February 26, 2016 – Physicians Shaping the Discourse

drmaldonado PRESIDENT’S  MESSAGE
 Dr. Joseph R.  Maldonado
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February 26,  2016
Volume 16, Number 8

Dear Colleagues:

This week, I attended the AMA National Advocacy Conference in Washington, DC.   New York had a very prominent number of physicians in attendance, many of whom went on their own dime.  It made me proud of their dedication and passion to take time from their busy schedules to go down to Washington and meet with our Federal legislators.  I was most impressed by Senator Schumer’s open style and graciousness in meeting with us.  He listened and made very insightful suggestions for our efforts.  Honestly I had not expected this level of engagement and I was glad to have seen it firsthand.

The sessions in Washington with the staff members of many of our legislators were refreshing.  They are a young group of individuals with a broad range of knowledge of the subject.  All of them have a keen aptitude and intellect in capturing the important concepts and engaging with them.  There was a seemingly genuine interest in listening to our perspective, which as a cynic of the Washington process, I had not expected.

While I tend to relate best to the seasoned staff of legislators in Albany, the group in Washington seemed to have a freshness about them that gave me hope that perhaps they were not jaded by years of work in the Washington arena.  They did a lot of listening, and didn’t seem to have established opinions.  They asked reasonable and smart questions.  They seemed interested in our views as physicians about how the problems could be addressed.  They offered options on how we might best tackle challenges facing us.

Most importantly, it was a pleasure not getting the sense that we were dealing with a group of young individuals who had an agenda to carry out and would indulge us on only those issues that complemented their agendas.  I’m not certain if there is a “Washington Staff Etiquette” course new staff members take before starting to work for Federal legislators, but the receptive style of engagement gave me hope that perhaps if we could not convince our legislators on key issues, engagement with their staff might provide them with the data needed for them to more effectively carry out the task on our behalf.

All in all, the advocacy experience was very positive.  Join us in Albany next week and see what your experience as a physician in the trenches can do for changing policymakers’ perspectives on healthcare.

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.  If you plan to attend, please register here.

A full slate of legislators and top Administration officials will attend and 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 Majority Leader Joe Morelle and Senate Majority Leader John Flanagan have also agreed to attend the morning proceedings.  Speaker Heastie has also been invited.  A brief informal luncheon to which members of each House are invited to speak with their constituents will follow the morning program.   County Medical Societies will be scheduling appointments for physicians to meet with their elected representatives.

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


Physicians Invited to Attend Fireside Chat with MSSNY President Dr. Joseph Maldonado and Troy Oechsner, Deputy Superintendent of Insurance
On March 7th, the evening before MSSNY’s Lobby Day, Joseph Maldonado, Jr., MD, MSc, MBA, will conduct a “fireside chat” with Troy Oechsner, Deputy Superintendent at DFS.

This is a relaxed and fluid format in which Dr. Maldonado and Mr. Oechsner can discuss issues of concern to the medical community (network adequacy, action taken by Emblem Health to narrow its network,  the collapse of Health Republic, etc). Physicians are invited to be physically present at this event in the DGA offices located at Ste 408, One Commerce Building, in Albany or can engage in real time by submitting their questions during the LIVE webcast of the event through the this link.

The program will run for one hour from 5:30-6:30PM on March 7th.  To register to attend the event, click here.
(DIVISION OF GOVERNMENTAL AFFAIRS)


Why Physicians Need to Take a Day Away From Your Practice to Lobby Albany on March 8, 2016

  • Think you pay too much in malpractice insurance costs?  The Trial Bar doesn’t care. They have introduced legislation that will certainly increase your premium costs.
  • If you practice in the Capital District, Southern Tier, Central NY, or Western NY, New York State wants to take away your Excess Liability Insurance Coverage.
  • New York State wants to enable NPs to deliver care to injured workers and take away County Medical Society review of authorized physicians rather than fixing what ails the Workers’ Compensation system.
  • The Proposed NYS Budget does nothing to compensate physicians for the unpaid care they have provided to Health Republic insureds.
  • New York State wants to enable Walmart and Target to hire NPs to deliver care to the public to compete directly against you.
  • Patient health could be threatened by inappropriately expanding the scope of practice of countless non-physicians, including dentists, optometrists and psychologists.
  • We need to prevent insurers from offering patients narrow networks for Exchange plans and denying patient access to out of network physicians.

These are very real issues that are currently being discussed and will be resolved either in the State Budget which will be enacted by April 1st or before the end of Session on June 16th. You need to come to Albany, and speak with your elected officials so that they can hear your concerns. Otherwise, all they will hear are the perspectives of trial lawyers and insurance companies.

PLEASE  JOIN YOUR COLLEAGUES FROM ACROSS THE STATE TO LOBBY YOUR ELECTED LEADERS IN PERSON IN ALBANY MARCH 8TH. REGISTER HERE.
(DIVISION OF GOVERNMENTAL AFFAIRS)


Legislation to Make Changes to the ERx Law to Exempt Low Volume Prescribers and to Enable Nurses in LTC Facilities to Act as Agent for the Physician Introduced and Reported by Assembly Health Committee
Just this week, legislation (A. 9335, Gottfried/ S.6779, Hannon) was introduced at MSSNY’s request which would exempt low volume prescribers from the e-prescribing mandate entirely. MSSNY is aware that physicians who are low volume prescribers (those who write less than 25 prescriptions a year) are receiving waivers from the mandate; but those waivers are only good for one year requiring low volume physicians to reapply each year. This measure would eliminate the need for them to re-apply for a waiver each year.

The bill would also amend the eRx law by eliminating existing provisions which require prescribers who invoke one or more of the exemptions to the eRx mandate to contact the department when they exercise an exemption. Instead, the bill would require a prescriber to make a notation in the patient’s record that the exercise of the exemption was utilized.

The Assembly bill was reported unanimously from the Assembly Health Committee to the Assembly Codes Committee. The Senate counterpart is on next week’s Senate Health Committee.

A second proposal (A.9334, Gottfried/S.6778, Hannon), also supported by MSSNY, was unanimously reported by the Assembly Health Committee this week to the Assembly floor. Specifically this proposal would allow prescirptions for non-controlled substances for nursing home residents to be made orally rather than electronically.  For decades, nurses, acting as the agent to the physician, have been authorized to take oral orders from the physician for non-controlled medications through the nursing home medication administration system to deliver medications to residents safely and without delay. In this long-standing system, the physician then routinely signs the oral orders within 48 hours.

Physicians are not physically present in nursing homes 24 hours a day. Nurses serve a vital role ensuring proper medication administration in nursing homes. This bill is necessary to assure that physician’s orders are timely filled to protect the health and well-being for each resident in a safe and secure method. The Senate counterpart to the Assembly bill is also on next week’s Senate Health Committee agenda.
(DEARS, AUSTER)


Senate Advances Legislation to Limit Opioid Prescribing to 3-10 Days for Patients in Acute Pain
Senate Bill 6091A, sponsored by Senator Kemp Hannon, has moved to the Senate floor for a vote.  This bill would limit the initial prescription by a physician or other prescriber of Controlled Substance, Schedule II or III, to a three to 10 day supply for patients suffering acute pain.   Its companion measure, A. 8601, sponsored by Assemblymember John McDonald, is in the Assembly Health Committee.  

The bill, if enacted, would establish a limitation on a physician’s license by prohibiting the physician from practicing to the fullest extent of his/her education and training when they seek to prescribe Schedule II or III controlled substance.  Senate Bill 6091A/A.8601 would effectively prevent a physician from exercising his/her clinical judgement on behalf of the patient.   Moreover, this action would set a dangerous precedent in New York State and represents an enormous encroachment of the New York State Legislature into the practice of medicine.  The Medical Society of the State of New York is strongly opposed to this measure.  Physicians are urged to contact their legislator and urge them not to enact this measure.   Physicians may call the NY Senate at 518-455-2800 or the Assembly at 518-455-4100.
(CLANCY, DEARS)


Health Republic Guarantee Fund Legislation (S.6667/A.9311) Picks Up Several New Assembly Co-Sponsors
13 Assemblymembers  have joined Assembly Health Committee Chair Richard Gottfried  and Assemblyman Charles Lavine (D-Nassau County) in introducing legislation (A.9311) to establish a Guarantee Fund to help to assure the payment of the hundreds of millions that Health Republic owes physicians and hospitals across New York State, as well as to protect consumers and health care providers from future health plan insolvencies.  To view the list of co-sponsors, click here.

Identical legislation (S.6667, Valesky, also with several co-sponsors) has been introduced in the State Senate.  Right now, New York is the only state in the country that does not have such a Guarantee Fund.  With the health insurance industry in strong opposition to this proposal, it is imperative that you urge your Senators and Assemblymembers to support this bill and include it as part of the State Budget currently under negotiation by sending a letter from here.

You must 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)


Please Complete Survey to Let Us Know What You are Owed as a Result of Health Republic Debacle
MSSNY’s updated survey of outstanding Health Republic claims shows that, based upon results received, physicians are owed nearly $25,000,000.  However, we believe that far more physicians who have been adversely impacted have yet to respond.  As we continue our advocacy in support of legislation (A.9311, Gottfried/S.6667, Valesky) to create a Guarantee fund and/or the allocation of other monies to pay for the unpaid claims as a result of the Health Republic demise, we need those of you who have not completed the survey to provide us with updated information regarding the amounts you are due from Health Republic.  To complete the survey, click hereThis data is critical to our advocacy efforts!   We need to obtain updated and more precise numbers from as many impacted physicians as possible since many legislators have asked us for this data.
(AUSTER, DEARS)


Physicians Must Continue to Let Their Legislators Know of Concerns with Adverse Workers’ Compensation Budget Proposal
All physicians must continue to contact their State Senators and Assemblymembers to express their strong opposition to sweeping Workers’ Compensation reform proposals contained in the Executive Budget.

MSSNY staff continues to meet with key legislative leaders and staff to voice its very serious concerns with Budget proposals that would:

  • Expand the list of non-physicians who can treat and be paid directly for care to injured workers without any clarity as to how these non-physicians will coordinate care delivery when specialized care is needed;
  • Expand the circumstances when a physician or other health care provider can have their authorization removed and empowers the Board to impose significant fines on a physician or any other Board-authorized health care provider for violating a Workers Compensation rule;
  • Remove the authority of county medical societies to recommend physicians to serve as treating providers or independent medical examiners under Workers Compensation.
  • Reduce choice for injured workers by expanding the circumstances when an injured worker must seek care within a PPO network; and
  • Remove the requirement for a referral by a physician for an injured worker as a pre-condition to receive psychological care;

In the 30-day Executive Budget amendments, the proposal was made even more adverse by a) requiring physicians and other currently authorized WC providers to execute an “authorization agreement” with the Board (as of now, it is unclear what would be contained within such “authorization agreement”) within 12 months of the effective date of the proposal, if it were to be enacted; and b) removing the ability of professional associations, such as MSSNY, to recommend arbitrators to resolve medical fee disputes between health care providers and carriers.

