April 28, 2017 – Success Requires Action!


PRESIDENT’S MESSAGE
Dr. Charles Rothberg
April 28, 2017
Volume 17
Number 16

MLMIC Insurance

Dear Colleagues:

In my view, success for physicians is well within MSSNY’s grasp. But that success won’t come easy.  And success will not result from inaction.  Nor will it result from being too risk averse.

  • We’ll need to work to advocate on behalf our doctors to provide legislative relief, regulatory relief, and administrative simplification.
  • We’ll need to advocate for them and help them to more effectively represent themselves in an ever changing practice environment – more often in the role of employee in a changing workforce.

I am well aware that I have just a one-year term to implement some ideas that I believe are critical going forward.  I intend to build upon the strong foundation provided by my predecessor, Dr. Malcolm Reid, and I expect to provide a bridge to the leadership of president elect Dr. Tom Madejski.  I introduce Three Pillars that make up my platform:

  • Wellness
  • Disparities
  • Engagement

Wellness
The term “burnout” has become so overused that it risks losing much of its meaning. We learned at a CME program at this year’s HOD and through our Task Force report that it is institutional factors that contribute to ‘burnout’— NOT defective doctors.  Yes, they are exhausted— from the hamster wheel of insurance authorizations, rejections and unfair remuneration for work that has been signed, sealed and delivered.  What is MSSNY doing to alleviate the problem?

MSSNY is currently working on early intervention programs. We must change our focus from intervention to one that places greater emphasis on prevention. We should refer to “Physician Wellness” which is suggestive of the remedy, rather than “burnout,” which refers solely to the symptom.

Engagement
If we want to survive as a viable society, we must engage NOT ONLY our members, but also non-members, students, health care stakeholders, and the press. If we do not engage, we undermine our own authority. The balance is tricky. When the press asks us for statements, we have to speak decisively, thoughtfully, unambiguously and without timidity. To do so we need to have strong policy positions and abundant discourse on which to rely.  We need to engage by means of all kinds of media – conventional, social media, face to face.  Please do not groan when I sincerely encourage you to sign up for twitter. You might enjoy it! Follow me @MSSNYRothberg and MSSNY@mssnytweet.

Engagement for MSSNY will involve much more than compelling policy, advocacy and effective messaging. It must involve enrichment as well.  However, expanding existing programs such as our CME, our advocacy, newsletters, and especially programs modeled on our successful leadership seminars which engaged over 100 physicians in programs both downstate and in central New York.

Disparities
We have developed an overly narrow view of disparities – a narrow view that I believe we have outgrown.  Going forward, our solutions must extend beyond just the ethnic. The future must include ALL contributors to adverse health outcomes— gender, LGBTQ, geography, poverty, age and even physician diversity. We need to look beyond how we traditionally view diversity. There are lots of people out there who don’t want to fit a mold. But they do want to feel free to be themselves. They look to us for understanding, not necessarily for advice.

As we are coming to understand, patients with gender identity issues have hated going to the doctor, any doctor. They were afraid, because they thought they might be judged. The people who have been outliers have stepped forward and we should walk beside them and learn how to better treat them in our offices. The objective of the three pillars I have outlined is to chart a path to the future. Other stakeholders are certainly positioning themselves to fill any voids – WE SEE HOW THAT IS WORKING OUT!  We must not allow voids, and where they exist, WE must fill them.

Now that we know better, we must listen better; then we will do better.

Addendum
A matter that was discussed at the House that is receiving some attention is our decision to develop an unbiased survey through the Bioethics Committee regarding MSSNY’s members’ attitude towards aid-to-the-dying. For now, our policy remains that “physicians should not assist in suicide.”

Results of this survey will be conveyed to the 2018 House of Delegates.

Sincerely,
Charles Rothberg, MD
MSSNY President

Please send your comments to comments@mssny.org



Appeals Court Blocks Proposed Anthem-Cigna Merger
In a landmark victory for patients and physicians, a federal appeals court upheld the lower-court ruling that blocked the proposed mega-merger between health insurance giants Cigna and Anthem (the parent of Empire Blue Cross/Blue Shield).   MSSNY worked together with the AMA and several other state medical associations to oppose this proposed merger.  Last fall, then-MSSNY President Dr. Malcolm Reid testified at a public hearing hosted by the New York Department of Financial Services examining this proposed merger.

Dr. Reid’s testimony emphasized the already very difficult practice environment for physicians in New York State that has become worse in recent years, in part the result of the narrowing of health insurer participating provider networks and increasing pre-authorization burdens, problems which undoubtedly would be made worse had this merger been permitted to move forward.  Indeed, DFS Superintendent Maria Vullo issued a letter that highlighted concerns with the significant market impact the merger would have had if approved.

New York Attorney General Eric Schneiderman, who had joined several AGs across the country in litigation to oppose the proposed merger, issued a statement praising the Appeal’s court’s ruling:

“Today’s decision is a win for consumers in New York and across the country.  We are very pleased that the Court of Appeals agreed with the District Court’s finding that this merger would violate antitrust laws by substantially lessening competition in commercial health insurance markets, likely leading to increased health insurance premiums and reduced quality and innovation.  I again thank my federal and state partners for their work to protect patients and ensure that competition in the health insurance industry remains vibrant across the country.”

To read more click here.                                                                                                      (AUSTER)

Last Weeks of Legislative Session Present Opportunities and Challenges
The legislature returned to session this past Monday after two weeks off following the passage of the state budget.  The last scheduled session day is June 21st. Issues for state lawmakers to address in the remaining weeks of session could include New York City Mayoral control, ethics reform and various MSSNY supported/opposed bills detailed below.   Stay tuned for future emails and go to MSSNY’s website for updates when actions are needed on our priority legislation.

One bill supported by MSSNY, S.3943 (Hannon), was moved through the Senate Health committee this week and has passed the Assembly (see related article).  This bill would provide physicians and other health care practitioners with necessary due process protections where health insurers seek to terminate a physician from its network by failing to renew the physician’s contract.

MSSNY is also working together with several specialty societies to reduce administrative hassles by advancing legislation that would enact several components of the AMA’s Prior Authorization Principles (click here), including:

  • Assuring that a practitioner of the same or similar specialty review health care pre-authorization request on behalf of a health plan before treatment is denied;
  • Require health plan utilization review criteria to be evidence-based and peer reviewed ;
  • Reduce the time frame for reviewing prior authorization requests from 3 business days to 48 hours (and to 24 hours for urgent situations)
  • Assure that a prior authorization, once given, is enduring for the duration of the medication or treatment.
  • Prohibit mid-year prescription formulary changes; and
  • Assure that once a prior authorization is given, it cannot be withdrawn if eligibility is confirmed on the day of the service.

Among the Many Other Bills MSSNY is fighting to achieve:

  • Collective Negotiations (4472, Gottfried /S.3663,Hannon) – would allow independently practicing physicians to collectively negotiate patient care terms with market dominant health insurers under close state supervision.  To send a letter to your legislators click here.
  • Changes Definition of Clinical Peer Reviewer (2539,Gottfried) – Would assure that a physician of the same or similar specialty review health care recommendations on behalf of a health plan before treatment recommendations are denied
  • Improving the Medical Liability Landscape in New York State (4913, Schimminger) – would implement a number of important reforms to the medical liability adjudication system to reduce the exorbitant cost of medical liability insurance.
  • Protecting the Peer-Review Process (2460 Gottfried / S.3661 Hannon) – Would extend the confidentiality provisions relating to discovery of testimony to apply to statements made by any person in attendance at peer-review committee that is a party to an action the subject matter of which was reviewed at such meeting.
  • Raising the purchase age of tobacco products to 21 and regulate e-cigarettes under the Clean Indoor Air Act.

