Doctors v Pharma Pricing

Thomas J. Madejski, MD MSSNY President
PRESIDENT’S MESSAGE
Thomas J. Madejski, MD
MSSNY President
MAY 18, 2018
Volume 18
Number 19

Dear Colleagues:

Last Friday, President Trump promised to “derail the gravy train” in the health-care system in a speech in which he unveiled his much-anticipated strategy to lower drug prices. The 44-page blueprint, called “American Patients First,” proposes a laundry list of policy ideas — but no specific timeline for implementation. He said he wanted to “promote competition; get generic drugs to market faster; lower fees paid to so-called middlemen…; and to block foreign countries from negotiating lower prices for their state-run health plans.”

A March 2018 Kaiser Family Foundation Health Tracking Poll found that 80 percent of Americans think prescription drug prices are unreasonably high. Slightly more than half responded that enacting policies to lower them should be our government’s top policy priority. One of the other hats that I wear, and welcomed in anticipation of becoming your President, is as a member of the AMA Council on Medical Service. Our Council has taken a deep dive into the escalating cost of insulin at the request of our AMA members. We have come up with some specific strategies that the practicing physician can use to help their patients now, and some suggestions to improve general affordability moving forward.

I anticipate after presentation (and hopefully, approval) at the AMA Annual meeting in June, that our Council will explore additional strategies to help make medication more available and affordable for our patients.

Additional information for your consideration:

 

• Physicians (and many patients) know that that US drug prices are the highest in the world. Americans spend $1,100 per person per year on prescription drugs. Public outrage over drug costs has been growing for years, because patients are being squeezed in a number of ways—new medicines for cancer and other life-threatening diseases often launch with prices exceeding $100,000 per year. Drugs for common ailments like diabetes and asthma routinely see price hikes around 10 percent annually. Meanwhile, some companies have been buying up once-cheap older drugs and raising prices by 1,000 percent or more.

• While private insurers and government programs pick up the biggest share of the bill, high drug costs are ultimately passed down to the public through premiums and taxes. Lawmakers have probed how they set prices, and the Justice Department is investigating possible price collusion by more than a dozen companies that make generic drugs.

• In 2016, the AMA set a new policy that established guiding principles for advocacy efforts aimed at changing the fundamentals of prescription drug pricing without compromising patient outcomes and access. The 2016 policy acknowledges the carte blanche approach to drug pricing needs to change to align with the health system’s drive for high-quality care based on value.

• Unlike other nations, the U.S. doesn’t directly regulate medicine prices. In Europe, governments negotiate directly with drugmakers to limit what their state-funded health systems pay. For most outpatient drugs reimbursed through Medicaid, drugmakers must provide the government rebates. But most medicine costs are paid for by Medicare or by private insurers. When prescription-drug benefits were added to Medicare under a 2003 law, the pharmaceutical industry successfully lobbied to prohibit the federal government from using its huge purchasing power to negotiate drug prices. Private payers typically rely on third-party pharmacy-benefit managers, such as Express Scripts, to negotiate discounts. Patients directly pay about 17 percent of prescription medicine costs out of their own pockets.

We have a crisis in drug prices in this country, where pharmaceutical companies, distributors and PBMs are able to charge whatever they want hiding their costs and legitimate profit through a labyrinth of pricing schemes, kickbacks, and special considerations.  I have remarked to my fellow Council members that looking at drug prices is like peeling an onion.  Each layer stinks and makes me cry!

We need political leaders that are willing to stand up to the power of the pharmaceutical industry.  We need physicians to call upon our elected officials to create a healthcare system that serves our patients, not middlemen and hedge fund managers, who like Don Fanucci in The Godfather, need to “wet their beak” at our patients’ expense.

Please send your thoughts to comments@mssny.org.

Thomas J. Madejski, MD 
MSSNY President


MLMIC Insurance

Capital Update

MSSNY Physician Participates in Senate Roundtable on Tick Borne Diseases—Senate Passes Package of Bills Addressing Tick Borne Diseases
Dr. William Valenti, chair of the Medical Society of the State of New York Infectious Diseases Committee, participated this week in a Senate Roundtable sponsored by the Senate’s Task Force on Lyme and Tick Borne Diseases.  The roundtable included representatives from the NYS Department of Health, SUNY at Stonybrook; Cornell University, and SUNY Adirondack.  Dr. Valenti discussed with members of the Senate the need to coordinate better laboratory testing and the need to continue to provide educational programing for physicians and other providers.   The New York State Senate also passed legislation this week which includes:

  • 2588, sponsored by Senator Susan Serino, would provide homeowners with vital and reliable information on the best way to protect their property from ticks.
  • 7242, sponsored by Senator Serino, directs the New York State Office of Parks, Recreation and Historic Preservation to install and maintain tick warning signs at all state-managed parks, including trail entryways and campgrounds.
  • 7169, co-sponsored by Senator Serino and Senator Kemp Hannon, would establish a pilot program for Lyme and tick-borne disease testing in children under the direction of the Commissioner of Health.
  • 8534, sponsored by Senator Serino, would direct the Commissioner of Education and the Commissioner of Health to promulgate and review rules and regulations related to pupils who have a tick removed from them during school or a school-sponsored activity.
  • 8539, sponsored by Senator Serino, would require the Department of Financial Services, in consultation with the DOH Commissioner, to conduct a study considering the current scope of health insurance coverage for Lyme and tick-borne diseases. The study would also examine initiatives in other states and the fiscal implications of various proposals.
  • 6926, sponsored by Senator Hannon, directs the Commissioner of Health to establish a standard protocol for the diagnosis and treatment of Lyme and other tick-borne diseases. This legislation requires the commissioner to work with health care providers and experts to develop a standard protocol process and patient notification of related symptoms, risk factors, diagnosis, and other information relating to Lyme and TBDs. During the roundtable, Dr. Valenti did discuss having a “standard protocol” but indicated that much more work needs to be done to establish what type of protocol is suitable and that work also needs to be done to develop a standard for each of the laboratories to follow.
  • 7168, co-sponsored by Senators Serino and Hannon, requires a coroner, pathologist, medical examiner or other qualified examiner that discovers Lyme and tick-borne disease infections during an examination of a deceased person to report the case to the DOH.
  • 7208, co-sponsored by Senators Serino and Hannon, would require that the Council on Human Blood and Transfusion Services review current medical research and guidance regarding the donation of blood by patients with a history of Lyme or tick-borne illnesses.
  • 3816, sponsored by Senator Kenneth LaValle, would allow Town of East Hampton to establish a tick control district.

The bills are now before the NYS Assembly for further action.                                        (CLANCY, AUSTER)

State Senate Advances DMV Reporting Mandate Legislation
The State Senate advanced a bill (S.3569 – Young / A. 10094 – Carroll) from the Transportation committee to the Senate floor that would require a licensed physician, physician assistant or nurse practitioner to report patients that have a chronic condition which cause or may cause unconsciousness or unawareness to the Department of Motor Vehicles.  The conditions include a convulsive disorder, epilepsy, fainting, dizzy spells, coronary ailments or other health conditions that may impair the ability to operate a motor vehicle.  While MSSNY has adopted a comprehensive policy on impaired drivers that supports the ability of a physician to voluntarily report certain patients to DMV whom the physician believes should not operate a motor vehicle, this bill goes too far by mandating physician reporting.  MSSNY has great concerns over the ambiguity of the bill language and the fact that it encompasses a number of medical conditions where there may only be a remote chance that unconsciousness and unawareness may occur.  This bill is also opposed by the Epilepsy Foundation and the New York State Trial Lawyers Association.

Please click here to contact your legislator to express your concerns with this legislation.                                                                                 (BELMONT)

Governor Cuomo Announces Multi-agency Effort To Combat Maternal Depression
Under a directive from Governor Andrew Cuomo, the New York State Department of Financial Services will now require all New York commercial health insurance policies to cover maternal depression screenings, including screening for the mother under the child’s policy.   Additionally, the NYS Department of Health and Office of Mental Health will launch a strategic awareness campaign to provide critical information about symptoms and treatment options for maternal depression. Finally, the Office of Mental Health will open the first state-operated intensive outpatient clinic focused on maternal depression. The new regulations will require health insurance policies issued in New York to include coverage for maternal depression screenings by both adult and pediatric primary care providers, as well as speedy referrals to treatment specialists.   Insurance policies that cover the child but not the mother must provide coverage for maternal depression screening.

The new regulations will take effect 60 days after publication in the State Register.   The Department of Health and the Office of Mental Health’s awareness campaign will provide critical information about symptoms and treatment options, and to more broadly remove the stigma associated with maternal depression. There will be a joint letter to all health care providers reminding them of the seriousness of the issue as well as encouraging expansion of treatment options.                           (CLANCY)

MSSNY Urges for Extension of Committee for Physicians Health Program
MSSNY continues to advocate for legislation (A.10221-A, Gottfried, S.8093-A, Hannon) that would extend for an additional 5 years the continued operations of the MSSNY Committee for Physicians Health (CPH) program.  Authorization for several key components of the program expired on March 31, 2018.   The bill, amended this week to clarify its retroactive applicability to March 31, has advanced to the Senate floor, and likely will be considered at the next meeting of the Assembly Health Committee.

The CPH is a program designed to confront and assist physicians thought to be suffering from alcoholism, substance abuse or mental illness.   Since the inception of this program, CPH has assisted thousands of physicians in returning healthy to medical practice.  The work of the CPH program is an important public service both to our health care system as well as the general public. As a result, the State Budget annually includes an appropriation of $990,000 for the program, which is generated from a $30 assessment on all physicians’ biennial registration fees.

The program has traditionally been extended by the Legislature in 3 or 5 year “demonstration programs” with the most recent extension in 2013.  The recently enacted State Budget included a provision to create another “demonstration program” until 2023.  However, it omitted other provisions historically extended at the same time that are essential to its functioning that could greatly impair its operations unless immediate action is taken.  These includes provisions that set forth the CPH program’s reporting requirements to the Office of Professional Medical Conduct (OPMC), provisions to ensure liability protections for the physician Committee members for work performed in the scope of CPH, and necessary confidentiality protections for the program given the sensitivity of the work they perform.   These protections are absolutely essential to the continued functioning of the program to ensure that physicians with the appropriate expertise are willing to serve on the Committee, as well as to assure that the program has the ability to report sensitive information to OPMC when warranted by the circumstances. (DIVISION OF GOVERNMENTAL AFFAIRS)

Governor, AG Announce Potential Lawsuit Against Opioid Manufacturer
New York Governor  Cuomo and Acting Attorney General Barbara Underwood announced this week that New York State would be initiating a lawsuit against opioid drug manufacturer Purdue Pharma.  To read their joint statement, click here.

Acting AG Underwood stated “We are committed to holding opioid manufacturers and distributors accountable for the damage they’ve wrought on New York’s towns, communities, and families.  After a lengthy investigation, we are preparing a lawsuit against Purdue Pharma for its alleged deception and reckless disregard for the health and wellbeing of New Yorkers. It is clear to us that Purdue profited by deliberately exploiting New Yorkers’ addictions, and by pushing healthcare providers to increase patients’ use and dependence on these potentially fatal drugs. In addition to our impending lawsuit against Purdue, our office will continue to lead the multi-state investigation of opioid manufacturers and distributors across the country.”

Governor Andrew M. Cuomo stated: “In New York, we will not sit idly by as big corporations fuel the opioid epidemic and ignore the consequences of their actions.  We said we would sue to hold opioid manufacturers and distributors responsible, and that’s exactly what we’re doing. By taking Purdue Pharma to court, we are taking this significant step forward to hold corporations accountable and put an end to the opioid crisis once and for all. Too many innocent lives have been lost and too many families destroyed.”