MSSNY has also reached out to labor organizations and associations representing attorneys for injured workers to coordinate its advocacy in opposition.  We are pleased to learn that the New York Insurance Association has released a memo in opposition to the provisions that would expand the role of non-physicians in Workers Compensation.  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)


Please Advocate for Due Process Rights When Physicians are Non-Renewed by a Health Insurer
Physicians are urged to contact their legislators to support a bill (A.1212, Lavine/S.4751, Hannon) 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.  To send a letter in support of this legislation here:.  The bill is currently on the Assembly calendar and in the Senate Insurance Committee.  The legislation is in response to situations such as the recent example of Emblem dropping 750 of its network physicians in October based upon specious allegation of failure to transition to value-based payments, severing patient treatment relationships for countless patients.  MSSNY has strenuously urged to the Department of Financial Services, Department of Health, and Attorney General that these physicians be given a fair opportunity to be reinstated, and have shared this information with the entire New York State Legislature. (See MSSNY letter to DFS here.

The Attorney General’s office continues to investigate specific complaints raised by individual physicians whether they were given a fair chance to appeal these non-renewals.
(AUSTER, DEARS)


Tell Your Legislators to Reduce Your Liability Costs, Not Expand Them!
All physicians must continue to contact their legislators to urge that they oppose legislation (A.285-A, Weinstein/S.6596, DeFrancisco) 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.

You need to tell your legislators that no liability increases can be tolerated.  MLMIC’s estimate is that this bill could increase physician liability premiums by nearly 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.

This week, MSSNY joined the Greater New York Hospital Association (GNYHA) and Healthcare Association of New York State (HANYS) in an ad in the Albany Times-Union with the headline “NEW YORK’S HOSPITALS AND DOCTORS HAVE THE HIGHEST MEDICAL MALPRACTICE COSTS – AND THAT MAKES NO SENSE”.

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%.   Please tell your legislators to enact comprehensive liability reform to bring down these costs, not legislation that increases them!                                                                                                       (AUSTER, DEARS)


Physicians Advocate for Their Colleagues and Patients in Nation’s Capitol
Several New York leader physicians and MSSNY staff traveled to Washington DC this week to meet with key members of New York’s Congressional delegation.  The meetings were in conjunction with the AMA’s National Advocacy Conference.  The physicians participating in these Hill visits included:

  • Rome urologist and MSSNY President Dr. Joseph Maldonado;
  • Manhattan physiatrist and MSSNY President-elect Dr. Malcolm Reid;
  • Saratoga Springs ENT and MSSNY Board of Trustees member Dr. Robert Hughes;
  • Touro College of Osteopathic Medicine Dean and past MSSNY President Dr. Robert Goldberg;
  • Schenectady ophthalmologist and MSSNY Councilor Dr. John Kennedy;
  • Harrison allergist and MSSNY House of Delegates Speaker Dr. Kira Geraci-Ciardullo;
  • Rochester Psychiatrist Dr. John McIntyre; and
  • Buffalo Urologist Dr. Willie Underwood

The physicians urged members of Congress to address a number of issues that are adversely affecting the delivery of patient care in New York State, including: assuring the claims of failed co-op insurer Health Republic are paid; simplifying the enormously cumbersome Meaningful Use program; assuring fairness in Medicare Recovery Audits; supporting comprehensive multipronged efforts to reduce the nation’s opioid abuse crisis in a way that does not inadvertently limit treatment options for patients; and pushing CMS to investigate Medicare Advantage plans (such as Emblem) interfering with existing treatment relationships by dropping scores of physicians from their networks.

In addition to meetings with many New York Congressional delegation members and staff, in conjunction with physician leaders of several other state medical societies, meetings were held with US House Ways & Means Chair Kevin Brady (R-TX); Rep. Dr. Michael Burgess, a key leader of the House Doctors Caucus; and with key health policy “central” staff for both the US House and US Senate.
(AUSTER)

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AMA National Advocacy Conference. L-R: Former MSSNY President  Dr. Robert Hughes, Representative .Dr. Michael Burgess (R-TX), Phil Schuh, MSSNY Executive VP

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Dr. Robert Goldberg, Dr. John Kennedy, Representative Eliot Engel, Dr. Malcolm Reid, Dr. Kira Geraci, and MSSNY VP Moe Auster

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MSSNY leadership with Ways and Means Chair Kevin Brady (R-TX)) & representatives of the  TX, CA, NJ, OK and NC state medical societies


Bill to Require  Physicians to Prescribe Medications in Accordance to Guidelines Moves Forward in Assembly; Would Create a New Element of Professional Misconduct
Assembly Bill 2230, sponsored by Assemblyman Richard Gottfried, has moved to the Assembly floor for a vote.  This legislation requires health care professionals to order, prescribe, administer and dispense pain-relieving medications in accordance with professional standards and guidelines. The bill would provide limited protections for physicians from professional discipline and criminal liability for ordering, prescribing, and administering pain relieving medications in accordance with reasonable standards of care including an “accepted guideline”.  The definition of “accepted guideline”, under the proposed legislation, means a peer reviewed clinical practice guideline for pain management developed, as applicable, by a nationally-recognized health care professional or specialty association, or a nationally-recognized pain management association.  However, Assembly Bill  2230 establishes  a new element of professional misconduct for failure to adequately order, prescribe, administer or dispense pain-reliving medications or other treatments for the relief of pain in accordance with the reasonable standard of care of the health care practitioner’s profession, including an accepted guideline. This legislation would apply to all patients with pain.   The Medical Society of the State of New York is opposed to this measure.                                                                            (CLANCY, DEARS)


Final Opioid Prescribing Webinar on March 10th;  Registration is Now Open
The final webinar in the opioid series will be held on Thursday, March 10th at 7:30 a.m. Title of the program is “Treatment of Opioid Use Disorders”.   Physicians and other prescribers are encouraged to register for the remaining webinars  at this link.  Click on the upcoming tab and select the programs.

Physicians will need to register for each webinar; each webinar has different topics described below. Physicians and other prescribers are allowed to register up to ½ hour before the webinar.

The Medical Society of the State of New York, the New York State Office for Alcoholism and Substance Abuse Service and the NYS Department of Health’s Bureau of Narcotic Enforcement, 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”, faculty for the session will be Charles Argoff, MD and Charles Morgan, MD, FASAM, FAAFP, DABAM.   The educational objectives are:    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 disordershysicians and other prescribers can take one or all of the webinars. The Medical Society of the State of New York is accredited by the Accreditation Council for Continuing Medical Education (ACCME) to provide continuing medical education for physicians. The Medical Society of the State of New York designates this live activity for a maximum of 1.0 AMA/PRA Category 1 credits™. Physicians should claim only the credit commensurate with the extent of their participation in the activity.

Please contact Pat Clancy at pclancy@mssny.org or Terri Holmes at tholmes@mssny.org for further information.                                       (CLANCY, DEARS)


MSSNY’s Opioid Webinars are Now Available Through its CME Online Site
The Medical Society has archived its opioid webinar series on its continuing medical education website at http://cme.mssny.org.  The webinars that are currently on the site are:  Webinar 1 Pain Management at the Crossroads:  A Tale of Two Public Health Problems and Webinar 2   Rational Opioid Prescribing:  Is this Possible for Chronic Pain?  Physicians and other prescribers can earn up to one hour of continuing medical credits by viewing this webinar and completing the test.    The reminder of the webinars will be placed on line in the very near future. 

The MSSNY CME site requires new users to register, but once registered physicians and other health care providers will have a personalized training page to take the webinars and other course work located on the site.   New registrants to the site will 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 tool bar menu located at the top of the page and click on “My training” to view and take the various courses.    

MSSNY has over 50 programs at this site and physicians are able to earn continuing medical education credits for each course.  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 number of continuing medical education credits for these online programs vary, but the majority of the programs are for 1.0 AMA/PRA Category 1 credit.  Further information on all these programs may be obtained by contacting Pat Clancy at pclancy@mssny.org.            (CLANCY)


PTSD and TBI in Returning Veterans:  March – June Webinars
MSSNY will be holding a series of CME webinars on PTSD and TBI in returning veterans on eight dates listed below from March through June. The faculty presenters will be Frank Dowling, MD and Joshua Cohen, MD.

Course objectives:

  • Explore the two most prevalent mental disorders facing American veterans today, their causes, symptoms, and comorbidities
  • Outline treatment options including evidence-based psychotherapy and pharmacotherapy
  • Discuss barriers to treatment, including those unique to military culture, and how to overcome them
  • Outline the process of recovery and post-traumatic grow

To register for this webinar, click on a date below and fill out the registration form

Wednesday, March 9, 7:30-8:30 AM

Tuesday, Mach 22, 6-7 PM

Thursday, April 7, 6-7 PM

Tuesday, April 12, 7:30-8:30 AM

Thursday, May 5, 6-7 PM

Thursday, May 19, 7:30-8:30 AM

Thursday, June 2, 6-7 PM

Thursday, June 9, 7:30-8:30 AM


MSSNY to Conduct Medical Matters Webinar on Zika Virus on March 16, April Session on Ebola
The Medical Society, in conjunction with the New York State Department of Health will conduct a Medical Matters webinar on the  “Zika Virus: An Evolving Story” on March 16th at 7:30 a.m.   Registration for this program is now open at. Click hereClick on the upcoming tab and select the programs.

The educational objectives for this program are: 1) Describe the epidemiology of Zika Virus infection;

2) Understand the modes of transmission; 3) Understand how to advise patients; and 4) Learn methods for prevention of infection.  William Valenti, MD, chair of MSSNY’s Infectious Disease Committee, and Elizabeth Dufort, MD,  Medical Director, Division of Epidemiology from the New York State Department of Health will conduct this presentation.

The April session of Medical Matters will take place at the MSSNY House of Delegates and is entitled,

“Ebola: A Perspective from the Field”.  The program will be conducted by Dario Gonzalez, MD, FACEP, Associate Medical Director,  Fire Department City of New York/Office of Medical Affairs.  Dr. Gonzalez was deployed for nine weeks by Americares to Liberia, West Africa as part of the US response to the Ebola epidemic.  The program will be held on Thursday, April 14, 2016 at 2:00pm. Physicians may attend the session at the Westchester Marriott, 670 White Plains Road, Tarrytown, NY 10591 or by webinar.  Registration is now. Click here.  Click on the upcoming tab and select the program.

The educational objective is: Offer perspective and lessons learned from an individual who treated Ebola patients firsthand.

The May session will be “Radiological Emergencies”, this session will be held on May 18, 2016 at 7:30 AM. (Please note that this session was originally scheduled for March 16, 2016) Faculty for this session will be Cham Dallas, PhD.  Dr. Dallas is a professor in the Department of Health Policy and Management at the College of Public Health, University of Georgia.  He is also the Director of the Institute for Disaster Management at the University of Georgia and a Board Member of the National Disaster Life Support Foundation (NDLSF).  Dr. Dallas has a national/international reputation in toxicology and emergency preparedness and response, including over 30 years of experience.

