campaign is currently centered on NYC, but ACS hopes to expand it throughout the state. In New York City, smoking continues to be the number one cause of preventable death.
  • Council approved the following Resolutions:
  • 2015-268: MSSNY will encourage further research into genomic sequencing, including its ethical implications, its clinical implications and its financial implications and will also encourage efforts to increase the number of qualified genetic counselors in anticipation of the increasing clinical need.
  • 2015-253: MSSNY will seek federal legislation to ensure that as the government moves forward to value based payment and reform that the legislature and federal agencies seek direct physician input to ensure that bundled payments result in quality care and best patient outcomes, rather than just concentrating on the cost of care.
  • 2015-263: MSSNY will seek legislation or regulation to ensure that Medicare, Medicaid and insurance plans allow physicians to make dosing adjustments for approved medications to allow the patient to achieve therapeutic levels regardless of BMI and differing metabolic considerations. The dose administered should be within the purview of the treating practitioners based on clinical parameters, documented in the medical record.
  • First District Branch E-Prescribing Motion: MSSNY will press for legislation or regulation that would allow patients’ requests for paper prescription and pharmacy choice to be honored and that this legislation or regulation permit any patient to request opting out of electronic prescribing by requesting the same in writing to a physician who will then be permitted to issue a paper prescription in person or by fax.


MLMIC Policyholders Will Receive 20% Dividend
Our mission is to provide insurance at cost, without a profit motive. To offset premiums, we offer dividends to our policyholders whenever we can. This year, MLMIC policyholders will receive a 20% dividend. To take advantage of this dividend, you simply need to be insured by May 1, 2016, and maintain continuous coverage through July 1, 2016.

MLMIC is a mutual insurer, owned by our policyholders. Over the years, our financial strength has allowed us to pay more than $300 million in dividends to our policyholders, something no other insurer can match.

Learn More  or call (888) 793-0393. 


Medical Schools Seek Dollars for Diversity
The Associated Medical Schools of New York is lobbying the state legislature to boost its funding for fiscal 2017. The organization, which represents 16 public and private medical schools throughout the state, is requesting $2.4 million for scholarships and diversity initiatives, up from $1.6 million last year. The bulk of the money, $2 million, would fund four post-baccalaureate programs that help students from underrepresented backgrounds get into medical school. An additional $400,000 is for launching a new scholarship. African-Americans, Latinos and indigenous peoples make up 35% of New York’s population but only 9% of the physician workforce, according to a 2014 report from the SUNY Albany Center for Health Workforce Studies. Funding for AMSNY’s diversity initiatives was slashed by about 20% after the 2008 financial crisis. The requested funding would help restore the programming that was dropped, said Jo Wiederhorn, the group’s president and chief executive.


Mt. Sinai HCV Intensive Training Preceptorship Program
The Mount Sinai Institute for Advanced Medicine – CEI HIV/HCV Center for Excellence is proud to debut our HCV Intensive Training Preceptorship program! This 2-day clinical education program (March 24-25, 2016) provides an intensive experience for practicing clinicians (e.g. physicians, physician assistants, nurses and nurse practitioners) in New York State. Through a combination of didactic sessions and experiential training, clinicians are able to enhance their HCV prevention, treatment, and care knowledge and competence to better serve their patients.

All clinical experience shadowing will take place at a Mount Sinai affiliated clinic located in Manhattan, NY. Accepted applicants from upstate New York will be provided with an honorarium to assist with transportation and lodging expenses.

The deadline to apply is Friday, January 25 at 5pm. For more information, please visit: https://www.surveymonkey.com/r/HepCPreceptorship or contact sjobe@chpnet.org. 


EHR Incentive Hardship Exception Instructions Available NOW
Today, CMS has posted new, streamlined hardship applications, reducing the amount of information that eligible professionals (EPs), eligible hospitals, and CAHs must submit to apply for an exception. The new applications and instructions for a hardship exception from the Medicare Electronic Health Records Incentive Program 2017 payment adjustment are available here.

This new, streamlined application process is the result of PAMPA, which established that the Secretary may consider hardship exceptions for “categories” of EPs, eligible hospitals, and CAHs that were identified on CMS’ website as of December 15, 2015. Prior to this law, CMS was required to review all applications on a “case-by-case” basis.

Importantly, EPs, eligible hospitals, and CAHs that wish to use the streamlined application must submit their application according to the timeline established in PAMPA:

  • Eligible Professionals: March 15, 2016
  • Eligible Hospitals & CAHs: April 1, 2016

Please note: CAHs should use the form specific for the CAH hardship exceptions related to an EHR reporting period in 2015. CAHs that have already submitted a form for 2015 are not required to resubmit.

In addition, we have heard from stakeholders that they would like a more efficient approach for submitting applications from groups of providers. We have reviewed our administrative authorities and determined that groups of providers may apply for a hardship exception on a single application. Under the group application, multiple providers and provider types may apply together using a single submission. The hardship exception categories are the same as those applicable for the individual provider application.

Providers will have the option to submit an electronic file (in excel or csv formats) with all National Provider Identifiers (NPIs) or CMS Certification Numbers (CCNs) for providers within the group or use a multiple NPI or CCN form to submit their application. In addition, facilities which include both inpatient and outpatient settings may include both the individual NPIs for any eligible professionals and the CCN for the eligible hospitals and CAHs on the same single submission for their organization.


Physicians in Western New York Wary about Medical Marijuana Treatment
The Buffalo (NY) News (1/19, Davis) reports that “of the 226 doctors certified to recommend marijuana in New York State as of last week, 12 of them work” at the Dent Neurologic Institute in Amherst. Dr. Laszlo Mechtler, Dent’s medical director, is a “strong advocate for marijuana’s use where the scientific evidence shows it can help,” but “like many other physicians – remains wary about the drug.”

For physicians, the four-hour NYSDOH approved course is now available online. The online course is provided by TheAnswerPage, an established online medical education site, and includes the following topics: the pharmacology of marijuana; contraindications; side effects; adverse reactions; overdose prevention; drug interactions; dosing; routes of administration; risks and benefits; warnings and precautions; and abuse and dependence. The course will cost $249 to take. Successful completion of the course will provide 4.5 hours of CME credits. The course may be accessed here.


Peconic Bay Joins Northwell Health Group
Newsday (1/19, Ochs) reports that Peconic Bay Medical Center and Northwell Health Group signed a formal agreement on Tuesday, making Peconic Bay the “21st hospital in the health system and anchoring Northwell’s presence on the East End.”  Peconic Bay chief executive Andrew Mitchell “said the agreement signals the beginning of a ‘new era for health care in central and eastern Suffolk’ that will make Peconic Bay, which serves about 200,000 patients and employs 1,300, a regional health care provider.” The agreement also signals the end of “Peconic Bay’s 10-year relationship with Stony Brook University Hospital and the demise of the East End Health Alliance formed in 2008.” 


CDC: Physicians Should Be Aware of Zika Virus in Pregnant Women
The CDC issued a travel warning to pregnant women and women of child-bearing age to avoid traveling to 14 countries in Central America and the Caribbean due to the risk of contracting the Zika virus, which is linked to severe birth defects. CDC is warning physicians to look out for symptoms of the Zika virus in pregnant women returning from trips to South and Central America http://wwwnc.cdc.gov/Travel. Published in

MMWR, the recommendations include:

  • All pregnant women should be asked if they have recently traveled to areas with active Zika virus transmission.
  • Those with recent travel to such areas and with symptoms of fever, rash, muscle aches, or conjunctivitis during or within 2 weeks of travel should be tested for Zika.
  • For pregnant women who test positive for Zika, clinicians should consider conducting ultrasounds every 3 to 4 weeks to monitor the fetus’s growth.

Zika is a mosquito-borne virus suspected of causing thousands of cases of microcephaly in infants born in Brazil over the past year. Last week, the CDC warned pregnant women to consider postponing travel to countries with ongoing Zika transmission.  Click here to read the full MMWR article.


Physicians Should Avoid Overuse of Antibiotics For Respiratory Problems
The CDC and the American College of Physicians have issued guidelines available at http://annals.org/article.aspx?articleid=2481815 intended to help physicians avoid overuse of antibiotics for respiratory problems. The guidelines were published in Annals of Internal Medicine. The guidelines “lay out how doctors begin deciding if antibiotics are warranted for” certain “respiratory complaints, explain that decision to patients and offer guidance on symptom relief.”


