March 24, 2017 – GOP Cancels Healthcare Vote

Dr. Reid - MSSNY President
PRESIDENT’S MESSAGE
Dr. Malcolm Reid
March 24, 2017
Volume 17
Number 12


Breaking News: House Republican leaders abruptly pulled a rewrite of the nation’s health-care system from consideration on Friday

MLMIC Insurance

Dear Colleagues:

This week, as Congress was feverishly debating whether to take up legislation that would change much of the Affordable Care Act (ACA), the MSSNY Executive Committee issued a statement highlighting both the positive and negative aspects of the proposed American Health Care Act (AHCA).

As a diverse group, our MSSNY members have a wide array of perspectives regarding whether they believe the ACA has been a success or a failure.  As a society that represents physicians of every region, of every specialty, and of every type of practice setting, extensive debate is to be expected.  The ACA was the most significant health care law enacted in our generation.  Regardless of our personal viewpoints on the ACA, most physicians would likely agree, that it is important that our policymakers address problems such as the narrow networks and use of high deductible plans that have clearly accelerated since the ACA went into effect.

In this regard, our statement acknowledged some of the positive aspects of the legislation before Congress, including ideas adopted at the MSSNY House of Delegates such as:

  • expanded use of Health Savings Accounts to provide health insurance coverage; and
  • preventing implementation of a tax on comprehensive health insurance coverage, also known as the “Cadillac Tax”, which would disincentivize employers from offering plans that limit patient cost-sharing.

At the same time, our statement expresses significant concerns regarding the impact that this bill may have for many of our patients who currently receive coverage through the “Essential Plan,” or expanded Medicaid.  The provisions of the AHCA under consideration  may cause patients to face  far greater out of pocket costs for plans that may not be as generous as what they are currently receiving under the ACA.  In fact, many patients may choose simply not to buy health insurance coverage at all.

That is a serious problem with this proposed legislation, which we hope can be addressed as Congress continues to debate how best to fix the ACA.  We also hope it is an opportunity to look at other issues that we believe impact upon health insurance costs, such as the excessive liability exposure faced by physicians, as well as the extraordinary market power held by the health insurance industry, not only in New York but also throughout much of our country.

For too long, debate over the ACA has been dominated by those who either want to completely eliminate it, or those who have been reluctant to change any aspect of it. In my opinion, neither side is correct.

It is my hope that the debate currently before Congress is the first step, not the last step, towards making necessary changes to improve the availability of affordable and comprehensive coverage options for our patients. For the benefit of our patients, let’s continue this conversation.

Please send your comments to comments@mssny.org




Final Stretch of NY Budget Negotiations
It comes down to just a few days.

Budget negotiations have entered their final stages as Governor Cuomo and legislative leaders iron out the details of a final State budget agreement. It is expected that “round the clock” talks will continue through the weekend and into early next week.  The final budget is due by April 1st. While the NYS Senate and NYS Assembly’s “one-House” budgets rejected several Executive Budget provisions that had been opposed by MSSNY, these provisions could still end up in the final enacted budget.

It is critical that you contact your legislators to ensure that they hold strong and to urge that they:

Critical items also under discussion in the final days of Budget negotiations include Workers Compensation reform, as well as proposals advanced by the Governor (and supported by MSSNY) that would directly regulate Pharmaceutical Benefit Managers, and regulate e-cigarettes under the “Clean Indoor Air” Act. To View a chart listing all of the Budget proposals in which MSSNY is engaging, please click here.   (Belmont)

Lacking Votes to Pass, ACA Repeal Bill Pulled From Consideration on House Floor
After a substantial floor debate on Friday afternoon, leaders of the US House of Representatives pulled from consideration the American  Health Care Act (AHCA), legislation to repeal and revise many aspects of the Affordable Care Act (ACA).  The bill was pulled from consideration when it appeared that there would not be enough votes for the bill to pass the House.

On Thursday, MSSNY President Dr. Malcolm Reid issued a statement developed by MSSNY’s Executive Committee shared with the New York Congressional delegation noting the need to fix the flaws of the ACA, and that the legislation had some beneficial provisions.  However, the statement also highlighted the concerns with provisions in the AHCA “that may cause New Yorkers who currently have low cost, ‘first dollar’ coverage to instead purchase coverage with high deductibles and other high cost sharing responsibilities.  Moreover, the statement noted our concerns regarding the “long-term impact of the AHCA on New York State’s Budget finances”.

As has been previously reported, several health care and patient advocacy organizations, including the AMA, AARP, the American Cancer Society, the Greater New York Hospital Association and the Healthcare Association of New York State (HANYS) had expressed strong concerns with the proposal.  Governor Cuomo also has issued several statements opposing the AHCA by highlighting the district by district financial impact on hospitals and nursing homes if the bill were to be enacted.

The proposal would have kept some of the popular provisions from the ACA, including required coverage for pre-existing conditions, prohibiting annual and lifetime limits, and requiring dependent coverage up to age 26.   It would also significantly expand the amount of funds that a person could direct to their Health Savings Account.

At the same time, the bill would have substantially revised ACA rules that facilitated various subsidized coverage programs for those who make up to 400% FPL ($94,000 for a family of 4).  While the expanded eligibility for Medicaid (up to 138% FPL) would be available through the end of 2019, starting in 2020 such expanded coverage would only be continued for those who had such coverage prior to the end of 2019.  The AHCA would also repeal the tax credits currently provided to help cover cost-sharing amounts for coverage for individuals who earn too much to qualify for Medicaid.

Instead, tax credits of $2,000-$4,500 (depending upon age) would be provided to enable the purchase of health insurance coverage.   Tax credits will be available in full to individuals earning less than $75,000 and households earning less than $150,000, but they will be capped for higher earners.  It appears as if the AHCA would have also completely eliminated funding for New York’s Essential Plan, which provides low-cost health insurance coverage with little cost-sharing responsibilities for over 600,000 New Yorkers who make between 138% and 200% of the FPL.

The bill would have repealed several other notable ACA provisions, including the requirement for all individuals to have health insurance coverage, the large employer coverage mandate, the provision to impose a “tanning” tax and a provision that limits the tax deductible treatment for health insurers of executive income that exceeds $500,000.

As of this writing, it is unclear how the legislation will be revised to garner majority support.  Please remain alert for further updates.        (AUSTER)


Increase in Cases of Hepatitis A among Men Who Have Sex with Men Reported in NYC
The New York City Health Department has noted an increase in hepatitis A cases among men who have sex with men (MSM) who did not report international travel.  There have been five cases of hepatitis A among unvaccinated MSM since January 1, 2017 and three of the five patients were hospitalized and all patients have recovered.   Since 1996, the Advisory Committee on Immunization Practices (ACIP) has recommended that all MSM receive two doses of hepatitis A vaccine; the second dose should be administered 6-12 months after the first dose.   The New York City Department of Health has issued Alert #6 and has sent a letter to all providers in the New York City region.   A copy of the letter can be found here.         (CLANCY)


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


SAVE THE DATE for Veterans’ Mental Health Training Initiative: CME Programs and Panel Discussions
The Medical Society of the State of New York, along with the New York State Psychiatric Association and the National Association of Social Workers will hold a two-day Veterans’ Mental Health Training Initiative: Addressing the Unspoken Needs of Veterans.

This two-day event will be held on Friday, May 5 (1-4:30 p.m.) and Saturday May 6 (8:30 a.m.-3 p.m.) at the Clarion Hotel and Conference Center, 3845 E Veterans Memorial Hwy, Ronkonkoma, NY.  Physicians are urged to reserve the dates for participation in this weekend.  Reservation links will be forthcoming for the entire conference.

The program will include three continuing medical education (CME) seminars on PTSD and TBI, Substance Use Disorders, and Suicide as well as panel discussions on the Dwyer Peer to Peer Program, Diversity among Veterans, and veteran-driven case studies.

Faculty for the CME programs includes Frank Dowling, MD, Thomas Madjeski, MD, and Adolph Meyer, MD. Physicians can register for all or part of the three CME programs. Just click on the program name listed below.

PTSD and TBI
Friday, May 5, 1:15 p.m.
Faculty Presenter: Thomas Madjeski, MD
The educational Objectives for the PTSD program are:

1)  Describe the symptoms of PTSD and TBI.

2)  Describe the treatment modalities of PTSD and TBI.

3)  Describe military culture & how to overcome unique barriers                 to treatment intrinsic to military culture

Suicide
Friday, May 5, 2:30 p.m.
Faculty Presenter: Frank Dowling, MD
The educational Objectives for the Suicide program are:

1)   Address the causes and warning signs of suicide and suicidal                  behavior among veterans.

2) Explore the best evidence-based diagnostic and treatment                       options available including psychotherapy and
pharmacotherapy.

3)  Identify barriers in military culture to identification and                             treatment and how to overcome them.

Substance Use Disorders
Saturday, 10:45 a.m.
Faculty Presenter: Adolph Meyer, MD
The educational objectives for the Substance Use Disorders program are:

1)  Explain substance use disorders (SUDs), symptoms, warning                   signs, comorbidities

2)  Explore treatment options for veterans including evidence-                      based practices in psychotherapy and pharmacotherapy

3)  Identify barriers to identification and treatment, including                        those unique to military culture, and how to overcome them

Veterans Matters is a CME series made possible through a grant from the New York State Office of Mental Health.

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

The Medical Society of the State of New York designates each 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.  (ELPERIN)


MSSNY to Hold CME Webinar on Concussion in Pediatric and Adult Population on April 19th; Registration Now Open
The Medical Society of the State of New York will hold a Continuing Medical Education (CME) webinar on the “Current Concepts in Concussion for Pediatric & Adult Patients” on Wednesday, April 19, 2017 at 1 p.m. for all physicians and other health care providers.  Registration for the webinar is now open HERE.

Faculty for the course will be John Anthony Pugh, MD, PhD, assistant professor of Neurology at Albany Medical Center (AMC), and Deborah Ilana Light, MD, primary care sports medicine and associate program director for the Sports Medicine Fellowship at Albany Medical Center.  Educational objectives are: 1) Identify signs and symptoms indicative of concussion as well as red flags that indicate alternate or more severe pathology; 2) Outline an appropriate management plan for a patient presenting with concussion including a return to “normal life” protocol; 3) Describe methods for the primary and secondary prevention of concussion; 4) Identify patients who would benefit from referral to a concussion specialist.

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

The Medical Society of the State of New York designates this live activity for a maximum of 1.0 AMA/PRA Category 1 credits™. Physicians should claim only the credit commensurate with the extent of their participation in the activity.  (CLANCY)

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

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

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AG: Three Heart Monitor-Related Apps Are Not Medical Devices nor FDA Approved
Today, Attorney General Eric T. Schneiderman announced settlements with three popular health-related applications sold in Apple’s App Store and Google Play regarding misleading claims and irresponsible privacy practices. The settlement follows a year-long investigation of mobile health applications and requires the implicated companies and developers to amend deceptive statements about their apps and modify their privacy policies to better protect consumers, while also making clear that their apps are not medical devices and are not approved by the U.S Food and Drug Administration. The Attorney General today announces settlements with the following app developers:

  • Cardiio, an American company that sells Cardiio, an app downloaded hundreds of thousands of times that claims to measure heart rate. The developer had not tested its accuracy with users who had engaged in vigorous exercise, despite marketing the app for that purpose. The developer also misleadingly implied that the app was endorsed by MIT.
  • Runtastic, an Austria-based company that sells Runtastic, an app that purports to measure heart rate and cardiovascular performance under stress. Yet the developer failed to test its accuracy with users who had engaged in vigorous exercise, despite marketing the app for that purpose to the 1 million people who downloaded it.
  • Matis, an Israel-based company that sells My Baby’s Beat, an app downloaded hundreds of thousands of times, which Matis previously claimed could turn any smartphone into a fetal heart monitor, despite the fact that it has never been approved by the FDA. Although Matis exhorted consumers to use My Baby’s Beat rather than a fetal heart monitor or Doppler, it never conducted, for example, a comparison to a fetal heart monitor, Doppler, or any other device that had been scientifically proven to amplify the sound of a fetal heartbeat.

Additionally, the developers now post clear and prominent disclaimers informing consumers that the apps are not medical devices and are not approved by the FDA.


