August 26, 2016 – DOH:Expand Marijuana Program

Dr. Reid
PRESIDENT’S MESSAGE
Dr. Malcolm Reid
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Aug. 26, 2016
Volume 16, Number 30

MLMIC

Dear Colleagues:

The following letter to the editor was sent to the Buffalo News to clarify several misstatements in an article about I-STOP.

The Medical Society of the State of New York (MSSNY) staunchly supports the need to reduce, prevent, and eliminate opioid addiction.

Several points of the Buffalo News article, (“I-STOP Supporters Urge Cuomo to Veto Bills They Say Would Weaken Pill Prescription Legislation”) at http://bit.ly/2bvehjU need clarification. In fact, the efforts of physicians across New York State complying with I-STOP are a major reason for the huge decrease in “doctor-shopping.”

Current law requires prescribers to consult the State’s prescription medication registry before they prescribe ANY controlled substance. This assures that patients are not “doctor shopping” for controlled substances from multiple prescribers. This I-STOP component of the law has been in effect since August 27, 2013 and remains unchanged by proposed legislation.

On March 27, 2016, an additional component of the I-STOP law took effect.  This portion of the I-STOP law mandates that all prescriptions for both controlled and non-controlled drugs be electronically filed to all pharmacies located in New York. There were allowances for a few exceptions to this mandate, such as: a power failure; or, the script would be filled by a pharmacy out of NYS; or, it would be impractical for a patient to obtain an electronically prescribed drug in a timely manner, and the delay could adversely impact the patient’s medical condition.

However, the law requires that any time a paper or oral prescription is used, the prescriber is obligated to send an email to the NYS Department of Health containing a burdensome amount of information.

MSSNY supported legislation that will ease the administrative burden resulting from the patient’s need for expeditious relief, the patient’s need to fill a script out of state, and/or transmission failures.  Electronic transmission of prescriptions have a 3% to 6% failure rate.  Since 255 million prescriptions are filled each year in NYS, between 7.6 and 15 million are subjected to technological failure.  It is unrealistic to expect prescribers to send an email each time an electronic failure causes a prescription to be handwritten or phoned into the pharmacy.

I would not want to be the patient waiting for a necessary prescription and caught in the limbo of today’s technology.  In addition, if patients are traveling out of state, they may need a paper prescription to take with them to be filled when they reach their destination.

Again, the original purpose of I-STOP— the duty to consult the State’s registry before prescribing any controlled substance— has NOT been modified by the new legislation.

Twelve additional exceptions were announced by the Department of Health that do not require reporting  to the DOH— which include compounded drugs, prescriptions that contain long or complicated directions, prescriptions for patients in nursing homes and residential health care facilities as defined in Article 28 of the Public Health Law.

Malcolm Reid, MD, MPP
President, Medical Society of the State of New York
Briarcliff Manor, NY
Thomas Madejski, MD
Vice-President, Medical Society of the State of New York
Medina, NY

 

Please send your comments to comments@mssny.org


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DOH: New Report re Use of Marijuana under Compassionate Care Act
The recommendations in a new report, “Medical Use of Marijuana Under the Compassionate Care Act,” published by the DOH this week, stated that New York’s medical marijuana program should double in size and include a broader range of authorized health providers.

Since the program began operations in January, more than 5,000 patients have been certified with the program while more than 600 physicians were registered across the state. The DOH said that’s more than other states whose programs have been in existence for significantly longer than New York’s program.

The DOH made three recommendations tied to increasing access:

·        Doubling the number of suppliers by registering five more organizations over the next two years; allowing nurse practitioners to certify patients

·        Evaluating the possibility of home-delivery services to allow for expanded distribution

·        Recommended exploring ways to make it easier for health-care facilities and schools to possess and administer medical marijuana for patients.

Among the 10 qualifying medical conditions, neuropathies and cancer make up the two largest categories of patients, with 1,704 or 34.1 percent and 1,238 or 24.8 percent, respectively. Pain is cited by 53.5 percent or 3,737 patients as the qualifying complication, while severe or persistent muscle spasms accounts for another 21.1 percent, or 1,477 patients.

AG: HealthNow Revising Mental Health/Nutritional Counseling Coverage
New York Attorney General Eric Schneiderman announced a settlement with HealthNow this week to address the company’s “wrongful denial of thousands of claims for outpatient psychotherapy and more than one hundreds of claims for nutritional counseling for eating disorders”. The wrongful denials totaled more than $1.6 million in patient claims.  The agreement requires HealthNow to pay members for the wrongfully denied claims, revise its policies, and eliminate a company policy that subjected all psychotherapy claims to review after a member’s 20th visit.

To read the AG’s press release, click here. 

According to the press release, the AG’s Health Care Bureau initiated an investigation last year after receiving patient complaints that HealthNow was improperly requiring all outpatient behavioral health visits be preauthorized after the first 20 visits per year, and by excluding coverage for nutritional counseling for eating disorders.  The investigation revealed that since 2012, HealthNow conducted thousands of wrongful reviews in outpatient behavioral health cases under its 20-visit threshold.  As a result, they denied coverage for outpatient behavioral health services for approximately 3,100 members, even though HealthNow generally did not impose the same type of utilization review process for outpatient medical services.

The AG settlement requires HealthNow to eliminate utilization review for outpatient behavioral health treatment based on set thresholds that trigger review, including but not limited to the 20-visit threshold it has applied since 2010. HealthNow will also cover nutritional counseling for eating disorders, including anorexia nervosa and bulimia nervosa. HealthNow will also reimburse members who paid out of pocket for treatment after their claims were denied under the 20-visit threshold or nutritional counseling exclusion, and retrain its staff regarding these reforms.

Consumers with a complaint regarding health insurance coverage for behavioral health treatment, or any other health care-related complaint, may always contact the Attorney General’s Office Health Care Helpline at 800-428-9071.


Your membership yields results and will continue to do so. When your 2017 invoice arrives, please renew. KEEP MSSNY STRONG!



If You Are Thinking of Retiring, Notify All Participating Plans
For doctors who are considering retirement, please be aware that you should notify any plans that you have done business with of your retirement date.

For Medicare, only:

Please be aware of the following:

SE1617 –  Timely Reporting of Provider Enrollment Information Changes

Reviewing your Medicare provider enrollment in the Provider Enrollment Chain Organization System (PECOS) system, takes about 10 minutes.  https://pecos.cms.hhs.gov

Your password for this system is the one you would have obtained when you created your National Provider Identifier (NPI) number.  If you don’t know your password, please call the National Plan & Provider Enumeration System.  The NPI Enumerator may be contacted at the following:  NPI customer service: 800.465.3203 |800.692.2326 (TTY); or, you can email them here.

For Medicaid:

…..end/terminate my enrollment with the Medicaid Program Send a letter to Computer Sciences Corporation, PO Box 4610, Rensselaer, NY 12144-4610, which includes your NPI (if appropriate) and a contact name and telephone number for questions. When your file has been closed, you will receive a notification letter. Questions? Contact CSC at 800-343-9000.

For any other insurance plans, you should notify them of your retirement date.

Plans should be able to update your provider record with the retirement date; but, still pay you for any dates of care provided before that date.
Regina McNally, VP MSSNY Div. Socio-Medical Economics

Sept. 15 Deadline to Apply for Advanced Primary Care Medical Home Model
Comprehensive Primary Care Plus (CPC+), a multi-payer program that will include 5,000 primary care practices nationwide, begins in January 2017. CPC+ is an advanced primary care medical home model that rewards value and quality by offering an innovative payment structure to support delivery of comprehensive primary care. CPC+ builds upon the CPCI demonstration and offers 2 primary care practice “tracks” with incrementally advanced care delivery requirements and payment options to meet the diverse needs of practices.