Longtime MSSNY Member Rufus Nichols, MD Passes Away
Rufus Nichols, MD passed away on January 20, 2016 after a battling a long illness.  Today would have marked Dr. Nichols’ 46 years as a member of the Society.  Many of you may remember seeing him at the House of Delegates. He served on many important MSSNY Committees: Committee to Eliminate Health Care Disparities; International Medical Graduates Committee; Long Term Care Committee; Organized Medical Staff Section (Officer); and Preventive Medicine and Family Health Committee.

Notes of condolence may be sent to Mrs. Jackie Nichols, 394 Joanne Court, Bartonsville, PA 18321.The funeral will be held at Bethlehem Church, 89-45 Lefferts Blvd., Richmond Hill, NY 11418.  Here is the website – Bethlehem Church NYC.

Services are as follows:


Classifieds

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. 212.371.0468drdese@gmail.com.


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 uneyes@verizon.net or call 914-772-5581



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

Council – January 21, 2016

AGENDA
Council Meeting
Thursday, January 21, 2016
Designated WEBEX locations: Albany Office, Broome County, Monroe County & Westbury Office

A. Call to Order and Roll Call

B. Approval of the Council Minutes of November 5, 2015

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

1. President’s Report
a. Executive Committee Minutes, December 22, 2015 & November 19, 2015
b. Verbal discussion on Corporate Practice of Medicine in New York
c. ACTION ITEM – MSSNY to join as a partner with the American Cancer Society & the American Cancer Action Network

2. Secretary’s Report – Nominations for Life Membership & Dues Remissions

3. Board of Trustees Report – Dr. Latreille will present the report (handout at Council)

4. MSSNYPAC Report – Dr. Sellers will present the verbal report (handout at Council)

5. MLMIC Update – Mr. Don Fager will present a verbal report (VIA WEBEX)

6. AMA Delegation Update – Dr. Kennedy will present a verbal update

7. MESF Update – No report submitted

8. Commissioners (All Action Items) FOR COUNCIL APPROVAL
1. Commissioner of Science and Public Health, Frank G. Dowling, MD
Committee on Bioethics Resolutions:
Resolution 2015-267, Complete Genomic Sequencing
Resolution 2015-268, Private Insurance Carriers Become Medicare Franchise
     2. Commissioner of Socio Medical Economics, Harold M. Sokol, MD
Interspecialty Committee Resolutions:
Resolution 2015-253, Reimbursement for Non-Bundled Lab Tests
Resolution 2015-260, Monitored Anesthesia Care & Pain Management Injections
Resolution 2015-263, Appeals Process for Medications with Proscribed Dosing
9. Councilors & Presidents (All Action Items from County Medical Societies & District Branches) FOR COUNCIL APPROVAL
1. A MOTION submitted by Zebulon Taintor, MD, President, First District Branch asking the MSSNY Council to ADOPT a Resolution on E-Prescribing and Patient Preference

ADJOURNMENT OF COUNCIL
ACTION ITEM

Empire State Medical, Scientific & Educational Foundation, Inc. Election of Directors

RECONVENE COUNCIL

 

D. Reports of Officers (Informational)
1. Office of the President – Joseph R. Maldonado, MD
2. Office of the President-Elect – Malcolm D. Reid, MD
3. Office of the Vice President – Charles Rothberg, MD
4. Office of the Treasurer – Thomas J. Madejski, MD Financial Statement for the period 1-1-15 to 12-31-15
5. Office of the Speaker – Kira A. Geraci-Ciradullo, MD
E. Reports of Councilors (Informational)
1. Kings and 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 – Frank G. Dowling, MD
6. Third District Branch Report – Harold M. Sokol, MD
7. Fourth District Branch Report – John J. Kennedy, MD
8. Fifth District Branch Report –Howard H. Huang, MD
9. Sixth District Branch Report – Robert A. Hesson, MD
10. Seventh District Branch Report – Mark J. Adams, MD
11. Eighth District Branch Report – Edward Kelly Bartels, MD (no written report submitted)
12. Ninth District Branch Report – Thomas T. Lee, MD
13. Medical Student Section Report – Charles A. Kenworthy
14. Resident & Fellow Section Report – Robert A. Viviano, DO (no written report submitted)
15. Young Physician Section Report – L. Carlos Zapata, MD (no written report submitted)
F. Commissioners (All Committee & Sub-Committee Informational Reports/Minutes)
1. Commissioner of Communications, Joshua M. Cohen, MD, MPH
Report of the Division of Communications
2. Commissioner of Science and Public Health, Frank G. Dowling, MD
Public Health & Education Informational Report
3. Commissioner of Socio Medical Economics, Harold M. Sokol, MD
Interspecialty Committee Minutes, Thursday, October 22, 2015
G. Report of the Executive Vice President
1. Membership Dues Revenue Schedule
2. PAI Letter re Proposed Health Insurer Mergers
3. Physician Advisory Council (PAC) Teleconference Minutes
H. Report of the General Counsel
(no written report submitted)
I. Report of the Alliance
Alliance Report
J. Other Information/Announcements
1. Sign-on Letter to CMS re Meaningful Use
2. Sign-on Letter supporting H.R. 2513, Protecting Access, Competition and Equity Act
3. AMA Letter to Dr. Frieden on Proposed 2016 Opioids for Chronic Pain
4. MSSNY Letter to Andy Slavitt, Acting Administrator, CMS re Request for Information(RFI) regarding the implementation on Alternative Payment Models(APMs) and Merit-Based Incentive Programs(MIPS) under the Medicare Access & CHIP Reauthorization Act(MACRA) handout at Council
K. Adjournment

January 15, 2016 – Governor’s Speech Challenges Physicians

drmaldonado PRESIDENT’S MESSAGE
 Dr. Joseph R. Maldonado
asset.find.us.on.facebook.lgTwitter_logo_blue1
January 15, 2015
Volume 16, Number 2

Dear Colleagues:

While on the surface the course of healthcare delivery in New York appears to be moving along unfettered, much is happening at levels that have not fully gotten doctors’ full attention.  This week, I would like to highlight several for you.  It is impossible to provide a full review of all the issues in one short column so I ask that you do your homework with others in your group, hospital medical staff or county society.

Senate Roundtable on Health Republic

Last week, Dr. Scott Hayworth (Mt. Kisco Medical Group) and I participated in a Senate roundtable on the Health Republic fiasco.  Other parties included representatives from the DOH, DFS, hospital provider side and other insurers. By far, the largest cohort was that of the insurers. It was an opportunity for the Committee on Health to hear views from stakeholders as to the causes of the debacle and how we should move forward.

Dr. Hayworth and I were clear in our presentations on three points:

1) MSSNY alerted NYS health officials a year earlier to the closing that Health Republic had serious payment problems.

2) Physicians have been harmed significantly, leaving them with financial losses that will impact their abilities to provide necessary services to other patients.

3)  Failure to make physicians whole in the solutions brought forth by the state will likely dissuade doctors from participating in any future DSRIP and SHIP initiatives for fear of another failed healthcare reform project sinking them.  We made it very clear—a guaranteed State Fund is necessary to make physicians whole and ensure future success of physician engagement in DSRIP and SHIP.

Governor’s Budget

The Governor’s Budget this year presents several challenges to physicians.  First, there is the proposal once again to expand the terms under which retail clinics can operate in New York.  Second, there is once again an effort to eliminate the second layer of excess coverage for malpractice at a time when the legislature is consideration expanding the date of discovery and statute of limitations on filing a lawsuit for malpractice.  Third, there is a push to expand the scope of healthcare providers who can participate in the Workmen’s Compensation Board program. Finally, there is NO budgetary proposal for the establishment of a guarantee fund to address the losses in the Health Republic debacle.  

Insurer Mergers and Physician Opposition

This past week, the Physician Advocacy Institute sent a 14-page letter outlining its opposition to the merger of several large insurers in the country, highlighting the problems that such controlling entities would have in the marketplace and on the practices of physicians.  I encourage you to review this work done by an organization MSSNY helped found through the United Healthcare lawsuit settlement several years ago.

E-prescribing

Finally, it is imperative that physicians who have not as yet enrolled in the state’s e-prescribing program do so ASAP. The March 27, 2017 is looming.  A caveat–it will be impossible to complete the instructions before the deadline if you wait much longer.  We encourage you to consider the member discounted DrFirst option endorsed by MSSNY.

If you believe you qualify for a waiver, apply NOW.

Have a Happy Martin Luther King’s Day!