As reported in numerous media outlets, Purdue Pharma responded: “We are disappointed that after months of good faith negotiations working toward a meaningful resolution to help the state of New York address the opioid crisis, the attorney general has unilaterally decided to pursue a costly and protracted litigation process.  We vigorously deny these allegations and look forward to the opportunity to present our defense.”  (AUSTER)

NYSDOH AIDS Institute Launches New Online Provider Directory
The NYSDOH AIDS Institute has launched a new online provider directory.  This new online directory will allow providers and consumers easier access to information regarding HIV, HCV, Buprenorphine, PEP, and PrEP service providers across New York State. This new directory will replace the former HIV and HCV provider directories located on the NYSDOH Health Commerce System (HCS). It will also replace the former PrEP/PEP Provider Voluntary Directory.  A copy of the directory can be found at this link: please click here.                                                                                  (CLANCY)

Medical Society of the State of New York Announces May and June CME Webinar Schedule
The Medical Society of the State of New York is pleased to announce its free Continuing Medical Education (CME) webinars for May and June.  Participation in the webinars will earn physicians one CME credit free of charge.  The webinar schedule for May and June is as follows: 

May 24th at 7:30amCurrent Concepts in Concussion for Pediatric and Adult Patients

Register for this webinar here.
Faculty: Deborah Light, MD & John Pugh, MD, PhD

Educational Objectives:

  • Identify signs and symptoms indicative of concussion as well as red flags that indicate alternate or more severe pathology;
  • Outline an appropriate management plan for a patient presenting with concussion including a return to “normal life” protocol;
  • Describe methods for the primary and secondary prevention of concussion;
  • Identify patients who would benefit from referral to a concussion specialist

June 20th at 12:30pmMedical Matters: Children’s Mental Health After Disaster

Register for this webinar here.
Faculty: Linda Chokroverty, MD

Educational Objectives:

  • Enhance physician’s understanding of the impact of disaster on children’s and family mental health
  • Improve physician skills to address potential psychiatric problems in children and families following a disaster

To view all of MSSNY’s scheduled programs, click here and select “Training Center” and “Upcoming”.

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 of these live activities for a maximum of 1.0 AMA/PRA Category 1 credits™.  Physicians should claim only the credit commensurate with the extent of their participation in the activity. 

Additional information or assistance with registration may be obtained by contacting Melissa Hoffman at  mhoffman@mssny.org.                                                                (HOFFMAN)

Ebola Webinars Available on CME Website
The Ebola outbreak in the Democratic Republic of Congo has now spread to Mbandaka city, and urban area with nearly 1.2 million residents.  There have now been 19 deaths and 39 patients infected with Ebola.  Additionally, 393 individuals are being monitored as contacts of Ebola patients.  Previous Ebola outbreaks proved stressful for healthcare providers in New York largely owing to uncertainty and media hype.  The Medical Society has two CME courses available that help to address these concerns regarding Ebola virus.

Please click here to view MSSNY’s free CME courses on this timely and relevant topic.  Ebola: A Perspective from the Field offers a firsthand description of the challenges surrounding Ebola virus.  And Viral Hemorrhagic Fevers with an Ebola Virus Update offers a comprehensive analysis of diagnosis and treatment for Ebola and other viral hemorrhagic fevers.                                                                                                  (HOFFMAN)

Bending the Diabetes Curve CME Course Available Online
Bending the Diabetes Curve webinar is now available to view online; please click here. By educating physicians and connecting more patients to evidence-based lifestyle change programs, this diabetes initiative will help bridge the gap between clinical care settings and communities to reduce the incidence of type 2 diabetes.

Webinar: Bending the Diabetes Curve

Faculty: Geoffrey Moore, MD & Sarah Nosal, MD

Educational Objectives:

  • Describe the trends in Type 2 diabetes and implications for clinical practice
  • Review evidence that supports referring patients with prediabetes to lifestyle change program
  • Outline the considerations for implementing a diabetes prevention initiative in a physician practice
  • Describe NYS specific incidents of prediabetes and diabetes in adult population
  • Understand the reimbursements mechanisms for DPP

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 of these live activities for a maximum of 1.0 AMA/PRA Category 1 credits™.  Physicians should claim only the credit commensurate with the extent of their participation in the activity.

Additional information or assistance with registration may be obtained by contacting Carrie Harring at  charring@mssny.org.                                                                                  (HARRING)

Please Join Us on July 28th for Physicians’ Day at the Races
Please join your friends and colleagues for a great event to benefit your profession.  MSSNY PAC uses its resources and mobilizes support to help elect candidates for state office who will stand and fight for us, regardless of what party they are from.  MSSNYPAC allows us to pool our resources and together, make a difference against other special interests that continue to try to undermine the delivery of quality health care.  MSSNY PAC continues to develop new fundraising opportunities for our physicians to become more active.

Please RSVP today. The Physicians’ Day at the Races will take place on Saturday, July 28, 2018 at the Saratoga Race Course in Saratoga Springs, NY.

Ticket prices are:

$500/physician,

$300/guest,

$250/guest under 21

Ticket price includes clubhouse admission, post parade programs, a gourmet buffet lunch at your own trackside table, unlimited open bar, private viewing of the horses as they bring them from the paddock and private betting windows. click here for further details.

Contact Jennifer Wilks at 518-465-8085 or by email at jwilks@mssny.org to secure tickets.  (BELMONT)


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

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


eNews

$750,000 Fine for Billing Medicaid when Physicians Were Not Enrolled in Program
Here is a cautionary New York tale –

MSSNY has recently heard from the U.S. Department of Justice that a medical practice has agreed to pay a large sum of money to settle a False Claims Act Suit for alleged improper billing practices.  The allegations were brought to the government’s attention through the filing of a complaint pursuant to the qui tam provisions (the whistleblower) of the False Claims Act.  Under the Act, private citizens can bring suit on behalf of the United States and share in any recovery.

The medical group agreed to pay $750,000.00 to resolve allegations that they billed the Medicaid Program for services provided by physicians who were not enrolled in the program.  The government’s investigation revealed that, from July 1, 2004 through December 31, 2010, the medical group employed a number of physicians who were not enrolled in the Medicaid Program who provided care to Medicaid patients.  Because the physicians were not enrolled in the program, the medical group should not have sought reimbursement from Medicaid for the services provided by these non-enrolled physicians.  Regardless, the medical group submitted requests for payment under the Medicaid provider identification numbers of the practice’s Medicaid enrolled physicians, thereby misrepresenting the identities of the individuals who were actually providing treatment to the group’s Medicaid beneficiaries.  This improper billing practice occurred at many of the medical group’s locations.

To avoid any impropriety, physicians must be enrolled in plans to treat and receive payment for a plan’s insured members. 

NY’s Acting AG to Sue Purdue Pharma for Exploiting Addictions
New York’s acting attorney general, Barbara Underwood, announced Wednesday that the state is preparing to sue the maker of the prescription painkiller OxyContin, making New York the seventh state to announce a lawsuit against Purdue Pharma this week.

In a press release, acting Attorney General Barbara Underwood said the state is readying its litigation against the opioid manufacturer for “its alleged deception and reckless disregard for the health and wellbeing of New Yorkers.”

“It is clear to us that Purdue profited by deliberately exploiting New Yorkers’ addictions, and by pushing healthcare providers to increase patients’ use and dependence on these potentially fatal drugs,” she said in a statement.

In its own statement, Purdue said the company “vigorously” denies the allegations and looks “forward to the opportunity to present our defense.”
Over the past year, the number of lawsuits filed against opioid manufacturers and distributors has substantially increased. Many of the suits claim companies aggressively marketed opioids whiledownplaying the risk of addiction and shipped suspiciously large quantities of painkillers without alerting authorities.

Three Firms Account for Over Half of All Medicare Part D Enrollees in 2018 Pending

Mergers Would Further Consolidate the Marketplace

In 2018, three Medicare Part D plan sponsors—UnitedHealth, Humana, and CVS Health—account for more than half of the program’s 43 million Part D enrollees (55 percent) and two-thirds of all stand-alone drug plan enrollees, indicating a marketplace that is dominated by a handful of major insurers, according to a new Kaiser Family Foundation analysis of Part D enrollment, premiums and cost-sharing data.

The proposed mergers of CVS Health and Aetna, and Cigna and Express Scripts would result in further consolidation of the Part D marketplace. If these mergers go through, four firms—the two merged firms plus UnitedHealth and Humana—would cover 71 percent of all Part D enrollees and 86 percent of stand-alone drug plan enrollees, based on 2018 enrollment.

New Yorkers Do Not Eat Enough Fruits, Vegetables, Analysis Finds
The 2018 American Fitness Index analysis indicates “that while New York City ranked 52 out of 100 American cities when it comes to overall health, it is weak in key dietary areas,” particularly in that only “18.4 percent of New Yorkers eat three or more vegetables a day and 31.9 percent eat two or more fruits a day.”

FDA Names Companies “Gaming” Drug Laws to Block Competition
The FDA has followed through on its promise to publicly name companies it says may be gaming drug laws to block generic competition.

The act comes as part of the Trump administration’s recently announced effort to bring down the price of pharmaceuticals. The list  — posted on the FDA’s website May 17— includes dozens of both generic and brand-name companies that the agency said appear to have refused to give up samples of their product to generic companies seeking to make copies. Without the samples, generic manufacturers can’t conduct bioequivalence testing and apply to the agency for approval, said FDA Commissioner Scott Gottlieb, MD, in a statement.

The agency has received more than 150 pleas for help from generic drugmakers who have not been able to get samples from brand companies, said Gottlieb. “We’re also notifying the Federal Trade Commission (FTC) — the agency responsible for addressing anticompetitive business practices — about these inquiries,” he said.

According to the list, the largest numbers of inquiries have been for problems getting copies of isotretinoin (14 inquiries), bosentan (14), lenalidomide (13), thalidomide (10), and ambrisentan (10).

Among the companies that appear to be multiple offenders:

  • Actelion Pharmaceuticals, listed for potentially blocking access to macitentan (Opsumit), bosentan (Tracleer), epoprostenol sodium (Veletri), and miglustat (Zavesca);
  • Celgene, for lenalidomide (Revlimid), thalidomide (Thalomid), and pomalidomide (Pomalyst); and
  • Novartis, for everolimus (Afinitor), deferasirox (Exjade), nilotinib hydrochloride monohydrate (Tasigna), and everolimus (Zortress). 

Please Answer Physicians Foundation’s Biennial Survey
This is the Physicians Foundation’s sixth biennial physician survey. Its purpose is to examine the morale, career plans, and practice metrics of today’s physicians – and to give physicians a voice! The goal is to produce a “state of the union” of the medical profession that can have a significant impact on both policy and public perceptions. The survey is expected to take around 10 minutes to complete. It will be open through June 5th and can be accessed here.

Reminder: MSSNY is a Charter Member of the Physicians Foundation.

The Physicians Foundation will make a $5,000 contribution to the state medical society generating the most survey responses and a $5,000 contribution to the state medical society that generates that most responses per-capita.

New PTSD Definition Would Exclude Many Patients, Study Says
A proposed change in how post-traumatic stress disorder is diagnosed could exclude as many as 57% of the people with moderate—and more easily treatable—PTSD worldwide, according to a study led by researchers at NYU School of Medicine.

The study appear May 17 in the journal Psychological Medicine. It looked at almost 4,000 people from six countries to see how changes in the upcoming 11th edition of the International Classification of Diseases would affect their diagnoses.

Most of the patients studied were survivors of traffic accidents, who underwent the Clinically Administered PTSD Scale.

When patients were diagnosed using the revised code, it boosted the incidence of severe PTSD by up to 35%, but the number of moderate cases decreased by more than half.

Proposed changes in the diagnostic tool could negatively affect successful treatment for many victims of PTSD because early treatment leads to the best outcomes, said senior author Dr. Arieh Shalev, the Barbara Wilson Professor in the Department of Psychiatry at NYU School of Medicine.

Shalev also expressed concerns that insurers might not cover cases where patients clearly have symptoms consistent with PTSD but don’t meet the new criteria for diagnosis.

The revised code uses just six criteria for assessing PTSD: dissociative flashbacks, nightmares, hypervigilance, exaggerated startle response, avoidance of external reminders, and avoidance of thoughts and feelings associated with the traumatic event. The current code includes 13 conditions, including sleep disturbances and irritability, which also can be associated with other disorders.

