Dr. Malcolm Reid
Do Not Wait – Tell Your Legislators That Patient Access to Care Will be Harmed By Legislation to Increase Lawsuits and Liability Premiums!
All physicians must continue to contact their legislators to urge them to oppose legislation (A.285-A, Weinstein/S.6596, DeFrancisco) under consideration that could increase by another 15% your already exorbitant medical liability premiums by changing the Statute of limitations.
This week MSSNY President Dr. Malcolm Reid participated in a “roundtable” discussion with Senate Majority Leader Flanagan, Senate Deputy Majority Leader DeFrancisco and Senate Health Committee Chair Hannon to have a frank discussion regarding the implications of this proposal on New York’s health care system. Other participants in the roundtable included representatives of the New York State Trial Lawyers Association, Greater New York Hospital Association, HANYS, MLMIC, PRI, NY-ACOG, the NYS Society of Plastic Surgeons and other specialty societies.
Dr. Reid emphasized the extremely difficult practice environment that New York physicians already face in light of already exorbitant medical liability premiums, and rapidly transitioning and dwindling payments from insurers and Medicare. He specifically noted a recent Wallet Hub study concluding that New York is the worst state in the country in which to practice medicine, a practice environment that will only get far worse if this bill was permitted to pass. Hospital representatives highlighted that New York’s hospitals have the second worst operating margins in the country.
In light of the huge financial pressures already facing physicians prompted by excessive government mandates, reduction in insurer payments and networks, and rapidly rising patient cost-sharing responsibilities, it is essential that you express to your elected representatives that “stand-alone” legislation driving further liability increases cannot be tolerated and could seriously impact access to care for patients.
In response to this threat, MSSNY and other groups have publicly highlighted the huge and unsustainable liability burden already assumed by New York physicians, and the threat this legislation poses to the already precarious stability of many New York hospitals and medical liability insurers. MSSNY together with numerous other specialty medical societies have joined GNYHA and HANYS in an ad campaign highlighting the disastrous consequences to our healthcare system should such a large expansion in the right to sue be permitted by the State Legislature. The ads have appeared in City & State, Politico New York, and the Albany Times-Union.
Please remind your legislators of the seriously adverse consequences to patient care should this legislation be enacted! (AUSTER, DEARS)
Legislation to Make Reasonable Changes to ERX Law on Senate Floor; Physician Action Needed
Legislation (S. 7801, Hannon) to address several issues which have arisen as part of the implementation of the e-prescribing law is on the Senate floor and is poised for passage. Physicians should send in a letter to urge their representative’s support for the bill by clicking on the this link.
Specifically, the bill would enable a pharmacy that receives an electronic prescription for a non-controlled substance to transfer the prescription to an alternative pharmacy at the request of the patient when the pharmacy receiving the prescription is unable to fill it. The bill would also prohibit pharmacies from requesting a physician to renew a patient’s prescription in a manner that is inconsistent with the e-prescribing law.
This is meant to address misleading pharmacy fax-back forms that haven’t been amended to reflect current law that prohibits a prescriber from faxing or calling in a prescription unless a statutory exception is being invoked. Importantly, the bill would also eliminate exposure to criminal penalty in the event that a prescriber fails to adhere to the requirements of the e-prescribing law. It is anticipated that similar legislation will be introduced in the Assembly next week.
Legislation to Reduce E-Prescribing Exception Reporting Burden Needs Your Support; Bill on Floor in Both Assembly and Senate
Physicians are urged to contact their legislators to urge that they support legislation (A. 9335A, Gottfried/S. 6779B, Hannon) to ease the onerous reporting burden on physicians every single time that they need to issue a paper prescription. The bill was reported from the Assembly Codes Committee to the full Assembly this week, and identical legislation is before the full Senate. It is poised for passage.
The Bureau of Narcotics Enforcement announced that when a physician invokes one of the three statutory exceptions and write a paper script because: their technology or power has failed; the prescription will be filled outside of New York; or it would be impractical for the patient to obtain medications in a timely manner, they must electronically submit to the department an onerous amount of information about the issuance of the paper prescription. DOH asks that each time a paper prescription is written, the prescriber must electronically inform the DOH of their name, address, phone number, email address, license number, patient’s initials and reason for the issuance of the paper prescription. This creates an onerous burden for all physicians, particularly in situations where there is a protracted technological failure, and the physician needs to report dozens upon dozens of paper prescriptions.
