January 27, 2017 – Victory! Aetna-Humana Merger Nixed!

Dr. Reid - MSSNY President
PRESIDENT’S MESSAGE
Dr. Malcolm Reid
January 27, 2017
Volume 17
Number 4

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Dear Colleagues:

This week, in a landmark win for organized medicine and the nation’s patients, federal judge John D. Bates blocked the proposed Aetna-Humana merger. The judge found that the merger would have substantially lessened competition in Medicare Advantage and commercial health insurance markets. This is a comprehensive, fact-based ruling that acknowledges that meaningful action was needed to preserve competition and protect high-quality medical care from unprecedented market power that Aetna would acquire from the merger deal. The decision is a historic, stunning affirmation of the position urged by the American Medical Association (AMA) and the 17-state medical association antitrust coalition members of which MSSNY is an active member. The court’s ruling sets a notable legal precedent by recognizing Medicare Advantage as a separate and distinct market that does not compete with traditional Medicare.

MSSNY was vigorously opposed to this merger and joined with stakeholders, various patient coalitions, and the National Association of Attorneys General. The coalition presented physician surveys that gauged physician concerns about the merger and presented the compelling survey results to DOJ and state regulators; testified in or submitted memoranda in state insurance department hearings and/or attorney general investigations, and secured outside experts to demonstrate how the merger would harm patients and physicians.

We want to take this opportunity to thank our physicians and, all of our coalition partners for helping to achieve this historic victory on behalf of our physician members and their patients. Our collective work on these mergers is, without a doubt, a model for future advocacy success.

Malcolm Reid, MD, MPP
President, Medical Society of the State of New York

Save the Date:
MSSNY Physician Advocacy Day in Albany March 8!

Please send your comments to comments@mssny.org



Please Contact Your Legislators to Express Concerns in Proposed State Budget
As noted last week, Governor Cuomo released his proposed $152.3 billion spending plan for the 2017-18 Fiscal Year.   While the proposed Budget contains a number of positive provisions, it also includes several proposals that could have an adverse impact on physician care delivery.  Physicians are urged to contact their legislators to ask that these adverse provisions be removed from the Budget or, where appropriate, additional allocations be made.  For example,

  • We appreciate that funding for the Excess Medical Malpractice Insurance program is proposed be continued at previous years’ funding levels.  However, physicians would be required to receive a “tax clearance” as a pre-condition, potentially a cumbersome requirement that could unnecessarily endanger coverage for some physicians.  To send a letter to your legislators, click here.
  • Pharmacists would be permitted to enter into “comprehensive medication management protocols” with physicians or nurse practitioners to manage, adjust and change the medications of patients with a chronic disease or diseases who have not met clinical goals of therapy, are or at risk for hospitalization.  While similar “collaborative drug therapy” programs exist within the hospital environment, only physicians are currently permitted to enter into such protocols.  To send a letter to the Legislature, click here.
  • “Prescriber prevails” protections that currently exist in Medicaid and Medicaid Managed Care would be eliminated, except for atypical antipsychotic and anti-depressant medications, forcing physicians to go through even more burdensome prior authorization requirements.  To send a letter to your legislators, click here.
  • The State Budget fails to include a specific allocation to address the likely shortcoming in payments due physicians arising from the financial collapse of liquidated insurer Health Republic.  To send a letter to your legislators urging funding in the Budget to address this shortfall, click here.

Other Items of Note in the State Budget

  • Funding for MSSNY’s Committee for Physicians Health would be continued at past levels;
  • Re-appropriating $300,000 for MSSNY’s Veterans Health Care Initiative.
  • E-cigarettes would be taxed in the same manner as tobacco cigarettes.
  • Requiring the registration and regulation of Pharmaceutical Benefit Manager (PBMs)
  • Creating a 25 member “Healthcare Regulation Modernization Team” to look at developing numerous health care delivery change proposals including: modernizing Certificate of Need laws; “creating more flexible rules on licensing and scope of practice for clinicians and caregivers” and “increasing flexibility of state agency regulations governing the delivery of and reimbursement for telehealth programs;
  • Making the “inappropriate prescribing of opioids” an unacceptable provider practice in the Medicaid program, giving the State discretion to remove a physician or other prescriber from the program.
  • Reducing prescription drug costs by making drug companies pay a surcharge when costs exceed a certain benchmark to be determined by a Drug Utilization Review Board within the NYS Department of Health;
  • Requiring the testing of public water systems every 3 years for contaminants

The state Senate and Assembly have scheduled a February 16 public hearing to receive comments regarding concerns with the proposed Health Budget, at which MSSNY will testify.
(DIVISION OF GOVERNMENTAL AFFAIRS)

MSSNY LOBBY DAY SCHEDULED FOR MARCH 8TH – PHYSICIANS URGED TO ATTEND AND WEAR YOUR WHITE LAB COATS
MSSNY’s “Physician Advocacy Day” will be held on Wednesday, March 8th in the Lewis Swyer Theatre in the Egg located at the Empire State Plaza in Albany, New York.  Please register here  if you plan to attend.

A full slate of legislators and key policymakers have been invited to dialogue with Advocacy Day participants including:

  • Jason Helgerson, NYS Medicaid Director;
  • Troy Oechsner, Special Assistant to the Superintendent, Department of Financial Services;
  • Legislative Panel: Senate Health Chair Kemp Hannon; Assembly Health Chair, Richard Gottfried; Senate Insurance Chair, James Seward; Assembly Insurance Chair Kevin Cahill.

In addition, Assembly Speaker Carl Heastie, Assembly Majority Leader Joe Morelle and Senate Majority Leader John Flanagan have been invited.  A brief luncheon to which members of each House are invited to speak with their constituents will follow the morning program.   County Medical Societies will be scheduling appointments for physicians to meet with their elected representatives.

Come meet with your legislators to urge that they:

  • Reject burdensome new impediments to obtaining Excess Medical liability insurance coverage contained in the proposed State Budget;
  • Reject inappropriate scope of practice expansions such as the proposal contained in the proposed State Budget that would permit pharmacists to enter into medication management protocols with nurse practitioners
  • Reject changes to increase burdensome physician prior authorization requirements contained in the proposed State Budget;
  • Support legislation to reduce prior authorization hassles including legislation to permit physicians to collectively negotiate contract terms with health insurers;
  • Support legislation to reduce the extraordinary cost of medical liability insurance in New York and reject legislation that would drive up these costs; and
  • Reject legislation that would impose costly and time consuming mandates on physician delivery of patient care

Please come to Albany to make your legislators aware of these challenges!                   (GOVERNMENTAL AFFAIRS STAFF)


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


ACA Discussions Continue in Washington
This week, several Senators proposed different pieces of legislation to repeal and replace pieces of the Affordable Care Act (ACA).

Under the Cassidy-Collins bill, called the Patient Freedom Act, states could enroll people who would otherwise be uninsured in health plans providing basic coverage and would allow consumers to buy additional coverage.  States could stay with the ACA, or they could receive a similar amount of federal money, which consumers could use to pay for medical care and health insurance.  The bill would eliminate the individual coverage mandate and the requirements for larger employers to offer coverage to full-time employees, but allow some protections to remain in place. Parents would still be allowed to keep children on their insurance until the age of 26, and insurers could not impose annual or lifetime limits on benefits.

Additionally, Senator Rand Paul announced the “Obamacare Replacement Act” which would eliminate several provisions of the ACA, including the individual mandate and minimum standards for care. It would also provide a two-year window for people with preexisting conditions to sign up for care.  It also allows insurers to sell plans in multiple states and a $5,000 tax credit that people can put toward a health savings account.

As reported previously, MSSNY has written to New York’s Congressional delegation to urge that the funding mechanism for ACA health insurance coverage programs not be repealed unless such proposals also specify how the current available coverage options will be repealed with improved coverage options that will increase the availability of comprehensive health insurance coverage.             (Belmont)

Governor Cuomo Announces Regulatory Action to Preserve Women Access to Reproductive Health Care
Governor Andrew M. Cuomo announced this week a series of New York State actions to protect access to women’s reproductive rights in New York State.  The Governor announced that New York State will take regulatory action to provide that contraceptive drugs and devices are covered by commercial health insurance policies without co-pays, coinsurance, or deductibles regardless of the future of the Affordable Care Act.

He also proposed that contraceptives are available in amounts exceeding one month’s supply at a time; and all medically necessary abortion services are covered by commercial health insurance policies without co-pays, coinsurance, or deductibles. The announcement coincided with the Women’s Marches in Washington D.C., across New York State and across the country, as well as the 44th anniversary of the landmark United States Supreme Court ruling in Roe v. Wade.  Further information can be obtained HERE and HERE.

The Governor’s action followed action by the New York State Assembly. The Assembly passed the Reproductive Health Act, (A.1748), sponsored by Assemblymember Deborah Glick,  which amended the public health law and placed the abortion procedure in the public health law rather than the penal law.   Additionally, the Assembly also passed A. 1378, the Comprehensive Contraception Coverage Act (CCCA), sponsored by Assemblymember Kevin Cahill.  This measure would require New York State insurers to cover all FAD approved contraceptive methods without out-of-pocket costs, and would ease the multiple barriers experienced by women in obtaining contraceptives and from using them effectively and consistently.                                                                          (CLANCY)

Advocates for Aid in Dying Legislation Hold Press Conference
This week, advocates for “aid in dying” legislation, along with members of the New York State Legislature, held a press conference to push for legislation that would allow a terminally ill patient in New York State to request and use medication to aid in dying.   Advocates from Compassion and Choices joined with Assembly members Amy Paulin and Richard Gottfried and Senator Diane Savino, sponsors of the bill A. 2383/S3151, at the January 23 press conference.  Susan Rahn, who has Stage IV breast cancer, spoke about advocating for the right to “die with dignity.”  The legislation is currently in the Assembly Health Committees.  A similar measure S. 2045 has also been introduced by Senator John Bonacic and is in the Senate Health Committee.

MSSNY position on Physician Assisted Suicide and Euthanasia 95.989 states: Patients, with terminal illness, uncommonly approach their physicians for assistance in dying including assisted suicide and euthanasia. Their motivations are most often concerns of loss of autonomy, concerns of loss of dignity, and physical symptoms which are refractory and distressing. Despite shifts in favor of physician-assisted suicide as evidenced by its legality in an increasing number of states, physician-assisted suicide and euthanasia have not been part of the normative practice of modern medicine. 

Compelling arguments have not been made for medicine to change its footing and to incorporate the active shortening of life into the norms of medical practice. Although relief of suffering has always been a fundamental duty in medical practice, relief of suffering through shortening of life has not.  Moreover, the social and societal implications of such a fundamental change cannot be fully contemplated. MSSNY supports all appropriate efforts to promote patient autonomy, promote patient dignity, and to relieve suffering associated with severe and advanced diseases.  Physicians should not perform euthanasia or participate in assisted suicide.”            (HARRING, CLANCY)

NYS Assembly Codes Committee Approves Expedited Partner Therapy Bill
The New York State Assembly Codes and Health committees approved legislative (A.313, Bichotte) supported by MSSNY, which would allow expedited partner therapy for sexually transmitted infections that the Centers for Disease Control and Prevention (CDC) recommend for the sexual partner or partners of someone having been diagnosed with the disease. Currently, the CDC has recommended the use of EPT for Chlamydia Trachomatis and in November 2012 also recommended EPT in cases of gonorrhea.

In 2005, the New York State passed a law to allow health care providers to provide EPT for Chlamydia infection.  This law was made permanent, along with immunity protections for prescribers as part of the 2013-14 NYS budget process.   This bill will expand the current law to include other sexually transmitted infections that the CDC recommends for expedited partner therapy. EPT helps physicians and other health care providers decrease rates of sexually transmitted infections. While expedited partner therapy in no way replaces a face to face interaction with a health care provider, it can help patients who otherwise would not reach out for treatment.

The CDC has found through randomized controlled tests that EPT has the potential for the same success that it has shown with Chlamydia with other sexually transmitted infections (STIs).  EPT can be highly effective in decreasing infection rates with other STIs that can be cured by taking antibiotics by mouth, such as gonorrhea.  The bill is expected to go to the Assembly floor for a vote and its companion measure, S. 2545, sponsored by Senator Kemp Hannon, is in the Senate Health Committee.                                      (CLANCY) 

AG Schneiderman Announces Settlement with Cigna to Resolve Mental Health Coverage Investigation
New York Attorney General Eric Schneiderman announced a settlement with Cigna this week to require the health insurer to eliminate a written ban on coverage for claims for neuropsychological testing of psychiatric conditions and autism spectrum disorder.

According to the press release the AG’s Health Care Bureau launched an investigation into Cigna’s administration of mental health benefits following a complaint about its written policy for neuropsychological testing. The policy said that “Cigna does not cover neuropsychological testing” for psychiatric conditions and autism spectrum disorder “because such testing is considered educational in nature and/or not medically necessary.”

Under the terms of the settlement, the company agrees to comply with Timothy’s Law, which requires New York group health plans provide “broad-based coverage for the diagnosis and treatment of mental, nervous or emotional disorders or ailments … at least equal to the coverage provided for other health conditions.”   The settlement also requires Cigna to revise its policies, pay autism claims previously rejected, and pay a penalty of $50,000.  Cigna also clarified its policy regarding concussion and mild cognitive impairment.                                                                            (AUSTER)

MSSNY, AMA and Others Release Principles Urging Reduction in Prior Authorization Burdens
Noting that 75% of surveyed physicians described prior authorization burdens as “high or extremely high”, the American Medical Association released a document this week calling on health insurers and benefit managers to reform prior authorization requirements imposed on medical tests, procedures, devices and drugs.  The document, entitled “Prior Authorization and Utilization Management Principles” lists 21 principles where prior authorization hassles could be reduced.  MSSNY was one of a handful of state medical societies to assist I the development of the principles.

While some of the principles that are already imposed on health insurers under New York law, many other principles listed, if implemented, would help reduce some of the PA burdens faced by New York physicians and their staff.  These suggested reforms include:

  • Utilization review entities should offer an appeals system for their utilization management programs that allows a prescribing/ordering provider direct access, such as a toll-free number, to a provider of the same training and specialty/subspecialty for discussion of medical necessity issues;
  • A drug or medical service that is removed from a plan’s formulary or is subject to new coverage restrictions after the beneficiary enrollment period has ended should be covered without restrictions for the duration of the benefit year;
  • Eligibility and all other medical policy coverage determinations should be performed as part of the prior authorization process.
  • If a utilization review entity requires prior authorization for non-urgent care, the entity should make a determination and notify the provider within 48 hours of obtaining all necessary information. For urgent care, the determination should be made within 24 hours of obtaining all necessary information.   (AUSTER)

CMS Again Institutes Audits to Check Physician & Home Care Compliance with Medicare Face to Face Requirements
All physicians should be aware that CMS is again instructing its Medicare Administrative Contractors (MACs), including National Government Services (NGS) covering New York, to conduct Home Health “Probe-and-Educate” medical review audits relating to claims submitted by home health agencies (HHAs) for Medicare home health services including the face-to-face (F2F) requirement.