Among the many Bills MSSNY is opposing:

  • Expanding the Medical Liability Lawsuits (3339/S.4080) – would substantially lengthen the statute of limitations for medical malpractice actions and lead to enormous increases in the cost of liability insurance for physicians and hospitals.  If enacted this bill could increase your liability premiums by 15%.  Please send a letter in opposition click here.
  • Expansion of Medical Liability Damages (411/A.1386) – would greatly expand the categories of damages which a plaintiff may recover in a wrongful death action.  Actuarial studies have predicted that this bill could increase liability premiums by over 50%.
  • Prohibiting Ex-Parte Interviews of Plaintiff’s Treating Physician (243/A.1404) – would prohibit a physician’s defense counsel in a medical liability action from conducting an interview with the plaintiff’s treating physician. This bill would present significant issues for physicians in a medical liability action by limiting the opportunity to fully examine the plaintiff’s health condition to evaluate the merit of the plaintiff’s claim.
  • Retail Clinics (A958) – would permit corporate owned “retail clinics” in big box stores
  • Certification of Certified Registered Nurse Anesthetists (CRNAs) (A.442/S.1385) – would provide for the certification by the education department of certified registered nurse anesthetists (CRNAs).  This bill fails to define a scope of practice consistent with existing New York State standards.  Under NYS Health Code (10 NYCRR 700.2), CRNAs are already required to register with the NYS Education Department and are prohibited from practicing nurse anesthesia without meeting specific education and testing requirements.
  • Podiatric scope of practice (1880/ S.4734) – would expand the scope of practice of podiatrists to allow podiatrists to “diagnose, treat, operate or prescribe for cutaneous conditions of the ankle to the level of the distal tibial tuberocity” (knee).(DIVISION OF GOVERNMENTAL AFFAIRS)

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


Legislation to Repeal Significant Portions of the ACA Could Be Back Before Congress; MSSNY Joins Several Other Organizations to Express Concerns
Multiple media outlets reported this week that the members of House Freedom Caucus agreed to support the American Health Care Act (AHCA) if it incorporated amendments that would permit states to modify specific ACA requirements, including age rating bands, essential health benefits, and continuous coverage incentives.  The amendment was the result of ongoing discussions between Representative Tom MacArthur (R-NJ), co-Chair of the centrist “Tuesday Group” and the House Freedom Caucus.

The AHCA was pulled from Congressional consideration in late March because it had insufficient “yes” votes, including lack of support from the Freedom Caucus.  However, as of this writing it is not known whether this amendment to the AHCA legislation will now produce a majority to support the legislation, or whether it could also pass the US Senate.

This week, MSSNY joined with nearly two dozen patient advocacy organizations in a letter to New York’s Congressional delegation that noted that “while the Affordable Care Act (ACA) can be improved, replacing it with the AHCA would have significant adverse consequences to millions of New Yorkers”  Instead, the letter urged that New York’s Congressional Delegation fight to: “Ensure uninterrupted healthcare coverage for the 24 million Americans, including the 850,000 New Yorkers who gained coverage under the ACA; Do not harm New York State’s budget and do not shortchange New York’s Medicaid program; and Protect the more than 600,000 New Yorkers who gained coverage under the Essential plan.”

The AMA sent a letter to Congressional leaders noting that “Nothing in the MacArthur amendment remedies the shortcomings of the underlying bill” and that the AMA remains “deeply concerned that the AHCA would result in millions of Americans losing their current health insurance coverage”.  It is urging physicians to send a letter in opposition to their legislators here: click here.

As has been previously reported, the AHCA would keep some of the popular provisions from the ACA, such as required coverage for pre-existing conditions, 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 for several years implementation of the “Cadillac Tax” on comprehensive health insurance coverage.

However, it 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 insurance coverage with little cost-sharing responsibilities for those who make between 138% -200% FPL.

The bill would also 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.

Please remain alert for further updates.
(AUSTER)

MSSNY Supports Legislation That Would Raise The Purchasing Age For Tobacco And Restrict E-Cigarettes
The New York State Senate Health Committee advanced two smoking related pieces of legislation this week.  S.3978/A.273 would increase the purchasing age for tobacco products from eighteen to 21 years of age and S.2543/A.516 would include the use of electronic cigarettes or e-cigarettes under the Clean Indoor Air Act.  The Medical Society of the State of New York strongly supports both these measures.  In its statement of support, MSSNY indicated that the best way to reduce the number of people who are addicted to tobacco is to prevent them from starting to smoke.  Addiction to tobacco products occurs relatively quickly once someone begins to smoke.  Once someone becomes addicted to tobacco it is very difficult to quit.  Data suggest the earlier the onset of smoking, the more severe the addiction is likely to be and 90% of all smokers begin before age 20.  Each day, 6,000 children under 18 years of age smoke their first cigarette.

Children most often try their first cigarette with a friend or peer who already smokes.  This bill aims at reducing the number of people who smoke by raising the age requirement to 21. E-cigarettes are not currently defined as a “tobacco product” under the New York S tax law, retailers that sell e-cigarettes do not need a tobacco registration from the Department of Taxation and Finance.

This opens a loophole for retailers to sell e-cigarettes, even if they are not registered and do not sell traditional tobacco products.  Since there is no registration requirement, there is no way for the Department of Health’s Enforcement Unit to know that they are selling e-cigarettes or conduct compliance checks to ensure that they are not selling to minors. This bill will further require that they register if they sell e-cigarettes. The Medical Society of the State of New York strongly supports both these measures and urges physicians to contact their legislators and urge their support for both bills.  Physicians can send a letter to their legislators by clicking on the link: click here.
(HARRING, CLANCY)                                                 

Legislation Advances to Assure Peer Review Prior to Health Plan Contract Non-Renewal
Legislation (S.3943, Hannon) to assure that a physician has a right to a hearing before their clinical peers before their participation contract with a health insurance company can be non-renewed was reported unanimously from the Senate Health Committee to the Senate floor this week.

MSSNY supports this legislation.  Identical legislation (A.2704, Lavine) recently passed the Assembly.  The purpose of the bill is to address a gap in current law that prohibits a health insurance company from terminating a physician’s contract with a health plan without a written explanation of the reasons for the proposed contract termination and an opportunity for a hearing before clinical peers, but does not apply those rights to situations where the physician’s contract is not renewed.

There have been instances in the last few years where certain health insurance companies have dropped significant numbers of physicians from their networks without providing any recourse to these physicians to challenge these non-renewals.  This legislation would provide important protections to better assure the continuity of the physician-patient treatment relationship.  Physicians can send a letter to their Senator in support of this legislation here (click here).
(AUSTER)

MSSNY Joins Other Advocacy Organizations to Continue Federal Support for Subsidized Health Insurance Coverage for those below 250% FPL
MSSNY joined several other health care, patient and employer organizations in a press statement (Click here ) this week that encouraged Congress and President Trump to ensure continued funding for health insurance cost-sharing reductions (CSRs) currently provided under the Affordable Care Act, as Congress was negotiating a continuing Budget resolution to prevent a government shutdown.

In particular, the press release highlighted that more than 700,000 New Yorkers benefit from these CSR funds, including those who are enrolled in the State’s Essential Plan (for those earn less than 200% of the FPL), as well as those who earn between 200-250% FPL who receive health insurance coverage through New York’s Health Insurance Exchange.   These subsidized health insurance coverage options could be lost if these CSR subsidies were not continued.  It was reported in several media outlets on Wednesday that the new administration intends to continue to make these subsidy payments (click here)
(AUSTER)

Register Now For Upcoming Medical Matters 2017 CME Webinar Series
Registration is now open for the next Medical Matters webinar on Wednesday, May 7, 2017 at 7:30 a.m.  “Exercise Response to Novel Influenza Strains” will be conducted by Pat Anders, MS, MEP, Manager, Health Emergency Preparedness Exercises, New York State Department of Health, Office of Health Emergency Preparedness.  Registration is now available at this link.

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) 

NYS DOH Announce Free Buprenorphine Training Across New York State
The NYSDOH AIDS Institute announces a Free Buprenorphine Waiver Training for Clinical Providers in various locations throughout the state.  Attached are flyers with further information, including location, online registration and pre-requisite training.  The NYSDOH trainings will be in Monticello (May 6th) click here , Plattsburgh (May 20th) click here, Ithaca (June 3rd)  click here. 

The New York City Department of Health and Mental Hygiene conducts free buprenorphine waiver trainings as well throughout all five boroughs.  For further information, please contact them at buprenorphine@health.nyc.gov. For more information about all upcoming MAT trainings, please visit www.pcssmat.org/mat-basics/mat-waiver-training/.  Should you have any questions, please do not hesitate to contact the department at 1-800-692-8528 or buprenorphine@health.ny.gov. Space is limited to 40 individuals and will fill up so please register fast!
(CLANCY)

LAST CHANCE TO REGISTER:  Please Join our Running/Walking Team for the CDPHP Workforce Team Challenge
Please join us on May 18th!  MSSNY will be a premium sponsor of the 2017 CDPHP Workforce Team Challenge, a 3.5-mile race for runners and walkers, taking place in Albany on May 18, 2017.  MSSNY members and alliance members are highly encouraged to join with us to participate, either as a runner or a walker.

MSSNY’s sponsorship of the event is part of an ongoing effort to have a visible presence at health-related public events.    As a premium sponsor, MSSNY’s logo will be featured on the official race t-shirt, and MSSNY will be recognized during the race announcements.  In addition, MSSNY will have an exhibit table on Empire State Plaza.