 MLMIC’s Risk Management Conference for Physicians on April 20 at HOD
In partnership with MSSNY and the 2017 MSSNY House of Delegates, Medical Liability Mutual Insurance Company (MLMIC) will be hosting its first House of Delegates Risk Management Conference on Thursday, April 20, 2017 at 9:30 a.m. at the Westchester Marriott in Tarrytown, NY.  Attendance at this complimentary educational event will enable physicians to earn AMA PRA Category 1 Credits™.

In this program, a renowned attorney from Fager Amsler Keller & Schoppmann, LLP, specializing in healthcare law will address recent legislative, regulatory and malpractice case law developments that impact the provision of healthcare.

The program will also feature risk management advice on electronic health records (EHRs) and their associated liability risks.  A highly regarded malpractice defense attorney and a physician expert and MLMIC Risk Management Consultant will discuss a number of topics, including the legal pitfalls of EHRs and the proper use of EHR features such as templates, the copy and paste function, and auto-population.  Recommendations will be provided to help improve medical and legal documentation and reduce potential liability exposures.

All NYS physicians are welcome to attend.  Pre-registration is required and space is limited. Register Today 


Multiple Physician Positions with DOHMH Office of School Health
Office of School Health is the largest program of the New York City Department of Health and Mental Hygiene (DOHMH). This bureau is responsible for managing the health issues and promoting the well-being of the over 1.3 million children and adolescents enrolled in New York City’s 1700 school buildings.

Positions with the Office of School Health (OSH) combine clinical skills and public health training. OSH focuses on child health, asthma prevention, obesity and nutrition, vision screening, dental care, mental health, reproductive health, and childhood disability. We collaborate with various city and community based agencies to provide social and academic services to address the needs of all New York City school children, especially those facing the most significant social, economic, and health challenges.

The Office of School Health is currently undergoing expansion. There is an immediate need for physicians with an expertise in pediatric, adolescent, or family medicine, with the capacity to utilize primary care skills set through a public health lens. OSH is also  interested in public health and preventive medicine graduates with programmatic, analytic, and social medicine skills.

The NYC DOHMH is reaching out to identify candidates for this recruitment. We are enlisting your help to nominate medical professionals who are committed to contributing their talents to improve health and academic outcomes in our schools. Please consider applying for these positions or passing these opportunities on to talented physicians among your own personal networks.

Attached are the American Academy of Pediatrics position statements on the role of the School Physician as well as the job description and recruitment flyers:

  • Adolescent School Health Physician, Family and Child Health/SH Reproductive/City Medical Specialist, Level: 01/Part-time/Flexible Work Schedule (20-35 hrs/week) To learn more about this position & apply, please submit your resume & cover letter to: https://a127-jobs.nyc.gov/ In the Job ID search bar enter: Job ID: 277208
  • Field Doctor, Bureau of School Health/SH Medical (pre-K-8 Programs or High School) City Medical Specialist, Level: 01/Part-time/Flexible Work Schedule (20-35 hrs/week) To learn more about this position & apply, please submit your resume & cover letter to: https://a127-jobs.nyc.gov/ In the Job ID search bar enter: Job ID: 265869
  • Supervising Medical Doctor, Bureau of School Health/SH Reproductive Health, City Medical Specialist, Level: 02/Part-time (35 hrs/week) To learn more about this position & apply, please submit your resume & cover letter to: https://a127-jobs.nyc.gov/ Job ID:  277026

Please list in your cover letter how you heard about this position (including name of the professional association, website, or individual who referred you). If you have questions, please contact Caroline Volel, MD, MPH at OSH@health.nyc.gov.


Weekly Charting Tip: Fair Market Value v. Commercial Reasonableness
In order to comply with three different federal laws, it is very important that you document the fair market value (FMV) and commercial reasonableness of the “arrangement” at issue. Fair Market Value is “the value in arm’s length transactions, consistent with the general market value”. In other words, if I were a stranger, and I wanted a similarly situated arrangement, what would it be worth? There are professional people who actually will prepare a FMV report for you. This is the safest way of doing it. What do rents go for in the same area for a similar amount of space? You can factor in closeness to public transportation, parking lots and the like. Commercial reasonableness encompasses both the series and payment for them. Is it reasonable to pay a neurologist say $300,000 for the 40 hours a week you are offering? That depends on the location and what is expected of the neurologist. Areas with many neurologists tend to offer less. Rural areas may offer more. Think supply and demand. If a deal is too good to be true, it probably is!

–Larry Kobak, Esq., LKobak@DrLaw.com

If you have any questions, please contact Kern Augustine, P.C. at 1-800-445-0954 or via email at info@DrLaw.com.


BECOME A LEADER IN HEALTH PROFESSION EDUCATION. ATTEND AN EVENT TO GET MORE INFORMATION ABOUT THIS DYNAMIC PROGRAM AT HOFSTRA UNIVERSITY
Hofstra University’s Master of Science in Health Professions Pedagogy and Leadership
is a program designed to prepare clinicians who provide care to patients with an expanded role as an educator for students, residents, externs and fellows and to advance in leadership roles in their field. The focus of the program is on advancing teaching, leadership and research skills applicable to established healthcare educational environments. All health professionals and administrators interested in teaching in their clinical fields of expertise, overseeing educational programs, or preparing for leadership roles can benefit from this program, which is offered in a hybrid, executive format.

Attend one of the following to learn more information about this dynamic MS program:

ONLINE WEBINAR
Tuesday, April 18, 2017 @ 5:30pm
Register

IN PERSON
Monday, April 24, 2017 @ 5:30pm
Center for Learning and Innovation (CLI)
1979 Marcus Avenue Suite #101
Lake Success, NY 11042
Register

In addition, you may contact Dr. Alice Fornari, Program Director, at Alice.Fornari@hofstra.edu for more information.


Pediatrics: Calls to Poison Control-60% re Kids Under Five; 30% Are Teenagers
A study published in Pediatrics  indicates that “from January 2000 until December 2015, about 188,000 calls were placed to poison control centers regarding pediatric and teenage exposure to opioids.” The data indicated “sixty percent of the children exposed to opioids were younger than 5, while teenagers accounted for 30 percent.”

A companion paper in Pediatrics  reports a strong link between prescribed opioids and their recreational use.” The study indicated that “teens who abused opioids were often prescribed the drugs at some point by a physician.”


Match Day Madness!
The Upstate Medical University Class of 2017 presents 2017 Matchin’, a parody of 24k Magic, in celebration of their Match Day! https://www.youtube.com/watch?v=sk6AyP4u2f0


CDC: Four Countries Added to Interim Travel Guidance
The CDC is working with other public health officials to monitor for ongoing spread of Zika virus‎. On March 10, 2017 CDC posted a Zika virus travel notice for Angola, Guinea-Bissau, Maldives and Solomon Islands. CDC has issued travel notices (level 2, “practice enhanced precautions”) for people traveling to destinations with Zika. For a full list of affected countries/regions, visit http://wwwnc.cdc.gov/travel/page/zika-travel-information.

To help pregnant women and others identify areas of Zika risk, CDC published a new interactive World Map of Areas with Zika Risk that allows people to search for location-specific Zika information and travel recommendations. CDC also published an interactive “Know Your Zika Risk” tool that offers tailored risk and prevention messages based on information provided by travelers.  In addition, CDC’s Zika testing recommendations for pregnant women have been aligned with these three risk categories, as depicted in a new map for healthcare providers to use for evaluating and caring for pregnant women possibly exposed to an area with Zika risk.

CDC update
From January 1, 2015 to March 15, 2017, there have been 5,139 Zika virus disease cases reported in the US. Of these cases:

  • 4,842 cases were in travelers returning from affected areas
  • 222 cases acquired through presumed local mosquito-borne transmission in Florida (N=216) and Texas (N=6)
  • 75 cases acquired through other routes, including sexual transmission (N=45), congenital infection (N=28), laboratory transmission (N=1), and person-to-person through an unknown route (N=1).

Meanwhile there were 1,534 pregnant women with any laboratory evidence of possible Zika virus infection in the US as of February 21, 2017.


Join Nassau County for Dinner and CME Program on “Frontiers in Cellular Therapy”
The Nassau Academy of Medicine and the Nassau County Medical Society Joint Membership Meeting will be held on TUESDAY, MARCH 28, 2017 at the WESTBURY MANOR, 1100 Jericho Turnpike, Westbury. Complimentary Dinner Meeting for NCMS / NAM Members. Non-members and their staff may attend at $25 per person. Seating is limited. REGISTRATION is at 6:30PM; dinner and meeting at 7:00PM.  PRE-REGISTER NOW – Send E-Mail Response To: NASSAUMED@GMAIL.COM The CME Program, “NEW FRONTIERS in CELLULAR THERAPY” will be presented by Patricia Shi, MD, MS, Medical Director, Therapeutic Apheresis and Cellular Therapy Collection Service, New York Blood Center

Educational Objective:  At the end of this CME activity, participants should be able to; distinguish between the various types of cellular therapies being investigated; understand the potential risks, benefits, and unknowns of such therapies and become familiarized with ethical concerns and questions raised by the advance of cellular therapy. 

Accreditation Statement: This activity has been planned and implemented in accordance with the Essential Areas and Policies of the Medical Society of the State of New York (MSSNY) through the joint providership of the Suffolk Academy of Medicine and the Nassau Academy of Medicine. The Suffolk Academy of Medicine is accredited by MSSNY to provide Continuing Medical Education for physicians. The Suffolk Academy of Medicine designates this live educational activity for a maximum of 1 AMA PRA Category 1 Credit. Physicians should claim



CLASSIFIEDS


Prime NYC Space for Rent
Prime Midtown Manhattan space two blocks away from Grand Central Station
next to Park Ave. 3100 RSF with nine windows in a professional building filled with MDs and DDSs. $59/RSF please inquire at wnyllc@aol.com



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.

Physician Opportunities

Internist Needed Mon.-Fri. for Psychiatric Inpt in Queens
Internist needed for Full time general medical care of psychiatric inpatients.  Creedmoor Psychiatric Center is in Queens, and convenient to NYC, Nassau/Suffolk and near major transportation.  We are a small well organized Medical Department looking for another member.  Our physicians enjoy their work- life balance. Please contact: alan.diner@omh.ny.gov or call 718-264-4046

Paging Primary Care MDs Who Love Technology
98point6 is a Seattle startup who wants your input. We’re seeking practicing physicians to join our council and help shape the next generation of primary care. If the fusion of health care and technology inspires you, please apply here.


Ophthalmologist Part Time
Ophthalmologist needed to work at multiple nursing homes in all 5 boros except Staten Island. Part time or full-time position available.  Generous salary and incentives.Ttech provided. Opportunity to perform surgery, but not required. Please email cv to privacyssw@gmail.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.

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

March 17, 2017 UnitedHealthcare Council: Any Questions?

Dr. Reid - MSSNY President
PRESIDENT’S MESSAGE
Dr. Malcolm Reid
March 17, 2017
Volume 17
Number 11

MLMIC Insurance

Dear Colleagues:

UnitedHealthcare Physician Advocacy Council: Any Questions to Ask Them?

As part of the last legal settlement with United that was concluded in 2015, United agreed to the formation of a Committee referred to as the PAC – Physician’s Advisory Council.  MSSNY has FOUR physician members who are on the UHC PAC.  The Committee meets FOUR times a year with similarly named physicians from United.  One criteria for being on this group is that the physician must be participating with United.

We are meeting again on Tuesday, March 28 and need your input.

MSSNY is asking members if they have specific issues with United that we can address and advocate for on your behalf. If you have a concern, please send an email to Regina McNally, VP, Socio-Medical Economics.  Please state the subject as “UHC PAC Item,” and send your email to rmcnally@mssny.org  MSSNY email is not HIPAA-secure, so please do NOT include any PHI! The Committee addresses any issue of contention, either operational or administrative, in dealing with United.

While issues are discussed at length, the agreement stipulates that UHC is there to listen and report back to the UHC leadership on items discussed. Optimistically, the discussion should then lead to a resolution of the issues.

The spirit of the settlement agreement is that MSSNY could share subject matters at a high level to garner a better relationship with UHC. MSSNY Surveys indicate that most of our members participate with UnitedHealthcare; I am certain that many of you have had issues that are discussion worthy.

To ensure that the Council is successful, we need your participation.