As many physicians know, the F2F provision requires a certifying physician to document that he or she, or a non-physician practitioner (NP or PA) working with the physician, has seen the patient, as a condition of eligibility for Medicare home health services.  Many home care agencies and physicians have noted that the CMS regulations implementing this provision have created unnecessary and overly burdensome documentation requirements that are delaying or denying coverage for needed home care services.  MSSNY has been working the Home Care Association of New York State (HCA) on efforts to eliminate or reduce the hassles in Medicare and Medicaid associated with this requirement.  Dr. Evelyn Dooley-Seidman chairs a MSSNY-HCA working group that also has the participation of Suffolk County geriatrician Dr. Jay Slotkin.

Specifically, CMS is directing MACs to sample five claims for pre-payment review from each HHA within their jurisdictions.  Based on the results of these reviews, MACs will conduct provider-specific educational outreach. CMS will instruct MACs to deny each non-compliant claim and to outline the reasons for denial in a letter to the HHA, which will be sent at the conclusion of the probe review portion of the process. CMS will also instruct the MACs to offer individualized phone calls/education to all providers with errors in their claim sample. During such calls, the MAC will discuss the reasons for denials, provide pertinent education and reference materials, and answer questions.  For those providers that are identified as having moderate or major concerns (two to five denials out of five), the MACs will repeat the probe-and-educate process for dates of services occurring after education has been provided.

The “probe and educate” initiative, in turn, will likely result in increased efforts to assure physicians are providing the necessary certification.  It is another example of the burdensome paperwork hassles associated with complying with the F2F requirement for physicians and home care agencies. As such, MSSNY will continue to work with HCA to convince New York’s Congressional Delegation to work towards repeal or substantial modification of this rule.  Moreover, we are hopeful that the new Trump Administration Executive Order to reduce regulatory burdens on health care providers and patients will provide a new opportunity to revisit this rule.  With the requirement also slated to go into effect for Medicaid patients as of July 1, 2017, MSSNY is also working with HCA to advocate to the NYS Department of Health to reduce the burdens associated with complying with this rule.                           (AUSTER)

Register Now for Upcoming Medical Matters 2017 CME Webinar Series
The Medical Society of the State of New York encourages you to register for its next Medical Matters webinar on Wednesday, February 15, 2017 at 7:30 a.m. with The Mental Health Impact of Active Shooter/Bombing on the Healthcare Team.  Faculty for this program is Craig Katz, MD, member of MSSNY’s Emergency Preparedness and Disaster/Terrorism Response Committee.  Registration is now open for this webinar here just click on “Upcoming”.

The educational objectives are: 1)  Describe the psychological problems and stress symptoms that can result from caring for victims of an active shooter/bombing event.  2) Identify means by which members of the healthcare team can address stress before, during and after an active shooter/bombing event.  3) Review resources and methodologies available to address the mental health impact of an active shooter/bombing on the healthcare team.

The Medical Matters program for March 15, 2017 at 7:30 a.m. is Exercise Response to Novel Influenza Strains.  Faculty for this program is Pat Anders, MS, MEP, Manager, Health Emergency Preparedness Exercises, New York State Department of Health, Office of Health Emergency Preparedness.

The educational objectives are: 1) Understand preparedness and response actions of public health and healthcare to a novel pandemic influenza, simulated in full-scale exercise.  2) Describe two delineated strategies in which public health and office-based physicians would interact in a pandemic influenza.

A copy of the flyer can be accessed here.  Additional information or assistance with registration may be obtained by contacting Melissa Hoffman at mhoffman@mssny.org. 

Medical Matters is a series of CME webinars sponsored by MSSNY’s Committee on Emergency Preparedness and Disaster/Terrorism Response. 

The Medical Society of the State of New York (MSSNY) is accredited by the Accreditation Council for Continuing Medical Education (ACCME) to provide continuing medical education for physicians. 

MSSNY 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.                                               (Clancy, Hoffman)

Activism Matters
The New York Times published an article highlighting the importance of activists to call and meet with legislators. Several lawmakers and staff indicated the value that a large volume of calls on an issue can have on legislator’s positions.  Even if you don’t speak directly to the lawmaker, staff members often pass the message along in one form or another.  From our firsthand experience, lawmakers have always expressed the importance that phone calls and meetings with their constituents can have on their position.

How can I help?
Your participation in the legislative and political process remains critical.  We need to make sure our elected officials know where we stand when their positions helps or hurts you.  MSSNY’s input is valued by many of our elected officials.  Throughout our website, MSSNY provides various resources to make sure you have the tools to fight back when harmful proposals are introduced.

Proposals are constantly introduced that directly affect you and your family.  As many know, physician activism is essential to making a difference in Albany.  MSSNY needs resources and activist like you to so that we will be a united force to be reckoned with.   Every MSSNY member has an opportunity to get involved in one form or another.  Becoming a member of MSSNY allows you to receive the latest information on legislative and budgetary proposals that impact you.

MSSNY is an important avenue to make sure our collective voices are heard.  Every physician should be a part of MSSNY and MSSNYPAC in order to be able to continue our efforts.  And please avail yourself of our resources that make it easier for you to contact your elected officials.                                                                  (BELMONT)

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 mauster@mssny.org         pclancy@mssny.org   jbelmont@mssny.org

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Council Notes: January 19, 2017

  • Council approved the Board of Trustees report, which included the pricing policy for the opioid training modules that MSSNY has developed in accordance with the regulations set by the Bureau of Narcotics. The course will be free to MSSNY members. The cost for Non-Members will be $150 for the 3 Module course. However, this $150 will be applied towards deferring the cost of MSSNY membership dues in the event that non-members decide to join MSSNY.
  • Michael R. Privitera, MD, presented a report of MSSNY’s Physician Burnout Task Force. In 2015, the MSSNY House of Delegates passed resolution 2015-200, titled “Physician Health Programs and Membership Recruitment” to develop a series of programs to assist physicians in early identification and management of stress. Council approved the following recommendations from the Task Force:
  1. Development of CME programs on physician stress and burnout, as well as the peer support model and recruitment of a cadre of doctors to do such CME presentations and presentations to leaders and other stakeholders.
  2. Seeking grants or other funding to support CME, burnout study and program activities in an enduring way.
  3. Continued collaboration with other organizations on burnout reduction and wellness efforts.
  4. Seek grants or other funding to help develop a peer support model to all county societies, hospitals and hospital systems and practices in an ongoing way.
  • Council approved the following mission and vision statements from MSSNY’s Committee to Eliminate Health Care Disparities:
    Mission Statement:
    The mission of the Committee to Eliminate Healthcare Disparities is to increase awareness of how factors such as race, ethnicity, culture and religious beliefs, sexual orientation, gender and gender identity contribute to both health and healthcare disparities.

Vision Statement:
The vision of the Committee to Eliminate Health Care Disparities is a New York State healthcare system that bridges gaps and identifies potential bias in order to provide the highest quality care to all people throughout the state with respect for their race, ethnicity, culture and religious beliefs; sexual orientation, gender and gender identity.

  • Speaker Dr. Kira Geraci-Ciardullo announced that Health Commissioner Howard Zucker, MD, JD, will address the 211th House of Delegates on Friday morning, April 21.
  • Don Moy, Esq. spoke briefly about the Overtime Pay Final Rule that was effective on December 31, 2016. Click here for more information.


MSSNYPAC – The Political Voice for New York’s Physicians
Advocating for our profession is both a duty and an honor and physicians are a force for change in New York State healthcare. Our patients deserve excellent care and we strive to provide that in our practices and in policy formation. Participation in MSSNYPAC is an important step in helping to elect physician-friendly candidates, and MSSNYPAC’s President’s Circle and Chairman’s Club help to develop the strong relationships that are necessary for effective political action.  It is essential that physicians not only have a seat at the discussion table but speak with a strong united voice. Join or increase your support and participation today at www.mssnypac.org/contribute. 

AARP Medicare Complete Is Not AARP Medicare Mosaic
For physicians who participate in a Medicare “Advantage” plan called AARP Medicare Complete, there is another plan called AARP Medicare Complete – Mosaic.

They are not the same and if a physician participates in AARP Medicare Complete, he/she does not necessarily participate in the Mosaic product.

When a patient calls for an appointment and says they have AARP Medicare Complete, the practice’s office staff should confirm if the patient is enrolled in the AARP Medicare Complete or the Mosaic product. UHC’s Mosaic plan is a limited language network for patients who speak Chinese, Korean, or Spanish.

The practice will only be paid for services from their contracted plan.

                                    From Regina McNally, VP of MSSNY Socio-Med Division

Nonmedical Vaccine Exemptions on the Rise in NY, Other States, CDC Data Show
STAT (1/20l7) reported that nonmedical vaccine exemptions are on the rise in some states, even as they decline nationally, according to data from the Centers for Disease Control and Prevention. The number of children not being vaccinated for nonmedical reasons in 11 states – Connecticut, Florida, Iowa, Kentucky, Maryland, New York, North Carolina, North Dakota, Ohio, Oklahoma, and Virginia –”is higher than at any point in the past five years.”

Deadline for Abstract submission Is Tuesday, Jan. 31 for Poster Symposium

Resident/Fellow/Medical Student

The Annual Poster Symposium will be held on:

Friday, April 21, 2017
Westchester Marriott
Tarrytown, New York
2 pm – 4:30 pm

In the words of past participants, the MSSNY symposium is an “excellent networking opportunity,” a place to “meet fellow residents and attendings” and “learn from other presentations” that they “would highly recommend.” 

Click here for detailed guidelines.

Check out last year’s Abstract Book here.

We welcome the participation of your residents and fellows. Participants must be MSSNY members, and membership is free for first-time resident members. Join online.


SAVE THE DATE
Physician Lobby Day in Albany
Wednesday, March 8th, 2017
YOU NEED TO TAKE A DAY AWAY FROM YOUR PRACTICE
Call Your County Medical Society for Details


Health Care Coalition Calls for Prior Authorization Reform
Releases new principles to improve timely access to care and reduce administrative burdens

CHICAGO – Responding to unreasonable hurdles for patients seeking care, a coalition including the American Medical Association (AMA) and 16 other health care organizations this week urged health plans, benefit managers and others to reform prior authorization requirements imposed on medical tests, procedures, devices and drugs.

The coalition, which represents hospitals, medical groups, patients, pharmacists and physicians, says that requiring pre-approval by insurers before patients can get certain drugs or treatments can delay or interrupt medical services, divert significant resources from patient care and complicate medical decisions.

Given the potential barriers that prior authorization can pose to patient-centered care, the coalition is urging an industry-wide reassessment of these programs to align with a newly created set of 21 principles. Prior authorization programs could be improved by applying the principles’ common-sense concepts grouped in five broad categories:

  • Clinical validity,
  • Continuity of care,
  • Transparency and fairness,
  • Timely access and administrative efficiency, and
  • Alternatives and exemptions.

The data entry and administrative tasks associated with prior authorization reduce time available for patients. According to a new AMA survey, every week a medical practice completes an average of 37 prior authorization requirements per physician, which takes a physician and their staff an average of 16 hours, or the equivalent of two business days, to process.

The AMA survey illustrates that physician concerns with the undue burdens of preauthorizing medical care have reached a critical level. Highlights from the AMA survey include:

  • Seventy-five percent of surveyed physicians described prior authorization burdens as high or extremely high.
  • More than a third of surveyed physicians reported having staff who work exclusively on prior authorization.
  • Nearly 60 percent of surveyed physicians reported that their practices wait, on average, at least 1 business day for prior authorization decisions—and  more than 25 percent of physicians said they wait 3 business days or longer.
  • Nearly 90 percent of surveyed physicians reported that prior authorization sometimes, often, or always delays access to care.

The AMA and other coalition organizations welcome the opportunity to work collaboratively with health plans and others to create a partnership that lays the foundation for a more efficient prior authorization process. In addition to the AMA, the coalition includes the: American Academy of Child and Adolescent Psychiatry, American Academy of Dermatology, American Academy of Family Physicians, American College of Cardiology, American College of Rheumatology, American Hospital Association, American Pharmacists Association, American Society of Clinical Oncology, Arthritis Foundation, Colorado Medical Society, Medical Group Management Association, Medical Society of the State of New York, Minnesota Medical Association, North Carolina Medical Society, Ohio State Medical Association and Washington State Medical Association.

CMS: New Participants Join Several CMS Alternative Payment Models
CMS announced over 359,000 clinicians are confirmed to participate in four of CMS’s Alternative Payment Models (APMs) in 2017. Clinicians who participate in APMs are paid for the quality of care they give to their patients. APMs are an important part of the Administration’s effort to build a system that delivers better care and one in which clinicians work together to have a full understanding of patients’ needs. APMs also strive to ensure that patients are in the center of their care, and that Medicare pays for what works and spends taxpayer money more wisely resulting in a healthier country.

“By listening to physicians and engaging them as partners, CMS has been able to develop innovative payment reforms that bring physicians back to the core practice of medicine – caring for the patient,” said Acting Administrator Andy Slavitt. “By reducing regulatory burden and paying for quality, CMS is offering solutions that improve the quality of services our beneficiaries receive and reduce costs, to help ensure the Medicare program is sustainable for generations to come.”

The Medicare Shared Savings Program (Shared Savings Program), Next Generation Accountable Care Organization (ACO) Model, Comprehensive End-Stage Renal Disease (ESRD) Care Model (CEC) and Comprehensive Primary Care Plus (CPC+) Model all apply the concept of paying for quality and effectiveness of care given to patients in different health care settings.


CLASSIFIEDS


Modern/High End Office (Upper East Side)
Large and Modern office to share.  Located on the ground floor.  2+ treatment/exam rooms, large waiting room, private office, storage.  Price is negotiable for 1-3 day/week.  Call Dr. Austin 5189284819 or email ian@caneandaustin.com No broker fee.  Craig Austin, M.D. 120 East 64th Street, NYC 10065


Prime Astoria Medical Office for Rent or Lease
23-15 Astoria Boulevard, Astoria, New York
Customizable Lower Level
7,500 Sq Feet Gross For Lease
Prime Location Close To Hospital and Other Medical Facilities.
Direct Street Access Private Elevator plus Direct Access From  
Street Level Stairs.
Contact:
AB Building Management LLC
George Miltiadou
718-482- 7262
917-939-0019

Upper East Side Medical Office for Sale
Suitable for a solo practice or shared multi- specialist group. Large unit, about 1100 Sq Ft, located on the ground floor of a cooperative building with own entrance to office, 2 or 3 equipped exam rooms with exam tables and work station areas, front waiting room with reception area with storage unit of shelves for medical charts, a consultation office, 1 and a half bathrooms and kitchenette. Lots of shelves throughout exam rooms, 2 EKGs, one PC computer that comes equipped with a PFT machine and operating software, an operating X-ray machine suitable for chest X-rays with film processor. No brokers, call office manager, Diana Peron @ 212-861-9012


Elegant Plastic Surgery Office (Upper East Side Manhattan)
Very large and classy office to share. Located in the ground floor of a 25′ x 100′ carriage house opposite the 66th Street Armory with large consult room, 2+ treatment/exam rooms, large waiting room, business office, storage. See video of office — you won’t believe it: www.youtube.com/watch?v=Uli8Cck_eRA   $5000/month incl utilities. no brokers. Call Doctor Fischman at (212) 472–3300.Jeffrey R. Fischman, M.D.  110 E 66th Street.