In fact, Surescripts has stated publicly that there is a 3-6% e-prescription transmission failure rate. This means that in the state of New York anywhere between 7.6 million to 15 million e-prescriptions will fail every year and each prescriber involved with these failures who subsequently write a paper prescription will need to file this information with the state. In some small communities, even the patient’s initials can convey information that will enable others who access this information to identify the patient who will receive the medication.
A much more preferable alternative is to allow physicians and other prescribers to make a notation in the patient’s chart indicating that they have invoked one of the three statutory exceptions. It is important to know that the 12 exceptions released by the DOH Commissioner 10 days before e-prescribing requirements went into effect, do not require reporting to the DOH. The same should hold true for the issuance of paper prescriptions when one of the three statutory exemptions apply. Please urge your legislators to pass this bill by sending a letter located on the MSSNY grassroots action center at the this link.
Lobby Day Generates Strong Support for Legislation to Enable Override of Insurer “Fail First” Medication Coverage Policies
Concerned about health insurance protocols requiring your patients to “fail first” on certain prescription medications before they are able to take the most medically appropriate medication? Please send a letter to your legislators in support of legislation (A.2834-B, 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.
This week, MSSNY representatives joined representatives of many other physician and patient advocacy groups in a press conference and lobby day in support of this critically needed legislation. The activities generated significant press activity regarding this legislation, including articles in the Albany Times Union, Politico New York, CBS 6 Albany, and Time Warner Cable News. (AUSTER, DEARS)
Aid in Dying Legislation Passes NYS Assembly Health Committee
By a vote of 14-11, legislation that would enable a terminally ill patient to request and use medication passed out of the Assembly Health Committee. A. 10059/ S. 7579, sponsored by Assemblywoman Amy Paulin and Senator Diane Savino, has been referred to the Assembly’s Codes Committee. The measure is still in the Senate Health Committee. David C. Leven, Executive Director of End of Life Choices New York, an organization who is advocating for the legislation, indicated in a statement following the Assembly Health Committee vote, that the legislation would not be acted on before the end of session in June. The Medical Society of the State of New York issued a memo of opposition to this legislation based on its position on physician assisted suicide. (CLANCY)
CME Mandate Bill Passes Assembly Health Committee; Now on Assembly Floor for Action
Senate Bill 4348/Assembly Bill 355, sponsored by Senator Kemp Hannon and Assemblywoman Linda Rosenthal and which would create a continuing medical education mandate for practitioners with prescribing privileges has passed the Assembly Health Committee and is now before the full Assembly and can be voted at any time. The measure has already been approved by the full Senate.
Under the bill’s provisions, every two years, physicians would need to complete three hours of continuing medical education that involves pain management. The curricula must include but is not limited to: I-STOP and drug enforcement administration requirements for prescribing control substances; pain management; appropriate prescribing; managing acute pain; palliative medicine; preventative, screening and signs of addiction; responses to abuse and addiction; and end-of-life care.
MSSNY has strongly opposed this measure in previous legislative sessions. While continuing medical education is valuable to physicians in keeping up-to-date on new clinical information, and physicians throughout the state voluntarily take continuing medical education for continued professional development in those areas that pertain to their individualized practice, this bill fails to recognize that the Medical Society of the State of New York, the specialty societies, the American Board of Medical Specialties, and the American Osteopathic Association have all been aggressively promoting voluntary CME on pain management and that there is other course work that addresses many of the above issues. Moreover, this mandate could potentially apply to many physicians who do not regularly prescribe opioid medications. (CLANCY, DEARS)
Bill to Limit Pain Medication in Assembly Codes Committee; Physicians Urged to Act
S. 6091-B/A.8601 – A, sponsored by Senator Kemp Hannon and Assemblymember John McDonald,has moved from the Assembly Health Committee to the Codes Committee. This measure passed the New York State Senate last week. The bill would limit the initial prescription by a physician or other prescriber of Schedule II or III Controlled Substances, to a 5-day supply for patients suffering acute pain. MSSNY strongly opposes this legislation.