Please send your comments to comments@mssny.org




Senate And Assembly Advance One-House Budget Proposals; 3-Way Negotiations To Begin
This week, the New York State Assembly and Senate each released and passed their respective proposals to amend the Governor’s proposed State Budget for 2017-18.  The passage of these resolutions identifying key priorities sets the stage for 3-ways negotiations with the Executive to pass an agreed upon budget before the deadline of April  1, 2017.   To view a chart of key changes to the Executive Budget click here.  Some of the important provisions contained in these proposals of interest to physicians and their patients:

  • Both the Assembly and Senate rejected an Executive Budget proposal opposed by MSSNY that would require a physician to receive a “tax clearance” as a pre-condition of receiving Excess medical malpractice insurance coverage.  Both Houses accept the Executive’s recommendation, supported by MSSNY, to continue funding the program at historical levels.
  • Both the Assembly and Senate rejected an Executive Budget proposal opposed by MSSNY that would have  permitted pharmacists to enter into “comprehensive medication management protocols” with   nurse practitioners to manage, adjust and change the medications of patients with a chronic disease or who have not met clinical goals of therapy.
  • Both the Assembly and Senate rejected the Executive Budget proposal opposed by MSSNY that would repeal “Prescriber prevails” protections in fee for service Medicaid and for several drug classes in Medicaid managed care.  Instead, the Assembly proposes to expand “prescriber prevails” across the entire Medicaid managed care program.
  • The Assembly rejected the Executive Budget proposal opposed by MSSNY to create a Regulatory Modernization Team.  The Senate included language to establish a workgroup but narrowed the scope, deleting the topic included in the Executive Budget proposal of revising “scope of practice” laws and deleting provisions that would give power to various agency commissioners to implement demonstration programs without the need for legislative approval.
  • The Assembly included an Executive Budget proposal supported by MSSNY to require the registration of PBMs and to disclose financial incentives to the State.  The Senate did not include this provision, instead requiring PBMs to disclose information to the health plans they contract with.
  • The Assembly included a proposal included an Executive Budget proposal supported by MSSNY to regulate vapor products under the “Clean Indoor Air” Act and to tax these products.  The Senate included language to regulate vapor products, but did not include the taxing provisions.
  • Both the Assembly and Senate included an Executive Budget proposal that would permit Medicaid to drop prescribers from the program who violate statutory opioid limits.  At MSSNY’s request, the Senate included language to assure that there first be a legal determination that the prescriber did in fact violate the opioid limit rather than giving Medicaid officials arbitrary authority to make this determination.
  • The Senate advanced a new proposal in its one-House to include information on physician profiles that detail each physician’s health plan participation information that DOH currently collects.   The information would be required to be included on the profile by DOH, not the physician, based on information maintained by DOH.  The proposal would also enable a physician to designate staff to complete and update the physician’s profile information.  The Assembly does not include a similar proposal.
  • The Senate proposed Workers’ Compensation reform, indicated it “will work to reduce the unsustainable cost increases for employers, while continuing to protect injured workers”. Suggested reforms include: updates to durational caps and schedule loss of use awards; ensuring prompt access to quality medical care and lost wage benefits; enhanced incentives for workplace safety programs; implementation of an efficient hearing process; and reducing frictional costs, streamline forms, improve independent medical examinations (IMEs), and require implementation of a prescription drug formulary.
    (DIVISION OF GOVERNMENTAL AFFAIRS)

House Budget Committee Votes to Advance ACA “Repeal and Replace” Bill
By a 19-17 vote, the US House of Representatives Budget Committee this week voted to advance the American Health Care Act (AHCA) to the House Rules Committee.  Three Republicans joined all 14 Democrats on the Committee in voting against the measure.  The lone New Yorker on the Committee, Rep. John Faso (R-Upper Hudson Valley) voted in support of the bill.

The AHCA would revise much of the Affordable Care Act (ACA) enacted in 2010.  As reported last week, several health care advocacy organizations, including the AMA, American Hospital Association (AHA), the Greater New York Hospital Association and the Healthcare Association of New York State (HANYS) have expressed strong concerns with the proposal.

The proposal would keep some of the popular provisions from the ACA, including required coverage for pre-existing conditions, prohibiting annual and lifetime limits, and requiring dependent coverage up to age 26.   It would also significantly expand the amount of funds that a person could direct to their Health Savings Account, and delay until 2025 implementation of the “Cadillac Tax” on comprehensive health insurance coverage.

At the same time, the bill would substantially revise ACA rules that facilitated various subsidized coverage programs for those who make up to 400% FPL ($94,000 for a family of 4).  While the expanded eligibility for Medicaid (up to 138% FPL) would be available through the end of 2019, starting in 2020 such expanded coverage would only be continued for those who had such coverage prior to the end of 2019.

The AHCA would also repeal the tax credits currently provided to help cover cost-sharing amounts for coverage for individuals who earn too much to qualify for Medicaid.  Instead, tax credits of $2,000-$4,500 (depending upon age) would be provided to enable the purchase of health insurance coverage.

Tax credits will be available in full to individuals earning less than $75,000 and households earning less than $150,000, but they will be capped for higher earners.  It appears as if the AHCA would also completely eliminate funding for New York’s Essential Plan, which provides low-cost health insurance coverage with little cost-sharing responsibilities for over 600,000 New Yorkers who make between 138% and 200% of the FPL.

The bill would repeal several other notable ACA provisions, including the requirement for all individuals to have health insurance coverage, the large employer coverage mandate, the provision to impose a “tanning” tax and a provision that limits the tax deductible treatment for health insurers of executive income that exceeds $500,000.

At this time, it still is not apparent whether there will be enough support for this legislation to pass the full US House as well as the US Senate, which could necessitate significant changes to this legislation.  Please remain alert for further updates.  (AUSTER)

 

CBO Predicts 24 Million to Lose Insurance Coverage as a Result of AHCA; Trump Administration Strongly Disagrees
This week, the Congressional Budget Office concluded that the AHCA under consideration by Congress would result in 14 million fewer people having health insurance coverage in 2018, and 24 million fewer people having health insurance coverage in 2026.  At the same time, it would produce an $880 billion reduction in Medicaid spending over the 2017-2026 period, and a $337 billion decrease in deficit spending over the same period.

Reacting to the CBO conclusion, AMA President Dr. Andrew Gurman issued a statement noting that While the Affordable Care Act was an imperfect law, it was a significant improvement on the status quo at the time, and the AMA believes we need continued progress to expand coverage for the uninsured. Unfortunately, the current proposal – as the CBO analysis shows – would result in the most vulnerable population losing their coverage… we hope the CBO estimates will motivate all Members of Congress to find a pathway to work together on significantly improving proposed health reform legislation so it is more focused on serving the very real needs of patients and improving the health of our nation.”

New HHS Secretary Dr. Tom Price issued a statement strongly objecting to the CBO conclusion:

“The CBO report’s coverage numbers defy logic…For there to be the reductions in coverage they project in just the first year, they assume five million Americans on Medicaid will drop off of health insurance for which they pay very little, and another nine million will stop participating in the individual and employer markets. These types of assumptions do not translate to the real world, and they do not accurately estimate the effects of this bill….Doctors and patients understand that, especially under current law, having coverage is not the same thing as having access to the care one wants or needs. Our approach will provide Americans with relief from the collapsing healthcare law, which never delivered on the benefits projected by the Congressional Budget Office in the first place.”  (AUSTER)


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


NYS DOH Releases Guidance On Mandated 3-Hour Course On Pain Management, Palliative Care And Addiction
The New York State Department of Health issued guidance on the required three (3) hours of course work or training in pain management, palliative care, and addiction that most New York prescribers with a DEA registration must complete.   The course work or training must be completed by July 1, 2017, and once every three years thereafter, pursuant to Public Health Law (PHL) §3309-a(3).

The course work or training must include the following eight (8) topics:

  • New York State and federal requirements for prescribing controlled substances;
  • Pain management;
  • Appropriate prescribing;
  • Managing acute pain;
  • Palliative medicine;
  • Prevention, screening and signs of addiction;
  • Responses to abuse and addiction; and
  • End of life care.

According to the letter, prescribers must complete course work or training in all eight topics. The topics may be covered by a single, comprehensive presentation or by multiple individual presentations for a total of at least three hours.  Depending on the presentations, it may take longer than three hours to complete all eight required topic areas.

The DOH letter lists the Medical Society of the State of New York as an accredited provider.  As reported previously, the Medical Society of the State of New York has developed three one-hour Continuing Medical Education (CME) webinars.  MSSNY will archive the webinars as an on-line program at MSSNY CME website.  This course work will be available from the CME website by the beginning of April.  Physicians and other prescribers will be able to view these webinars and obtain CME credit.  The online program will be available free of charge to MSSNY members; non-MSSNY members will pay a fee of $150 to view all three modules.

ATTESTATION
According to the information from DOH, prescribers must attest to their own completion of the course work or training.  For medical residents who prescribe under a facility’s DEA registration number, however, the facility must make such attestation.  For the initial attestation deadline of July 1, 2017, applicable course work or training completed from July 1, 2015, to July 1, 2017, is allowed.

For each and every subsequent attestation period, course work or training must be completed during the applicable attestation period.  Prescribers licensed on or after July 1, 2017, who have a DEA registration, as well as medical residents prescribing controlled substances under a facility DEA registration, shall complete the course work or training within one year of registration, and once within each three-year period thereafter.

DOCUMENTATION
Documentation of the completion of the course work or training must be maintained by the prescriber for a minimum of six (6) years from the date of the applicable attestation deadline for audit purposes. Documentation must include the course work or training provider name, course work or training name, location it occurred, date it occurred, and number of hours completed for each.

EXEMPTIONS
In certain limited circumstances, the Department may grant an exemption to the required course work or training to an individual prescriber who clearly demonstrates to the Department that there is no need to complete such training.

New York State Department of Health has indicated that that an attestation form to notify the Department of the satisfaction of the educational requirement, as well as FAQ’s and additional information, are coming soon.

A copy of the Department of Health letter can be found here.(CLANCY)

NYS DOH Adds Chronic Pain To List of Qualifying Conditions for Medical Marijuana And Permit PA’s To Certify Patients
Final regulations were adopted by the NYS Department of Health to add “chronic pain” to the list of conditions for patients to use medical marijuana.  Chronic pain is defined as “any severe debilitating pain that the practitioner determines degrades health and functional capability; where the patient has contraindications”.  Additionally, the regulations also allow physicians assistants to certify patients for the use of medical marijuana.

Authorization is dependent upon whether the supervising physician is already qualified to certify patients for medical marijuana. Physician assistants would have to complete the required coursework. Physician assistants who successfully complete the NYSDOH approved course and are in full compliance with other regulatory requirements must complete an authorization form with their supervising physicians, and mail this form along with the course completion certificate to the department. Once the information provided is validated, the department will send an email confirmation to the physician assistant containing a link that will authorize the physician assistant to register to certify patients.

In December, the Medical Society of the State of New York President Malcolm Reid, MD sent a letter to DOH Commissioner Howard Zucker that expressed concerns that the use of medical marijuana to treat chronic pain may be inconsistent with national treatment guidelines, and perhaps most importantly, could expose physicians’ to enhanced risk of federal prosecution especially with the change in the federal administration.   A copy of Dr. Reid’s letter can be found here(CLANCY)

New York Makes Large Jump in National Health Rankings
New York came in No. 12 in the country in health system performance, moving up from No. 20, according to the latest rankings from the Commonwealth Fund. New York and Washington made the biggest jumps in ranking, with New York moving into the top-performing group for the first time. New York saw gains on eight of 15 prevention and treatment measures, and it jumped from No. 10 to No. 6 in health care equity rankings, which took into account income and ethnicity. However, New York only improved on two of five measures in access and affordability. Notably, the share of adults who went without care because of cost over the course of a year dropped from 15% in 2013 to 12% in 2015.

The report released by the Commonwealth Fund compares health access and quality measures. The Commonwealth Fund is a private foundation that provides independent research on health care issues and making grants to improve health care practice and policy.  The report intentionally emphasized that states that expanded Medicaid access under the Affordable Care Act showed stronger progress than states that did not.                                           (BELMONT)

Senate Advances Legislation to Permit CV Techs to Administer Contrast Media
The New York State Senate Health Committee advanced legislation (S.3570, Valesky) this week to the Senate Higher Education Committee that would authorize Cardiovascular Technologists (CVTs) to administer contrast media during cardiovascular interventional procedures, under the “direct supervision” of a physician.