House Passes Bill to Expand Veterans’ Healthcare Access Outside of VA
The AP (5/16) reports that on Wednesday, the US House “voted to give veterans more freedom to see doctors outside the Veterans Affairs health system” although some Democrats “cast it as a risky step toward dismantling the struggling agency.” The plan would “fulfill President Donald Trump’s promise to expand private care to veterans” who feel VA healthcare is inadequate by allowing them to seek care from private physicians. Legislators passed the $5 billion bill in a 347-70 vote.

Congressional Quarterly (5/16) reports the vote comes as “a major overhaul to a veterans’ health care program just two weeks before funds dry up.” The $5.2 billion funding will extend the Veterans Choice Program “before combining the program with other community care programs offered by the Department of Veterans Affairs in 2019.”

IPRO Hosting 34th Annual Membership Meeting at Garden City Hotel

When:   Tuesday, June 5, 2018
Time:    12:30 p.m.—3:30 p.m.
Where:  The Garden City Hotel – 45 Seventh Street, Garden City, NY

For further information, click here.

 

Classified

RENTAL/LEASING SPACE

For Sale-Outpatient Mental Health Clinic
Started in 1998 and located in the NYC metro area, this multi-location business is a well-established, highly reputable, mental health clinic providing outpatient psychotherapy and counseling services.
Revenues 2017 $1.2 mil.
Profits: 2017 $326k
Asking Price: $970k
Terms are available. The clinic’s market consists of Manhattan, Bronx, Brooklyn and Queens Counties. The 25 clinician practice specializes in group, women’s and psycho-educational therapy as well as parenting groups, court mandated services, domestic violence victims groups, anger management and supervised visitation programs. There are 250+ weekly patients and the business accepts most insurances. Buyer must be a NYS licensed physician, NYS licensed mental health consultant, NYS licensed social worker, psychologist or PhD. The owner is retiring.

Direct All Inquiries to:
Steve Epstein, V.P.
Gottesman Company
O: 201-750-9605
C: 201-704-8051


Thriving Internal Medicine Practice for Sale by the Physician.
Has been growing exponentially, with number of patients doubling over last two years.
Has the visits-volume and the potential space & hours to keep expanding
The physician will stay to overlap for at least one year to personally transition all the practice’s patients, to seamlessly transfer all insurance account and to assist with acquirement of hospital privileges

Well established location at street level, with dedicated handicap entrance, easy access to public transportation, a parking lot and within one mile from all three leading local hospitals.
Fully credentialed as a medical practice site with all health insurances in the market, and compliant with Americans with Disability Act requirements. Office space lease guaranteed for extended period of time. Call 917-596-8936


Are You Trying to Lease Your Medical Office or Sell Your Medical Practice? Trying to Sell New or Used Medical Equipment?
Clineeds, the new online platform designed for medical providers. With Clineeds you can lease your medical officeshared your office spacebuy and sell used medical equipment, or post healthcare job opportunities. LISTING IS FREE! Why wait? Click here to sign-up: www.clineeds.com/sign-up


Beautiful NYC Medical Office — Long-term Share
Bright, big consultation room and one or two exam rooms in large,  tastefully furnished office in first-rate building. 58th Street between Park and Lexington. Near transportation.  Smaller, windowed consultation room and exam room also available. Rent by the day or week, beginning June 1 or sooner. $180 per day or $5500 per months. Perfect for internist, rheumatologist, physical medicine, ob-gyn and others. Superb front desk and office management available, along with many amenities including internet, ultrasound, EMG, kitchen, optional C-arm. Call Carol: 917-856-6402.


For Rent – Medical Office 715 W 170 Street New York
Ground floor just completed build out 4 exam rooms with sinks and wall cabinets
Waiting and reception areas, windows throughout.
Street and private entrances, two bathrooms and storage/lab/staff room.
One block to bus and two blocks to Presbyterian Medical Center and subway.
$1900-$7900/ month for one to 4 exam rooms.
Drdese@gmail.com or 917.8618273


For Share – Plastic Surgeon’s Office Facing Central Park Ground Floor Lobby Entrance/Private exit
One to three exam rooms, consult/private office and procedure room for full or part time use.
Elegant, modern and spacious secretarial, waiting and two exam rooms.
Accredited operating rooms and recovery rooms on site.
One block to bus and 20 feet to subways.
$1275-$3750/day monthly for one to three exam rooms.
Drdese@gmail.com or 917.861.8273


Office Space – Sutton Place
Newly renovated medical office. Windows in every room looks out to a park like setting on the plaza level. 2-4 exam rooms/offices available, possible procedure room or gym. Separate reception and waiting area, use of 3 bathrooms and a shower. Central air and wireless. All specialties welcome. Public transportation nearby. Please call 212-772-6011 or e-mail: advocate@medicalpassport.org


PHYSICIAN OPPORTUNITIES


Paging Primary Care Doctors Who Love Technology
98point6 is a healthcare technology startup that needs your input.  We’re seeking practicing physicians to join our Primary Care Council to help shape the future of primary care.  If the fusion of healthcare and technology inspires you, please join us and apply today. Visit: www.98point6.com/about/pcc/


Private Multidisciplinary Medical Group Seeking Full Time or Part Time Podiatrist and Full Time or Part Time Internal Medicine/Family Practice/Allergy & Immunology Physicians.
Midtown, Union Square & Lower Manhattan locations. Attractive base salary plus comprehensive benefits package. E-mail CV to tsrgexpress@gmail.com. No recruiters please.


Chief of Medical Services
MINIMUM QUALIFICATIONS: Possession of a license and current registration to practice medicine in New York State, plus six years of experience in the practice of medicine, two years of which must be in an administrative or supervisory capacity. Appointee must be eligible for and maintain eligibility for full and unconditional participation in Medicaid and Medicare programs. Appropriate certification by an American Medical Specialty Board and one year of post certification experience in that specialty can be substituted for four years of general experience.
PREFERRED QUALIFICATIONS: Board certification in Geriatric Medicine and/or Certification as a Medical Director (AMDA), and experience in a long-term care facility.
RESPONSIBILITIES: Serve as Medical Director of a 242-bed skilled nursing facility for veterans and their dependents. Provide medical leadership and oversight ensuring the delivery of quality health care services while also ensuring compliance with clinical, statutory and regulatory standards.Send resume to:  NYS Veterans Home, Attn: Human Resources, 4207 State Highway 220, Oxford, NY 13830

The New York State Veterans Home at Oxford is a 242-bed skilled nursing facility operated by the NYS Department of Health located in Chenango County. It is an Affirmative Action/Equal Opportunity Employer. 


Family Practice Physician – Schenectady/Amsterdam, NY
Hometown Health Centers is a Federally Qualified Community Health Center in the Upstate, Schenectady and Amsterdam, NY areas. Bi-lingual in English/Spanish is a plus.  Excellent total compensation package.  No hospital rounding. Flexible and part-time schedules available.  Sign-on bonus. For additional information please send inquiries or resumes to href=”mailto:jobs@hhchc.org”>jobs@hhchc.org. www.hometownhealthcenters.org


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


 

MSSNY eNews: You, Your Patients & MOLST

 

Thomas J. Madejski, MD MSSNY President
PRESIDENT’S MESSAGE
Thomas J. Madejski, MD
MSSNY President
MAY 11, 2018
Volume 18
Number 18

Dear Colleagues:

Several years ago, the New York State Department of Health approved use of a form called Medical Orders for Life-Sustaining Treatment (MOLST) that can be used statewide by health care practitioners and facilities for patients with serious health conditions who:

  • Want to avoid or receive any or all life-sustaining treatment;
  • Reside in a long-term care facility or require long-term care services; and/or
  • Might die within the next year.

The MOLST form is a way to document a patient’s wish concerning life-sustaining treatment.   This is an optional form that physicians and other health care practitioner can use–or they may choose to use other forms.  However, the MOLST form is the only authorized form in New York State for documenting both non-hospital DNR and DNI orders.  In hospitals, hospice and nursing homes, the form may be used to issue any orders concerning life-sustaining treatment and in the community setting, MOLST can be used to notify EMS personnel about a Do Not Resuscitate (DNR) and Do Not Intubate (DNI) order.

The concept for MOLST came from MSSNY member Patricia Bomba, MD, Vice President of Excellus Blue Cross Blue Shield. Dr. Bomba is a strong advocate for physicians to have “that difficult conversation” with their patients about their end of life choices. Over the years, MSSNY has supported MOLST as another “tool” in our medical toolbox and a great way to begin the difficult conversation.

Legislation (A9603), introduced by Assemblymember Joseph Morelle, would create an “eMOLST registry” that calls upon DOH to develop the registry.  If passed, physicians who use the MOLST form will then be required to report patient related information from the MOLST form to the registry within 14 days.

The problems that I see with any compulsory mandate are:

  • Doctors fear OPMC problems if they do not comply with the law
  • Doctors are concerned that the data may not be housed at the NYS DOH.
  • Doctors are concerned about multiple different documents which may have conflicting data

MSNY continues to support improving the care of all of our patients, especially when they approach the end of their lives. Our Council had extensive discussion today on end of life care and approved creation of a task force on end of life care.

What do you think? comments@mssny.org

Thomas J. Madejski, MD 
MSSNY President



MLMIC Insurance

Capital Update
MSSNY Council Approves Formation of a Task Force Death and Dying, Palliative and End Of Life Care
The Medical Society of the State of New York’s Council approved this week the formation of a task force to examine the role of physicians as it relates to death and dying, palliative and end-of-life care.  The task force was formed in lieu of a House of Delegates resolution that requested that MSSNY change its position of opposition to one of neutrality on physician-assisted suicide and euthanasia.  “These are complex issues and it is very important that we address this controversial issue in the most appropriate way,” Thomas Madejski, the society’s president, said in a release. “The Task Force will be ethnically and philosophically diverse and will include members from across MSSNY’s membership — including physicians from the Long-Term Care and Health Disparities committees.”                                                (CLANCY)


Please Urge Your Legislators to Enact Legislation to Address Prior Authorization Hassles and Expand Patient Choice of Physicians

Working together with several other patient advocacy organizations and specialty societies, MSSNY continues to advocate for numerous pieces of legislation in the final weeks of Session that would reduce barriers imposed by health insurance companies that interfere with patient care, and expand patient choice by limiting the ability of health insurers to narrow their networks.   These bills include:

  • 3663 (Hannon)/A.4472 (Gottfried) – would permit independently practicing physicians to collectively negotiate patient care terms with market dominant health insurers under close state supervision. In addition to the ability to push back against exorbitant administrative hassles imposed by insurers, it would also help to protect physicians to have a stronger option to remain in independent practice. The bill is in the Senate Health Committee, and the Assembly Ways and Means Committee.  Please send a letter to your legislators in support here.
  • 7872 (Hannon)/A.9588 (Gottfried) – would reduce prior authorization hassles by requiring health plan utilization review criteria to be evidence-based and peer reviewed; reducing the time frame for reviewing prior authorization requests from 3 business days to 48 hours (and to 24 hours for urgent situations); assuring that a prior authorization, once given, is enduring for the duration of the medication or treatment; prohibiting mid-year prescription formulary changes; and assuring that once a prior authorization is given, it cannot be withdrawn if eligibility is confirmed on the day of the service. We are pleased that several legislators have joined on as co-sponsors of this legislation. Please send a letter to your legislators in support here.
  • 3943 (Hannon)/A.2704 (Lavine) – 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.  The bill is on the Assembly floor and in the Senate Health Committee.  Please send a letter in support here.
  • 5022-C (Serino)/A.2317-C (People-Stokes) – would prohibit health insurance companies from making changes to a prescription formulary or shifting a medication to a different cost-sharing tier during a policy year. The bill has passed the Assembly, and is before the Senate Insurance Committee.

            (DIVISION OF GOVERNMENTAL AFFAIRS)

New York Settles Lawsuit Against Federal Government to Preserve Essential Plan Funding
New York State and Minnesota settled a lawsuit this week they had filed against the US Department of Health and Human Services to protest HHS’ action to cut funding for the Basic Health programs operating in New York and Minnesota.   The settlement will result in New York receiving $151 million for its Essential Plan, and $17 million for Minnesota’s plan.  The states will continue to discuss with HHS a revised funding formula for the program.