Physician action is needed to prevent this bill from becoming law. Physicians are urged to call their state Assembly members today and indicate opposition to this measure.
Assemblymembers can be found http://assembly.state.ny.us/mem/
Members of the Assembly Codes Committee are listed here.
Physicians can also send a letter to their members by logging onto MSSNY’s Grass Roots Action Center here.
This legislation would effectively prevent a physician from exercising his/her clinical judgement on behalf of the patient by imposing an arbitrary standard not developed by any medical authority. 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. A physician’s clinical judgment in addressing the unique needs of the individual patient should always prevail to ensure that patients receive the most appropriate and effective medication in a timely manner.
The Medical Society agrees with the concerns expressed by some that there have been instances when prescribers have authorized doses for opioid medications in excess of what was needed to address a patient’s medical condition. Therefore, to address this concern, MSSNY has been working with the American Medical Association and other state medical societies across the country to urge Congress to pass legislation that would enable a physician to authorize a “partial fill” of a controlled substance prescription, thereby reducing the likelihood of unused medications being left in medicine cabinets.
Furthermore, the development of guidance for pain management must be addressed from the broadest spectrum and be generally applicable to all physician practices without being too specific or proscriptive as to how pain should be treated. (CLANCY, DEARS, AUSTER, MCPARTLON)
Lobby Day Advances Efforts to Include E-Cigarettes Under the Clean Indoor Air Act
Yesterday, May 24th, health care organization from across the state and country, including the Medical Society of the State of New York, held a press event and met with legislators to advocate for placing E-Cigarettes under the New York State Clean Indoor Air Act.
Sponsors of the legislation (A.5955/S.2202), Republican Senator Kemp Hannon and Democratic Assemblywoman Linda Rosenthal, spoke in support of bill at the press event; along with teenage members of Reality Check Youth organization, who shared their insights on rampant use among youth populations in both schools and public places across New York State.
The Food and Drug Administration (“F.D.A.”) recently announced regulations that, when in effect, will regulate the manufacture, import, packaging, labeling, advertising, and sale of e-cigarettes and liquid nicotine. Among the new regulations, e-cigarettes must contain a warning label and manufactures must submit a list of ingredients and information on harmful or potentially harmful ingredients to the F.D.A. for consideration during the products approval process.
To send a letter in support of legislation to place E-Cigarettes under the New York State Clean Indoor Air Act click here. (MCPARTLON, CLANCY)
Senate Seeks to Require Fingerprinting and FBI Background Checks For Physician Licensure
Amid recent reports of deficient monitoring and sanctioning of the licensed professions, specifically nurses, with regards to professional misconduct or criminal convictions, Senator Ken LaValle has introduced a bill (S.7791) that would require all Title 8 licensed professions, including physicians, to undergo mandatory FBI background checks and fingerprinting for licensure.
The legislation also seeks to establish a unit within the state Education Department’s Office of the Professions specifically tasked with monitoring and sanctioning the licensed professions. What’s missing from the legislation is a carve out for physicians and physicians assistants, whose professions are already subject to strict compliance of professional conduct standards through oversight by the Office of Professional Medical Conduct (“OPMC”) within the State Health Department. Established in 1977, the OPMC is statutorily mandated to investigate every complaint and monitor any legal action taken against a NYS-licensed physician.
With New York State earning marks as the worst state in the country to practice medicine, now is not the time to force a duplicative sanctioning body upon physicians; or to mandate FBI criminal background checks and fingerprinting for licensure—a measure even our neighboring states, including Massachusetts, Vermont, and Pennsylvania do not currently required. The Medical Society of the State of New York strongly opposes this legislation. (MCPARTLON)
Previously Vetoed Legislation in Assembly and Senate Higher Education Committees
The purported “Title Bill” for certified registered nurses (“CRNA”), which was previously vetoed by Governor Cuomo in 2012, is back again for consideration in both houses’ higher education committees (A. 140-A, Paulin/ S.7166-A, Gallivan). Worse yet, the language is nearly identical to language from a bill vetoed last year and once more contains no provisions on scope of practice, and supervision/oversight requirements by physicians. CRNA’s have sought for years to be able to practice independently of physicians, and when viewed in conjunction with other legislation which seeks to permit direct reimbursement to CRNA’s for anesthesia services, this bill is a major step in that direction. The Medical Society of the State of New York strongly opposed this legislation. (MCPARTLON)
Ensuring Medicare Home Health Eligibility: The Shared Responsibility Across the Continuum of Care – Webinar Hosted By National Government Services (Ngs)—June 2nd From 10-11:30am
A free webinar on Medicare home care eligibility and documentation requirements for all settings of care will be held June 2, from 10 to 11:30 a.m., by Medical Society of the State of New York, HANYS, Home Care Association of New York State, and National Government Services (NGS).