CVTs assist in technical procedures for cardiac catheterizations and interventions, but are not expressly permitted by statute in New York to administer contrast media.  MSSNY has heard from cardiologists in support of legislation to authorize CVTs to administer contrast media.   MSSNY and the NY Chapter of the American College of Physicians have requested an amendment to this legislation to require that the physician provide “personal supervision” of the CVT, which means they must be in the same room, instead of “direct supervision” which means that the physician must be in the same general area. Identical legislation (A.5963, Magee) has been introduced in the Assembly.
(AUSTER, BELMONT)

HCA Hosts Hospice and Palliative Care Forum
MSSNY recently participated in a meeting with representatives from the Home Care Association of New York State, the New York State Health Department, and hospitals state-wide to discuss the status of the State Palliative Care Education and Training Council. Vice-Chair of the State Council, Joan Dacher, PhD, RN, encourages the reformation of Social Work and RN training and education at the provider and professional school levels to include more concentrated training on long-term and palliative care.

In addition, representatives from Lourdes at Home/Hospice at Lourdes provided recommendations for encouraging the development of articulation agreements between hospitals and Homecare facilities to increase the number of homecare visits for patients with chronic illnesses.
(HARRING)

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


NYS: First Sepsis Report: Mortality Rates Have Declined
Mortality rates for sepsis have declined in recent years and more hospitals are on the hunt for the dangerous bacteria, according to New York State’s first sepsis report. The report is mandated by regulations that went into effect in late 2013. Read the report here.


2017 NRMP Main Residency Match the Largest Match on Record
Today the National Resident Matching Program® (NRMP®) announced the results of the 2017 Main Residency Match®, the largest in its history. A record-high 35,969 U.S. and international medical school students and graduates vied for 31,757 positions, the most ever offered in the Match. The number of available first-year (PGY-1) positions rose to 28,849, 989 more than last year.

Program Highlights
Results of the Main Residency Match are closely watched because they can be predictors of future changes in physician workforce supply.

Primary Care
In 2012, the NRMP implemented a policy requiring Match-participating programs to place all positions in the Match, spurring significant increases in the number of primary care positions offered. In the six years since implementation of the policy, Internal Medicine, Family Medicine, and Pediatrics have added a combined 2,900 positions, a 25.8 percent increase. Highlights from the 2017 Match include:

  • Internal Medicine programs offered 7,233 positions, 209 more than in 2016; 7,101 (98.2%) positions filled, and 3,245 (44.9%) filled with U.S. allopathic seniors.
  • Family Medicine programs offered 3,356 positions, 118 more than in 2016; 3,215 (95.8%) positions filled, and 1,513 (45.1%) filled with U.S. allopathic seniors. Since 2012, the number of U.S. allopathic seniors matching to Family Medicine has increased every year.
  • Pediatrics programs offered 2,738 positions, 49 more than in 2016; 2,693 (98.4%) filled, and 1,849 (67.5%) filled with U.S. allopathic seniors.

Other Highlights

  • Emergency Medicine offered 2,047 first-year positions, 152 more than in 2016, and filled all but six. The overall fill rate was 99.7 percent, and 78.2 percent were filled by U.S. seniors. Since 2012, the number of Emergency Medicine positions has increased by 379, or 23 percent.
  • Psychiatry offered 1,495 first-year positions, 111 more than in 2016, and filled all but four. The overall fill rate was 99.7 percent, and 61.7 percent were filled by U.S. seniors. Since 2012, the number of Psychiatry positions has increased 378, or 34 percent, and the number of positions filled by U.S. allopathic seniors has increased 307.
  • Specialties with more than thirty positions that achieved the highest percentages of positions filled by U.S. allopathic seniors, which is one measure of competitiveness, were Integrated Plastic Surgery (93.1% U.S. seniors), Orthopedic Surgery (91.9% U.S. seniors), and Otolaryngology (91.5% U.S. seniors).

Unmatched Applicants
Applicants who did not match to a residency position participated in the NRMP Match Week Supplemental Offer and Acceptance Program® (SOAP®) to attempt to obtain an unfilled position. This year, 1,177 of the 1,279 unfilled positions were offered during SOAP. SOAP results will be available in the full Match report published in May.


Upstate Association Sponsoring Tours for Medical Students
The Iroquois Healthcare Association (IHA) is sponsoring tours of Upstate NY for medical students and residents to `take a look’ and learn about practice opportunities in this area. Participants will learn about hospitals, medical staffs, communities and culture through visits to hospitals and ambulatory care settings.

The next all expenses paid tour is April 26-28th and will explore opportunities in the Finger Lakes Region. Click as follows for information on the program, a FAQ sheet, and a tour schedule.


MSSNYPAC – The Political Voice for New York’s Physicians
MSSNYPAC would like to thank the dedicated members of its leadership team, the MSSNYPAC Executive Committee  and the hundreds of physicians, residents, students and spouses for helping to raise over $10,000 for MSSNYPAC at this year’s Physician Advocacy Day!  If you were not able to attend in person but wish to support MSSNYPAC’s efforts to help elect physician-friendly candidates to office, consider making a contribution to MSSNYPAC.  Please join with your colleagues to help to assure that physicians have a meaningful seat at the table as health care policy is developed.


Join Nassau County for Dinner and CME Program on “Frontiers in Cellular Therapy”
The Nassau Academy of Medicine and the Nassau County Medical Society Joint Membership Meeting will be held on TUESDAY, MARCH 28, 2017 at the WESTBURY MANOR, 1100 Jericho Turnpike, Westbury. Complimentary Dinner Meeting for NCMS / NAM Members. Non-members and their staff may attend at $25 per person. Seating is limited. REGISTRATION is at 6:30PM; dinner and meeting at 7:00PM.  PRE-REGISTER NOW – Send E-Mail Response To: NASSAUMED@GMAIL.COM The CME Program, “NEW FRONTIERS in CELLULAR THERAPY” will be presented by Patricia Shi, MD, MS, Medical Director, Therapeutic Apheresis and Cellular Therapy Collection Service, New York Blood Center

Educational Objective:  At the end of this CME activity, participants should be able to; distinguish between the various types of cellular therapies being investigated; understand the potential risks, benefits, and unknowns of such therapies and become familiarized with ethical concerns and questions raised by the advance of cellular therapy. 

Accreditation Statement: This activity has been planned and implemented in accordance with the Essential Areas and Policies of the Medical Society of the State of New York (MSSNY) through the joint providership of the Suffolk Academy of Medicine and the Nassau Academy of Medicine. The Suffolk Academy of Medicine is accredited by MSSNY to provide Continuing Medical Education for physicians. The Suffolk Academy of Medicine designates this live educational activity for a maximum of 1 AMA PRA Category 1 Credit. Physicians should claim


CLASSIFIEDS


Prime NYC Space for Rent
Prime Midtown Manhattan space two blocks away from Grand Central Station
next to Park Ave. 3100 RSF with nine windows in a professional building filled with MDs and DDSs. $59/RSF please inquire at wnyllc@aol.com



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.

Physician Opportunities

Internist Needed Mon.-Fri. for Psychiatric Inpt in Queens
Internist needed for Full time general medical care of psychiatric inpatients.  Creedmoor Psychiatric Center is in Queens, and convenient to NYC, Nassau/Suffolk and near major transportation.  We are a small well organized Medical Department looking for another member.  Our physicians enjoy their work- life balance. Please contact: alan.diner@omh.ny.gov or call 718-264-4046

Paging Primary Care MDs Who Love Technology
98point6 is a Seattle startup who wants your input. We’re seeking practicing physicians to join our council and help shape the next generation of primary care. If the fusion of health care and technology inspires you, please apply here.


Ophthalmologist Part Time
Ophthalmologist needed to work at multiple nursing homes in all 5 boros except Staten Island. Part time or full-time position available.  Generous salary and incentives.Ttech provided. Opportunity to perform surgery, but not required. Please email cv to privacyssw@gmail.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.

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

March 10, 2017 – Lobby Day – Another Home Run!

Dr. Reid - MSSNY President
PRESIDENT’S MESSAGE
Dr. Malcolm Reid
March 10, 2017
Volume 17
Number 10

MLMIC Insurance

Dear Colleagues:

This week, Moe Auster, Senior VP Government & Regulatory Affairs, wanted to thank everyone who participated in our Lobby Day.

Please send your comments to comments@mssny.org




Thank You For All Who Came to Physician Advocacy Day This Week
A big thank you to the over 250 physicians, residents, medical students and other physician advocates who took the time to come to Albany this week to participate in MSSNY’s Annual Physician Advocacy Day!  We also thank the American College of Obstetricians & Gynecologists – District II and the New York State Osteopathic Medical Society for participating and coordinating their annual Advocacy Days with MSSNY.

We appreciate the challenges you face in taking a day away from your practice or hospital to advocate for your profession and for your patients.  But your participation was absolutely essential to demonstrating to our legislative leaders the importance of ensuring physicians are able to continue to deliver the timely and quality care patients expect and deserve.  Moreover, it was important for legislators to hear the perspective of residents and students how the challenges of New York’s health care delivery system makes it difficult to considering practicing in New York State in the future.  As the Assembly and Senate will each be finalizing their respective “one-House” Budgets this week, having the opportunity to share with legislators our concerns with excessive liability exposure, and excessive health  insurer imposed prior authorization hassles is essential to ensuring that the State Budget does not incorporate provisions that will exacerbate these problems.

We also thank the several legislative and regulatory policy leaders who took the time away from State Budget negotiations to address the assembled physicians, share their vision for health care, and answer questions from the audience.  The speakers included Senate Majority Leader John Flanagan, Assembly Majority Leader Joseph Morelle, Senate Health Committee Chair Kemp Hannon, Senate Insurance Committee Chair James Seward, Assembly Health Committee Chair Richard Gottfried, Assembly Insurance Committee Chair Kevin Cahill, Deputy Financial Services Superintendent Troy Oechsner and Dr. Doug Fish, Medical Director for the New York State Department of Health.
(DIVISION OF GOVERNMENTAL AFFAIRS)

Council Meeting in Albany on March 7
Moe Auster, Dr. Frank Dowling: Dr. Art Fougner; Dr. Thomas Madejski; Dr. Nicholas Kulbida; (Front) MSSNY President Elect Dr. Charles Rothberg; MSSNY President Malcolm Reid; Assembly Majority Leader Joseph D. Morelle; Dr. Christine Herde; Dr. Carla Eng; Dr. Paul Pipia

Legislation Introduced and Debated in Congress to Make Major Changes to the ACA
This week the US House of Representatives Leadership released the American Health Care Act, its proposal to change much of the Affordable Care Act (ACA) enacted in 2010.  Several health care advocacy organizations, including the AMA, expressed strong concerns with the proposal.

The proposal would keep some of the popular provisions from the ACA, including required coverage for pre-existing conditions, prohibiting annual and lifetime limits, requiring dependent coverage up to age 26, and required coverage of “Essential Health benefits”.  It would also expand the amount of funds that a person could direct to their Health Savings Account.

At the same time, the bill would substantially revise ACA rules that facilitated various subsidized coverage programs for those who make up to 400% FPL ($94,000 for a family of 4).  While the expanded eligibility for Medicaid (up to 138% FPL) would be available through the end of 2019, starting in 2020 such expanded coverage would only be continued for those who had such coverage prior to the end of 2019.

The AHCA would also repeal the tax credits currently provided to help cover cost-sharing amounts for coverage for individuals who earn too much to qualify for Medicaid.  Instead, tax credits of $2,000-$4,500 (depending upon age) would be provided to enable the purchase of health insurance coverage.   Tax credits will be available in full to individuals earning less than $75,000 and households earning less than $150,000, but they will be capped for higher earners.  It appears as if the AHCA would also completely eliminate funding for New York’s Essential Plan, which provides low-cost health insurance coverage with little cost-sharing responsibilities for over 600,000 New Yorkers who make between 138% and 200% of the FPL.

The bill would repeal several other notable ACA provisions, including the requirement for all individuals to have health insurance coverage, the large employer coverage mandate, the provision to impose a “tanning” tax and a provision that limits the tax deductible treatment for health insurers of executive income that exceeds $500,000.

The Healthcare Association of New York State (HANYS) issued a statement saying that the AHCA “would be disastrous for New York. It would threaten health coverage for millions of New Yorkers, create a fiscal crisis for the state, and burden hospitals and health systems with fewer resources and more uninsured or underinsured patients. The proposal would also destabilize insurance markets, driving up costs for all consumers.”

The Greater New York Hospital Association released an analysis in which it noted that “the proposed Medicaid changes would put a huge amount of pressure on state budgets and put many Americans at risk of losing health care coverage. In addition, the Medicaid DSH (Disproportionate Share Hospital) cuts will cost expansion states hundreds of millions in DSH dollars, adversely affecting safety net hospitals.”

