June 24, 2016 – MACRA: More Alphabet Soup

 

Dr. Reid
PRESIDENT’S MESSAGE
Dr. Malcolm Reid
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June 24,  2016
Volume 16, Number 23

Dear Colleagues:

The federal Government came up with MACRA in answer to the dissolution of the horrible SGR. While MSSNY, along with the AMA, was pooling our forces to override SGR fee cuts, other Medicare problems popped up. In an effort to address some of these problems, MACRA consolidated and revised Medicare’s Physician penalty and incentive programs, hoping to simplify and improve them. It appears that the result will be neither simplified nor improved.

What MACRA is supposed to do is alleviate the burdens of PQRS and MU.  Oh yes, we are still in alphabet soup. MACRA= Medicare Access and CHIP Reauthorization Act of 2015; PQRS= Physician Quality Reporting System; MU= Meaningful Use.

Now, under MACRA we now have MIPS and APMs.  MIPS=Merit-based Incentive Payment System and APMs= Alternative Payment Models.  MIPS allows Medicare clinicians to be paid for providing high value care through success in four performance categories: Quality, Advancing Care Information, Clinical Practice Improvement Activities, and Cost.

Clinicians who participate in APMs such as the new Comprehensive Primary Care Plus (CPC+) model, the Next Generation ACO model, and other Alternative Payment Models  would be exempt from MIPS reporting requirements and qualify for financial bonuses.  Under APMs, clinicians accept both risk and reward for providing coordinated, high-quality care.

For more information about MACRA, MIPS and APMs, please look at CMS’ website.

CMS’ PRESS release.

Oh yes, we are still in the soup –alphabet soup that is.

See article below regarding MSSNY’s comments on the CMS’ proposal.

Malcolm Reid, MD, MPP
MSSNY President

Please send your comments to comments@mssny.org

MLMIC


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MSSNY, Many Other Physician Organizations Comment on MACRA Implementation
Noting that the proposal by CMS to implement the MIPS and APM Medicare value-based payment programs are “far too complex for many physicians who are already drowning in required paperwork from public and private payers”, this week MSSNY submitted extensive comments to CMS to urge significant changes before the rule is finalized.  To read MSSNY’s comments, click here.  

In addition, MSSNY has signed on to a letter initiated by the American Medical Association with medical societies across the country, and is working with the Coalition of State Medical Societies on a joint letter.  These letters all stress to CMS the physician community’s strong concerns with the overwhelming complexity of this proposal, and the need to assure that physicians are exempted who have little possibility of earning more than it takes to comply.

With the comment deadline this Monday, June 27, physicians are encouraged to send their own comments to CMS by clicking here.

The comments were in response to the proposal announced by CMS in early May to implement the value-based payment programs contained in the MACRA legislation enacted by Congress in 2015 that repealed the Medicare SGR methodology.  While payment adjustments under the Merit Based Incentive Payment System (MIPS) and Alternative Payment Models (APMs) are not applied until 2019, it will be based upon care delivered to Medicare patients in 2017.  Under MIPS, Medicare payments could be adjusted up or down by 4% beginning in 2019, and up to +/ – 9% by 2022, with additional bonus payments possible.

The key points made by MSSNY and other associations in its comments included:

  • The need to significantly raise the MIPS exemption threshold from 100 Medicare patients and $10,000 in Medicare revenue.
  • The need to postpone the implementation start date to at least several months after January 1, 2017, and for a shorter “performance period”
  • The need for a mechanism for physicians to receive comprehensive periodic feedback from CMS as to how they are performing in each of the 4 categories before a “performance period” ends
  • The need to assure that the MIPS program for determining bonuses or penalties compares physicians practicing in similar specialties, and practice sizes rather than all being lumped into one big pool.
    (AUSTER)


Urge Governor Cuomo to Sign Step Therapy Override Bill
With the Legislature’s passage of a bill (A.2834-D/S.3419-C) last week to establish specific criteria for physicians to request an override of a health insurer step therapy medication protocol when it is in the best interest of their patients’ health, all physicians are urged to send a letter to Governor Cuomo to ask that he sign this important bill into law.  A letter can be sent here.

MSSNY strongly supported this bill, and worked with a wide array of patient advocacy organizations, specialty societies, hospitals, and pharmaceutical manufacturers to achieve passage of this legislation. We know the insurers are strongly fighting this bill, so the Governor’s office needs to hear your support.

This week, Long Island Newsday had an editorial in strong support of the bill.

The bill would require a health insurer to grant a physician’s override request of an insurer step therapy protocol if one of the following factors are present: 1) the drug required by the insurer is contraindicated or could likely cause an adverse reaction; 2) the drug required by the insurer is likely to be ineffective based upon the patient’s clinical history; 3) the patient has already tried the required medication, and it was not effective or caused an adverse reaction; 4) the patient is stable on the medication requested by the physician; 5) the medication is not in the best interests of the patient’s health.

While the legislation would generally require the health insurer to make its decision within 3 days of the override request of the physician, the insurer would be required to grant the override request within 24 hours of the request if the patient has a medical condition that places the health of such patient in serious jeopardy if they do not receive the requested medication.  Perhaps most importantly, if the physician’s request for an override is denied, it would enable a physician to formally appeal the decision both within the plan’s existing appeal mechanism as well as taking an external appeal.
(AUSTER, DEARS)                                                                                           

Governor Signs Opioid Package
In a three city whirlwind tour of the state, Governor Cuomo this week signed into law legislation designed to arrest the growing opioid epidemic. The effective date of each provision of law varies and is set forth below for your information. Importantly, the new seven day limit on the number of days for which opioids can be prescribed for the initial onset of acute pain will go into effect on July 22, 2016.

  1. Mandate to complete three hours of CME training on pain management must be completed by July 1, 2017. Course standards and regulations are being developed. MSSNY in conjunction with OASAS and DOH, has already developed such a course—currently on its website. MSSNY will apply to assure that this course meets the standards developed by the agency.
  1. Inpatient residential coverage without utilization review limitations becomes effective on January 1, 2017.
  1. Requirements that DOH must create and pharmacies must make available information materials regarding the dangers of misuse and the potential for addiction to controlled substances to the public at the time of dispensing controlled substances will go into effect on October 22, 2016.
  1. Requirements that hospitals must coordinate discharge planning for individuals with suspected substance use disorder with SUD programs go into effect on December 22, 2016.
  1. Required use of utilization review tools designate by OASAS goes into effect on January 1, 2017.
  1. Required access to a five day supply for emergency use of medication for substance use disorder and access to buprenorphine and naltrexone for detoxification without prior authorization goes into effect on January 1, 2017.
  1. Involuntary commitment of a person incapacitated for drug or alcohol abuse for up to 72 hours goes into effect on September 22, 2016.
  1. The new seven day limit on the number of days for which opioids can be prescribed for the initial onset of acute pain will go into effect on July 22, 2016.
    (DEARS, CLANCY, AUSTER) 


Physicians Urged To Send Letters of Support to Governor for ERX Changes
As reported in last week’s Capitol Update, two measures passed which will address issues which have arisen with the implementation of the e-prescribing mandate. Physicians are encouraged to send letters of support for each of these bills to the Governor to urge that he sign the bills into law.

The first bill, S. 6779, Hannon/A.9335-B, Gottfried would ease the onerous reporting burden on physicians every single time that they need to issue a paper prescription in lieu of e-prescribing.  The letter urging the Governor to sign the bill can be accessed by clicking on this link.

In March, the Bureau of Narcotics Enforcement announced that when a physician invokes one of the three statutory exceptions and writes/faxes or calls in 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/fax/oral prescription is issued, 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.

The bill passed this week affords a much more preferable alternative by allowing physicians and other prescribers to make a notation in the patient’s chart indicating that they have invoked one of the three statutory exceptions.

The second bill A.10448, Schimel/S. 7537, Martins would authorize a pharmacy which does not have a particular medication in stock to transfer the prescription to another pharmacy. The letter urging the Governor to sign the bill can be accessed by clicking on the following link.

Currently, e-prescriptions cannot be transferred by one pharmacy to another thereby requiring the patient to return to or call the prescriber’s office to ask that he/she transmit the e-prescription to another pharmacy creating unnecessary burdens on the patient and delaying timely access to their medication.                                             (DEARS, AUSTER) 

HHS Announces Funding Opportunity to Assist Small Practices Prepare  for Value-Based Payment Programs
The U.S. Department of Health and Human Services announced this week an initiative to financially assist small practices preparing for Quality Payments under the Medicare Program.The $20 million funding will support “on-the-ground training and education” for physicians and other participating Medicare clinicians in both individual and small group practices of 15 clinicians or fewer – especially in historically under-resourced areas including rural and medically underserved areas.

“Doctors and healthcare providers in small and rural practices are critical to our goal of building a health care system that works for everyone,” said HHS Secretary Sylvia M. Burwell in a statement. “Supporting local health care providers with the resources and information necessary for them to provide quality care is a top priority for this administration.”

To read the HHS press release, click here.

The funding was allocated in the MACRA legislation passed by Congress in 2015 that repealed the SGR and established the MIPS and APM value-based payment programs (as replacements for the existing PQRS, meaningful use and VBM programs).   The press release notes that “organizations receiving the funding would support small practices by helping them think through what they need to be successful under the Quality Payment Program, such as what quality measures and/or electronic health record (EHR) may be appropriate for their practices’ needs. Organizations would also train clinicians about the new clinical practice improvement activities and how these new activities could fit into their practices’ workflow, or help practices evaluate their options for joining an Alternative Payment Model.”

HHS will announce the awardees by November.
(AUSTER)

Six Months Before You Re-Register License with NYS Department of Education, You Must Update Your Physician Profile
Physicians are required under New York State Public Health Law §2995-a and Education Law §6524, to update their Physician Profile in the six (6) months prior to the expiration of their current registration and submission of his/her biennial registration.  There has been recent email notification to physicians whose re-registration is due within the next six months from New York State Department of Health informing them that they must update their physician profile.  If a physician plans on renewing his/her registration with the State Department of Education, the Physician Profile must be updated.  If a physician is not renewing his/her registration no action is required.

To update the Profile please log on to the Health Commerce System (HCS) account here.

The Physician Profile icon is in the menu on the left of the screen.  If you need assistance in order to access your HCS account, please call 1-866-529-1890, Monday – Friday 8:00 am – 4:45 pm. If you need assistance or have questions specific to the Physician Profile, please call 1-888-338-6998, Monday – Friday 8:30 am – 4:45 pm.

If the profile is up to date, a physician must still log into the Physician Profile through his/her HCS account in order to confirm the information is current and accurate.

The Health Commerce System (HCS), accessible via the Internet, is the secure website for web-based interactions with the New York State Department of Health.  Besides being required to update a physician profile through the HCS, physicians need an HCS to order prescription pads; to check the Prescription Monitoring Program (PMP); tumor and cancer reporting and to access the Immunization Registry, etc.

Physicians who do not have a Health Commerce System account are urged to do so.  A paperless HCS account application can be found here.

Reported cases of Zika in New York City: 197

  • 20 of the 197 cases were pregnant at the time of diagnosis;
  • All cases contracted Zika while visiting other countries; and
  • All patients have recovered.
  • To date, 3,605 people in the city have been tested for the virus for a 5% infection rate. All of the confirmed cases of Zika in the city are from a result of traveling abroad. There have also been two cases of Guillain-Barré, a syndrome that has been associated with the virus, according to the CDC.
  • The Zika statistics for New York City were reported in the Morbidity and Mortality Weekly Report as part of an effort to determine which demographic populations were getting tested. Officials from the city’s Department of Health and Mental Hygiene used Census data to cross-reference testing — rates with neighborhoods that have residents from regions at the center of the Zika crisis — Brazil, the Caribbean, Central America.

For More Information


Medicare Trustees Report Shows Continued Slow Cost Growth
The Medicare Trustees projected that the trust fund financing Medicare’s hospital insurance coverage will remain fully funded until 2028, 11 years longer than they projected in 2009 before the passage of the Affordable Care Act.

Per-enrollee Medicare spending growth has been low, averaging 1.4 percent over the last five years, slower than GDP per capita (2.9 percent) and overall health expenditures per capita (3.4 percent). And over the next decade, per-enrollee Medicare spending growth (4.3 percent) is expected to continue to be lower than the growth in overall per capita national health expenditures (4.9 percent). Total Medicare spending is projected at a faster 6.9 percent average annual rate over the next decade, reflecting continued enrollment growth driven by the growth of the over-65 population.

The Medicare Trustees did highlight an area of spending growth, however, noting that that growth in the costs of prescription drugs paid by Medicare continue to exceed growth in other Medicare costs and overall health expenditures. Medicare Part D expenditures per enrollee are estimated to increase by an average of 5.8 percent annually through 2025, nearly 50 percent higher than the estimated increase in GDP per capita (3.9 percent) and higher than the combined per-enrollee growth rate for Medicare Part A and B (4.0 percent). The report found that these costs are trending higher than previously predicted, particularly for specialty drugs. A prior Department of Health and Human Services report also provided a detailed analysis of high cost prescription drug spending trends.