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 contacting Melissa Hoffman at mhoffman@mssny.org.
(CLANCY, HOFFMAN)

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 jMcPartlon@mssny.org    

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MSSNY President Dr. Joseph Maldonado Quoted in Wall Street Journal Article on Looming E-Prescribing Deadline
In a Wall Street Journal article on Tuesday, Corinne Ramey reports that some medical institutions in New York are asking for more time to comply with a state law that will take effect on March 27th, requiring that all medications be prescribed electronically in order to cut down on drug abuse, errors, and fraud. Commenting on how the new policy will limit patients’ ability to shop for lower drug costs or take the prescription to another pharmacy, Medical Society of the State of New York President Joseph Maldonado stated, “The physician now has to deal with an angry patient, a belligerent patient or a patient that insists they want this in writing.” 


This Year’s Flu Vaccine Is 59% Effective, Preliminary Data Show
The CDC reported this week preliminary overall influenza effectiveness of 59 percent this year. Unlike last year, this year’s vaccine is a good match to the strains that make people sick. These data were presented at a meeting of the agency’s Advisory Committee for Immunization Practices (ACIP) in Atlanta. This finding is comparable to past estimates for seasons when most circulating flu viruses and vaccine viruses have been similar.

“This means that getting a flu vaccine this season reduced the risk of having to go to the doctor because of flu by nearly 60 percent,” said Joseph Bresee, M.D., chief of CDC’s Epidemiology and Prevention Branch. “It’s good news and underscores the importance and the benefit of both annual and ongoing vaccination efforts this season.”


CDC Study: HPV Infections Decline Among Teenage Girls
A CDC study published in the March issue of Pediatrics suggests that fewer US women are entering adulthood infected with HPV thanks to a vaccination program that began a decade ago. The study is the first to show falling levels of dangerous strains of the virus among American women in their early 20s. Girls between 14 and 19 years old saw infection rates on the four types of HPV covered by the Gardasil vaccine fall 64 percent from the rate prior to the vaccine’s introduction — from 11.5 percent in 2003-2006 to 4.3 percent between 2009 and 2012.


MSSNY Member Richard Lockwood, MD Named Vice President and Chief Medical Officer of Excellus BlueCross BlueShield Central New York Region
Excellus BlueCross BlueShield has named Richard Lockwood, M.D., vice president and chief medical officer of the company’s Central New York region. He replaces Marybeth McCall, M.D., who is now serving as vice president and chief medical officer of Excellus BlueCross BlueShield’s Utica region.

Lockwood has been vice president and chief medical officer of utilization management for Excellus BlueCross BlueShield since July 2015. He joined the company as a part-time associate medical director in 1999 and was named medical director for the company’s Central New York region in 2011.

In his professional career, Lockwood has been in private practice with Onondaga Hill Internists, Family Care Medical Group, Van Duyn Home and Hospital, Loretto, and Hill Haven Nursing Home, all in Syracuse. He has held the position of medical director at Iroquois Nursing Home, Jamesville, since 2005.

After graduating cum laude from Syracuse University and SUNY Downstate College of Medicine, Brooklyn, Lockwood completed his internship and residency in internal medicine at the Medical College of Pennsylvania in Philadelphia. He is a clinical instructor at SUNY Upstate Medical Center, Syracuse, and has hospital privileges at Upstate Medical University and Upstate University Hospital Community Campus, where he served as president of the medical staff prior to the hospital’s merger with Upstate Medical University.

A member of MSSNY since 1982, Dr. Lockwood is also a member of the Onondaga County Medical Society and American College of Physicians,  and is a Fellow of the American Board of Internal Medicine.


CMS Webinar on TCPI and CJR Programs
The New York City Regional Office of the Centers for Medicare & Medicaid Services will be hosting a webinar entitled “New Program Initiatives – Goals and Operations” on Tuesday, March 8, 2016, from 11:30 AM – 1:00 PM EST.  The programs that will be discussed along with a Q & A segment include:

  • Transforming Clinical Practice Initiative (TCPI) &
  • Comprehensive Joint Replacement Program (CJR)

The target audience is State Health and Trade Associations, Hospitals, Group, Specialty and Individual Physician Practices, and Ancillary providers (all provider types).

There is no charge to attend, but registration is required.  To register, click here 


Do You Have Expertise in Physician Stress and Burnout? We Need You!
At the 2015 House of Delegates of the Medical Society of the State of New York, a resolution was passed calling for action to address the prevalence of physician burnout.

We need your help!

We are looking to assemble the MSSNY team to tackle this work. This calls for physicians who have experience or expertise in designing or implementing physician health programs or stress/burnout programs for physicians. Please contact 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.


Physician Entrepreneurship: Transform the Future of Health Care
Interested in opportunities to impact medicine beyond your clinical practice? Join the AMA for an exclusive event to discuss how physicians are getting involved in and, indeed, helping to lead health care innovation.

A dynamic panel of physicians will share their perspectives, accomplishments and insights gleaned as they’ve developed new products, formed companies, advised start-ups and invested in innovative health care ventures.

WHEN: 7 p.m., Tuesday, March 1. Cocktails and hors d’oeuvres will be provided.

WHERE: Impact Hub NYC, 394 Broadway, New York, NY

Register today! Free for AMA members. Limited seating available. $500 for non-AMA members.


Poster Symposium Seeks Judges on April 15 in Tarrytown
If you’re coming to the House of Delegates in Tarrytown – or just live in the neighborhood – and are free on Friday afternoon, April 15, from 2 – 4 pm, please consider participating as a judge at the MSSNY Resident and Fellow Section Poster Symposium. It’s always an exciting, lively event! Please contact sbennett@mssny.org or 516-488-6100 extension 383 if you’re interested. Thank you.


CLASSIFIED

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February 19, 2016 – We Are NOT Burned Out or Stressed! We Are Fed Up!

drmaldonado PRESIDENT’S MESSAGE
 Dr. Joseph R.  Maldonado
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February 19, 2016
Volume 16, Number 7

Dear Colleagues:

We Are NOT Burned Out or Stressed!  We Are Fed Up!

Over the past year, we have all read headlines highlighting physician burnout and stress.

I have to admit that I have been advocating for greater physician awareness and attention to physician burnout and stress.  I have established a taskforce that seeks to address physician stress and burnout.  I have done so by trying to look at the stressors placed on our lives from an observer perspective.

From that perspective, one frames physician stress as a common phenomenon.  The observer perspective allows us to distance ourselves from the overwhelming stresses, identify them for others while framing those affecting us differently.  From an observer perspective, our stresses are manageable and we are always capable of effectively dealing with stresses.  We are, of course, different than those other doctors who have a difficult time effectively coping with their stresses.  For those physicians, we clearly need solutions for managing stress and burnout – or so we frame it to distance ourselves from “those” colleagues.

This week, I came to realize the fallacy of this framework.  Yes, there are physicians who are coping ineffectively with stress.  Some physicians do burn out. HOWEVER, there is something ABSOLUTELY WRONG about framing the stresses facing physicians in context of our coping abilities.  Such framing seems to make it perfectly acceptable and normal to pile stressor upon stressor upon stressor onto physicians.  Any failure of a physician to respond like Superman or Wonder Woman is viewed as weakness.

The failing is NOT the inability of physicians to merrily face the assaults on the profession.  The failing is in our buying into these assaults and stresses as part of what we bought into when we entered our profession.  We must stop accepting these assaults and must fight back!  We are not stressed!  We are not burnt out.  WE ARE FED UP AND HAVE HAD ENOUGH!

This is NOT what I bought into when I became a doctor.  It’s time we reframed this demoralization within our profession.  We must stand up and say, “The problem is not with my abilities to cope with stress or burnout.  The problem lies in the assaults on us and our profession!  Enough is Enough!  We will not continue to accept these assaults.  We will walk away before burning out.”

I’m MAD AS HELL AND I’M NOT GONNA TAKE THIS ANYMORE!

I’M GONNA GIVE SOME LEGISLATORS A PIECE OF MY MIND NEXT MONTH!

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.  If you plan to attend, please register here.

A full slate of legislators and top Administration officials will attend and 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 Majority Leader Joe Morelle and Senate Majority Leader John Flanagan have also agreed to attend the morning proceedings and Speaker Heastie has been invited to the event but has not yet confirmed his participation. A brief informal luncheon to which members of each House are invited to speak with their constituents will follow the morning program.   County Medical Societies will be scheduling appointments for physicians to meet with their elected representatives.

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


MSSNY Lobby Team to Conduct one more Pre-Lobby Day Webinar on Issues to be Discussed on March 8th
In advance of the Lobby Day, MSSNY DGA staff will offer one more morning briefing program so that you can hit the ground running on March 8th. The next briefing program will be held on Wednesday, February 24 from 7:30-8:30AM. If you and/or your colleagues wish to participate on this briefing session, please register by clicking onto the link below.

February 24 briefing session 7:30-8:30AM:
(DIVISION OF GOVERNMENTAL AFFAIRS)


Physicians Invited to Attend Fireside Chat With MSSNY President Dr. Joseph Maldonado and Troy Oechsner, Deputy Superintendent of Insurance and Donna Frescatore, Executive Director of the NY State of Health
On March 7th, the evening before MSSNY’s Lobby Day, Joseph Maldonado, Jr., MD, MSc, MBA, will conduct a “fireside chat” with Troy Oechsner, Deputy Superintendent at DFS and Donna Frescatore, Executive Director for the NY State of Health in the MSSNY office. This is a relaxed and fluid format in which Dr. Maldonado, Mr. Oechsner and Ms. Frascatore can discuss issues of concern to the medical community (network adequacy, action taken by Emblem Health to narrow its network,  the collapse of Health Republic, etc). Physicians are invited to be physically present at this event in the DGA offices located at Ste 408, One Commerce Building, in Albany or can engage in real time by emailing their questions during the LIVE webcast of the event. The program will run for one hour from 5:30-6:30PM on March 7th.  To register to attend the event, click onto this link:
(DIVISION OF GOVERNMENTAL AFFAIRS)


Why Physicians Need to Take a Day Away from Your Practice To Lobby Albany on March 8, 2016

  • Think you pay too much in malpractice insurance costs?  The Trial Bar doesn’t care. They have introduced legislation that will certainly increase your premium costs.
  • If you practice in the Capital District, Southern Tier, Central NY, or Western NY, New York State wants to take away your Excess Liability Insurance Coverage.
  • New York State wants to enable NPs to deliver care to injured workers and take away County Medical Society review of authorized physicians rather than fixing what ails the Workers’ Compensation system.
  • The Proposed NYS Budget does nothing to compensate physicians for the unpaid care they have provided to Health Republic insureds.
  • New York State wants to enable Walmart and Target to hire NPs to deliver care to the public to compete directly against you.
  • Patient health could be threatened by inappropriately expanding the scope of practice of countless non-physicians, including dentists, optometrists and psychologists.
  • We need to prevent insurers from offering patients narrow networks for Exchange plans and denying patient access to out of network physicians.

These are very real issues that are currently being discussed and will be resolved either in the State Budget which will be enacted by April 1st or before the end of Session on June 16th. You need to come to Albany, and speak with your elected officials so that they can hear your concerns. Otherwise, all they will hear are the perspectives of trial lawyers and insurance companies.