Registration for this event closes May 1, 2017, OR when the cap of 10,000 registrants is reached.  As of today, Friday, April 28, 2017, at 10:00 AM, 9,200 people had already registered.  Please do not wait! 

The race begins at 6:25 PM, at Empire State Plaza, and features a scenic route that traverses Albany’s Washington Park.  The popular event always attracts great crowd support and on-course entertainment.  Sawyer Fredericks, winner of the eighth season of The Voice, will be singing the National Anthem.

Instructions and registration link are available  here.  Please choose “Medical Society of the State of New York” from the team drop-down list.  Registration is $24, and a portion of the registration fees go to this year’s “Charities of Choice,” Boys and Girls Club of Albany and Vanderheyden.   A flyer may be accessed here.  For more information, please contact Miriam Hardin (mhardin@mssny.org).   (HARDIN)

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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Clinicians: MIPS Participation Status Letter
CMS is reviewing claims and letting practices know which clinicians need to take part in the Merit-based Incentive Payment System (MIPS), an important part of the new Quality Payment Program (QPP). In late April through May, you will get a letter from your Medicare Administrative Contractor that processes Medicare Part B claims, providing the participation status of each MIPS clinician associated with your Taxpayer Identification Number (TIN).

Clinicians should participate in MIPS in the 2017 transition year if they:

  • Bill more than $30,000 in Medicare Part B allowed charges a year and
  • Provide care for more than 100 Part B-enrolled Medicare beneficiaries a year

QPP intends to shift reimbursement from the volume of services provided toward a payment system that rewards clinicians for their overall work in delivering the best care for patients. It replaces the Sustainable Growth Rate formula and streamlines the “Legacy Programs” – Physician Quality Reporting System, the Value-based Payment Modifier, and the Medicare Electronic Health Records Incentive Program. During this first year of the program, CMS is committed to working with you to streamline the process as much as possible. Our goal is to further reduce burdensome requirements so that you can deliver the best possible care to patients. Learn more about the Quality Payment Program.

A MSSNY House United Can Never Be Defeated
One of the important messages that came out of the MSSNY’s Annual House of Delegate’s meeting was the powerful force we can play in the legislative process when physicians are united.  While physicians may have differing views on key health issues, it was again demonstrated that respectful dialogue and discussions lead to a productive MSSNY agenda.  The House of Delegate’s meeting has concluded but a lot of work still has to be done.  Various speakers highlighted the importance of contacting your legislators and the role of MSSNYPAC.   We have a lot of work ahead, but if all physicians engage in advocacy and the political process, there is much we can accomplish.  Please join us in these efforts.
(Belmont)

Upcoming Veterans Health Care Conference in LI: CME for Primary Care Physicians
MSSNY, the New York State Psychiatric Association, and the National Association of Social Workers New York State Chapter are hosting a two-day conference on Long Island on Friday, May 5 and Saturday, May 6, 2017 at the Clarion Hotel & Conference Center, located at 3845 E Veterans Memorial Hwy, Ronkonkoma, NY 11779.

The conference will consist of interactive seminars and panel discussions focusing on the current and evolving healthcare needs of veterans.The training section is fully subscribed. However, physicians can still attend the conference.,/span>

There is no cost, but separate registration is required for both the trainings and conference. The presentation is part of Veterans Mental Health Training Initiative, which is supported by a grant provided by the New York State Legislature and administered through 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

Further information or for assistance in registering for these programs, contact Greg Elperin at gelperin@mssny.org

MLMIC Releases New Risk Management CME Program
As part of MLMIC’s ongoing commitment to help physicians and other healthcare practitioners improve the quality of patient care and reduce potential liability exposure in their practices, a new online risk management CME program, Proactive Risk Management Follow-Up Program VII (Follow-Up VII), has been developed for its policyholders and is now available at policyholders’ secure login at MLMIC.com.

The topics covered in this program include:

  • the benefits as well as the associated liability risks of using electronic health records (EHRs) in the office practice
  • the proper use of EHR features and the use of EHR data in litigation
  • the key factors considered by plaintiffs’ attorneys when evaluating a potential malpractice claim
  • the areas of risk commonly identified in high exposure liability cases
  • follow-up procedures in the office practice and the liability risks of patient noncompliance
  • recent trends in pediatric claims and the main areas of liability risk in the treatment of pediatric patients

In addition to its educational value, physicians can earn CME credits, ABIM and ABP MOC credits (if appropriate), the applicable premium credit (5%, VAP or ECPIP) and eligibility to participate in the NYS excess medical malpractice insurance program (Section 18 professional liability coverage).  To view the program now, click here to log in.

Should you have any questions regarding this program, please do not hesitate to contact MLMIC’s Risk Management Department at (212) 576-9601, from 9 a.m. – 4:45 p.m., Monday through Friday.


41.6% of Heart Attack Patients Not Taking Meds after Two Years
study in JAMA Cardiology analyzed data on 29,932 Medicare patients ages 66 to 75 who had been hospitalized for a heart attack from 2007 through 2012 and had filled a prescription for either Lipitor or Crestor.

At six months after their discharge from the hospital, 58.9 percent of them were still taking the medicine with high adherence rates. By two years, only 41.6 percent were taking it as directed; many were taking lower dosages than prescribed, and nearly one in five had stopped taking the medicine completely.

The senior author, Dr. Robert S. Rosenson, a professor of medicine at the Icahn School of Medicine at Mt. Sinai, said that failing to take the medicine properly results in greater risk for heart attack, stroke and unstable angina.

“Health care providers have an obligation to educate the patient,” he said. “We need to stress the evidence that supports the therapy. People who continue the medicine have progressively fewer adverse outcomes over time. Once you have a heart attack, this is prevention for the rest of your life.”


MSSNYPAC – The Political Voice of New York’s Physicians
MSSNYPAC Medical Society of New York
More than 100 MSSNYPAC-supporting physicians participated in our Physician Advocacy Roundtable held in Westchester last Friday during MSSNY’s annual House of Delegates meeting.  Senator Terrence Murphy, Assemblyman Andrew Raia, Nassau-Suffolk Hospital Council Chair Kevin Dahill and AMA Trustee Barbara McAneny, MD discussed the importance of physician participation in the development of health care policies affecting the communities we serve, such as implications of a potential ACA repeal, and response to the opioid and heroin addiction epidemic.  To support our work, please join MSSNYPAC at www.mssnypac.org/contributeMSSNYPAC is a force for change in healthcare delivery. 

Malaria May Be More Common In US Than Previously Reported, Study Suggests
The New York Times (4/25) reports in “Global Health” that malaria may be more common in the US than previously reported, according to a new study published in The American Journal of Tropical Medicine and Hygiene. After analyzing hospital discharge records in the Agency for Healthcare Research and Quality’s National Inpatient Sample, researchers concluded there were at least 2,100 cases of malaria each year in the US between 2000 and 2014. The article also points out that the Centers for Disease Control and Prevention estimates that there are around 1,500 to 2,000 cases of malaria each year.

Illegal Cancer Treatments: FDA Warning – Fraudulent Claims of Diagnosis, Treatment, Prevention or Cure
FDA issued warning letters addressed to 14 U.S.-based companies illegally selling more than 65 products that fraudulently claim to prevent, diagnose, treat or cure cancer.

It is a violation of the Federal Food, Drug and Cosmetic Act to market and sell products that claim to prevent, diagnose, treat, mitigate or cure diseases without first demonstrating to the FDA that they are safe and effective for their labeled uses. The illegally sold products cited in the warning letters include a variety of product types, such as pills, topical creams, ointments, oils, drops, syrups, teas and diagnostics (such as thermography devices).

They include products marketed for use by humans or pets that make illegal, unproven claims regarding preventing, reversing or curing cancer, killing/inhibiting cancer cells or tumors, or other similar anti-cancer claims. See the list of illegally sold cancer treatments.

The products are marketed and sold without FDA approval, most commonly on websites and social media platforms. Healthcare professionals and patients are encouraged to report adverse events or side effects related to the use of these products to the FDA’s MedWatch Safety Information and Adverse Event Reporting Program:

  • Complete and submit the report Online: www.fda.gov/MedWatch/report
  • Download form or call 1-800-332-1088 to request a reporting form, then complete and return to the address on the pre-addressed form, or submit by fax to 1-800-FDA-0178 


Do You Want to Comment on Role of Physician-Owned Hospitals?The Fiscal Year (FY) 2018 Hospital Inpatient Prospective Payment System proposed rule released by the Centers for Medicare and Medicaid Services (CMS) on April 14 asks the public to comment on the appropriate role of physician-owned hospitals in the nation’s health care delivery system.  Specifically, the proposed regulation asks about the impact that CMS regulations and the statutory restrictions on these facilities have had on health care delivery and on Medicare beneficiaries.