Based on early data showing the potential for a small Social Security cost of living adjustment, the Trustees Report projects that Medicare’s “hold harmless” protection will be triggered again this year. This would result in a small increase in Part B premiums for about 70 percent of Medicare beneficiaries, with increases in Part B costs spread over the remaining 30 percent, which includes individuals enrolling in Part B for the first time in 2017, those that do not receive a Social Security benefit or who are directly billed for their premium, Medicare and Medicaid dual-eligible beneficiaries, and current enrollees who pay an income related higher premium.

However, this a projection based on preliminary data. The final Social Security cost of living adjustment will be announced in the fall based on updated data. The 2017 Medicare Part B premiums, which typically differs from these projections, will be announced later in the year.

The report is available here.


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The 2016 MSI Survey Is Here!
CMS is once again conducting their annual survey of Medicare Administrative Contractors (MAC) performance and requesting feedback from the provider community NGS Medicare serves through the MAC Satisfaction Indicator (MSI). This survey should only take about 10 minutes of your time and helps NGS understand how they can better service you.

NGS Medicare encourages all Medicare Providers of service as well as their office staff members who work with National Government Services Medicare to participate in the survey!

  1. What is the MAC Satisfaction Indicator (MSI)? The MSI is a tool used by CMS to measure provider satisfaction with their MAC. This survey is presented once a year and includes questions on services the MAC provides in these functional areas: Provider Outreach and Education, Provider Telephone Inquiries, Claims Processing, Electronic Data Interchange (EDI) Help Desk, Reopenings and Redeterminations (Appeals), Provider Enrollment, Medical Review, Self-Service Portal and Cost Report and Reimbursement.
  1. Who is eligible to participate in the MSI? Medicare providers who receive services from their MAC can participate. This includes Medicare fee-for-service physicians, suppliers, health care practitioners and institutional facilities who serve Medicare beneficiaries across the country.
  1. What does this mean to NGS? The MSI allows providers the opportunity to influence CMS’s understanding of Medicare contractor performance. In addition to monitoring NGS’s performance, CMS will use the results for monitoring trends, to improve oversight, and to increase efficiency of the Medicare program. CMS will incorporate the results into our MAC incentive plans. The MSI also provides NGS with more insight into our provider communities and it allows us to make process improvements based on this provider feedback.

To take the survey, click: here.


For Residents: Introducing NEJM Resident 360
NEJM Resident 360, a new website and discussion platform from NEJM Group, gives residents the information, resources, and support they need to approach each rotation with confidence. Create a profile now. Access to premium content is free with any NEJM Group individual or institutional subscription. 

Federal Panel Says Nasal Spray Flu Vaccine Should Not Be Used Next Flu Season
The AP (6/22, Stobbe) reports research presented at a medical meeting in Atlanta showed the nasal spray FluMist vaccine “was somewhat effective, but still not did not work as well as flu shots,” according to the maker of the vaccine, AstraZeneca. However, Centers for Disease Control and Prevention flu expert Dr. Joseph Bresee said, “We could find no evidence (the spray) was effective.” The nasal spray accounts for just 8 percent of the total flu vaccine doses produced each year. But because it’s mainly used in kids, about a third of the flu vaccinations of children were done with FluMist, health officials say.


CLASSIFIEDS



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Recently renovated Medical Office
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Recently renovated Medical Office Space available June, 2016 in desirable midtown Manhattan building located between Park and Madison Avenues.Please Call Mr Mel Farrell at 212. 696.7107 for further information.



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

 

 

 

 

 

 

 

 

 

 

 

 

 

June 17, 2016 – Gun Violence Is a Crisis

 

Dr. Reid
PRESIDENT’S MESSAGE
Dr. Malcolm Reid
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June 17,  2016
Volume 16, Number 22

Dear Colleagues:

This week, the American Medical Association’s House of Delegates approved a resolution to identify gun violence as a public health crisis. The AMA will lobby Congress to repeal the 20-year ban on funding CDC research into gun violence as a public health problem.

The resolution was sponsored by Joshua Cohen, MD, MPH, a member of the Medical Society of the State of New York’s AMA delegation.  “Thousands of Americans are injured or die each year as a result of gun violence,” Dr. Cohen told the group. “America is looking to its physicians for our voice on this public health crisis and for our leadership in addressing it.  As such, we also ask in this resolution that our AMA actively lobby to end the 20-year ban on gun violence research.” Though President Barack Obama lifted the research ban through executive order nearly three years ago, Congress has blocked funding for these studies.

Dr. Cohen continued with an impassioned plea for action. “As scientists, we understand that we must study a problem in order to discover ways to solve it.  Now is the time to act,” he said. “We will not stand idly by and watch our fellow Americans be slaughtered by the thousands.  We will lead the charge to promote the public health and safeguard our family, friends, and neighbors against such horrific acts.  Please stand with me and call for an end to this public health crisis.”

Early co-sponsors of the resolution included GLMA and the Young Physicians Section. In total, 56 delegations signed on as co-sponsors, an unprecedented coalition of state medical societies and specialty societies.

In a dramatic show of solidarity, it was passed almost unanimously by the AMA House of Delegates.

Following the vote, the delegation applauded their decision with a standing ovation.

Malcolm Reid, MD, MPP
MSSNY President

Please send your comments to comments@mssny.org

MLMIC


Capital_Update_Banner


Dear MSSNY and Alliance Members:

The 2016 legislative session concluded early this morning. Through your efforts guided by MSSNY leadership and the collective efforts of MSSNY staff, MSSNY has had a very successful legislative year. 

As we did when the budget negotiations concluded, your lobby team would again like to acknowledge each and every County and Specialty Medical Society, MSSNY leadership, and the many rank-and-file physicians who answered the call for grassroots action and met locally with their representatives or wrote a letter and/or took a day away from their practice to travel to Albany to personally meet with their elected representatives on issues of importance to all of medicine. 

Sustained physician involvement can make a difference.  Because of your efforts, we list the many successes that together we have achieved. It is our hope that you will share this newsletter with your colleagues so that we may continue to build membership in MSSNY to support even greater legislative accomplishments in the future. 

Your Lobby Team                                                                                                                    Liz, Moe, Pat, and JP

Legislature Does Not Pass Proposed Statute of Limitations Changes
The State Legislature left Albany without taking action on legislation (A.285-A and A.10719-A/S.6596-B) that would have substantially lengthened New York’s medical liability statute of limitations.  We thank the thousands of physicians who contacted their legislators over the last several weeks to express their concerns regarding the adverse impact to patient access to care if this legislation were to be enacted without corresponding tort reforms to offset the huge premium increase this legislation would have required.  Conversations will be continuing over the summer and fall regarding comprehensive changes that are necessary to correct our dysfunctional medical liability adjudication system.
(DIVISION OF GOVERNMENTAL AFFAIRS)


Legislation Advanced By MSSNY to Rectify E-Prescribing Issues Encountered By Physicians Passes Both Houses
MSSNY is pleased to report the passage of three bills by both Houses of the Legislature which, if enacted into law, would address many concerns which have arisen as a result of the e-prescribing law.  The first bill, S. 6779, Hannon/A.9335-B, Gottfried would ease the onerous reporting burden on physicians every single time that they need to issue a paper prescription in lieu of e-prescribing.

In March, the Bureau of Narcotics Enforcement announced that when a physician invokes one of the three statutory exceptions and writes/faxes or calls in 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/fax/oral  prescription is issued, 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.

The bill passed this week affords a much more preferable alternative by allowing physicians and other prescribers to make a notation in the patient’s chart indicating that they have invoked one of the three statutory exceptions.

The second bill, A.9837, Gottfried/S. 7334, Hannon, would allow for the transmissions of e-prescriptions to a secure centralized site from which they can be downloaded by a pharmacy when the patient presents. This would lessen the pressure on the patient to decide during the office visit which pharmacy he or she will use, enable a patient to shop around and change his or her mind for whatever reason. If a patient requests, the prescriber would print out a copy of the prescription to make it easier for the pharmacy, and be useful for the patient as a reminder.

The third bill, A.10448, Schimel/S. 7537, Martins would authorize a pharmacy which does not have a particular medication in stock to transfer the prescription to another pharmacy. Currently, e-prescriptions cannot be transferred by one pharmacy to another thereby requiring the patient to return to or call the prescriber’s office to ask that he/she transmit the e-prescription to another pharmacy creating unnecessary burdens on the patient and delaying timely access to their medication.

Each of these measures will be sent to the Governor for his consideration. MSSNY will keep you apprised of the action taken on each of these very helpful proposals.
(DEARS, AUSTER,CLANCY)

Legislative Package Approved to Address and Arrest Opioid Abuse in NYS
Three measures were introduced and approved by the legislature to comprehensively address and arrest the opioid epidemic in NYS. While MSSNY expressed strong concerns regarding some aspects of these proposals, MSSNY was able to secure modifications that protect clinical discretion and allow for the recognition that every physician practice and the needs of our patients are unique. In addition, the Legislature places new requirements on insurers to provide coverage for needed treatment and on hospitals and pharmacists to disseminate information.

CME Mandate

The legislation requires prescribers authorized to prescribe opioids by the U.S. Drug Enforcement Administration and every prescribing resident under a facility registration to complete three hours of coursework on pain management, palliative care, and addiction by July 1, 2017 and every three years thereafter. With regard to the course, the legislation:

  • recognizes that the course must be approved by commissioner who shall establish standards and review and approve course work; MSSNY this year with the OASAS medical director and representatives from the nurse practitioner and physician assistant associations developed and offered a course – already available through MSSNY’s website (mssny.org)– which MSSNY will seek to have approved in order to assure that its members may comply with July 1, 2017 deadline;
  • establishes that the coursework may be taken online;
  • requires that, upon completion of course, must document by attestation on a form prescribed by the commissioner that he/she has completed the course; and
  • requires the department to allow for an exception process for those (1) who can demonstrate to the department’s satisfaction that there would be no need to complete the course; or (2) that he/she has completed course work deemed by the department to be equivalent to the course work approved by the department. 

While MSSNY was not able to secure a one-time course or sunset we were able to assure that the course can be completed online and that the department would allow for an exception process to be utilized to exempt those for whose practice such a course is not applicable and those who have already taken a course. 

Opioids Limits

The legislation would establish limits on the prescription of a seven-day supply of any schedule II, III, or IV opioid upon initial consultation or treatment of acute pain. The bill gives flexibility to the prescriber to, upon any subsequent consultations for the same pain, issue (up to a thirty day supply) by appropriate renewal, refill or new prescription for the opioid or any other drug. In addition, the legislation:

  • defines “acute pain” to mean pain, whether resulting from disease, accidental or intentional trauma or other cause that the practitioner reasonably expects to last only a short period of time. Such term shall not include chronic pain, pain being treated as part of cancer care, hospice or other end-of-life- care or pain being treated as part of palliative care practices; and
  • limits application of co-pays for the limited initial prescription of an opioid to either (i) proportionate amount between the copayment for a thirty day supply and the amount of drugs the patient was prescribed or (ii) the equivalent to the copay for the full thirty-day supply provided that no additional copays may be charged for any additional prescriptions for the remainder of the thirty-day supply. 

MSSNY advocacy assured that the prescriber, upon any subsequent consultations, has flexibility in prescribing appropriate renewals, refills or new prescription beyond the initial period.Importantly, the term ”consultation” is intended to not require in person examination but can include a phone conversation between prescriber and patient at the conclusion of the initial 7-day supply. 

Insurance Coverage for Substance Abuse Treatment

The legislation requires insurers to afford coverage currently not afforded for substance abuse and treatment services including provision to:

  • require insurers to  (i) provide insurance coverage, without prior authorization, for inpatient services for the diagnosis and treatment of a substance use disorder as long as needed; and (ii) only conduct a utilization review, including retrospective review, commencing on or after the fifteenth day;
  • require insurers to use an objective diagnostic tool approved by the New York State Office of Alcoholism and Substance Abuse Services (OASAS) and consistent with the treatment service levels within the OASAS system (gives insurers until December 31, 2016 to ensure their review tools comply with OASAS standards);
  • require insurers to provide at least five days of coverage, without prior authorization, for medications necessary for the treatment of a substance use disorder;
  • eliminate prior authorization under Medicaid and by commercial carriers for access to buprenorphine or injectable naltrexone;
  • require insurers to provide coverage for the prescription of opioid antagonists to any person (e.g.parent, guardian, sibling) under the same policy as the treated addicted individual; and
  • extend the period individuals may be held at treatment facilities for drug treatment from 48 to 72 hours. During such time, patients must be reevaluated regularly. Under the bill, patients must also be given a discharge plan upon their discharge from the facility in order to ensure a continuum of care, including information on how to access additional treatment services. 

Generally speaking MSSNY policies support timely access to medical care and treatment. These provisions are consistent with the direction taken in those policies.

Information to Patients

The legislation seeks to assure that patients are made aware of the risks associated with controlled substances and of addiction services that are available in their community. The bill would:

  • require the commissioner of the office of alcoholism and substance abuse services (OASAS)to create educational materials that would be disseminated by a pharmacist to a consumer at the time the consumer receives his or her prescription of controlled substances concerning the risks of using controlled substances, the warning signs of addiction and contact numbers for HOPELINE; and
  • require hospitals to develop discharge protocol for services for individuals suffering from substance use disorder which include distribution of informational materials to patients upon their discharge and procedures for the identification, assessment, and referral of individuals with a substance use disorder.