PLEASE JOIN YOUR COLLEAGUES FROM ACROSS THE STATE TO LOBBY YOUR ELECTED LEADERS IN PERSON IN ALBANY MARCH 8TH.
REGISTER HERE.
(DIVISION OF GOVERNMENTAL AFFAIRS)


Urge Your Legislators to Support Health Republic Guarantee Fund Legislation (S.6667/A.9311)
Assembly Health Committee Chair Richard Gottfried together with Assemblyman Charles Lavine (D-Nassau County) introduced legislation (A.9311) this week to establish a Guaranty Fund to help to assure the payment of the hundreds of millions that Health Republic owes physicians and hospitals across New York State, as well as to protect consumers and health care providers from future health plan insolvencies.  Identical legislation (S.6667, Valesky, with several co-sponsors) has been introduced in the State Senate.  Right now, New York is the only state in the country that does not have such a Guarantee Fund.  With the health insurance industry in strong opposition to this proposal, it is imperative that you urge your Senators and Assemblymembers to support this bill and include it as part of the State Budget currently under negotiation by sending a letter from 
here .

You must 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)


Please Complete Survey to Let Us Know What You Are Owed as a Result of Health Republic Debacle
MSSNY’s updated survey of outstanding Health Republic claims shows that, based upon results received, physicians are owed nearly $25,000,000.  However, we believe that far more physicians who have been adversely impacted have yet to respond.  As we continue our advocacy in support of a Guarantee or other special fund to pay for the unpaid claims as a result of the Health Republic demise, we need those of you who have not completed the survey to provide us with updated information regarding the amounts you are due from Health Republic.  To complete the survey, click hereThis data is critical to our advocacy efforts!   We need to obtain updated and more precise numbers from as many impacted physicians as possible since many legislators have asked us for this data.
 (AUSTER, DEARS)


Physicians Urged to Oppose Huge Cuts to Excess Medical Liability Insurance Program
Physicians are urged to continue to contact their legislators to object to a provision in the Executive Budget that would cause more than half of physicians to lose their Excess Medical Malpractice Insurance coverage.

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.  Absent meaningful liability reform, with verdicts and physician liability premiums continuing to be far out of proportion compared to the rest of the country, 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)


Physicians Urged to Oppose Adverse Workers’ Compensation Budget Proposal; 30-Day Amendments Bring Additional Concerns
All physicians must continue to contact their State Senators and Assemblymembers to express their strong opposition to sweeping Workers’ Compensation reform proposals contained in the Executive Budget.

MSSNY staff continues to meet with key legislative leaders and staff to voice its very serious concerns with Budget proposals that would:

  • Enable treatment of injured workers and direct payment for care by various non-physicians without clarity as to: how non-physicians treating patients with serious health conditions will coordinate patient care delivery when specialized care is needed; 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;
  • Expand the circumstances when a physician or other health care provider can have their authorization removed and empowers the Board to impose significant fines on a physician or any other Board-authorized health care provider for violating a Workers Compensation rule;
  • Remove 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.
  • Reduce choice for injured workers by prohibiting in many instances an injured worker from seeking medical treatment from outside a Workers Compensation PPO before 120 days after his or her first visit to a PPO provider;
  • Remove the requirement for a referral by a physician for an injured worker as a pre-condition to receive psychological care;

In the 30-day Executive Budget amendments released last weekend, the proposal was made even more adverse by a) requiring all physicians and other currently authorized WC providers to execute an “authorization agreement” with the Board (as of now, it is unclear what would be contained within such “authorization agreement”) within 12 months of the effective date of the proposal, if it were to be enacted; and b) removing the ability of professional associations, such as MSSNY, to recommend arbitrators to resolve medical fee disputes between health care providers and carriers.

Exacerbating these concerns is that the proposal also does not meaningfully address the many excessive administrative hassles and payment delays that have caused many physicians to be unable to 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 carriers, the Budget proposals if enacted could further chase physicians away from the program.

MSSNY has also reached out to labor organizations and associations representing attorneys for injured workers to coordinate its advocacy in opposition.  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)


MSSNY President Appears on News Program to Urge Passage of Legislation to Enable Override of Insurer “Fail First” Medication Policies
Concerned about health insurer policies that require your patients to “fail first” on certain prescription medications before they are able to take the medication that you believe is most medically appropriate to improve their health?  MSSNY is working together with a number of patient advocacy groups in support of legislation (A.2834-A, Titone/S.3419-A, Young) to provide physicians with an expeditious manner to override an insurer “fail first” policy when it is in the best interest of their patients’ health.  To send a letter in support of this legislation click here.   This week, MSSNY President Dr. Joseph Maldonado appeared on the YNN Statewide news program Capital Tonight along with Matthew Shapiro of the National Alliance on Mental Illness’ Matthew Shapiro to discuss the importance of the legislation.  To watch the broadcast, click here.(AUSTER, DEARS)


Please Advocate for Due Process Rights When Physicians are Non-Renewed by a Health Insurer
Physicians are urged to contact their legislators to support a bill (A.1212, Lavine/S.4751, Hannon) 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.  To send a letter in support of this legislation here.  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 allegations of failure to transition to value-based payments, severing patient treatment relationships for countless patients.  MSSNY has strenuously urged to the Department of Financial Services, Department of Health, and Attorney General that these physicians be given a fair opportunity to be reinstated, and have shared this information with the entire New York State Legislature. (See MSSNY letter to DFS here.   The Attorney General’s office continues to investigate specific complaints raised by individual physicians whether they were given a fair chance to appeal these non-renewals.
 (AUSTER, DEARS)


To Physicians in Long Island, NYC, Hudson Valley, and Capital District:  Please Complete this Survey
State and federal regulators are very interested in knowing the prospective effects of these possible mergers on your practice and patient care.   In this regard, MSSNY working together with the American Medical Association Advocacy Resource Center have developed a survey seeking physician input on the potential impact on these proposed mergers.

Last fall, the AMA released a report articulating the significant potential anticompetitive effects that would occur in numerous regions all across the country as a result of this merger.  Among the identified regions of concern in New York State were Long Island, New York City, the Hudson Valley, the Capital District and the Glens Falls area.  Therefore, physicians practicing in these regions are asked to complete the Survey! 


Opioid Prescribing Webinar on Feb 23rd; Registration is Now Open
Registration is on-going for the third webinar in the opioid series which will be held Tuesday, February 23rd at 7:30 a.m. Title of the program is “Treatment of Opioid Use Disorders”.   Physicians and other prescribers are encouraged to register for the remaining webinars  at the this link.

Click on the upcoming tab and select the programs.

Physicians will need to register for each webinar; each webinar has different topics described below. Physicians and other prescribers are allowed to register up to ½ hour before the webinar.

The Medical Society of the State of New York, the New York State Office for Alcoholism and Substance Abuse Service and the NYS Department of Health’s Bureau of Narcotic Enforcement, 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”.  Faculty for the session will be Jeffrey Selzer, MD and the educational objective:  Describe potential for patient addiction, screening, diagnosis and subsequent treatment or referral.

The fourth webinar will be held on 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.

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

Please contact Pat Clancy at pclancy@mssny.org or Terri Holmes at tholmes@mssny.org for further information.                                        (CLANCY, DEARS)


MSSNY Continues Work to Address Disparities in Health Care
MSSNY’s Committee to Eliminate Health Care Disparities met this Friday, February 19th, and hosted Kyle Ishmael, the Executive Director of the Black, Puerto Rican, Hispanic and Asian Legislative Caucus. Mr. Ishmael spoke at length on the background of the Caucus and its legislative priorities outlined in the Caucus’ 2016-17 People’s Budget.

As budget season progresses, MSSNY hopes to collaborate with the Caucus and develop synergies to address health care disparities among minority populations. With a wide variety of illnesses and ailments disproportionately affecting minority populations, MSSNY remains diligent in its efforts to address these disparities and committed to attracting members of minority populations to the practice of medicine. A special thanks to Kyle Ishmael and the Black, Puerto Rican, Hispanic and Asian Legislative Caucus.
(MCPARTLON)


MSSNY to Conduct Medical Matters Webinar on Zika Virus on March 16, April Session on Ebola
The Medical Society, in conjunction with the New York State Department of Health will conduct a Medical Matters webinar on the  “Zika Virus: An Evolving Story” on March 16th at 7:30 a.m.  
Registration for this program is now open.

Click on the upcoming tab and select the programs.

The educational objectives for this program are: 1) Describe the epidemiology of Zika Virus infection;

2) Understand the modes of transmission; 3) Understand how to advise patients; and 4) Learn methods for prevention of infection.  William Valenti, MD, chair of MSSNY’s Infectious Disease Committee, and physicians from the New York State Department of Health will conduct this presentation.  Further information will be available shortly.

The April session of Medical Matters will take place at the MSSNY House of Delegates and is entitled,

“Ebola: A Perspective from the Field”.  The program will be conducted by Dario Gonzalez, MD, FACEP. Associate Medical Director,  Fire Department City of New York/Office of Medical Affairs.  Dr. Gonzalez was deployed for nine weeks by Americares to Liberia, West Africa as part of the US response to the Ebola epidemic.  The program will be held on Thursday, April 14, 2016 at 2:00pm. Physicians may attend the session at the Westchester Marriott, 670 White Plains Road, Tarrytown, NY 10591 or by webinar.  Registration is now open.

Click on the upcoming tab and select the program.

The educational objective is: Offer perspective and lessons learned from an individual who treated Ebola patients firsthand.

The May session will be “Radiological Emergencies”, this session will be held on May 18, 2016 at 7:30 AM. (Please note that this session was originally scheduled for March 16, 2016) Faculty for this session will be Cham Dallas, PhD.  Dr. Dallas is a professor in the Department of Health Policy and Management at the College of Public Health, University of Georgia.  He is also the Director of the Institute for Disaster Management at the University of Georgia and a Board Member of the National Disaster Life Support Foundation (NDLSF).  Dr. Dallas has a national/international reputation in toxicology and emergency preparedness and response, including over 30 years of experience.

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 contacting  Melissa Hoffman at mhoffman@mssny.org.                                                      
(CLANCY, HOFFMAN)
 


PTSD and TBI in Returning Veterans: March – June Webinars
MSSNY will be holding a series of CME webinars on PTSD and TBI in returning veterans on eight dates listed below from March through June. The faculty presenters will be Frank Dowling, MD and Joshua Cohen, MD.

Course objectives:

  • Explore the two most prevalent mental disorders facing American veterans today, their causes, symptoms, and comorbidities;
  • Outline treatment options including evidence-based psychotherapy and pharmacotherapy;
  • Discuss barriers to treatment, including those unique to military culture, and how to overcome them;Outline the process of recovery and post-traumatic grow. 

To register for this webinar, click on a date below and fill out the registration form

Wednesday, March 9, 7:30-8:30 AM

Tuesday, Mach 22, 6-7 PM

Thursday, April 7, 6-7 PM

Tuesday, April 12, 7:30-8:30 AM

Thursday, May 5, 6-7 PM

Thursday, May 19, 7:30-8:30 AM

Thursday, June 2, 6-7 PM

Thursday, June 9, 7:30-8:30 AM

(ELPERIN, DEARS)

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 jMcPartlon@mssny.org    


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Do You Have Expertise in Physician Stress and Burnout? We Need You!
At the 2015 House of Delegates of the Medical Society of the State of New York, a resolution was passed calling for action to address the prevalence of physician burnout.