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Physician Opportunities


A Private Multidisciplinary Medical Group is seeking an Internal Medicine/Family Medicine Physician in Manhattan
A well-established Manhattan based private multidisciplinary medical group is seeking to hire an Internal Medicine/Family Medicine Physician. This is a great opportunity to start your own practice in a modern office in midtown Manhattan. Attractive base salary plus comprehensive benefits package offered (Malpractice, 3 weeks paid vacation, 1 week CME, CME allowance, paid health insurance, etc).If you are a solo practitioner in private practice looking to join a private group practice, we will work with you to make the transition seamless. Please email your CV to tsrgexpress@gmail.com. No recruiters please.

A Private Multidisciplinary Medical Group is seeking a Podiatrist in Manhattan
A well-established Manhattan based private multidisciplinary medical group is seeking to hire a Podiatrist. This is a great opportunity to start your own practice in a modern office in midtown Manhattan. Attractive base salary plus comprehensive benefits package offered (Malpractice, 3 weeks paid vacation, 1 week CME, CME allowance, paid health insurance, etc).If you are a solo practitioner in private practice looking to join a private group practice, we will work with you to make the transition seamless. Please email your CV to tsrgexpress@gmail.com. No recruiters please.

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

January 20, 2017 – Positive Provisions in the Proposed $153B Budget

Dr. Reid - MSSNY President
PRESIDENT’S MESSAGE
Dr. Malcolm Reid
January 20, 2017
Volume 17
Number 3

mssny_enews_dividend

Dear Colleagues:

This week, our Government Affairs Division outlines Governor Cuomo’s proposed budget for 2017-2018 highlighting items that relate to New York State physicians.

Malcolm Reid

Save the Date:
MSSNY Physician Advocacy Day in Albany March 8!

Please send your comments to comments@mssny.org



Governor Proposes $152 Billion Budget for 2017-18
This week Governor Cuomo released his proposed $152.3 billion spending plan for the 2017-18 Fiscal Year.  The Budget proposed is to address a $3.5 billion budget deficit and a proposed increase of $1 billion in education aid in part by retaining the “millionaires’ tax” for an three additional years. At the same time the Governor proposes to reduce income taxes for those with incomes of $300,000 or less.  The budget would also extend for an additional three years the health financing mechanisms of the Health Care Reform Act (HCRA) for a variety of public good programs.

Among the positive provisions in the proposed Budget:

  • Funding for the Excess Medical Malpractice program would be continued at its historic level of $127,400,000;
  • Funding for MSSNY’s Committee for Physicians Health would be continued at its historic level of $990,000;
  • Re-appropriating $300,000 for MSSNY’s Veterans Health Care Initiative.
  • E-cigarettes would be taxed in the same manner as tobacco cigarettes.
  • Requiring the registration and regulation of Pharmaceutical Benefit Manager (PBMs)

Some of the items of significant concern in the proposed budget include:

  • Physicians would be required to receive a “tax clearance” as a pre-condition to receiving Excess Medical Malpractice Insurance coverage;
  • “Prescriber prevails” protections that currently exist in Medicaid and Medicaid Managed Care would be eliminated, except for atypical antipsychotic and anti-depressant medications, forcing physicians to go through even more burdensome prior authorization requirements;
  • Pharmacists would be permitted to enter into “comprehensive medication management protocols” with physicians or nurse practitioners to manage and adjust the medications of patients with a chronic disease or diseases who have not met clinical goals of therapy, are at risk for hospitalization.  While similar “collaborative drug therapy” programs exist within the hospital environment, only physicians are currently permitted to enter into such protocols.
  • Creating a 25 member “Healthcare Regulation Modernization Team” to look at developing numerous health care delivery change proposals including: modernizing Certificate of Need laws; “creating more flexible rules on licensing and scope of practice for clinicians and caregivers” and “increasing flexibility of state agency regulations governing the delivery of and reimbursement for telehealth programs;
  • Making the “inappropriate prescribing of opioids” an unacceptable provider practice in the Medicaid program, giving the State discretion to remove a physician or other prescriber from the program.

Other items of note within the proposed Budget include:

  • Reducing prescription drug costs by making drug companies pay a surcharge when costs exceed a certain benchmark to be determined by a Drug Utilization Review Board within the NYS Department of Health;
  • $150 million for a life sciences laboratory public health initiative;
  • Increase cost-sharing for certain enrollees in the State’s Essential Plan;
  • Requiring the testing of public water systems every 3 years for contaminants

MSSNY staff is continuing its review of the thousands of pages of budget documents and will follow up with further information.  The state Senate and Assembly have scheduled a February 16 public hearing to receive comments regarding concerns with the proposed Health Budget, at which MSSNY will testify.
 (DIVISION OF GOVERNMENTAL AFFAIRS) 

MSSNY Lobby Day Scheduled for March 8TH – Physicians Urged to Attend and Wear Your White Lab Coats
MSSNY’s “Physician Advocacy Day” will be held on Wednesday, March 8th in the Lewis Swyer Theatre in the Egg located at the Empire State Plaza in Albany, New York.  Please register here  if you plan to attend.

A full slate of legislators and key policymakers have been invited to dialogue with Advocacy Day participants including:

  • Jason Helgerson, NYS Medicaid Director;
  • Troy Oechsner, Special Assistant to the Superintendent, Department of Financial Services;
  • Legislative Panel: Senate Health Chair Kemp Hannon; Assembly Health Chair, Richard Gottfried; Senate Insurance Chair, James Seward; Assembly Insurance Chair Kevin Cahill.

In addition, Assembly Speaker Carl Heastie, Assembly Majority Leader Joe Morelle and Senate Majority Leader John Flanagan have been invited.  A brief luncheon to which members of each House are invited to speak with their constituents will follow the morning program.  County Medical Societies will be scheduling appointments for physicians to meet with their elected representatives.

Shifts in Medicare and Medicaid payment methodologies are producing enormous changes in our health care delivery system that is affecting how patients receive care.  These changes are profoundly affecting the daily lives of physicians and the patients they serve.  At the same time, actions are being taken by the health insurance industry to greatly shrink their networks at the expense of long-standing physician-patient relationships, and increasing burdensome prior authorization requirements.

Adding to this uncertainty are the consequences to New York State’s extensive health insurance coverage programs if proposals under consideration by Congress to repeal the Affordable Care Act were to be enacted.

Please come to Albany to make your legislators aware of these challenges!
(DIVISION OF GOVERNMENTAL AFFAIRS STAFF)

Bill Introduction Update
Over the last several weeks, the State Legislature has introduced thousands of bills.  The Governmental Affairs team will continue to monitor and advocate where legislation will  have an impact on physicians and medical services in New York State. Several scope of practice bills have been introduced that MSSNY opposes:

  • Licensing of genetic counselors (A.2275 Rosenthal / S.1323 LaValle)

This bill would allow the licensing of genetic counselors and providing them with a scope of practice, which includes communication to and education of clients, their families, other health care professionals and the general public with regard to genetic testing, individual family histories, or other genetic, medical, and technical information associated with the occurrence , risk of occurrence or recurrence, of a genetic or hereditary condition or birth defect in a comprehensive, understandable, ethical manner.  The Medical Society believes that there should be a connection to a physician required, such as requirement of a referral from the physician or other health care provider who is treating the patient, specifying the reason for the referral.  

  • Certification of certified registered nurse anesthetists (CRNAs) (A.442 Paulin / S.1385 Gallivan)

This measure would provide for the certification by the education department of certified registered nurse anesthetists (CRNAs).  This bill fails to define a scope of practice consistent with existing New York State standards.  Under NYS Health Code (10 NYCRR 700.2), CRNAs are already required to register with the NYS Education Department and are prohibited from practicing nurse anesthesia without meeting specific education and testing requirements.

  • Podiatric scope of practice (A.1880 Pretlow)

This bill would expand the scope of practice of podiatrists to allow podiatrists to “diagnose, treat, operate or prescribe for cutaneous conditions of the ankle to the level of the distal tibial tuberocity” (knee). The bill would eliminate existing law that currently limits a podiatrist’s treatment of wounds to those relating or originating on the foot.

Several other reform bills have been introduced that MSSNY supports: 

  • Continuity of Care (A.256 Dinowitz)

This bill would extend the time period which health plan enrollees may continue to receive services from a health care provider who is not a member of the plan’s network from 60 or 90 days to one year, or in the case of terminal illness, until the time of the enrollee’s death within three years.

  • Coverage for “Dually Eligible”(A.1435 Cahill)

This proposal ensures health care services are accessible to the elderly and people with developmental disabilities that are dually eligible for Medicaid and by restoring full “crossover” payments.  The bill provides Medicaid reimbursements for 100% of any Medicare deductible and co-insurance amounts for services and items provided to individuals “dually eligible” for Medicaid and Medicare.

Restores “Prescriber Prevails”(A.700 Rodriguez / S.2919) Carlucci This bill would require Medicaid managed care (MMC) and Child Health Plus plans to adopt the procedures of the Preferred Drug Program and restores “prescriber prevails” for all drugs.              (BELMONT)

AG Announces Settlements to Resolve Inappropriate Prior Authorization and Drug Price Change Allegations
Attorney General Eric Schneiderman announced the following settlements with various health care entities this week:

  • A settlement with Anthem, the parent of Empire BlueCross BlueShield, to end prior authorization requirements for Medication Assisted Treatment (MAT) for opioid use disorders. According to the press release, Anthem required providers to submit a prior approval form for MAT coverage requests, which required the providers — who had already received specific training regarding MAT and federal authorization to prescribe these drugs — to answer numerous questions about the patient’s current treatment and medication history.   This subsequently caused significant delays in patients obtaining treatment for addiction – or patients never obtaining the treatment at all.  The press release noted that, in contrast to its policy for drugs to treat opioid use disorder, Empire does not require prior authorization for the majority of drugs it covers for medical conditions.

Under the agreement, Empire will also launch an initiative to expand access to MAT for members in its New York service area. Empire BCBS will conduct provider outreach and education regarding the benefits of MAT, informing qualified health care providers how they can obtain certification from the Substance Abuse and Mental Health Services Administration (“SAMHSA”) to prescribe buprenorphine and buprenorphine/naloxone as part of MAT for opioid dependence. Empire BCBS will provide the Attorney General with a list of MAT providers who have joined its network as a result of this initiative.

  • A $100 million settlement with drug manufacturer Mallinckrodt and its U.S. subsidiary, formerly known as Questcor Pharmaceuticals (“Questcor”), to resolve allegations of preventing competition for its drug H.P. Acthar Gel, which is typically used as a last resort to treat certain life-threatening diseases, including infantile spasms and multiple sclerosis.   To read the press release, click here.
    (AUSTER)

House Advances Resolution to Consider ACA Repeal Legislation
By a 227-198 vote, the US House of Representatives approved a resolution to enable the consideration of legislation that would repeal much of the funding mechanisms under the Affordable Care Act (ACA).  The resolution, which enables the repeal to be considered via the process of “reconciliation”, had been passed by the US Senate the week before.  All but 9 House Republicans voted in favor of the resolution, with eight of the nine republicans from the New York Congressional delegation voting in favor.   All 189 Democrats in the US House voted against the measure, including 18 Democrats from New York Congressional delegation as well as Rep. John Katko (R-Syracuse).

Last week, President Donald Trump said that Republicans will introduce proposals to repeal and replace the ACA as soon as Health and Human Services secretary, Tom Price, is approved.  MSSNY recently wrote to the New York Congressional delegation to express concerns with proposals that would repeal ACA funding streams for insurance coverage without simultaneously specifying what they will be replaced with, as well as concerns with the impact to New York patients and the New York State Budget.
(AUSTER)

Free Buprenorphine Training for Provides to Be Held February 25 on Long Island
The New York State Department of Health’s  AIDS Institute is sponsoring a free buprenorphine waiver training for clinical providers.  The training will be held on Saturday, February 25, 2017 from 8 a.m. to 1 p.m. at the Farmingdale State College, 2350 Broadhollow Road, Roosevelt Hall, Room 111; Farmingdale NY 11735.

On-line registration is required here.

Physicians, nurse practitioners and physician assistants are welcome and highly encouraged to attend this training.   Five hours of Continuing Medical Education (CME) will be provided.

Under current regulations, physicians are required to obtain a ‘waiver’ to prescribe buprenorphine. Physicians can acquire this waiver by attending and completing standardized and required 8-hour training. This training is offered in a half-and-half format [4 hours of online training followed up by 4 hours of in-person training]. NPs and PAs are required to complete an additional 16 hours of training. Upon completion, providers will meet the requirement of the DATA 2000 to be qualified to prescribe buprenorphine for opioid-dependent patients. (Prerequisite: additional information about required online training will be sent out to registrants). 

Faculty for the training is Sharon Stancliff, MD, from the Harm Reduction Coalition, New York, NY and Ray Harvey, MD, Institute for Family Health, Kingston NY.  Directions to Farmingdale State College can be found at here.

More information on this program can be found here:(CLANCY)                                                                                                                                                            

Register Now for a January 26 Lunchtime Program to Discuss the Medicare MIPS Program
The Medicare MACRA/MIPS program has now gone into effect.  Do you and your staff want to learn more regarding what you need to know to comply with this new program that could have a significant impact on your revenue from Medicare?  Please join us for a webinar this Thursday January 26, from 12:30 – 1:30, where you will hear from Frank Winter of New York Regional Office for CMS present important information about this new program for physicians and their staffs.  To register Click Here. 

Upon your registration, you will receive a confirmation e-mail with instructions for joining this session either by webinar or conference call.                                                                                                                (AUSTER)

Register Now for Medical Matters 2017 CME Webinar Series Upcoming
The Medical Society of the State of New York encourages you to register for its next Medical Matters webinar on Wednesday, February 15, 2017 at 7:30 a.m. with The Mental Health Impact of Active Shooter/Bombing on the Healthcare Team.  Faculty for this program is Craig Katz, MD, member of MSSNY’s Emergency Preparedness and Disaster/Terrorism Response Committee.  Registration is now open for this webinar here just click on “Upcoming”.  

The educational objectives are: 1) Describe the psychological problems and stress symptoms that can result from caring for victims of an active shooter/bombing event.  2) Identify means by which members of the healthcare team can address stress before, during and after an active shooter/bombing event.  3) Review resources and methodologies available to address the mental health impact of an active shooter/bombing on the healthcare team.

The Medical Matters program for March 15, 2017 at 7:30 a.m. is Exercise Response to Novel Influenza Strains.  Faculty for this program is Pat Anders, MS, MEP, Manager, Health Emergency Preparedness Exercises, New York State Department of Health, Office of Health Emergency Preparedness.