Joseph Maldonado, M.D, MSc, MBA, DipEBHC
MSSNY President

Please send your comments to comments@mssny.org


MLMIC Physianns Insurance


Governor Andrew Cuomo Delivers Joint State of the State and Budget Message
Gov. Andrew Cuomo this week set forth his state of the state message proclaiming the accomplishments of his administration over the past five years of his term and unveiling143.6 billion budget for the coming 2016-17 fiscal year.

Many of Cuomo’s 2016 priorities have been released over the past week including plans for a massive, multi-year infrastructure investment for airports, roads and bridge construction as well as a strengthening of mass transit systems in the New York City area, and increasing the state’s minimum wage to $15 (in NYC by 2018  and by July 2021 for businesses in the rest of State) and proposing 12 weeks of paid family leave in the budget, which would be paid for with a $1 paycheck deduction for employees.

Earlier in the week, Governor Cuomo announced a $7M grant to four organizations working to control obesity, diabetes, heart disease and stroke. The funding will allow each organization to implement strategies to encourage lifestyle change and link community programs to include clinical services. Included among the four organizations awarded funding were: Albany County Department of Health ($879,880); HealtheConnections ($2M); Hudson River Healthcare ($2M) and P2 Collaborative of WNY ($2M).

Cuomo proposed divvying up more than $2 billion in settlement relief funds to a variety of areas. He wants to spend $700 million on a plan that would stabilize the Thruway Authority’s finances, $340 million for what is being term a toll “reduction” plan, $200 million on a transportation capital plan, $640 million to provide affordable housing and combat homelessness and $225 million for economic development.

Cuomo’s proposal included an increase of $1.4 B on education aid, an increase of more than 6 percent. Overall, education aid would increase by $2.1 billion over the next two years.

Components of the Governor’s tax cut for small businesses include: a reduction of the corporate tax rate for small businesses from 6.5% to 4%; increasing the exemption from 5-15% of income for tax purposes for sole proprietors and farmers; and granting a 15% exemption for partnerships and s-corps.

The Governor proposes adoption of broad new ethics measures, including limits on outside income for the Legislature. He also proposed to limit how much money lawmakers can earn in the private sector to 15 percent of their base salary. Cuomo also proposed that lawmakers end the practice of allowing single donors to give unlimited contributions through a network of limited liability companies. Cuomo also proposed public financing of political campaigns, which Senate Republicans have insisted they will not pass.

Describing the personal issues faced by his partner Sandra Lee last year, the Governor ended his presentation by proposing a $90M program in NYS for breast cancer screening and an initiative to require all health insurers to cover breast cancer screening.

In addition, the budget contains a number of initiatives—some of which we have seen previously- which will if ultimately enacted by the Legislature impact physicians and patients across NYS including the proposals listed below:

  • Limit Access to Excess Medical Malpractice Coverage. The Governor has again proposed (as he did three years ago) to significantly limit access to the second layer of medical malpractice coverage. Specifically, the proposal would require the Superintendent to, at least once every five years beginning on July 1, 2016, rank from highest to lowest each class and territory combination used for apportionment of premiums to pay for the excess coverage.  Ranking will be a function of physician primary coverage costs and “applicable” (and unspecified) excess tier factors. The proposal requires the Superintendent to grant priority for purchasing policies in descending order beginning with high risk class and territory combination until the appropriation is exhausted. This initiative will result in a $25 million reduction to the program from $127.4M to $102.4M. Three years ago, he proposed somewhat different language but his articulated goal was to limit Excess coverage to physicians with the highest risk…which would have left nearly 40% of physicians who currently have such coverage without it.
  • Authorizes Establishment of Retail Clinics. The Governor has proposed to enable the establishment of ‘limited service’ clinics which provide a limited list of services in retail stores- provided that they adhere to regulations which would among other things require them: to be accredited; accept walk ins; adhere to advertising and signage standards; disclose ownership interests; directly employ a medical director; and strengthen primary care through integration of services with the patient’s other health care providers. The justification given for this proposal is “to increase access to economical primary care services for Medicaid recipients and reduce unnecessary emergency room and inpatient visits”. This proposal is also somewhat modified from those advanced in previous years. It now would allow diagnostic and treatment centers (owned by hospitals), community health centers and federally qualified health centers to operate a limited services clinic.  The proposal would also require an establishment to ‘demonstrate a commitment’ to operate limited service clinics in medically underserved areas; and would allow the department in determining whether to approve additional limited service clinic locations, to consider whether the operator has fulfilled its commitment to operate limited services clinics in medically underserved areas of the state.
  • Makes Significant Changes to Workers Compensation program. The Governor’s proposal would expand the list of providers who are eligible to deliver (and receive payment directly form the W/C program) to include acupuncturists, nurse practitioners, physician assistants, and social workers. Currently, only chiropractors, physicians, podiatrists, psychologists and physical therapists were authorized to receive reimbursement from the workers’ compensation program. Ostensibly, NPs and PAs employed by physicians provided care but the physician’s practice was reimbursed. The proposal also eliminates need for county medical society review of physicians looking to be authorized to deliver care. The initiative would also enhance the flexibility of hearing times and enables virtual hearings for workers compensation cases. See related article.
  • Health Republic. The Governor’s proposed budget does not include language to require the creation of a Guarantee Fund or identify the use of any settlement monies or other pool of monies to address the financial plight of physicians and other providers due to the recent demise of Health Republic. MSSNY is working closely with several physician practices, the Greater New York Hospital Association and HANYS to urge enactment of legislation to reimburse providers who have incurred significant losses as a result of providing care to HR insureds.
  • Statutory Proposals to advance DSRIP/VBP. The Governor’s proposed budget did not include the statutory language changes that have been advanced by various subcommittees to the VBP Workgroup, the Governor’s State of the State message did stipulate that “in 2016, DSRIP will move to the next phase of transforming the health care delivery system in New York by implementing pilot programs to replace expensive fee-for-service payments with ‘value-base’ payments that reward providers for successful patient outcomes and help achieve one of the core DSRIP goals of reducing avoidable hospital admissions by 25 percent over five years.”
  • Additional funding ($200M) to combat AIDS. Specifically, these funds will be used to expand the availability of affordable housing and housing assistance for those living with HIV and identify undiagnosed persons, link them with treatment and facilitate access to necessary medications to keep them HIV negative to prevent spreading the disease.
  • Additional funding ($6M) to combat heroin epidemic. These funds will continue to support prevention, treatment and recovery programs targeted toward chemical dependency, residential service opportunities, and public awareness and education activities.
  • Permits certain state facilities to share patient medical records. Permits facilities, including facilities operated or licensed by the Department of Mental Hygiene, to share clinical records with managed care organizations, behavioral health organizations, health homes, and other entities authorized by the Department or Department of Health (DOH) to provide, arrange or coordinate health care services for Medicaid recipients for whom such entities are responsible.
  • Eliminates the prescriber prevails. Eliminates existing statutory prescriber prevails protections for medications for patients covered in the Medicaid program, except for atypical antipsychotic and anti-depressants. (DEARS, AUSTER, CLANCY, MCPARTLON) 

Executive Budget Seeks to Marginalize Physician Care to Injured Workers
The Governor’s proposed Budget released this week contains sweeping changes to long standing Workers’ Compensation laws to, according to the supporting memo: ensure the system provides more timely and appropriate medical and wage replacement benefits to workers; provide broader and more accessible options for medical care; make hearings more accessible through flexible scheduling and use of virtual hearings; and streamline Workers’ Compensation Board processes and administration to expedite decision making.

While these goals are obviously shared by the physician community, the proposal includes a number of seriously problematic proposals that could further discourage physician participation in the Workers’ Compensation program.  Among the proposals:

  • 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 community function provide by county medical societies;
  • 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 with physicians; 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; and
  • 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.

Of further concern, the proposal does not address any of the many excessive administrative hassles identified by physicians that have caused many physicians to choose to not participate 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 to coordinate its advocacy in opposition to these adverse proposals. (AUSTER)


MSSNY Lobby Day Scheduled For March 8th– Physicians Urged To Attend And To Wear Your White Coats
SAVE THE DATE- MSSNY’s Physician’s Lobby Day will be held on March 8th in the Louis Swyer Theater in the Egg located on the Empire State Plaza in Albany New York.  A full slate of legislators and key staff to the Departments of Health and Financial Services has been invited to dialogue with Lobby Day participants including:

  • Donna Frescatore, Executive Director of the NYS Health Benefit Exchange
  • Troy Oechsner, Acting Executive Deputy Superintendent Of Insurance , Department of Financial Services
  • Jason HElgerson, Medicaid Director, Department of Health
  • Legislative Panel: Senate Health Chair Kemp Hannon; Assembly Health Chair Richard Gottfried; Senate Insurance Committee Chair and Assembly Insurance Chair Kevin Cahill.
  • Senate Majority Leader John Flanagan, Assembly Speaker Carl Heastie

A brief 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.
(DEARS)


Date of Discovery Liability Expansion Bill Back on Assembly Calendar; Physicians Must Contact Their Legislators to Oppose Now!
With the Legislature back in Session, all physicians must again contact their legislators to urge that they oppose legislation (A.285, Weinstein) 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.