CPC+ is specifically identified in the Quality Payment Program under the Medicare Access and CHIP Reauthorization Act (MACRA) as an advanced Alternative Payment Model (APM). Most practices that qualify for CPC+ will receive significant additional payment and, by qualifying as an advanced APM, will be excluded from the upcoming Merit-Based Incentive Payment System (MIPS).

Comprehensive Primary Care Plus (CPC+), the CMS Innovation Center’s new national advanced primary care medical home model, is now accepting applications. New York State is one of only 14 regions selected for this initiative. The deadline to apply is Sept. 15.

Who can apply: CPC+ targets primary care practices with varying capabilities to deliver comprehensive primary care. In order to participate, all CPC+ practices must demonstrate multi-payer support, use Certified EHR Technology (CEHRT), and demonstrate other capabilities. CPC+ will provide financial support and educational resources to assist practices with elements such as data collection and team based care that can have an impact far beyond CPC+. Participants from CPCI are eligible and encouraged to apply. Not all practices who apply will be selected, so this webinar is crucial to obtaining the information you to need to apply.

Why CPC+ is important: Besides the additional payments tied to CPC+, practices that participate in CPC+ and meet certain requirements will be excluded from MIPS and will receive the 5% Advanced APM bonus payment on their fee-for-service payments starting in 2019, as per the MACRA law.

CMS is conducting Open Door Forums throughout August and September, featuring Question and Answer sessions, overviews of key model elements, and step-by-step instructions for completing the CPC+ Practice Application. For more information, go here.

This webinar is being conducted specifically for the designated NYS Region to discuss CPC+ with state officials, those who participated in CPCI, and the payers who will be participating in this initiative.

New Report on Protecting New Yorkers from Zika Virus
NYC’s public advocate, Letitia James, released a report, “Protecting New Yorkers from Zika Virus” on protecting New Yorkers from the Zika virus. Recommendations included allowing Medicaid coverage of mosquito repellent when prescribed by a doctor. As of July 29, there were 387 reported cases of Zika virus, including 45 cases involving women who were pregnant.

The Wall Street Journal (8/25) reports that a survey of state and local laboratories suggests that the US has the capacity to perform between 3,500 and 5,000 Zika tests weekly, considerably less than what is required under the Center for Disease Control and Prevention’s worst-case scenario of a Zika outbreak. According to the WSJ, the survey’s findings are likely to spark a rush to expand lab capacity as Zika continues to spread in the US.

Nursing Homes: Sept. 20 Webinar re Challenges/Successes of Quality Initiatives
During a webinar on September 20, from 11 a.m. to 12:30 p.m., three ETTA leadership teams will discuss their journeys, successes, and challenges implementing very different quality improvement initiatives:  communicating effectively with hospital emergency departments, reducing psychoactive medications, and respiratory rounding in the nursing home.

Each presentation will include lessons learned about the vital role effective communication plays in achieving and sustaining success in nursing home quality improvement.

All nursing homes are welcome to register online for this free webinar.

Medical Direction and Medical Care in Nursing Homes Education, Training, and Technical Assistance (ETTA) is a quality improvement initiative funded by the Department of Health to educate nursing home leadership teams about and facilitate the implementation of Medical Director and Attending Physician Guidelines.

During the ETTA Successes from the Field: Part 2—More Quality Improvement Stories webinar on September 20, ETTA leadership teams from Smithtown Center for Rehabilitation & Nursing Care, Crown Nursing & Rehabilitation Center, and Maria Regina Residence will share stories of each of their quality improvement projects.

ETTA provides tools and resources that helped these teams strengthen communication among facility staff, and between the facility and outside partners, including nursing home medical directors and hospital physicians.

All ETTA project materials are easily used by any organization. ETTA tools, resources, archived webinars, and regional workshop learning materials are all available online.

This webinar is free and open to all nursing facilities across the state. Please register online.

Questions Contact our ETTA Program Director, Debbie LeBarron at dlebarro@hanys.org with any questions or concerns. 

Unique Payment Opportunity for Physicians in the Hudson/Capital Region
MSSNY, along with the NYS Department of Health and participating payers, CDPHP, MVP and Empire Blue Cross Blue Shield, invites you join us on a one-hour webinar to learn more about a unique payment opportunity being offered by CMS.

Two options available:
Webinar 1: Tuesday, August 30th
Time: Noon- 1 pm

Register 

Webinar 2: Tuesday August 30th
Time 6:00 – 7:00 pm

Register


CMS Proposes Expansion of Bundled Payments Program Including Cardiac Care Episodes
The CMS Innovation Center) will host a webinar next Wednesday August 31, 2016 from 12:00 to 1:00 PM to discuss its proposal to create a new Medicare bundled payment model for heart attacks and bypass surgery using 90-day episodes of care.   To register for the important webinar, click here.  MSSNY staff will be participating in this program.

CMS has proposed that the program be applicable in nearly 100 regions across the country, including in the New York City metropolitan statistical area (MSA), as well as in the Elmira, Rochester, Syracuse and Utica MSAs.  The model would be tested for 5-year performance period, beginning July 1, 2017, and ending December 31, 2021.

At the same time, CMS is proposing to expand the existing Medicare Joint Replacement Bundled Payment program adopted by CMS last year (and implemented this past April) to cover surgical hip/femur fracture treatment.  The Joint Replacement bundled payment program is currently applicable to 67 MSAs including the Buffalo and New York City MSAs.

To read the proposed regulation describing this proposal, click here.

To read the CMS fact sheet describing these new programs click here.

According to the CMS fact sheet, once the models are fully in effect, participating hospitals would be paid a fixed target price for each care episode, with hospitals that deliver higher-quality care receiving a higher target price.

While payment would still be made to hospitals and physicians on a fee for service basis, at the end of a model performance year, actual spending for the episode (total expenditures for related services under Medicare Parts A and B) would be compared to the target price that reflects episode quality for the responsible hospital. Hospitals that work with physicians and other providers to deliver the needed care for less than the quality-adjusted target price, while meeting or exceeding quality standards, would be paid the savings achieved. Hospitals with costs exceeding the quality-adjusted target price would be required to repay Medicare.

As with the current Medicare hip surgery bundle program, upside and downside risk would be limited initially but increase significantly by years 4 and 5 of the program.

According to the CMS Fact sheet, Downside risk to hospitals would as follows:

  • July 2017 – March 2018 (performance year 1 and quarter 1 of performance year 2):  No repayment;
  • April 2018 – December 2018 (quarters 2 through 4 of performance year 2): Capped at 5%;
  • 2019 (performance year 3): Capped at 10%; and
  • 2020 – 2021 (performance years 4 and 5): Capped at 20%

Bonuses (payments from Medicare to hospitals) would be as follows

  • July 2017 – December 2018 (performance years 1 and 2): Capped at 5%;
  • 2019 (performance year 3): Capped at 10%; and
  • 2020 – 2021 (performance years 4 and 5): Capped at 20%.

Importantly, the CMS proposal would permit these bundled payments in certain circumstance to qualify as an Alternative Payment Model (APM) as set forth in the MACRA law passed by Congress last year.  Participation in an APM “pathway” could enable a physician to not have to participate in the Medicare Merit Based Incentive Payment System (MIPS) program as enacted through MACRA and further spelled out in a regulation proposed by CMS earlier this year.

Analysis of this proposal is ongoing and further updates regarding its impact upon patient care delivery will be provided.