MSSNY was successful in eliminating a proposal that would have placed a duty on a prescriber to provide consultation regarding the addictive nature of opioids and eliminated the proposed requirement to have the patient sign a form attesting that they received such counseling from their prescriber.
(DEARS, AUSTER, CLANCY, MCPARTLON)

Legislation to Enable Physician Override of Insurer “Step Therapy” Medication Protocols Passes Legislature
Legislation (A.2834-D, Titone and S.3419-C, Young) passed the Assembly and Senate this week to articulate a process for physicians to request and be granted an override of an insurer medication step therapy protocol when it is in the best interest of their patients’ health.    MSSNY strongly supported this bill, and worked with a wide array of patient advocacy organizations, specialty societies, hospitals, and pharmaceutical manufacturers to achieve passage of this legislation.   The bill will must be approved by the Governor for it to become law.

The bill would require a health insurer to grant a physician’s override request of an insurer step therapy protocol if one of the following factors are present: 1) the drug required by the insurer is contraindicated or could likely cause an adverse reaction; 2) the drug required by the insurer is likely to be ineffective based upon the patient’s clinical history; 3) the patient has already tried the required medication, and it was not effective or caused an adverse reaction; 4) the patient is stable on the medication requested by the physician; 5) the medication is not in the best interests of the patient’s health.

While the legislation would generally require the health insurer to make its decision within 3 days of the override request of the physician, the insurer would be required to grant the override request within 24 hours of the request if the patient has a medical condition that places the health of such patient in serious jeopardy if they do not receive the requested medication.  Perhaps most importantly, if the physician’s request for an override is denied, it would enable a physician to formally appeal the decision both within the plan’s existing appeal mechanism as well as taking an external appeal.
(AUSTER, DEARS)

Legislative Session Produces Administrative Simplification Bills
In addition to passage of the “step therapy” bill, the Legislature also approved other bills prior to adjourning designed to reduce the administrative burden on physicians in their dealings with health insurers.

The Assembly and Senate passed legislation (A.501-E, Cusick/S.2545-D, Lanza) this week that would reduce from 90 to 60 days the time within which a health insurer must complete its review of the application of a physician to participate in the network of a health insurer, as well as reducing from 90 to 60 days the time within which a physician in some situations can become “provisionally credentialed” if the plan does not complete its review.

The bill also would eliminate some ambiguous statutory language that currently gives discretion to a health insurer to delay a decision on a physician’s application after these deadlines have passed.   The Assembly and Senate also recently passed legislation (A.6983-A, McDonald/S.4721-A, Hannon) that would direct the Commissioner of Health and Department of Financial Services to create standards to provide greater uniformity among health insurers when physicians request insurers to cover their patients’ needed prescription medications.

MSSNY worked closely with the New York Chapter of the American College of Physicians in support of the legislation.  Both bills must be signed by the Governor to become law.                                                                 (AUSTER, DEARS)

CVS Health’s Retail Clinic Bill Fails- Again
CVS HEALTH which operates CVS Pharmacies, a pharmacy benefit manager, mail order and specialty pharmacies, and retail-based health clinic subsidiary, MinuteClinic, attempted to secure passage of legislation (S. 5458, Hannon and a similar bill A. 1411, Paulin) which would allow the establishment of corporate owned retail clinics statewide without establishment of public need as is normally required under the certificate of need provisions of current law

MSSNY had previously succeeded against an effort to defeat the retail clinic proposal that had advanced as part of the executive budget.  Subsequently, a similar proposal (S. 5458, Hannon) was passed by the Senate in May. Just this week, a similar bill was considered by the Assembly but it failed to garner the necessary votes. MSSNY working closely with the Nurses Association and other specialty medical societies succeeded in beating back this additional effort defeating the bill for the second time this year.

Convenience care clinics’ or ‘retail clinics’ operate in states outside New York in big box stores such as Walgreens or CVS retail pharmacies. They are a growing phenomenon across the nation, particularly among upper class young adults who live within a one mile radius of the clinic. These clinics are usually staffed by nurse practitioners and focus on providing episodic treatment for uncomplicated illnesses such as sore throat, skin infections, bladder infections and flu.  Physicians feel strongly that retail based clinics pose a threat to the quality of patient care and to the ability of physician practices to sustain financially and should not be allowed to propagate in New York.                                                       

Another significant concern is the potential conflict of interest posed by pharmacy chain ownership of retail clinics which provides implicit incentives for the nurse practitioner or physicians’ assistant in these settings to write more prescriptions or recommend greater use of over-the-counter products than would otherwise occur. The same self-referral prohibitions and anti-kickback protections which apply to physicians are not applicable to retail clinics, raising the concern for significant additional cost to the health care system. Rather than bend the cost continuum, we are concerned that costs will increase and   quality of care will be negatively impacted.

We thank all physicians and county and specialty medical societies who took the time this week to contact their Assembly representatives to urge defeat of the bill. Your efforts and that of your lobby team proved successful.
(DEARS, AUSTER, CLANCY)

Extended Hours for Breast Cancer Screening
In his State of the State Message in January, Governor Cuomo announced his initiative to expand access to mammography services. Initially, the proposal presented to the Legislature would have applied this new mandate beyond the hospital and extension clinic setting to the private physician practice. MSSNY, working with the NYS Radiological Society, were able to block application of this mandate to private physician practices.

In effect, the legislation adopted by both Houses of the Legislature this week will put into statute regulations adopted earlier this year that:

  • Require hospitals and extension clinics to offer extended hours for screening mammography services on at least two days each week for at least two hours each day offered for a total of at least four hours each week including: (a) M-F between 7-9AM (b) M-F between 5-7PM or (c) Saturday or Sunday between 9AM-5PM.
  • Eliminate annual deductibles, co-payments, and co-insurance payments (“cost-sharing”) for screening and diagnostic imaging for the detection of breast cancer. This includes mammograms, breast ultrasounds, and MRIs covered under a patient’s insurance policy.
  • Eliminate cost-sharing for all screening mammograms, including those provided to women who may not meet current federal screening guidelines but need screening.
  • Provide four hours of paid annual leave for breast cancer screening for public employees in New York City.

We thank the many county medical society Executive Directors who provided us with important information regarding the hours of local mammography providers.
(DEARS, AUSTER)

Midwifery-Led Birthing Center Bill Passes Both Houses
Legislation which would allow for the establishment of midwifery-led birthing centers passed both Houses of the Legislature over the objection of ACOG and MSSNY. The bill would authorize the Commissioner to issue regulations relating to their establishment, construction and operation, using state and national professional association standards in consultation with industry and midwives. MSSNY expressed its strong concern over the fact that the bill does not require these centers to be supervised by a physician and would in fact, allow a midwife to supervise care provided at these centers. In the event that the bill is signed into law by the Governor, MSSNY will work with ACOG and the Department of Health on the development of regulations to implement this legislation.                        (DEARS)

Legislation to Assure Proactive Discipline and Fingerprinting of Health Professionals Fails
Well-intended legislation (S.7791, LaValle and A.10532, Glick) was introduced this year to address media attention that developed over the alleged lax disciplinary procedures of the Office of Professions in the State Education Department which disciplines all licensed health professionals except physicians, physician assistants and specialist assistants. Initially, the bill would have required fingerprinting and background checks by SED of all newly licensed health professionals including physicians.

These provisions were discarded. Other provisions, however, were retained which would have established a process for summary suspension and would have required disciplinary action to be taken in NY where similar action was taken in another state. These provisions would have been put in place for all health professions including physicians PAs and SAs which are already subject to such processes under OPMC. At MSSNY’s request, the Senate amended its bill to remove applicability to physicians. The bill was passed. The Assembly, however, did not make those amendments and did not advance the bill. It is anticipated that the bill will be re-introduced next year.


NYS Legislature Passes Opioid Abuse Deterrent Coverage Bill in Effort to Combat Abuse/Diversion of Opioid Drugs
Legislation has passed both houses that would require insurance companies to cover abuse-deterrent opioid analgesic drugs.   S. 6962A/A.10478, sponsored by Senator Kemp Hannon and Assemblymember Michael Cusick,  is intended  to ensure that  patients are not able to take an abuse deterrent opioids due to lack of insurance coverage.   The Food and Drug Administration (FDA) has stated that abuse-deterrent technologies are important in the creation of safer opioid analgesics. Abuse deterrent technologies make it harder to crush or liquefy a drug in order to snort or inject.  (CLANCY)


Legislature Passes HIV-Related Bills as Part of Governor’s End the Epidemic Efforts
Legislation (S. 8129, Hannon/A. 10724,Gottfried) to expand the requirement for patients ages 13 and above to receive an offer for HIV test, has passed the New York State Legislature.   This measure amends the 2010 law which required physicians and other health care practitioners to offer an HIV test to any individual ages 13 to 64.  

The change eliminates the upper age limit.  Importantly, at the same time, the bill simplifies consent procedures by allowing physician and other health care practitioners to orally advise the patient that an HIV test will be performed and that if the patient objects, than that objection shall be noted in the patient’s chart.  Additionally, the bill also would allow a nurse to screen persons at increased risk for syphilis, gonorrhea and chlamydia pursuant to not-patient specific order.   It also would allow a physician or a nurse practitioner to prescribe and order a patient specific or non-patient specific order to a pharmacist for dispensing a seven day starter kit of post-exposure prophylaxis (PEP) for the purposes of preventing HIV.   The measure will also allow a pharmacist to dispense a seven day starter kit. 

Another measure, S. 7505/A. 9834, sponsored by Senator Hannon and Assembly Gottfried, also passed both houses and would allow for disclosure of HIV/AIDS related medical information to qualified researches who have received approval from a human research review committed or an institutional review board (IRB).   Both measures are part of Governor Cuomo’s recommendations stemming from his task force to End the Epidemic.                                          (CLANCY)

MSSNY Efforts Prevail on Scope of Practice & Allied Health Provider Bills
With the final remarks and closing gavel of the extended 2016 Legislative Session in Albany— MSSNY, our physicians, and specialty societies succeeded in defeating numerous scope of practice and allied health provider bills. Our combined efforts helped to ensure that the following bills will not become law this year:

  • Athletic Trainers Scope Bill – A.1266 (LAVINE)/ S.4499 (FUNKE), would have established licensure requirements and expanded the scope of practice for athletic trainers to include the ability to examine, evaluate, assess, manage, treat and rehabilitate neuromusculoskeletal injuries, including concussions and spinal cord injuries. This bill passed the Senate, but died in the Assembly Higher Education Committee.
  • Podiatry Scope Bill – A.719 (PRETLOW)/ S.6990 (AMEDORE), would have expanded the scope of practice for a podiatrist to include care of any wound, up to the knee, “related to” a condition of the foot or ankle, and removed the requirement for podiatrist to be “directly supervised” by an advanced NYS-licensed podiatrist  or physician.  The bill remains in the Higher Education Committees in the Assembly and Senate.
  • Two Corporate Practice bills which would have allowed non-physician providers to form Limited Liability Partnerships with physicians were defeated:
    • 8153 (PEOPLES-STOKES)/ S.5862 (LAVALLE), would have permitted non-physician title eight licensed health professionals to form limited liability companies with physician. This bill remains in the Assembly Higher Education Committee and the Senate Corporations, Authorities, and Commissions Committee.
    • 4391 (O’DONNELL)/ S.215 (MARTINS), would have permitted doctors of chiropractic to form limited liability companies with physicians. This bill remains in the Assembly Higher Education Committee and the Senate Corporations, Authorities, and Commissions Committee.
  • Nurse Anesthetist “Title Bill” – A.140 (PAULIN)/ S.7166 (GALLIVAN), 3835 (MORELLE)/ S.35 (DEFRANCISCO), A.3941 (GOTTFRIED)/ S.2048 (HASSELL-THOMPSON), would have provided for the certification by the NYSED of certified registered nurse anesthetists (CRNAs) and further supported CRNA efforts to apply to CMS for a waiver to the requirement of physician supervision. With the exception of A.140 which advanced to 3rd reading in the Assembly, the various bills remain in their respective house’s Higher Education Committee.
  • Nurse Anesthetist Reimbursement Bill – A.7722 (CAHILL)/ S.2955 (RITCHIE), would have authorized health insurance reimbursement for certified nurse anesthetists providing anesthesia services and further supported CRNA efforts to apply to CMS for a waiver to the requirement of physician supervision. The bill remains in both the Senate and Assembly Insurance Committees.
  • Optometry Prescribe bill – A.9961 (PAULIN)/ S.7440 (FUNKE), would have allowed optometrists to prescribe certain oral prescriptions. Negotiations produced an agreement between the New York State Ophthalmological Society (NYSOS) and the New York State Optometric Association (NYSOA). Therefore, MSSNY took no position on this legislation. While the bill passed the Senate, it did not pass the Assembly.

As in years past, the majority of the legislation is likely to return next year. As this year brings to an end the two-year session cycle, bills will need to be re-introduced next year upon which time they will assigned a new bill number.  They will also be assigned to their committee of origin and so begins the process again.
(MCPARTLON, DEARS, CLANCY, AUSTER)


DOH Announces Updates to Medical Marijuana Course
The New York State Department of Health has announced updates to the four hour department-approved online medical use of marijuana course developed by TheAnswerPage, an established online medical education provider. The course has been updated to include additional information regarding the use of medical marijuana in each of the conditions covered in the Compassionate Care Act, based on available scientific evidence.