The educational objectives are: 1) Understand preparedness and response actions of public health and healthcare to a novel pandemic influenza, simulated in full-scale exercise.  2) Describe two delineated strategies in which public health and office-based physicians would interact in a pandemic influenza.

A copy of the flyer can be accessed here.  Additional information or assistance with registration may be obtained by contacting Melissa Hoffman at mhoffman@mssny.org. 

Medical Matters is a series of CME webinars sponsored by MSSNY’s Committee on Emergency Preparedness and Disaster/Terrorism Response. 

The Medical Society of the State of New York (MSSNY) is accredited by the Accreditation Council for Continuing Medical Education (ACCME) to provide continuing medical education for physicians. 

MSSNY 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.
(Clancy, Hoffman)

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

pschuh@mssny.org mauster@mssny.org         pclancy@mssny.org   jbelmont@mssny.org

enews large

MA Insurers Warned of Fines if They Don’t Correct Provider Directory Errors
Kaiser Health News (1/18) http://bit.ly/2jDycTs reports Federal officials warned earlier this month “21 Medicare Advantage insurers with high rates of errors in their online network directories that they could face heavy fines or have to stop enrolling people if the problems are not fixed by Feb. 6.” The warning comes after the first in-depth review by the government “of the accuracy of Medicare Advantage provider directories, which consumers and advocates have complained about for years.”

MSSNYPAC – The Political Voice for New York’s Physicians
The Governor’s proposed budget includes many provisions which impact physicians.  Advocacy on these and a myriad other health care reform proposals will be necessary.  Your voice and support matter as they enable physicians as a group to have political power.  It is critically important for the physician to have a meaningful seat at the table in shaping these proposals. Through MSSNYPAC, physicians are a force for change in New York State healthcare policy.   Join or increase your support and participation today at www.mssnypac.org/contribute

Physician Judges Needed for HOD Poster Symposium
Doctors: If you’re coming to the House of Delegates in Westchester– or just live in the neighborhood – and are free on Friday afternoon, April 21, from 2 – 4:30 pm, please consider participating as a judge at the MSSNY Resident and Fellow Section Poster Symposium. It’s always an exciting, lively event! Please contact sbennett@mssny.org or 516-488-6100 extension 383 if you’re interested.  

Governor Cuomo Discusses Potential Impact of Repealing ACA with Trump
Reuters (1/18) http://reut.rs/2kaRX67 reports Gov. Andrew Cuomo said that he discussed how the potential repeal of the Affordable Care Act could impact residents of New York with President-elect Donald Trump. Cuomo said the repeal of the law could leave 3 million New Yorkers without health insurance.

Study Identifies New Zika Proteins That Explain Fetal Brain Abnormalities
A study published in the Proceedings of the National Academy of Sciences http://bit.ly/2iT04Ps “could contribute to Zika treatment efforts” by identifying two new Zika proteins that may help explain how the virus actually causes fetal brain abnormalities. The study builds on previous research using fission yeast that identified seven possible proteins. The earlier study had used a strain of the virus from 1947.

MLMIC: Monitoring Management Changes at PRI
On January 17, the Albany Times Union reported a new development in the struggles for one of New York’s major malpractice insurance carriers. You can access the article here under the Times Union headline, “Amid scandal and fiscal woes, insurance mogul steps aside.”

Instability of a large provider creates some uncertainty for the entire market, of course, but we want to assure MLMIC policyholders that their coverage is not at risk. By adhering to responsible underwriting practices from our beginning, MLMIC continues to demonstrate sound financial condition and is able, once again, to offer a policyholder dividend (20% for those insured by May 1 and continuously insured through July 1).

We’ll keep monitoring the situation in the market on your behalf and will apprise you of further developments. In the meantime, if you have questions, please call 1 (888) 488-9253.

One in Three Adults Diagnosed with Asthma – May Not Have It
An article published in JAMA suggests “as many as one in three adults diagnosed with asthma may not actually have the” condition. The study’s 613 participants, all of whom “had been diagnosed with asthma in the previous five years,” underwent “multiple tests and examinations to determine if they had signs of asthma.” Investigators “determined that 203 participants, or” about “33 percent, did not have baseline symptoms of asthma after the initial examination.”  LiveScience (1/17) reports, “When the participants without asthma were evaluated by the study” physicians, approximately “60 percent were diagnosed with other conditions, such as seasonal allergies, acid reflux or breathing difficulties that were due to obesity.”

Attest to 2016 Program Requirements by February 28
The Centers for Medicare & Medicaid Services Registration and Attestation System is now open. Providers participating in the Medicare EHR Incentive Program must attest to the 2016 program requirements by February 28, 2017 at 11:59 p.m. ET in order to avoid a 2018 payment adjustment. The EHR reporting period was any continuous 90 days between January 1 and December 31, 2016.

If you are participating in the Medicaid EHR Incentive Program, please refer to your states deadlines for attestation information.

If you are eligible to participate in both the Medicare and Medicaid EHR Incentive Programs, you MUST demonstrate meaningful use to avoid the Medicare payment adjustment. You may demonstrate meaningful use under either Medicare or Medicaid.

Reminder: Remember to visit the registration tab in the Registration and Attestation system to ensure your personal information is accurate. For more information on registration, visit the Registration & Attestation page of the EHR Incentive Programs website.

Payment Adjustments and Hardship Exceptions

In January 2018, CMS will begin to apply payment adjustments for providers that did not successfully demonstrate meaningful use of EHR technology or apply for and receive a hardship exception for the 2016 program year. CMS will send a separate announcement with more information on the hardship exception application process, once available.

Attestation Resources

Eligible Professional (EP) and Eligible Hospital and Critical Access Hospital (CAH) Attestation Worksheets

EP and Eligible Hospital and CAH Attestation User Guides

EP and Eligible Hospital and CAH Registration User Guides

Attestation Batch Upload Webpage

For More Information

For questions about the Registration and Attestation System, contact the EHR Information Center at 1-888-734-6433 (press option 1). The EHR Information Center is open Monday through Friday from 6:30 a.m. to 5:30 p.m. ET, except federal holidays.


SAVE THE DATE
Physician Lobby Day in Albany
Wednesday, March 8th, 2017
YOU NEED TO TAKE A DAY AWAY FROM YOUR PRACTICE
Call Your County Medical Society for Details


CLASSIFIEDS


Modern/High End Office (Upper East Side)
Large and Modern office to share.  Located on the ground floor.  2+ treatment/exam rooms, large waiting room, private office, storage.  Price is negotiable for 1-3 day/week.  Call Dr. Austin 5189284819 or email ian@caneandaustin.com No broker fee.  Craig Austin, M.D. 120 East 64th Street, NYC 10065


Prime Astoria Medical Office for Rent or Lease
23-15 Astoria Boulevard, Astoria, New York
Customizable Lower Level
7,500 Sq Feet Gross For Lease
Prime Location Close To Hospital and Other Medical Facilities.
Direct Street Access Private Elevator plus Direct Access From  
Street Level Stairs.
Contact:
AB Building Management LLC
George Miltiadou
718-482- 7262
917-939-0019

Upper East Side Medical Office for Sale
Suitable for a solo practice or shared multi- specialist group. Large unit, about 1100 Sq Ft, located on the ground floor of a cooperative building with own entrance to office, 2 or 3 equipped exam rooms with exam tables and work station areas, front waiting room with reception area with storage unit of shelves for medical charts, a consultation office, 1 and a half bathrooms and kitchenette. Lots of shelves throughout exam rooms, 2 EKGs, one PC computer that comes equipped with a PFT machine and operating software, an operating X-ray machine suitable for chest X-rays with film processor. No brokers, call office manager, Diana Peron @ 212-861-9012


Elegant Plastic Surgery Office (Upper East Side Manhattan)
Very large and classy office to share. Located in the ground floor of a 25′ x 100′ carriage house opposite the 66th Street Armory with large consult room, 2+ treatment/exam rooms, large waiting room, business office, storage. See video of office — you won’t believe it: www.youtube.com/watch?v=Uli8Cck_eRA   $5000/month incl utilities. no brokers. Call Doctor Fischman at (212) 472–3300.Jeffrey R. Fischman, M.D.  110 E 66th Street.

Want to Sell Your Medical Practice? Do You Have Medical Office Space to Sell or Share?
Clineeds is a new online platform designed to help medical providers sell their practice or buy, sell and share medical office space. Listing is FREE! No contracts. No commitments. No fees. Sign up today at http://www.clineeds.com/sign-up

Physician Opportunities


A Private Multidisciplinary Medical Group is seeking an Internal Medicine/Family Medicine Physician in Manhattan
A well-established Manhattan based private multidisciplinary medical group is seeking to hire an Internal Medicine/Family Medicine Physician. This is a great opportunity to start your own practice in a modern office in midtown Manhattan. Attractive base salary plus comprehensive benefits package offered (Malpractice, 3 weeks paid vacation, 1 week CME, CME allowance, paid health insurance, etc).If you are a solo practitioner in private practice looking to join a private group practice, we will work with you to make the transition seamless. Please email your CV to tsrgexpress@gmail.com. No recruiters please.

A Private Multidisciplinary Medical Group is seeking a Podiatrist in Manhattan
A well-established Manhattan based private multidisciplinary medical group is seeking to hire a Podiatrist. This is a great opportunity to start your own practice in a modern office in midtown Manhattan. Attractive base salary plus comprehensive benefits package offered (Malpractice, 3 weeks paid vacation, 1 week CME, CME allowance, paid health insurance, etc).If you are a solo practitioner in private practice looking to join a private group practice, we will work with you to make the transition seamless. Please email your CV to tsrgexpress@gmail.com. No recruiters please.

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

January 13, 2017 – ACA Cut Concerns Our Patients

Dr. Reid - MSSNY President
PRESIDENT’S MESSAGE
Dr. Malcolm Reid
January 13, 2017
Volume 17
Number 2

mssny_enews_dividend

Dear Colleagues:

I know that many of you like me are keeping a close eye on the activities in Washington DC regarding Congress’ consideration of legislation to repeal much of the Affordable Care Act (ACA).

Physicians of every specialty and every part of the State can identify various shortcomings with the ACA.  Over the last several years, we have raised concerns to our Congressional delegation as well as to the media that the ACA has encouraged the proliferation of insurance plans with huge patient cost-sharing responsibilities and plans with less choice of physicians. This, in turn, has accelerated the trend of physicians feeling forced to leave private practice and becoming part of large health care systems.

At the same time, the ACA has provided the opportunity for hundreds of thousands of our patients in New York to obtain affordable health insurance coverage that previously was not available to them.  Understandably, many are concerned about losing this coverage altogether if the ACA were to be repealed without a suitable replacement. Moreover, there could be huge budget consequences to New York State if funding were to be repealed, which could prompt untenable cuts affecting millions of more New Yorkers.

Given these concerns, MSSNY has urged that any legislation that threatens the availability of affordable health insurance options for our patients must simultaneously specify how these currently available coverage options will be replaced with improved coverage options.

According to news reports, it appears that an increasing number of Congress members, including many in New York’s Congressional delegation representing both parties, have publicly articulated the importance of Congress specifying with what the ACA would be replaced before voting on its repeal.

However, it is still unclear what will happen over the next few weeks and months.  Please be assured that MSSNY will continue to work closely with medical societies across the country as well as the AMA to be a strong advocate for our patients.  Our foremost request is that any proposal to replace the ACA enhance, not reduce, the availability of affordable and comprehensive health insurance options for our patients.

Anything less is unacceptable.

Malcolm Reid, MD, MPP
President, Medical Society of the State of New York

Save the Date:
MSSNY Physician Advocacy Day in Albany March 8!

Please send your comments to comments@mssny.org



Governor Advances Numerous Health Reform Measures for 2017 Session
Governor Cuomo is expected to release his full 2017-18 Executive Budget proposal this Tuesday 1/17 after releasing a 380-page book this week that outlined many of the proposals he intends to pursue in the State Budget and the legislative session.

Among the proposals highlighted include measures that would:

  • Combat heroin and opioid abuse and addiction (see related article);
  • Contain rising prescription drug prices (see related article);
  • Work with business and labor “to come together…on legislation that will deliver a workers’ compensation system that works for everyone”;
  • Expand efforts to “end the AIDS epidemic by 2020” (see related article);
  • Improving the healthcare system in eastern and Central Brooklyn (see related article) and
  • Launching a comprehensive agenda to promote health and wellness through interconnected strategies (see related article).(AUSTER, CLANCY, BELMONT)

MSSNY Lobby Day, March 8 – Plan Now to Be in Albany
MSSNY’s 2017 Annual Physician Legislative Advocacy Day is Wednesday, March 8.  Please hold that day open to join hundreds of your colleagues from across the State in Albany to hear from New York State’s legislative leaders and top health policymakers and to meet with your local legislators to urge that they fix the challenging issues that are confronting our health care delivery system.  To register, click here.
(DIVISION OF GOVERNMENTAL AFFAIRS) 

Governor Announces Proposal to Regulate PBM Practices and Drug Prices
Among the proposals announced by Governor Cuomo that he will pursue during the 2017 Legislative Session was a three-pronged approach to addressing rising prescription drug prices.  The measures would:

  • Require Pharmacy Benefit Managers (PBMs) to be regulated in New York beginning in 2019, as well as requiring them to disclose financial incentives or benefits for promoting the use of certain drugs, and other financial arrangements affecting customers.
  • Increase drug company rebates to New York State when the price for a particular medication exceeds a certain benchmark for Medicaid; and
  • Impose a “surcharge” on companies when prices exceed a certain benchmark, to be dedicated to lowering health insurance premiums.  (AUSTER, BELMONT)

Governor’s Proposal to Combat Heroin/Opiod Abuse Would Require ER I-Stop Checks and Improved Insurance Coverage for Outpatient Treatment
Among the proposals announced by Governor Cuomo in his “State of the State” tour across New York was a 6-point plan to further combat heroin and opioid abuse in New York State. The proposal includes:

  • Eliminating prior authorization requirements for insurance coverage of outpatient substance use disorder treatment;
  • Adding fentanyl analogs to the New York controlled substances schedule to subject emerging synthetic drugs to criminal drug penalties;
  • Increasing access to life-saving buprenorphine treatment by recruiting physicians, physician’s assistants and nurse practitioners to become prescribers;
  • Establishing 24/7 crisis treatment centers to ensure access to critical support services;
  • Requiring Emergency Department prescribers to consult the Prescription Monitoring Program registry prior to writing controlled substance prescriptions; and
  • Creating New York’s first recovery high schools to help young people in recovery finish school
    (AUSTER, CLANCY, BELMONT)

Cuomo Announces the Brooklyn Community Health and Wellness Transformation Initiative
Governor Cuomo proposed a three-point plan to dramatically improve the health care delivery system in central and eastern Brooklyn:

  1. Creating affordable healthy foods opportunities and other health
  2. Three existing not-for-profit hospitals in the area will work closely with community-based organizations and community health workers to provide non-clinical interventions that increase health, such as mold remediation programs to eliminate environmental triggers of asthma and programs to improve chronic disease management, promote access to healthy food, and create opportunities for physical activity
  3. Build new capacity for primary and ambulatory care.
  • The Governor is proposing to develop a large primary and ambulatory care network supported by an integrated state-of-the-art health information technology system with a common electronic medical record platform through a community-based healthcare delivery-system.
  • The proposal will develop a total of 36 primary and ambulatory care facilities to be built, increasing primary care visits from 300,000 annually to 800,000 annually.
  1. Create a new healthcare system by bringing together three independent not-for-profit hospitals in the area into a regional system that will leverage significant operating efficiencies and address the serious life and safety infrastructure issues at each of these hospitals, while restructuring and improving healthcare delivery in the communities of central and eastern Brooklyn. The new health system will also collaborate closely with Downstate University Hospital.  (BELMONT)

Governor’s State of the State Announces Several Proposals on HIV Testing and Treatment
Governor Andrew Cuomo announced several proposals to enhance testing and treating of HIV including the development of new regulations to allow minors to give informed consent for HIV treatment and prophylaxis.   Under current state law, minors can consent to STD and HIV testing and for treatment for STDs without parental consent.   Parental consent for HIV treatment is not permitted in the statute.