While there have been longstanding restrictions on physician hospital ownership under the Stark self-referral regulations, these restrictions were tightened with passage of the Affordable Care Act (ACA), which essentially banned the construction of new facilities and placed restrictions on the expansion of already existing physician-owned hospitals.

Representative Sam Johnson (R-TX) recently re-introduced H.R. 1156, the “Patient Access to Higher Quality Health Care Act of 2017,” which would repeal the ACA limits on physician-owned hospitals and allow these facilities to remain competitive.  The legislation is supported by the American Medical Association.

Physician-owned hospitals provide high-quality care and contribute to a competitive health care marketplace.  If allowed to compete on a level playing field, they may play an important role in enhanced care coordination as well as new health care delivery models.

Physicians are encouraged to submit comments to CMS electronically, following the instructions under the “comment now” button, before 5:00 pm ET on June 13, 2017. 

Doctors’ Visas: Bronx Lebanon Filed 213 Applications in 2016
Bronx-Lebanon Hospital Center filed 213 applications for H-1B visas in 2016, second only to Michigan’s William Beaumont Hospital, according to a study published in JAMA last week and reported on by Kaiser Health News. Employers in New York, Michigan and Illinois submitted the most H-1B applications for foreign physicians, causing concern amid President Donald Trump’s call for a review of the visa program. The H-1B visa program allows employers to hire highly skilled professionals from abroad to fill employment gaps in the U.S., typically in high-tech, science, engineering and math jobs. But hospitals use the program as well, often to recruit doctors to serve in rural or underserved urban areas. The number of visas is capped at 85,000 annually.

Review Your Open Payments Data Before it Becomes Available to the Public
CMS will publish the Open Payments Program Year 2016 data and updates to the 2013, 2014, and 2015 program years on June 30, 2017.
Review and dispute for the Program Year 2016 Open Payments data publication began on Saturday, April 1, 2017 and will last until May 15, 2017. Physicians and teaching hospitals must initiate their disputes during this 45-day review period in order for any disputes to be addressed before the June 30th publication.
Physician and teaching hospital review of the data is voluntary, but strongly encouraged. While the opportunity for physicians and teaching hospitals to dispute any data associated with them expires at the end of the calendar year in which the record is published, the disputes must be initiated during this 45-day review and dispute period, ending on May 15th, in order to be reflected in the June 30th publication.

If you have never registered with Open Payments before:
Make sure you have your National Provider Identifier (NPI) number, and State License Number (SLN). Initial registration is a two-step process and should take approximately 30 minutes:

  1. Register in the CMS Enterprise Identity Management System (EIDM);
  2. Register in the Open Payments system

For users that registered last year and have used their accounts in the last 60 days:
Physicians and teaching hospitals who registered last year do not need to reregister in the EIDM or the Open Payments system. If the account has been accessed within the last 60 days, go to the CMS Enterprise Portal, log in using your user ID and password, and navigate to the Open Payments system home page.

For users that registered last year but have been inactive for more than 60 days:
The EIDM locks accounts if there is no activity for 60 days or more. To unlock an account, go to the CMS Enterprise Portal, enter your user ID and correctly answer all challenge questions; you’ll then be prompted to enter a new password.

For users that registered last year but have been inactive for more than 180 days:
The EIDM deactivates accounts if there is no activity for 180 days or more. To reinstate an account that has been deactivated, contact the Open Payments Help Desk.

For more information about the registration process, visit the physician and teaching hospital registration page on the Open Payments website.

Submit questions to the Help Desk via email at openpayments@cms.hhs.gov or by calling 1-855-326-8366, Monday through Friday, from 8:30 a.m. to 7:30 p.m. (ET), excluding Federal holidays.



CLASSIFIEDS


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


Luxurious Medical Office Space to Share in Manhattan
Spacious and modern wellness office suite off 5th avenue, near grand central, and all major subway lines. Newly renovated space catering to the needs of various health practitioners and their clients (vision, chiropractors, acupuncturists, psychologists, nutritionists, etc.) 13 foot ceilings throughout. Two spacious waiting areas, elegantly furnished. Two bathrooms en suite. Fully equipped kitchen/pantry area. Two elevators. Free coffee/tea station, hot/cold water cooler, free mail sorting services. Windowed offices starting from $2,800. Utilities, cleanings and high speed internet. Call: 570-499-5851 / email: columbuslaservision@gmail.com


Physician Opportunities


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


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.


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

April 14, 2017 – Budget’s High Points for Us

Dr. Reid - MSSNY President
PRESIDENT’S MESSAGE
Dr. Malcolm Reid
April 14, 2017
Volume 17
Number 15

MLMIC Insurance

Dear Colleagues:

The New York State Legislature completed passage of a $153 Billion State Budget 9 days after the State due date of April 1, and after several weeks of “round the clock” negotiations on an extraordinary number of difficult issues including raising the age of criminal responsibility, ride-sharing, education funding, emergency Budgetary powers, a Medicaid prescription drug price cap and Workers Compensation reform.  While the Legislature passed a two-month Budget extender, this final Budget deal overrides that legislation.

Thanks to strong advocacy by MSSNY physician leaders, MSSNY member physicians, county medical societies, and the many specialty societies with whom MSSNY works closely, the final Budget enacted DID NOT contain several objectionable provisions that had been opposed by MSSNY.  The final Budget:

  • Deleted a proposal opposed by MSSNY that would have required a physician to receive a “tax clearance” as a pre-condition of receiving Excess Medical Liability Insurance coverage, while assuring that the more than 20,000 physicians who currently receive Excess coverage continue to receive such coverage;
  • Deleted a proposal opposed by MSSNY that would have expanded burdensome prior authorization requirements by repealing statutory provisions that assure that the prescriber has the final say for all prescriptions for fee for service Medicaid patients as well for several drug classes for patients covered through Medicaid managed care;
  • Deleted a 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;
  • Deleted a proposal opposed by MSSNY to create a Regulatory Modernization Team that could have empowered state agencies to override existing scope of practice laws without legislative approval;
  • Substantially revised provisions to permit Medicaid to sanction or remove a health care practitioner who violates a statutory limit on opioid prescribing, by assuring that a prescriber has appropriate due process protections before a sanction is imposed.
  • Continues necessary funding for MSSNY’s Committee for Physician’s Health and MSSNY’s Veterans Mental Health Care educational program;
  • Deleted several problematic elements that had been under serious consideration to be included in Workers’ Compensation Reform package enacted as part of the Budget, including provisions that would have:
    • Limited injured worker choice of treating physician by expanding the required use of Workers Compensation PPOs;
    • Removed the authority of county medical societies to recommend physicians to be approved to be WC-authorized providers or IMEs;
    • Expanded the penalties that the Board could impose on WC-authorized physicians;
    • Expanded the list of authorized health care providers in Workers Compensation, without any requirement for several of these providers to collaborate with a physician.

It should be noted that the final package includes a number of notable reforms that will have a significant long-term impact on New York’s Workers Compensation system including provisions that will:

  • Implement new impairment guidelines by year end 2017 after “consultation with  representatives of labor, business, medical providers, insurance carriers, and  self-insured employers”;
  • Create a prescription drug formulary by year end 2017 which “shall  include  a tiered list of high-quality, cost-effective medications that are pre-approved to be  prescribed  and  dispensed,  as well as additional non-preferred drugs that can be prescribed with prior approval”.
  • Create a workgroup in 2018 to review the criteria for those who provide Independent Medical Exams (IMEs);
  • Expedite the timeframe for Workers Compensation coverage disputes to be resolved; and
  • Grant additional powers to the Workers Compensation Board to impose “performance standards” on Workers Compensation carriers.

MSSNY’s Division of Governmental Affairs

Please send your comments to comments@mssny.org


enews large



MLMIC Hosting Physician Meetings throughout State to Discuss Strategies
MLMIC will be hosting Healthcare Law Review programs for physicians at 11 different locations in the state during May and June. This program will provide:

  • Overview of the recent case law developments that impact the provision of healthcare
  • Strategies to safeguard the privacy of a patient’s medical information.
  • Strategies to protect Quality Assurance materials from discovery in a lawsuit
  • Steps that a physician should take to clarify his/her role as a consulting physician to improve patient care and reduce potential liability exposure
  • Review the information that the physician must disclose to the patient to establish true informed consent.

Click here to open the brochure regarding the 2017 Network Meetings. If you are interested in attending, please feel free to contact Ms. Diane Allen, MLMIC’s Risk Management Coordinator at 518-786-2741 or email: dallen@mlmic.com.