The cost to take the course is $249. Practitioners taking the course will earn 4.5 hours of CME credit upon successful completion of the course. The new material is also accessible through TheAnswerPage’s website at no extra cost for those who have already taken the medical use of marijuana course.

The course may be accessed here.

Practitioners who wish to register with the Department and certify their patients for the Medical Marijuana Program must complete this course.

For further information, visit the department’s web page for more information about becoming a registered practitioner:
(CLANCY)


MSSNY’s Opioid Webinars Series Now Available Online
The Medical Society of New York has archived its opioid webinar series on its continuing medical education website at http://cme.mssny.org.  

The course was developed by MSSNY and the NYS Office of Alcoholism and Substance Abuse Services (OASAS) and the New York State Department of Health’s Bureau of Narcotic Enforcement.  The webinars are:

  • Webinar 1 Pain Management at the Crossroads: A Tale of Two Public Health Problems
  • Webinar 2 Rational Opioid Prescribing: Is this Possible for Chronic Pain?
  • Webinar 3 Treatment of Opioid Use Disorders and Webinar For Pain Patients w/Substance Use Disorders.
  • Webinar 4 Pain Patients w/Substance Use Disorders

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 right of the page and click on “My training” to view the physician’s individualized training page. The courses are listed under: A Webinar Series on Opioid Use, Treatment, and Addiction. 

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 enduring 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 on all these programs may be obtained by contacting Pat Clancy at pclancy@mssny.org.
(CLANCY, DEARS)

PTSD and TBI in Returning Veterans:  June Webinar
MSSNY will be holding the last in a series of CME webinars on PTSD and TBI in returning veterans on Monday, June 20. The faculty presenter will be 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 growth

To register for this program, click on the date below and fill out the registration form
Monday, June 20, 6-7 PM                                                                                 (ELPERIN, DEARS)

MSSNY Joins Other State Medical Societies to Express Strong Opposition to VA Rule to Eliminate Physician Supervision Requirements
This week MSSNY joined the Coalition of State Medical Societies in a letter to the Veterans’ Administration to express deep concerns with the Veterans Administration (VA) proposed rule that would allow all Advanced Practice Registered Nurses (APRNs) to practice independently in the VA Health System.

In particular, the letter noted the Coalition’s strong concerns about the impact on quality of care for veterans as it would, among other concerns, permit nurse anesthetists to practice independently in the VA system, despite state scope of practice that do not permit this.  Specifically, the letter notes that “while nurse anesthetists are an important part of the anesthesia care team, they do not have the 12,000 to 16,000 hours of clinical training and nearly a decade of formal post-graduate education and residency training that enables anesthesiologists to prevent and respond competently and swiftly in critical emergencies before, during and after surgery.”

Instead, the letter urges that the VA “continue to advance veterans’ health care by maintaining physician leadership of the health care team”. In addition to MSSNY, the Coalition of State Medical Societies consists of the medical societies of the states of Arizona, California, Florida, Louisiana, New Jersey, North Carolina, Oklahoma, South Carolina and Texas.

To read letter click here.                                                                                                    (AUSTER) 

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    

enews large


NEJM: Birth Defects Noted in 3 U.S. Infants Born to Zika-Infected Women
Three children of U.S. women infected with the Zika virus were born with birth defects, the CDC reported on Thursday. In addition, in three pregnancy losses in Zika-infected women, the fetuses had signs of birth defects.

This is the first time the CDC is releasing specific pregnancy outcome counts. As of June 9, some 234 pregnant women in the U.S., not including U.S. territories, have laboratory evidence of Zika infection.

Birth defects include microcephaly, calcium deposits in the brain that point to possible brain damage, excess fluid in brain cavities and the area surrounding the brain, missing or malformed brain structures, abnormal eye development, or other conditions from brain damage that affects nerves, muscles, and bones (e.g., clubfoot or inflexible joints).

A study published in the NEJM suggests that pregnant women who contract the Zika virus during the third trimester could face a lesser risk of birth defects. According to scientists in Colombia and at the US Centers for Disease Control and Prevention, no microcephaly or brain abnormalities were present in the babies of 616 Colombian women who were diagnosed during their third trimester.

The study’s author’s emphasized that their research was “preliminary.” Most of the women “followed by researchers were still pregnant at the time the report was completed” and the researchers only considered live births, so it is unknown “how many Zika-affected pregnancies developed birth defects but ended in stillbirth, miscarriage or abortion.”

USPSTF Changes Guidance on Colon Cancer Screening Tests
Adults should pick the colon cancer screening test they feel the most comfortable with, according to a new recommendation from the US Preventive Services Task Force. The new recommendation differs from past guidance, which recommended screenings for colon cancer “on a specific time table using one of four tests.” The new recommendation published in JAMA reaffirmed that patients should be screened for colon cancer beginning “at age 50 and continue until at least age 75.” 

Reminder: July 1 deadline to Apply for EHR Incentive Program Hardship Exception
Hospitals, critical access hospitals and eligible professionals who did not achieve meaningful use in the Medicare Electronic Health Record Incentive Program for the 2015 reporting period can apply through July 1 for a hardship exception from the 2017 payment adjustment. CAHs that have already submitted a form for 2015 are not required to resubmit. For instructions and applications, visit www.cms.gov.


All Providers Must Take Action by July 1, 2016 to Avoid Payment Adjustments
Hardship exception applications are due by July 1, 2016 for eligible professionals (EPs), eligible hospitals, and critical access hospitals (CAHs).

Applications and Instructions
The Medicare EHR Incentive Program 2017 hardship exception instructions and application for EPs and eligible hospitals are available on the Payment Adjustments & Hardship Information webpage of the EHR Incentive Programs website. Please visit the EHR Incentive Programs FAQs page for answers to specific hardship exception questions.

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

Register for MIPS Webinars Today and Don’t Forget to Comment by June 27, 2016
CMS invites the public to join the final listening sessions in our ongoing webinar series designed to help the public learn more about the Merit-Based Incentive Payment System (MIPS) proposed in the Medicare Access and CHIP Reauthorization Act of 2015 (MACRA) Notice of Proposed Rulemaking (NPRM). These webinars will focus on the proposed Clinical Practice Improvement Activities (CPIA) performance category and the MIPS scoring system.
Register Now

MIPS: Clinical Practice Improvement Activities (CPIA) Performance Category Overview

Dates: June 22, 2016

Time: 12:00-1:00 p.m. ET

Register: To participate, visit the June 22 registration webpages.

Details: The webinars will provide an overview of the MIPS CPIA performance category, as outlined in the key provisions of the recently released MACRA NPRM. The new CPIA performance category accounts for 15% of the first year MIPS score, and rewards clinical practice improvement activities focused on care coordination, beneficiary engagement, and patient safety.

MIPS Scoring Overview

Dates: June 24, 2016

Time: 12:00-1:00 p.m. ET

Register: To participate, visit the June 24 registration webpages.

Details: The webinars will provide an overview of the proposed MIPS performance category scoring and how a composite performance score (CPS) will be calculated based on each performance score. CMS subject matter experts will review the proposed scoring system for MIPS, and also discuss how payment adjustments will be determined based on the composite performance score, as outlined in the key provisions of the MACRA NPRM. The information will pertain to MIPS participants in the first year of the program and


CLASSIFIEDS



Medical Office Space For Sale in Prime Bay Ridge Co-op Building
Recently renovated Medical Office
Bay Ridge, Brooklyn You will be sure to impress your patients with this move-in condition over 2500 square foot professional space in a prime Bay Ridge Coop Building.  Office space has a separate private entrance. Low maintenance of $866.67 includes heat, water and real estate taxes.  Currently set up as a medical office so little work to do.  You have two reception areas; large waiting room; four large offices/exam rooms and plenty of extra work areas.   The outer rooms have windows facing Shore Road. Easy to park and accessible by bus.  Go to the link below to see the virtual tour of this great space. Asking $675,000.00.
http://tours.tourfactory.com/tours/tour.asp?t=1512876&guid={4A6DD20B-CF78-432D-B56F-19CF4BC55DF6}

Liz Hammann                                                Keller Williams Realty Empire                    Licensed Associate Real Estate Broker
Cell:    646-773-2785      lizhamm15@gmail.com
www.lhammann.kwrealty.com   
                           
 Michelle Epstein, CBR  Keller Williams Realty Empire
Licensed Associate Real Estate Broker
Cell:    917- 359-0721
michellerealestate1@gmail.com
www.epstein.kwrealty.com                        


121 EAST 60TH ST – 6TH FL OFFICE ROOM FOR RENT
Professional Co-op office in an established part time Doctors office. Recently re-done, waiting area with a full time receptionist for your clients. The elegant lobby is attended 24-hours and offers live operator answering service for your clients, and more. Available Monday through Sunday (Monthly $2,000). Please call to schedule an appointment. 212-355-7017121 E 60thst


Recently renovated Medical Office Space available June, 2016 in desirable midtown Manhattan building located between Park and Madison Avenues.Please Call Mr Mel Farrell at 212. 696.7107 for further information.


Spacious, Newly Renovated Medical Office to Sublet Near the United Nations
Handicapped accessible, Wi-Fi ready, separate reception area 1 to 3 rooms rooms available, 1 to 7 days per week Ideal for ophthalmologist/optometrist with onsite optical dispensary Could easily suit other specialties Excellent value, long-term lease available if desired Contact Dr. Scott Weissman email scott.weissmanmd@gmail.com  cell 914 772-5581



Office to Share/Rent
Medical Co-op Building located on East 60th Street, NYC. Includes one consult room and 2 examination rooms, waiting room, 2 bathrooms, plus 2 medical assistants. Space for one secretary. Available 2.5 days per week.  Free internet and Wi-Fi. For more information, contact mamdocs9B@gmail.com or (212) 230-1144.


Want to Rent your Medical Office? Need to Lease Space to Expand your Practice?
Clineeds is an online platform designed to help physicians find or rent medical office space. Listing is completely FREE! Sign up today at http://clineeds.com/signup. We take care of the rest!


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. $1300 for four days a month. Available full or part-time. 212.371.0468 / drdese@gmail.com


Medical Office For Rent – 715 West 170 Street
Two to five examination rooms available plus Reception,secretarial areas. Two bathrooms and entrances. Ethernet and cable ready. $4000 – $9500/ month. 917.861.8273 drdese@gmail.com Can build to suit including accredited O.R.s


Physician Opportunities

Columbia University – Associate Vice President for Health Services
Reporting to the Vice President for Campus Services, the Associate Vice President for Health Services (AVP) provides leadership for health policy, programs, outreach, facilities, finances, and health programming on the Morningside Campus of Columbia University. Serving the total health, health information, disability, sexual assault, sexual misconduct, and wellness needs of over 25,000 students, the AVP serves as a principal advisor on health affairs to the Vice President for Campus Services, the Executive Vice President for Facilities & Operations, and the Senior Executive Vice President.

The position requires a minimum of 10 years experience in health/human services or a related setting with at least five years of senior leadership at a director level or above. MD, DO, PhD, or equivalent clinical degree in a health related field is required. Additional requirements include: experience in crisis management coupled with ability to manage confidential information in a sensitive manner and use of sound judgment; ability to manage and lead collaboration with diverse constituencies, including traditionally underserved communities; demonstrated ability to provide leadership in complex institutions and to work with health providers and a wide range of University and contracted personnel; and evidence of strong customer service orientation with proven methods of soliciting, responding to, and managing feedback.

Review of applications will begin June 6, 2016, and will continue until the position is filled. The full position announcement, including application instructions, is available on the Spelman Johnson website at http://www.spelmanandjohnson.com/position/associate-vice-president-health-services 

Columbia University is an equal opportunity/affirmative action — Race/Gender/Disability/Veterans employer.


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

 

 

 

 

 

 

 

 

 

 

 

 

 

June 10, 2016 – Don’t Stop Now!

 

Dr. Reid
PRESIDENT’S MESSAGE
Dr. Malcolm Reid
asset.find.us.on.facebook.lgTwitter_logo_blue1

June 10,  2016
Volume 16, Number 21

Dear Colleagues:

As legislators seek to close down the Legislative Session for the year, please be warned that anything can happen at the end of Session.  Proposals thought to be “dead” or languishing often come back to life.

For example, many years ago, legislation to completely eliminate the statutory limitation on attorney fees for medical malpractice lawsuits seemingly came out of nowhere to be passed on one of the last calendars of the Assembly and Senate.  Thankfully, newspapers across the State editorialized just how bad that bill was and it was vetoed by then-Governor Pataki.

This is why we need you.

I thank the many of you who have answered our call over the last few months to contact your legislators and the Governor to express your strong opposition to a bill that would greatly increase the length of time for a medical malpractice suit to be brought.   We are pleased many newspaper and TV articles about this issue have prominently highlighted our concerns that you cannot bestow new rights to sue doctors and hospitals without taking corresponding action to bring down the exorbitant cost of medical liability insurance in New York.  There could be serious consequences to the availability of patient care.