With the bill having passed the Assembly in 2015, but not the Senate, it resumes a place on the Assembly Calendar, where it could be voted on by the full Assembly at any time.   The bill was brought up for initial consideration on Monday 1/11, but was “laid aside” by the Assembly Republican Conference  at MSSNY’s rquest.  While the bill currently does not have a Senate sponsor, it is likely to be introduced shortly.

MLMIC’s estimate based upon similar legislation is that this single 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.  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 due to the collapse of Health Republic.  Therefore, YOU NEED TO LET YOUR LEGISLATORS KNOW THAT NO LIABILITY INCREASES CAN BE TOLERATED!

MSSNY is working with many other groups also impacted by this legislation, including hospitals, nursing homes, other specialty societies and the Lawsuit Reform Alliance of New York, in an effort to defeat this disastrous legislation.   (AUSTER, DEARS)


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.

Last week, MSSNY President Dr. Joseph Maldonado strongly urged key State Senators to work to enact a fund to assure that Health Republic claims are completely paid, and that this legislation be enacted in the opening weeks of the 2016 Legislative Session.   Dr. Maldonado’s statements were made as part of a Senate Health & Insurance Committees Roundtable discussion examining the demise of Health Republic, discussing solutions to minimize its adverse consequences, and working to prevent similar events in the future.  The meeting was chaired by Senate Health Committee Chair Kemp Hannon and Insurance Committee Chair James Seward.

To read Dr. Maldonado’s full written statement to the State Senate click here.

Dr. Maldonado’s comments received extensive media coverage, including in Buffalo Business First, Crain’s Health Pulse, and in an Associated Press article that was printed in papers across the country. 

Please 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 and declining payments from insurers, failure to assure payment for these claims would have serious negative consequences for your community.
(AUSTER, DEARS)


Legislation Before Assembly to Accord Due Process Rights When Physicians Are Non-Renewed By A Health Insurer
Legislation (A.1212, Lavine/S.4751, Hannon) is back before the full Assembly that would assure physicians are accorded a fair peer review appeals mechanism before their participation contract with a health insurance company can be non-renewed.  The legislation is in response to situations such as the disrespectful way by which Emblem treated 750 of its network physicians who were unceremoniously dropped from the network in October based upon specious allegation of failure to transition to value-based payments, severing patient treatments relationships for countless patients.  MSSNY has raised this issue with Department of Financial Services, Department of Health, and Attorney General, as well as the entire New York State Legislature. (See MSSNY letter to DFS here.

The legislation passed the Assembly overwhelmingly in 2015, but not the Senate.  Physicians can send a letter in support of this legislation here.  A customizable template is provided.
(AUSTER, DEARS)


Cuomo Calls for Ethics Reform
On Wednesday, Governor Cuomo introduced two freestanding Article VII Ethics reform bills in his budget proposal designed to address the public perception of Albany’s political culture quagmire.

The first bill, a smorgasbord of ethics reform, tackles: (1) closing the LLC Loophole by removing an LLC’s designation as an individual, requiring LLCs making political expenditures to register with the State of Board  of Elections, and to disclose direct and indirect LLC ownership thereby proportionally attributing such political expenditures toward individual campaign contribution limits; (2) capping outside earned income of legislators to no more than 15% of member base compensation, with exceptions for investments and capital gains accrued prior to taking office, and tying members’ ability to vote in the legislature on compliance with civil penalties up to $50,000; (3) reforming campaign finance with heightened disclosure requirements for intermediaries, and proposing a system for the public financing of campaigns; (4) reforming the Freedom of Information Law (FOIL) by statutorily making both houses of the legislature subject to FOIL requirements; (5) expanding the Joint Commission of Public Ethics (JCOPE) civil penalty jurisdiction and mandating JCOPE hold one meeting location for every meeting open to the public; and (6) requiring political consultants to register as lobbyists.

The second bill, a constitutional amendment subject to voter approval, would strip a public official of his or her pension or retirement benefits/privileges if they are convicted of a crime related to public office. The constitutional amendment would be retroactive in the sense that benefits/privileges are subject to forfeiture regardless of when such rights accrued or vested.

The ambitious and seemingly all-inclusive ethics reform bills are highly contentious in both houses, and are unlikely pass without significant changes.
(DEARS, MCPARTLON)

MSSNY and OASAS to Conduct CME Webinars on Opioid Use; Registration Now Open
The Medical Society of the State of New York and New York State Office for Alcoholism and Substance Abuse Services are pleased to present a free,  four part webinar series on opioid prescribing.  Entitled, “Revisiting the Role of Opioid Analgesics for Simple and Complex Patients with Chronic Pain”, the series will begin on Tuesday, January 26, 2016.

Registration is now open.

A copy of the flyer can be found here.

Opioid abuse is a national epidemic that physicians and other prescribers have the power to help prevent.  This series will provide information on managing pain, understanding the potential for patient addiction, and determining best practices for safe, responsible opioid prescribing. 

Tuesday January 26, 2016,  12:30 p.m.

Faculty: Charles Morgan, MD, FASAM, FAAFP, DABAM and Patricia Bruckenthal PhD, APRN-BC, ANP, FAAN

Educational Objectives:

  • Compare and contrast the dual epidemics of chronic pain and opioid abuse and the implications on public health
  • Understand requirements of New York State laws/regulations with regard to prescribing of controlled substances.

Wednesday, February 10, 2016, 7:30 a.m.

Faculty:  Charles E. Argoff, MD

Educational Objective:

  • Discuss evidence based best practice recommendations for opioid therapy for chronic pain, patient risk assessment and documentation. 

Tuesday, February 23, 2016, 7:30 a.m.

Faculty:  Jeffrey Selzer, MD

Educational Objective:

  • Describe potential for patient addiction, screening, diagnosis and subsequent treatment or referral.  

Thursday, March 10, 2016, 7:30 a.m.

Faculty: Charles E. Argoff, MD and Charles Morgan, MD, FASAM, FAAFP, DABAM

Educational Objectives:

  • Recommend tools to assist in the management of patients for whom opioids are indicated and prescribed.
  • Discuss strategies to reduce risk of treating pain in patients with substance use disorders

Physicians and other prescribers can take one or all of the webinars; each webinar has been accredited for one hour of continuing medical education credits.  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.

For further information or assistance in registering for the program, please contact Pat Clancy at pclancy@mssny.org or Terri Holmes at tholmes@mssny.org.
(CLANCY, DEARS)


MSSNY E-Prescribing Webinar Now Available on MSSNY CME Site
MSSNY e-prescribing webinar, entitled, “NYS Requirement for E-prescribing ALL Substances” is now available at MSSNY Continuing Medical Education site at http://cme.mssny.org/  Faculty for this program is Sandra Knapp, Manager, Official Prescription Program, NYS Department of Health, Bureau of Narcotic Enforcement.    The requirement to e-prescribe all substances will become effective on March 27, 2016.   The Medical Society of the State of New York designates this enduring activity for a maximum of 1.0 AMA/PRA Category 1 credit™. New registrants to the site will have to register and create a username and password, which should be retained and be used for continued access to the site. Once registered and logged into the site, physicians will be taken to an instruction page.   Click on the menu on “My training page” to view and take the e-prescribing course.  There are over 50 free courses that are also available.  Further information on all these programs may be obtained by contacting Pat Clancy at pclancy@mssny.org.                                         (CLANCY)


E-Prescribing Waiver Applications Now Available from BNE
With March 27, 2016 as the date that all prescriptions must be electronically submitted, the New York Bureau of Narcotic Enforcement has announced the availability of the Electronic Prescribing Waivers (EPW) application on the Health Commerce System (HCS).

A prescriber must have a HCS account in order to file an electronic prescribing waiver.  Using the HCS account is the quickest way to file the EPW application.