Registration Now Open for CME Webinar on Concussion in Pediatric and Adult Population
MSSNY 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 A copy of the flyer can be found 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 an activity.  (CLANCY)

USPSTF Releases Draft Guidelines on PSA Testing
The US Preventive Services Task Force (USPSTF) “has dropped its controversial opposition to routine screening for prostate cancer, and now says that men between the ages of 55 and 69 should discuss the test’s potential benefits and harms with their physicians “and make decisions based on their own ‘values and preferences.’” The group said in proposed new guidelines on April 11, “The decision about whether to be screened for prostate cancer should be an individual one.” The task force “continues to recommend that men 70 and older forgo screening altogether.”

The USPSTF’s 2012 advice against screening said there was little evidence that PSA screening was reducing deaths. Since that time, “PSA screening rates have declined by as much as 10%, and now less than one-third of US men get the tests.” Meanwhile, fewer men are being diagnosed with early-stage disease, when it is more treatable, while more are being diagnosed with more aggressive harder-to-treat cancer.

The draft prostate cancer recommendations announced online in JAMA, are open for public comment until May 8.


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



Physicians Still Disagree as to When to Recommend Mammograms
Research indicates “primary-care physicians and gynecologists continue recommending breast cancer screening for younger and older women despite changes to breast cancer screening guidelines.” Researchers found that “trust in different guidelines and a physician’s specialization affect their screening recommendations.” The findings were published in JAMA Internal Medicine http://bit.ly/2ojV8Ju. The US Preventive Services Task Force recommends biennial mammograms starting at 50 for all women.”

DFS: Insurers to Provide Coverage for Visits that Result in Marijuana Certification
New York State Department of Financial Services sent a letter issued on April 12, 2017 to remind insurers authorized in New York State that they must provide coverage for office visits for covered services, including those that result in medical marijuana certification, as long as the office visit wasn’t solely for the purpose of medical marijuana certification. 

Upcoming Veterans Health Care Training Program on Long Island: Includes CME Training for Primary Care Physicians
MSSNY, the New York State Psychiatric Association, and the National Association of Social Workers – New York State Chapter are hosting a two day conference on Long Island on Friday, May 5 and Saturday, May 6, 2017 at the Clarion Hotel & Conference Center, located at 3845 E Veterans Memorial Hwy, Ronkonkoma, NY 11779.

The conference will consist of interactive seminars and panel discussions focusing on the current and evolving healthcare needs of veterans. MSSNY will be conducting three CME accredited trainings for primary physicians and specialists, covering PTSD and TBI in returning veterans, suicide among returning veterans, and substance use disorders among returning veterans.

There is no cost, but separate registration is required for both the trainings and conference.

Click here to view a detailed schedule and register for the Veterans’ Mental Health Training Initiative

To register for each CME program, click on the program name below

PTSD and TBI in Returning Veterans
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 among Returning Veterans
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 Among Returning Veterans
Saturday, May 6, 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

The presentation is part of Veterans Mental Health Training Initiative, which is supported by a grant provided by the New York State Legislature and administered through 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

Further information or for assistance in registering for these programs, contact Greg Elperin at gelperin@mssny.org.

Trans-Fat Ban Linked to Reduction in New York’s CVD Admissions
Banning the use of trans-fatty acids in some New York counties coincided with a decline in admission rates for cardiovascular disease, JAMA Cardiology reports.

Researchers compared admission rates for the composite of myocardial infarction and stroke between New York counties implementing the ban in its eateries versus those that did not. The restricting counties showed an additional 6% drop in admissions relative to non-restricting counties after adjustment for an already-declining trend across the state. The difference became significant 3 years after implementation of the bans and benefitted men and women equally.

Of note, in 2015, the FDA mandated that food manufacturers remove partially hydrogenated oils from their products by mid-2018.

JAMA Cardiology article

Dietary & Lifestyle Strategies in Cardiovascular Risk Reduction – Half Day!

Friday, May 12, 2017, 8:00 AM – 1:30 PM

To Register and for more information, click here.

  • Diet and lifestyle are crucial components in the development and progression of cardiovascular disease (CVD), but are underemphasized in the educational training of most health care providers. This course will review the evidence for diet and cardiovascular disease including recent guidelines, analyses and controversies while providing practical counseling advice for assessing and implementing change to patients’ diets and lifestyle patterns. The evidence for dietary supplements will be reviewed as well as the evidence for exercise and how to appropriately and safely prescribe an exercise regimen for the prevention and treatment of cardiovascular disease. Attendees will learn specific time- efficient strategies to assess patients’ diet, use technology and motivational strategies for greater patient engagement and convey basic dietary advice within the time constraints of an office visit.

The NYU Post-Graduate Medical School designates this live activity for a maximum of 5.00 AMA PRA Category 1 Credits™. Physicians should claim only the credit commensurate with the extent of their participation in the activity. ​



CLASSIFIEDS


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


Luxurious Medical Office Space to Share in Manhattan
Spacious and modern wellness office suite off 5th avenue, near grand central, and all major subway lines. Newly renovated space catering to the needs of various health practitioners and their clients (vision, chiropractors, acupuncturists, psychologists, nutritionists, etc.) 13 foot ceilings throughout. Two spacious waiting areas, elegantly furnished. Two bathrooms en suite. Fully equipped kitchen/pantry area. Two elevators. Free coffee/tea station, hot/cold water cooler, free mail sorting services. Windowed offices starting from $2,800. Utilities, cleanings and high speed internet. Call: 570-499-5851 / email: columbuslaservision@gmail.com


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


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.


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

Council Meeting – April 23, 2017

AGENDA
Council Meeting
Sunday, April 23, 2017
Westchester Marriott, Tarrytown, NY

A.          Call to Order and Roll Call

B.          APPROVAL of the Council Minutes of March 7, 2017

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

        1. President’s Report
          Please welcome our MSSNY Officers, Councilors, Trustees, County Execs, MSSNY Staff and the following new MSSNY Councilors:

          Janine Fogarty, MD
          – Monroe County Medical Society Councilor

          Justin Fuehrer, DO
          – Resident & Fellow Section Councilor

          Pratistha Koirala
          – Medical Student Section Councilor

          Bonnie Litvack, MD
          – Organized Medical Staff Section Councilor

          a.  APPROVAL – 2017/2018 Meeting Schedule
          b. APPROVAL – 2017/2018 Committee Appointments

        2. Board of Trustees Report
          – No report – Board meets after Council

D.           Commissioners (All Committee & Sub-Committee
                Informational Reports/Minutes  
(No reports submitted)

E.           Reports of Officers (Verbal Reports)

        1. Office of the President
          Charles Rothberg, MD
        2. Office of the President-Elect
          Thomas J. Madejski, MD, FACP
        3. Office of the Vice President
          Arthur C. Fougner, MD
        4. Office of the Treasurer
          Joseph R. Sellers, MD, FAAP, FACP
          Financial Statement for the period January 1, 2017 March 31, 2017
        5. Office of the Secretary
          Frank G. Dowling, MD
        6. Office of the Speaker
          Kira A. Geraci-Ciardullo, MD, MPH

F. Reports of Councilors (Informational)
1.    Nassau County Report    
2.    Kings/Richmond Report 
3.    Seventh District Branch Report               
4.    Suffolk County Report                   
5.    Fifth District Branch Report 
6.    Sixth District Branch Report
 7.    Ninth District Branch Report
8.    Manhattan/Bronx Report                   

G.  Report of the Executive Vice President

  1.  Membership Dues Revenue Schedule
  2.  Group Institutional Dues Schedule

H.  Other Information/Announcements

  1.      Final version of the penalty sign-on letter
  2.     AMA/MSSNY Sign On Letter – 3 Hour CME Program

 I.  Adjournment

 

April 7, 2017 – Take Required 3-Hour Opioid Course Now! Click Here

Dr. Reid - MSSNY President
PRESIDENT’S MESSAGE
Dr. Malcolm Reid
April 7, 2017
Volume 17
Number 14

MLMIC Insurance

Dear Colleagues:

New York State requires every prescriber, who has a DEA license, to take a three (3) hour continuing medical education (CME) program in Pain Management, Palliative Care and Addiction medicine by July 1, 2017 and every three years after that.

The Medical Society of the State of New York has developed an online program that meets New York State’s coursework requirements.   The on-line course is now available at cme.mssny.org

The MSSNY course includes the eight (8) statutory 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
  • End of life care

MSSNY’s CME program was developed in conjunction with the NYS Office for Alcoholism and Substance Abuse Service.   The NYS Department of Health’s Bureau of Narcotic Enforcement lists the Medical Society of the State of New York as an accredited provider for this coursework.