CLASSIFIEDS


Luxurious Medical Office Space to Share in Midtown (East) Manhattan! $6,950/monthly
Plastic surgeons desire to share office space (entire office is app. 5,000 square ft., Grade A building) with any medical or surgical specialty (Plastic, Facial plastic, dermatology, surgical subspecialty).  Space is located in concierge building on 3rd Avenue (3 blocks to Grand Central Station).

2-year sublease starting immediately; includes spacious doctor’s office with wall of windows (15 x 12 ft), and doctor’s staff office (9 x 8 ft).  The shared space includes luxurious waiting room (29 x 15 ½ ft) with a grand custom-made mahogany reception desk, three patient exam rooms (one used as procedure room which is 15 x 13 ft), the kitchen (10 x 8 ft), the photo room (8 x 7 ft), and staff bathroom (7 x 6 ft). Price negotiable.  Serious inquiries only, may contact us at 201-615-6963 or email us: cahnmd@gmail.com
Midtown1Midtown2



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!


Physician Opportunities

Crown Medical PC Needs a New Internist and Pediatrician to Join Our Team! Salary $200,000 + plus benefits.
As a part of our continued growth, we are searching for a new Internist and Pediatrician to join our team. Salary is $200,000 + plus benefits.
Primary Responsibilities:
Examines, diagnoses and treats patients for acute injuries, infections, and illnesses
Counsels and educates patients and families about acute and chronic conditions or concerns
Documents items such as: chief complaint, past medical, family, and social history, review of systems, examinations, medications, allergies, assessment and plan
Formulates diagnostic and treatment plans
Prescribes and administers medications, therapies, and procedures
Orders lab and imaging tests to determine and manage an immediate treatment plan and provides advice on follow up
Responsible for the coordination of care with specialists and appropriate ancillary services
Completes all documentation and paperwork in a timely manner
Maintains quality of care standards as defined by the practice

Required Qualifications:
Active and unrestricted New York medical license
Board certified in Internal Medicine or Pediatrics
Current and unrestricted DEA certificate
Effective communication skills
Outstanding organization skills and ability to multi-task
Takes Initiative, creative, has problem solving ability, is adaptable, and flexible
Ability to work without direct supervision and practice autonomously
Ability to work in fast-paced environment
Crown Medical, PC / ER Medical, PC
Contact: Michael Furman
Practice Administrator
718-208-1215
e: michael@crownmd.com


Nurse Practitioner/ Family Practice Physician
Full time/part time Urgent Care; Primary care/urgent care experience necessary. Rome NY. 315-335-7777


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

 

 

 

 

 

 

 

 

 

 

 

 

 

August 19, 2016 – MSSNYPAC Needs You

Dr. Reid
PRESIDENT’S MESSAGE
Dr. Malcolm Reid
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Aug. 19, 2016
Volume 16, Number 29

MLMIC

Dear Colleagues:

MSSNYPAC needs you.

As a New York physician, you have already benefited from MSSNY’s legislative advocacy efforts on a wide range of impactful matters that directly affect your ability to continue delivering care to your patients including:

  • defeat of the date of discovery bill which would have caused your liability premium rates to increase by as much as 15%;
  • passage of three bills to address issues which have arisen as a result of our e-prescribing law;
  • passage of legislation to address administrative hassles with insurers, including allowing physician override of insurer step therapy protocols;
  • defeat of changes to the Excess Medical Malpractice program that would have eliminated coverage for over 13,000 physicians across the state who currently receive an additional $1M layer of coverage from New York State
  • defeat of legislation that would have allowed clinics staffed by nurse practitioners to be located in retail establishments owned by publicly traded corporations like CVS Health, Walmart and Walgreen; and
  • defeat of every piece of legislation seeking to expand the scope of practice of non-physician practitioners like psychologists, oral surgeons, optometrists, nurse-anesthetists, and naturopaths  .

As you can see, sustained physician involvement can make a difference! While we win these legislative fights on your behalf year after year, the issues return and must be fought again!  Our opponents do not relent in their efforts. Unfortunately, our ability to fight for needed reforms and against harmful governmental actions is compromised by a decreasing number of physicians willing to join us in these efforts.

While advocacy and grassroots efforts are essential components of success, the stool supporting our advocacy efforts has three legs; the third being political contributions.

If we want to continue to have a seat at the table to discuss the very important issues that we confront, we must have a healthy political action arm.

Please join me in becoming a MSSNYPAC member. Basic membership starts at just $175– just $15/month. But why stop there?  We also have a Chairman’s Club for $1000 (Just $83/month) and a President’s Circle at $2500(Just $208/month).  Membership can be paid in monthly or quarterly installments.

Join MSSNYPAC by going to www.mssnypac.org  to add the weight of your voice to our efforts.

Your colleagues are counting on you.

Malcolm Reid, MD, MPP
MSSNY President

Please send your comments to comments@mssny.org


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Aetna to Withdraw from 11 ACA Exchanges in 2017
On Monday, Aetna announced that it will pull back from 11 of the 15 states where it offers individual insurance on the ACA exchanges.

This year, Aetna offers plans on the health insurance marketplace in the following states: Arizona, Delaware, Florida, Georgia, Iowa, Illinois, Kentucky, Missouri, Nebraska, North Carolina, Ohio, Pennsylvania, South Carolina, Texas and Virginia. In 2017, The company will maintain a presence on exchanges in Delaware, Iowa, Nebraska and Virginia only.

In a statement, Healthcare.gov CEO Kevin Counihan said Aetna’s decision does “not change the fundamental fact that the Health Insurance Marketplace will continue to bring quality coverage to millions of Americans next year and every year after that.”

New York City Officials Call for Zika Funding
NYC officials warned this week of the growing threat of the Zika virus. 483 people in New York, including 49 pregnant women, have tested positive for the Zika virus. Five of the victims contracted Zika through sex, while the other 478 are believed to be travel-related cases. And while there has not yet been local transmission of the virus, NYC Mayor Bill de Blasio and Health Commissioner Dr. Mary Bassett this week called on Congress to approve additional funds now. “Failure to address Zika will come to our door,” said Dr. Bassett. “Global is local.”

The officials called on Republicans in Congress to pass a $1.9 billion appropriation bill to fight the virus. “Without federal dollars, we cannot deepen our work and we won’t have the reassurance that other jurisdictions are doing all they can do to fight Zika,” DeBlasio said. “It’s time to take the action to stop this crisis while we can.”

Adult Brain Cells Key to Learning May be Susceptible to Zika, Study Suggests
The Washington Post reports that a study involving mice published in Cell Stem Cell suggests that “adult brain cells critical to learning and memory also might be susceptible to the Zika virus.” Researchers believe that Zika can infect “pockets” of neural progenitor cells in adults, which “replenish the brain’s neurons over the course of a lifetime.” The study authors “admit that the findings represent only an initial step in discovering whether Zika can endanger adult human brain cells,” but these findings “suggest that the Zika virus…may not be as innocuous as it seems for adults.”

The Wall Street Journal reports that researchers believe the findings apply to children as well as adults. The researchers intend to analyze whether infected neural progenitor cells recover over time.

CDC Researchers Take Measurements in Manhattan for National Health Survey
The Wall Street Journal reports that researchers have been collecting data in New York City that will be used to make the National Health and Nutrition Examination Survey, which is designed to offer insights on US health issues – ranging from alcohol consumption to diabetes rates – for use by academics, government agencies, and the public. Researchers will take measurements from approximately 5,000 people, who serve as a cross-section representative of different American demographics.