This application allows an institution, medical group practice or an individual practitioner to submit a request for a waiver from the requirement to electronically prescribe. Below are links to instructions for completing the online application on the Health Commerce System, based on the type of requestor:

Institution

Medical Group Practice

Individual Practitioner

If physicians do not have an HCS account, a paper version is NOW available upon request. Please contact the BNE at 1-866-811-7957, option 1.  The paper form is available for applications for institutions, group practices and individual practices and will be sent to requestors.

If physicians experience difficulties with their HCS account,  please call:  1-866-529-1890.  If a prescriber experiences any issues with the on-line Electronic Prescribing Waiver, they should call 1-866-811-7957.                                                                 (CLANCY, DEARS) 


MSSNY Announces 2016 Medical Matters Schedule
The Medical Society of the State of New York will begin its 2016 Medical Matters webinars on January 20, 2016 with a program entitled Immunizations During A Disaster, with Dr. William Valenti as faculty.  All programs will begin at 7:30 a.m.   Registration is now open to physicians and other public health officials:

Go to training session and upcoming sessions tab

Educational objectives for the January 20 program are:

  • Review recommendations for immunizations during disasters
  • Review recommendations for immunizations for responders
  • Describe best practices to avoid vaccine preventable diseases (VPD) during disasters
  • Describe the importance of herd immunity

Additional programs are: Public Health Preparedness 101 on February 17, 2016 and Radiological Emergencies on March 16, 2016.   Further information on these programs can be found here.

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.

Further information or assistance in registering for any of these programs,  may be obtained by contact Melissa Hoffman at mhoffman@mssny.org.
(CLANCY, HOFFMAN) 


NYS DOH AIDS Institute Announces HCV Provider Directory
The AIDS Institute Viral Hepatitis Section is excited to announce the launch of the NYS HCV Provider Directory.  The purpose of the directory is to provide the public and other providers with a listing of HCV care and treatment providers within the State. The directory is an expansion of the existing HIV Provider Directory re-launched last year by the AIDS Institute.

Participation in this directory is voluntary. The information is compiled through provider self-identification, and includes physicians, nurse practitioners, physician assistants, and doctors of osteopathic medicine with the experience in HCV care and treatment and who meet the NYSDOH definition of an experienced HCV provider.

For more information relating to any of the above articles, please contact the appropriate contributing staff member at the following email addresses:          

pschuh@mssny.org ldears@mssny.org            mauster@mssny.org  
pclancy@mssny.org bellman@mssny.org    


CVS Pharmacies in NY Can Sell Naloxone without Prescriptions
Yesterday, the New York State DOH announced an agreement with CVS/pharmacy to help prevent opioid overdose deaths in New York State. This agreement, which became effective January 2, authorizes 479 CVS/pharmacy locations across the State to provide naloxone to their customers without a prescription. Pharmacists are currently receiving training and ordering naloxone for their stores. Naloxone (also known as Narcan®) is a medication that reverses opioid overdose.
Although traditionally administered by emergency medical (EMS) or hospital personnel, naloxone can be administered by laypeople with minimal training. CVS pharmacists are now able to provide this training in addition to dispensing the naloxone to their customers. All individuals who are given naloxone should still go to the hospital with EMS personnel. Naloxone is effective in blocking the effects of an opioid for 30 to 90 minutes. When the naloxone has worn off, someone may slip back into a life-threatening overdose. For more information, click here.


REMINDER:  All Prescriptions Must Be Sent Electronically Beginning March 27th
With the e-prescribing mandate quickly approaching on March 27th, we at MSSNY yare 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.

As 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, 2016 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.

To learn more, register for DrFirst’s educational e-prescribing webinar to help you learn more about I-STOP and the patient safety and workflow benefits of using e-prescribing.  Sign-up today using the registration links below:

1/19 @ 12:00 pm – http://www.drfirst.com/mssny/mssny-lp/#webinar


MSSNY Multi-Section Meeting February 27 for YPS, Residents and Students
MSSNY’s Young Physicians, Resident and Fellow, and Medical Students Sections will hold a joint meeting on Saturday, February 27, 2016. While the business portions will be held separately, all three sections will get together to partake in a leadership presentation* by Richard Popovic, a highly experienced consultant in the fields of physician leadership, strategy, management and patient safety.

Don’t miss this essential leadership presentation and opportunity to discuss relevant issues with your colleagues and help shape MSSNY policy. Section Governing Council elections will be held. Business meetings will take place at MSSNY offices, 865 Merrick Avenue, Westbury, and the leadership presentation at the Hilton Garden Inn (across the street). Web conferencing will be available. The Hilton is offering a corporate room rate of $164.00 for those who may wish to stay overnight (contact sbennett@mssny.org for corporate number).

YPS and RFS can register at sbennett@mssny.org. Students can register at mreyes@mssny.org.

  • YPS business 8:00 am
  • MSS business 9:00 am and after lunch as necessary
  • Presentation 10:30 am
  • Lunch noon
  • RFS business 1:00 pm

*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 Creditsä. Physicians should claim only the credit commensurate with the extent of their participation in the activity.


CDC To Provide $2M to Combat Chronic Diseases in Western NY
Buffalo Business First reports that the nonprofit organization, the P2 Collaborative of Western New York, “will receive $2 million over three years from CDC to fight chronic diseases such as obesity, diabetes, heart disease and stroke in the eight-county region. The article points out that “P2 is among four organizations across New York that will receive $7 million in all.” Recipients for the grants were “selected based on high rates of chronic disease and/or more than 40 percent minority population in the counties they serve.” The funds “will support strategies in community and care settings that promote health, support and reinforce healthful behaviors, encourage lifestyle change program participation and link community programs to clinical services.” 


Eight Marijuana Dispensaries Open throughout State
On January 7, Columbia Care opened the first medical marijuana dispensary in New York City on East 14th Street in Manhattan; other dispensaries that opened in the state were in White Plains, Syracuse, Williamsville, Albany, Kingston, Amherst, and Liverpool.


Average Age of First-Time Moms in US at All-Time High
On January 14, a report released by the Centers for Disease Control and Prevention revealed that the average age of first-time mothers is at an all-time high in the United States http://www.cdc.gov/nchs/data/databriefs/db232.htm The report put the average age at 26 years, 4 months for first-time moms in 2014. Lead author T.J. Mathews from the CDC attributed the change to the drop in teen moms. Overall, the average age of first-time moms “has been rising in every racial and ethnic group, and in every state,” but the highest average ages for first-time moms are still in the Northeast.

American Academy of Pain Medicine Meeting in February in Palm Springs
The American Academy of Pain Medicine (AAPM) 32nd Annual Meeting will be held February 18-21, 2016, in Palm Springs, CA. The theme of this year’s event is Ensuring Access to Pain Care: Engaging Pain Medicine and Primary Care Teams. Of particular connection to their work on the AMA task force, the Academy is offering a preconference session titled Opioid and Non-Opioid Medications Management: Filling in the Gaps, Prescribing for the Whole Patient. Learn more by visiting www.painmed.org/annualmeeting.


Classifieds

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. 212.371.0468drdese@gmail.com.


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 uneyes@verizon.net or call 914-772-5581



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

January 8, 2016 – Do You Need Opioid Education?

drmaldonado PRESIDENT’S MESSAGE
 Dr. Joseph R. Maldonado
asset.find.us.on.facebook.lgTwitter_logo_blue1
January 8, 2015
Volume 16, Number 1

Dear Colleagues:

For several years, MSSNY has fought state legislation aimed at mandating CME for chronic pain management and opioid abuse.  The fight thus far has been successful but honestly, the odds of doing this again are slim.  How can we all help to win the battle once and for all?  The answer is: EVIDENCE that physicians are voluntarily educating themselves.  While you may have already done this through other programs, I am asking every MSSNY member to ante up their non-financial contribution by signing up for one of the webinar times listed below.  If we get sufficient numbers, we may be able to show robust evidence that we can do this voluntarily and a mandate is unnecessary.  Short of doing this voluntarily and providing the State evidence of it, mandatory CME WILL succeed because much of the public believes many of us are prescribing inappropriately and abetting many patients in becoming addicted to prescription pain medications.  Regardless of how you feel on what is the best solution, signing up will go a LONG way in our talks with legislators.