In 2014, the American Medical Association , the Medical Society of the State of New York and more than 25 states, specialty and other health care associations joined together to create a task force to help reduce the nation’s burden from prescription opioids and heroin.   We believe that a comprehensive public health approach is needed to address prescription opioid-related harm and the growing heroin epidemic.   This is an issue of high importance to the profession. This interest is reflected by the fact that nearly every state has considered—and enacted—multiple pieces of legislation to address this problem.

More than 16,000 patients annually suffer an unintentional overdose and death from opioid analgesics, and more than 8,000 deaths occur annually from heroin overdoses.  MSSNY’s course discusses the safe and effective prescribing practices; approaches to treating pain, ways to respond to abuse and treatment and how to prevent, screen and recognize the signs of addiction.

We urge you to take the MSSNY 3 Hour CME program on Pain Management, Palliative Care and Addiction and join your colleagues in helping to combat the opioid epidemic.

Sincerely,

Malcolm Reid, MD, MPP
MSSNY President

Patrice Harris, MD
Chair, AMA Board of Trustees
Chair, AMA Task Force to Reduce
Opioid Abuse

Please send your comments to comments@mssny.org



Final Budget Deal Remains Elusive – Legislature and Governor Enact 2-Month Budget Extender
A final budget deal has remained elusive in Albany.  As of this writing, many major items, including raising the age of criminal responsibility, affordable housing tax credits in New York City and funding for schools remain unfinished. The adage in Albany is “nothing is decided until everything is decided.”

On Monday, the State Legislature enacted a two month “bare bones” budget extender, until May 31, after “round the clock” weekend negotiations at the State Capitol failed to produce a State Budget agreement. The State Budget was due April 1, and the budget extender was necessary to fund state operations. The Budget extender bill included several substantive health policy issues. New York became the first state to cap the growth of prescription drug spending in its Medicaid program.  The bill also included $2.5 Billion in funding for a Clean Water Infrastructure Initiative.

Importantly, the Budget extender included language that extended authority for the Excess Medical Malpractice Insurance program from July 1, 2017 through June 30, 2018 without the language opposed by MSSNY that would have required a physician to receive a “tax clearance” as a pre-condition of receiving Excess coverage.  The historical funding ($127.4 million) contained in the Executive Budget proposal and agreed to by the Senate and Assembly (in its respective one-House Budgets) was included in a separate bill that passed both houses.

Many other items that MSSNY advocated against were not included in any agreed upon budget bills yet.  These proposals include:

  • A proposal opposed by MSSNY contained in the Executive Budget that would permit 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 this proposal in their respective one-House Budgets adopted last month.
  • A proposal opposed by MSSNY contained in the Executive Budget that would repeal “Prescriber prevails” protections in fee for service Medicaid and for several drug classes in Medicaid managed care.  Both the Assembly and Senate rejected this proposal in their respective one-House Budgets.
  • A proposal opposed by MSSNY contained in the Executive Budget to create a Regulatory Modernization Team.  The Assembly rejected the proposal in its one-House Budget, while the Senate included language to greatly narrow its focus and powers.
  • A proposal supported by MSSNY in the Executive Budget to regulate PBMs.
  • A proposal supported by MSSNY in the Executive Budget to regulate and tax e-cigarettes.
    (DIVISION OF GOVERNMENTAL AFFAIRS)


Workers’ Compensation – Reform Provisions Likely to Be Included in State Budget
MSSNY Governmental Affairs staff has been engaged in discussions with the Assembly and Senate to urge that numerous problematic proposals to reform the Workers Compensation system be rejected.   These damaging proposals would limit patient choice of their treating physician, give greater discretion to the Board to impose financial penalties on WC-authorized physicians, and limit the ability of county medical societies to assist local physicians in completing applications to become WC-authorized.

Moreover, there are proposals to expand the use of non-physicians in Workers’ Compensation without sufficient physician collaboration.  MSSNY has argued that such provisions would drive physicians away from the program, and would not reduce premium costs.  Instead, we have urged that there should be efforts to reduce administrative hassles in the Workers Compensation program.

MSSNY thanks the many physicians and county medical society leaders who contacted their legislators to oppose these measures.

Other issues under consideration include a prescription formulary, expanded requirements for “Independent Medical Examiners (IME), revising the impairment guidelines and expediting hearings.

Without lawmakers passing a final budget bill — what is known as the “big ugly” in Albany, all issues still hang in the balance.  Final agreements are still in flux as budget negotiations between the Legislature and Governor continue as they work towards a three-way agreement for a final budget.   Please check MSSNY’s website and next week’s edition of “Capital Update” for additional budget updates.
(DIVISION OF GOVERNMENTAL AFFAIRS)

Federal Health Care Discussions Continue
In an interview with the New York Times, President Trump indicated that the White House is still working on health care reform and that it remains a continuing negotiation.  There have been other reports that a new proposal being pushed by the Freedom Caucus would give states the option to opt out of provisions that require insurers to cover a standard, minimum package of benefits, known as the essential health benefits and do away with the requirement that insurance companies charge the same price to everyone who is the same age, a provision called community rating.

Instead there are proposals to add to the AHCA legislation before Congress $15 billion to subsidize “high risk” pools.  Some moderate Republicans have already expressed concern stating they want to preserve the provisions of the Affordable Care Act, which bars insurers from denying coverage to people with pre-existing medical conditions.
(BELMONT)

MSSNY Joins AMA and Federation of Medicine in Urging CMS to Create Hardship Waivers for 2016 Reporting Obligations
MSSNY joined nearly 90 other state medical and national specialty associations in a letter initiated by the AMA urging that CMS create “hardship waivers” for physicians to prevent imposition of Medicare payment penalties for failing to satisfactorily complete participation of the Meaningful Use (MU) and PQRS programs in 2016.

As many physicians are aware, failing to have satisfactorily complied with the cumbersome MU and PQRS programs in 2016 could result in penalties that will produce significant cuts to a physician’s Medicare payments in 2018.  2016 was the last year for physicians to have to comply with the old MU, PQRS and Value Based Modifier (VBM) programs, as the new Medicare Merit-Based Incentive Payment System (MIPS) takes effect this year and will impact Medicare physician payments in 2019.

Specifically, the AMA-medical societies’ letter to CMS notes that the societies are “grateful the agency recognized there were a number of challenges with the requirements of MU, PQRS, and VM. Consequently, we urge the Administration to take a series of steps to address these same challenges in MU, PQRS, and VM prior to their replacement by MACRA and minimize the penalties assessed for physicians who tried to participate in these programs. Clearly this would send a strong message to the physician community about the extensive regulations with which physicians have been dealing and the Administration’s commitment to reduce the burden”.

Specifically, the letter requested that CMS:

  • create a hardship exemption that would allow physicians who successfully reported on any number of PQRS measures in 2016 to avoid the 2% penalty in 2018; and
  • protect physicians from additional penalties of up to 4% under the VBM Program, urging that any physician who avoided the PQRS penalty in 2018 should be exempt from any VBM penalties as well.   (AUSTER)

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



MSSNY Joins Patient Advocacy Organizations to Oppose Proposals to Cut Part B Medication Reimbursement
MSSNY has once again joined nearly 200 patient and physician advocacy groups across the country in a letter here sent to the Medicare Payment Advisory Commission (MedPAC) expressing strong concerns with a proposal under MedPAC consideration to reduce reimbursements for medications provided by physicians to patients under Medicare Part B.  Similar proposals to reduce Part B medication reimbursement were advanced by CMS last year, but were pulled back due to substantial opposition from many members of the US Congress as well as many patient and physician advocacy organizations including MSSNY.

The letter notes that “the recommendations MedPAC is proposing could accelerate the problem in ways that make care more difficult to obtain, potentially forcing changes to treatment plans that are working well for patients.   Currently, Medicare Part B offers beneficiaries broad access to infused therapies, allowing patients and their doctors to decide which treatments are best.”

The letter further notes its specific concerns with the MedPAC proposals, including that:

  • Some providers, particularly those in small or rural practices would be unable to provide certain medicines if reimbursements are reduced or blended through consolidated billing codes.
  • Patient safety could be harmed if proposals to blend coding and reimbursement for biologics or therapeutically similar treatments go forward because it will be more difficult to track and attribute adverse events.
  • Proposals to blend coding and reimbursement for Part B medicines or establish arbitrary reimbursement caps through an inflation limit could stifle innovation in the next generation of Part B treatments, including biosimilars, which are expected to generate savings for beneficiaries and the Medicare program.
  • the MedPAC proposal to create a new “Drug Value Program” leaves a number of critical questions unanswered, and as proposed could harm patient access by imposing new restrictions on Part B therapies. (AUSTER)


Register Now for Veterans’ Mental Health CME Seminars at the MSSNY House of Delegates
The Medical Society of the State of New York will hold two Continuing Medical Education (CME) seminars on veterans’ mental health as part of the MSSNY House of Delegates on Thursday, April 20, 2017 from 1-3 p.m. Entitled, “PTSD and TBI in Returning Veterans” and “Suicide Among Returning Veterans.”  The programs will be held at the Grand Ballroom D&E of the Westchester Marriott, 670 White Plains Road, Tarrytown, NY.  The programs are open to MSSNY delegates and physicians throughout the area free of charge.