So far, neither the Assembly nor the Senate have passed the bill this year.

But like I said, anything can happen in the last days of a Legislative Session, particularly when we are but a few months away from an election.  Controversial issues are often among the last bills taken up.  And the trial lawyers and their allies are putting enormous pressure on the Legislature.

Therefore, it is absolutely critical that you continue to contact your lawmakers and remind them of the huge problems to patient care in your community that will occur if they enact liability expansion legislation in a “vacuum.”  Remind them of just how dysfunctional and expensive New York already is.  Remind them that we need comprehensive reform of our medical malpractice adjudication system.  And remind them of the many health services that may not be provided by hospitals and doctors because resources will instead be spent instead on increased malpractice coverage costs.

In addition to calling your local legislators, you can send a letter to your legislators from here.

And make sure your colleagues do the same. You’ve stepped up for your profession— make sure they do so too.

I know many physicians think the “game is rigged” and that these contacts don’t make a difference. Let me assure you – it does make a difference.  The key, however, is generating a critical mass of physicians to weigh in simultaneously with their legislators to give them a stronger sense of the breadth of our concerns.

So please make these contacts NOW.  It’s essential to protect ourselves, our colleagues and, most importantly, to preserve the availability of timely quality patient care in our communities.

Malcolm Reid, MD, MPP
MSSNY President

Please send your comments to comments@mssny.org

MLMIC


Capital_Update_Banner

One Week Left – Please Urge Your Legislators to Prevent Legislation to Increase Lawsuits and Liability Premiums
With just a few days left in the 2016 Session, all physicians must continue to call and write their legislators to urge that they reject legislation (A.285-A, Weinstein/S.6596, DeFrancisco) that could increase by another 15% your already exorbitant medical liability premiums by changing the Statute of limitations to a “Date of Discovery” rule.   A letter can be sent from here. The bill was placed on the Debate List in the Assembly this past Wednesday, June 8, indicating action by the Assembly could be imminent, and it is under active consideration by the State Senate.

Therefore, you must let your legislators know that the cost impact of this legislation is unsustainable to New York’s fragile health care system.  Any premium increases, let alone the premium increase that would be imposed as a result of this bill, are not assumable by physicians and hospitals given the cuts in payment being imposed by health insurers and from Medicare, as well as the huge costs to comply with burdensome state and federal mandates.  Let your legislators know that New York physicians already pay in many instances among the highest premiums in the country and that New York was recently ranked by WalletHub.com as the worst state to practice medicine in the country.  And most importantly, let them know the harmful consequences to patient access to care in your community if this legislation were to be enacted without also enacting reforms to reduce the cost of liability coverage.

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 print and radio 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 print ads (http://www.nymedmalreform.org/) have appeared in City & State, Politico New York, and the Albany Times-Union.  Moreover, MSSNY’s concerns about the impact of this legislation on New York’s fragile health care system were documented extensively in a recent AP article.
(AUSTER, DEARS)

Governor and Legislature Negotiations on Opioid Package Continue
MSSNY President Malcolm Reid, MD, MPP met this week with Paul Francis, Deputy Secretary for Health and Human Services and other Governor’s health policy staff to put forward MSSNY’s concerns with several issues imbedded in the opioid package now being negotiated by the Governor and Legislative leaders to address the burgeoning epidemic of opioid abuse and addiction. This week the Governor’s Task Force released a report making 25 recommendations to combat this epidemic.  A copy fo the report can be found at this link.

Specifically, Dr. Reid weighed in on four issues of concern including: (1) how often and whom should take mandatory continuing education on effective pain management; (2) whether to establish a day limit on the initial prescription of opioids for acute pain, for how long, and the need for physicians to maintain some discretion to prescribe longer than the limit; (3) whether the exception from the duty to consult the state prescription monitoring database currently granted for emergency room physicians should be repealed; and (4) whether to mandate counseling of patients for whom a prescription is being written for a schedule II, II or IV opioid/narcotic on the addictive nature of opioids.  Discussions on these issues remain fluid. To read a copy of MSSNY’s letter to Mr. Francis, please go here.(DEARS, AUSTER, CLANCY)

Legislation to Reduce E-Prescribing Exception Reporting on Senate Floor; Physician Action Needed
Physicians are urged to contact their elected State Senator to urge that the Senate take up and pass legislation (S. 6779, Hannon/A.9335-B, Gottfried) before they leave town next week to ease the onerous reporting burden on physicians every single time that they need to issue a paper prescription in lieu of e-prescribing.  The Assembly counterpart was overwhelmingly approved the Assembly last week by a 132-2 vote.

In March, 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 Senators to pass this bill by sending a letter located on the MSSNY grassroots action center at this link.
 (DEARS, AUSTER)


Previously Vetoed “Title Bill” for Certified Registered Nurse Anesthetists on Assembly Floor.   Urge Your Elected Representatives to Vote Against A.140 (Paulin)/S.7166 (Gallivan)
Physicians are urged to immediately contact their elected Assembly representatives to urge defeat of legislation (A.140 (Paulin)/S.7166 (Gallivan), currently on the 3rd reading rules cal. 150 on the Assembly floor, where if passed would statutorily recognize the title of certified registered nurse anesthetists (“CRNA”).   A letter can be sent from MSSNY’s Grassroots Action Center here.

Passage of this legislation is cause for great concern because it will empower CRNAs to encourage the State to apply to the Centers for Medicaid and Medicare Services (CMS) for CMS approval of an exemption from the requirement for physician supervision of CRNAs, thereby poetentially allowing for CRNA independent practice.

While this bill purports to be a “title protection” for CRNAs it actually establishes the certification necessary for CRNAs to be directly reimbursed by health insurance companies, as would be provided in legislation currently before both the Senate & Assembly Insurance Committees. 
(
DEARS, MCPARTLON)         


Legislation to Enable Physician Override of Insurer “Fail First” Medication Protocols Moving
With just 3 scheduled Session days remaining in the 2016 Legislative Session, physicians are urged to send a letter and call their legislators in support of legislation (A.2834-D, Titone and S.3419-C, Young) to articulate a process for physicians to request and be granted an override of an insurer medication step therapy protocol when it is in the best interest of their patients’ health.    MSSNY has been working with a wide array of patient advocacy organizations, specialty societies, hospitals, and pharmaceutical manufacturers in support of this legislation.

Last week, A.2834-D was overwhelmingly advanced from the Assembly Insurance Committee to the Rules Committee.  The bill has been substantially modified from earlier versions to more clearly delineate the circumstances when an override must be granted, and the time frames within which a health insurer must grant such override request.  Specifically, a health insurer would be required to grant a physician’s override request if one of the following factors are present: 1) the drug required by the insurer is contraindicated or could likely cause an adverse reaction; 2) the drug required by the insurer is likely to be ineffective based upon the patient’s clinical history; 3) the patient has already tried the required medication, and it was not effective or caused an adverse reaction; 4) the patient is stable on the medication requested by the physician; 5) the medication is not in the best interests of the patient’s health.

While the legislation would generally require the health insurer to make its decision within 3 days of the override request of the physician, the insurer would be required to grant the override request within 24 hours of the request if the patient has a medical condition that places the health of such patient in serious jeopardy if they do not receive the requested medication.  Perhaps most importantly, if the physician’s request for an override is denied, it would enable a physician to formally appeal the decision both within the plan’s existing appeal mechanism as well as taking an external appeal.  S.3419-C is currently before the Senate Insurance Committee, and its sponsor Senator Young is pushing hard for its passage.                                                                                                                                       (AUSTER, DEARS)

Bill to Limit Pain Medication Passes Assembly Codes Committee
A6091-B/A.8601-A, sponsored by Senator Kemp Hannon and Assemblymember John McDonald, passed the Assembly Codes Committee this week by a vote of 14-6. Voting against the measure were: Assemblymembers Robin Schimminger;  Charles Lavine; Thomas McKevitt; Michael Montesano; Edward Ra; and Claudia Tenney.  The bill would limit the initial prescription by a physician or other prescriber of a Schedule II or III Controlled Substances, to a 5-day supply for patients suffering acute pain.   MSSNY strongly opposes this legislation because it fails to allow for a prescriber to exercise professional medical judgement in prescribing based upon the patient’s medical condition. The bill is now is in the Assembly Rules Committee and can be voted on at any time.

Physicians can send a letter to their members in opposition by logging onto MSSNY’s Grass Roots Action Center here.

This issue is being heavily discussed in the context of the opoid/heroin abuse package under negotiation (See related article.)

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.
(CLANCY, DEARS, AUSTER, MCPARTLON)


Physician Collective Negotiation Legislation AdvanceThe Senate Finance Committee this week advanced to the Senate Rules Committee critically important legislation (S.1157-A, Hannon) that would permit independently practicing physicians to collectively negotiate patient care contract provisions with health insurance companies under close state supervision.      MSSNY strongly supports this legislation as a means to enable patients and physicians to be able to negotiate fairly with those health insurance companies that have huge market power dominance in many regions across New York State.  

It is more important than ever given the push on insurers to impose often untested value-based payment strategies.   Earlier this session, identical legislation (A.336-A, Gottfried)   advanced from the Assembly Health Committee to the Assembly Ways & Means Committee.  With just a few days left in the Legislative Session, all physicians are urged to contact their Senators and Assemblymembers to urge support for this legislation.  A letter can be sent from MSSNY’s Grassroots Action Center here.
(AUSTER, DEARS)


Renewed Effort to Address Ethics Reform
On Wednesday, Governor Cuomo visited Fordham University in the Bronx and delivered an address outlining his renewed agenda for ethics reform. In the address, Governor Cuomo announced he would take “first-in-the-nation action to curb the power of independent expenditure campaigns.” Governor Cuomo lambasted the standing 2012 U.S. Supreme Court decision which prohibits government from restricting people and corporations from making unlimited independent political expenditures on behalf of candidates—effectively undoing provisions of state and federal campaign finance law which existed at that time. While leaders of both houses of the state legislature have indicated that ethics reform remains a priority, differences remain over the breadth of potential changes and exactly which provisions are ripe for reform.                        (MCPARTLON)   

PTSD and TBI in Returning Veterans:  June Webinar
MSSNY will be holding the last in a series of CME webinars on PTSD and TBI in returning veterans on Monday, June 20. The faculty presenter will be 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 growth

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

Monday, June 20, 6-7 PM                                                                                (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    

enews large

Our Message Is Everywhere
A message from Doctors and Hospitals: New York is home to many of the world’s finest doctors and hospitals, but they spend billions annually on medical malpractice costs—by far the nation’s highest. Let’s make sure Albany doesn’t make things worse by passing bills that will raise those costs even higher and damage patient care. Learn more here.


Info You Need: Medicare’s Mail-Order Program for Diabetes Testing Supplies
If you treat patients with Original Medicare who use diabetes testing supplies, you should know that Medicare is continuing its National Mail-Order Program. This program includes all parts of the US, and it requires Medicare beneficiaries who want diabetes testing supplies delivered to their homes to use a national mail-order supplier that has a contract with Medicare. The program is designed to help beneficiaries get quality supplies while also saving money.

This website contains the latest information about the national mail-order program.

EPaces: Do Not Share Your User ID and Password
As a result of recent security improvements to the ePACES log-in process, eMedNY is aware that some ePACES users are sharing their log-in credentials with their co-workers in order to facilitate daily processing of eligibility checks, among other functions.
We would like to remind all ePACES users of the following policy stated in the Medicaid Confidentiality Regulations under “ePACES Access Control.”

Warning: As per the Health Insurance Portability and Accountability Act (HIPAA), CSC or the on-site ePACES Administrator is required to assign unique user IDs and passwords for identifying and tracking user’s identity [Ref: § 164.312(a)(2)(i)]. Users that share their ePACES user id and password are in violation of the HIPAA Security Regulation. If this practice is detected, the user’s access will be revoked and other sanctions may apply.

HOW TO SET UP ePACES USER IDs:
Fortunately, there are only 3 steps needed for your ePACES Administrator to create and define roles for ePACES user IDs – click, create, assign!

Read all about them in the ‘ePACES – Setting Up User Accounts’ Quick Reference Guide. No Call Center tokens required!



SPECIAL OFFER:  Sign up for the “New York State Practitioner Education – Medical Use of Marijuana Course” today and get free admission to the CWCBExpo Exhibits at the Javits Center.
The “New York State Practitioner Education-Medical Use of Marijuana Course” created by TheAnswerPage.com[1] is the sole required course for physicians seeking to register with the NYSDOH to certify patients for medical marijuana.  We also offer a legal educational course, written by the Medical Marijuana Law Group of Abrams Fensterman, which addresses the common legal concerns of physicians who are interested in certifying patients for the New York Medical Marijuana Program.

Sign up today at www.TheAnswerPage.com and receive:

  • Complimentary admission to all of the exhibits at the Cannabis World Congress & Business Expo (CWCBExpo), June 16-17, 2016, Javits Convention Center
  • Up to a year to complete the “New York State Practitioner Education-Medical Use of Marijuana Course” and earn 4.5 AMA PRA Category 1 CME Credits™
  • Access to legal educational guidance written by the Medical Marijuana Law[2] Group of Abrams Fensterman


Differences in Incomes of Physicians by Race and Sex
“The median annual income of white male doctors between 2010 and 2013 was $253,042, compared with $188,230 for black male doctors, according to a study published in the BMJ. Both groups of men far out-earned female doctors of both races, although the pay gap between white and black women was modest and not statistically significant.”