Additionally, as part of the Governor’s Efforts to End the AIDS Epidemic by 2020, the governor will propose, through legislation, to require emergency department and urgent care facilities to provide emergency non-occupational Post Exposure Prophylaxis (nPEP )following a potential non-occupational exposure to HIV.   The governor will alsoadvance legislation requiring the electronic reporting of filled HIV antiretroviral therapy prescriptions dispensed with New York State to monitor the number of persons who are taking prescribed antiretroviral therapy.               (CLANCY)

Governor’s State of the State Advances “Health Across All Policies” Initiative
To make New York the healthiest state in the nation, Governor Andrew Cuomo will advance a “Health Across All Policies” initiative where each state agency is directed to take into account how agency actions can have a positive impact on public health.   The State of the State message specifically highlights the NYS Prevention Agenda and calls on the Public Health and Health Planning Council and the Ad Hoc Committee to Lead the Prevention Agenda to work together to advance a Health Across All Policies initiative.

Physicians from the Medical Society of the State of New York have worked with the NYS Department of Health in setting the Prevention Agenda.   Kira Geraci-Ciardullo, MD, MPH,  is the MSSNY representative on the Ad-Hoc Committee for the Prevention Agenda.   Also involved in helping develop the Prevention Agenda are MSSNY Preventive Medicine and Family Health Committee chair, Geoffrey Moore, MD; and committee members Nina Huberman, MD, vice chair; Frank Dowling, MD; Sheila Bushkin, MD.   At the November meeting, members of the Ad-Hoc Committee discussed with DOH Commissioner Howard Zucker, MD, and with Deputy Secretary for Health Paul Francis, the need to implement this type of initiative to improve the health of all New Yorkers.  (CLANCY)

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

$50 Million Investment in Montefiore Health System to Expand Affordable Healthcare
Governor Cuomo proposed investing $50 million in Montefiore Health System.  According to the Governor’s press release, the funding will be used to “extend its healthcare delivery model to other parts of the Bronx and lower Hudson Valley.”                                   (Belmont) 

President-Elect Trump Promises Swift Repeal and Replacement
In a news conference this week, President-Elect Donald Trump said that Republicans will introduce proposals to repeal and replace Obamacare as soon as Health and Human Services secretary, Tom Price, is approved.  His confirmation hearings will begin next week.  “We’re going to be submitting — as soon as our secretary’s approved, almost simultaneously, shortly thereafter, a plan. It’ll be repeal and replace. It will be essentially simultaneously,” Trump said. “Probably the same day, could be the same hour.”  As reported last week, MSSNY wrote to the New York Congressional delegation  to express concerns with proposals that would repeal ACA funding streams for insurance coverage without simultaneously specifying what they will be replaced with, as well as concerns with the impact to New York patients and the New York State Budget.

Moreover, MSSNY President-Elect Charles Rothberg, MD, was interviewed about these concerns on News 12, Long
Island.                                                                                                                (BELMONT, AUSTER)

Let’s Make Sure They Hear Us
MSSNY will continue to work elected officials and leaders of any party to enhance the availability of affordable and comprehensive health insurance options for patients and prevent cuts to critical federal funding provided to New York State.  At this time, it is not clear what legislation will be enacted by Congress to replace the ACA but we have to make sure our voices and health care expertise are heard.                                                                             (BELMONT)


Help Us Fight by Joining MSSNYPAC and becoming a MSSNY Member Today

AG Schneiderman Propsosed Expanded Insurance Coverage for Contraceptives
New York Attorney General Eric Schneiderman this week announced his development of draft legislation to protect and enhance New Yorkers’ access to cost-free contraception. The stated purpose of the legislation is to ensure the continuation of insurance coverage for contraception in New York were the ACA to be repealed.  To read the AG’s press release, click here. 

Among the provisions in the draft legislation:

  • Require state-regulated health insurance policies to provide cost-free coverage for all FDA-approved methods of birth control, including emergency contraception;
  • Prohibit insurance companies from “medical management” review restrictions that can limit or delay contraceptive coverage.
  • Require coverage of men’s contraceptive methods and bring their insurance coverage in line with the benefits enjoyed by women; and
  • Permit the provision of a year’s worth of a contraceptive at a time.

The press release included statements of support from several state legislators and advocacy groups, including ACOG.                                                                                                      (AUSTER, CLANCY)

Register Now For A January 26 Lunchtime Program to Discuss the Medicare MIPS Program
The Medicare MACRA/MIPS program has now gone into effect.  Do you and your staff want to learn more regarding what you need to know to comply with this new program that could have a significant impact on your revenue from Medicare?  Please join us for a webinar on Thursday January 26, from 12:30 – 1:30, where you will hear from Frank Winter of New York Regional Office for CMS present important information about this new program for physicians and their staffs.  To register Click Here.

Upon your registration, you will receive a confirmation e-mail with instructions for joining this session either by webinar or conference call.  (AUSTER)

MSSNY Attends Forum on the Future of Health Care
The Empire Center for Public Policy hosted a forum to discuss New York’s Health Care Reform Act, the future of the Affordable Care Act and the impact on New York’s state budget. Speakers and panelists included Assembly Health Committee Chairman Gottfried, the New York State Medicaid Director Jason Helgerson, and Tom Wickham, the top health care policy staff  to the Senate Majority.  There was also a panel discussion regarding the future of HCRA that included representatives of health plans and hospital associations.  Robert Hinckley, Senior Vice President and Chief Strategy Officer, Capital District Physicians’ Health Plan (CDPHP), noted that more is spent on pharmacy than on doctors under their health insurance plans.  (BELMONT) 

Register Now for Upcoming Medical Matters 2017 CME Webinar Series
The Medical Society of the State of New York will continue its Medical Matters webinars this coming Wednesday, January 18, 2017 at 7:30 a.m. with Triage in a Disaster Event.   Arthur Cooper, MD, vice-chair of MSSNY’s Emergency Preparedness and Disaster/Terrorism Response Committee and Zachary Hickman, MD, member of MSSNY’s Emergency Preparedness and Disaster/Terrorism Response Committee will serve as faculty for this program. Register for this webinar here then click on “Upcoming”.

Educational objectives are: 1) Describe the importance of immediate bleeding suppression during a disaster event; 2) Describe the SALT methodology for triage and where to access SALT training; 3) Recognize the importance of not just general triage training, but triage training for bio-events as well.

Medical Matters continues on Wednesday, February 15, 2017 at 7:30 a.m. with The Mental Health Impact of Active Shooter/Bombing on the Healthcare Team.  Faculty for this program is Craig Katz, MD, member of MSSNY’s Emergency Preparedness and Disaster/Terrorism Response Committee.  Registration is now open for this webinar here just click on “Upcoming”.

The educational Objectives are: 1) Describe the psychological problems and stress symptoms that can result from caring for victims of an active shooter/bombing event; and 2) Identify means by which members of the healthcare team can address stress before, during and after an active shooter/bombing event; and 3) Review resources and methodologies available to address the mental health impact of an active shooter/bombing on the healthcare team.

A copy of the flyer can be accessed here.  Additional information or assistance with registration may be obtained by contacting Melissa Hoffman at mhoffman@mssny.org.  

Medical Matters is a series of CME webinars sponsored by MSSNY’s Committee on Emergency Preparedness and Disaster/Terrorism Response. 

The Medical Society of the State of New York (MSSNY) is accredited by the Accreditation Council for Continuing Medical Education (ACCME) to provide continuing medical education for physicians.  

MSSNY 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.           (CLANCY, HOFFMAN)

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

pschuh@mssny.org mauster@mssny.org         pclancy@mssny.org   jbelmont@mssny.org

enews large

State Expanding Clinicians’ Course Offerings for Marijuana Program
New York is expanding its course offerings for clinicians and pharmacists who want to participate in the state’s medical marijuana program. The state has awarded a two-year contract to TMCI Global to offer an alternate version of the 4.5-hour online course that’s required for clinicians to register to prescribe cannabis in New York. It will become available in mid-2017. The state also secured a two-year contract with the current course vendor, the Answer Page.

On a related topic, Vireo Health is planning to start home delivery service of medical marijuana to consumers in New York City, Long Island and Westchester County within the next 90 days.

AMA: Five Issues Physicians Will Take to State Legislators in 2017
A survey of more than 65 state and specialty societies revealed the top issues to be addressed in 2017 include Medicaid, the nation’s opioid epidemic, private payer reforms, and numerous public health issues.

The annual AMA State Legislative Strategy Conference was held in Amelia Island, Fla., where physician leaders met to discuss state legislative and regulatory issues that will occupy their efforts in the months to come. Five issues rise to the top of the queue.

·    Strengthening Medicaid

Many states are preparing for debates this year over the future of Medicaid expansion. Also, on the agenda for state medical associations will be advocating for responsible Medicaid reforms that improve patient access and quality of care.

  • Reducing the nation’s opioid epidemic

Physicians across the nation will keep up their efforts to reverse the opioid misuse, overdose and death epidemic. Much of the legislation focuses on mandated prescription drug monitoring program (PDMP) use (New York’s program is a model), physician educationsubstance-use disorder treatment, guidelines or restrictions on prescribing controlled substances.

  • Advancing physician-led team-based care

The AMA’s Advocacy Resource Center tracked more than 450 scope-of-practice bills last year and included in those bills were provisions to establish a framework for physician-led team-based care. Several states will consider AMA model state legislation, which encourages flexible, innovative health care teams under a framework of physician leadership. The AMA’s STEPS Forward™ collection of practice improvement strategies offers several modules to help physicians move their practices toward physician-led team-based care, including instructions on the implementation of team meetings, team documentation and strengthening team culture.

  • Provider network issues

As provider networks continue to narrow and patients’ financial responsibility for their health care continues to increase, the issues of network adequacy and out-of-network care will continue to be a focus in many state legislatures in 2017. Physicians are having discussions with key stakeholders across the country about how to ensure access to quality and affordable care for their patients while maintaining their ability to enter into fair contract negotiations.
Improving public health State legislatures continue to debate highly politicized issues, such as vaccinesfirearm safety, reproductive health and many others. Assaults on the patient-physician relationship will continue in many states with legislation that attempts to decide what can and cannot be discussed in the exam room.

State and national medical societies will be targeting a long list of additional issues such as diabetes prevention, decreasing cardiovascular disease, infectious disease prevention, obesity, student-athlete concussion and cardiac laws, women’s reproductive rights, tanning restrictions for minors and many others.

The top issues that will affect physicians in 2017
Health insurance coverage and access
Implementation of new Medicare pay system
Reversing the opioid epidemic
Prescription drug pricing
EHR interoperability
Regulatory relief


SAVE THE DATE
Physician Lobby Day in Albany
Wednesday, March 8th, 2017
YOU NEED TO TAKE A DAY AWAY FROM YOUR PRACTICE
Call Your County Medical Society for Details


MLMIC: Latest Developments in NY’s Medical Malpractice Marketplace
As reported by Politico New York, one of New York’s major malpractice insurance carriers “continues to struggle financially, reporting significant losses through the end of the third quarter.” This news, along with disciplinary action from the Joint Commission on Public Ethics, has raised legitimate concerns.

Instability of a large provider creates some uncertainty for the entire market, of course, but we want to assure MLMIC policyholders that their coverage is not at risk. By adhering to responsible underwriting practices from our beginning, MLMIC continues to demonstrate sound financial condition and is able, once again, to offer a policyholder dividend (20% for those insured by May 1 and continuously insured through July 1).

We’ll keep monitoring the situation in the market on your behalf and will apprise you of further developments. In the meantime, if you have questions, please call 1 (888) 488-9253.

Fourth and Fifth District Retreat on January 27 -29 at Lake Placid
Third and Fourth  District Retreat on Friday (8am) January 27 to Sunday (9am) January 29 at the Mirror Lake Inn in Lake Placid. Call for reservations (518) 523-2544. More information here.

ARTMED INSIGHT’s January Workshop at the MET Museum!
THE ART OF SEEING: ART IN CLINICAL PRACTICE

January 20th, 2017, from 6 to 8.30 pm & January 21st, 2017 from 5 to 7.30 pm 

Enhance your perceptual and communication skills and strengthen your clinical practice! Open to all physicians, physician assistants, psychiatrists, residents, nurses, medicals students, and healthcare professionals across disciplines

January 20th from 6 to 8.30 pm: Enhancing Presence and Observation

January, 21st from 5 to 7.30 pm: Increasing Self-Awareness and Empathic Intelligence 

Cost: $285 (includes 1/20/17 and 1/21/17 + museum entrance fee) $185 for students

Art experience is welcome but not necessary–Location: The MET Museum in NYC

Space is limited to insure interactivity! For more information check out our website  and to register go here.

BREAKING: ICD-10 Glitch Leads CMS to Relax Physician Quality Penalties
The CMS issued a two-year pass to physicians and group practices because of a glitch with quality reporting measures based on a recent update to the ICD-10 diagnosis and procedure codes.

Note, this is not across the board.  Only certain specialties and procedures will be impacted by this waiver of negative payment adjustments.  The majority of ICD-10-CM coding changes that impacted 2016 PQRS measures were related to diabetes, pregnancy, cardiovascular, oncology, mental health and eye disease diagnosis.

In addition, it will be up to CMS to decide if the payment adjustment should or should not be applied.  CMS will perform an analysis after the close of the 2016 PQRS reporting period and CMS will review the submissions to determine which group practices and EPs were negatively impacted by the ICD-10-CM coding changes. The group practices and EPs affected by the impact of the ICD-10-CM code updates will be removed from the PQRS payment adjustment prior to the release of feedback reports.