Pre-registration is required and physicians may register for both programs at:

PTSD and TBI: https://mssny.webex.com/mssny/k2/j.php?MTID=tbdb5295479d5ee1865aab56f91a2ca59

Suicide: https://mssny.webex.com/mssny/k2/j.php?MTID=tcd75a710181bbd6dd4034a6625500151

Faculty for the CME programs are Frank Dowling, MD and Thomas Madjeski, MD.

PTSD and TBI

Thursday, April 20, 1 pm
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

Thursday, April 20, 2 pm
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.

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, CLANCY)

Registration Now Open for CME Webinar on Concussion in Pediatric and Adult Population
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.

A copy of the flyer can be found 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, HARRING) 

Task Force Releases New Recommendation To Promote Safe Storage And Disposal Of Medications
The AMA Task Force to Reduce Opioid Abuse released new recommendations urging physicians to make increased efforts to raise awareness about safe storage and disposal of expired, unwanted or unused medications. The recommendations emphasize three steps for physicians to take:

  1. Talk to your patients and educate them about safe use of prescription opioids to help prevent misuse and diversion;
  2. Remind patients that medications should be stored out of reach of children and in a safe place; and
  3. Urge patients to safely dispose of expired, unwanted and unused medications.

The Task Force also pointed to several resources that physicians and patients can use to search for drug disposal locations.  The Medical Society of the State of New York is a member of the AMA’s Task Force.

For more information, and to download a copy of the new Task Force recommendation, visit www.ama-assn.org/opioids-disposal
(CLANCY)

Nominations Sought:  2016 Bernstein Award
The Medical Society of the State of New York is accepting nominations for the 2016 Albion O. Bernstein, MD Award.  This prestigious award is given to:  “the physician, surgeon or scientist who shall have made the most widely beneficial discovery or developed the most useful method in medicine, surgery or in the prevention of disease in the twelve months prior to December, 2016.”

This award was endowed by the late Morris J. Bernstein in memory of his son, a physician who died in an accident while answering a hospital call in November, 1940.   The $2,000 award will be presented to the recipient during a MSSNY Council Meeting.  Nominations must be submitted on an official application form and must include the nominator’s narrative description of the significance of the candidate’s achievements as well as the candidate’s curriculum vitae, including a list of publications or other contributions.   To request an application, please contact: 

Committee on Continuing Medical Education
 Miriam Hardin, PhD, Manager, Continuing Medical Education
Medical Society of the State of New York
99 Washington Avenue, Suite 408
Albany, NY 12210
518-465-8085
mhardin@mssny.org

DEADLINE FOR NOMINATIONS:  May 31, 2017                                          (HARDIN)


CDPHP Workforce Team Challenge Running Event.  Please Join Us!
MSSNY will be a premium sponsor of the 2017 CDPHP Workforce Team Challenge, a 3.5-mile race for runners and walkers, taking place in Albany on May 18, 2017.  MSSNY’s sponsorship of the event is part of an ongoing effort to have a visible presence at health-related public events.  The CDPHP Workforce Team Challenge, which caps participation at 10,000 registrants, is known for reaching capacity each year.  Many Capital District health-related organizations participate annually.  As a premium sponsor, MSSNY’s logo will be featured on the official race t-shirt, and MSSNY will be recognized during the race announcements.  In addition, MSSNY will have an exhibit table on Empire State Plaza.

The race begins at 6:25 PM, at Empire State Plaza, and features a scenic route that traverses Albany’s Washington Park.  The popular event always attracts great crowd support and on-course entertainment.  Sawyer Fredericks, winner of the eighth season of The Voice, will be singing the National Anthem.

Instructions and registration link are available here.  MSSNY members and alliance members are highly encouraged to participate on our team, either as a runner or a walker.  Please choose “Medical Society of the State of New York” from the team drop-down list.  Registration is $24, and a portion of the registration fees go to this year’s “Charities of Choice,” Boys and Girls Club of Albany and Vanderheyden.   Registration deadline is May 1, 2017. A flyer may be accessed here.  For more information, please contact Miriam Hardin (mhardin@mssny.org).                                                                                                (HARDIN)

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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Pain Management, Palliative Care and Addiction Online Program Now Available
The Medical Society of the State of New York Pain Management, Palliative Care and Addiction modules are now available on-line here. 

These modules are being offered free of charge to all MSSNY members.  Physicians who are new users to the MSSNY CME site will be required to register as a new user.

As a new user, physicians and non-physicians will be required to enter fields that include: position; name (the name should be what you want to appear on the CME certificate); email address; and then create a password.  MSSNY members who encounter a payment page or have difficulty registering, please email cme@mssny.org for technical support.  Directions for creating a new account/or logging in can be found HERE.  Non-MSSNY physicians will be charged $50 per module. 

The MSSNY CME is a new site and while many MSSNY members have an account with mssny.org a MSSNY member may not necessary have an account with cme.mssny.org   If in doubt, try to create an account and if it tells you that the email address is unavailable or in use,  an account exists.   Passwords can be reset if you don’t know it. 

Physicians who have previously had an account at the MSSNY CME site will need to log into the site using their email and password. The MSSNY CME site provides the ability for physicians and other prescribers to view the archived webinar at their leisure, take the required test, and download their certificate.

The online program covers all eight topics required in the New York State statute. MSSNY developed the program with the NYS Office of Alcoholism and Substance Abuse Services (OASAS).  MSSNY is listed as an accrediting organization by the NYS DOH Bureau of Narcotic Enforcement.   Information on the three CME modules is available HERE. 

Additional information or technical support may be obtained by contacting cme@mssny.org

DOH Announces Attestation Process for Mandatory Prescribers
The New York State Department of Health has announced the attestation process for prescribers. Prescribers must attest to the completion of the pain management, palliative care and addiction course work or training by July 1, 2017, and again every three years thereafter. The prescriber should only attest after completion of at least three hours of course work or training covering all eight topics.

A prescriber with a Health Commerce System (HCS) account will attest online using the Narcotic Education Attestation Tracker (NEAT) application.  Complete the steps to access the NEAT (Narcotic Education Attestation Tracker) application in the NYS Health Commerce System (HCS):

  1. Log into the HCS here.
  2. . Under “My Content” click on “All Applications”
  3. Click on “N”
  4. Scroll down to NEAT (Narcotic Education Attestation Tracker) and double click to open the application. You may also click on the “+” sign to add this application under “My Applications” on the left side of the Home screen.

Complete the steps to ATTEST to the completion of the education requirement.   A full set of instructions can be found HERE.

Prescribers that do not have access to a computer can request a paper attestation form by calling the Bureau of Narcotic Enforcement (BNE) toll-free at 1-866-811-7957. They may then complete the form and return it by mail to the address provided in the form.

The Bureau of Narcotic Enforcement has also released a Frequently Asked Questions (FAQs) on the prescriber mandate.   A copy of the FAQs can be found HERE.

In certain limited circumstances, the New York State Department of Health 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.  Exemptions will be granted only in very limited circumstances, and not solely on the basis of economic hardship, technological limitations, prescribing volume, practice area, specialty, or board certification.  Prescribers may applied for an exemption through the Health Commerce System.

Further information may be obtained by contacting BNE at 1-866-811-7957 or narcotic@health.ny.gov.

Dr. Bill Valenti Publishes Book on NY’s Early AIDS Epidemic at drbillvalenti.com
          All Proceeds Go to Trillium Health End the Epidemic Fund
Bill Valenti, MD, has dedicated his life and career to ending the HIV/AIDS epidemic and rightfully earned his reputation as a medical maverick and pioneer in HIV prevention, research and policy.

A Clinical Associate Professor of Medicine (Infectious Diseases) at the University of Rochester  School of Medicine, Dr Valenti has authored more than 150 peer-reviewed articles, book chapters, and scientific abstracts on HIV medical care, infectious diseases, and healthcare epidemiology and infection control. In the early 1980s, he would see AIDS patients in his office in the evening, after the staff left.

Dr. Valenti has served the first chair of MSSNY AIDS Advisory Panel (now the Infectious Disease Committee) since the early 90s.  The MSSNY Advisory Panel was one of the first formal committees nationwide to begin a medical discussion of this epidemic. Dr. Valenti has devoted countless hours to educating his peers for MSSNY .