We need your help!

We are looking to assemble the MSSNY team to tackle this work. This calls for physicians who have experience or expertise in designing or implementing physician health programs or stress/burnout programs for physicians. Please contact 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.


CDC Report: New Yorkers and Others Not Getting Enough Sleep
The CDC released a report revealing that about one-third of adults in the US appear to be getting insufficient sleep. Prevalence of healthy sleep duration varied among states and ranged from 56.1% in Hawaii to 71.6% in South Dakota (Table 2). Most of the Great Plains states were in the upper quintile for healthy sleep duration; states in the southeastern United States and along the Appalachian Mountains tended to be in the lower quintiles (Figure). After surveying some 444,000 US adults in 2014, the CDC “also found that while two-thirds of white people nationally got enough sleep, only about half of blacks, Native Hawaiians and Pacific Islanders did.”

In New York, 61.6-63.2 % of age-adjusted percentage of adults reported ≥7 hours sleep per 24-hour period.


Humana Fined $500,000 for Discriminating Against AIDS /HIV Patients
The Florida Office of Insurance Regulation (FOIR) announced this week that it had concluded its market examination of Humana and fined the health insurer $500,000 for failing to cooperate with investigators. In a consent order dated February 16, 2016, Humana agreed to “maintain procedures to ensure that it does not by effect or design treat people living with HIV/AIDS less favorably than any other condition.”

In 2014, The AIDS Institute and NHeLP filed a complaint with the U.S. Department of Health and Human Services’ Office for Civil Rights (OCR) charging four Florida health plans, including Humana, with unlawful discrimination against people living with HIV and AIDS by placing all HIV medications, including generics, on the highest cost sharing tier, thus requiring enrollees to pay as much as 50 percent co-insurance for every HIV drug. In the complaint, the groups contend that such practices discourage people with HIV/AIDS from enrolling in the plans and violate the Affordable Care Act’s (ACA) non-discrimination provisions. The ACA bans plans from discriminating against individuals based upon disability and prohibits them from discouraging enrollment by people with significant health needs.

Last year, HHS issued guidance to all plans nationwide informing them that such practices are discriminatory; and in proposed regulations implementing the ACA’s non-discrimination provision, Section 1557, HHS made clear that plan benefits cannot be designed to discriminate. However, OCR has yet to issue a ruling on the complaint.

The AIDS Institute’s analysis of Florida’s 2016 qualified health plans found that coverage for nearly all Hepatitis B and C drugs by several insurers remains subject to high co-insurance levels. Humana places almost all Hepatitis C drugs on Tier 5, which translates into coinsurance of either a 40 or 50 percent of drug cost, after the patient pays a $3,800 deductible. Aetna and CoventryOne place all Hepatitis C drugs and almost all hepatitis B drugs on Tiers 4 and 5, which carry coinsurance of 40 percent and 50 percent of drug cost, after a $2,750 deductible.


Young Adults on Adderall: Dramatic Increase in Emergency Room Visits
A study published online Feb. 16 in the Journal of Clinical Psychiatry indicates that “incidences of misuse and emergency room visits related to Adderall increased dramatically for young adults between 2006 and 2011.” Researchers arrived at this conclusion after examining data from the “National Disease and Therapeutic Index, a survey of office-based practices; National Survey on Drug Use and Health, a population survey of substance use; and Drug Abuse Warning Network, a survey of hospital emergency department visits.”


Medical School Deans Promote Three-Year Medical Degree
In an opinion piece in the Wall Street Journal (2/18, A11), dean and CEO Robert I. Grossman, MD, and vice dean for education, faculty, and academic affairs Steven B. Abramson, MD, of New York University’s Langone Medical Center and the NYU School of Medicine, write in favor of the three-year medical degree instead of the traditional four-year path as a way to save students money and help medical education adapt to the needs of the current century.


CA Hospital Pays “Ransomware”
Hollywood Presbyterian Medical Center paid a ransom in bitcoins equivalent to about $17,000 to hackers who infiltrated and disabled its computer network, the hospital’s chief executive said Wednesday. It was in the hospital’s best interest to pay the ransom of 40 bitcoins after the hacking that began Feb. 5, the C.E.O., Allen Stefanek said. The F.B.I. is investigating the attack, often called “ransomware,” in which hackers encrypt a computer network’s data to hold it hostage, providing a digital decryption key to unlock it for a price. “The quickest and most efficient way to restore our systems and administrative functions was to pay the ransom and obtain the decryption key,” Mr. Stefanek said. Bitcoins, an online currency, are hard to trace. The Los Angeles hospital network was operating fully again Monday, and patient care was not affected by the hacking, Mr. Stefanek said. 


CMS Plans to Correct Attestation System to Allow EPs to Claim an Exclusion for Measure 1 of the Patient Electronic Access Objective
The Centers for Medicare & Medicaid Services (CMS) will shut down the Medicare & Medicaid EHR Incentive Program Registration and Attestation System on Sunday, February 21, 2016, between 6:00 a.m. and 10:00 a.m. EST, to correct an error that is preventing eligible professionals (EPs) from claiming an exclusion for Measure 1 of the Patient Electronic Access Objective (referred to as 8A in the attestation system).

  • Patient Electronic Access, Measure 1 Exclusion: Any EP who neither orders nor creates any of the information listed for inclusion as part of the measures except for ‘Patient Name’ and ‘Provider’s name and office contact information.

EPs whose attestation was rejected as a result of not meeting objective 8 may modify and resubmit their attestation information after February 21, 2016. EPs who have successfully attested to the EHR Incentive Programs 2015 requirements do not need to take any action.

Batch attestation users who have not yet submitted their files will also need to wait to submit their data until after February 21. To successfully upload a batch attestation with this exclusion, please ensure the batch files include a Y/N indicator for each provider record on the file. Users who have already submitted a batch attestation file for the 2015 program year do not need to resubmit.

For More Information

Visit the CMS website or contact the EHR Information Center Help Desk at (888) 734-6433/ TTY: (888) 734-6563. The hours of operation are Monday through Friday between 7:30 a.m. and 6:30 p.m. EST.


CLASSIFIED

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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.


Jerome I. Sager – Attorney at Law
The health care law experts representing medical professionals for more than 25 years.  See us for Professional Medical Conduct Defense, Medicaid and Medicare Fraud Cases, DEA and Controlled Substance Issues, Third party insurance issues. 212-685-2333 / 917-312-6631, jeromesager@cs.com.



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

February 12, 2016 – NY Doctors Are Under Attack

drmaldonado PRESIDENT’S MESSAGE
 Dr. Joseph R.  Maldonado
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February 12, 2016
Volume 16, Number 6

Dear Colleagues:

THE DOCTORS OF NEW YORK ARE UNDER ATTACK—the likes of which we have not seen since the malpractice crisis of 1975. AT that time, we joined together and did the impossible—we created our own malpractice insurance company!

This time, the assault comes in the form of the change to the date of discovery and extension of the statute of limitations as well as the cut in the excess liability program.

The net effect of passage of these efforts will be a 30% increase in malpractice premiums. Is there any doctor in New York who can stay in practice with such an increase?

It is imperative that you be in Albany on March 8— if we stand any chance to stop this assault on our profession.

If that is not enough, consider the loss of millions of dollars to doctors from the Health Republic debacle, the radical changes in methodology through the DSRIP and SCHIP initiatives and the mounting efforts to kick doctors off insurance networks.

The events in this legislative session are going to radically change the practice of medicine in New York.

This year’s issues are of critical importance to YOU.

The outcome will change the ability of many physicians to remain in practice.

Last year, 15,000 teachers marched on Albany to demand their rights. Do teachers care more about their profession than we care about ours?

A lot of doctors feel it is someone else’s responsibility. This year, it is YOUR responsibility.

We will NOT have a second opportunity to turn this situation around.

Every physician in NY who is not engaged in emergency care must be in Albany on March 8 to lobby their legislators.

BE there –it’s YOUR FUTURE!

We cannot afford to allow the trial lawyers to expand the statute of limitations to 10 years.

We cannot afford physicians to lose millions of dollars in the Health Republic fiasco.

We cannot afford to lose the excess layer of coverage.

We cannot afford to have physicians excluded from insurance plans.

YOU MAY THINK YOU CANNOT AFFORD TO TAKE A DAY OFF TO COME TO ALBANY ON LOBBY DAY! But I can assure you that you will NOT be able to afford to stay in practice if you stay home.

NEXT YEAR MAY BE TOO LATE!

REGISTER NOW!

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.  If you plan to attend, please register here.

A full slate of legislators and top Administration officials will attend and 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 Majority Leader Joe Morelle and Senate Majority Leader John Flanagan have also agreed to attend the morning proceedings and Speaker Heastie has been invited to the event but has not yet confirmed his participation. A brief informal luncheon to which members of each House are invited to speak with their constituents will follow the morning program.   County Medical Societies will be scheduling appointments for physicians to meet with their elected representatives.

It is imperative for physicians to attend 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.   http://goo.gl/forms/Mw7CX8JfzL      
(DIVISION OF GOVERNMENTAL AFFAIRS)
 


MSSNY Lobby Team to Conduct Pre-Lobby Day Webinars on Issues to be Discussed on March 8th
In advance of the Lobby Day, MSSNY DGA staff will offer two morning briefing programs so that you can hit the ground running on March 8th. Those briefing programs will be held on Tuesday, February 16 from 8:00-9:00AM and on Wednesday, February 24 from 7:30-8:30AM.

If you and/or your colleagues wish to participate on either of these briefing sessions, please register by clicking onto the appropriate link below.

February 16 briefing session: 8:00-9:00AM:

https://mssny.webex.com/mssny/k2/j.php?MTID=t20bd638fa04191a6a1ef419b97ccf6ec 

February 24 briefing session 7:30-8:30AM:

https://mssny.webex.com/mssny/k2/j.php?MTID=t93c8681382ad535070e436984c4e19ce
(DIVISION OF GOVERNMENTAL AFFAIRS) 


Physicians Invited to Attend Fireside Chat with MSSNY President Dr. Joseph Maldonado and Troy Oechsner, Deputy Superintendent of Insurance and Donna Frescatore, Executive Director of the NY State of Health
On March 7th, the evening before MSSNY’s Lobby Day, Joseph Maldonado, Jr., MD, MSc, MBA, will conduct a “fireside chat” with Troy Oechsner, Deputy Superintendent at DFS and Donna Frescatore, Executive Director for the NY State of Health in the MSSNY office. This is a relaxed and fluid format in which Dr. Maldonado, Mr. Oechsner and Ms. Frascatore can discuss issues of concern to the medical community (network adequacy, action taken by Emblem Health to narrow its network,  the collapse of Health Republic, etc). Physicians are invited to be physically present at this event in the DGA offices located at Ste 408, One Commerce Building, in Albany or can engage in real time by emailing their questions during the LIVE webcast of the event.  To View this event CLICK HERE.  The program will run for one hour from 5:30-6:30PM on March 7th.
(DIVISION OF GOVERNMENTAL AFFAIRS) 

Why Physicians Need to Take a Day Away from Your Practice To Lobby Albany on March 8, 2016
Think you pay too much in malpractice insurance costs?  The Trial Bar doesn’t care. They have introduced legislation that will certainly increase your premium costs.