FDA Warns Overdosing on Anti-Diarrhea Drugs Can Cause Fatal Heart Problems
The FDA warned on June 7 that common anti-diarrhea drugs, such as prescription Imodium (loperamide) and related over-the-counter drugs, “can cause potentially deadly heart problems when taken at higher-than-recommended levels.” According to the agency, abusers try to achieve highs by taking up to 300 milligrams at once, far in excess of the recommended 8 to 16 milligrams per day. The agency has received 31 reports of people hospitalized due to the heart problems, including 10 deaths over the last 39 years. 

Please Take Physicians Foundation Survey: NY Should Be Heard
We need your support to make the 2016 Physicians Foundation Biennial Physician Survey a success! Your participation is essential for generating awareness about the key challenges facing the physician community today as well as for helping policymakers formulate efficient and effective policies that improve patient care. We would greatly appreciate you taking 10 minutes to complete the survey.

USPSTF Reaffirms Syphilis Screening Guidelines as Cases Increase
The US Preventive Services Task Force reaffirmed their 2004 guidelines on syphilis screening, which recommend that “men who have sex with men, people living with HIV and others at an increased risk of the sexually transmitted disease” be screened for syphilis. The United States Preventive Services Task Force made this recommendation in a JAMA article published online, the first update to the syphilis screening recommendation since 2004 (JAMA. 2016;315[21]:2321-2327. doi: 10.1001/jama.2016.5824). The article points out that the number of new syphilis cases in the US was almost 20,000 in 2014 compared to only 5,979 in 2005, according to the CDC.

Albany County Executive to Sign Law to Raise Tobacco Purchase Age
The Albany (NY) Times Union (6/8) reports that on Wednesday, Albany County Executive Dan McCoy is expected to sign a law that would raise the age to buy tobacco products to 21. Lawmakers have pushed this legislation “in hopes of preventing young adults from ever taking up a tobacco habit.” Albany would become the third county in New York to pass this legislation. 


MSSNY in the News

Associated Press – 06/02/16
New York Bill Extends Deadline for Medical Malpractice Suits
(MSSNY Senior VP, Liz Dears quoted)

Also ran in:

McDowellNews.com
New York bill extends time for medical malpractice lawsuits                                    

The Observer-Dispatch (AP)
NY bill extends time for medical malpractice lawsuits                                              

ObserverToday.com
NY bill would extend deadline for medical malpractice suits

TheIndyChannel.com
New York bill extends deadline for medical malpractice suits                                   

KMTV
New York bill extends deadline for medical malpractice suits                                   

The Denver Channel
New York bill extends deadline for medical malpractice suits                                   

FOX 4 Now
New York bill extends deadline for medical malpractice suits                                   

WPTV NewsChannel 5
New York bill extends deadline for medical malpractice suits                                   

KTNV ABC Channel 13
New York bill extends deadline for medical malpractice suits                                   

Kivi Tv
New York bill extends deadline for medical malpractice suits                                   

Newsnet5.com
New York bill extends deadline for medical malpractice suits                                   

Columbia Missourian
New York bill extends deadline for medical malpractice suits                                   

PostBulletin.com (AP)
New York bill extends deadline for medical malpractice suits                                   

Pantagraph.com
New York bill extends deadline for medical malpractice suits                                   

Olean Times Herald
New York bill extends deadline for medical malpractice suits                                   

Journal Gazette & Times-Courier
New York bill extends deadline for medical malpractice suits                         

Dailyamerican.com
New York bill extends deadline for medical malpractice suits                                     

The Daily Star (AP)
New York bill extends deadline for medical malpractice suits                                     

KDWN
New York bill extends deadline for medical malpractice suits                                     

The Leader Herald
New York bill extends deadline for medical malpractice suits                                     

Adirondack Daily Enterprise
New York bill extends deadline for medical malpractice suits                                     

ObserverToday.com
New York bill extends deadline for medical malpractice suits                                     

Westfield Republican
New York bill extends deadline for medical malpractice suits                                     

Elkhart Truth
New York bill extends deadline for medical malpractice suits                                     

WKBW
Bills extends time for medical malpractice suits                                                       

Fox Carolina
New York bill extends deadline for medical malpractice suits

Albany Times Union – 06/02/16
New York opioid pill bill would limit prescriptions
(MSSNY mentioned)

Also ran in:

San Antonio Express News

Newsday – 06/05/16
Medical malpractice lawsuit bill stalls in state Senate 

WCBS-TV New York  – 06/03/16
N.Y. State Lawmakers Push For Change To Limitations On Medical Malpractice Suits
(MSSNY President, Dr. Malcom Reid interviewed) 

Black Daily News – 06/03/16
N.Y. State Lawmakers Push For Change To Limitations On Medical Malpractice Suits
(MSSNY President, Dr. Malcom Reid quoted)

Examiner.com – 06/06/16
NY Senate sits on malpractice bill passed by Assembly
(MSSNY mentioned)

Newsday – 06/05/16
Medical malpractice lawsuit bill stalls in state Senate
(MSSNY Mentioned)


CLASSIFIEDS



Medical Office Space For Sale in Prime Bay Ridge Co-op Building
Recently renovated Medical Office
Bay Ridge, Brooklyn You will be sure to impress your patients with this move-in condition over 2500 square foot professional space in a prime Bay Ridge Coop Building.  Office space has a separate private entrance. Low maintenance of $866.67 includes heat, water and real estate taxes.  Currently set up as a medical office so little work to do.  You have two reception areas; large waiting room; four large offices/exam rooms and plenty of extra work areas.   The outer rooms have windows facing Shore Road. Easy to park and accessible by bus.  Go to the link below to see the virtual tour of this great space. Asking $675,000.00.
http://tours.tourfactory.com/tours/tour.asp?t=1512876&guid={4A6DD20B-CF78-432D-B56F-19CF4BC55DF6}

Liz Hammann                                                Keller Williams Realty Empire                    Licensed Associate Real Estate Broker
Cell:    646-773-2785      lizhamm15@gmail.com
www.lhammann.kwrealty.com   
                           
 Michelle Epstein, CBR  Keller Williams Realty Empire
Licensed Associate Real Estate Broker
Cell:    917- 359-0721
michellerealestate1@gmail.com
www.epstein.kwrealty.com                        


121 EAST 60TH ST – 6TH FL OFFICE ROOM FOR RENT
Professional Co-op office in an established part time Doctors office. Recently re-done, waiting area with a full time receptionist for your clients. The elegant lobby is attended 24-hours and offers live operator answering service for your clients, and more. Available Monday through Sunday (Monthly $2,000). Please call to schedule an appointment. 212-355-7017121 E 60thst


Recently renovated Medical Office Space available June, 2016 in desirable midtown Manhattan building located between Park and Madison Avenues.Please Call Mr Mel Farrell at 212. 696.7107 for further information.


Spacious, Newly Renovated Medical Office to Sublet Near the United Nations
Handicapped accessible, Wi-Fi ready, separate reception area 1 to 3 rooms rooms available, 1 to 7 days per week Ideal for ophthalmologist/optometrist with onsite optical dispensary Could easily suit other specialties Excellent value, long-term lease available if desired Contact Dr. Scott Weissman email scott.weissmanmd@gmail.com  cell 914 772-5581


Office to Share/Rent
Medical Co-op Building located on East 60th Street, NYC. Includes one consult room and 2 examination rooms, waiting room, 2 bathrooms, plus 2 medical assistants. Space for one secretary. Available 2.5 days per week.  Free internet and Wi-Fi. For more information, contact mamdocs9B@gmail.com or (212) 230-1144.


Want to Rent your Medical Office? Need to Lease Space to Expand your Practice?
Clineeds is an online platform designed to help physicians find or rent medical office space. Listing is completely FREE! Sign up today at http://clineeds.com/signup. We take care of the rest!


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. $1300 for four days a month. Available full or part-time. 212.371.0468 / drdese@gmail.com


Medical Office For Rent – 715 West 170 Street
Two to five examination rooms available plus Reception,secretarial areas. Two bathrooms and entrances. Ethernet and cable ready. $4000 – $9500/ month. 917.861.8273 drdese@gmail.com Can build to suit including accredited O.R.s


Physician Opportunities

Columbia University – Associate Vice President for Health Services
Reporting to the Vice President for Campus Services, the Associate Vice President for Health Services (AVP) provides leadership for health policy, programs, outreach, facilities, finances, and health programming on the Morningside Campus of Columbia University. Serving the total health, health information, disability, sexual assault, sexual misconduct, and wellness needs of over 25,000 students, the AVP serves as a principal advisor on health affairs to the Vice President for Campus Services, the Executive Vice President for Facilities & Operations, and the Senior Executive Vice President.

The position requires a minimum of 10 years experience in health/human services or a related setting with at least five years of senior leadership at a director level or above. MD, DO, PhD, or equivalent clinical degree in a health related field is required. Additional requirements include: experience in crisis management coupled with ability to manage confidential information in a sensitive manner and use of sound judgment; ability to manage and lead collaboration with diverse constituencies, including traditionally underserved communities; demonstrated ability to provide leadership in complex institutions and to work with health providers and a wide range of University and contracted personnel; and evidence of strong customer service orientation with proven methods of soliciting, responding to, and managing feedback.

Review of applications will begin June 6, 2016, and will continue until the position is filled. The full position announcement, including application instructions, is available on the Spelman Johnson website at http://www.spelmanandjohnson.com/position/associate-vice-president-health-services 

Columbia University is an equal opportunity/affirmative action — Race/Gender/Disability/Veterans employer.


New York Life Seeks Experienced Medical Director
New York Life is seeking an experienced Medical Director. Full time physician (M.D. or D.O.) needed for our underwriting department in Manhattan. At least 3-5 years Internal Medicine or Family Practice required. Competitive industry salary, excellent benefits, outstanding culture. Visit: https://career8.successfactors.com/sfcareer/jobreqcareer?jobId=30244&company=NYLPRD&username=


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

 

 

 

 

 

 

 

 

 

 

 

 

 

June 3, 2016 – Let’s End Opioid Abuse

 

Dr. Reid
PRESIDENT’S MESSAGE
Dr. Malcolm Reid
asset.find.us.on.facebook.lgTwitter_logo_blue1

June 3,  2016
Volume 16, Number 20

Dear Colleagues:

It seems that every day we read or hear about another opioid related death. In fact, more than 78 people die each day due to opioid misuse and overdose, including heroin. Many of these individuals are our patients. As physicians, we can—and must—help to end the opioid abuse epidemic.

The Governor and New York State Legislature are currently discussing and negotiating an Opioid Prevention Package that will likely be voted on before the end of session. This comprehensive package includes provisions to require coverage for inpatient treatment for substance abuse for a period of time and eliminating utilization review and prior authorization requirements that has served as obstacles for necessary treatment to combat substance abuse. The proposal also would establish specific day limitations on the amount of Schedule II and Schedule III prescriptions for acute pain; a requirement that all prescribers of schedule II, III or IV controlled substances counsel and make available information relating to the risk of addiction and a requirement for all prescribers to take a 3 hour course on pain management, addiction, palliative and end of life care which will be tied to licensure. The MSSNY Council and its leadership, along with our Division of Governmental Affairs, are responding to these proposals.

At the recent MSSNY Council meeting, the Council supported two very important proposals to address the opioid issue. MSSNY supports legislation to allow patients to have access to Medication Assisted Therapy (MAT) and psychosocial strategies for substance use disorders covered by insurance including services provided in the primary care setting.  MSSNY also continues to support insurance coverage for inpatient substance use treatment and increasing funding for more available treatment beds.

MSSNY Council also supported federal legislation to allow “partial fill” of Schedule II Controlled Substance medications.  Partial fills for Schedule II controlled substances are currently prohibited under the Drug Enforcement Agency’s (DEA) regulation. This bill, part of the Congressional opioid discussion, would allow physicians/prescribers, in consultation with their patient, to prescribe up to a 30 day supply of Controlled Schedule II with a notation to the pharmacist that he/she should only dispense the agreed to amount. The DEA allows partial fill for Controlled III and IV.

Since 2014, MSSNY has been an active participant of the American Medical Association’s Task Force to Reduce Opioid Abuse. The task force, comprised of over 25 states, specialty and other health care associations was formed in an effort to reduce the nation’s burden from the inappropriate prescribing of opioids, and the growing crisis of heroin overdose and death.

One of the goals of the task force is to increase physicians’ registration and use of effective prescription monitoring programs (PMP).  Here, in New York State, physicians who wish to prescribe a Schedule II, III or IV controlled substance are required to consult the PMP—and since the implementation of this requirement, doctor shopping has been reduced by over 85% and prescriptions for opioids are down!

And, every state in the country saw a decrease in the number of opioid analgesic prescriptions filled in 2015 according to new data from IMS Health.  This information, which reflects the activity of physicians and other healthcare professionals, shows that nationally, there was a 6.8 percent decrease in the total number of prescriptions for opioid analgesics in 2015 compared to 2014. For New York State, there has been a 10.5% reduction in opioid analgesics prescriptions since 2013!