In New York, we have already reduced the incidence of doctor shopping by 86% because physicians are checking the Prescription Monitoring Program prior to prescribing a controlled substance. We have also supported legislation to increase access to naloxone to reduce deaths from overdose. We have also supported efforts to increase voluntary education and training for physicians on safe prescribing practices. Our efforts have proven successful.  According to IMS data, New York has seen substantial decreases in the number of prescriptions written for oxycodone, hydrocodone and other controlled substances. New York’s utilization rate for these medications is below other states that currently require prescriber education of opioid medications. But there’s more to do.

If we educate ourselves now voluntarily, we may be able to stave off an extensive mandatory course in the near future.

Beginning on Tuesday, January 26, at 12:30 pm
, MSSNY and the New York State Office for Alcoholism and Substance Abuse Services are presenting a free, four-part webinar series on opioid prescribing— Revisiting the Role of Opioid Analgesics for Simple and Complex Patients with Chronic Pain. This series will provide information on managing pain, understanding the potential for patient addiction, and determining best practices for safe, responsible opioid prescribing. Registration is now open here.

National experts Charles Morgan, MD, FASAM, FAAFP, DABAM and Patricia Bruckenthal PhD, APRN-BC, ANP, FAAN will compare and contrast the dual epidemics of chronic pain and opioid abuse and the implications on public health and explain the requirements of New York State laws/regulations with regard to prescribing of controlled substances.

On Wednesday, February 10, 2016 at 7:30 am
, Charles E. Argoff, MD will discuss evidence-based best practice recommendations for opioid therapy for chronic pain, patient risk assessment and documentation.

On Tuesday, February 23, 2016, 7:30 am
, Jeffrey Seltzer, MD will describe potential for patient addiction, screening, diagnosis and subsequent treatment or referral. 

On Thursday, March 10, 2016 at  7:30 am,
Charles E. Argoff, MD and Charles Morgan, MD, FASAM, FAAFP, DABAM will recommend tools to assist in the management of patients for whom opioids are indicated and prescribed and discuss strategies to reduce risk of treating pain in patients with substance use disorders.

Registration is now open to physicians here.

Registration is now open to physicians and other prescribers in your practice here.

We are strongly urging physicians to voluntarily take these webinars; please assist us in this endeavor. If there are any questions regarding this; please call Pat Clancy at 518-465-8085 ext 311.

Joseph Maldonado, M.D, MSc, MBA, DipEBHC
MSSNY President

Please send your comments to comments@mssny.org


MLMIC Physianns Insurance


MSSNY Fights for Guarantee Fund to Pay for Unpaid Health Republic Claims
MSSNY President Joseph Maldonado, MD, MSc, MBA strongly urged key State Senators this week to work to enact a Guarantee or other special fund to assure that Health Republic claims are completely paid, and that this legislation be enacted in the opening weeks of the 2016 Legislative Session.   Dr. Maldonado’s statements were made as part of a Senate Health & Insurance Committees Roundtable discussion examining the demise of Health Republic, discussing solutions to minimize its adverse consequences, and working to prevent similar events in the future.  The meeting was chaired by Senate Health Committee Chair Kemp Hannon and Insurance Committee Chair James Seward.

To read Dr. Maldonado’s full written statement, click here and to view the Senate Roundtable in its entirety click here.

In addition to Dr. Maldonado, other participants in the roundtable discussion included MSSNY member Dr. Scott Hayworth, President of the Mt. Kisco Medical Group, as well as representatives of the Greater New York Hospital Association, the Healthcare Association of New York, the New York Health Plan Association, the Conference of Blue Cross/Blue Shield Plans, the National Association of Health Underwriters, United and Health Now.   Also participating were DFS Executive Deputy Superintendent Troy Oechsner and New York State of Health Executive Director Donna Frescatore.

The roundtable discussion focused on the events leading to the collapse of Health Republic and legislative solutions to prevent against such insurer collapses in the future.  This included extensive discussions whether revisions were necessary to New York’s law requiring DFS to approve premium rates as well as whether the State should enact a special Guarantee fund to address unpaid medical claims from physicians and hospitals for care to Health Republic-insured patients.   In arguing for the necessity of a Guarantee fund, Dr. Maldonado highlighted the commitment of physicians to continue to deliver the care needed by their patients despite the knowledge that it was highly unlikely that Health Republic would able to cover these claims.  In particular, he highlighted the tens of millions of dollars in outstanding claims that are owed to medical practices across New York State.  For example, 5 medical practices in the Lower Hudson Valley alone are owed over $12 million.  Moreover, MSSNY’s survey with close to 1,000 respondents showed 42% with outstanding claims to Health Republic, of which:

  • 11% are owed $100,000 or more;
  • 20% are owed $25,000 or more; and
  • 49% are owed $5,000 or more.

Dr. Maldonado’s statement also noted that, in addition to these tangible financial consequences, there is another consequence to physicians – fear of “being burned” again in what may be viewed as risky health care initiatives.  He noted that he had heard from many physicians who are now expressing great reluctance to participate in other new health coverage initiatives, as well as reluctant to participate in other reform initiatives that hold out the promise of upside financial benefits but also could potentially put their medical practices at risk.   MSSNY’s statement included a statement from William Moorely, President & CEO of the Westchester County Association who expressed “deep concern wit the financial consequences to physician practices and patients across New York State as a result of The Collapse of Health Republic” and urged the enactment of legislatures to make physicians and hospitals whole.                      
(AUSTER, DEARS)

Senate Health Committee Moving CPH Immunity Bill and Protection for Statements Made During Peer Review
The Senate Health Committee next week will advance two bills strongly supported by MSSNY. The first bill (S. 3461A, Hannon) would clarify that the statutory liability protections offered for physician participants in the Committee for Physicians’ Health (CPH) program extend to the organization who sponsors the program as well as to the employees of the sponsoring program acting without malice and within the scope of its functions for the committee. Assemblyman Gottfried has introduced the companion bill (A.7267) in the Assembly.  Last year, the Senate passed the bill but it was never reported out of the Assembly Codes Committee.

The second bill (S.4698, Hannon) would extend the confidentiality provisions relating to discovery of testimony to apply to statements made by any person in attendance at peer-review committee that is a party to an action the subject matter of which was reviewed at such meeting. Assemblyman Gottfried has sponsored the companion bill (A.3353) in the Assembly.                           
(DEARS, AUSTER)


MSSNY and OASAS to Conduct CME Webinars on Opioid Use; Registration Now Open
The Medical Society of the State of New York and New York State Office for Alcoholism and Substance Abuse Services are pleased to present a free,  four part webinar series on opioid prescribing.  Entitled, “Revisiting the Role of Opioid Analgesics for Simple and Complex Patients with Chronic Pain”, the series will begin on Tuesday, January 26, 2016.

Registration is now open.

A copy of the flyer can be found here.

Opioid abuse is a national epidemic that physicians and other prescribers have the power to help prevent.  This series will provide information on managing pain, understanding the potential for patient addiction, and determining best practices for safe, responsible opioid prescribing. 

Tuesday January 26, 2016,  12:30 p.m.

Faculty: Charles Morgan, MD, FASAM, FAAFP, DABAM and Patricia Bruckenthal PhD, APRN-BC, ANP, FAAN

Educational Objectives:

  • Compare and contrast the dual epidemics of chronic pain and opioid abuse and the implications on public health
  • Understand requirements of New York State laws/regulations with regard to prescribing of controlled substances.

Wednesday, February 10, 2016, 7:30 a.m.

Faculty:  Charles E. Argoff, MD

Educational Objective:

  • Discuss evidence based best practice recommendations for opioid therapy for chronic pain, patient risk assessment and documentation.

Tuesday, February 23, 2016, 7:30 a.m.

Faculty:  Jeffrey Selzer, MD

Educational Objective:

  • Describe potential for patient addiction, screening, diagnosis and subsequent treatment or referral.  

Thursday, March 10, 2016, 7:30 a.m.

Faculty: Charles E. Argoff, MD and Charles Morgan, MD, FASAM, FAAFP, DABAM

Educational Objectives:

  • Recommend tools to assist in the management of patients for whom opioids are indicated and prescribed.
  • Discuss strategies to reduce risk of treating pain in patients with substance use disorders

Physicians and other prescribers can take one or all of the webinars; each webinar has been accredited for one hour of continuing medical education credits. 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.

For further information or assistance in registering for the program, please contact Pat Clancy at pclancy@mssny.org or Terri Holmes at tholmes@mssny.org.
(CLANCY, DEARS) 


E-Prescribing Waiver Applications Now Available from BNE
With March 27, 2016 as the date that all prescriptions must be electronically submitted, the New York Bureau of Narcotic Enforcement has announced the availability of the Electronic Prescribing Waivers (EPW) application on the Health Commerce System (HCS).