New York’s Essential Plan provide comprehensive health insurance coverage with little cost-sharing for over 600,000 New Yorkers who earn too much to qualify for Medicaid but make less than 200% of the Federal Poverty Level.  Acting New York Attorney General Barbara Underwood released the following statement:

“The Essential Plan serves hundreds of thousands of low-income New Yorkers. We filed suit earlier this year to protect the quality, affordable health care on which New York’s families rely.  We are gratified that the federal government has agreed to make this interim payment. 

We hope and expect that, in the coming weeks, we’ll reach agreement with the federal government on a payment formula for the program, so that we can resolve this matter fairly and appropriately for all New Yorkers.”  (AUSTER)

Legislation To Require Physicians to Report Patients to DMV on Senate Transportation Committee Agenda
Legislation introduced by Senator Young would require a licensed physician, physician assistant or nurse practitioner to report patients that have chronic condition which may cause unconsciousness or unawareness to the Department of Motor Vehicles. Such conditions may include a convulsive disorder, epilepsy, fainting, dizzy spells, coronary ailments or other health conditions that may impair the ability to operate a motor vehicle.

The bill, S.3569 (Young) / A.10094 (Carroll), is on the Senate Transportation Committee agenda for Tuesday, May 15. The Medical Society understands and supports efforts to ensure pedestrian and driver safety and reduce vehicular accidents.  MSSNY policy supports the ability of physicians to voluntarily report certain patients to DMV whom the physician believes should not operate a motor vehicle.  However, a lack of well-defined medical and legal guidelines may force a physician to “over-report” which in turn could discourage patients from receiving needed medical care.  Please contact your legislators to oppose this legislation imposing burdensome and ambiguous new mandates on physicians that may jeopardize the sanctity of the doctorpatient relationship. They can be reached at 518-455-2800.                          (BELMONT)

MSSNY Urges for Extension of Committee for Physicians Health Program
MSSNY continues to advocate for legislation (A.10221-A, Gottfried, S.8093, Hannon) that would extend for an additional 5 years the continued operations of the MSSNY Committee for Physicians Health (CPH) program.  Authorization for several key components of the program expired on March 31, 2018.   The legislation was amended this week to clarify that the legislation would be retroactive to March 31 once enacted.  It has advanced to the Senate floor, and is before the Assembly Health Committee.

The CPH is a program designed to confront and assist physicians thought to be suffering from alcoholism, substance abuse or mental illness.   Since the inception of this program, CPH has assisted thousands of physicians in returning healthy to medical practice.  The work of the CPH program is an important public service both to our health care system as well as the general public. As a result, the State Budget annually includes an appropriation of $990,000 for the program, which is generated from a $30 assessment on all physicians’ biennial registration fees.

The program has traditionally been extended by the Legislature in 3 or 5 year “demonstration programs” with the most recent extension in 2013.  The recently enacted State Budget included a provision to create another “demonstration program” until 2023.  However, it omitted other provisions historically extended at the same time that are essential to its functioning that could greatly impair its operations unless immediate action is taken.  These includes provisions that set forth the CPH program’s reporting requirements to the Office of Professional Medical Conduct (OPMC), provisions to ensure liability protections for the physician Committee members for work performed in the scope of CPH, and necessary confidentiality protections for the program given the sensitivity of the work they perform.   These protections are absolutely essential to the continued functioning of the program to ensure that physicians with the appropriate expertise are willing to serve on the Committee, as well as to assure that the program has the ability to report sensitive information to OPMC when warranted by the circumstances.  (DIVISION OF GOVERNMENTAL AFFAIRS)

MSSNY Continues to Express Concerns with Cuts to Patient-Centered Medical Home Program
MSSNY continues to work with primary care associations to respond to Medicaid cuts to the Patient Centered Medical Home (PCMH) program.  As reported last week, earlier this year the NYS Health Department announced its intent to implement a huge cut in Medicaid payments to physicians participating in the PCMH program. Specifically, DOH intended to slash the current $7.50 Per Member Per Month (PMPM) payment for each Medicaid patients to $2.00 for May and June.  The amount would increase to $5 or $5.50 PMPM in July but would also have required that each PCMH participant have a Level 1 Value-Based Payment contract with a Medicaid Managed Care plan.

If permitted to go forward, these cuts and new requirements would likely have pushed many physicians away from participating in the PCMH program, which in turn would have significantly impaired access to primary care services for many patients insured through Medicaid.   As a result of these concerns, MSSNY worked together with the New York Chapters of the American College of Physicians, Academy of Family Physicians and American Academy of Pediatrics, as well as the Community Healthcare Association of New York State (CHCANYS), to successfully advocate for the Legislature to include $20 million in the State Budget to prevent these Medicaid payment cuts from being implemented.

While a NYS Assembly summary of the final State Budget noted that these funds were intended to “reject a reduction in reimbursement rates for patient centered medical home services”, that point has been disputed by the NYSDOH. Last week DOH released a letter noting payment changes to the PCMH program starting in May.  Importantly, DOH has indicated that it was not going forward with a requirement for PCMH participants to have VBP contract by July 1.  However, of significant concern, the letter indicated that there are still going to be cuts to Medicaid PCMH payment, as follows:

  1. Effective May 1, 2018 – June 30, 2018, the MMC PCMH PMPM for providers recognized under NCQA 2014 Level 3, NCQA 2017, or NYS PCMH standards will be $5.75.
  1. Effective July 1, 2018 to the end of SFY 18-19, the MMC PCMH PMPM for providers recognized under NCQA 2014 Level 3, NCQA 2017, or NYS PCMH standards will be $6.00.
  1. Effective May 1, 2018, the PCMH incentive payments for providers recognized under NCQA’s 2014 Level 2 standards will be permanently eliminated for both MMC and FFS.

MSSNY continues to work with the ACP, AFP, AAP and CHCANYS to express significant concerns to the Legislature, DOH and Governor’s Office with these PCMH cuts, even at a reduced level, in spite of the action taken by the Legislature.  An article discussing these concerns that quoted MSSNY President Dr. Thomas Madejski appeared in Politico-NY this week.  Physicians are urged to contact the Governor and their legislators to express their concerns here.                                                             (AUSTER)

New CMS Tool for Physicians To Check Whether They Need to Comply with MIPS
The Centers for Medicare and Medicaid Services (CMS) has announced that physician practices/groups may now log into the CMS QPP website to check their 2018 eligibility for Medicare’s Merit-based Incentive Payment System (MIPS), according to an alert from the American Medical Association.

After groups log in, they will be able to click into a details screen to see the eligibility status of every clinician in the group (based on their National Provider Identifier or NPI) to find out whether they need to participate during the 2018 performance year for MIPS.  The AMA also advised that CMS will not be sending out letters to advise physicians of their eligibility status this year so checking on the QPP participation status look-up tool is the only way to determine or verify eligibility status.  Eligibility rules in 2018 are different than in 2017 so status this year may be different than last.  Also as is indicated in the look-up tool, exempt individual clinicians still will need to report if their group is eligible and chooses to report as a group.

The look-up tool can be found here.                                                 (AUSTER)

Physicians Encouraged to Take Survey; Bending the Diabetes Curve CME Course Available Online
The Medical Society of the State of New York has partnered with the American Medical Association to bring its Prevent Diabetes STAT initiative to New York.  MSSNY has developed a short survey to sample physician’s knowledge of the National Diabetes Prevention Program (DPP) and the Prevent Diabetes STAT program. The survey also serves as a platform to physicians to express what specific boundaries they have experienced or anticipate experiencing regarding the implementation of the DPP and/or Prevent Diabetes STAT. Participation in this survey is essential to the development of various educational components that will benefit both the physician and patient communities. Click here to take the one-minute survey.

Bending the Diabetes Curve webinar is now available to view online; click here. By educating physicians and connecting more patients to evidence-based lifestyle change programs, this diabetes initiative will help bridge the gap between clinical care settings and communities to reduce the incidence of type 2 diabetes.

Webinar: Bending the Diabetes Curve

Faculty: Geoffrey Moore, MD & Sarah Nosal, MD

Educational Objectives:

  • Describe the trends in Type 2 diabetes and implications for clinical practice
  • Review evidence that supports referring patients with prediabetes to lifestyle change program
  • Outline the considerations for implementing a diabetes prevention initiative in a physician practice
  • Describe NYS specific incidents of prediabetes and diabetes in adult population
  • Understand the reimbursements mechanisms for DPP

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 of these live activities for a maximum of 1.0 AMA/PRA Category 1 credits™.  Physicians should claim only the credit commensurate with the extent of their participation in the activity.

Additional information or assistance with registration may be obtained by contacting Carrie Harring at 2020 charring@mssny.org.                                       (HARRING)

Learn How You Can Help Meet the Mental Health Needs of Veterans at the Dwyer Peer Project Annual Day of Wellness
The Suffolk County United Veterans and the Suffolk County Veterans Service Agency are jointly hosting the 5th annual Joseph P. Dwyer Veterans Peer Support Project Day of Wellness. The event will take place on Saturday, June 9 at Camp Pa-Qua-Tuck, 2 Chet Swezey Road, Center Moriches, NY. It will from 9 am to 4 pm with provider demonstrations from 10 am to 3 pm. The day will include educational activities for veterans and their families with a focus on dealing with post-service transition issues as well as family-oriented entertainment by veterans. Complimentary breakfast and lunch will be served. 

To register for the live event, CLICK HERE.  Both registrants and walk-ins are accepted. 

Ebola Webinars Available on MSSNY CME Website
An Ebola outbreak has been confirmed in the Democratic Republic of Congo.  Following 17 deaths and 21 patients showing signs of hemorrhagic fever, an Ebola outbreak was declared in the Democratic Republic of Congo this week.  The Medical Society has two CME courses available that help to address these concerns regarding Ebola virus.  Go to https://cme.mssny.org to view MSSNY’s free CME courses on this timely and relevant topic.  Ebola: A Perspective from the Field offers a firsthand description of Ebola virus.  And Viral Hemorrhagic Fevers with an Ebola Virus Update offers a comprehensive analysis of diagnosis and treatment for Ebola and other viral hemorrhagic fevers.         (HOFFMAN)


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

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


eNews

Council Notes—May 10, 2018

  • MSSNY will convene a Task Force on Death and Dying to develop a white paper regarding the physicians’ role in end of life and palliative care. The paper will also discuss the impact of these issues on the disparate populations and the disabled community. Click here to read MSSNY’s press statement.
  • Dean P. McElwain, President and COO of Castle Connolly Private Health Partners, presented information about transitioning to a concierge practice model. McElwain noted that the standard concierge practice has 55-60 patients and doesn’t differ greatly from a traditional practice model, but offers both patients and physicians convenience, connectivity and care. Castle Connelly currently focuses on IM practices, but is currently in experimental stages with specialty practices. Council approved pursuing a member benefit that would assist physicians in transitioning to a concierge practice.
  • As a pilot project in participating counties, MSSNY and the county medical society will offer member benefits and services to international medical students engaged locally in New York State-approved clinical rotations free of charge until they are eligible for student or other membership. This will include invitations to county and state medical society meetings, without the right to vote unless and until formal membership is obtained.
  • MSSNY Burnout Committee will change its name to MSSNY Committee for Physician Wellness and Resilience. The mission is to increase education, awareness and recognition of stress and their effects on both the individual physician and the physician workforce and to support physicians in optimizing their physical, emotional, cognitive and psychological well-being in order to recover the intrinsic joy of the practice of medicine in a dynamic healthcare environment. The vision of the Committee for Physician Wellness and Resilience is for physicians to have a workforce and environment free of extraneous stressors and to be free from the effects of stress and their wide-ranging consequences.
  • Council discussed and approved a request from MSSNY’s General Counsel, Garfunkel Wild, to support an Amicus brief. The issue on appeal involves whether the NYS Comptroller is required to obtain a patient’s written authorization in order to subpoena patient medical records for the purpose of conducting an audit of payments made under the Empire Plan to a medical practice.

Help Patients Find You: Confirm Your Practice Info Using NYS’s New Tool
On April 25, the New York State Department of Health (NYSDOH) and the New York State of Health launched a new tool called NYS Provider & Health Plan Look-Up.