The American Medical Association sent a letter to Congressional leaders and issued a statement noting several areas where the AHCA “fell short” of the health system reform objectives that had been adopted by the AMA, including concerns with:

  • Relating tax credits to age, rather than inversely related to income, which could result in more uninsured.
  • The proposed rollback of Medicaid expansions, which the AMA noted “have been highly successful in providing coverage for lower income individuals”.
  • Cutting funding for affiliates of the Planned Parenthood Federation of America, as “the AMA cannot support the precedent of restricting access to otherwise qualified providers of care for covered services”.

After extensive debate the bill was advanced from the Ways & Means Committee, and will be combined with the bill language that was advanced by the Energy & Commerce Committee this week.  At this time, it is unclear whether there are enough votes in the US House or Senate to enact this measure.  MSSNY will continue to monitor these developments, engage with New York’s Congressional delegation, and follow up with more details.
(AUSTER)

Assembly and Senate to Finalize One House Budget This Weekend; Keep Up Grassroots Activity
Details of the Senate and Assembly “one-house” budget proposals are expected to be released over the weekend or early next week.  It is expected that the Senate will leave out all tax and fee increases, including the proposed requirement that physicians receive a “tax clearance” as a pre-condition to receiving Excess Medical Malpractice Insurance coverage, a proposal opposed by MSSNY.  The Assembly has also shown some indications that they will reject the proposal as well. We will provide an update when more details become available.

Once each house has released its budget proposal, negotiations can begin between the two houses and the Executive to find agreement on a final budget.  MSSNY will continue to fight to have our concerns addressed in any final budget agreement but we will only be as successful as the participation of the MSSNY membership.  We encourage you to talk to your friends, family and colleagues to continue a strong grassroots effort to address all of the issues facing physicians.  Please continue to remain active and reach out to your legislators throughout the finalization of the budget. (Belmont) 

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, March 15, 2017 at 7:30 a.m. with 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.  Registration is now open for this webinar here just click on “Upcoming”.

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.

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)


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


First Webinar on Pain Management, Palliative Care and Addiction Completed; 2nd in Series on March 14th
The Medical Society of the State of New York held its first webinar on its Pain Management, Palliative Care and Addiction on Thursday, March 9th with over 1000 attendees and will hold the second webinar in the series on March 14th.   As has been previously reported, a 2016 law requires most physicians with DEA licenses to complete three hours of pain management education prior to July 1st of this year.

The first webinar, entitled “Understanding the Current Legal Landscape in New York State for Prescribing Controlled Substances” will be archived on the MSSNY CME site shortly.   This archived webinar will allow physicians to view the program at their leisure and receive CME credit.  The program will be free to MSSNY members and there will be a $50 charge for each archived webinar for non-members.  

The webinar is free to MSSNY member with a discount code; please check www.mssny.org website, under the Pain Management, Palliative Care and Addiction blue box on the opening page for information on how to obtain the code.  There is a fee of $50 for non-MSSNY members for each webinar.

Physicians may register for the live webinar on Tuesday below:

Tuesday, March 14, 2017—7:30-8:30am

Rational Opioid Prescribing for Chronic Pain Conditions

Faculty: Charles Argoff, MD & Patricia Bruckenthal, PhD, APRN-BS, FAAN

Educational Objectives:

Discuss evidence based best practice recommendations for opioid therapy for chronic pain, patient risk assessments and documentation

Describe palliative medical care and end-of-life care

Register for this webinar here

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

The Medical Society of the State of New York designates this live activity for a maximum of 1.0 AMA/PRA Category 1 credits™. Physicians should claim only the credit commensurate with the extent of their participation in the activity. (CLANCY)

CME Needs Assessment
The Continuing Medical Education (CME) Program of MSSNY strives to provide educational activities relevant to the practice of all recognized medical disciplines and include forums for public health, socio-economic, ethical, and legal issues related to the provision of quality healthcare.  In order to fulfill that goal, MSSNY’S office of CME is conducting a CME needs-assessment survey.  Physicians who have not already done so are encouraged to complete the survey here.  Questions about the survey or the MSSNY CME program may be directed to Miriam Hardin (mhardin@mssny.org or (518) 465-8085).       (HARDIN)

Register Now For Upcoming Veterans Matters CME Programs
The Medical Society of the State of New York encourages you to register for its upcoming Veterans Matters programs. These programs include CME presentations on PTSD and TBI in as well as Suicide in Returning Veterans.  Faculty for these programs is John McIntyre, MD and Frank Dowling, MD. Registration for all of these programs is open.  Just click on either of the presentation dates below.

Veterans’ Matters: PTSD and TBI

Webinar: Tuesday, April 4 at 8 a.m.

Faculty Presenter: John McIntyre, MD

The educational Objectives for the PTSD program are:

1) Describe the symptoms of PTSD and TBI.

2) Describe the treatment modalities of PTSD and TBI.

3) Describe military culture & how to overcome unique barriers to treatment intrinsic to military culture

Veterans’ Matters: Suicide
Live Seminar: Friday, April 28 at 8 a.m. at Brookhaven Memorial Hospital

Faculty Presenter: Frank Dowling, MD

The educational Objectives for the Suicide program are:

1) Address the causes and warning signs of suicide and suicidal behavior among veterans.

2) Explore the best evidence-based diagnostic and treatment options available including psychotherapy and pharmacotherapy.

3) Identify barriers in military culture to identification and treatment and how to overcome them.

Additional information or assistance with registration may be obtained by contacting Greg Elperin at gelperin@mssny.org.

Veterans Matters is a CME series made possible through a grant from the New York State Office of Mental Health.

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

The Medical Society of the State of New York designates each 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
(Elperin)

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

Physicians from Countries Affected by Immigration Order Serve Millions in NY
The Buffalo News (3/7) reports an analysis from the Immigrant Doctors Project found that roughly 75 doctors in the Buffalo-Niagara region from the six countries included in the most recent immigration ban “provide 100,000 to 150,000 appointments each year to patients.” On a national level, the project estimates that the six countries affected by the order have produced more than 7,000 physicians in the US who “see an estimated 14 million visits from patients each year.” The Association of American Medical Colleges criticized the executive order, stating, “We are deeply disappointed that the revised executive order and accompanying fact sheet do not explicitly recognize the importance of international medical graduates, physicians and medical researchers to the nation’s health security.”

PRI Reports $203 Million Loss in 2016 as Premiums Decline
Physicians Reciprocal Insurer reported a $203M underwriting loss (Politico, 3/7) in 2016. They now have a negative surplus of $354M as compared to an $83M loss in 2014, and $138M in 2015. Its premium revenue declined 24% in two years, from $384M to $293M. The Princeton Partnership, a firm that specializes in turnaround management, took over the day-to-day operations of PRI earlier this year.

119 Health Organizations Call for Task Force to End HepC in New York
A group of 119 health care organizations, including hospitals, advocacy groups and drug treatment centers have signed onto a statement renewing the call for Gov. Andrew Cuomo and the state legislature to create a task force to end the hepatitis C epidemic in New York. More than 100 organizations from across the state signed a letter to Gov. Andrew Cuomo and the leaders of the Legislature, calling for a commitment to eliminate hepatitis C, and, more specifically, an additional $10.8 million in this year’s budget to combat the virus. The statement comes one month after activists held a HepC elimination summit in Albany. An estimated 200,000 New Yorkers have chronic hepatitis C, with as many as half unaware they carry the virus, according to patient advocate VOCAL-NY. There were more than 16,000 reported new cases in 2014.

AG: $7.9M Settlement and Prison in Illegal Script Buy-Back/Laundering Scheme
AG Eric T. Schneiderman announced the sentencing of two pharmacy owners, a supervising pharmacist and ten corporations for defrauding several government-funded healthcare programs, including Medicaid and Medicare. An investigation revealed that on at least eight separate occasions between November 2013 and February 2014, the defendants paid patients hundreds of dollars in cash to forgo their prescription medications, the vast majority of which were to treat HIV. The defendants then submitted false claims to Medicare, Medicaid and Medicaid-managed care organizations and were reimbursed for distributing the medications, despite the fact that they were never dispensed to patients. Tarek Elsayed, 50, of Elmhurst Queens, the co-owner of 184th Street Pharmacy in the Bronx, was sentenced today in Bronx County Supreme Court by the Honorable Stephen Barrett to one to three years in state prison.

Previously, in August of 2016, Ahmed Hamed, 39, of Elmhurst, Queens, the second co-owner of 184th Street Pharmacy, was sentenced to two to six years in state prison. In October of 2016, Mohamed Hassan Ahmed, 38, of Bayside, the supervising pharmacist at 184th Street Pharmacy, was sentenced to one to three years in state prison and was required to surrender his license to practice pharmacy. Collectively, the three defendants stole over $10 million from government-funded health care programs.

In addition, the Attorney General’s Medicaid Fraud Control Unit (MFCU) reached a $4.1 million civil settlement agreement with defendant Elsayed and a $3.8 million civil settlement agreement with defendant Hamed. Defendant Hamed was also required to forfeit a Maserati and BMW he purchased with the proceeds from the scheme. Both vehicles have since been sold and proceeds from the sales returned to the state Medicaid program.

Between March 2013 and March 2014, Medicare, Medicaid and Medicaid-managed care organizations paid 184 St. Pharmacy over $10 million for medications 184 St. Pharmacy claimed to have dispensed to patients. MFCU’s investigation revealed however that the pharmacy ordered only $1 million in medications from legitimate pharmaceutical wholesalers. 

HHS: OIG Hotline Number Part of a Nationwide Phone Spoofing SCAM
The HHS Office of Inspector General (OIG) recently confirmed that the HHS OIG Hotline telephone number is being used as part of a telephone spoofing scam targeting individuals throughout the country. These scammers represent themselves as HHS OIG Hotline employees and can alter the appearance of the caller ID to make it seem as if the call is coming from the HHS OIG Hotline 1-800-HHS-TIPS (1-800-447-8477).

The perpetrator may use various tactics to obtain or verify the victim’s personal information, which can then be used to steal money from an individual’s bank account or for other fraudulent activity. HHS OIG takes this matter seriously. We are actively investigating this matter and intend to have the perpetrators prosecuted.

It is important to know that HHS OIG will not use the HHS OIG Hotline telephone number to make outgoing calls and individuals should not answer calls from 1-800-HHS-TIPS (1-800-447-8477). We encourage the public to remain vigilant, protect their personal information, and guard against providing personal information during calls that purport to be from the HHS OIG Hotline telephone number. We also remind the public that it is still safe to call into the HHS OIG Hotline to report fraud.  We particularly encourage those who believe they may have been a victim of the telephone spoofing scam to report that information to us through the HHS OIG Hotline 1-800-HHS-TIPS (1-800-447-8477) or spoof@oig.hhs.gov. Individuals may also file a complaint with the Federal Trade Commission 1-877-FTC-HELP (1-877-382-4357).

More information is available on the OIG Consumer Alerts webpage.

Percentage of “Inappropriate” PCIs Decreased in NY between 2010 And 2014
The New York State Insurance Fund is pleased to announce several enhancements to our online services for medical providers, improving your experience at nysif.com. We encourage you to register for an online account so you can take full advantage of the services we provide.

  • Direct Deposit
    Beginning March 1, medical providers will be able to sign up for direct deposit with simple online enrollment. Enjoy quicker access to funds, and avoid trips to the bank. Direct deposit payments are more secure, with no worry that your check may be lost or stolen. We’ll send you an email each time we deposit a payment into your account. Each direct deposit can contain payment for up to 25 separate bills. You can access information on each individual bill payment through your NYSIF online account.
  • Medical Provider Portal Search
    We have expanded search parameters in the medical provider portal to make it easier for providers to obtain the information needed to submit their bills for payment. Including complete information on your bill submission helps NYSIF process your bill more efficiently, resulting in faster payments to you.
  • Enhanced Online Privacy Protections
    NYSIF takes privacy seriously. NYSIF will be adding a second layer of protection to verify your identity. This additional step will help safeguard your login credentials and the confidential health information of your patients.

In addition, a third billing vendor has been added, which you can now use to submit your medical bills electronically. We urge you to take advantage of electronic bill submission by using any of our three vendors: iHCFA, ImageWork or IT Solutions of WNY. There is no cost to you to submit, and you’ll save on paper and postage.