CMS requires that establishing patients’ Medicare eligibility and supplying supporting medical record documentation for post-acute home care services be a shared responsibility between referring providers—hospital, nursing home, and practitioners—and the receiving home care agency.
The referring entity—hospital or nursing home—and ordering practitioner must review and document the patient’s status at the time of discharge in the context of Medicare’s home care eligibility criteria, and provide that information as part of the patient transition to the receiving home care agency.
All staff involved with planning and implementing a patient’s transition to post-acute home care services are urged to attend this valuable program.
Physician Action Urged to Oppose Federal VA Rule Change to Permit Independent Nurse Anesthetist Practice in the VA Health System
The Veterans Administration this week issued a proposed rule that would allow Advanced Practice Nurses (APRNs) (nurse anesthetist, nurse practitioner, nurse midwife, clinical nurse specialist) to practice independently within the VA health system. The proposed rule would not change state law on APRN practice outside of VA facilities.
AMA Board Chair Dr. Stephen Perlmut issued a statement expressing great disappointment in the proposal by the VA including noting that “While the AMA supports the VA in addressing the challenges that exist within the VA health system, we believe that providing physician-led, patient-centered, team-based patient care is the best approach to improving quality care for our country’s veterans. We feel this proposal will significantly undermine the delivery of care within the VA. With over 10,000 hours of education and training, physicians bring tremendous value to the health care team. All patients deserve access to physician expertise, whether for primary care, chronic health management, anesthesia, or pain medicine.” To read the full AMA statement, click here.
The American Society of Anesthesiologists has set up a webpage to give physicians the opportunity to let the VA and their federal legislators know of its concern with this proposed rule. Physicians are encouraged to do two things to help ensure that we maintain safe care for our nation’s veterans:
- Go here and click on the text that reads “Take action today …” This will allow you to send your legislators a message urging them to protect VA care.
- Go here to submit a comment. Pre-drafted text is available, but you are encouraged to include personal stories about your experiences in the operating room, including the crucial role of the physician anesthesiologist in an environment where seconds count. After completing the contact information, click “Submit.” When the proposal is entered into the Federal Register, your comments are automatically entered.
Take action now, for yourself, your profession, and, most importantly, for our veterans!
New York Kicks Butts Campaign to Be Held May 31-June 6th
The Medical Society of the State of New York has joined with the American Cancer Society, the American Lung Association, and Tobacco Free Kids and a variety of other affiliated health organizations and businesses to encourage New York City residents to quit smoking. The New York Kick Butts campaign will be held May 31-June 6th and New York City physicians are asked to discuss with patients smoking cessation treatment options. By offering medication and counseling, physicians can help patients to double their quit rates.
Helpful tools can be found on line at PlanMyQuit.com/NYC or by calling the New York State Smokers’ Quit line at 1-866-NY-QUITS (697-8487) or by just dialing 311. Additional resources can also be found at NYSmokeFree.com. Physicians can find an information flyer here.
Patient information here.
Zika CME Webinar to Be Held June 8 At 6 P.M.; Physician Registration Now Open
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–UPDATE” on Wednesday June 8th at 6 p.m. Registration for this program is now open here.
Click on the upcoming tab and select the programs.
MSSNY conducted the original program in March 2016, but this program will provide updates to the ever changing story of Zika. 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 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 firstname.lastname@example.org.
PTSD and TBI in Returning Veterans: June Webinars
MSSNY will be holding a series of CME webinars on PTSD and TBI in returning veterans on two remaining dates listed below from May through June. The faculty presenters will be Frank Dowling, MD and Joshua Cohen, MD.
- 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 growth
To register for this program, click on a date below and fill out the registration form
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