  • If you practice in the Capital District, Southern Tier, Central NY, or Western NY, New York State wants to take away your Excess Liability Insurance Coverage.
  • New York State wants to enable NPs to deliver care to injured workers and take away County Medical Society review of authorized physicians rather than fixing the broken Workers Compensation system.
  • The Proposed NYS Budget does nothing to compensate physicians for the unpaid care they have provided to Health Republic insureds.
  • New York State wants to enable Walmart and Target to hire NPs to deliver care to the public to compete directly against you.
  • Patient health could be threatened by inappropriately expanding the scope of practice of countless non-physicians, including dentists, optometrists and psychologists.
  • We need to prevent insurers from offering patients narrow networks for Exchange plans and denying patient access to out of network physicians.

These are very real issues that are currently being discussed and will be resolved either in the State Budget which will be enacted by April 1st or before the end of Session on June 16th. You need to come to Albany, and speak with your elected officials so that they can hear your concerns. Otherwise, all they will hear are the perspectives of trial lawyers and insurance companies.


PLEASE JOIN YOUR COLLEAGUES FROM ACROSS THE STATE TO LOBBY YOUR ELECTED LEADERS IN PERSON IN ALBANY MARCH 8THREGISTER HERE.
 (DIVISION OF GOVERNMENTAL AFFAIRS)


Contact Your Legislators to Support a Health Republic Guarantee Fund (S.6667)
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 to cover these costs as part of the State Budget process.

Senator David Valesky (D-Onondaga County) has introduced legislation (S.6667) to create such a Guarantee Fund.  The bill is co-sponsored by Senators Tony Avella (D-Queens), David Carlucci (D-Rockland County), Marc Panepinto (D-Erie County) and Diane Savino (D-Richmond County).  It is anticipated that similar legislation will be introduced in the Assembly shortly.

To read MSSNY’s memo in support of a Guarantee Fund, click here.

You must 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)


Please Complete Survey to Let Us Know What You Are Owed as a Result of Health Republic Debacle
As MSSNY continues its advocacy in support of a special fund to pay for the unpaid claims as a result of the Health Republic demise, we need you to take the time to complete a MSSNY survey to provide us with updated information regarding the amounts you are due from Health Republic.  To complete the survey, click here: https://www.surveymonkey.com/r/HRepublic2This data is critical to our advocacy efforts!  We thank the many of you who provided data in November detailing the amounts you are owed, but we need to obtain updated and more precise numbers since many legislators have asked us for this data.
(AUSTER, DEARS)

Physicians Urged to Oppose Huge Cuts to Excess Medical Liability Insurance Program
Physicians are urged to continue to contact their legislators (http://cqrcengage.com/mssny/app/onestep-write-a-letter?0&engagementId=161374) to object to a provision in the Executive Budget that would cause more than half of physicians currenty enrolled to lose their Excess Medical Malpractice Insurance coverage.     

MSSNY has expressed its strong opposition to these cuts in numerous meetings with Senators and Assemblymembers and in testimony to the Assembly Ways & Means and Senate Finance Committees.   To read MSSNY’s memo in opposition, click 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.  Absent meaningful liability reform, with verdicts and physician liability premiums continuing to be far out of proportion compared to the rest of the country, 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)


Tell Your Legislators to Reduce Your Liability Costs, Not Expand Them!
All physicians must continue to contact their legislators to urge that they oppose legislation (A.285-A, Weinstein/S.6596, DeFrancisco) 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.   

You need to tell your legislators that no liability increases can be tolerated.  MLMIC’s estimate is that this bill could increase physician liability premiums by nearly 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%.   Please tell your legislators to enact comprehensive liability reform to bring down these costs, not legislation that increases them!                                                                                  (AUSTER, DEARS) 


Physicians Urged to Continue to Oppose Adverse Workers Compensation Budget Proposal
All physicians should continue to contact their State Senators and Assemblymembers to express their strong opposition to sweeping Workers’ Compensation reform proposals contained in the Executive Budget.

MSSNY staff continues to meet with key legislative leaders and staff to voice its very serious concerns with Budget proposals that would:

  • Enable treatment of injured workers and direct payment for care by various non-physicians without clarity as to: how non-physicians treating patients with serious health conditions will coordinate patient care delivery when specialized care is needed; 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;
  • Expand the circumstances when a physician or other health care provider can have their authorization removed and empowers the Board to impose significant fines on a physician or any other Board-authorized health care provider for violating a Workers Compensation rule;
  • Remove 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.
  • Reduce choice for injured workers by prohibiting 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 PPO provider;
  • Remove the requirement for a referral by a physician for an injured worker as a pre-condition to receive psychological care;

Exacerbating these concerns is that the proposal also does not meaningfully address the many excessive administrative hassles and payment delays that have caused many physicians to be unable to 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 carriers, the Budget proposals if enacted could further chase physicians away from the program.

MSSNY has also reached out to labor organizations and associations representing attorneys for injured workers to coordinate its advocacy in opposition.  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) 


Please Urge Support for Legislation 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 strenuously urged to the Department of Financial Services, Department of Health, and Attorney General that these physicians be given a fair opportunity to be reinstated, and have shared this information with the entire New York State Legislature. (See MSSNY letter to DFS here.

A.1212 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)


Urge Your Legislators to Pass Legislation to Override Insurer “Fail First” Medication Policies
Concerned about insurer policies that require your patients to “fail first” on certain prescription medications before they are able to take the medication that you believe is most medically appropriate to improve their health?  MSSNY is working together with a number of patient advocacy groups in support of legislation (A.2834-A, Titone/S.3419-B, Young) to provide physicians with an expeditious manner to override an insurer “fail first” policy when it is in the best interest of their patients’ health.  To send a letter in support of this legislation click here.  To read an op-ed in the Albany Times-Union from earlier this week from Mental Health Association CEO Glenn Liebman articulating the need for this legislation, click here. (TU password required).
(AUSTER, DEARS) 


Third Webinar on Opioid Prescribing to be Held Feb 23rd; Registration Is Now Open
The third webinar in the opioid series will be held Tuesday, February 23rd at 7:30 a.m. Physicians and other prescribers are encouraged to register for the entire webinar series at this link.

Click on the upcoming tab and select the programs.

Physicians will need to register for each webinar; each webinar has different topics described below. Physicians and other prescribers are allowed to register up to ½ hour before the webinar.

The Medical Society of the State of New York, the New York State Office for Alcoholism and Substance Abuse Service and the NYS Department of Health’s Bureau of Narcotic Enforcement, 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”.  Faculty for the session will be Jeffrey Selzer, MD and the educational objective:  Describe potential for patient addiction, screening, diagnosis and subsequent treatment or referral.

The fourth webinar will be held on 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.

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.
(CLANCY, DEARS) 


To Physicians In Long Island, NYC, Hudson Valley, and Capital District: Please Complete This Survey Regarding Impact of Proposed Cigna-Anthem Merger
As many physicians know, Anthem, the parent of Empire Blue Cross/Blue Shield, has filed paperwork to acquire CIGNA.   MSSNY has written to the New York State Department of Financial Services and Attorney General’s office to express its concerns about the impact to patient care as a result of further health insurer consolidation.

State and federal regulators are very interested in knowing the prospective effects of these possible mergers on your practice and patient care.   In this regard, MSSNY working together with the American Medical Association Advocacy Research Center have developed a survey seeking physician input on the potential impact on these proposed mergers.

Last fall, the AMA released a report articulating the significant potential anticompetitive effects that would occur in numerous regions all across the country as a result of this merger.  Among the identified regions of concern in New York State were Long Island, New York City, the Hudson Valley, the Capital District and the Glens Falls area.  Therefore, physicians practicing in these regions are asked to complete the Survey!
(AUSTER) 


Influenza Declared Prevalent in New York State Requiring Unvaccinated Health Care Workers to Wear Masks
On Thursday, New York State Health Commissioner Dr. Howard Zucker declared influenza prevalent in New York State, subsequently requiring health care workers who are not vaccinated against influenza to wear surgical or procedure masks in areas where patients are typically present.

In a statement Dr. Zucker reasoned, “Health care workers play a vital role in containing the spread of the flu…Although flu shots are a safe and effective way to reduce the risk for flu, not all health care workers choose to get vaccinated. By requiring those who are unvaccinated to wear masks when they’re around patients, we’re doing what we can to protect the most vulnerable.”

So far this year the flu has been confirmed in 44 counties and all five boroughs of New York City, along with 817 flu-related hospitalizations.

More information about influenza and NYS’ monitoring techniques can be found here.
(MCPARTLON) 

NYS DOH to Conduct Webinar Update on Zika Virus
New York State Department of Health will be offering a session of the ‘Zika Virus Webinar: an Update for Healthcare Providers’ on Wednesday February 17th, 2016 at noon. This webinar will provide updated guidance on Zika virus and review Zika virus testing eligibility, processes, and interpretation of results The webinar is being offered again to provide clinicians with another opportunity to join. Additionally, the webinar will be posted on the NYSDOH website.

Zika Virus Webinar: An Update on New Guidance and Testing for New York State Healthcare Providers

Time: 12-1pm; Presenter: Elizabeth Dufort, MD, FAAP, Medical Director, Division of Epidemiology, New York State Department of Health.
Registration
(CLANCY)


MSSNY to Sponsor Free CME Webinar On Public Health Preparedness on Feb. 17th
Public Health Preparedness 101 will be the topic of MSSNY’s Medical Matters webinar on Wednesday, February 17, 2016 with. Kira Geraci-Ciardullo, MD, MPH and Arthur Cooper, MD, MS serving as faculty.  This program is designed to help physicians and staff on how to prepare professionally and personally for a public health emergency.  The program will begin at 7:30 a.m.   Registration is now open to physicians and other public health officials:.

Go to training session and click on the upcoming sessions tab.

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)

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 jMcPartlon@mssny.org    

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DOH Commissioner Zucker: Flu Prevalent in New York
On February 11, State health commissioner Dr. Howard Zucker declared flu prevalent in New York State, meaning all health care workers who are not vaccinated must wear surgical masks when dealing with patients. The flu virus has been found in 44 counties and all five boroughs of New York City, according to the state health department. There have been no flu-related deaths so far this season.   “Health care workers play a vital role in containing the spread of the flu,” Dr. Zucker said. “Although flu shots are a safe and effective way to reduce the risk for flu, not all health care workers choose to get vaccinated. By requiring those who are unvaccinated to wear masks when they’re around patients, we’re doing what we can to protect the most vulnerable, which includes the sick and the elderly.”

So far this season in New York, 817 flu-related hospitalizations have been reported, and no reports of pediatric deaths from flu. Over the last three seasons, there have been 26 pediatric flu deaths in New York and an average of 9,966 flu-related hospitalizations each season.