It’s an online tool that allows consumers to quickly locate information about their doctors and the health insurance plans in which their doctors participate. To make sure plan members can find you, go to the website to review and ensure your practice information is accurate.

To report an error in the listing, go to the NYS Provider & Health Plan Look-Up home page and select the Contact/Report an Error button. Then, select the health plan and the reason you are contacting them. The issue will be routed electronically to the NYSDOH and to the selected health plan(s) for review and follow-up.

Rockefeller Institute Study: Medical Marijuana v. Opioid
According to the Albany-based Rockefeller Institute of Government, some states allowing medical marijuana and recreational pot saw declines in opioid prescribing as authorities pushed urgent efforts to combat the historic American drug crisis. Medicaid patients, for example, are getting about 5.9 percent fewer prescription painkillers in medical marijuana states. Further, the opioid prescription declines are deeper where recreational pot is allowed, down nearly 6.4 percent. http://rockinst.org/blog/can-marijuana-alleviate-the-opioid-crisis-data-suggest-yes/

One high-profile National Institutes of Health study was awarded recently to researchers at Albert Einstein College of Medicine and Montefiore Health System in the Bronx. The five-year, $3.8 million grant is for the first long-term study to test whether medical marijuana reduces opioid use among adults with chronic pain, including those with HIV, the health system said.

Against that backdrop, the Rockefeller Institute report detailed a range of studies from medical journals and universities. They include:

  • Overall, patients in medical marijuana states filled fewer daily doses of opioids, University of Georgia research found. For example, they saw a 14.4 percent reduction by Medicare patients in states with access to a medical marijuana dispensary.
  • Marijuana reforms have also saved taxpayers’ money, according to recent JAMA Internal Medicine
  • Recreational marijuana laws were tied to 9.78 percent lower Medicaid spending on prescription opioids, an annual savings of $1,815 Medicaid spending per 1,000 enrollees, the study found.
Physicians’ Day at the Races 2018 – Secure Your Tickets Today!
Join your colleagues for MSSNYPAC’s Physicians’ Day at the Races on Saturday, July 28, 2018 at Saratoga Race Track in Saratoga Springs, NY.  All physicians, including non-members of MSSNY are welcome to support this state-wide fellowship event for MSSNYPAC while supporting a great cause which strengthens our profession.  Tickets are $500/physician, $300/guest and $250/guests under 21.  As it’s the day of the renowned “Jim Dandy” stakes, tickets for this event are limited. Visit www.mssnypac.org/events for details or to download an invitation.  Ticket requests and questions can be directed to Jennifer Wilks at518-465-8085.

Study: Older Adults’ Hearing Aid Use Linked To Lower Hospitalizations, ER Visits
A report published in JAMA Otolaryngology–Head & Neck Surgery suggests that older adults with hearing loss who wear hearing aids “are less likely to be hospitalized or to visit the emergency room…compared to those who don’t” wear the aids. However, the article says, “people with hearing aids also averaged 1.4 more doctor visits than those without the devices.” Researchers also published an accompanying editorial.

New York Rx Card Helps Patients Fill Their Prescriptions
The Medical Society of the State of New York (MSSNY) in partnership with New York Rx Card reminds physicians that patients who are not insured or who take prescription drugs that are not covered by their health insurance plans, can use the New York Rx Card to obtain discounts of up to 75 percent off the retail price for FDA-approved medications.

New York Rx Card has been working closely with MSSNY, as well as numerous clinics and hospitals around the state to distribute free discount prescription cards so that all New York residents will have access to this free program. The program can also be used by people that have health insurance coverage with no prescription benefits, which is common in many health savings accounts (HSA) and high deductible health plans.

Please help by encouraging your patients to print a free New York Rx Card at the MSSNY website or at www.newyorkrxcard.com.  New York Rx Card also has an available app for your iPhone and Android phones. You can visit www.newyorkrxcard.com and download the app today.  Any physicians who are interested in ordering free cards for their clinic/hospital can email Chez Ciccone, via email at fciccone@nyrxcard.com or by phone at 800-931-2297.

Five Opioid Distributor Execs: Four of Five Deny Contributing to Opioid Abuse
Five of the nation’s top opioid distributors on Tuesday told a House panel that responsibility for the opioid crisis rests with “bad actors” at pharmacies and doctors who wrote too many prescriptions, not with their companies. Executives from four of the five distributors denied contributing to widespread painkiller abuse when questioned by Energy and Commerce Oversight and Investigations Chairman Gregg Harper (R-Miss.). Joseph Mastandrea, chairman of Ohio drug wholesaler Miami-Luken, answered “yes” and blamed prior management.

Another executive, Cardinal Health Executive Chairman George Barrett, apologized for not catching bad actors faster. Several of the other executives expressed contrition for not catching large requests for opioids more quickly. Earlier this year, the committee released documents alleging that between 2006 and 2014, McKesson and Cardinal Health shipped 12.3 million pills to one pharmacy in Mount Gay-Shamrock, West Virginia, which has fewer than 2,000 residents. Likewise, over five years, AmerisourceBergen distributed 60.9 million doses of hydrocodone and 29.4 million doses of oxycodone to West Virginia.

Energy and Commerce Chairman Greg Walden (R-Ore.) recounted how one West Virginia town of about 400 people received 9 million opioid pills in two years and how a single pharmacy in a town of 1,800 people got 17 million opioid pills in a decade.

Since the 1970s, drug distributors have been responsible for flagging suspicious orders and monitoring sales — something Walden suggested has not been done.

The executives largely shifted blame, despite their role in supplying the drugs at the center of the nationwide crisis. Three of the companies that testified — McKesson, Cardinal Health and AmerisourceBergen — account for about 85 percent of the opioid drug supply, Walden said.

https://www.politico.com/story/2018/05/08/opioid-distributors-blame-pharmacies-docs-522433

MLMIC to Host Spring 2018 Network Meetings Across NYS
These programs are designed to provide risk management education to MLMIC’s insured physicians, medical directors, facility risk managers, office practice administrators, nursing staff, marketing and IT staff and other healthcare professionals. This year’s program, which can qualify participants for CME credits, focuses on “Managing Your Social Media Presence.” It will:

  • examine the use of social media in healthcare;
  • analyze the positive and negative aspects of social media;
  • describe the appropriate use of social media in marketing;
  • formulate approaches to address negative online patient reviews;
  • evaluate the potential legal implications of social media on patient privacy and confidentiality; and
  • select strategies to develop and monitor social media policies.

The program is part of MLMIC’s ongoing efforts to provide education, promote patient safety and reduce potential liability exposure for all our insured providers and entities.

MLMIC is accredited by the Medical Society of the State of New York (MSSNY) to provide CME for physicians.

MLMIC designates this live educational activity for a maximum of 2.0 AMA PRA Category I Credits™.

Physicians should claim only the credit commensurate with the extent of their participation in the activity.

Click here to read the program brochure and obtain registration information for a spring Network Meeting near you. 

USPSTF: Neutral Stance on Prostate Cancer Screening in Middle-Aged Men
Prostate-specific antigen (PSA) screening for prostate cancer isn’t recommended unless men request the test after being informed of its potential benefits and risks, the U.S. Preventive Services Task Force (USPSTF) says in new guidance published in JAMA. The grade C recommendation applies to asymptomatic men aged 55 to 69. The group recommends against PSA screening in men aged 70 and older (grade D recommendation). USPSTF recommendation statement in JAMA ; JAMA Internal Medicine editorial ; USPSTF grade definitions

Geisinger Health: Now Offering DNA Sequencing to All Patients
Geisinger Health this week announced that over the next six months it will offer DNA sequencing to all of its patients as part of their “routine” preventive care in an effort to inform patients about potential genomic risk factors for cancer or heart disease. Geisinger said it plans on making DNA sequencing a “routine screening,” just like colonoscopies, cholesterol checks, and mammograms, and will have doctors work with patients on responding to any identified risk factors.

CMS

CMS’ Eight-Page Plan for Rural Health Strategy; Commitment to Telehealth
On May 8, CMS unveiled an eight-page rural health strategy, which detailed the agency’s commitment to improve access to telehealth, improve outreach to rural health care providers, and find practical solutions to improve care in those areas. The strategy marks CMS’ first focused on rural health, but it did not contain any specific policy changes.

CMS Hosting a Medicare Learning Network Call: QPP FAQs
The Centers for Medicare & Medicaid Services (CMS) is hosting a call on Wednesday, May 16 at 1:30 PM ET to discuss the most frequently asked questions (FAQs) about the Quality Payment Program that came up during the 2018 Healthcare Information and Management Systems Society (HIMSS) Annual Conference & Exhibition.

Attendees will have the opportunity to listen to 2018 programmatic updates and FAQs that were discussed at HIMSS 2018. CMS will also open the phone lines for participants to ask questions about the Quality Payment Program.

Call Details

Title: Quality Payment Program: Answering Your Frequently Asked Questions Call

Date: Wednesday, May 16, 2018

Time: 1:30-3:00 p.m. ET

Registration Link: https://blh.ier.intercall.com

Classified

RENTAL/LEASING SPACE

Thriving Internal Medicine Practice for Sale by the Physician.
Has been growing exponentially, with number of patients doubling over last two years.
Has the visits-volume and the potential space & hours to keep expanding
The physician will stay to overlap for at least one year to personally transition all the practice’s patients, to seamlessly transfer all insurance account and to assist with acquirement of hospital privileges

Well established location at street level, with dedicated handicap entrance, easy access to public transportation, a parking lot and within one mile from all three leading local hospitals.
Fully credentialed as a medical practice site with all health insurances in the market, and compliant with Americans with Disability Act requirements. Office space lease guaranteed for extended period of time. Call 917-596-8936


Are You Trying to Lease Your Medical Office or Sell Your Medical Practice? Trying to Sell New or Used Medical Equipment?
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Beautiful NYC Medical Office — Long-term Share
Bright, big consultation room and one or two exam rooms in large,  tastefully furnished office in first-rate building. 58th Street between Park and Lexington. Near transportation.  Smaller, windowed consultation room and exam room also available. Rent by the day or week, beginning June 1 or sooner. $180 per day or $5500 per months. Perfect for internist, rheumatologist, physical medicine, ob-gyn and others. Superb front desk and office management available, along with many amenities including internet, ultrasound, EMG, kitchen, optional C-arm. Call Carol: 917-856-6402.


For Rent – Medical Office 715 W 170 Street New York
Ground floor just completed build out 4 exam rooms with sinks and wall cabinets
Waiting and reception areas, windows throughout.
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$1900-$7900/ month for one to 4 exam rooms.
Drdese@gmail.com or 917.8618273


For Share – Plastic Surgeon’s Office Facing Central Park Ground Floor Lobby Entrance/Private exit
One to three exam rooms, consult/private office and procedure room for full or part time use.
Elegant, modern and spacious secretarial, waiting and two exam rooms.
Accredited operating rooms and recovery rooms on site.
One block to bus and 20 feet to subways.
$1275-$3750/day monthly for one to three exam rooms.
Drdese@gmail.com or 917.861.8273


Office Space – Sutton Place
Newly renovated medical office. Windows in every room looks out to a park like setting on the plaza level. 2-4 exam rooms/offices available, possible procedure room or gym. Separate reception and waiting area, use of 3 bathrooms and a shower. Central air and wireless. All specialties welcome. Public transportation nearby. Please call 212-772-6011 or e-mail: advocate@medicalpassport.org


PHYSICIAN OPPORTUNITIES


Paging Primary Care Doctors Who Love Technology
98point6 is a healthcare technology startup that needs your input.  We’re seeking practicing physicians to join our Primary Care Council to help shape the future of primary care.  If the fusion of healthcare and technology inspires you, please join us and apply today. Visit: www.98point6.com/about/pcc/


Private Multidisciplinary Medical Group Seeking Full Time or Part Time Podiatrist and Full Time or Part Time Internal Medicine/Family Practice/Allergy & Immunology Physicians.
Midtown, Union Square & Lower Manhattan locations. Attractive base salary plus comprehensive benefits package. E-mail CV to tsrgexpress@gmail.com. No recruiters please.