Nominations Open for Review Committee Positions
Physicians are invited to apply for nomination to leadership positions in key medical education organizations. These are positions appointed by the AMA, Board of Trustees. Take advantage of opportunities to gain valuable leadership experience, enhance your career and make your voice heard in the service of helping shape the future of our profession. Current leadership positions available include opportunities with the American Board of Emergency Medicine, the American Board of Preventive Medicine, the Liaison Committee on Medical Education (LCME) and various Accreditation Council for Graduate Medical Education (ACGME) Review Committees. More information on submitting a nomination can be obtained by going here.

All nominations should be submitted to Mary O’Leary at mary.oleary@ama-assn.org by September 12, 2016.   You must be an AMA member to be considered.   Please feel free to share with your colleagues.

Attention Physicians in the Hudson/Capital Region: Unique Payment Opportunity
MSSNY—along with the NYS Department of Health and participating payers, CDPHP, MVP and Empire Blue Cross Blue Shield—invites physicians in the Hudson/Capital Region to join us on a one-hour webinar to learn more about a unique payment opportunity being offered by CMS. CPC+ is an advanced primary care medical home model that rewards value and quality by offering an innovative payment structure to support delivery of comprehensive primary care.

Two options available:
Webinar 1: Tuesday, August 30th
Time: Noon- 1 pm

Register 

Webinar 2: Tuesday August 30th
Tim: 6:00 – 7:00 pm
Register

Comprehensive Primary Care Plus (CPC+), a multi-payer program that will include 5,000 primary care practices nationwide, begins in January 2017. CPC+ is an advanced primary care medical home model that rewards value and quality by offering an innovative payment structure to support delivery of comprehensive primary care. CPC+ builds upon the CPCI demonstration and offers 2 primary care practice “tracks” with incrementally advanced care delivery requirements and payment options to meet the diverse needs of practices.

CPC+ is specifically identified in the Quality Payment Program under the Medicare Access and CHIP Reauthorization Act (MACRA) as an advanced Alternative Payment Model (APM). Most practices that qualify for CPC+ will receive significant additional payment and, by qualifying as an advanced APM, will be excluded from the upcoming Merit-Based Incentive Payment System (MIPS).

Comprehensive Primary Care Plus (CPC+), the CMS Innovation Center’s new national advanced primary care medical home model, is now accepting applications. New York State is one of only 14 regions selected for this initiative. The deadline to apply is Sept. 15.

Who can apply: CPC+ targets primary care practices with varying capabilities to deliver comprehensive primary care. In order to participate, all CPC+ practices must demonstrate multi-payer support, use Certified EHR Technology (CEHRT), and demonstrate other capabilities. CPC+ will provide financial support and educational resources to assist practices with elements such as data collection and team based care that can have an impact far beyond CPC+. Participants from CPCI are eligible and encouraged to apply. Not all practices who apply will be selected, so this webinar is crucial to obtaining the information you to need to apply.

Why CPC+ is important: Besides the additional payments tied to CPC+, practices that participate in CPC+ and meet certain requirements will be excluded from MIPS and will receive the 5% Advanced APM bonus payment on their fee-for-service payments starting in 2019, as per the MACRA law.

CMS is conducting Open Door Forums throughout August and September, featuring Question and Answer sessions, overviews of key model elements, and step-by-step instructions for completing the CPC+ Practice Application. For more information, go here.

This webinar is being conducted specifically for the designated NYS Region to discuss CPC+ with state officials, those who participated in CPCI, and the payers who will be participating in this initiative.

Studies Suggest Elderly Getting too Many Prescriptions for Chronic Illnesses
Kaiser Health News reports a growing number of elderly patients are being prescribed too many medications to treat chronic illnesses, “raising their chances of dangerous drug interactions and serious side effects.” Furthermore, the piece points out that different drugs are often prescribed by different physicians, “who don’t communicate with each other,” further complicating the situation. Data from the Institute of Medicine show that in 2006, “at least 400,000 preventable ‘adverse drug events’ occur[ed]… in American hospitals.” Similarly, a 2013 study found that nearly 20 percent of patients discharged from hospitals “had prescription-related medical complications during their first 45 days at home.”

Maternal Acetaminophen Use in Pregnancy May be Associated with Behavioral Problems in Offspring
In “Science Now,” the Los Angeles Times reports that a study published online Aug. 15 in JAMA Pediatrics associates acetaminophen with “behavioral problems in children born to mothers who used it during pregnancy.” The findings of the 7,796-mother study revealed that “compared to women who reported no acetaminophen use at 18 weeks of pregnancy, those who took the medication at that point of gestation were 42% more likely to report hyperactivity and 31% more likely to report conduct problems in the children they bore.” Expectant mothers who took the medicine “at 32 weeks of pregnancy were 29% more likely than women who did not to report emotional difficulties in their child at age seven.”


CLASSIFIEDS


Luxurious Medical Office Space to Share in Midtown (East) Manhattan! $6,950/monthly
Plastic surgeons desire to share office space (entire office is app. 5,000 square ft., Grade A building) with any medical or surgical specialty (Plastic, Facial plastic, dermatology, surgical subspecialty).  Space is located in concierge building on 3rd Avenue (3 blocks to Grand Central Station).

2-year sublease starting immediately; includes spacious doctor’s office with wall of windows (15 x 12 ft), and doctor’s staff office (9 x 8 ft).  The shared space includes luxurious waiting room (29 x 15 ½ ft) with a grand custom-made mahogany reception desk, three patient exam rooms (one used as procedure room which is 15 x 13 ft), the kitchen (10 x 8 ft), the photo room (8 x 7 ft), and staff bathroom (7 x 6 ft). Price negotiable.  Serious inquiries only, may contact us at 201-615-6963 or email us: cahnmd@gmail.com
Midtown1Midtown2



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!


Physician Opportunities

Crown Medical PC Needs a New Internist and Pediatrician to Join Our Team! Salary $200,000 + plus benefits.
As a part of our continued growth, we are searching for a new Internist and Pediatrician to join our team. Salary is $200,000 + plus benefits.
Primary Responsibilities:
Examines, diagnoses and treats patients for acute injuries, infections, and illnesses
Counsels and educates patients and families about acute and chronic conditions or concerns
Documents items such as: chief complaint, past medical, family, and social history, review of systems, examinations, medications, allergies, assessment and plan
Formulates diagnostic and treatment plans
Prescribes and administers medications, therapies, and procedures
Orders lab and imaging tests to determine and manage an immediate treatment plan and provides advice on follow up
Responsible for the coordination of care with specialists and appropriate ancillary services
Completes all documentation and paperwork in a timely manner
Maintains quality of care standards as defined by the practice

Required Qualifications:
Active and unrestricted New York medical license
Board certified in Internal Medicine or Pediatrics
Current and unrestricted DEA certificate
Effective communication skills
Outstanding organization skills and ability to multi-task
Takes Initiative, creative, has problem solving ability, is adaptable, and flexible
Ability to work without direct supervision and practice autonomously
Ability to work in fast-paced environment
Crown Medical, PC / ER Medical, PC
Contact: Michael Furman
Practice Administrator
718-208-1215
e: michael@crownmd.com


Nurse Practitioner/ Family Practice Physician
Full time/part time Urgent Care; Primary care/urgent care experience necessary. Rome NY. 315-335-7777


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

 

 

 

 

 

 

 

 

 

 

 

 

 

August 12, 2016 – Did You Know MACRA Is Mandatory?

Dr. Reid
PRESIDENT’S MESSAGE
Dr. Malcolm Reid
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Aug. 12, 2016
Volume 16, Number 29

MLMIC

Dear Colleagues:
The alphabet soup continues.

Yesterday, MSSNY had a call with several Medicare officials regarding the government’s proposed rule about MACRA, MIPS and APMs. Surprisingly, they were interested in learning what MSSNY is hearing from our members about the potential roll out of THE new payment proposal.