Registries, Qualified Clinical Data Registry (QCDR) and Electronic Health Record (EHR) vendors should calculate the measures as defined in the 2016 measure specifications and utilize the calculated measures data in their submission on your behalf. CMS determined that there has been minimal impact to the Group Practice Reporting Option (GPRO) Web Interface measures due to the assignment and sampling process. Therefore, those PQRS group practices and Accountable Care Organizations (ACOs) reporting via the GPRO Web Interface will not be impacted by the ICD-10-CM code updates. If you receive a payment adjustment and believe it is due to ICD-10-CM code updates, you have the option to submit a request for an informal review of the payment adjustment.

For more information, please click here. Please be sure to review the FAQs referenced on the bottom of this website.

Save the Date: Annual Joint Meeting of YPs, Resident/Fellow, Medical Students

When:  Saturday, February 11, 2017

Where: Marriott Courtyard, 1800 Privado Road, Westbury NY 11590.

Presentations will include “Telemedicine/Telehealth: Tools for Clinical Practice and Patient Engagement.” Gain a better understanding of and appreciation for the use of telemedicine as part of a patient management strategy that will improve and increase access to treatment, lower costs, and more effectively engage patients.

We will also present important financial planning strategies and tips specifically for younger physicians, including Student Loan Management, Main Financial Issues to Address in Residency and as you Transition to Practice, Asset Protection Strategies and Risk Management, and more. Click here for agenda.

Policy will be created, elections will be held.

YPS and RFS register at sbennett@mssny.org; MSS register at mreyes@mssny.org. 

CMS Releases 2017 QPP Quality Measure Benchmarks
If a physician or practice plans to participate in 2017 Quality Payment Program (aka MIPS) with the goal of receiving a bonus in 2019 it is highly recommended that they review the recently released 2017 QPP Measure Benchmark information. The 2017 quality benchmark information does not apply to physicians who only plan to participate in 2017 to avoid a 2019 penalty (submit one measure, one time in 2017). 

The 2017 CMS QPP benchmark information was released late last week and posted to the CMS QPP website. The benchmark calculations for the 2017 performance year use data that was submitted for PQRS in 2015 by clinicians that were a Quality Payment Program provider type eligible for MIPS and were not newly enrolled in 2015, or groups with at least 1 such clinician. When a clinician submits measures for the QPP Quality Performance Category, each measure is assessed against its benchmarks to determine how many points the measure earns. A clinician can receive anywhere from 3 to 10 points for each measure (not including any bonus points).

Benchmarks are specific to the type of submission mechanism: EHRs, QCDRs/Registries, CAHPS and claims. For CG-CAHPS, the benchmarks are based on two sets of data, 2015 PQRS CAHPS and 2015 ACO CAHPS data. Submissions via CMS Web Interface will use benchmarks from the Shared Savings Programs.

CMS Releases Patient Facing Encounter Codes
Late last week CMS released and posted to the QPP website the list of patient-facing encounter codes. The list is used to determine the non-patient facing status of MIPS eligible clinicians. Given the flexibility in program requirements for non-patient facing clinicians, the encounter codes are critical for CMS to identify MIPS eligible clinicians. A non-patient facing MIPS eligible clinician is:

  • An individual MIPS eligible clinician that bills 100 or fewer patient-facing encounters (including Medicare telehealth services defined in section 1834(m) of the Act) during the non-patient facing determination period, and
  • A group provided that more than 75 percent of the clinicians billing under the group’s TIN meet the definition of a non-patient facing individual MIPS eligible clinician during the non-patient facing determination period.

The list of patient-facing encounter codes are categorized into three overarching groups of codes (Evaluation and Management Codes; Surgical and Procedural Codes, and Visit Codes). The utilization of Evaluation and Management Codes, Surgical and Procedural Codes, and Visit Codes classifies MIPS eligible clinicians as non-patient facing and patient-facing.

AMA-IMG Section Governing Council Nominations Due Feb. 17
Nominations are being accepted for the 2017 AMA-IMG Section Governing Council election to fill two vacancies.

Consider nominating a colleague or, if you have leadership experience, consider nominating yourself for this important upcoming governing council election.

The AMA-IMG Section Governing Council positions carry three-year terms. Council nominees must be:

  • An AMA member
  • Able to attend the AMA Annual Meeting in June, Interim Meeting in November and a separate meeting in the spring
  • Committed to their governing council service, able to participate in evening teleconferences and have proficient computer knowledge
  • Available to serve as chair of an AMA-IMG Section committee

Nominations are being accepted now through Friday Feb. 17. Be sure to submit your nomination form, bio sketch and photo (JPEG format) to img@ama-assn.org by midnight Friday, Feb. 17.  Submission of a letter of support from an organization is optional.

Visit https://www.ama-assn.org/about-us/international-medical-graduates-sectionimgs-leadership-opportunities to obtain your nomination and bio sketch forms. If you have questions, contact carolyn.carter-ellis@ama-assn.org for assistance.


CLASSIFIEDS


Prime Astoria Medical Office for Rent or Lease
23-15 Astoria Boulevard, Astoria, New York
Customizable Lower Level
7,500 Sq Feet Gross For Lease
Prime Location Close To Hospital and Other Medical Facilities.
Direct Street Access Private Elevator plus Direct Access From  
Street Level Stairs.
Contact:
AB Building Management LLC
George Miltiadou
718-482- 7262
917-939-0019

Upper East Side Medical Office for Sale
Suitable for a solo practice or shared multi- specialist group. Large unit, about 1100 Sq Ft, located on the ground floor of a cooperative building with own entrance to office, 2 or 3 equipped exam rooms with exam tables and work station areas, front waiting room with reception area with storage unit of shelves for medical charts, a consultation office, 1 and a half bathrooms and kitchenette. Lots of shelves throughout exam rooms, 2 EKGs, one PC computer that comes equipped with a PFT machine and operating software, an operating X-ray machine suitable for chest X-rays with film processor. No brokers, call office manager, Diana Peron @ 212-861-9012


Elegant Plastic Surgery Office (Upper East Side Manhattan)
Very large and classy office to share. Located in the ground floor of a 25′ x 100′ carriage house opposite the 66th Street Armory with large consult room, 2+ treatment/exam rooms, large waiting room, business office, storage. See video of office — you won’t believe it: www.youtube.com/watch?v=Uli8Cck_eRA   $5000/month incl utilities. no brokers. Call Doctor Fischman at (212) 472–3300.Jeffrey R. Fischman, M.D.  110 E 66th Street.

Want to Sell Your Medical Practice? Do You Have Medical Office Space to Sell or Share?
Clineeds is a new online platform designed to help medical providers sell their practice or buy, sell and share medical office space. Listing is FREE! No contracts. No commitments. No fees. Sign up today at http://www.clineeds.com/sign-up

Physician Opportunities


A Private Multidisciplinary Medical Group is seeking an Internal Medicine/Family Medicine Physician in Manhattan
A well-established Manhattan based private multidisciplinary medical group is seeking to hire an Internal Medicine/Family Medicine Physician. This is a great opportunity to start your own practice in a modern office in midtown Manhattan. Attractive base salary plus comprehensive benefits package offered (Malpractice, 3 weeks paid vacation, 1 week CME, CME allowance, paid health insurance, etc).If you are a solo practitioner in private practice looking to join a private group practice, we will work with you to make the transition seamless. Please email your CV to tsrgexpress@gmail.com. No recruiters please.

A Private Multidisciplinary Medical Group is seeking a Podiatrist in Manhattan
A well-established Manhattan based private multidisciplinary medical group is seeking to hire a Podiatrist. This is a great opportunity to start your own practice in a modern office in midtown Manhattan. Attractive base salary plus comprehensive benefits package offered (Malpractice, 3 weeks paid vacation, 1 week CME, CME allowance, paid health insurance, etc).If you are a solo practitioner in private practice looking to join a private group practice, we will work with you to make the transition seamless. Please email your CV to tsrgexpress@gmail.com. No recruiters please.

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

 

 

 

Council Meeting – January 19, 2017

AGENDA
Council Meeting
January 19, 2017 9:00 am
Courtyard Marriott, Westbury Long Island
1800 Privado Road
Westbury, NY  11590

A.Call to Order and Roll Call

B.Approval of the Council Minutes of November 3, 2016

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

    1. President’s Report
      a.  Physician Burnout Update presented by
      Michael R. Privitera, MD, Chair,  MSSNY Physician Burnout  Task Force (VIA Telephone) (handout)
      b. Update on DSRIP/PPS Initiatives presented by
      Joseph R. Maldonado, Jr., MD
    2. Board of Trustees Report  – Dr. Leah McCormack will present the report (handout)
    3. Secretary’s Report – Dr. Arthur Fougner will present the report for Nominations for Life Membership, Dues Remissions and Special Life Membership request from Albany County Medical Society
    4. MLMIC Update  – Mr. Donald Fager will present a verbal report
    5.  AMA Delegation Update – Dr. John Kennedy will present the report
    6.  MSSNYPAC Report – Dr. Charles Rothberg will present the report
    7. MESF Update – Mr. Thomas Donoghue  will present the report
    8.  CME Update Dr. Mark Adams will present the report
    9. Update/Discussion on Coalition of State Medical Societies (handout)

      ADJOURNMENT OF COUNCIL 

      Approval of the Empire State Medical, Scientific and Educational Foundation, Inc. Election of Directors

      RECONVENE COUNCIL

    10.  Commissioners (Action Items – For Council Approval)
              1. Commissioner of Socio Medical Economics,
                   Howard H. Huang, MD 
      Committee on Interspecialty
                   (For Council Approval)
                     a.   Resolution 2016-268, Mobility
      Impairment Increases Risk of Illness

  2. Commissioner of Science & Public Health
Frank G. Dowling, MD
                                       Committee to Eliminate Health Care Disparities
                                       (For Council Approval)
                             a .   Revised Mission Statement

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

D. Reports of Officers (Informational)
1. Office of the President – Meetings attended:

  • Fifth and Sixth District Retreat
  • AMA Interim Meeting
  • Lecture given by Andrew Gurman, MD, AMA President @ Albert Einstein School of Medicine
  • MAMES Gala
  • Andrew Cuomo Fundraiser, Bronx Tale on Broadway
  • MLMIC Executive Committee Meeting
  • NYSPM&R Society Legislative Lecture, at NYU Langone Medical Center
  • Annual Meeting of the New York State Society of Anesthesiologists  at the New York Marriott Marquis
  • MLMIC Board of Directors Meeting
  • State Leg Conference
  1. Office of the President Elect – Charles Rothberg, MD
  2. Office of the Vice President – Thomas J. Madejski, MD
  3. Office of the Treasurer – Joseph R. Sellers, MD,
    Financial Statement for the period 1/1/16 – 11/30/16
  4. Office of the Speaker  –  Kira A. Geraci-Ciradullo, MD, MPH

E. Reports of Councilors (Informational)
1.    Kings/Richmond Report Parag H. Mehta, MD
2.    Manhattan/Bronx Report – Joshua M. Cohen, MD, MPH
3.    Nassau County Report – Paul A. Pipia, MD
4.    Queens County Report – Saulius J. Skeivys, MD
 5.   Suffolk County Report – 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 Section Report
  Christina Kratschmer  (no written report submitted)
14. Organized Medical Staff Section Report –
   Richard A. Ritter, MD (no written report submitted)
             15. Resident & Fellow Section Report
  Robert A. Viviano, DO
16. Young Physician Section Report – L. Carlos Zapata, MD
                     (no written report submitted) 

F. Commissioners (Committee Informational Reports/Minutes)
1. Commissioner of Communications
                  Joshua M. Cohen, MD, MPH
a.  Report of the Division of Communications
             2 .Commissioner of Science & Public Health,
                  Frank G. Dowling, MD
                  a.   Bio Ethics Minutes, October 28, 2016
                  b.   Preventive Medicine and Family Health Minutes,
 October 21, 2016
 c. Public Health and Education Informational Report
    3. Commissioner of Socio Medical Economics,
Howard H. Huang, MD
                   a. Committee on Interspecialty Minutes, October 27, 2016
              4. Commissioner of Governmental Relations,
                   Gregory Pinto, MD
                  a.   MSSNY-HCA Task Force Minutes, November 18, 2016
  b.   MSSNY HIT Committee Minutes, December 16, 2016
  c.   Report from the Division of Governmental Affairs

G. Report of the Executive Vice President, Philip Schuh, CPA, MS     

              1.    Membership Dues Revenue Schedule
              2.    Group/Institution Membership Revenue
                Schedule
              3.    Empire State Foundation Update

HReport of the General Counsel,
      Donald Moy Esq. & David Vozza, Esq.
             No written report submitted 

I. Report of the Alliance, Barbara Ellman, President
               Alliance Report

J. Other Information/Announcements

  1.   Letter dated January 5, 2017 to Representative Chris Collins     re Affordable Care Act
  2.   Letter dated December 9, 2016 to Commissioner Zucker re
    Medical Marijuana
  3.   MSSNY Five-Step MACRA Checklist
  4.   Dr. Duane & Joyce Cady Honor Fund (2016 Activity Report)
  5.   Sign-on letter dated January 9, 2017 to Leishia Smallwood,
    Director, NYS Area Health Education Center (NYS AHEC)  re    continued funding for the NYS AHEC

K.  Adjournment

 

April 2017 Update: CME Pain Management Course Now Available!

Click Here for the Compulsory Pain Management Course

Dr. Reid - MSSNY President
PRESIDENT’S MESSAGE
Dr. Malcolm Reid
January 6, 2017
Volume 17
Number 1

mssny_enews_dividend

Dear Colleagues:

By July 1, 2017, every physician and prescriber who has a DEA registration will need to complete three hours of course work or training in pain management, palliative care, and addiction. Governor Andrew Cuomo and the New York State Legislature passed the measure in June 2016 as part of a comprehensive package to combat opioid abuse that also included extensive new requirements on health insurers to cover needed treatments (see related article below).

But where can you take this new required course?

I am pleased to report that the Medical Society of the State of New York has been working with several knowledgeable and dedicated physician members and the NYS Office of Alcoholism and Substance Abuse Services to develop a program that comports with this statute. It is anticipated that this program will begin through a series of webinars in February. Then the program will be placed on-line on the MSSNY CME website so physicians can take it at their convenience.

The statute specifically requires that prescribers need course work in the following:

  • state and federal requirements for prescribing controlled substances;
  • pain management;
  • appropriate prescribing;
  • managing acute pain;
  • palliative medicine;
  • prevention, screening and signs of addiction;
  • response to abuse and addiction;
  • and end of life care.

Officials from the Department of Health’s Bureau of Narcotic Enforcement (BNE) have indicated that— for at least the first year— prescribers would simply need to “attest” that they have taken a CME course that includes all the components. This attestation will probably be done electronically through the Health Commerce System and we are hopeful that this attestation will be forthcoming shortly.

I know some of you have asked if every physician has to take the course.  The law provides a waiver for a DEA registered prescriber who 1) clearly demonstrates to the department’s satisfaction that there would be no need for him or her to complete such course work or training or 2) that he or she has completed course work or training deemed by the department to be equivalent to the course work or training approved by the department.