Chief of Medical Services
MINIMUM QUALIFICATIONS: Possession of a license and current registration to practice medicine in New York State, plus six years of experience in the practice of medicine, two years of which must be in an administrative or supervisory capacity. Appointee must be eligible for and maintain eligibility for full and unconditional participation in Medicaid and Medicare programs. Appropriate certification by an American Medical Specialty Board and one year of post certification experience in that specialty can be substituted for four years of general experience.
PREFERRED QUALIFICATIONS: Board certification in Geriatric Medicine and/or Certification as a Medical Director (AMDA), and experience in a long-term care facility.
RESPONSIBILITIES: Serve as Medical Director of a 242-bed skilled nursing facility for veterans and their dependents. Provide medical leadership and oversight ensuring the delivery of quality health care services while also ensuring compliance with clinical, statutory and regulatory standards.Send resume to:  NYS Veterans Home, Attn: Human Resources, 4207 State Highway 220, Oxford, NY 13830

The New York State Veterans Home at Oxford is a 242-bed skilled nursing facility operated by the NYS Department of Health located in Chenango County. It is an Affirmative Action/Equal Opportunity Employer. 


Family Practice Physician – Schenectady/Amsterdam, NY
Hometown Health Centers is a Federally Qualified Community Health Center in the Upstate, Schenectady and Amsterdam, NY areas. Bi-lingual in English/Spanish is a plus.  Excellent total compensation package.  No hospital rounding. Flexible and part-time schedules available.  Sign-on bonus. For additional information please send inquiries or resumes to href=”mailto:jobs@hhchc.org”>jobs@hhchc.org. www.hometownhealthcenters.org


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


 

MSSNY Will Convene Task Force on Death and Dying


MSSNY Seal
MEDICAL SOCIETY OF THE STATE OF NEW YORK
865 Merrick Avenue, Westbury, New York 11590-9007
www.mssny.org
Communications Division
Telephone: (516) 488-6100

 

For Immediate Release

MSSNY Will Convene Task Force on Death and Dying

May 10, 2018, Westbury, NY—The Council of The Medical Society of the State of New York (MSSNY) today voted to convene a Task Force on Death and Dying to develop a white paper regarding the physicians’ role in end of life and palliative care. The paper will also discuss the impact of death and dying on the disparate and the disabled populations.

“These are complex issues and it is very important that we address this controversial issue in the most appropriate way,” said MSSNY President Dr. Thomas Madejski. “The Task Force will be ethnically and philosophically diverse and will include members from across MSSNY’s membership—including physicians from the Long-Term Care and Disparities committees.”

MSSNY has a long-standing policy that opposes physicians’ participation in accelerating a patient’s natural death. 

# # #

About the Medical Society of the State of New York
Founded in 1807, the Medical Society of the State of New York is the state’s principal non-profit professional organization for physicians, residents and medical students of all specialties. Its mission is to represent the interests of patients and physicians to assure quality healthcare services for all.

 

Media Contact:
Roseann Raia

Medical Society of the State of New York
865 Merrick Ave.
Westbury, New York
516.488.6100 x 302
rraia@mssny.org

 

Doing Right for Patients & Members

 

Thomas J. Madejski, MD MSSNY President
PRESIDENT’S MESSAGE
Thomas J. Madejski, MD
MSSNY President
MAY 4, 2018
Volume 18
Number 17

Doing Right by Our Patients and Our Members

Dear Colleagues:

I related to you last week my testimony before the Assembly Health Committee explaining MSSNY’s policy on physician assisted suicide/aid in dying. I testified to MSSNY’s existing policy, which was last reviewed and updated at our 2015 House of Delegates.  Our HOD explicitly indicated that physicians should not participate in physician assisted suicide or euthanasia.

Contentious Issue

I acknowledged that this is a difficult and contentious issue amongst our members, and that there are reasoned arguments on both sides.  My testimony indicated what MSSNY’s present policy is, and that there has not been any attempt to change that policy.

MSSNY was asked at the last House of Delegates to conduct a survey of our members’ attitudes toward physician assisted suicide/aid in dying.  Of note, the 2017 resolution DID NOT ask MSSNY to change its policy; just that a survey be conducted. I testified that the survey has been completed and that the results are being analyzed and reviewed by the MSSNY Bioethics Committee.

MSSNY routinely conducts surveys on many different issues throughout the course of the year.  We use various instruments and recognize that all surveys have inherent bias and methodological issues.  We consider the information and potential flaws of all the data that we use when we formulate policy.

Under Consideration Now in NY

The Medical Aid in Dying Act (S3151/ A2383) is currently under consideration during this legislative session.  Our Council and Bioethics Committee did not have an opportunity to discuss their work prior to the completion of public hearings. After discussion with MSSNY leadership and staff, I wanted to provide as much information as we could to aid the legislators in their deliberations, acknowledging that we had not completed our consideration of the information.

No good deed goes unpunished.

In response to my testimony, organizations that support aid in dying accused MSSNY of mishandling the survey. The organizations are: Compassion and Choices; End of Life Choices New York; Death with Dignity National Center; and Death with Dignity-Albany.

I testified at the hearing that MSSNY is committed to improving care for all of our patients, especially those near the end of their life.  One of the core principles of the practice of medicine is the easing of suffering, and I acknowledged in my testimony that sometimes physicians may hasten a patient’s death in an attempt to ease their pain.

My job as MSSNY President is to represent MSSNY policy— which I believe I did.

Response

The organizations chose to attack us, rather than work with MSSNY to improve the care of our patients at end of life.  I think it is important to respond to some of the criticism in an attempt to clear the air, and hopefully move forward together:

  • The organizations indicated we released information “unexpectedly.” MSSNY members who are part of the Aid in Dying movement have been asking for information, and questioning why MSSNY wasn’t giving out results. Again, we continue to work on the analysis, but with time constraints and pending legislation, I felt it was important to try and give some information about the results, fully acknowledging that these were preliminary conclusions and will be reviewed further.
  • The organizations indicated that MSSNY did not produce an unbiased survey.  Our Bioethics Committee took great care in creating a survey instrument to minimize bias, and created an instrument that would help to inform leadership on the concerns of MSSNY members.
  • The organizations were concerned that non-MSSNY members participated in the survey.  MSSNY became aware of this early in the survey process.  In fact, Compassion and Choices interfered in the survey process only hours after MSSNY released the survey and several days later we learned that the Catholic Conference was also sending out the MSSNY survey. The organizations don’t indicate that MSSNY legal counsel had to have a discussion with organizations advocating for and against Aid in Dying to cease and desist redistributing the survey to their non-MSSNY members.
  • MSSNY shares Assemblymember Paulin’s concern about the participation of non-MSSNY members and will consider that in our evaluation of the data.
  • One of the difficulties in discussing physician assisted suicide/aid in dying is conflation of related issues. The organizations quoted a number of different studies, but does not seem to be concerned about sources of bias in their parsing of data favorable to their position.
  • Those organizations indicated that it defies logic that a majority of MSSNY physicians oppose medical aid in dying in the light of other national surveys. If that is truly the case, then why be concerned with our process? Then why are the organizations so vested in our process?    We have a very democratic and open process in determining policy through our House of Delegates.

I have already tasked some of our committees with reviewing the issues related to death and dying.  This issue will also be discussed at the MSSNY Council Meeting.

MSSNY has been advocating for the care of patients, the proper practice of medicine, and the betterment of public health since 1807. The last time the majority of MSSNY members spoke through our House of Delegates they opposed physician assisted suicide. That policy has not changed.

NY Is a Policy Leader 

New York State is a national leader in educating physicians and creating health care policy.  I think we can work together to create policy and systems of care that ease our patients’ suffering without creating additional disparities in care.

As President of MSSNY, I am committed to leading a discussion amongst all physicians on how best to care for patients at end of life.

Excelsior!

I am interested in hearing your comments on this topic: comments@mssny.org.

Thomas J. Madejski, MD 
MSSNY President


Dr. Donald Moore, host of the well-attended, all-day HIT Symposium at Brooklyn Boro Hall on Saturday, April 28. Dr. Sal Volpe, Dr. Parag Mehta were featured speakers.


MLMIC Insurance

Capital Update

MSSNY Joins Patient Groups to Advocate to Prevent Mid-Year Formulary Changes
This week MSSNY representatives participated with representatives of several other patient advocacy groups as well as the bill sponsors in a press conference and legislative meetings in support of legislation (A.2317-C, People-Stokes/S.5022-C, Serino) that would (in most cases) prohibit a health insurer from making a change to their prescription drug formulary or moving a prescription drug to a higher tier during a policy year.  The legislation passed the Assembly unanimously this week, and is before the Senate Insurance Committee.

The measure is supported by many patient and physician advocacy groups, including the Global Healthy Living Foundation, Lupus and Allied Diseases Association, NAACP, AARP, New Yorkers for Accessible Health Coverage, the Epilepsy Foundation, the Arthritis Foundation, the American Cancer Society, the National Association on Mental Illness-NY, the NY Chapter of the American College of Physicians, the NYS Osteopathic Medical Society, and the American College of Rheumatology.  This week’s event received significant media coverage, including through Newsday and Capital Tonight.

Also participating in the press conference and meetings were parents of children with chronic diseases who shared stories of the impact of these mid-year formulary changes.

The press release referenced a survey released by the Global Healthy Living Foundation found that 65% of New Yorkers reported that their insurance company switched their medication to a drug that was different from the one their physician prescribed; 86% reported paying more out-of-pocket for their prescription medications due to formulary changes; and 93% reported that the medication they were switched to worked worse than the original prescribed medication.

MSSNY President Dr. Thomas Madejski stated the following for the press release:Continuation of a medication regimen prescribed by a patient’s treating physician is critical to assuring a patient’s recovery from illness, maintaining their health, or preventing worsening of their condition. Unexpected changes to a medication formulary could result in significantly higher out-of-pocket costs for patients. This could seriously interfere with their continued ability to obtain these needed medications.  Insurance company formulary changes are not made with the intimate knowledge of the patient’s personal physician.  Additionally, this legislation would help to protect consumers from unforeseen higher cost-sharing requirements.  (AUSTER, BELMONT)

Update on the Patient-Centered Medical Home Program – Physicians Concerned that Some PMPM Cuts Going Forward
To respond to State Budget constraints, earlier this year the NYS Health Department announced its intent to implement a huge cut in Medicaid payments to physicians participating in the Patient-Centered Medical Home program. Specifically, DOH intended to slash the current $7.50 Per Member Per Month (PMPM) payment for each Medicaid patients to $2.00 for May and June.  The amount would increase to $5 or $5.50 PMPM in July but would also have required that each PCMH participant have a Level 1 Value-Based Payment (VBP) contract with a Medicaid Managed Care plan.

If permitted to go forward, these cuts and new requirements would likely have forced many physicians out of the Medicaid PCMH program, which in turn would have significantly impaired access to primary care services for many patients insured through Medicaid.   As a result of these concerns, MSSNY worked together with the New York Chapters of the American College of Physicians, Academy of Family Physicians and American Academy of Pediatrics, as well as the Community Healthcare Association of New York State (CHCANYS), to successfully advocate for the Legislature to include $20 million in the State Budget to prevent these Medicaid payment cuts from being implemented.

While a NYS Assembly summary of the final State Budget noted that these funds were intended to “reject a reduction in reimbursement rates for patient centered medical home services”, that point has been disputed by the NYSDOH.     This week DOH released a letter noting payment changes to the PCMH program starting in May.  We are pleased that, DOH has indicated that it was not going forward with its original proposal to require PCMH participants to have VBP contract by July 1.  However, of significant concern, the letter indicated that there are still going to be cuts to Medicaid PCMH payment, as follows:

  1. Effective May 1, 2018 – June 30, 2018, the MMC PCMH PMPM for providers recognized under NCQA 2014 Level 3, NCQA 2017, or NYS PCMH standards will be $5.75.
  1. Effective July 1, 2018 to the end of SFY 18-19, the MMC PCMH PMPM for providers recognized under NCQA 2014 Level 3, NCQA 2017, or NYS PCMH standards will be $6.00.
  1. Effective May 1, 2018, the PCMH incentive payments for providers recognized under NCQA’s 2014 Level 2 standards will be permanently eliminated for both MMC and FFS.