NYSIF appreciates the important role health care providers play in the workers’ compensation system. We want to make doing business with NYSIF easier for you, and we expect these improvements will help accomplish that goal. Visit the Medical Provider section of nysif.com for more details. Link to ACH Med Provider User Guide:

JACC: Quality Improvement in Inappropriate Use of PCI in New York
Findings published online in the Journal of the American College of Cardiology http://bit.ly/2mtMEyI report that research indicated “quality improvement efforts in 2011-2012 took a solid bite out of inappropriate use of percutaneous coronary intervention (PCI)—at least in New York.” Investigators found that “in that state, inappropriate PCIs fell from 18.2% in 2010 to 10.6% in 2014, with a particularly sharp drop of 15.3% to 6.8% for the subgroup of Medicaid patients.”

Nasal Spray Approved to Treat Frequent Overnight Urination in Adults
The FDA has approved desmopressin acetate nasal spray (marketed as Noctiva) to treat adults who wake up at least twice nightly to urinate due to nocturnal polyuria.

The treatment is taken each night, about 30 minutes before bedtime. It increases water absorption through the kidneys, thereby decreasing urine production. Noctiva is approved only for those with nocturia caused by overproduction of urine. Accordingly, a 24-hour urine collection should be taken before treatment to confirm nocturnal polyuria.

Noctiva’s label includes a boxed warning about the risk for hyponatremia with treatment. Clinicians should check that patients’ serum sodium levels are normal before treatment, at 1 week and 1 month after treatment initiation, and periodically after that. The drug should not be used in those at high risk for severe hyponatremia — for example, patients with excessive fluid intake, those with conditions that can lead to fluid or electrolyte imbalances, and patients taking loop diuretics or glucocorticoids.

Additionally, Noctiva should not be used in those with symptomatic congestive heart failure or uncontrolled hypertension or in pregnant women. FDA news release

Physician Charged with Narcotics Distribution Resulting in Death
Avinoam Luzon, 32, a physician at Mercy Medical Center, allegedly provided Gabriel Tramiel, 32, with the fentanyl that took his life, according to US Attorney Preet Bharara.  Mr. Bharara said: “As a medical doctor and graduate student in public health, Avinoam Luzon was supposed to help the sick get healthy, but instead he allegedly helped fuel the nation’s most serious health crisis, the opioid abuse epidemic. As an alleged drug dealer with a medical degree, Luzon sold fentanyl to Gabriel Tramiel, a 32-year-old New Yorker, and it allegedly killed him.” Luzon, 32, of New York, New York, has been charged with one count of narcotics distribution resulting in the death of another, which carries a maximum sentence of life in prison, and a mandatory minimum sentence of 20 years in prison.

Cuomo: $1.4 Billion Plan to Fight Poor Health, Poverty in Central Brooklyn
The New York Times (3/9) reports Gov. Andrew Cuomo announced a $1.4 billion plan called Vital Brooklyn, which will target the persistence of poverty, violence, and poor health in central Brooklyn. Cuomo said his “holistic plan” will focus particularly on “health and wellness,” in a move the Times calls a “striking investment in one geographic location.” Other parts of the plan promote “healthy food, education and youth development, job creation, violence prevention, affordable housing and climate resiliency.”

The plan intends to add “$700 million for community health care clinics and programs, five acres of new recreation space, and programs to help young people stay out of trouble and learn job skills.” As Cuomo spoke, the Department of Health released a request for applications for the $700 million. The application can be found here.

CDC: 25% of US Adults Have Arthritis
Centers for Disease Control and Prevention Vital Signs report indicates that approximately 25% of US adults have arthritis. The report also indicated that “activity limitations from arthritis increased by 20 percent since 2002.”

Last Chance to Take Action! New and Improved NGSConnex Coming 3/6/2017!
NGSConnex is going through a transformation. On Monday, 3/6/2017 the new and improved NGSConnex provider portal launched. In order to make sure you are prepared follow these three simple steps.

Step 1: Verify you are using a supported browser to prevent interruption in use and for an optimal NGSConnex experience. (A supported browser is also required to access NGSMedicare.com.)

Step 2: Confirm the email address associated with your NGSConnex User Profile is current so that you can receive your MFA code and successfully log in.

Step 3: Familiarize yourself with the redesigned navigation for efficient use by reviewing the NGSConnex Navigation Crosswalk.

For detailed instructions on the new and improved NGSConnex and multi-factor authentication, visit the NGSConnex home page in the Provider Resources section of our website, NGSMedicare.com.

If you’re not already registered to use NGSConnex, you are missing out on an innovative and ever-evolving self-service tool; it’s free of charge and available 24/7 to all NGS providers. Sign up today at NGSConnex.com.

Council Notes-March 7, 2017 

  • Council reconsidered the MSSNY Physician Stress and Burnout Task Force Report, which was developed following a 2015 HOD resolution that directed MSSNY to “develop a series of programs, which may include CME credit, to assist physicians in early identification and management of stress.” In January 2017, Council approved four Task Force recommendations, but voted to table two recommendations. At Tuesday’s meeting, Council approved the following amendments by addition to the tabled recommendations:
  1. MSSNY membership distribution of burnout survey data coupled with a preliminary plan for interventions, beginning with distribution of survey results at House of Delegates and CME presentations during the annual meeting weekend.
  2. Development of a program to assist doctors when they need to reach out for help to sustain their wellness before it progresses to mental health or substance use disorder; charge MSSNY legal team and MSSNY staff to devise a solution which meets the needs of our members and maintains the legal and financial integrity of the MSSNY organization.
  • Valerie Grey, Executive Director of New York e-Health Collaborative (NYeC) presented a briefing on the Statewide Health Information Network of New York (SHIN-NY).
  • Douglas G. Fish, MD, Medical Director, Division of Program Development & Management for the New York State Department of Health presented on the Delivery System Reform Incentive Payment program (DSRIP).


CLASSIFIEDS



Prime NYC Space for Rent
Prime Midtown Manhattan space two blocks away from Grand Central Station
next to Park Ave. 3100 RSF with nine windows in a professional building filled with MDs and DDSs. $59/RSF please inquire at wnyllc@aol.com



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.

Physician Opportunities

Internist Needed Mon.-Fri. for Psychiatric Inpt in Queens
Internist needed for Full time general medical care of psychiatric inpatients.  Creedmoor Psychiatric Center is in Queens, and convenient to NYC, Nassau/Suffolk and near major transportation.  We are a small well organized Medical Department looking for another member.  Our physicians enjoy their work- life balance. Please contact: alan.diner@omh.ny.gov or call 718-264-4046

Ophthalmologist Part Time
Ophthalmologist needed to work at multiple nursing homes in all 5 boros except Staten Island. Part time or full-time position available.  Generous salary and incentives.Ttech provided. Opportunity to perform surgery, but not required. Please email cv to privacyssw@gmail.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.

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

March 3, 2017- DC Welcomes MSSNY

Dr. Reid - MSSNY President
PRESIDENT’S MESSAGE
Dr. Malcolm Reid
March 3, 2017
Volume 17
Number 9

Commissioner’s Grand Rounds

MLMIC Insurance

Dear Colleagues:

New York Physician Leaders Head To Nation’s Capital  

Several MSSNY physician leaders travelled to Washington DC to join their colleagues from across the country to meet with their Representatives and Senators fighting for needed improvements in health care delivery, and in opposition to proposals that would jeopardize health care access and coverage for their patients.  The Hill visits were in conjunction with the AMA’s Annual National Advocacy Conference.

Specifically, these physicians urged the enactment of legislation to ease some of the burdens associated with the new Medicare Merit-Based Incentive Payment System (MIPS), and for carefully considered reforms to the Affordable Care Act (ACA) that improve, rather than reduce, coverage options for our patients.  While physicians expressed strong concerns regarding the high deductible plans and narrow networks that have accelerated since the adoption of the ACA, they also noted the new opportunity for affordable health insurance options that have been provided to hundreds of thousands of New Yorkers that could be lost if ACA reforms are not carefully crafted.

The physicians represent every part of New York State and work in small practices, large practices, hospital medical staffs, and academia.  They included: MSSNY President-elect Dr. Charles Rothberg; Past-MSSNY President Dr. Robert Hughes; Past MSSNY President Dr. Robert Goldberg; Speaker of the MSSNY House of Delegates Dr. Kira Geraci; Past-Speaker of the MSSNY House of Delegates Dr. Jerome Cohen; Erie County Medical Society President-Elect Dr. Willie Underwood; Kings County President-Elect Dr. Hilary Fairbrother; Dr. Jack Mcintyre; Dr. Steve Lee, and MSSNY staff.

Meetings were held with key members of New York’s Congressional delegation who will play a large role in developing and analyzing proposals that restructure the ACA, including US Senate Minority Leader Charles Schumer, Senator Kirsten Gillibrand, and Representatives Yvette Clarke, Chris Collins, Joseph Crowley, Eliot Engel, Brian Higgins, Tom Reed, Paul Tonko and Lee Zeldin.  MSSNY physician representatives, in conjunction with other state medical societies, met with other key top policymakers including Representative Dr. Michael Burgess (R-TX) and Ways & Means Committee Chair Kevin Brady (R-TX).

These physicians are to be commended for the extensive time they took away from their practices to advocate on behalf of their colleagues and their patients.

National Advocacy Conference attendees MSSNY Senior VP Legislative & Regulatory Affairs Moe Auster; MSSNY EVP Phil Schuh; Past-Speaker of the MSSNY House of Delegates Dr. Jerome Cohen; Past MSSNY President Dr. Robert Goldberg; Past MSSNY President Dr. Robert Hughes; Rep Chris Collins (R-NY 27th District); Dr. Jack McIntyre; Dr. Steve Lee; and Speaker of the MSSNY House of Delegates Dr. Kira Geraci.

SAVE THE DATE!  Physician Advocacy Day in Albany March 8!

Please send your comments to comments@mssny.org




Last Call! MSSNY Lobby Day (MARCH 8) is Quickly Approaching! Register Now!
MSSNY’s “Physician Advocacy Day” will be held this Wednesday, March 8th in the Lewis Swyer Theatre in the Egg, located at the Empire State Plaza, Albany NY.

If you have not already, please Register Here.  Please join your colleagues from across the state to urge needed reform to our health care system, and for our profession and our patients.

Take advantage of this opportunity to express your support and voice your concerns to a full slate of legislators and key policymakers including:

  • Assembly Majority Leader, Joe Morelle
  • Senate Majority Leader, John Flanagan
  • Senate Health Chair, Kemp Hannon; Assembly Health Chair, Richard Gottfried: Senate Insurance Chair, James Seward; Assembly Insurance Chair, Kevin Cahill; and
  • Troy Oechsner, Deputy Superintendent for eaHealthHealth, Department of Financial Services

Come meet with your legislators to urge that they:

  • REJECT burdensome new impediments to obtaining Excess Medical liability insurance coverage contained in the Governor’s 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 costs; and
  • REJECT legislation that would impose costly and time consuming mandates on physician delivery of patient care.

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 also be scheduling appointments for physicians to meet with their elected representatives.

If you have any questions/comments, please contact Carrie Harring at charring@mssny.org or call 518-465-8050.
(DIVISION OF GOVERNMENTAL AFFAIRS)

Budget Update
After a brief recess where legislators heard feedback from constituents in their districts, the legislature returned to Albany on Tuesday.  The Senate and Assembly released their joint revenue forecast this week.  Both houses project that there will be more revenue than Governor Cuomo’s budget has estimated.  The Senate estimated $354 million in additional revenue beyond Cuomo’s 2017-18 budget.  The Assembly forecast estimates having an additional $1 billion more than what Governor Cuomo expects.  This is an important first step in budget negotiations.  Each house is then expected to release its one-house budget proposal in the next few weeks and the final budget agreement is due by April 1.  Budget negotiations will now begin to heat up and we must continue to apply pressure on the legislature to ensure that our voices are heard.