MSSNY has had email correspondence with officials from BNE who have stated that:

  • Each exemption request will be reviewed by the department to determine if the requestor has clearly demonstrated to the department there would be no need for them to complete the course work.
  • Practitioners who do not have a DEA number are exempt and do not require a waiver.
  • If the candidate has completed equivalent course work or training, they can attest that they have met the requirement.  There would be no need for a waiver.

Attestation by practitioners is anticipated to be available online with an expected launch in March, 2017 and will be through the Health Commerce System (HCS).  The process for seeking an exemption will also be through the HCS and is expected to be in place in March 2017.  More information about the process will be forthcoming and MSSNY will keep you informed as we learn more details.

Once we have finalized the three-hour CME program, MSSNY will notify its members as to its availability.   If you have any questions regarding this requirement, please contact me or Pat Clancy at pclancy@mssny.org.

Malcolm Reid, MD, MPP
President, Medical Society of the State of New York

Save the Date:
MSSNY Physician Advocacy Day in Albany March 8!

Please send your comments to comments@mssny.org




Legislature Returns to Albany to Begin Legislative Session
The New York State Legislature returned to Albany this week to begin the 2017 Legislative Session.  Senator John Flanagan was re-elected as Majority Leader of the New York State Senate, and Assemblymember Carl Heastie was re-elected as Speaker of the New York State Assembly.

Speaker Heastie also announced Committee Chairs in the Assembly for the 2017-18 Session.  While there were some changes from last year, the leadership of many key committees remained the same. Assemblymember Richard Gottfried will be Chair of the Health Committee, Assemblymember Kevin Cahill will be Chair of Insurance Committee, Assemblymember Deborah Glick will be Chair of the Higher Education Committee, Assemblymember Michele Titus will be Chair of the Labor Committee, Assemblymember Joseph Lentol will be Chair of the Codes Committee and Assemblymember Denny Farrell will be Chair of the Ways and Means Committee.

The Governor’s proposed budget for the 2017-18 State Fiscal Year is expected to be formally proposed by January 17.
(DIVISION OF GOVERNMENTAL AFFAIRS)

MSSNY Lobby Day, March 8-Plan Now to Be in Albany
MSSNY’s 2017 Annual Physician Legislative Advocacy Day is Wednesday, March 8.  Please hold that day open to join hundreds of your colleagues from across the State in Albany to hear from New York State’s top policymakers and to meet with your local legislators regarding the challenging issues that are confronting our health care delivery system.  To register, click here.                                                    (DIVISION OF GOVERNMENTAL AFFAIRS)

Governor Cuomo Signs MSSNY-Supported Step Therapy Reform Legislation into Law
We are pleased to report that, on New Years Eve, Governor Cuomo signed into law legislation (A.2834-D, Titone/S.3419-C, Young) advocated for MSSNY and many other physician and patient advocacy organizations that would provide stronger regulation of health insurer step therapy prescription medication protocols.

The bill will require a health insurer to grant a physician’s override request of an insurer step therapy protocol for their patient if the physician can demonstrate that the drug required by the protocol is contraindicated, likely to be ineffective, or if the patient is stable on the medication requested by the physician.  If the physician’s request for an override of the step therapy protocol is denied, the new law would better enable a physician to formally appeal the decision both within the plan’s existing appeal mechanism as well as taking an external appeal.

For more specific information regarding the legislation, click here: Click Here.  The new law will apply to all New York regulated health insurance products issued or renewed January 1, 2017 and after.  Please be aware that since many New York health insurance plans for 2017 were already approved prior to the new year, the new law will not initially be applicable to all plans.

We thank Governor Cuomo for signing this legislation into law, and Senator Young and Assemblymember Titone for sponsoring this legislation.  We also thank the many other Assemblymembers and Senators who co-sponsored this legislation and advocated for its enactment.

We also thank the many physicians who took time to send letters to their legislators and Governor Cuomo in support of this legislation.  In November, MSSNY President-elect Dr. Charles Rothberg appeared in a Fios Long Island news story discussing the importance of this legislation.  In October, a letter to the editor in support of the legislation from MSSNY President Dr. Malcolm Reid () was published in the Albany Times-Union.
(DIVISION OF GOVERNMENTAL AFFAIRS)

New Health Insurer Requirements Effective 1/1/17 to Combat Heroin and Opioid Addiction
Governor Cuomo released a statement highlighting new requirements on health insurers that went into effect January 1, 2017, aimed at combatting heroin and opioid addiction in New York.  To read the press release, click here.  The reforms were part of a comprehensive legislative package enacted in 2016. As noted in the press release, among the new requirements that apply to New York regulated health insurance products issued or renewed on or after January 1:

  • Insurers must cover necessary inpatient services for the treatment of substance use disorders for as long as an individual needs them. In addition, the legislation establishes that utilization review by insurers can begin only after the first 14 days of treatment, ensuring that every patient receives at least two weeks of uninterrupted care before the insurance company becomes involved.
  • Insurers cannot require prior approval for emergency supplies of drug treatment medications. Similar provisions that also apply to managed care providers treating Medicaid recipients who seek access to buprenorphine and injectable naltrexone took effect in June.
  • All insurers operating in New York State must use objective, state-approved criteria when making coverage determinations for all substance use disorder treatment in order to make sure individuals get the treatment they need.
  • Insurance companies must cover the costs of naloxone when prescribed to a person who is addicted to opioids and to his/her family member/s on the same insurance plan.

These important new provisions were part of an omnibus opioid abuse package enacted in 2016 that also: required most physicians and other prescribers to complete three hours of education every three years on addiction, pain management, and palliative care; limit to no more than seven days the length of an opioid prescription for an initial consultation or treatment of “acute pain”; and require pharmacists to provide educational materials to consumers about the risk of addiction, including information about local treatment services.   (AUSTER, CLANCY)

U.S. Senate Begins Debate Over ACA Repeal; MSSNY Urges Caution and Requests More Specificity
As the U.S. Senate began debate this week of a concurrent resolution introduced by Senate Budget Committee Chair Mike Enzi (R-WY) to proceed with legislation to enact a repeal of many of the funding provisions of the Affordable Care Act (ACA), MSSNY President Dr. Malcolm Reid wrote to each member of New York’s Congressional delegation to express concern with efforts to repeal  funding for coverage expansions without simultaneously specifying how it will be replaced.

Dr. Reid’s letter articulated that physicians across New York State have expressed great concerns with several ACA provisions, noting that the ACA has “encouraged and/or accelerated the proliferation of health insurance plans with huge patient cost-sharing responsibilities, prompted the narrowing of physician networks and elimination of coverage options for small businesses and sole proprietors”.  Nevertheless, the letter also states that “the ACA has provided the opportunity for hundreds of thousands of New Yorkers to obtain affordable health insurance coverage that previously was not available to them” and that “elimination of the funding currently provided to New York State through these programs could drive a huge hole in our State Budget, and prompt untenable cuts affecting millions of more New Yorkers.”

The letter urges members of New York’s Congressional delegation “to assure that any legislation that threatens the availability of affordable health insurance options for our patients simultaneously specifies how these currently available coverage options will be replaced with improved coverage options.”

The American Medical Association also sent a letter to Congressional leaders this week that requests that “before any action is taken through reconciliation or other means that would potentially alter coverage, policymakers should lay out for the American people, in reasonable detail, what will replace current policies.” The AMA letter was accompanied by a listing of key health system reform objectives including:

  • Assure that individuals currently covered do not become uninsured and take steps toward achieving coverage and access for all Americans.
  • Maintain key insurance market reforms, such as coverage for pre-existing conditions, guaranteed issue and parental coverage for young adults;
  • Stabilize and strengthen the individual insurance market;
  • Ensure that low and moderate income patients are able to secure affordable and adequate coverage;
  • Ensure that Medicaid, CHIP, and other safety net programs are adequately funded;
  • Reduce regulatory burdens that detract from patient care and increase costs;
  • Provider greater cost transparency throughout the health care system; and
  • Incorporate common sense medical liability reforms.
     (AUSTER)


Liability Expansion Bills Re:Introduced
Among the first bills introduced by the legislature are several bills being pushed by the trial lawyers.  The bills include:

Prohibiting ex-parte interviews of plaintiff’s treating physician (S.243)
This bill would prohibit a physician’s defense counsel in a medical liability action from conducting an interview with the plaintiff’s treating physician. This bill would present significant issues for physicians in a medical liability action by limiting the opportunity to fully examine the plaintiff’s health condition to evaluate the merit of the plaintiff’s claim. 

Expansion of Wrongful Death Damages (S.411)
This bill would expand the categories of damages which a plaintiff may recover in a wrongful death action to include emotional as well as economic loss. The categories for recovery would be expanded to include grief or anguish caused by the decedent’s death as well as loss of love, loss of society, loss of protection, loss of comfort, loss of companionship, and loss of consortium.

Recoveries against Third Parties (S.412)
This bill permits a plaintiff to recover directly against a third party defendant when the judgment against the original defendant has not been satisfied after thirty days.  It would also allow a plaintiff to recover against a third party against which it did not litigate, and with which it has no privity.
(BELMONT)

MSSNY Advocates to Address Physician Shortages
For the past several years, MSSNY has been advocating for funding to expand the Doctors across New York (DANY) program. This week, MSSNY participated in a meeting with other physician and hospital advocates to discuss strategies to provide additional resources in this year’s budget toward the DANY program.  MSSNY will continue to work with legislators in the upcoming legislative session to find ways to attract and retain physicians in underserved areas of the state.                                                                              (BELMONT)


Register Now for a January 26 Lunchtime Program to Discuss the Medicare MIPS Program
The Medicare MACRA/MIPS program has now gone into effect.  Do you and your staff want to learn more regarding what you need to know to comply with this new program that could have a significant impact on your revenue from Medicare?  Please join us for a webinar on Thursday January 26, from 12:30 – 1:30, where you will hear from Frank Winter of New York Regional Office for CMS present important information about this new program for physicians and their staffs.  To register Click Here.

Upon your registration, you will receive a confirmation e-mail with instructions for joining this session either by webinar or conference call.  (AUSTER) 

MSSNY Veterans’ Matters Upcoming Grand Rounds on Substance Use Disorders; Physicians Strongly Urged to Attend
Following a positive response to 2016’s expansion of Veterans’ Matters to include programming on substance use disorders, a live grand rounds presentation will be held on Friday, January 13th. Frank Dowling, MD, will present at Brookhaven Memorial Hospital, 101 Hospital Rd., Patchogue, NY at 8 am.

The Medical Society of the State of New York (MSSNY) is accredited by the Accreditation Council for Continuing Medical Education (ACCME) to provide continuing medical education for physicians.

MSSNY designates this live activity for a maximum of 1 AMA PRA Category 1 Credits™.  Physicians should claim only the credit commensurate with the extent of their participation in the activity.

To register for the live program, click on the link below

Substance Use Disorders: Live at Brookhaven Memorial Hospital – 1/13/17 at 8 am

Information and the educational objectives for the program can be found here

Substance Use Disorders: Live at Brookhaven Memorial Hospital – 1/13/17

If your hospital is interested in having one of these programs presented, or if you need assistance with registering, please contact Greg Elperin at gelperin@mssny.org or call (518)465-8085.                      (CLANCY, ELPERIN)


Medical Matters CME Webinar Series Continues in 2017; Registration now open
The Medical Society of the State of New York will continue its Medical Matters webinars on January 18, 2017 at 7:30 a.m. with Triage in a Disaster Event.   Arthur Cooper, MD, vice-chair of MSSNY’s Emergency Preparedness and Disaster/Terrorism Response Committee and Zachary Hickman, MD, member of MSSNY’s Emergency Preparedness and Disaster/Terrorism Response Committee will serve as faculty for this program. Registration is now open for this webinar here. Educational objectives are: 1) Describe the importance of immediate bleeding suppression during a disaster event; 2) Describe the SALT methodology for triage and where to access SALT training; 3) Recognize the importance of not just general triage training, but triage training for bio-events as well. February’s webinar will be: The Mental Health Impact of Active Shooter/Bombing on the Healthcare Team.  This program will be held on Wednesday, February 15, 2017 at 7:30 a.m. Craig Katz, MD, member of MSSNY’s Emergency Preparedness and Disaster/Terrorism Response Committee will serve as faculty for this program. Registration is now open for this webinar here

The educational objectives are: 1) Describe the psychological problems and stress symptoms that can result from caring for victims of an active shooter/bombing event.  2) Identify means by which members of the healthcare team can address  stress before,  during and after an active shooter/bombing event.  3) Review resources and methodologies available to address the mental health impact of an active shooter/bombing on the healthcare team. A copy of the flyer can be accessed here.  Additional information or assistance with registration may be obtained by contacting Melissa Hoffman at mhoffman@mssny.org. 

Medical Matters is a series of CME webinars sponsored by MSSNY’s Committee on Emergency Preparedness and Disaster/Terrorism Response. The Medical Society of the State of New York (MSSNY) is accredited by the Accreditation Council for Continuing Medical Education (ACCME) to provide continuing medical education for physicians. MSSNY 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. (CLANCY, HOFFMAN) 

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

pschuh@mssny.org mauster@mssny.org         pclancy@mssny.org   jbelmont@mssny.org

enews large

Analysts Say VA Has Failed To Provide Rehabilitation to Opioid-Addicted Veterans
In a nearly 6,000-word story, the Wall Street Journal (12/29) reports that the Department of Veterans Affairs admits that the large population of opioid-addicted veterans is due in part to its over prescription of painkillers for injuries and PTSD and says it is working to fix the damage. However, analysts say budgetary and bureaucratic hurdles have prevented the Department from building a rehabilitation that can handle the treatment needs of the tens of thousands of veterans with opioid addiction, and many veterans are left to their own devices to find resources to combat the condition.

NYS Group Wants Constitutional Amendment to Guarantee Clean Air and Water
AP (12/29) reports Environmental Advocates of New York and are calling for an amendment to the New York state constitution “that would guarantee residents a right to clean air and water.” The two groups are promoting the proposed amendment with online videos that feature “children from Hoosick Falls, where water wells have been contaminated by an industrial chemical. At a state Senate hearing in August, Health Commissioner Howard Zucker said the state followed federal guidelines in addressing the issue.

“In 2016, we saw communities in New York struggling with clean drinking water and clean air,” Environmental Advocates executive director Peter Iwanowicz said. “What was missing was clear language in the state constitution giving people the right to drink water that won’t make them sick and breathe air that’s safe.”

ARTMED INSIGHT’s January Workshop at the MET Museum!THE ART OF SEEING: ART IN CLINICAL PRACTICE

January 20th, 2017, from 6 to 8.30 pm & January 21st, 2017 from 5 to 7.30 pm 

Enhance your perceptual and communication skills and strengthen your clinical practice! Open to all physicians, physician assistants, psychiatrists, residents, nurses, medicals students, and healthcare professionals across disciplines

January 20th from 6 to 8.30 pm: Enhancing Presence and Observation

January, 21st from 5 to 7.30 pm: Increasing Self-Awareness and Empathic Intelligence 

Cost: $285 (includes 1/20/17 and 1/21/17 + museum entrance fee) $185 for students

Art experience is welcome but not necessary–Location: The MET Museum in NYC

Space is limited to insure interactivity! For more information check out our website  and to register go here.