MSSNY continues to work with the ACP, AFP, AAP and CHCANYS to express significant concerns to the Legislature, DOH and Governor’s Office with these PCMH cuts, even at a reduced level, in spite of the action taken by the Legislature.  Physicians are urged to contact the Governor and their legislators to express their concerns here(AUSTER) 

MSSNY Urges for Extension of Committee for Physicians Health Program
This week the Senate Health Committee unanimously advanced legislation (S.8093, Hannon) to the Senate floor that would extend for an additional 5 years the continued operations of the MSSNY Committee for Physicians Health (CPH) program.  Authorization for several key components of the program expired on March 31, 2018.   Identical legislation (A.10221, Gottfried) is before the Assembly Health Committee.

The CPH is a program designed to confront and assist physicians thought to be suffering from alcoholism, substance abuse or mental illness.   Since the inception of this program, CPH has assisted thousands of physicians in returning healthy to medical practice.  The work of the CPH program is an important public service both to our health care system as well as the general public. As a result, the State Budget annually includes an appropriation of $990,000 for the program, which is generated from a $30 assessment on all physicians’ biennial registration fees.

The program has traditionally been extended by the Legislature in 3 or 5 year “demonstration programs” with the most recent extension in 2013.  The recently enacted State Budget included a provision to create another “demonstration program” until 2023.  However, it omitted other provisions historically extended at the same time that are essential to its functioning that could greatly impair its operations unless immediate action is taken.  These includes provisions that set forth the CPH program’s reporting requirements to the Office of Professional Medical Conduct (OPMC), provisions to ensure liability protections for the physician Committee members for work performed in the scope of CPH, and necessary confidentiality protections for the program given the sensitivity of the work they perform.   These protections are absolutely essential to the continued functioning of the program to ensure that physicians with the appropriate expertise are willing to serve on the Committee, as well as to assure that the program has the ability to report sensitive information to OPMC when warranted by the circumstances.
(DIVISION OF GOVERNMENTAL AFFAIRS)

Physicians Encouraged to Take Survey; Bending the Diabetes Curve CME Course Available Online
The Medical Society of the State of New York has partnered with the American Medical Association to bring its Prevent Diabetes STAT initiative to New York.  MSSNY has developed a short survey to sample physician’s knowledge of the National Diabetes Prevention Program (DPP) and the Prevent Diabetes STAT program. The survey also serves as a platform to physicians to express what specific boundaries they have experienced or anticipate experiencing regarding the implementation of the DPP and/or Prevent Diabetes STAT. Participation in this survey is essential to the development of various educational components that will benefit both the physician and patient communities. Click here to take the one-minute survey.

Bending the Diabetes Curve webinar is now available to view online; click here. By educating physicians and connecting more patients to evidence-based lifestyle change programs, this diabetes initiative will help bridge the gap between clinical care settings and communities to reduce the incidence of type 2 diabetes.

Webinar: Bending the Diabetes Curve

Faculty: Geoffrey Moore, MD & Sarah Nosal, MD

Educational Objectives:

  • Describe the trends in Type 2 diabetes and implications for clinical practice
  • Review evidence that supports referring patients with prediabetes to lifestyle change program
  • Outline the considerations for implementing a diabetes prevention initiative in a physician practice
  • Describe NYS specific incidents of prediabetes and diabetes in adult population
  • Understand the reimbursements mechanisms for DPP

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 of these live activities for a maximum of 1.0 AMA/PRA Category 1 credits™.  Physicians should claim only the credit commensurate with the extent of their participation in the activity.

Additional information or assistance with registration may be obtained by contacting Carrie Harring at charring@mssny.org.  (HARRING)

Register now for the Medical Society of the State of New York’s May 2018 Medical Matters CME Webinar Program
The Medical Society of the State of New York is pleased to announce its free Continuing Medical Education (CME) webinar for May, 2018.  Participation in this webinar will earn physicians one CME credit free of charge.

May 16 at 7:30am – Medical Matters: Physically and Biologically Derived Chemical Agents: An Overview

Register for this webinar here.
Faculty: Arthur Cooper, MD

Educational Objectives:

  • Acquire a basic understanding of physically and biologically derived chemical agents
  • Identify types of physically and biologically derived chemical agents used as chemical weapons
  • Understand the indicators of each type of chemical agent
  • Describe the treatment of each type of chemical agent
  • Identify local and state resources

To view all of MSSNY’s scheduled programs, click here and select “Upcoming”.

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 of these live activities for a maximum of 1.0 AMA/PRA Category 1 credits™.  Physicians should claim only the credit commensurate with the extent of their participation in the activity.

Additional information or assistance with registration may be obtained by contacting Melissa Hoffman at mhoffman@mssny.org.                                                               (HOFFMAN)

Medical Society of the State of New York Announces May and June CME Webinar Schedule
The Medical Society of the State of New York is pleased to announce its free Continuing Medical Education (CME) webinars for May and June.  Participation in the webinars will earn physicians one CME credit free of charge.   The webinar schedule for May and June is as follows: 

May 24th at 7:30amCurrent Concepts in Concussion for Pediatric and Adult Patients

Register for this webinar here.
Faculty: Deborah Light, MD & John Pugh, MD, PhD

Educational Objectives:

  • Identify signs and symptoms indicative of concussion as well as red flags that indicate alternate or more severe pathology;
  • Outline an appropriate management plan for a patient presenting with concussion including a return to “normal life” protocol;
  • Describe methods for the primary and secondary prevention of concussion;
  • Identify patients who would benefit from referral to a concussion specialist

June 20th at 12:30pmMedical Matters: Children’s Mental Health After Disaster
Register for this webinar here.
Faculty: Linda Chokroverty, MD

Educational Objectives:

  • Enhance physicians’ understanding of the impact of disaster on children’s and family mental health
  • Improve physician skills to address potential psychiatric problems in children and families following a disaster

To view all of MSSNY’s scheduled programs, click here and select “Training Center” and “Upcoming”.

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 of these live activities for a maximum of 1.0 AMA/PRA Category 1 credits™.  Physicians should claim only the credit commensurate with the extent of their participation in the activity. 

Additional information or assistance with registration may be obtained by contacting Melissa Hoffman at mhoffman@mssny.org.                                                                  (HOFFMAN)

Warmer Weather Means More Disease
As the summer months and warmer weather draw near, there is the inevitable onslaught of pests that cause disease.  The New York Times reported on Tuesday, May 1st that the incidence of diseases transmitted by mosquito, tick and flea bites has more than tripled in the United States between 2004 and 2016, with nine such diseases newly discovered or introduced in the U.S. since 2004.

Prepare yourself for the season by going to https://cme.mssny.org for MSSNY’s free CME courses on Mosquito Borne diseases and Zika Virus.   If you do not already have an account, you will need to create one.  And while you’re there, check out all of MSSNY’s CME offerings. (Hoffman)


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

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


eNews

Insys’ Controversial Opioid Sales Tactic Examined
In an 8,112-word feature, the New York Times (5/2) spotlights Insys Therapeutics’ controversial opioid sales practices and outreach to physicians to push its fentanyl drug, Subsys. “The Insys speaker program was central to Insys’ rapid rise as a Wall Street darling, and it was also central to the onslaught of legal troubles that now surround the company,” and seven former top executives “now await trial on racketeering charges in federal court in Boston.” The pieces profiles Insys founder John Kapoor who “flirted with legal trouble throughout his long career as a pharmaceutical entrepreneur” and “bankrolled Insys almost entirely on his own for over a decade” as he pursued the Food and Drug Administration’s approval for Subsys.

Three Nonprofit Insurers in Western New York Posted Higher Profits For 2017
The Buffalo (NY) News (4/30) reports, “Three of Western New York’s major nonprofit health insurers performed better in 2017, each of them helped by gains in investments and lower administrative expenses.” The article says Independent Health posted a surplus of $22.4 million for 2017, compared to $13 million in 2016, while HealthNow New York had “a $55 million surplus, up from $4.2 million in 2016, on revenue of $2.5 billion.” For its part, Univera Healthcare had net income “of $182.3 million last year, up from $99.5 million in 2016, on total premium revenue of $5.6 billion.”

Calling All IMGs! Symposium on May 23 at Jacobi Medical Center in the Bronx
Essen Health Care will host an IMG Symposium on May 23 from 5-8 pm at Jacobi Medical Center in the Bronx. Topics range from Navigating Residency: What to Expect to Residency Application and Interview Tips; and from Primary Care Pathway to IMG Onboarding and Training. IMGs are invited to participate in a pre-symposium networking from 5-6 pm. RSVP at internship@essenmd.com or by calling 929.239.4160. Click here for more information on the symposium

WORKERS COMP

Workers’ Comp: Schedule Loss of Use Informational Webinars
As part of the 2017 executive budget, Workers’ Compensation law §15(3)(x) required the Workers’ Compensation Board to implement new Permanency Impairment Guidelines for Schedule Loss of Use (SLU) evaluations. The new 2018 SLU Guidelines took effect January 1, 2018.

The Board’s Medical Director and Senior Policy Advisor, Elain Sobol Berger, MD, JD will provide training in the 2018 Guidelines’ approach to assessing SLU permanent impairment. Case studies will demonstrate how to apply the SLU principles and objective criteria in making an SLU determination.

There will be four webinars, so you can register for the time that works best for you. Each webinar will last approximately one hour and will include time for questions and answers. Space is limited, so please register early. When you click ‘register here’, you will be taken to a general information page. You must click ‘Register’ on the bottom of that page to sign up.

Register

Wednesday, May 16, 8:30 a.m. – 9:45 a.m. Register here
Wednesday, May 16, 4:00 p.m. – 5:15 p.m. Register here
Wednesday, May 23, 8:30 a.m. – 9:45 a.m. Register here
Wednesday, May 23, 4:00 p.m. – 5:15 p.m. Register here 

More information

For more information on the Schedule Loss of Use Guidelines, please see Subject No. 046-1011. The enabling regulation is set forth at 12 NYCRR 325-1.6, and is also available at the Board’s website.

FDA

FDA Suggests Reexamination of Safe Harbor Protecting Drug Rebates
Bloomberg News (5/3) reports Food and Drug Administration Commissioner Scott Gottlieb, MD, asked whether the legality of drug-plan rebates should be reconsidered. Dr. Gottlieb asked if the federal government should reexamine the safe harbor provision that prevents such rebates from being considered kickbacks.

Reuters (5/3) reports that Dr. Gottlieb has repeatedly criticized the common industry practice of setting high list prices for drugs, which are then lowered for health insurers through large rebates. Dr. Gottlieb asked in remarks prepared for a Food and Drug Law Institute conference, “What if we took on this system directly, by having the federal government reexamine the current safe harbor for drug rebates under the Anti-Kickback Statute?”

CMS

New Yorkers Will Be Getting New Medicare Cards Soon
CMS has three ways for card recipients to find out when they should expect new Medicare card in the mail:

  • Check out the map on Medicare.gov/NewCard. Remember, once card mailings begin in New York, it will take about a month from start to finish.
  • Keep an eye on email. CMS will send an email update when new Medicare cards start mailing in your state.
  • Log in to MyMedicare.gov account to see if a new card has been mailedSign up now at MyMedicare.gov —  it’s a free, secure, and easy way to access all your Medicare information in one place.