We should be very proud of our collective efforts to reduce “doctor-shopping.”

MSSNY has, and will continue to support expanded access to naloxone through New York State’s Opioid Prevention Program.  As a result, 3,500 overdose reversals have been documented, and over 1,500 lives were saved in 2015.

Another goal of the task force is to enhance physicians’ education on effective, evidence-based prescribing. This year, 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, jointly provided a free, four part webinar series on Opioid Use, Treatment, and Addiction. This program is now available on line here.

MSSNY has also developed and placed on its website information on best practices, physicians’ resources and educational programs that are currently available to physicians.  Please click this link.

Let me be clear—78 patients dying EVERY DAY from this epidemic is unacceptable. This is not a problem that physicians created; but physicians are needed to effectuate the remedy.  And while we have concerns regarding some of the proposals under consideration, we stand ready to participate in negotiations to assure that patients can continue to have access to medically indicated treatment for acute and chronic pain. This will likely mean that we—both the prescriber and the patient—will need to be better educated as to appropriate pain management for all patients including those with addiction so that we can arrest the wide ranging and persistent scourge affecting our patients throughout New York and across the nation. MSSNY is committed to assisting the state and, indeed, the nation in ending the opioid misuse and overdose epidemic.

We will need every physician in this state to do his/her part in this effort!

Malcolm Reid, MD, MPP
MSSNY President

Please send your comments to comments@mssny.org

MLMIC


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Governor Advances Draft Legislation to Curb Opioid Epidemic
Governor Cuomo, fresh from a listening tour that has transpired across all communities through the state, has advanced draft legislation that would address issues that have arisen in New York communities with regard to the burgeoning epidemic of opioid abuse and addiction.  Based upon MSSNY’s conversations with the Legislature, the draft proposal would attempt to attack the problem comprehensively by proposing the following:

  • Establishment of insurance law changes that enhance coverage for substance abuse diagnosis and treatment opportunities and reduce obstacles such as utilization review and prior authorization requirements that insurers impose to restrict access to medically necessary substance abuse treatment, including: (1) a requirement to use the OASAS clinical review tool in making UR decisions; required coverage for at least fourteen days of inpatient care for diagnosis and treatment of substance abuse; and elimination of prior authorization for buprenorphine;
  • Attacking the problem in our schools by requiring teachers to take continuing education on drug addiction and response; requiring students to receive education on heroin and opioid abuse; requiring the establishment of recovery high schools; and requiring substance abuse free living beds in colleges;
  • Establishing a seven day limit on the initial prescription of opioids for acute pain (that does not include chronic pain, cancer pain, pain that is addressed by palliative care practices or pain that is a normal consequence of a surgery that is performs on an inpatient basis) and
  • Establishing a requirement that all prescribers (physicians, physician assistants, nurse practitioners, nurse midwives and podiatrists) complete a three hour continuing education course before each re-registration on pain management, addiction and palliative care; and
  • Establishing a requirement that prescribers of any schedule II, III or IVcontrolled substance offer counseling and make available information relating to the risk of addiction and available local resources for addiction and have a patient sign a form acknowledging that he or she has been offered consultation related to the prevention, mitigation and treatment of such addiction.

MSSNY lobby staff met this week with the Lieutenant Governor and Commissioner of Health to discuss the perspective of organized medicine on these issues. MSSNY lobby staff has also met with members of the Senate and Assembly and is working toward addressing many of the concerns raised by MSSNY leadership concerning these proposals.                                                                                           (DEARS, CLANCY, AUSTER)

Do Not Wait – Contact Your Legislators to Prevent 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 to a “Date of Discovery” rule.   A letter to your Senator and Assemblymember can be sent from here.

There are just two weeks left in the legislative session, and anything can happen.  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 print and radio 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 print ads (http://www.nymedmalreform.org/) have appeared in City & State, Politico New York, and the Albany Times-Union.  Moreover, MSSNY’s concerns about the impact of this legislation on New York’s fragile health care system were documented extensively in an AP article this week.                                                                                       (AUSTER, DEARS)

Legislation to Enable Physician Override of Insurer “Fail First” Medication Protocols Moving
With just 7 schedule Session days remaining in the 2016 Legislative Session, physicians are urged to send a letter in support of legislation (A.2834-C, Titone and S.3419-B, Young) to articulate a process for physicians to request and be granted an override of an insurer medication step therapy protocol when it is in the best interest of their patients’ health.    MSSNY has been working with a wide array of patient advocacy organizations, specialty societies, hospitals, and pharmaceutical manufacturers in support of this legislation.

This week, A.2834-C was overwhelmingly advanced from the Assembly Insurance Committee to the Rules Committee.  The bill has been substantially modified from earlier versions to more clearly delineate the circumstances when an override must be granted, and the time frames within which a health insurer must grant such override request.

Specifically, a health insurer would be required to grant a physician’s override request if one of the following factors are present: 1) the drug required by the insurer is contraindicated or could likely cause an adverse reaction; 2) the drug required by the insurer is likely to be ineffective based upon the patient’s clinical history; 3) the patient has already tried the required medication, and it was not effective or caused an adverse reaction; 4) the patient is stable on the medication requested by the physician; 5) the medication is not in the best interests of the patient’s health.  While the legislation would generally require the health insurer to make its decision within 3 days of the override request of the physician, the insurer would be required to grant the override request within 24 hours of the request if the patient has a medical condition that places the health of such patient in serious jeopardy if they do not receive the requested medication.  Perhaps most importantly, if the physician’s request for an override is denied, it would enable a physician to formally appeal the decision both within the plan’s existing appeal mechanism as well as taking an external appeal.  Similar legislation S.3419-B is currently before the Senate Insurance Committee.

Last 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)

Legislation to Reduce E-Prescribing Exception Reporting Passes the Assembly
Legislation (A.9335-B, Gottfried) overwhelmingly passed the Assembly this week by a 132-2 vote to ease the onerous reporting burden on physicians every single time that they need to issue a paper prescription in lieu of e-prescribing.    Identical legislation (S.6779-B, Hannon) is before the full Senate and poised for passage.
In March, 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 Senators to pass this bill by sending a letter located on the MSSNY grassroots action center.
(DEARS, CLANCY, AUSTER)

Bill to Limit Pain Medication Will Be Voted on By Assembly Codes Committee; Physicians Urged to Act
S6091-B/A.8601-A, sponsored by Senator Kemp Hannon and Assemblymember John McDonald, will be voted on by members of the Assembly Codes Committee, next 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. While the bill was originally to be considered by the Committee this week, the meeting was postponed until next week. 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 here.  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.

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.
(CLANCY, DEARS, AUSTER, MCPARTLON)


Senate Finance Committee to Consider Collective Negotiation Legislation
The Senate Finance Committee will consider legislation (S.1157-A, Hannon) next week that would permit independently practicing physicians to collectively negotiate patient care contract provisions with health insurance companies under close state supervision.   The bill had been favorably reported to the Finance Committee from the Health Committee earlier this year.  MSSNY strongly supports this legislation as a means to enable patients and physicians to be able to negotiate fairly with those health insurance companies that have huge market power dominance in many regions across New York State.   It is more important than ever given the push on insurers to impose often untested value-based payment strategies.   Identical legislation (A.336-A, Gottfried) recently advanced from the Assembly Health Committee to Assembly Ways & Means Committee.  All physicians are urged to contact their Senators and Assemblymembers to urge support for this legislation.  A letter can be sent from MSSNY’s Grassroots Action Center here.                      (AUSTER, DEARS)


DOH Provides Certification Process For Low Volume Prescribers to Receive One Year Exemption From E-Prescribing Requirment
The New York State Department of Health has announced its certification procedures for prescribers who write less than 25 prescriptions a year.  This process will enable prescribers to write paper prescriptions rather the e-prescriptions.

The Medical Society of the State of New York secured this provision within the 2016-17 New York State Budget and the certification process can either be done electronically or by paper application. Prescriptions in both oral and written form for both controlled substances and non-controlled substances are included in determining whether the practitioner will reach the limit of twenty-five prescriptions.  A certification is valid for one year. Should the practitioner exceed twenty-five prescriptions within the twelve-month period, he or she is required to issue prescriptions electronically or obtain from the Department a waiver from the requirement to electronically prescribe.

Certifications postmarked or submitted to the Department by July 1, 2016, may be specified to begin as of March 27, 2016.  Such certifications remain valid through March 26, 2017.

Instructions for filing a certification through the Health Commerce System (HCS) can be found here.

The paper certification form can be found here and can be either emailed, mailed or faxed back to the NYS DOH Bureau of Narcotic Enforcement.
(CLANCY, DEARS)


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 mhoffman@mssny.org.
(CLANCY, HOFFMAN)


MSSNY Participates in New York Kicks Butts Campaign
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 is being held this week, 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.

There is also a new 5 Steps to Quit Smoking flier in both ENGLISH and SPANISH found on the resources page of nykicksbutts.org.  Additional information can also be found here.
(CLANCY)

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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BNE: Low Prescribers Do Not Have to Issue Scripts Electronically
The Bureau of Narcotic Enforcement (BNE) announced that the process for a practitioner to certify that he or she will not issue more than twenty-five prescriptions during a twelve-month period is now available.  A practitioner submitting a certification will not be required to issue prescriptions electronically.

A practitioner can either submit a certification online through the Electronic Prescribing Waiver (EPW) application on the NYS Health Commerce System or by submitting a paper certification form to BNE.

Below is a list of Frequently Asked Questions (FAQ’s) related to “Certifications” that will be included in the Electronic Prescribing FAQ document on our website.

VP Socio-Med Regina McNally 

Q: How does a practitioner certify that he or she will not issue more than 25 prescriptions during a twelve-month period?

A: A practitioner can either submit a certification online through the Electronic Prescribing Waiver (EPW) application on the NYS Health Commerce System or by submitting Certification form, DOH-5221, to the Bureau of Narcotic Enforcement.

Complete the steps below to submit a certification online in HCS:

  1. Log into the HCS here
  2. Under “My Content” click on “All Applications”
  3. Click on “E”
  4. Scroll down to Electronic Prescribing Waivers and double click to open the application. You may also click on the “+” sign to add this application under “My Applications” on the left side of the Home screen.
  5. Select the practitioner name from the list. If the name appears more than once, select the option that starts with the profession (i.e., Medicine-###### Doe John).
  6. Provide contact information for the person who should be contacted regarding the Certification.
  7. Click on “Submit Certification”
  8. Enter in the “Begin Date” of the twelve-month certification period.
  9. Enter in the Mailing Address of the practitioner submitting the certification.
  10. Click “Submit”
  11. Click “Certify”
  12. You will be returned to the “Waiver Requests and Certifications Summary” screen. The certification period will be displayed.

Q: Can a practitioner submit a certification with an effective date prior to the date of submission?

A: During the first year of the certification process, certifications postmarked or submitted to the Department by July 1, 2016, may specify a begin date as early as March 27, 2016.  Certifications submitted to the Department after July 1, 2016, cannot be backdated.  

Q: Can a practitioner submit a certification with a future effective date?

A: Yes, up to 3 months in the future.

Q: Does the 25 count script limit include all prescriptions?  

A: Prescriptions in both oral and written form for both controlled and non-controlled substances must be included in determining whether the practitioner will reach the limit of twenty-five prescriptions.

Q: What should a practitioner do if he or she exceeds twenty-five prescriptions within the twelve-month certification period?  

A: The practitioner is required to issue prescriptions electronically or obtain a waiver from the requirement to electronically prescribe.  Please see information related to electronic prescribing waivers here.

Q: Does my certification need to be approved?   

A: There is no review and approval process for certifications.

Q: Who can submit the certification for a practitioner?   

A: Each individual practitioner must certify independently.  A hospital or group practice organization cannot submit a certification on behalf of the practitioner.

Q: How long is the certification valid?   

A: A certification is valid for one year from the begin date.

Q: Does a practitioner need to submit a certification each year?   

A: Yes. A practitioner must recertify each year.

Q: Can a practitioner submit a certification for a period that begins prior to the end date of its current certification period?   

A: No.  The certification periods can’t overlap.  The begin date of a new certification period must be after the end date of the previous certification.

Q: Does a practitioner who already has an approved waiver from the requirement to electronically prescribe also need to submit a certification?   

A: No.  The practitioner is covered by the waiver until March 26, 2017.

Q: Does a practitioner who issues less than 25 prescriptions per year and already has an approved waiver from the requirement to electronically prescribe also need to submit a certification?   

A: No.  The practitioner is covered by the waiver until March 26, 2017.


Fidelis: Pain Management Provider Access Crisis in Erie County,  NY:
On 5/18/2016 MSSNY contacted CMS regarding a crisis in Erie Co concerning access to pain management providers as alerted by members of Fidelis (The New York State Catholic Health Plan).  After learning that Dr. Eugene Gosy, a participating pain management provider, was indicted on 114 counts by the United States’ Attorney for the Western District, Fidelis suspended this provider who operated a large pain management practice.  Concurrently, and perhaps unrelated, another large pain management practice has closed, leaving large numbers of patients in Erie Co. without access to pain management services.  On 5/24/2016 Fidelis advised CMS that it is actively recruiting providers to fill this gap.  However, since some may not meet credentialing standards, Fidelis is allowing its members to receive care out of network.  In addition it is working with local anesthesiologists to contract with them, as they would be qualified.