A prescriber must have a HCS account in order to file an electronic prescribing waiver.  Using the HCS account is the quickest way to file the EPW application.

This application allows an institution, medical group practice or an individual practitioner to submit a request for a waiver from the requirement to electronically prescribe. Following are links to instructions for completing the online application on the Health Commerce System, based on the type of requestor:

Institution

Medical Group Practice

Individual Practitioner

If physicians do not have an HCS account, a paper version is NOW available upon request. Please contact the BNE at 1-866-811-7957, option 1.  The paper form is available for applications for institutions, group practices and individual practices and will be sent to requestors.

If physicians experience difficulties with their HCS account,  please call:  1-866-529-1890.

If a prescriber experiences any issues with the on-line Electronic Prescribing Waiver, they should call 1-866-811-7957.
(CLANCY, DEARS)


NYS Medical Marijuana Program Launched on January 7th
The New York State Department of Health initiated the state’s Medical Marijuana Program on January 7, 2016; this program will make approved forms of medical marijuana, available with a physician’s certification at designated dispensaries across New York State. The program provides access to medical marijuana to certified patients suffering from cancer, HIV/AIDS, ALS (Lou Gehrig’s disease), Parkinson’s disease, multiple sclerosis, intractable spasticity caused by damage to the nervous tissue of the spinal cord, epilepsy, inflammatory bowel disease, neuropathies and Huntington’s disease.

Physicians seeking to certify patients for the use of medical marijuana are required to take a four and ½  hour online educational program.   The physicians CME certificate must then be forwarded to DOH.   This course is available at TheAnswerPage, an established online medical education provider here.

The cost to take the course is $249, and practitioners will earn 4.5 hours of CME credit upon successful completion of the course.

Practitioners who wish to register with the department and certify their patients for the Medical Marijuana Program must:

  • be qualified, by training or experience, to treat patients with one or more of the serious conditions eligible for medical marijuana;
  • be licensed, in good standing as a physician and practicing medicine, as defined in article one hundred thirty one of the Education Law, in New York State;
  • possess a Health Commerce System (HCS) Medical Professions Account user ID and password;
  • possess an active Drug Enforcement Administration (DEA) registration number; and
  • complete the four hour Department-approved medical use of marijuana course.

The course includes the following topics, which are required in the regulations: the pharmacology of marijuana; contraindications; side effects; adverse reactions; overdose prevention; drug interactions; dosing; routes of administration; risks and benefits; warnings and precautions; and abuse and dependence.  Additional information regarding the practitioner registration process is available on the department’s Medical Marijuana Program webpage, which can easily be accessed via the this link.  The NYS Department of Health has indicated that 150 physicians have taken the course and also said that a list of physicians names, who have given their consent to the DOH for their names to be made public,  should be released shortly.

The department’s press release provided the following information:  “In order to obtain medical marijuana, a patient must receive a DOH Medical Marijuana Program certification from a registered physician.   The patient must then access DOH’s online Patient Registration System to apply for a registry identification card. Additional information regarding registration can be found here.

To apply for a registry card, certified patients will need: a valid DOH Medical Marijuana Program certification form issued and signed by a registered practitioner, photographic identification, documentation of his or her temporary or permanent New York State residency, and designated caregiver information, if applicable.  A patient who is under the age of eighteen or who is otherwise incapable of consenting must apply through a proxy.

Patients with valid registry identification cards are then eligible to purchase medical marijuana from one of the dispensing locations across the State.  DOH selected five registered organizations on July 31, 2015 to grow marijuana and manufacture it into approved forms.  Each registered organization operates a manufacturing facility and four dispensing facilities. Information on the registered organizations can be found at here.
(CLANCY)


MSSNY E-Prescribing Webinar Now Available on MSSNY CME Site
MSSNY e-prescribing webinar, entitled, “NYS Requirement for E-prescribing ALL Substances” is now available at MSSNY Continuing Medical Education site at http://cme.mssny.org/  Faculty for this program is Sandra Knapp, Manager, Official Prescription Program, NYS Department of Health, Bureau of Narcotic Enforcement.    The requirement to e-prescribe all substances will become effective on March 27, 2016.   The Medical Society of the State of New York designates this enduring activity for a maximum of 1.0 AMA/PRA Category 1 credit™. New registrants to the site will have to register and create a username and password, which should be retained and be used for continued access to the site. Once registered and logged into the site, physicians will be taken to an instruction page.   Click on the menu on “My training page” to view and take the e-prescribing course.  There are over 50 free courses that are also available.  Further information on all these programs may be obtained by contacting Pat Clancy at pclancy@mssny.org.
(CLANCY)


MSSNY is Member of The AMA’s Task Force on Opioid Abuse
The Medical Society of the State of New York is participating on the American Medical Association’s (AMA) national Task Force to Reduce Opioid Abuse.  The task force, established in 2014, consists of over 20 medical national specialty organizations and MSSNY is one of the eight state medical societies on the task force.  The goals of the task force are to:

  • Increase physicians’ use of effective PMPs
  • Enhance physicians’ education on appropriate prescribing
  • Reduce the stigma of pain and promote comprehensive assessment and treatment
  • Reduce the stigma of substance use disorder and enhance access to treatment
  • Expand access to naloxone in the community and through co-prescribing.

The task force ultimate goals are to create a behavioral shift in physicians to create a sense of urgency that they are a part of the solution to the opioid epidemic and to tap into their fundamental desire to effectively help their patients and improve their patients’ health.  The task force will also urge physicians to use PMPs to have a better—realistic—perspective about patients’ use of opioids.  Dr. Frank Dowling, MSSNY Councilor and Pat Clancy, Vice President of Public Health and Education are MSSNY appointees to the task force.

MSSNY has also developed a page entitled, “Opioids: What One Doctor Can Do“  This page is located on the MSSNY website and is located in a blue box at the top of the home page:  www.mssny.org   The page provides information on the AMA Task Force, provides resources and best practices for physicians and also provides tools for physicians along with patient information.
(CLANCY)


MSSNY Announces 2016 Medical Matters Schedule
The Medical Society of the State of New York will begin its 2016 Medical Matters webinars on January 20, 2016 with a program entitled Immunizations During A Disaster, with Dr. William Valenti as faculty.  All programs will begin at 7:30 a.m.   Registration is now open to physicians and other public health officials.

Go to training session and upcoming sessions tab

Educational objectives for the January 20 program are:

  • Review recommendations for immunizations during disasters
  • Review recommendations for immunizations for responders
  • Describe best practices to avoid vaccine preventable diseases (VPD) during disasters
  • Describe the importance of herd immunity

Additional programs are: Public Health Preparedness 101 on February 17, 2016 and Radiological Emergencies on March 16, 2016.   Further information on these programs can be found here.

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.

Further information or assistance in registering for any of these programs,  may be obtained by contact Melissa Hoffman at mhoffman@mssny.org.
(CLANCY, HOFFMAN) 


Legislative Advocacy Leadership Workshop for HCV Clinicians to Be Held January 15
A legislative leadership workshop will be held January 15, 2016 for HCV clinicians at Lenox Hill Hospital, 130 East 77th Street, NY, NY; Aron Board Room.  The workshop is sponsored by the Empire Liver Foundation, HepCx, and NYC Health Department.   Clinicians can learn about strategies to change policies and support legislation. The workshop will also be broadcast over WebEx.    Further information and/or to register for the conference,  please  Eric Rude at erude@health.nyc.gov
(CLANCY)

REMINDER:  All Prescriptions Must Be Sent Electronically Beginning March 27th
With the e-prescribing mandate quickly approaching on March 27th, 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.
  • As a MSSNY member, 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, 2016 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.
  • To learn more, register for DrFirst’s educational e-prescribing webinar to help you learn more about I-STOP and the patient safety and workflow benefits of using e-prescribing.  Sign-up today using the registration link below
  • 1/19 @ 12:00 pm – http://www.drfirst.com/mssny/mssny-lp/#webinar


Longtime MSSNY Counsel Don Moy Retiring from Kern Augustine Conroy & Schoppmann
Don Moy Esq.
Kern Augustine Conroy & Schoppmann, P.C. would like to announce that as of December 31, 2015, one of its partners, the esteemed Donald (“Don”) R. Moy, Esq. has retired.  Over the past five years, the partners, attorneys, staff and clients of Kern Augustine Conroy & Schoppmann have had the honor and privilege of working with Mr. Moy, one of the most honorable, knowledgeable and respected attorneys in the world of healthcare law, and he will truly be missed.