From the prologue: By 1986, there were 10,000 cases of AIDS reported in the U.S. The fatality rate was 75 percent. That same year, Jackie Nudd, executive director of AIDS Rochester, and I went to Auburn State Prison to do an educational program for prison staff. Almost 200 cases had been reported in New York State prisons by that time. Condoms weren’t allowed, so we couldn’t talk about sex in prisons. We promoted HIV testing, but testing was complicated in the corrections system, and it would be another year before AZT would be available. They served us lunch for our efforts. It’s true what they say about prison food.

Medscape Physician Salary Survey: North Dakota Physicians Earn Most!
The nation’s physicians earned an average of $294,000 a year, according to Medscape’s 2017 compensation survey. Orthopedists continued to be the best paid, with an average salary of $489,000, while family physicians and pediatricians stayed on the bottom rungs with average salaries of $209,999 and $202,000, respectively.

Despite higher costs in big cities, doctors in rural areas earned the most. According to the survey, physicians in North Dakota were the best paid, with an average income of $361,000. “It’s a supply-and-demand issue,” said Dr. Michael Smith, medical director and chief medical editor for WebMD/Medscape.

Most physicians saw their pay rise from the previous year. Plastic surgeons fared the best, with a 24% increase to $354,500, while pediatricians saw their pay decline by 1%. Both primary care docs (45%) and specialists (33%) thought they should earn more, and almost 20% said they’re working longer hours for less money. But most doctors said they wouldn’t trade in their stethoscopes. Nearly 8 out of 10 (77%) said they’d choose a medical career again, compared with just 64% last year.

Medscape surveyed 19,200 physicians in 26 specialty areas between Dec. 20, 2016, and March 7, 2017.

First LGBTQ Center to Open in Downtown Brooklyn
The Callen-Lorde Community Health Center has signed a 20-year lease in Brooklyn that will allow it to expand its health services to the LGBTQ community in 2019. The 25,000 square foot space at 40 Flatbush Avenue Extension in downtown Brooklyn will be the organization’s first health center in the borough. Currently, about 30% of its patients travel from Brooklyn to their clinics in the Bronx and Manhattan, said Wendy Stark, executive director of Callen-Lorde.

“LGBTQ communities are in dire need of competent health care services, and we see proof of that every day in the numbers of callers we have,” she said. “We’ve expanded our capacity to the outer limits.”

For example, the Bronx clinic, which opened in July 2016, currently has a waiting list for appointments stretching until early summer, she said. (Crains)


New York AG Joins Whistleblower Lawsuit against AstraZeneca
On March 31, New York Attorney General Eric Schneiderman joined a whistleblower lawsuit against AstraZeneca’s MedImmune unit that accuses the company of creating “baby leads” for sales of its Synagis treatment for severe respiratory illness in premature infants. The lawsuit claims MedImmune gathered “private information from patient logbooks” and shared it with a specialty pharmacy Trinity Homecare, which then contacted the babies’ families or physicians “regardless of patient need or if the current physician sought a prescription.”

In its complaint that intervened in a whistleblowing nurse’s 2009 lawsuit, Attorney General Eric Schneiderman said that MedImmune’s sales representatives paid kickbacks to Trinity Homecare LLC from 2007 to 2011 by passing along “baby leads.” STAT (4/4)

MAC Satisfaction Indicator (MSI) – JK Now Available!
Evaluate Our Services in 10 Minutes!
The MAC Satisfaction Indicator (MSI) is the best way to share your opinions of our service directly with the Centers for Medicare & Medicaid Services (CMS). This survey should only take 10 minutes of your time and helps us understand how we can better serve you. To take the survey, click on the URL below:

Jurisdiction K providers may access the survey at 2017 Jurisdiction K MSI Survey

We found your 2016 feedback helpful, and we made improvements to our services. You can read about some of the changes in an article titled, “Feedback-Based Improvements from the 2016 MSI Survey“, which can be found on the NGSMedicare.com website under News & Alerts. Thank you for your feedback.

Register Now for Merit-based Incentive Payment System (MIPS) Group Web Interface and CAHPS Reporting
Groups Must Register to Utilize the CMS Web Interface and/or CAHPS for MIPS Survey by June 30, 2017. Groups participating in the Merit-based Incentive Payment System (MIPS) track of the Quality Payment Program are not required to register, except for groups that intend to utilize the CMS Web Interface and/or administer the Consumer Assessment of Healthcare Providers and Systems (CAHPS) for MIPS survey. To register, please visit the Quality Payment Program website.
The registration period is from April 1, 2017 through June 30, 2017.

Under MIPS, a group is defined as a single Taxpayer Identification Number (TIN) with two or more eligible clinicians (including at least one MIPS eligible clinician), as identified by their National Provider Identifiers (NPI), who have reassigned their billing rights to the TIN. Eligible clinicians who participate as a group will be assessed at a group level across all four MIPS performance categories. The group will receive one payment adjustment for the group’s performance.

Note: Groups that participate in a Shared Savings Program ACO are not required to register or report; the Shared Savings Program ACO is required to report quality measures on behalf of participating eligible clinicians for purposes of MIPS.

For 2017, only groups of 25 or more eligible clinicians that have registered can report via the CMS Web Interface. Groups that participate in MIPS through qualified registry, qualified clinical data registry, or electronic health record data submission mechanisms do not need to register. For 2017, only groups of 2 or more eligible clinicians that have registered can participate in the CAHPS for MIPS survey.

As a courtesy, CMS automatically registered groups for the CMS Web Interface for the 2017 performance period that previously registered for group reporting under the Physician Quality Reporting System (PQRS) via the Group Practice Reporting Option (GPRO) Web Interface. If you need to remove your registration for Web Interface submission because your group now has fewer than 25 eligible clinicians, you should cancel your registration. If your group wants to administer the CAHPS for MIPS survey, your group will need to make an election via the registration system.

The registration period for groups who choose Web Interface or CAHPS for MIPS Survey as their data submission method is April 1 June 30, 2017.

Note: For individual or group participation, registration is not required for any other submission method.

How to Register

To register, visit Quality Payment Program website. You will need a valid Enterprise Identity Management (EIDM) account with a Physician Value � Physician Quality Reporting System (PV-PQRS) role in order to register.

EIDM Account Information

Open a New Account: To create or modify an EIDM account, review the Guide for Obtaining a New EIDM Account.

Reactivate an Account: To reactivate or confirm the status of an account, contact the Quality Payment Program at 1-866-288-8292 (TTY: 1-877-715-6222) or qpp@cms.hhs.gov, Monday-Friday 8:00am-8:00pm EST and provide the group name and TIN.

Use a Current Account:To request a role to access the Physician Quality and Value Programs application in the CMS Enterprise Portal, review the Guide for Obtaining a Physician Quality and Value Programs Role for an Existing EIDM User. 

CMS Quality Measure Public Comment Announcement: Quality Measure Development and Maintenance for CMS Programs Serving Medicare-Medicaid Enrollees and Medicaid-Only Enrollees
Mathematica Policy Research is seeking public comment on a measure specification and justification for a quality measure called Healthy Days in the Community that is currently under development and testing for potential use by the Centers for Medicare & Medicaid Services (CMS) and State Medicaid agencies.  This is a measure of the average number of days within a year that dual eligible beneficiaries are alive and residing in the community without utilizing acute or post-acute health care services.

A memo listing questions on which we request public comment, as well as the measure information form (MIF) and measure justification forms (MJF), are available in a zip file in the Download section on this web page: https://www.cms.gov/Medicare/Quality-Initiatives-Patient-Assessment-Instruments/MMS/CallforPublicComment.html

The public comment period runs from March 27, 2017 to April 14, 2017.  If you wish to comment on these measures, please submit your comments by close of business April 14, 2017 to MedicaidQualMeasures@mathematica-mpr.com.



CLASSIFIEDS


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


Luxurious Medical Office Space to Share in Manhattan
Spacious and modern wellness office suite off 5th avenue, near grand central, and all major subway lines. Newly renovated space catering to the needs of various health practitioners and their clients (vision, chiropractors, acupuncturists, psychologists, nutritionists, etc.) 13 foot ceilings throughout. Two spacious waiting areas, elegantly furnished. Two bathrooms en suite. Fully equipped kitchen/pantry area. Two elevators. Free coffee/tea station, hot/cold water cooler, free mail sorting services. Windowed offices starting from $2,800. Utilities, cleanings and high speed internet. Call: 570-499-5851 / email: columbuslaservision@gmail.com



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


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


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.


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