New Cases of Hepatitis C  Increasing In NYC
The number of New York City residents newly diagnosed with chronic hepatitis C increased to 7,691 in 2014, a 13 percent jump from 2013 and the most new cases the city has seen since 2011.” According to a new report from the city’s health department “an estimated 146,000 New Yorkers over the age of 20 – 2.4 percent of that population – have hepatitis C.” According to the report, “an estimated 146,000 New Yorkers over the age of 20 – 2.4 percent of that population – have hepatitis C.  Bedford-Stuyvesant and Crown Heights lead the city in new HIV infections, according to data.


Travel Alerts on Zika Virus
The CDC has issued a Health Advisory on Zika Virus infections for returning travelers from Central America, South America, the Caribbean, and Mexico. The CDC has also issued a Level 2 Travel Advisory for those same areas. For maps of the latest affected areas, visit the websites for the Center for Disease Control and Prevention (CDC) and the Pan American Health Organization (PAHO).
·       Health Advisory: Zika Virus Testing Process – February 9, 2016 (PDF, 112KB)
Two additional cases of Zika virus infections have been identified in Suffolk County, bringing the statewide total to 12 cases. On February 11, the CDC reported that two women who contracted the Zika virus while traveling out of the country miscarried after returning home. The virus was later found in the placentas.


Gov. Cuomo Proposes Extending Confidentiality for Minors with HIV
The New York Times (2/11) reports, “A new proposal from Gov. Andrew M. Cuomo’s office seeks” to extend “to minors the confidentiality that is already given to them for the treatment of other sexually transmitted infections.” Currently, minors in New York “generally cannot be treated or get medication to prevent its transmission without parental consent,” which physicians “say can deter minors from seeking help.” In 2013, “only 48 percent of HIV-positive people aged 13 to 24 in New York took medications that reduced their virus levels to very low levels, compared with the overall statewide rate of 63 percent, the governor’s office said.”


Do You Want to Be on IPA Task Force? Looking for Leaders Successful Models
Do You Have Expertise in Physician Stress and Burnout? We Need You!

At the 2015 House of Delegates of the Medical Society of the State of New York, a resolution was passed calling for action to address the prevalence of physician burnout.

We need your help!

We are looking to assemble the MSSNY team to tackle this work. This calls for physicians who have experience or expertise in designing or implementing physician health programs or stress/burnout programs for physicians. Please contact 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.



Physician Entrepreneurship: Transform the Future of Health Care.

Interested in opportunities to impact medicine beyond your clinical practice? Join the AMA for an exclusive event to discuss how physicians are getting involved in and, indeed, helping to lead health care innovation.

A dynamic panel of physicians will share their perspectives, accomplishments and insights gleaned as they’ve developed new products, formed companies, advised start-ups and invested in innovative health care ventures.

WHEN: 7 p.m., Tuesday, March 1. Cocktails and hors d’oeuvres will be provided.

WHERE: Impact Hub NYC, 394 Broadway, New York, NY
Register today! Free for AMA members. Limited seating available. $500 for non-AMA members.


Opinion: Repealing Certificate-Of-Need Laws Will Improve Healthcare in NY
Nathan Nascimento, director of state initiatives at Freedom Partners Chamber of Commerce, wrote an opinion piece for the Buffalo (NY) News (2/6) arguing that the states outdated laws and regulations, “including New York’s decades old certificate-of-need laws,” are contributing to the “troubling trend” of “rising costs and fewer choices in health care.” Nascimento concluded that “for the sake of New Yorkers, all of whom deserve access to the best and most affordable health care, state legislators in Albany should start 2016 by cutting the red tape blocking the door to the doctor’s office.” Adopted in 1966, it requires New York health care providers to obtain permission from the Department of Health before adding new medical equipment, opening a new facility, expanding a current practice or even relocating.

“In practice, certificate-of-need laws drive up costs and deprive people of more health care choices. It requires reams of paperwork – forcing health care providers to satisfy bureaucrats over their patients. This is all in addition to other licenses and training requirements physicians face. Although 14 states have repealed their own versions of these laws, New Yorkers continue to deal with the negative impact of this red tape.

When health care providers submit their applications for a certificate, competitors are often invited to weigh in, and frequently succeed in blocking the certificate from being granted. In fact, practicing physicians and hospital representatives even sit on many state certificate-of-need boards, regulating the very industry in which they work.


NY Presbyterian and Northwell Run Super Bowl Ads
Crain’s New York Business (2/5) reports that “rivals New York-Presbyterian and Northwell Health” launched new television advertisements during the Super Bowl on Sunday in order “to attract new patients.” New York-Presbyterian is running a Super Bowl ad “to highlight innovation and scientific discovery at the health system and its medical schools.” Northwell Health ran three ads to “highlight the 42,000 babies delivered at Northwell hospitals each year, which was also the theme of its commercial introducing its new moniker on Jan. 1.”

Classifieds

 


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.


Jerome I. Sager – Attorney at Law
The health care law experts representing medical professionals for more than 25 years.  See us for Professional Medical Conduct Defense, Medicaid and Medicare Fraud Cases, DEA and Controlled Substance Issues, Third party insurance issues. 212-685-2333 / 917-312-6631, jeromesager@cs.com.



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

February 5, 2016 – Come on March 8th or Retire

drmaldonado PRESIDENT’S MESSAGE
 Dr. Joseph R. Maldonado
asset.find.us.on.facebook.lgTwitter_logo_blue1

February 5, 2016
Volume 16, Number 5

Dear Colleagues:

Reschedule Your Schedule for March 8 or Go Ahead and Take Early Retirement

It is IMPERATIVE that Doctors across New York who are not providing critically necessary medical services to patients be in ALBANY on March 8, 2016.  The medical malpractice crisis with the almost certain lengthening of the Statute of Limitations will adversely affect every physician in the state.  The failure to address the Health Republic debacle will cost millions of dollars to doctors across the state.  Unfunded mandates and radical changes in how we are reimbursed will change the practice of medicine like nothing in the past century.  IF YOU ARE NOT IN ALBANY on MARCH 8th, 2016 you may as well retire from medicine.  Most of us in this society will find the looming threats too onerous to remain in solo or small independent practices.  MSSNY CAN NOT BRING ABOUT THE NECESSARY CHANGES WITH A FEW DOCTORS.  New York’s PHYSICIANS MUST RISE UP AND COME TO ALBANY AND CONVEY OUR POSITION TO THE LEGISLATOR AND THE GOVERNOR.  Contact your county society to make plans to be present that date.  RESCHEDULE your patients.  Be in Albany on March 8, 2016.

Follow-up on last week’s column

Last week’s President’s column evoked the greatest response to date for my column.  Before elaborating further on the response, I want to thank you all for reading my column, and especially to those who took time from their busy schedules to share their views.  For all readers, it should be clear that the column reflects my personal views on issues I believe to be relevant to New York physicians.  On occasion, they may reflect MSSNY policy and in those instances, I state it.

While most applauded the idea of reframing the discussion to de-politicize the issue in the context in which it is currently debated, a few felt the reframe raised other concerns.  These included most importantly, those raised by colleagues in the mental health community who are concerned that I have advanced the notion that individuals with mental illness perpetrate violent crimes.  I do not believe nor do I in anyway support the notion that individuals with mental illness are more prone than members of the general population to commit violent crimes.  However, I do hold the belief that many individuals who commit violent crimes have untreated mental illness which may have in addition to other factors, contributed to their perpetration of acts of violence.  The nuances of this complex discussion can be better understood by carefully reading the Position Statement of the American Psychiatry Association   the press release by the American Psychological Association at:

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.  If you plan to attend, please register here.

A full slate of legislators and top Administration officials 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.   

http://goo.gl/forms/Mw7CX8JfzL                                                                            (GOVERNMENTAL AFFAIRS STAFF)


Contact Your Legislators to Support a Health Republic Guarantee Fund; Senator Valesky Introduces Legislation

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 to cover these costs.

This week Senator David Valesky (D-Onondaga County) and fellow Independent Democratic Conference member David Carlucci (D-Rockland County) introduced legislation (S.6667) to create such a Guarantee Fund.  Senator Valesky’s press release announcing the introduction of this legislation

(http://www.nysenate.gov/newsroom/press-releases/david-j-valesky/senator-valesky-proposes-guaranty-fund-rx-consumer-and) included a statement from MSSNY President Dr. Joseph Maldonado that “Physicians thank Senator Valesky for introducing legislation to assure that Physicians can receive payment for services rendered to their patients who had health insurance coverage through the now defunct Health Republic. Physicians and other healthcare stakeholders should not bear the losses associated with the demise of this company. The failure to address this problem will have a de-stabilizing effect on our already fragile health care system at a time changes are being demanded of by policymakers on physicians to accept far greater insurance risk”.  The press release also included statements in support by the Healthcare Association of New York State and the Greater New York Hospital Association, groups MSSNY has been working with to support such a 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 recently to a joint hearing of the Assembly Ways & Means and Senate Finance Committees.  For more information, see here.

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)


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 recent testimony to the Assembly Ways & Means and Senate Finance Committees, as well as in meetings with legislators and key legislative staff.  For more information, click 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.  Absent meaningful liability reform, with verdicts and physician liability premiums continuing to be far out of proportion compared to the rest of the country, 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)


Disastrous Liability Expansion Bill Back on Assembly Calendar and Now Re-Introduced in Senate; 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, S. 6596, DeFrancisco) 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.

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/S.6596 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)

Physicians Urged to Continue to Oppose One-Sided Workers Compensation Reform Proposals
All physicians should continue to contact their State Senators and Assemblymembers here to express their strong opposition to sweeping Workers’ Compensation reform proposals contained in the Executive Budget.

MSSNY recently gave testimony to the Senate Finance and Assembly Ways & Means Committees raising significant concerns with Budget proposals that would:

  • Enable treatment of injured workers and direct payment for care by various non-physicians 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;
  • Expand the circumstances when a physician or other health care provider can have their authorization removed and empowers the Board to impose significant fines on a physician or any other Board-authorized health care provider for violating a Workers Compensation rule;
  • Remove 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;
  • Reduce choice for injured workers by prohibiting 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 PPO provider; and
  • Remove the requirement for a referral by a physician for an injured worker as a pre-condition to receive psychological care;

Exacerbating these concerns is that the proposal also does not meaningfully address the many excessive administrative hassles and payment delays that have caused many physicians to be unable to 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 carriers, these one-sided 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)


MSSNY Testifies Before Joint Senate Finance and Assembly Ways & Means Committee
Last 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 through the following link.
(DEARS, AUSTER) 


To Physicians in Long Island, NYC, Hudson Valley, and Capital District: Please Complete Survey Regarding Impact of Proposed Cigna-Anthem Merger
As many physicians know, Anthem, the parent of Empire Blue Cross/Blue Shield, has filed paperwork to acquire CIGNA.   MSSNY has written to the New York State Department of Financial Services and Attorney General’s office to express its concerns about the impact to patient care as a result of further health insurer consolidation.

State and federal regulators are very interested in knowing the prospective effects of these possible mergers on your practice and patient care.  In this regard, MSSNY working together with the American Medical Association Advocacy Resource Center have developed a survey seeking physician input on the potential impact on these proposed mergers.

Last fall, the AMA released a report articulating the significant potential anticompetitive effects that would occur in numerous regions all across the country as a result of this merger.  Among the identified regions of concern in New York State were Long Island, New York City, the Hudson Valley, the Capital District and the Glens Falls area.  Therefore, physicians practicing in these regions are asked to complete the Survey!