We asked them what they were hearing about the potential for delay and the rumored 90-day time period of reporting quality measures for compliance with this proposal. Regrettably, all remains up in the air. We do not know if the Final Rule anticipated to be published in November will delay the anticipated effective date of January 1, 2017.

We do know is that the payment proposal is MANDATORY.

We don’t much more than that and neither do they.

We have sent out an email to specialty societies to learn if they have created or developed specialty-specific lists of measures that will coincide with the quality reporting related to the specialty and the physician’s patient population. We are waiting to hear from them.

MSSNY wants to educate our members on CMS’ payment proposal since, I repeat, it is mandatory. Yet, we are in a hurry-up-and-wait mode. We will give you as much information as we can as soon as we are able.

However, since this is a top down operation, we can’t force them to help us to help you.

Stay tuned.

Malcolm Reid, MD, MPP
MSSNY President

Please send your comments to comments@mssny.org


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Applications for Primary Care Model (CPC) Now Open
On August 1, CMS opened the application period for practices to participate in the new primary care model, Comprehensive Primary Care Plus (CPC+, which is available to practices in Region II, NY & NJ.  CPC+ is a five-year primary care medical home model beginning January 2017 that will operate in 14 regions across the U.S.

The goal of the model is to give primary care practices more flexibility in caring for their patients in the way they think will deliver the best outcomes and to pay them for achieving results and improving care. CPC+ is an opportunity for practices of diverse sizes, structures, and ownership types who are interested in qualifying for the incentive payment for Advanced Alternative Payment Models through the proposed CMS Quality Payment Program. CMS estimates that up to 5,000 primary care practices serving an estimated 3.5 million Medicare beneficiaries could participate in the model.

Additionally, other payers, including commercial insurers and state Medicaid agencies, are partnering with CMS to provide enhanced support to the primary care practices selected to participate in CPC+.  The practice application period runs from August 1 – September 15, 2016.

More information is available on the CPC+ website.

Other materials your members might be interested in:

General questions about CPC+ can be submitted to CPCplus@cms.hhs.gov.

DFS to Hold September 8 Hearing to Examine Anthem-Cigna Merger Proposal
New York’s Department of Financial Services will hold a hearing in New York City on September 8 to obtain public input regarding the proposal of Anthem (the parent of Empire) to acquire health insurance giant Cigna.

MSSNY’s President Dr. Malcolm Reid is planning to testify at this hearing to express MSSNY’s great concern with the continuing consolidation of the health insurance industry, and its adverse impact on patient care.  Interested physicians are also invited to testify by submitting a request to public-hearings@dfs.ny.gov with the heading “ANTHEM-CIGNA 2016 HEARING”.  To read the full hearing notice, click here.

Last week, DFS Superintendent Maria Vullo public released a letter (http://dfs.ny.gov/about/press/pr160803_anthem_cigna_letter.pdf) noting that DFS has “serious concerns that Anthem’s proposed acquisition of Cigna will adversely impact the competitiveness of the health insurance market and harm consumers in New York”.

This action followed the filing of litigation by the US Department of Justice (See the press release here to block the proposed Anthem takeover of Cigna, as well as the proposed Aetna takeover of Humana.  In announcing the suit, DOJ noted that the proposed mergers of four of the five largest health insurance companies in the country “are unprecedented in their scale and in their scope”.

The DOJ intervention had been strongly supported by the American Medical Association, numerous state medical societies across the country including MSSNY, and several powerful consumer/patient advocacy groups.

The letter from Superintendent Vullo noted the huge market impact if Anthem and Cigna were permitted to merge.  It would increase Anthem’s market share across commercial products to 31.2% statewide, of which Anthem would command 9.8% of New York’s fully insured market and 47.6% of the self-insured market.  The biggest impact would be felt in the New York City metro area, where Anthem would control nearly 70% percent of the commercial self-insured market in the Bronx and Staten Island, 63% in Queens and Brooklyn, and 55% in Putnam County.

“Increased concentration means that insurers are more able to offer non-negotiable rates to providers in a take it or leave it deal. Therefore, the merger likely would limit New Yorkers’ access to healthcare because providers would be forced either to not participate with the dominant insurer or to cut hours or services in order to accommodate a deal they have to accept. This result would be highly problematic for New York consumers.” stated Superintendent Vullo in the letter.

New York Health Insurance Exchange Releases Enrollment Report
The New York State of Health release a report today that show that enrollment through New York’s Health Insurance Exchange increased by 33%, or nearly 700,000 enrollees from the previous enrollment period, and that 92% of those enrolled through the Exchange report that they did not have health insurance at the time they applied.

The full report from NYSOH is available here.

A fact sheet summarizing the demographic data is available here.

According to the report, as of January 31, 2016, 2,833,823 New Yorkers enrolled in coverage through the NY State of Health’s Individual Marketplace. This includes 271,964 people enrolled in Qualified Health Plans (QHP), 379,559 people enrolled in the Essential Plan (EP), 1,966,920 people enrolled in Medicaid, and 215,380 enrolled in Child Health Plus (CHP).

With regard to individual QHPs, Fidelis (26%) garnered the largest market share, followed by Empire, Oscar, Metro Plus and Health First all with 10% market share. As of January 31, 2016, 16% of the enrollees are enrolled in Platinum plans, 14% are in Gold plans, 25% are in Silver plans without cost sharing reductions, 17 % are in a Silver costsharing reduction plan, 26 % are in Bronze plans, and 2 percent are in Catastrophic plans.

CDC: Infants with Neonatal Abstinence Syndrome up 300% in 15 Years
The number of babies being born in the United States addicted to opioids (NAS) has tripled in a 15-year stretch, according” to a CDC report published Aug. 12 in the Morbidity and Mortality Weekly Report. The CDC “said…that the findings, based on hospital data, are likely underestimates of the true problem and point to an urgent need for public health efforts to help pregnant women deal with addiction.” The report revealed that “the incidence of neonatal abstinence syndrome jumped to 6 per 1,000 hospital births in 2013, up from 1.5 per 1,000 in 1999. Maine, Vermont and West Virginia – recorded more than 30 such cases per every 1,000 births by 2013.” New York recorded 3.6 per 1,000 (2013), up from 2.8 (2012); 2.6 in 2011; and 1.9 in 2010.

NYC Medical Schools Will Stop Using Unclaimed Bodies as Cadavers
The NY Times (8/10)  reports “eight medical schools in New York City will no longer accept the city’s unclaimed bodies as cadavers,” the schools announced on Wednesday. Additionally, “a group representing the 16 medical schools in the state is withdrawing its opposition to a recently passed bill that would end the educational use of bodies with no known survivors.”

The bill “passed both houses overwhelmingly in June, a month after a New York Times investigation highlighted provisions in the current law that give families as little as 48 hours to claim a relative’s body before the city must make it available for dissection or embalming practice.” The bill is now awaiting Gov. Andrew Cuomo’s signature.

Medicare Telehealth Services Wednesday, August 31 at 1-2 PM EST
NGS Medicare is holding a 1-hour webinar about Telehealth services.  If you are interested and have the time, click on the GREEN register box below to register for this program. During this webinar we will provide you with insight into covered Medicare telehealth services and coverage requirements. We will discuss originating sites, equipment requirements, and billing and payment guidelines.  Read More

During this webinar we will provide you with insight into covered Medicare telehealth services and coverage requirements. We will discuss originating sites, equipment requirements, and billing and payment guidelines. Read More
REGISTER

Notice Act Went Into Effect on August 6: Must Tell PTs re Out-of-Pocket Costs
The NY Times (8/6) http://nyti.ms/2aEW40Vreports the Notice Act, passed by Congress last year, went into effect on August 6. The new Medicare law “requires hospitals to notify patients that they may incur huge out-of-pocket costs if they stay more than 24 hours without being formally admitted” and the “patients can expect to start receiving the warnings in January.” According to the Times, the Administration “issued rules last week to carry out the new law,” which will let hospitals “keep Medicare patients in observation status,” and while “some of the patients will be responsible for nursing home costs,” they would still get the “time in a hospital under observation [to] count toward the three-day inpatient stay required for Medicare coverage.”