CMS Baltimore has been apprised of the situation and the Account Manager was advised that since pain management is not a specialty subject to time and distance standards, this case would not justify running the network through the Network Management Module (NMM) for a review.  However, we can address the issue from the perspective of accuracy of provider directories and closely monitor the plan’s progress in providing appropriate provider access.

Before this incident came to light, Fidelis had already been subject to a review of its online provider directory by CMS Baltimore. Since this issue is not limited to Fidelis, other Account Managers who have plans with service areas in Erie County have been notified to review with their plans. (Socio-Med VP Regina McNally) 


Council Notes—June 2, 2016

Council approved the following:

  • MSSNY will support development of a comprehensive stroke system within New York State and will support development of either statewide or regional stroke protocols for New York State’s EMS agencies.
  • MSSNY will support the New York State Pathology Association’s efforts in seeking a repeal of the New York State regulation that prohibits pathologists from speaking directly to patients about test results.
  • MSSNY will support legislation/regulations allowing partial fill of Schedule II Controlled Substance medications similar to partial prescription fills permitted under regulations for Schedule III and IV medications.
  • MSSNY will support legislation/regulation to allow access to Medication Assisted Therapy and psychosocial strategies for substance use disorders and that insurance companies be required to provide coverage for these programs including in the primary care non-psychiatric non –addiction specialist setting.
  • MSSNY Task Force on Physician Stress and Burnout will continue in its efforts to promote wellness efforts as a way of prevention of the consequences of burnout.  Next steps will include assigning a subcommittee to review survey options; outreach to liability companies to discuss partnering options; and outreach to NYS resident education leadership regarding opportunities for collaboration.
  • The 2016 House of Delegates Resolutions that were referred to Council by the HOD were approved to go back to committees for further discussion. The resolutions will then be brought back to Council.


NY Law: Can Register as Organ Donors When Buying Insurance through Exchange
On June 1, Gov. Andrew Cuomo signed a bill into law that will require the state’s health insurance exchange to “ask anyone signing up for coverage…if they’d like to register as [an organ] donor.” The article points out that the state has the second lowest organ donation participation rate in the US. Currently, only one in four eligible New Yorkers is registered. That’s the second lowest participation rate in the nation. The law’s sponsor, Sen. Kemp Hannon, says nearly 10,000 people in the state are now on a waiting list for available organs or tissue. AP (5/26)


United Healthcare Will Offer Exchange Plans in Only Three States
On May 31, UnitedHealthcare disclosed on a website dedicated to insurance brokers that it plans to offer on-exchange plans in only three states — New York, Nevada, and Virginia. A company spokeswoman confirmed that it will withdraw from the Illinois exchange.


Preliminary CDC Report: Long Decline In US Death Rates Has Reversed Course
The Centers for Disease Control and Prevention reports preliminary numbers indicate that “the long decline in Americans’ death rates has reversed course.” Factors contributing to the “turnaround” include “a rise in deaths from firearms, drug overdoses, accidental injuries, suicides, Alzheimer’s disease, hypertension and stroke.” Still, “‘there’s no smoking gun here,’ said Farida Ahmad, mortality surveillance lead for the CDC’s National Center for Health Statistics.” Ahmad called “the increase in mortality ‘unusual,’ noting that it’s the first time since 2004-2005 that the rate went up rather than down.” 


First-Ever Addiction Implant
FDA last week approved a first-of-its-kind implantable device that emits a drug used to treat opioid-related substance use disorders. The device over a six-month period releases buprenorphine, a medication used to treat opioid-related substance use disorders. Expanding the use and availability of medication-assisted treatment (MAT) options like buprenorphine is an important component of the FDA’s opioid action plan and one of three top priorities for the U.S. Department of Health and Human Services’ Opioid Initiative aimed at reducing prescription opioid and heroin related overdose, death and dependence.


CLASSIFIEDS



Medical Office Space For Sale in Prime Bay Ridge Co-op Building
Recently renovated Medical Office
Bay Ridge, Brooklyn You will be sure to impress your patients with this move-in condition over 2500 square foot professional space in a prime Bay Ridge Coop Building.  Office space has a separate private entrance. Low maintenance of $866.67 includes heat, water and real estate taxes.  Currently set up as a medical office so little work to do.  You have two reception areas; large waiting room; four large offices/exam rooms and plenty of extra work areas.   The outer rooms have windows facing Shore Road. Easy to park and accessible by bus.  Go to the link below to see the virtual tour of this great space. Asking $675,000.00.
http://tours.tourfactory.com/tours/tour.asp?t=1512876&guid={4A6DD20B-CF78-432D-B56F-19CF4BC55DF6}

Liz Hammann                                                Keller Williams Realty Empire                    Licensed Associate Real Estate Broker
Cell:    646-773-2785      lizhamm15@gmail.com
www.lhammann.kwrealty.com   
                           
 Michelle Epstein, CBR  Keller Williams Realty Empire
Licensed Associate Real Estate Broker
Cell:    917- 359-0721
michellerealestate1@gmail.com
www.epstein.kwrealty.com                        


121 EAST 60TH ST – 6TH FL OFFICE ROOM FOR RENT
Professional Co-op office in an established part time Doctors office. Recently re-done, waiting area with a full time receptionist for your clients. The elegant lobby is attended 24-hours and offers live operator answering service for your clients, and more. Available Monday through Sunday (Monthly $2,000). Please call to schedule an appointment. 212-355-7017121 E 60thst


Recently renovated Medical Office Space available June, 2016 in desirable midtown Manhattan building located between Park and Madison Avenues.Please Call Mr Mel Farrell at 212. 696.7107 for further information.


Spacious, Newly Renovated Medical Office to Sublet Near the United Nations
Handicapped accessible, Wi-Fi ready, separate reception area 1 to 3 rooms rooms available, 1 to 7 days per week Ideal for ophthalmologist/optometrist with onsite optical dispensary Could easily suit other specialties Excellent value, long-term lease available if desired Contact Dr. Scott Weissman email scott.weissmanmd@gmail.com  cell 914 772-5581


 

Office to Share/Rent
Medical Co-op Building located on East 60th Street, NYC. Includes one consult room and 2 examination rooms, waiting room, 2 bathrooms, plus 2 medical assistants. Space for one secretary. Available 2.5 days per week.  Free internet and Wi-Fi. For more information, contact mamdocs9B@gmail.com or (212) 230-1144.


Want to Rent your Medical Office? Need to Lease Space to Expand your Practice?
Clineeds is an online platform designed to help physicians find or rent medical office space. Listing is completely FREE! Sign up today at http://clineeds.com/signup. We take care of the rest!


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. $1300 for four days a month. Available full or part-time. 212.371.0468 / drdese@gmail.com


Medical Office For Rent – 715 West 170 Street
Two to five examination rooms available plus Reception,secretarial areas. Two bathrooms and entrances. Ethernet and cable ready. $4000 – $9500/ month. 917.861.8273 drdese@gmail.com Can build to suit including accredited O.R.s


Physician Opportunities

Columbia University – Associate Vice President for Health Services
Reporting to the Vice President for Campus Services, the Associate Vice President for Health Services (AVP) provides leadership for health policy, programs, outreach, facilities, finances, and health programming on the Morningside Campus of Columbia University. Serving the total health, health information, disability, sexual assault, sexual misconduct, and wellness needs of over 25,000 students, the AVP serves as a principal advisor on health affairs to the Vice President for Campus Services, the Executive Vice President for Facilities & Operations, and the Senior Executive Vice President.

The position requires a minimum of 10 years experience in health/human services or a related setting with at least five years of senior leadership at a director level or above. MD, DO, PhD, or equivalent clinical degree in a health related field is required. Additional requirements include: experience in crisis management coupled with ability to manage confidential information in a sensitive manner and use of sound judgment; ability to manage and lead collaboration with diverse constituencies, including traditionally underserved communities; demonstrated ability to provide leadership in complex institutions and to work with health providers and a wide range of University and contracted personnel; and evidence of strong customer service orientation with proven methods of soliciting, responding to, and managing feedback.

Review of applications will begin June 6, 2016, and will continue until the position is filled. The full position announcement, including application instructions, is available on the Spelman Johnson website at http://www.spelmanandjohnson.com/position/associate-vice-president-health-services 

Columbia University is an equal opportunity/affirmative action — Race/Gender/Disability/Veterans employer.


New York Life Seeks Experienced Medical Director
New York Life is seeking an experienced Medical Director. Full time physician (M.D. or D.O.) needed for our underwriting department in Manhattan. At least 3-5 years Internal Medicine or Family Practice required. Competitive industry salary, excellent benefits, outstanding culture. Visit: https://career8.successfactors.com/sfcareer/jobreqcareer?jobId=30244&company=NYLPRD&username=


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

 

 

 

 

 

 

 

 

 

 

 

 

 

Council June 2, 2016

 

       AGENDA
         MSSNY Council Meeting
            Thursday, June 2, 2016, 9:00 a.m.
                  Long Island Marriott
                     101 James Doolittle Blvd.
                  Uniondale, NY  11553

A.    Call to Order and Roll Call

B.    Approval of the Council Minutes of April 17, 2016

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

1.   President’s Report
a. 2016 HOD Resolutions referred to Council
    (For Council Approval)

 

b. Presidential Appointments to the Executive Committee of the Council are:
Joshua M. Cohen, MD, MPH
Parag H. Mehta, MD

 

c. Minutes of he MSSNY Task Force on Physician Stress and Burnout

 

2.  Board of Trustees Report – No Report Submitted.  Council met prior to the Board of Trustees at the HOD.

 

3.  Secretary’s Report – Nominations for Life Membership and Dues Remissions.

 

4. MLMIC Update  –  Mr. Donald Fager, Esq. will present a verbal report

 

5. AMA Delegation Update – Dr. Kennedy will present a verbal
report

 

6. MSSNYPAC Report – (Handout at Council)

 

7. Commissioners  (All Action Items, For Council Approval )
Commissioner of Science & Public Health, Frank G. Dowling, MD
1. Preventive Medicine & Family Health Committee:
a. Request to support a three-tiered system of stroke centers in NYS  and repeal of prohibition preventing pathologists from speaking directly to patients about test results

 

  2. Addiction & Psychiatric Medicine Committee
a. Support of partial fill of Schedule II Controlled Substance and Support to allow access to Medication Assisted Therapy

(MAT)

8.  Councilors  (All Action Items from County Societies
and District Branches)
     No reports submitted

 

D.  Reports of Officers (Verbal Reports)

1. Office of the President – Meetings attended:
  • Suffolk County Legislative Breakfast
  • MLMIC Cocktail Dinner & Board of Directors
  • Erie County Annual Meeting
  • Annual Bangladesh Convention
  • Specialty Society Fundraiser & Lobby Day
  • Kings County Annual Meeting
  • Nassau County Annual
  • Richmond County Legislative Brunch
  • Round Table Meeting with Senator Flanagan

2. Office of the President Elect – Charles Rothberg, MD
3. Office of the Vice President – Thomas J. Madejski, MD
4. Office of the Treasurer – Joseph R. Sellers, MD, Financial Statement for the period 1/2/16 to 4/30/16
5. Office of the Secretary – Arthur C. Fougner, MD – Discussion re Eisenhower Park walk to boost community health
6. Office of the Speaker –  Kira A. Geraci-Ciradullo, MD, MPH

E. Reports of Councilors  (Informational)

1 .     Kings and Richmond Report – Parag H. Mehta, MD, Verbal
Report  on ABIM First Community Exploration Day Meeting
2 .      Manhattan/Bronx Report – Joshua M. Cohen, MD, MPH
3.       Nassau County Report – Paul A. Pipia, MD
4.       Queens County Report – Saulius J. Skeivys, MD
5.       Suffolk County Report – Maria A. Basile, MD, MBA
6.       Third District Branch Report – Brian P. Murray, MD
7.       Fourth District Branch Report – John J. Kennedy, MD
8.       Fifth District Branch Report –Howard H. Huang, MD
9.       Sixth District Branch Report – Robert A. Hesson, MD
10.    Seventh District Branch Report – Mark J. Adams, MD
11.    Eighth District Branch Report – Edward Kelly Bartels, MD
12.    Ninth District Branch Report  –  Thomas T. Lee, MD
13.    Medical Student Report – Christina Kratschmer
14.    Organized Medical Staff Report – Richard Ritter, MD
No written report submitted
15.    Resident/Fellow Report Robert A. Viviano, DO
16.   Young Physician  Report – L. Carlos Zapata, MD

F. Commissioners (Committee Informational Reports/Minutes)

1. Commissioner of Communications,
Joshua M. 
Cohen, MD, MPH
     Report of the Division of Communications

 

2. Commissioner of Science & Public Health,
Frank G. Dowling, MD

a. Bio Ethics Minutes Committee , April 1, 2016
b. Preventive Med and Family Health Minutes, May 12, 2016

G. Report of the Executive Vice President
Membership Dues Revenue Schedule

 

HReport of the General Counsel
No written report submitted

 

I. Report of the Alliance  
Alliance Report

 

J.   Other Information/Announcements

 

K.  Adjournment