Don Moy’s career has been dedicated to the counseling of physicians, other healthcare professionals, and medical societies and other professional associations in matters pertaining to the regulation of the profession, including state and federal regulatory issues.  Prior to working with KACS, Mr. Moy served as the Senior Vice President and General Counsel to the Medical Society of the State of New York (“MSSNY”) for 25 years.

As the firm transitions as MSSNY’s General Counsel, David Vozza and David Adelson will take over Mr. Moy’s role with MSSNY, however, Mr. Moy will also be available to the firm on a consulting Of Counsel basis to ease and bolster the transition.  Mr. Vozza and/or Mr. Adelson can be reached at 1-800-445-0954 or via email at dvozza@drlaw.com and dadelson@drlaw.com, respectively.


AG Announces Settlements to Stop Prohibited ‘Direct Access Testing’
DirectLabs and LabCorp Are Prohibited from Enabling New Yorkers to Receive Clinical Laboratory Testing Without Required Medical Provider Oversight 

Attorney General Schneiderman recently announced agreements with Direct Laboratories LLC and Laboratory Corporation of America that prevent these companies from enabling New Yorkers to undergo clinical laboratory testing without a licensed medical provider’s involvement, as required by New York State law.

DirectLabs, a Louisiana-based company, advertises “direct access” to laboratory testing, and sells requisitions directly to consumers, with no physician involvement, for over 250 different tests and testing packages, including tests for parasites, heavy metals, thyroid levels, vitamin levels, various cancer markers, and specific diseases such as celiac disease and rheumatoid arthritis.  Without a health provider overseeing the test results in the context of a person’s clinical overall presentation, these test results can give consumers a mistaken impression to the detriment of their health – particularly where tests may have a propensity for either false positives or false negatives.

“My office is committed to helping all New Yorkers take control of their health and make educated health care decisions,” Attorney General Schneiderman said. “However, enabling consumers to purchase laboratory tests for serious medical conditions without consulting a physician does not help New Yorkers control their health, but rather risks placing their health in jeopardy.  Licensed medical providers are essential to ensuring consumers undergo testing that will yield clinically useful results and that the results are properly interpreted in light of the patient’s medical condition as a whole.”

DirectLabs has been able to offer its direct testing service because of its relationship with LabCorp.  LabCorp provided DirectLabs with the technology needed to generate requisitions and receive test results, and LabCorp processed specimens based on DirectLabs’ requisitions.  As a result of DirectLabs’ and LabCorp’s actions, New Yorkers were able to undergo clinical laboratory testing without ever consulting a health care practitioner, even when New York State law requires that such testing be performed only at a licensed practitioner’s request.

The settlement with DirectLabs and LabCorp comes after an investigation by the Attorney General’s Health Care Bureau showed that DirectLabs sold requisitions for a wide range of tests, and that these requisitions were automatically generated with a licensed chiropractor’s name – who had never seen or spoken with the patients – in exchange for a $24 “access fee” payment.  Consumers could then take those requisitions to a LabCorp patient service center to have the testing performed at reduced prices negotiated between LabCorp and DirectLabs.  The chiropractor whose name appeared on the requisitions not only never met or spoke with any of the approximately 1,100 consumers whose laboratory tests he authorized, he did not follow up with any of the consumers about the test results.

Under the settlement with DirectLabs, DirectLabs will no longer operate in New York State and must refund all customers with requisitions that have not yet been presented to a laboratory for testing to be performed.  Under the settlement agreement with LabCorp, LabCorp’s patient service centers in New York will no longer accept specimens for examination pursuant to requisitions generated by DirectLabs or any similar company.  Further, LabCorp will ensure that requests for laboratory testing submitted by health care providers are within the provider’s scope of practice as set forth by the New York State Education Department and that the providers’ licenses are current.  DirectLabs is obliged to pay a $24,500 penalty, while LabCorp will pay a $225,000 penalty. 


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Resident/Fellow/Medical Student Poster Symposium Reminder
Deadline for abstract submission is 4 pm, Monday, January 25, 2016 for the Annual Poster Symposium on Friday, April 15, 2016 at the Westchester Marriott in Tarrytown, New York from 2 pm to 4:30 pm.
Click here for detailed guidelines


Holding of 2016 Date-of-Service Claims for Services Paid Under the 2016 Medicare Physician Fee Schedule
In order to implement corrections to technical errors discovered after publication of the MPFS rule and process claims correctly, Medicare Administrative Contractors will hold claims containing 2016 services paid under the MPFS for up to 14 calendar days, (i.e., Friday, January 1, 2016 through Thursday, January 14, 2016). The hold should have minimal impact on provider cash flow as, under current law, clean electronic claims are not paid sooner than 14 calendar days (29 days for paper claims) after the date of receipt.
MPFS claims for services rendered on or before Thursday, December 31, 2015 are unaffected by the 2016 claims hold and will be processed and paid under normal procedures and time frames.


CMS Announces the 2015 PQRS Data Submission Timeframes

  • EHR Direct or Data Submission Vendor (QRDA I or III) – 1/1/16 – 2/29/16
  • Qualified clinical data registries (QCDRs) (QRDA III) – 1/1/16 – 2/29/16
  • Group practice reporting option (GPRO) Web Interface – 1/18/16 – 3/15/16
  • Qualified registries (Registry XML)  – 1/1/16 – 3/31/16
  • QCDRs (QCDR XML) – 1/1/16 – 3/31/16

Submission ends at 8:00 P.M. Eastern Time on the end date listed. An Enterprise Identity Management (EIDM) account with the “Submitter Role” is required for these PQRS data submission methods. Please see the EIDM System Toolkit for additional information.

Eligible Professionals who do not satisfactorily report quality measure data to meet the 2015 PQRS requirements will be subject to a negative PQRS payment adjustment on all Medicare Part B Physician Fee Schedule (PFS) services rendered in 2017.

For questions, please contact the QualityNet Help Desk 1-866-288-8912 or via email at Qnetsupport@hcqis.org from 7:00 a.m. – 7:00 p.m. Central Time. Complete information about PQRS is available at http://www.cms.gov/Medicare/Quality-Initiatives-Patient-Assessment-Instruments/PQRS/index.html.


USPSTF Releases Draft Recommendation on Who Should Use Statins
On December 21, the US Preventive Services Task Force (USPSTF) issued a draft recommendation on “who qualifies for cholesterol-lowering statins.” In the new “draft guidelines” released for public comment, the USPSTF says “the…medications will be of most benefit to some people ages 40 to 75 whose risk of cardiovascular disease over the next decade is at least 10 percent. The USPSTF concluded that people with a 10% or greater risk of heart problems in the next 10 years, based on the 2013 AHA-ACC calculator, and who have diabetes, high cholesterol, high blood pressure or who smoke, can lower their risk of having a heart attack or stroke by a ‘moderate amount’ by taking a statin.”

The draft recommendation states that USPSTF maintains that “there’s not enough evidence to recommend screening all children and teens for high cholesterol.” It remains unclear “if such screening up to age 20 reduces the risk of cardiovascular disease in adulthood.


FDA Lifts Lifetime Ban on Blood Donations from Gay Men
On December 21, 2015, the Food and Drug Administration lifted a decades-old lifetime prohibition on blood donation by gay and bisexual men. The FDA will continue to ban “men who have had sex with men in the past year, however, saying that the measure was needed to keep the blood supply safe.” Dr. Peter Marks, deputy director of the FDA’s Center for Biologics Evaluation and Research, spoke at a press conference and said that the 12-month deferral period was “supported by the best available research,” and that the newest blood tests are “highly accurate but not perfect,” which is “why the elimination of all deferrals is not feasible at this time.” However, gay rights groups consider the lifting of the life time ban, “a major stride toward ending a discriminatory national policy, but had wanted blanket bans for gay men to be removed entirely.”

Dr. Marks said the policy change is “backed by sound scientific evidence” and will “continue to protect our blood supply.” The FDA had “considered eliminating all restrictions on blood donations from gay and bisexual men, but concluded that would increase the transmission of HIV through the blood supply by 400 percent.” Dr. Marks said Monday that “an increase of that magnitude is not acceptable.” Dr. Marks wrote in a statement that the FDA “will continue to actively conduct research in this area and further revise our policies as new data emerge.”


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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 uneyes@verizon.net or call 914-772-5581



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