Legislation Enacted Regarding Drugs Used for Detox or Maintenance Treatment of Opioid Addiction in Medicaid Fee-for-Service (FFS) & Medicaid Managed Care
Per changes to Social Services Law section 364j, and Public Health Law section 273, prior authorization is not allowable for initial or renewal prescriptions for preferred or formulary buprenorphine or injectable naltrexone when used for detoxification or maintenance treatment of opioid addiction. Food and Drug Administration (FDA) and Compendia supported frequency, quantity and/or duration limits may continue to be applied.

To obtain preferred/formulary drug listings and plan limitations please see the following websites:

  • Medicaid FFS Preferred Drug List and Pharmacy Prior Authorization Programs- https://newyork.fhsc.com/
  • Medicaid Managed Care Pharmacy Formulary and Benefit Information- http://mmcdruginformation.nysdoh.suny.edu/

Change to Medicaid Payment of Part C Co-payment and Co-insurance Liabilities
Effective April 1, 2016, an amendment to New York State Social Services Law changes Medicaid reimbursement of Medicare Part C (Medicare Advantage or Medicare managed care) co-payment and/or co-insurance liabilities for services provided to dually eligible Medicaid members. Dually eligible members are those individuals having both Medicare and Medicaid coverage.

Presently the Medicaid program pays the full co-payment or co-insurance amounts for Medicare Part C claims. Retro-actively to April 1, 2016, Medicaid will reimburse at the rate of eighty-five percent (85%) of the Medicare Part C co-payment or co-insurance amount. The Department is in the process of making the necessary eMedNY system changes to enable the implementation of the new payment policy. Implementation will be applied retro-actively pending system support. Paid claims will then be adjusted automatically to reflect the new cost-sharing limits.

This change will affect institutional claims and professional claims when submitting claims for Medicaid reimbursement of a Medicare Part C co-payment or co-insurance. This change will also apply to Pharmacy Claims for drugs and supplies when submitted via a NCPDP transaction or as a professional claim.

There is no change to the current reimbursement methodology of Medicare Part C co-payment/co-insurance amounts for ambulance providers and psychologists. Medicaid will continue to reimburse these providers the full Medicare Part C co-payment/co-insurance amounts.

Note: A provider of a Medicare Part C benefit cannot seek to recover any co-payment, or coinsurance amount from Medicare/Medicaid dually eligible individuals. The provider is required to accept the Medicare Part C health plan payment and any Medicaid payment as payment in full for the service. The member may not be billed for any Medicare Part C co-payment/co-insurance amount that is not reimbursed by Medicaid.


CLASSIFIEDS


Luxurious Medical Office Space to Share in Midtown (East) Manhattan! $6,950/monthly
Plastic surgeons desire to share office space (entire office is app. 5,000 square ft., Grade A building) with any medical or surgical specialty (Plastic, Facial plastic, dermatology, surgical subspecialty).  Space is located in concierge building on 3rd Avenue (3 blocks to Grand Central Station).

2-year sublease starting immediately; includes spacious doctor’s office with wall of windows (15 x 12 ft), and doctor’s staff office (9 x 8 ft).  The shared space includes luxurious waiting room (29 x 15 ½ ft) with a grand custom-made mahogany reception desk, three patient exam rooms (one used as procedure room which is 15 x 13 ft), the kitchen (10 x 8 ft), the photo room (8 x 7 ft), and staff bathroom (7 x 6 ft). Price negotiable.  Serious inquiries only, may contact us at 201-615-6963 or email us: cahnmd@gmail.com
Midtown1Midtown2


Brand-New Medical Office for Sale in Lynbrook. Ground Floor in Medical Office Bldg. Parking Available
Close to all area hospitals. Ideal for any specialty. Two spacious exam rooms with sinks, cabinetry and two brand-new exam tables. One consultation room, receptionist’s space, waiting area, one bathroom and lab area. Fully furnished. Asking $125,000 (negotiable). Please email gumd3@aol.com to arrange for a viewing.


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!


Physician Opportunities

Crown Medical PC Needs a New Internist and Pediatrician to Join Our Team! Salary $200,000 + plus benefits.
As a part of our continued growth, we are searching for a new Internist and Pediatrician to join our team. Salary is $200,000 + plus benefits.
Primary Responsibilities:
Examines, diagnoses and treats patients for acute injuries, infections, and illnesses
Counsels and educates patients and families about acute and chronic conditions or concerns
Documents items such as: chief complaint, past medical, family, and social history, review of systems, examinations, medications, allergies, assessment and plan
Formulates diagnostic and treatment plans
Prescribes and administers medications, therapies, and procedures
Orders lab and imaging tests to determine and manage an immediate treatment plan and provides advice on follow up
Responsible for the coordination of care with specialists and appropriate ancillary services
Completes all documentation and paperwork in a timely manner
Maintains quality of care standards as defined by the practice

Required Qualifications:
Active and unrestricted New York medical license
Board certified in Internal Medicine or Pediatrics
Current and unrestricted DEA certificate
Effective communication skills
Outstanding organization skills and ability to multi-task
Takes Initiative, creative, has problem solving ability, is adaptable, and flexible
Ability to work without direct supervision and practice autonomously
Ability to work in fast-paced environment
Crown Medical, PC / ER Medical, PC
Contact: Michael Furman
Practice Administrator
718-208-1215
e: michael@crownmd.com


Nurse Practitioner/ Family Practice Physician
Full time/part time Urgent Care; Primary care/urgent care experience necessary. Rome NY. 315-335-7777


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

 

 

 

 

 

 

 

 

 

 

 

 

 

August 5, 2016 – Interested in Telemedicine?

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

Aug. 5, 2016
Volume 16, Number 28

MLMIC

Dear Colleagues:

According to Medicare.gov, telemedicine (which may also be referred to as “telehealth,” or “virtual healthcare”) “seeks to improve a patient’s health by permitting two-way, real time interactive communication between the patient, and the physician or practitioner at the distant site. This electronic communication means the use of interactive telecommunications equipment that includes, at a minimum, audio and video equipment.”

With evidence-based telemedicine, clinicians can evaluate, diagnose and treat patients remotely using store-and-forward technology or real-time video conferencing.  Remote practitioners can capture and transmit medical data to share with peers and specialists around the corner or around the world.

About five years ago, I attended a Council meeting where a physician executive from UnitedHealthcare gave us a presentation informing us that telemedicine was in our near future and it was a good idea whose time had come. When the presentation ended, the room was silent until a Council member spoke up and said that this was an outrage and goes against one of the ancient tenets of medicine—that we had to lay our hands on our patients to examine them. An extended lively discussion ensued and finally, one Councilor had the courage to ask what the logistics of payment for a telehealth exam would be.

Today, we are well aware that telemedicine is provided throughout New York and is spreading rapidly. From our current and ongoing research, we know that there are different payment arrangements to practitioners who provide this new and vital service— “vital” as in a mother of four children and one of them has a high fever. She should not be expected to pack up the family car for a trip to the emergency room when her fears can be allayed by speaking to (hopefully) a NY physician. In addition, does a patient really need to make a trip to the office when they all they need is a routine prescription refill?