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


Come to YPs, Resident and Fellow Meeting in Westbury on February 11
Save the Date for the Annual Joint Meeting of the Young Physicians, Residents, Fellows, and Medical Student Sections: Saturday, February 11, 2017 at the Marriott Courtyard, 1800 Privado Road, Westbury NY 11590.

Presentations will include “Telemedicine/Telehealth:Tools for Clinical Practice and Patient Engagement.” Gain a better understanding of and appreciation for the use of telemedicine as part of a patient management strategy that will improve and increase access to treatment, lower costs, and more effectively engage patients.

We will also present important financial planning strategies and tips specifically for younger physicians, including Student Loan Management, Main Financial Issues to Address in Residency and as you Transition to Practice, Asset Protection Strategies and Risk Management, and more.

Policy will be created, elections will be held.

YPS and RFS register at sbennett@mssny.org; MSS register at mreyes@mssny.org.


MSSNYPAC – The Political Voice for New York’s Physicians
The 2017 session of the NYS Legislature has convened!  For the next several months, many health policy proposals will be offered and perspectives from many stakeholders will be considered as policy is formulated.  It is critically important for the physician to have a meaningful seat at the table in shaping these proposals.  Physicians have experienced many victories and the legislative session offers opportunity for further reforms and administrative simplifications yet it is also fraught with danger in the form of expansions of medical liability and scope of practice of non-physicians that we must oppose.Through MSSNYPAC, physicians are a force for change in New York State healthcare policy.Join or increase your support and participation today at www.mssnypac.org


Former Anesthesiologist with Addiction Problem Helps Others to Recover
The Syracuse Post-Standard published an interesting story about a former anesthesiologist who changed specialties and went into addiction medicine after recovering from drug addiction. http://www.syracuse.com/empire/index.ssf/2017/01/follette.html#incart_river_home 

Now Accepting Abstracts for Student Poster Symposium at April 21 HOD
We are accepting abstracts for consideration for our 12th Annual Resident/Fellow/Medical Student Poster Symposium to be held on:

Friday, April 21, 2017
Westchester Marriott
Tarrytown, New York
2 pm – 4:30 pm

In the words of past participants, the MSSNY symposium is an “excellent networking opportunity,” a place to “meet fellow residents and attendings” and “learn from other presentations” that they “would highly recommend.” 

Click here for detailed guidelines.

Deadline for abstract submission is 4 pm, Tuesday, January 31, 2017. Check out last year’s Abstract Book here.

We welcome your participation!

Improving Payment for Chronic Care, Behavioral Health and Diabetes Prevention
Improving payment for chronic care management and behavioral health, enhancing diabetes prevention, and a data collection strategy for global services will significantly reduce burden on practitioners compared to the proposal are key focus areas of the 2017 Medicare Physician Fee Schedule (PFS) that CMS released on Nov. 2, 2016. CMS says that the new policies will improve Medicare payment for those services provided by primary care physicians for patients with multiple chronic conditions, mental and behavioral health issues, and cognitive impairment conditions.

A few highlights of the final rule include:

  • Reimbursement for chronic care management (CCM), complex chronic care management, and care plan development— The 2017 Medicare PFS includes several revisions to the billing code set to more accurately recognize the work of primary care and other cognitive specialties to accommodate the changing needs of the Medicare patient population, and the value of care management and care coordination.
  • Expansion of the Medicare Diabetes Prevention Program (MDPP) ―The 2017 Medicare PFS finalizes policies including the definition of the MDPP benefit, beneficiary eligibility criteria, and supplier eligibility and enrollment criteria that will enable organizations, including those new to Medicare, to prepare for enrollment into Medicare as MDPP suppliers. Learn more in CMS’ fact sheet. CMS said that future rulemaking will address policies related to payment, virtual providers, and other program integrity safeguards.
  • Behavioral Health Integration– CMS will pay for the care collaboration for beneficiaries with behavioral health issues. Payment is based on the collaborative care model, and is meant to foster discussion, information sharing and planning between the PCP and the behavioral health care specialists
  • Reimbursement for Non Face-to-Face Prolonged Evaluation & Management Services (E/M) – CMS will pay for additional time spent by the physician or non-physician practitioner beyond the direct patient care visit.
  • Data collection within surgical global period— The 2017 Medicare PFS finalizes a data collection strategy that aims to significantly reduce the burden on practitioners by requiring reporting of post-operative visits only for high-volume/high-cost procedures, using existing CPT code 99024 instead of the proposed G-codes.

The Medicare Access and CHIP Reauthorization Act of 2015 (MACRA) requires CMS to gather data on visits in the post-surgical period that could be used to accurately value these surgical services. CMS is hopeful that use of the existing CPT code for reporting these services will be significantly less burdensome than the proposal to require time-based reporting using the G-codes.

For more information:


EHR Incentive Programs Attestation Programs Open January 23 to February 28
In 2016, the EHR reporting period was a minimum of any continuous 90 days between January 1, 2016 and December 31, 2016. There is also a 90-day reporting period for CQMs for providers that choose to report CQMs by attestation. The EHR Incentive Programs attestation system will be open from January 3, 2017 to February 28, 2017. Providers must attest by the attestation deadline to avoid a 2018 payment adjustment. In preparation for attestation, CMS encourages providers to review the 2016 program requirements webpage on the EHR Incentive Programs website.

Columbia’s Mailman School of Public Health: Marijuana Use up in Pregnant Women
More pregnant women are using marijuana than were a decade ago, according to a study from Columbia University’s Mailman School of Public Health published in JAMA. Researchers found that the percentage of pregnant women who used marijuana in the past month increased from 2.37 percent in 2002 to 3.85 percent in 2014. Pregnant women between 18 and 25 years old had the highest use rate, with 7.47 percent of them using the drug within the past month. http://jamanetwork.com/journals/jama/fullarticle/2594398

New: DrFirst Rcopia® Prescribers Receive Notice of Failed e-Prescriptions via Mobile Device
Have you ever issued an e-prescription for a patient, and then found hours later that the transmission failed to reach the pharmacy?  Many docs have. According to Surescripts, e-prescription failures occur 3% to 6% of the time. Failure is typically not a result of a problem with your prescribing software; the error is more likely to be somewhere between the network and the target pharmacy.

DrFirst’s Rcopia e-prescribing software mitigates failed transmissions through the use Notification of Undelivered Scripts or “NUS.” NUS, delivered through DrFirst’s Backline® secure communications software, sends a secure message directly to your mobile device within minutes of any patience prescription failing to reach the pharmacy. That means you can be notified and correct the problem before your patient arrives at the pharmacy.

To activate this service, individual physicians can sign-up for a complementary Backline account for NUS support. Once you register, DrFirst will connect your Backline account with your Rcopia account to transmit NUS messages. You can also use the Backline software to secure text with other colleagues in the Backline community.

DrFirst is a MSSNY member benefit.

For more information, MSSNY Members should visit this link: http://www.drfirst.com/mssny 

New Legislation Re Emergency 5-Day Supply of Drugs Used to Treat Substance Use Disorders in Medicaid Fee-for-Service (FFS) & Medicaid Managed Care
As a result of changes to Insurance Law section 3216 paragraph 31-a, effective January 1, 2017, insurance carriers will be required to provide at least 5 days’ coverage for emergencies, without prior authorization, for medications used to treat substance use disorders. This includes medication associated with the management of opioid withdrawal and/or stabilization as well as medication used for opioid overdose reversal. Additionally, no policy shall impose an additional copayment or coinsurance on an insured who received an emergency supply of medication and then received up to a thirty day supply of the same medication in the same thirty day period in which the emergency supply of medication was dispensed.

Medicaid Fee-for-Service (FFS)

A pharmacist can initiate an emergency 5-day supply of a non-preferred medication for the treatment of a substance use disorder by calling the clinical call center at 1-877-309-9493. The clinical call center is available 24 hours per day, 7 days per week.

To obtain FFS preferred medication listings and criteria see also the following website: Medicaid FFS Preferred Drug List and Pharmacy Prior Authorization Programs.

If a prescriber initiates a subsequent prescription for the same medication for the treatment of a substance use disorder within 30 days of the initial 5-day emergency supply, and the pharmacist is notified and/or confirms this upon reviewing the patient’s prescription history or utilizing ProDUR editing, the following may be used to exempt the copayment for the subsequent prescription:

  • In NCPDP field 461-EU, enter a value “04” (Exempt Copay and/or Coinsurance)
  • Please refer to the NCPDP Companion Guide at: https://www.emedny.org/HIPAA/5010/transactions/NCPDP_D.0_Companion_Guide.pdf and the ProDUR Manual at: https://www.emedny.org/ProviderManuals/Pharmacy/ProDUR-D.0-ECCA_Provider_Manual/Pro%20DUR%20ECCA%20Provider%20Manual%20(D.0).pdf

This process will be utilized until such a time the Department is able to systematically address the exemptions of copayment(s) on eligible subsequent prescription(s) within the 30 day period.

Managed Care plans will develop and communicate their own processes/procedures to comply with this law.

DEA Reverses Decision re Registration Renewal Process
The good news is that registration numbers will not automatically be retired if renewal applications are filed within the one-month grace period after the expiration date. However, there are a few issues that need clarification from the DEA, including whether the filing of a renewal application during the one-month grace period automatically reinstates the registration number or whether DEA must adjudicate the renewal application before the number becomes valid.  It also is not clear whether a registration number remains valid if the registrant files a renewal application during the grace period and DEA fails to adjudicate the application before the end of the month. The AMA will be following up with DEA staff

We recently alerted physicians to a notice from the Drug Enforcement Administration (DEA) that effective January 1, 2017, the DEA was changing its long-standing policy of allowing a grace period for registrants who failed to file a timely renewal application. The revised announcement states the following: 

At this time, DEA will otherwise retain its current policy and procedures with respect to renewal and reinstatement of registration. This policy is as follows:

  • If a renewal application is submitted in a timely manner prior to expiration, the registrant may continue operations, authorized by the registration, beyond the expiration date until final action is taken on the application.
  • DEA allows the reinstatement of an expired registration for one calendar month after the expiration date. If the registration is not renewed within that calendar month, an application for a new DEA registration will be required.
  • Regardless of whether a registration is reinstated within the calendar month after expiration, federal law prohibits the handling of controlled substances or List 1 chemicals for any period of time under an expired registration.

If you want to check your registration expiration date, please contact the DEA Registration Service Center at 1-800-882-9539 or email DEA.Registration.Help@usdoj.gov and include your DEA Registration number in your email.  For questions about this alert, please contact Debra Cohn, Senior Washington Counsel, at (202) 789-7423 or debra.cohn@ama-assn.org.


CLASSIFIEDS


Prime Astoria Medical Office for Rent or Lease
23-15 Astoria Boulevard, Astoria, New York
Customizable Lower Level
7,500 Sq Feet Gross For Lease
Prime Location Close To Hospital and Other Medical Facilities.
Direct Street Access Private Elevator plus Direct Access From  
Street Level Stairs.
Contact:
AB Building Management LLC
George Miltiadou
718-482- 7262
917-939-0019

Upper East Side Medical Office for Sale
Suitable for a solo practice or shared multi- specialist group. Large unit, about 1100 Sq Ft, located on the ground floor of a cooperative building with own entrance to office, 2 or 3 equipped exam rooms with exam tables and work station areas, front waiting room with reception area with storage unit of shelves for medical charts, a consultation office, 1 and a half bathrooms and kitchenette. Lots of shelves throughout exam rooms, 2 EKGs, one PC computer that comes equipped with a PFT machine and operating software, an operating X-ray machine suitable for chest X-rays with film processor. No brokers, call office manager, Diana Peron @ 212-861-9012

State of the Art Midtown Medical Office for Rent
Elegant, modern, beautifully designed medical office available, furnished or non-furnished. Full or part time share with thriving Dermatology practice which occupies its own floor. Class A Architects and Designers Building in the best possible Midtown East location near Bloomingdales. Your own private corner, consultation room, two or three large equipped treatment rooms with beautiful cabinetry, sinks, and exam tables. All rooms wired and windowed. Shared oversized waiting room, kitchenette. Your own reception, administrative, front desk and storage space (preview images of space can be seen on www.instagram.com/dermroom). $8,000-$11,500/month. For details contact (212)–583–2966 or email Hefderm@outlook.com, no brokers.


Elegant Plastic Surgery Office (Upper East Side Manhattan)
Very large and classy office to share. Located in the ground floor of a 25′ x 100′ carriage house opposite the 66th Street Armory with large consult room, 2+ treatment/exam rooms, large waiting room, business office, storage. See video of office — you won’t believe it: www.youtube.com/watch?v=Uli8Cck_eRA   $5000/month incl utilities. no brokers. Call Doctor Fischman at (212) 472–3300.Jeffrey R. Fischman, M.D.  110 E 66th Street.

Want to Sell Your Medical Practice? Do You Have Medical Office Space to Sell or Share?
Clineeds is a new online platform designed to help medical providers sell their practice or buy, sell and share medical office space. Listing is FREE! No contracts. No commitments. No fees. Sign up today at http://www.clineeds.com/sign-up


Physician Opportunities


Executive Director – Bronx County Medical Society
Bronx County Medical Society, a leader in promoting excellence in Clinical Care, Education & Public Policy, is seeking an executive director. Candidates should have either a bachelor degree and/or three years of work experience with non-profit medical groups. The Executive Director should be knowledgeable on healthcare policy and nonprofit compliance. Candidate must demonstrate strength in event planning and fundraising, member recruitment and retention, community outreach, and possess strong communication skills. We offer a competitive salary and benefits package. Please send resume and cover letter to Diane Miller, Executive Director at bxcms@msn.com


A Private Multidisciplinary Medical Group is seeking an Internal Medicine/Family Medicine Physician in Manhattan
A well-established Manhattan based private multidisciplinary medical group is seeking to hire an Internal Medicine/Family Medicine Physician. This is a great opportunity to start your own practice in a modern office in midtown Manhattan. Attractive base salary plus comprehensive benefits package offered (Malpractice, 3 weeks paid vacation, 1 week CME, CME allowance, paid health insurance, etc).If you are a solo practitioner in private practice looking to join a private group practice, we will work with you to make the transition seamless. Please email your CV to tsrgexpress@gmail.com. No recruiters please.

A Private Multidisciplinary Medical Group is seeking a Podiatrist in Manhattan
A well-established Manhattan based private multidisciplinary medical group is seeking to hire a Podiatrist. This is a great opportunity to start your own practice in a modern office in midtown Manhattan. Attractive base salary plus comprehensive benefits package offered (Malpractice, 3 weeks paid vacation, 1 week CME, CME allowance, paid health insurance, etc).If you are a solo practitioner in private practice looking to join a private group practice, we will work with you to make the transition seamless. Please email your CV to tsrgexpress@gmail.com. No recruiters please.

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