As these negotiations ensue, please take action as noted below:

  • We appreciate that funding for the Excess Medical Malpractice Insurance program is proposed to 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.  Send a letter to your legislators 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 who have not met clinical goals of therapy. While similar “collaborative drug therapy” programs exist within the hospital environment, only physicians are currently permitted to enter into such protocols.  Send a letter to your legislators 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.
  • The Budget would establish a 25 member “Healthcare Regulation Modernization Team” to look at developing numerous health care delivery change proposals including “modernizing” Certificate of Need laws, and changing scopes of practice for non-physicians. Of significant concern, the language would permit state agencies to implement demonstration programs without the need for legislative approval.Over a dozen specialty societies have joined MSSNY in a letter to the entire Legislature to urge that this proposal be removed from the budget, or remove the provision that enables these demonstration programs.
  • Giving overbroad discretion to state officials to drop physicians and other prescribers from the Medicaid program based upon the “inappropriate prescribing of opioids”.
    (BELMONT)

US House Committees to Begin Consideration of ACA Repeal Legislation Next Week
The US House of Representatives has outlined a three-week time frame for developing and passing legislation to repeal and replace large portions of the Affordable Care Act, according to numerous media reports.   Next week, the House Ways& Means and Energy & Commerce Committees will begin “marking up” legislation.  The following week, the House Budget Committee would move to combine the bills into a “reconciliation” package eligible for expedited Senate debate, with votes on the House floor expected the week after that.

While many concepts have been highlighted such as expanded use of health savings accounts, providing states more flexibility to spend Medicaid funds, expanded use of tax credits to purchase health insurance coverage and permitting sales of health insurance coverage across state lines,  no legislative text has been publicly released as of yet.

As such, there is little ability to assess at this time how such proposals will impact upon the millions of New Yorkers who have obtained coverage through the several new coverage expansion mechanisms established through the ACA, as well as the impact on the New York State Budget.  There are also questions regarding whether the significant health policy divisions within the House and Senate Republican conferences can be reconciled in such a way that a majority vote can be achieved in both houses.  With details on this enormously important issue still fluid, please remain alert for further updates.
(AUSTER)

Starting next Thursday, March 9,  MSSNY is Offering a 3 Hour CME Program on Pain Management.  NYS Requires Every Prescriber to take this 3 Hour Course By July 1, 2017
The Medical Society of the State of New York announces a series of three one-hour CME webinars on pain management, palliative care and addiction.  New York State statute requires all prescribers holding a DEA license to complete three hours of coursework no later than July 1st, 2017.   These webinars are being offered FREE OF CHARGE to MSSNY members with a discount code.  The discount code has been provided to MSSNY members.  Non-MSSNY members will be charged $150 for the series.

The Medical Society of the State of New York has worked with the New York State Office for Alcoholism and Substance Abuse Services in the development of this program.   Following the webinars, the course will be offered on-line on the MSSNY CME site.   The program will be offered to MSSNY members free of charge and there is a non-member fee of $150 for the on-line series.

The three webinars cover all issues required in the New York State statute and participation is only by computer, or with the Webex app.

Webinars will be held on:

Thursday, March 9, 2017—7:30-8:30am

Understanding the Current Legal Landscape in New York State for Prescribing Controlled Substances

Faculty: Patricia Bruckenthal, PhD, APRN-BS, FAAN & Trishia Allen, Esq.

Educational Objectives:

Understand New York State and Federal Requirements for Prescribing Controlled Substances

Discuss Guidelines for Chronic Pain

Register for this webinar here 

Tuesday, March 14, 2017—7:30-8:30am

Rational Opioid Prescribing for Chronic Pain Conditions

Faculty: Charles Argoff, MD & Patricia Bruckenthal, PhD, APRN-BS, FAAN

Educational Objectives:

Discuss evidence based best practice recommendations for opioid therapy for chronic pain, patient risk assessments and documentation

Describe palliative medical care and end-of-life care

Register for this webinar here 

Tuesday, March 21, 2017—7:30-8:30am

Patients with Opioid Use Disorders: Identification, Treatment, and Management of Co-occurring Pain

Faculty: Jeffrey Selzer, MD, Charles Morgan, MD & Frank Dowling, MD

Educational Objectives:

Describe the Potential for Addiction, Patient Screening, Diagnosis and Subsequent Treatment or Referral.

Recommend Tools to Assist in the Identification of High-Risk Patients for Whom Opioids are Indicated and Prescribed.

Describe Strategies for Treating Pain in Patients with Substance Use Disorders.

Register for this webinar here 

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

The Medical Society of the State of New York designates this live activity for a maximum of 1.0 AMA/PRA Category 1 credits™. Physicians should claim only the credit commensurate with the extent of their participation in the activity.

Additional information or assistance with registration may be obtained by contacting Pat Clancy at pclancy@mssny.org
(CLANCY)

AMA Expresses “Alarm” Regarding Possible Revival of Anthem-Cigna Merger with New Administration
The American Medical Association (AMA) wrote to Acting US Assistant Attorney General Brent Snyder this week to express its “alarm” regarding recent statements by Anthem, made in a Delaware Court, asserting that the company expects to close its merger transaction with CIGNA through “resolution with a new DOJ”.

MSSNY has shared the AMA letter with New York’s Attorney General Eric Schneiderman to urge that the New York AG continue to oppose the merger.  Connecticut AG George Jepsen issued a statement Wednesday indicating that his office would continue to oppose the merger.

As has been previously reported, on February 8, 2017, Judge Amy Berman Jackson issued a ruling blocking the proposed Anthem-Cigna merger from moving forward. The merger had been challenged by several patient advocacy and physician advocacy organizations including the AMA and MSSNY, as well as the Department of Justice and 11 state attorney generals because of the very significant market impact the mergers would have had in various regions across the country, and in New York. Last fall, MSSNY President Dr. Malcolm Reid and AMA representatives testified at a New York Department of Financial Services (DFS) hearing to express strong concerns with the proposed merger.

The AMA letter this week expresses great concern with the possibility that, despite the recent strong ruling, the merger could be revived because of a new Administration.  In particular, the letter referenced a statement by an Anthem attorney that “the company believes that its prospects for a timely closing are enhanced by a supportive Vice President Mike Pence.”  The letter goes on to state that it is “implausible that the U.S. Department of Justice (DOJ), eleven states, and the District of Columbia—that have diligently and successfully prosecuted this antitrust merger case—could now be swayed to allow this merger to close pursuant to politically-driven settlement negotiations as Anthem has suggested. To do so would cause irreparable harm to the integrity of the federal courts to adjudicate anticompetitive behavior in a fair and impartial manner, leaving consumers at risk.  We strongly believe that political influence should play no role in the enforcement of the antitrust laws and urge you to vigorously defend Judge Jackson’s ruling”.

Please remain alert for further updates on this issue.  To read the letter, click here.
(AUSTER)


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


Governor Cuomo Announces Action To Expand Cutting-Edge Breast Cancer Screening Options For Women
Governor Andrew Cuomo announced this week that health insurers are required under New York Insurance Law to provide medically necessary coverage for 3-D mammograms (tomosynthesis) without co-pays, coinsurance, or deductibles.   To read the press release, click here.  The Medical Society supported this initiative.

“We are undertaking the most aggressive action in the nation to expand access to breast cancer screenings, because early detection is the best possible treatment,” Governor Cuomo said“By expanding access to cutting-edge, life-saving breast cancer screening options, like 3D mammograms, we are taking our efforts to protect our mothers, sisters and daughters another step further. We will continue working to further remove barriers to breast cancer detection and treatment to create a stronger, healthier New York for all.”

The press release notes that that the action was part of continuing series of actions by the Governor to support women’s health and reproductive rights, including increasing access to breast cancer screenings and health insurance coverage that went into effect January 1, 2017; ensuring that all medically necessary abortion services are covered by health insurance policies without cost sharing; and ensuring that all women are covered by health insurance policies for contraceptives in amounts up to twelve month’s supply at a time without cost-sharing.
(AUSTER, CLANCY)

DFS Fines Oxford Health $1 Million For New York Insurance Law Violations
New York State Department of Financial Services Superintendent Maria Vullo announced this week that Oxford Health Plan has been fined $1 million by the Department of Financial Services (DFS) for improper payments to an unlicensed producer and for failing to respond to consumer grievances within required timeframes in violation of New York State Insurance Law. 

The press release noted that the violations were discovered through a “market conduct” examination by DFS looking at claims between 2009 and 2013.  Among the violations found were that Oxford failed to timely acknowledge insureds’ grievances and failed to send initial adverse determination notices as well as adverse appeal determination letters to insureds as mandated by New York Insurance Law.  Specifically, the press release noted that, in almost 1/3 of the cases sampled, Oxford failed to acknowledge consumer grievances within the required 15-day time frame; it also did not resolve grievance cases regarding referrals or benefit coverage within 30 days; and, in 44% of additional cases sampled, the company failed to issue initial adverse determination letters or adverse determination letters following an appeal within the 30 days mandated by law.  You can read the consent order here.                    (AUSTER) 

FDA Notice to Physicians
The FDA issued a notice to health professionals on the risks of buying drugs from unlicensed sources.  It reminded physicians that purchasing drugs from unlicensed sources (foreign or domestic) puts patients at risk of consuming drugs that may be unapproved, counterfeit, contaminated, or ineffective.  It also noted that medical practices should be aware that importing medications from foreign sources other than those authorized by the FDA is in violation of the Federal Food Drug and Cosmetic Act.

The FDA stated, “While the U.S. health care supply chain is one of the most secure and sophisticated in the world, there is a growing network of rogue wholesale drug distributors selling potentially unsafe drugs in the U.S. market.”   Since 2012, FDA has notified nearly 3,500 physicians that their drug purchasing practices may be illegal. DOJ has successfully prosecuted more than 95 corporations and individuals, including physicians, for criminal charges related to selling unapproved drug products, or receiving and administering unapproved drug products to patients. These criminal convictions have resulted in jail time and fines of millions of dollars.  The full notice may be viewed here.

In order to protect patients from unsafe or ineffective drugs, FDA advises health care providers to know the source for prescription drugs.  Additional information may be found on the FDA’s website.(BELMONT)    

NYS Department of Health Issues Blanket Waivers for Certain E-prescribing Requirements
The NYS Department of Health Commissioner of Health Howard Zucker, MD, JD issued a blanket waiver for certain electronic prescribing requirement.   The waiver replaces and supersedes the Commissioner March 26, 2017 waiver letter.  This letter has been sent to all practitioners and pharmacists in NYS.  The new waiver letter can be found here.

The following exceptional circumstances from the requirement of electronic prescribing include:

  1. any practitioner prescribing a controlled or non-controlled substance, containing two (2) or more products, which is compounded by a pharmacist;
  2. any practitioner prescribing a controlled or non-controlled substance to be compounded for the direct administration to a patient by parenteral, intravenous, intramuscular, subcutaneous or intraspinal infusion;
  3. any practitioner prescribing a controlled or non-controlled substance that contains long or complicated directions;
  4. any practitioner prescribing a controlled or non-controlled substance that requires a prescription to contain certain elements required by the federal Food and Drug Administration (FDA) that are not able to be accomplished with electronic prescribing;
  5. any practitioner prescribing a controlled or non-controlled substance under approved protocols for expedited partner therapy, collaborative drug management or comprehensive medication management, or in response to a public health emergency that would allow a non-patient specific prescription;
  6. any practitioner prescribing an opioid antagonist that would allow a non-patient specific prescription;
  7. any practitioner prescribing a controlled or non-controlled substance under a research protocol;
  8. a pharmacist dispensing controlled and non-controlled substance compounded prescriptions, prescriptions containing long or complicated directions, and prescriptions containing certain elements required by the FDA or any other governmental agency that are not able to be accomplished with electronic prescribing;
  9. a pharmacist dispensing prescriptions issued under a research protocol, or under approved protocols for expedited partner therapy, or for collaborative drug management or comprehensive medication management; and
  10. a pharmacist dispensing non-patient specific prescriptions, including opioid antagonists, or prescriptions issued in response to a declared public health emergency.

The letter also noted that waivers would be continued for the following situations in nursing homes and residential facilities:

  1. a practitioner prescribing a controlled or non-controlled substance either through an Official New York State Prescription form or an oral prescription communicated to a pharmacist serving as a vendor of pharmaceutical services, by an agent who is a health care practitioner, for patients in nursing homes and residential health care facilities as defined by PHL § 2801; and
  1. a pharmacist serving as a vendor of pharmaceutical services dispensing a controlled or non-controlled substance through an Official New York State Prescription form or an oral prescription communicated by an agent who is a

health care practitioner, for patients in nursing homes and residential health care facilities as defined by PHL § 2801.

The waiver is effective from March 26, 2017 until March 25, 2018.   For further information, please go to the DOH website here.           
(CLANCY)

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, March 15, 2017 at 7:30 a.m. with 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.  Registration is now open for this webinar here just click on “Upcoming”.

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.