Many plans pay equally to the level of service based on the documentation contained in the medical record.

On July 18, we sent out a survey regarding telemedicine. Since this is a MSSNY hot topic, we are surprised at the low response rate. As we continue to develop our plans for your benefit, you could help us out by completing our 10-question survey. Even better, you can send it on to your colleagues so that we have a clearer picture of our members’ interest.

Please take it NOW!

10-question  telemedicine survey

Malcolm Reid, MD, MPP
MSSNY President

Please send your comments to comments@mssny.org


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Westchester, LI Medical Groups Team Up for Contract with Empire BCBS
Commack, LI-based Independent Physicians Association of Nassau/Suffolk Counties (IPANS) and Hudson Doctors Independent Physicians Association in Valhalla, N.Y., plan to develop a shared-savings contract with Empire BlueCross BlueShield. John Franco, MD, President and Medical Director of the Nassau Suffolk of Independent Physicians Association of Nassau/Suffolk Counties (IPANS) and a member of MSSNY’s Task Force on Survival of Independent Practice, said, “We here at IPANS are very pleased to affiliate with Hudson IPA. Independent physicians will have greater strength in numbers and receive the necessary support to remain independent and successful.”

The two groups represent about 1,600 physicians generating about $2 billion in annual revenue, said Anthony Demetracopoulos, executive director and general counsel of the Hudson Doctors IPA, based in Valhalla, N.Y. The Hudson Doctors IPA was created in 1996 as an association for medical faculty from New York Medical College in Valhalla, but now it includes mostly non-faculty physicians. In a potential accountable care arrangement with Empire, the entity would be responsible for cost and quality for about 50,000 patients. In all, the doctors involved in the two groups see about 500,000 patients annually. (Crains, Aug 3)

With more doctors, the organizations can more easily afford investments in software that helps physicians track their patients through the health care system and avoid unnecessary duplication of care.

The agreement will give IPANS greater scale, making the combined entity more attractive to managed-care plans, which are increasingly shrinking their networks to include only high-performing providers. Hudson Doctors IPA could also help IPANS improve certain processes, such as credentialing doctors to verify their certifications, malpractice insurance and hospital privileges.

Tom Lee, MD, a board member of Hudson Doctors IPA, and Co-Chair of MSSNY’s Task Force on Survival of Independent Practice and commented, “”Hudson Doctors IPA looks forward to collaborating with IPANS to provide quality integrated services for our physician members’ patients, and keep independent practice a viable option for physicians in the future.”

Fee Waivers for Non-Compensated NYS License Renewal
A point of information for those physicians who have retired and are no longer compensated for medical care provided – a waiver of the fee for the registration of your license as a physician in the State of New York is allowed under the provisions of Section 6524(10) of the New York State Education Law.  This law allows a waiver of the registration fee requirement for physicians who certify to the State Education Department that, for the period of their registration, they will only practice medicine without compensation or the expectation or promise of compensation. The waiver of the registration fee is limited to the duration of the registration period indicated the affidavit.  http://www.mcms.org/sites/default/files/resources/NC-Affidavit11-02.pdf or see attached.

Patient Advocacy Groups Rally to Urge Governor Cuomo to Sign Step Therapy Override Bill Into Law
Dozens of patient advocates rallied at the State Capitol this week to urge Governor Cuomo to sign into law legislation (A.2834-D/S.3419-C) supported by MSSNY and unanimously passed by the State Legislature that would 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.

The rally received significant media attention, including from WNYT,  TWC’s Capital Tonight and Politico-NY.

Las week, MSSNY representatives joined several other patient advocacy groups in a meeting with Governor Cuomo’s top health policy staff last week to urge that he sign this bill into law.   In addition to lobbying staff, MSSNY was also represented by Interspecialty Committee and Committee to End Healthcare Disparities member Dr. Inderpal Chhabra, who spoke regarding the hassles he regularly experiences with some insurers when trying to assure his patients have coverage for the medications they need.  Also joining the meeting were representatives of the NYS Society of Dermatology and Dermatologic Surgery (MSSNY member Dr. Mary Ruth Buchness), the NYS Academy of Family Physicians, the National Psoriasis Foundation, the Global Healthy Living Foundation, National Lupus Foundation, Mental Health Association of New York State, National Alliance on Mental Illness-NY, and the American Cancer Society.

To assist in our collective efforts to convince Governor Cuomo to sign this important bill into law, we ask you send a letter to him in support of this legislation.  A customizable template is available from MSSNY’s Grassroots Action Site here.

We know the insurers are strongly fighting this bill, so the Governor’s office needs to hear your support.

AG Warns Stop False Advertising re Ineffective Products as “Zika-Preventive”
Attorney General Eric T. Schneiderman announced that his office issued cease and desist letters to seven companies that market products with claims that the products prevent or protect against Zika virus even though the products are known to be ineffective for that purpose. The letters demand that the companies selling these products stop advertising them as “Zika-protective” or “Zika-preventive.” The Attorney General also issued a consumer alert warning New Yorkers about the deceptive ads and directing them to evidence-based Zika prevention measures that have been recommended by public health authorities.

“The only products that provide effective protection from mosquito bites contain DEET, picaridin, oil of lemon eucalyptus, and an insect repellent called IR3535 – all other products are a waste of money and may put you at risk of being bitten,” said NYC Health Commissioner Dr. Mary T. Bassett. “We continue to remind women who are pregnant or trying to become pregnant to not travel to a Zika-affected area – that includes most of Latin America and the Caribbean, and a neighborhood in Miami, Florida. Because of the risk of sexual transmission, partners of pregnant women should consider staying away from these areas, too.”
http://www.mssny.org/MSSNY/Public_Health/2016/SCHNEIDERMAN_ISSUES_CEASE_AND_DESIST_LETTERS.aspx

NY DFS Issues Letter Expressing Strong Concerns with Anthem-Cigna Merger Proposal
Noting its “serious concerns that Anthem’s proposed acquisition of Cigna will adversely impact the competitiveness of the health insurance market and harm consumers in New York”, this week the New York Department of Financial Services publicly released a letter from DFS Superintendent Maria Vullo indicating that she intends to call a public hearing to more fully evaluate the proposal.

The DFS announcement comes on the heels of litigation filed by the US Department of Justice two weeks ago (See the press release here  to block the proposed Anthem takeover of Cigna, as well as the proposed Aetna takeover of Humana.  In announcing the suit, DOJ noted that the proposed mergers of four of the five largest health insurance companies in the country “are unprecedented in their scale and in their scope”.

The DOJ intervention had been strongly supported by the American Medical Association, numerous state medical societies across the country including MSSNY, and several powerful consumer/patient advocacy groups.

However, as reported last week, Anthem (the parent of Empire) indicated its intent to fight the DOJ action, including purchasing full-page ads in several national papers including the Washington Post, the USA Today and the New York Times to present a letter to the public from its chair, Joseph Swedish, that it was “surprised and disappointed” by the DOJ’s actions.

The letter from Superintendent Vullo noted the huge market impact if Anthem and Cigna were permitted to merge.  It would increase Anthem’s market share across commercial products to 31.2% statewide, of which Anthem would command 9.8% of New York’s fully insured market and 47.6% of the self-insured market.  The biggest impact would be felt in the New York City metro area, where Anthem would control nearly 70% percent of the commercial self-insured market in the Bronx and Staten Island, 63% in Queens and Brooklyn, and 55% in Putnam County.

“Increased concentration means that insurers are more able to offer non-negotiable rates to providers in a take it or leave it deal. Therefore, the merger likely would limit New Yorkers’ access to healthcare because providers would be forced either to not participate with the dominant insurer or to cut hours or services in order to accommodate a deal they have to accept. This result would be highly problematic for New York consumers.”