This survey, and any information collected in response, will be used by the Medical Society solely for the purpose of petitioning state and federal government concerning the antitrust issues raised by Anthem’s proposed acquisition of Cigna. The antitrust laws prohibit the state medical association from using any information collected pursuant to this survey for any anticompetitive purposes, including, but not limited to, using that information in discussions with health insurers and other payers in an effort to raise physician payment or otherwise increase physician compensation. The state medical society will also not disclose any information received in response to this survey to its physician members without first consulting experienced antitrust Counsel.                                                                         (AUSTER)


Rescheduled Webinar on Opioid Prescribing to be Held Feb. 9th; Second Webinar in Series to be Held Feb 10
The first webinar in the opioid series will be held Tuesday, February 9th at 7:30 a.m. followed on February 10, 2016 with the second webinar at 7:30 a.m.   Physicians and other prescribers are encouraged to register for the entire webinar series at the following link. Click on the upcoming tab and select the programs.

Physicians will need to register for each webinar; each webinar has different topics described below. Physicians and other prescribers are allowed to register up to ½ hour before the 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, February 9, 2016 at 7:30 a.m.,  and 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 second webinar will be held on Wednesday, February 10, 2016, 7:30 a.m. Faculty:  Charles E. Argoff, MD.  The educational objective is to:  Discuss evidence based best practice recommendations for opioid therapy for chronic pain, patient risk assessment and documentation. 

The remaining webinars in the series are scheduled for:

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.

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.
(CLANCY)


Please Complete the New Health Republic Survey!
As MSSNY continues its advocacy in support of a special fund to pay for the unpaid claims as a result of the Health Republic demise, we need you to take the time to complete a MSSNY survey to provide us with updated information regarding the amounts you are due from Health Republic.  To complete the survey, click here: https://www.surveymonkey.com/r/HRepublic2This data is critical to our advocacy efforts!  We thank the many of you who provided data in November detailing the amounts you are owed, but we need to obtain updated and more precise numbers since many legislators have asked us for this data.
(AUSTER, DEARS)

NYS Department of Health Issues Protocals for Zika Virus
The New York State Department of Health has issued new protocols for Zika virus which now include the collection of a urine sample in addition to blood samples.   The health advisory and guidelines for pregnant women may be found at the department website.

The World Health Organization has declared a global emergency due to the Zika virus and NY state officials have indicated that guidelines may change.   DOH Commissioner Howard Zucker indicated that the state will be monitoring mosquitoes closely as the weather gets warmer.  The Department of Health conducted a webinar on Zika and the webinar is now available at the department’s website.
(CLANCY)

 


MSSNY to Sponsor Free CME Webinar on Public Health Preparedness on Feb. 17th
Public Health Preparedness 101 will be the topic of MSSNY’s Medical Matters webinar on Wednesday, February 17, 2016 with. Kira Geraci-Ciardullo, MD, MPH and Arthur Cooper, MD, MS serving as faculty.  This program is designed to help physicians and staff on how to prepare professionally and personally for a public health emergency.  The program will begin at 7:30 a.m.   Registration is now open to physicians and other public health officials.  Go to training session and click on the upcoming sessions tab.

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) 


Assembly Gottfried Seeks to Double the Number of In-State Med. Marijuana Dispensaries
With only several hundred physicians currently registered to certify the use of medical marijuana for their patients, Assemblyman Gottfried introduced legislation (A.9151) last Friday to double to number of marijuana manufacturers and dispensaries in the state. Under the current program, 49 counties with an aggregate population of 7.5 million lack access to a medical marijuana dispensary in their county. With counties underserved and “978,500 New Yorkers for every medical marijuana dispensary”, Assemblyman Gottfried’s legislation would allow for five additional manufacturers, each permitted to operate up to four dispensaries. Currently, the legislation is a one-house bill, without a Senate same-as.
(MCPARTLON) 


NYU Arthur Caplan – It’s Time to Cancel the Summer Olympics
In Wednesday’s Forbes Sport Money section, Arthur Caplan, PhD, of NYU Langone Medical Center, presents the case for evaluating whether the 2016 Summer Olympic Games in Rio de Janiero should to be cancelled. Caplan argues that it is irresponsible to allow the games to take place in an area under a wide-spread outbreak of the Zika virus, which the WHO recently declared an “explosively spreading” “public health emergency of international concern”.            (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 jMcPartlon@mssny.org    

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Physicians and Zika Virus
Commissioner of Health Howard Zucker, MD, JD NYS has placed on the DOH website, “Zika Virus What New York State Clinicians Need to Know” dated February 1, 2016.


Resolutions for the 2016 House of Delegates
The deadline for resolutions is 5:00pm on February 19; or for resolutions resulting from our Lobby Day, 5:00 on March 11 is the deadline. Send all resolutions to lmayer@mssny.org
 


New York State Earns Mixed Reviews in New Tobacco Report
In a report from the American Lung Association (ALA) titled “State of Tobacco Control 2016,” reports, New York earned an “A” in 2015 “on policies that promote smoke-free air.” However, the ALA “called on New York officials to increase funding for the state’s tobacco control programs by $10 million to $52 million per year and expand New York’s Clean Indoor Air Act to restrict the use of electronic cigarettes.”

The smoking rate among the state’s high school students has dropped to 7.3 percent, while the adult smoking rate has dropped to 14.5 percent, below the national average of 17.8 percent, according to figures released by the state last year.

The lung association raised concerns, however, about an increase in the use of products like e-cigarettes and hookahs. And it gave the state failing grades for funding and providing access to programs that help people quit smoking.

The advocacy group called on New York officials to increase funding for the state’s tobacco control programs by $10 million to $52 million per year and expand New York’s Clean Indoor Air Act to restrict the use of electronic cigarettes.


From Socio-Med VP Regina McNally: Go with Dr. First for
E-Prescribing
I have been receiving many calls from physicians regarding the upcoming NYS e-prescribing mandate of March 27, 2016 and you might be getting calls, too. We endorse DrFirst as a “stand-alone” e-prescribing product.  I believe software would be added to the physician’s existing computer.  This stand-alone product will help those physicians who have an EMR or EHR that might not be ready by the 3/27/16 deadline.  Please see the following:  http://www.drfirst.com/mssny/mssny-lp/

MSSNY members get a discount!  DrFirst’s MSSNY hotline number is (866)980-0553.

If a physician member can document either financial or technical limits, s/he can apply for a waiver from electronic prescribing.  The application for the waiver would apply for both controlled and non-controlled prescription drugs.  Note, there’s no guarantee that the waiver will be granted.  Please see the attached for waiver information.

As a point of physician protection, a medical record for the patient (spouse, family, friends, etc.) must be maintained (even if it is on an index card) for every prescription written in either paper or electronic mode. 

E-prescribing of both controlled and non-controlled substances is currently permissible in New York. Practitioners must ensure compliance with the requirement, including working with their software vendors to implement the additional security requirements needed for e-prescribing of controlled substances, and registering their certified software applications with the Bureau of Narcotic Enforcement

Below are highlights/key points that may be of particular interest to prescribers and pharmacists:

  • A prescription generated on an electronic system that is printed out to the Official New York State Prescription form or faxed is NOT an electronic prescription.
  • After March 27, 2016, a pharmacist is NOT required to verify that a practitioner properly falls under one of the exceptions from the requirement to electronically prescribe. Pharmacists may continue to dispense medications from valid written, oral, or fax prescriptions that are consistent with current laws, regulations, and Medicaid policies.

A comprehensive list of FAQs can be found here.

The FAQs provide an explanation of the laws and regulations, pharmacy registration forms, registration for official prescriptions and e-prescribing systems (ROPES), software and data requirements, waivers and exceptions, and resource information and contacts.

Questions? Please contact the Bureau of Narcotic Enforcement at

1-866-811-7957 or via e-mail to narcotic@health.ny.gov


Poster Symposium Seeks Judges on April 15 in Tarrytown
If you’re coming to the House of Delegates in Tarrytown – or just live in the neighborhood – and are free on Friday afternoon, April 15, from 2 – 4 pm, please consider participating as a judge at the MSSNY Resident and Fellow Section Poster Symposium. It’s always an exciting, lively event! Please contact sbennett@mssny.org or 516-488-6100 extension 383 if you’re interested. Thank you.


AMA: All Physicians Subject to 2015 Medicare MU Program Should Apply for Hardship
Prior to adjourning for the holidays, Congress passed the Patient Access and Medicare Protection Act (PAMPA), which directed CMS)to make AMA-supported changes to the Medicare EHR Incentive Program hardship exception process that allows physicians to avoid a Meaningful Use (MU) penalty in 2017.

CMS has stated that it will broadly accept hardship exemptions because of the delayed publication of the program regulations. 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.

Step-by-step instructions for completing the hardship exception application are attached.

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:

Following Congress’ efforts in PAMPA, 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. 


NEJM: Surgical Residents’ Long Shifts May Have No Impact on Patient Outcomes
Research published online in the New England Journal of Medicine indicated that “allowing surgeons in training to work extremely long shifts without breaks had no effect on patient outcomes and created only minor dissatisfaction among the young” physicians. http://bit.ly/1P9tCnV Investigators “looked at how many patients died or had serious complications in the month after surgery and found the same low rate – about 9 percent – in both groups.” Meanwhile, “residents’ self-rated dissatisfaction with their education and with their well-being were similarly low – 11 percent and roughly 13 percent respectively in each group.” In an accompanying editorial at http://bit.ly/1VRjodv, Dr. John Birkmeyer “wrote the experiment’s results ‘effectively debunks concerns that patients will suffer as a result of increased handoffs and breaks in continuity of care.’”


Nat’l Center on Addiction/Substance Abuse Releases Report on Food Addiction
The National Center on Addiction and Substance Abuse announced the release of a report that lays out the characterizing symptoms, risk factors and underlying neurobiological characteristics of food addiction, and how these features overlap with those of obesity, eating disorders and substance addiction. This report, Understanding and Addressing Food Addiction: A Science-Based Approach to Policy, Practice and Research, highlights how the knowledge and experience gained from years of substance use research and work in substance prevention, intervention and policy might be applied to controlling unhealthy eating and the food environment that contributes to it. It offers evidence-based recommendations for policy, prevention, health care practice and research to help reduce the deadly and costly health consequences of unhealthy eating.
Highlights of the report include:

  • Evidence regarding the prevalence of food addiction and its co-occurrence with obesity, binge eating disorder and other health conditions
  • The risk factors, characterizing symptoms and biological mechanisms of food addiction and related disorders and how these overlap with other eating disorders and with substance addiction
  • Recommendations for policy, prevention, health care practice and research, and resources for additional information

The report is available for download at no cost and can be found here.

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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.


Jerome I. Sager – Attorney at Law
The health care law experts representing medical professionals for more than 25 years.  See us for Professional Medical Conduct Defense, Medicaid and Medicare Fraud Cases, DEA and Controlled Substance Issues, Third party insurance issues. 212-685-2333 / 917-312-6631, jeromesager@cs.com.



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