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)


Commissioner’s Grand Rounds to be held on March 21, 2017 on “Baby Boomer Health”
NYS Department of Health Commissioner, Howard A. Zucker, MD, JD will host “Baby Boomer Health” on Tuesday, March 21 2017 at 7:30-9 a.m. at SUNY Upstate, Medical Alumni Auditorium, Weiskotten Hall, 766 Irving Avenue, Syracuse NY, 13210.   The intent of the program is to inform physicians and other providers of often undiagnosed conditions in baby boomers.

The presenter will be:  David Bernstein, MD, FAASLD, FACG, AGAF, FACP, Chief of Hepatology and Director, Sandra Atlas Bass Center for Liver Diseases, Northwell Health, Professor of Medicine, Hofstra-Northwell School of Medicine; Bob Morrow, MD Associate Clinical Professor-Department of Family and Social Medicine, Associate Director of Interventional CME-Center for CME Albert Einstein College of Medicine’ Sophia McIntyre, MD, MPH, MBA, FAAFP, CPE, Chief of Clinical Quality and Physician Leadership Development, Hudson River HealthCare, Inc..   The grand rounds program is free and advance registration is required for the live session and webinar.  A copy of the flyer and the link to register can be found here.

There will be CME credits awarded.  The Medical Society of the State of New York has partnered with the DOH to provide this program.                                                                                                                        (CLANCY)

CME Needs Assessment
The Continuing Medical Education (CME) Program of MSSNY strives to provide educational activities relevant to the practice of all recognized medical disciplines and include forums for public health, socio-economic, ethical, and legal issues related to the provision of quality healthcare.  In order to fulfill that goal, MSSNY’S office of CME is conducting a CME needs-assessment survey.  Physicians are encouraged to complete the survey here:

https://www.surveymonkey.com/r/MSSNYCME1

Questions about the survey or the MSSNY CME program may be directed to Miriam Hardin (mhardin@mssny.org or (518) 465-8085).                                                                                                                     (HARDIN) 

Register Now for Upcoming Veterans Matters CME Webinars
The Medical Society of the State of New York encourages you to register for its upcoming Veterans Matters webinars. These programs include CME presentations on PTSD and TBI in Returning Veterans.  Faculty for these programs is John McIntyre, MD. Registration for all of these programs is open.  Just click on either of the presentation dates below. 

Veterans’ Matters: PTSD and TBI

Friday, March 10 at 8 am

Tuesday, April 4 at 8 am

Faculty Presenter: John McIntyre, MD

The educational Objectives for the PTSD program are:

1) Describe the symptoms of PTSD and TBI.

2) Describe the treatment modalities of PTSD and TBI.

3) Describe military culture & how to overcome unique barriers to treatment intrinsic to military culture

Additional information or assistance with registration may be obtained by contacting Greg Elperin at gelperin@mssny.org.

Veterans Matters is a CME series made possible through a grant from the New York State Office of Mental Health.

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

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

AMA/Over 100 Societies Send Letter to CMS to Defer Mandatory EHR until 2019
On February 27, the AMA sent a letter to CMS and Office of the National Coodinator for Health Information (ONC), requesting a deferment from implementing certified electronic health record technology (CEHRT) until such technology is widely available and no sooner that January 2019. The letter cites that the CEHRT should remain voluntary because:

  • Mandating 2015 Edition CEHRT by 2018 jeopardizes success in the QPP and MY
  • A rush to certify products will result in broad hardship exemptions
  • Hasty deployment of CEHRT is counterproductive and threatens patient safety
  • 2015 Edition CEHRT should incorporate improvements to HER certification

The letter was delivered yesterday.  Over 100 state, national and specialty societies signed the letter, including MSSNY.

Albany Considers Compensation to Live Organ Donors For Expenses
Crain’s New York Business (2/23) reports the Living Donor Support Act “could make New York the first state in the country to directly compensate living organ donors…for lost wages, child care and other expenses.” The bill “has broad support from lawmakers” and has already unanimously passed the Senate Health Committee. Many state lawmakers and health care groups are rallying behind the cause because of some dire statistics.

New York ranks 50th in the United States for organ donation registration, according to LiveOn NY, the metropolitan region’s federally designated organ-procurement organization. While most organs are donated after a person’s death, increasing living donations is one way to address the acute shortage, advocates say.|

The proposed legislation would cost the state about $3 million per year, and donors would receive on average about $4,400 each, according to Waitlist Zero.

·        About 10,000 New Yorkers are awaiting an organ transplant, and about every 18 hours, a New Yorker dies waiting for a heart, lung, kidney or pancreas.
·        New York State is ranked last in the nation for the share of people registered as organ donors—just 28% versus a national average of about 50%, according to the latest data from LiveOnNY.
·        More than 8,000 await kidneys; over 1,300 need livers; and more than 300 need hearts.
·        Others also need pancreas (more than 100), lungs (over 50) and intestine (around 10).

·        Every 2½ hours, a person’s name is added to the New York State organ transplant waiting list.

Some Doctors Worried about Prosecution if They Prescribe Opioids
The Buffalo News http://buffalonews.com/2017/02/27/physicians-raise-alarm-criminalizing-efforts-treat-patients-pain/ carried a story about doctors who do prescribe painkillers are very worried about prosecution. Patients with chronic conditions complain that they cannot find a physician to help them. Six physicians in Erie and Niagara counties have been criminally prosecuted for illegally prescribing opioids in recent years. “We certainly have no problem with physicians being prosecuted if they have committed a true crime, said MSSNY Vice President Dr. Thomas Madejski.  “But to criminalize physicians in the practice of medicine is really a step in the wrong direction.”


 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



SUNY Albany Researchers Develop Cheaper, More Efficient Test for Ebola
The Albany Times Union http://bit.ly/2mf4KVn (2/28) reports Mehmet Yigit, a SUNY Albany assistant chemistry professor, has developed a method of detecting the Ebola virus by sampling patient urine or saliva. His “cheaper and more efficient” methods “could prove crucial for combating Ebola” as well as for detecting the Zika virus. The article points out that samples of the Zika virus “are largely inaccessible for researchers not funded by the National Institutes of Health.”

WHO Lists 12 Bacteria that Pose Greatest Threat to Human Health
The World Health Organization has listed 12 families of bacteria that “pose the greatest threat to human health” because of resistance to antibiotics. The group hopes the list will guide research into and development of new treatments.

These three carbapenem-resistant bacteria earned highest priority (critical) based on their threat to patients in hospitals, those in nursing homes, and those reliant on ventilators and blood catheters:

  • Acinetobacter baumannii
  • Pseudomonas aeruginosa
  • Extended-spectrum beta-lactamase-producingEnterobacteriaceae

The second priority tier (high) includes:

  • Enterococcus faeciumresistant to vancomycin
  • Staphylococcus aureusresistant to methicillin and vancomycin
  • Helicobacter pyloriresistant to clarithromycin
  • Campylobacterspecies resistant to fluoroquinolone
  • Salmonellaeresistant to fluoroquinolone
  • Neisseria gonorrhoeaeresistant to cephalosporin and fluoroquinolone

The third priority group (medium) includes:

  • Streptococcus pneumoniaenot susceptible to penicillin
  • Haemophilus influenzaeresistant to ampicillin
  • Shigellaspecies resistant to fluoroquinolone

WHO news release

JAMA Pediatrics: Parents Notice Errors/Reactions Not Documented in Records
JAMA Pediatrics published a study that found parents of hospitalized children noticed “medical errors and bad reactions to treatment that aren’t documented in their children’s hospital records.” The study found overall error rates were “nearly 16 percent higher with family reporting than without, “while overall rates of adverse events were nearly 10 percent higher with family reporting.” The report states “family-reported error rates were five-fold higher than hospital incident rates, and adverse event rates reported by families were nearly three-fold higher.”

Study: Colon and Colorectal Cancers Increases in Millennials and Gen X Adults
Research published in the Journal of the National Cancer Institute https://academic.oup.com/jnci/article/3053481/Colorectal indicates “colon and rectal cancers have increased dramatically and steadily in millennials and Generation X adults in the United States over the past four decades.” Investigators found that “rates of rectal cancer are increasing by about 3 percent a year in 20- and 30-somethings, and by 2 percent a year among the 40- to 54-year-old age group.” Meanwhile, “colon cancer rates are rising by smaller amounts in those age groups.”

Rebecca Siegel, who led the study, “suggested one explanation might be a complex interaction involving the same factors that have contributed to the obesity epidemic — changes in diet, a sedentary lifestyle, excess weight and low fiber consumption.”


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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.

Physician Opportunities

Ophthalmologist Part Time
Ophthalmologist needed to work at multiple nursing homes in all 5 boros except Staten Island. Part time or full-time position available.  Generous salary and incentives.Ttech provided. Opportunity to perform surgery, but not required. Please email cv to privacyssw@gmail.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.

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

Council – March 7, 2017

AGENDA
Council Meeting
Tuesday, March 7, 2017 at 1:00 p.m.
Renaissance Albany Hotel
144 State Street
Albany, NY  12205
518-992-2500

A.Call to Order and Roll Call

B.Approval of the Council Minutes of January 19, 2017

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

      1. President’s Report
        a.  Action Item – Request to Reconsider MSSNY Physician Stress  &  Burnout Task  Force Report – To be presented by Maria A. Basile, MD, MBA
      2. Board of Trustees Report  – Dr. Leah McCormack will present the report (handout)
      3. Secretary’s ReportDr. Fougner will present the report
      4. MLMIC Update  – Mr. Fager will present a verbal report (via phone)
      5.  AMA Delegation Update -Dr. John Kennedy will present a verbal report
      6.  MSSNYPAC Report – Dr. Joseph Sellers will present the report
      7. Commissioners  (Action Items)
        (No reports submitted)
      8. Councilors (All Action Items from County Societies and District Branches)
        (No reports submitted)

D. Reports of Officers (Informational)

  1.   Office of the President – Malcolm D. Reid, MD, MPP –  Meetings Attended:
    • Meeting w/ Mike Borden, NYS Podiatric Association
    • 3rd & 4th District Retreat @ Mirror Lake Inn
    • MLMIC Executive Committee
    • YPS, RFS & Student meeting
    • Retirement Party for Stu Friedman
    • Black/Hispanic Dinner Caucus
    • Mitchell Wealth Care Annual Dinner
  2.      Office of the President Elect – Charles Rothberg, MD
  3.      Office of the Vice President – Thomas J. Madejski, MD
  4.      Office of the Treasurer – Joseph R. Sellers, MD, Financial
    Statement for the  period 1/1/16 – 12/31/16
  5.  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
                      (No written report submitted)

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
                       (No written report submitted)
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
(No written report submitted)
   
12. Ninth District Branch Report – Thomas T. Lee, MD
13. Medical Student Section Report
  Christina Kratschmer 
14. Organized Medical Staff Section Report –
   Richard A. Ritter, MD  (No written report submitted)
             15. Resident & Fellow Section Report
  Robert A. Viviano, DO (No written report submitted)
16. Young Physician Section Report – L. Carlos Zapata, MD
  (No written report submitted)
                     

F. Presentations

      1.  SHIN-NY Presentation – Presented by Valerie Grey, Executive Director  New York e-Health Collaborative (NYeC)
      1.  DSRIP Presentation – Presented by Douglas G. Fish, MD, Medical Director,  Division of Program Development & Management New York State Department of Health

G. Commissioners (Committee Informational Reports/Minutes)

      1. Commissioner of Communications,
        Joshua M. Cohen, MD, MPH
        a. Report from the Division of Communications
      1.  Commissioner of Science & Public Health,
        Frank G. Dowling, MD
        a.  Long Term Care Subcommittee Minutes, January 11, 2017
        b. Quality Improvement & Patient Safety Minutes, January 11, 2017
      1. Commissioner of Governmental Relations,
        Gregory Pinto, MD
        a. MSSNY-HCA Task Force Minutes, January 13, 2017
        b. MSSNY-HCA Task Force Minutes, February 24, 2017
        c. Report from the Division of Governmental Affairs

HReport of the Executive Vice President, Philip Schuh, CPA, MS
      1. Membership Dues Revenue Schedule
2. Group/Institution Membership Revenue Schedule

I. Report of the General Counsel,
    Donald Moy, Esq. & David Vozza, Esq.
    1. Report of the General Counsel (verbal report)

J. Report of the Alliance, Barbara Ellman, Co-President
    1. Alliance Report

K.  Other Information/Announcements

  1.      Federation Health Reform Notes
  2.      National Restaurant Association (NRA) vs. DOH
    Sodium Warning Rule
  3.       CEHRT Sign On Letter

L.  Adjournment