We will keep you posted as to when the hearing is scheduled.

CDC Director: Zika Travel Advisory Could Last as Long As a Year
The Center for Disease Control and Prevention’s travel advisory for the south Florida neighborhood experiencing a Zika outbreak could last for as long as a year, according to CDC director Dr. Tom Frieden. “When dengue hit Florida a few years ago, it took over a year to control that outbreak. We certainly hope that doesn’t happen. We saw what happened in the Florida Keys and that did go on for a long time despite extensive efforts,” he said. 

James Hitt, MD to Step Into Dr. Eugene Gosy’s Pain Specialty Practice in Amherst
The Buffalo News reports: “The temporary arrangement to care for Dr. Eugene Gosy’s 9,500 patients ends this week, but another doctor is stepping in to ensure the big pain management practice remains open.” http://bit.ly/2aIpNu7 Dr. Gosy, a neurologist and pain specialist, was indicted in April on federal charges. His large patient load was due to the fact that many physicians referred their patients to Dr. Gosy. Area physicians were very concerned about Dr. Gosy’s practice closing, since he was the only pain specialist in the Amherst area.

Three area physicians volunteered to keep Dr. Gosy’s practice going temporarily. As of August 1, James Hitt, MD, a pain management specialist who had been working with cancer patients at Roswell Park Cancer Institute and veterans at the Buffalo VA Medical Center.

Want to Learn More about Comprehensive Primary Care?
On August 1, CMS opened the application for practices to apply for Comprehensive Primary Care Plus (CPC+), the largest-ever initiative to improve primary care in America. CPC+ rewards value and quality through an innovative payment structure to support comprehensive primary care.

In CPC+, CMS has provisionally selected 57 payer partners, including commercial insurers, state Medicaid agencies, Medicaid managed care organizations, and Medicare Advantage plans in 14 regions across the nation.

Want to learn more about CPC+?

–          Get your questions answered in the Practice FAQs.

–          Register for one of the 20 upcoming CPC+ Practice Open Door
Forums
in August and September.

–          Watch the CPC+ Video Series to get an overview of CPC+
payment innovations and care delivery transformation.

–          Submit a CPC+ application via the online portal today through
11:59pm ET on Thursday, September 15.

–          Download the CPC+ toolkit: CPC+ In Brief, CPC+ Care
Delivery Transformation Brief
, and CPC+ Payment Innovations
Brief and Case Studies
.

At CMS, we believe CPC+ is the future of primary care in America. We are pleased to partner with aligned public and private payers across the country to support up to 5,000 practices delivering the care that best meets the needs of their patients and improves health outcomes.

Timely Reporting of Provider Enrollment Information Changes
http://www.cms.gov/Outreach-and-Education/Medicare-Learning-Network-MLN/MLNMattersArticles/Downloads/SE1617.pdf

Reviewing your Medicare provider enrollment in the Provider Enrollment Chain Organization System (PECOS) system, takes about 10 minutes.  https://pecos.cms.hhs.gov  Your password for this system is the one you would have obtained when you created your National Provider Identifier (NPI) number.  If you don’t know your password, please call the National Plan & Provider Enumeration System.  The NPI Enumerator may be contacted at the following:  NPI customer service: 800.465.3203 |800.692.2326 (TTY); or, you can email them at:  customerservice@npienumerator.com

Suicide Among Veterans: 20 Per Day
The suicide rate among U.S. veterans increased by nearly one-third between 2001 and 2014, according to a Veterans Affairs (VA) report released this week. According to the report, an average of 20 veterans died from suicide daily in 2014, totaling about 7,300 suicide deaths that year. VA estimated that the veteran suicide rate increased by 32 percent from 2001 to 2014. In comparison, the suicide rate among the total U.S. population increased by 23 percent during that time.


CLASSIFIEDS


Luxurious Medical Office Space to Share in Midtown (East) Manhattan! $6,950/monthly
Plastic surgeons desire to share office space (entire office is app. 5,000 square ft., Grade A building) with any medical or surgical specialty (Plastic, Facial plastic, dermatology, surgical subspecialty).  Space is located in concierge building on 3rd Avenue (3 blocks to Grand Central Station).

2-year sublease starting immediately; includes spacious doctor’s office with wall of windows (15 x 12 ft), and doctor’s staff office (9 x 8 ft).  The shared space includes luxurious waiting room (29 x 15 ½ ft) with a grand custom-made mahogany reception desk, three patient exam rooms (one used as procedure room which is 15 x 13 ft), the kitchen (10 x 8 ft), the photo room (8 x 7 ft), and staff bathroom (7 x 6 ft).

Price negotiable.  Serious inquiries only, may contact us at 201-615-6963 or email us: cahnmd@gmail.com
Midtown1Midtown2


Brand-New Medical Office for Sale in Lynbrook. Ground Floor in Medical Office Bldg. Parking Available
Close to all area hospitals. Ideal for any specialty. Two spacious exam rooms with sinks, cabinetry and two brand-new exam tables. One consultation room, receptionist’s space, waiting area, one bathroom and lab area. Fully furnished. Asking $125,000 (negotiable). Please email gumd3@aol.com to arrange for a viewing.


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!


Physician Opportunities

Crown Medical PC Needs a New Internist and Pediatrician to Join Our Team! Salary $200,000 + plus benefits.
As a part of our continued growth, we are searching for a new Internist and Pediatrician to join our team. Salary is $200,000 + plus benefits.
Primary Responsibilities:
Examines, diagnoses and treats patients for acute injuries, infections, and illnesses
Counsels and educates patients and families about acute and chronic conditions or concerns
Documents items such as: chief complaint, past medical, family, and social history, review of systems, examinations, medications, allergies, assessment and plan
Formulates diagnostic and treatment plans
Prescribes and administers medications, therapies, and procedures
Orders lab and imaging tests to determine and manage an immediate treatment plan and provides advice on follow up
Responsible for the coordination of care with specialists and appropriate ancillary services
Completes all documentation and paperwork in a timely manner
Maintains quality of care standards as defined by the practice

Required Qualifications:
Active and unrestricted New York medical license
Board certified in Internal Medicine or Pediatrics
Current and unrestricted DEA certificate
Effective communication skills
Outstanding organization skills and ability to multi-task
Takes Initiative, creative, has problem solving ability, is adaptable, and flexible
Ability to work without direct supervision and practice autonomously
Ability to work in fast-paced environment
Crown Medical, PC / ER Medical, PC
Contact: Michael Furman
Practice Administrator
718-208-1215
e: michael@crownmd.com


Nurse Practitioner/ Family Practice Physician
Full time/part time Urgent Care; Primary care/urgent care experience necessary. Rome NY. 315-335-7777


Board Eligible-Board Certified Adult & Pediatric Allergist – Full Time /Part Time MD, DO
Unique opportunity with a successful, established and respected Allergy, Asthma, Immunology and Internal Medicine practice in the prestigious Main Line suburb of Philadelphia. Highly desirable area with award-winning public school systems. Close proximity to Center City Philadelphia, Pocono Mountains, New Jersey Seashore and New York City. Affiliation with an exceptional suburban health system with active residency program.

Academic appointment a possibility. Large-volume practice with established base built on close personal patient relationships. We offer a professional caring environment supported by an experienced dedicated staff. Competitive salary, pension & profit sharing, paid health insurance and med-mal insurance, and CME stipend. Competitive compensation with bonus structure. Partnership/Equity opportunities available after initial period of employment. Send resume to allergypa@aol.com or call 610-649-9300.


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