Brexit Starting to Drain U.K. Health Workforce
The National Health Service is bracing for an exodus of European doctors and nurses, POLITICO Europe reports. A new survey of 68 NHS hospitals and other care institutions found 1 in five have already altered recruitment plans, despite the U.K. not being scheduled to leave for another year. More than a third say the workforce impact of Brexit has been negative. The NHS relies heavily on non-British European doctors and nurses. Polls indicated one of the factors driving support for Brexit was improved funding for the U.K.’s taxpayer-funded health service. The Vote Leave campaign claimed free movement from the EU was creating unsustainable demands on health services. (Politico 5/1/18)

Uninsured Can Get Appointments but Cannot Pay Average Cost of $160
The US uninsurance rate has nearly been cut in half under the Affordable Care Act, and access to care has improved for the newly insured, but less is known about how the remaining uninsured have fared. In 2012–13 and again in 2016 Health Affairs conducted an experiment in which trained auditors called primary care offices, including federally qualified health centers, in ten states. The auditors portrayed uninsured patients seeking appointments and information on the cost of care and payment arrangements. In both time periods, about 80% of uninsured callers received appointments, provided they could pay the full cash amount. However, fewer than one in seven callers in both time periods received appointments for which they could make a payment arrangement to bring less than the full amount to the visit. Visit prices in both time periods averaged about $160. Trends were largely similar across states, despite their varying changes in the uninsurance rate. Federally qualified health centers provided the highest rates of primary care appointment availability and discounts for uninsured low-income patients. (Health Affairs April 2018) https://bit.ly/2HETH3K


Classified

RENTAL/LEASING SPACE

Thriving  Internal Medicine Practice for Sale by the Physician.
Has been growing exponentially, with number of patients doubling over last two years.
Has the visits-volume and the potential space & hours to keep expanding
The physician will stay to overlap for at least one year to personally transition all the practice’s patients, to seamlessly transfer all insurance account and to assist with acquirement of hospital privileges

Well established location at street level, with dedicated handicap entrance, easy access to public transportation, a parking lot and within one mile from all three leading local hospitals.
Fully credentialed as a medical practice site with all health insurances in the market, and compliant with Americans with Disability Act requirements. Office space lease guaranteed for extended period of time. Call 917-596-8936


Are You Trying to Lease Your Medical Office or Sell Your Medical Practice? Trying to Sell New or Used Medical Equipment?
Clineeds, the new online platform designed for medical providers. With Clineeds you can lease your medical officeshared your office spacebuy and sell used medical equipment, or post healthcare job opportunities. LISTING IS FREE! Why wait? Click here to sign-up: www.clineeds.com/sign-up


Beautiful NYC Medical Office — Long-term Share
Bright, big consultation room and one or two exam rooms in large,  tastefully furnished office in first-rate building. 58th Street between Park and Lexington. Near transportation.  Smaller, windowed consultation room and exam room also available. Rent by the day or week, beginning June 1 or sooner. $180 per day or $5500 per months. Perfect for internist, rheumatologist, physical medicine, ob-gyn and others. Superb front desk and office management available, along with many amenities including internet, ultrasound, EMG, kitchen, optional C-arm. Call Carol: 917-856-6402.


For Rent – Medical Office 715 W 170 Street New York
Ground floor just completed build out 4 exam rooms with sinks and wall cabinets
Waiting and reception areas, windows throughout.
Street and private entrances, two bathrooms and storage/lab/staff room.
One block to bus and two blocks to Presbyterian Medical Center and subway.
$1900-$7900/ month for one to 4 exam rooms.
Drdese@gmail.com or 917.8618273


For Share – Plastic Surgeon’s Office Facing Central Park Ground Floor Lobby Entrance/Private exit
One to three exam rooms, consult/private office and procedure room for full or part time use.
Elegant, modern and spacious secretarial, waiting and two exam rooms.
Accredited operating rooms and recovery rooms on site.
One block to bus and 20 feet to subways.
$1275-$3750/day monthly for one to three exam rooms.
Drdese@gmail.com or 917.861.8273


Office Space – Sutton Place
Newly renovated medical office. Windows in every room looks out to a park like setting on the plaza level. 2-4 exam rooms/offices available, possible procedure room or gym. Separate reception and waiting area, use of 3 bathrooms and a shower. Central air and wireless. All specialties welcome. Public transportation nearby. Please call 212-772-6011 or e-mail: advocate@medicalpassport.org



PHYSICIAN OPPORTUNITIES


Private Multidisciplinary Medical Group Seeking Full Time or Part Time Podiatrist and Full Time or Part Time Internal Medicine/Family Practice/Allergy & Immunology Physicians.
Midtown, Union Square & Lower Manhattan locations. Attractive base salary plus comprehensive benefits package. E-mail CV to tsrgexpress@gmail.com. No recruiters please.


Chief of Medical Services
MINIMUM QUALIFICATIONS: Possession of a license and current registration to practice medicine in New York State, plus six years of experience in the practice of medicine, two years of which must be in an administrative or supervisory capacity. Appointee must be eligible for and maintain eligibility for full and unconditional participation in Medicaid and Medicare programs. Appropriate certification by an American Medical Specialty Board and one year of post certification experience in that specialty can be substituted for four years of general experience.
PREFERRED QUALIFICATIONS: Board certification in Geriatric Medicine and/or Certification as a Medical Director (AMDA), and experience in a long-term care facility.
RESPONSIBILITIES: Serve as Medical Director of a 242-bed skilled nursing facility for veterans and their dependents. Provide medical leadership and oversight ensuring the delivery of quality health care services while also ensuring compliance with clinical, statutory and regulatory standards.Send resume to:  NYS Veterans Home, Attn: Human Resources, 4207 State Highway 220, Oxford, NY 13830

The New York State Veterans Home at Oxford is a 242-bed skilled nursing facility operated by the NYS Department of Health located in Chenango County. It is an Affirmative Action/Equal Opportunity Employer. 


Family Practice Physician – Schenectady/Amsterdam, NY
Hometown Health Centers is a Federally Qualified Community Health Center in the Upstate, Schenectady and Amsterdam, NY areas. Bi-lingual in English/Spanish is a plus.  Excellent total compensation package.  No hospital rounding. Flexible and part-time schedules available.  Sign-on bonus. For additional information please send inquiries or resumes to href=”mailto:jobs@hhchc.org”>jobs@hhchc.org. www.hometownhealthcenters.org


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


 

Council – May 10, 2018


AGENDA
    MSSNY Council Meeting
                  Courtyard Marriott Westbury Long Island
         1800 Privado Road
         Westbury, NY  11590
         Thursday, May 10, 2018, 9:00 a.m

A. Call to Order and Roll Call

B. Approval of the Council Minutes of Sunday, March 25, 2018

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

  1. President’s Report
    1. 2018 HOD Resolutions referred to Council (For Council Approval)
    2. Discussion on Physician Assisted Suicide – Jeffrey Berger, MD & Jay Federman, MD
  1. PresentationConcierge Medicine
    Dr. Dean P. McElwain, President and COO
    Castle Connolly Private Health Partners LLC

Dr. McElwain is a seasoned healthcare executive with nearly 30 years of progressive leadership in a variety of healthcare settings. Dr. McElwain has a professional doctorate (DPT) from Simmons College Graduate School for Health Studies, with a specialty in Health Care Administration.A recognized national thought leader in the area of Concierge Medicine, Dr. McElwain has provided guidance, leadership and innovation to more than 70 providers, as well as regional and national corporate clients over the last 9 years. Renowned organizations, such as the Lown Cardiovascular Institute, have relied on Dr. McElwain’s guidance for effective design and management when evaluating and or transitioning their practices to the subscription-based or concierge membership model.

A lifelong endurance athlete, Dr. McElwain is also a respected leader in the areas of Health Coaching, Wellness and Human Performance. Having completed undergraduate studies in exercise physiology as well as graduate studies in Physical Therapy, Dr. McElwain combines his passion and expertise in the areas of exercise, nutrition and wellness in leading a robust initiative to incorporate wellness into the practices and members he guides.

Dr. McElwain is a member of the American Academy of Private Physicians (AAPP) as well as the Healthcare Financial Managers Association (HFMA) and is an external consultant member of the Medical Group Managers Association (MGMA).

  1. Board of Trustees Report – Robert Hughes will present the report (handout)
  2. Secretary’s Report – Dr. Frank Dowling will present the report for Nominations for Life Membership, Dues Remissions & Special Life Membership requests
  3. MLMIC Update  –  Mr. Donald Fager will present a verbal report
  4. MSSNYPAC Report –   Joseph Sellers will present the report (handout)
  5. MESF Update – Dr. Charles Rothberg will present the report
  6. CME Update – Dr. Mark Adams (no written report submitted)
  7. Councilors (All Action Items, For Council Approval)
    a. Motion from New York County Medical Society:
        Joshua M. Cohen, MD, MPH, Manhattan and The Bronx Councilor
    Because of membership deals in recent years, county medical society leaders are more often asked to explain to members and prospective members why some pay full dues and others pay significantly less. Although MSSNY staff may have letters and information in place to formally send on such inquiries, the NYCMS Board agreed that when possible, doctors should be equipped to respond in the best way themselves.
    Therefore, the New York County Medical Society is asking the MSSNY Council to craft talking points so that members can respond to colleagues about dues differentials.

MOTION: THAT MSSNY CRAFT TALKING POINTS FOR COUNTY MEDICAL SOCIETY LEADERS TO USE TO ADDRESS QUERIES ABOUT MEMBERSHIP DEALS SOME RECEIVE AT SIGNIFICANTLY LOWER DUES RATES.

D. Reports of Officers (Verbal Reports)    

  1. Office of the President  – Thomas J. Madejski, MD
  2. Office of the President Elect – Arthur C. Fougner, MD
  3. Office of the Vice President –  Bonnie L. Litvack, MD
  4. Office of the Treasurer – Joseph R. Sellers, MD Financial Statement for the period 1/1/18 to 3/31/18
  5. Office of the Speaker – Kira A. Geraci-Ciradullo, MD

E. Reports of Councilors (Informational)

  1.           Kings and Richmond Report – Parag H. Mehta, MD
  2.           Manhattan and Bronx Report – Joshua M. Cohen, MD
  3.           Nassau County Report – Paul A. Pipia, MD
  4.           Queens County Report – Saulius J. Skeivys, MD
  5.           Suffolk County Report – Maria A. Basile, MD 
  6.           Third District Branch Report – Brian P. Murray, MD
  7.           Fourth District Branch Report – Gregory Pinto, MD
                  (no written report submitted)
  8.           Fifth District Branch Report –Howard H. Huang, MD
  9.           Sixth District Branch Report – Robert A. Hesson, MD
  10.         Seventh District Branch Report – Janine L. Fogarty, MD
  11.         Eighth District Branch Report – Edward Kelly Bartels, MD
  12.         Ninth District Branch Report  –  Thomas T. Lee, MD
  13.         Medical Student Section Report –  Breyen Coffin
  14.         Organized Medical Staff Section – Stephen F. Coccaro, MD
                  (no written report submitted)
  15.         Resident and Fellow Section Report – Justin Fuehrer, DO
  16.         Young Physician Section Report – L. Carlos Zapata, MD
                  (no written report submitted)

F. Commissioners (Committee Action & Informational Items)

  1. Commissioner of Communications, Maria A. Basile, MD, MBA
         Report of the Division of Communications
  1. Commissioner of Governmental Relations, Gregory Pinto, MD
        Report From The Division Of Governmental Affairs
  2. Commissioner of Membership, Parag H. Mehta, MD
    Membership Committee Discussion & Action Items:
    At the 2018 meeting of the MSSNY House of Delegates, the International Medical Graduate caucus considered a number of issues and focused on ways to increase participation of IMGs in the medical societies.
    One suggestion was to engage those international medical students doing clinical rotations in New York at the stage of their career when they are starting out on the difficult path to New York State medical licensure.  To exclude a segment of the future NYS physician workforce from membership when they most need support runs counter to our mission as a medical society and is likely to have a negative effect on those individuals’ future membership decisions.
    The IMG Caucus agreed to ask MSSNY to change its definition of medical student for the purposes of society membership so that it will also include those attending medical school outside the United States who are doing approved clinical rotations in New York State.
    It’s understood that a Bylaw change would be needed to make this happen, and the draft language below will be circulated to members of the IMG Committee and the IMG Caucus for feedback before submitting it as a resolution for the 2019 HOD.


    PROPOSED BYLAW AMENDMENT:
    Student members shall be those members
    (1)(a) enrolled in an LCME-accredited medical or AOA-accredited osteopathic school or (b) enrolled in a medical or osteopathic school that is approved to place students in clinical clerkships in teaching hospitals in New York State, and (2) attend such medical or osteopathic school or maintain a residence in New York State.  (FOR COUNCIL DISCUSSION)


    PROPOSED PILOT PROJECT:
    MSSNY’s Membership Committee is drawing up plans with the Medical Student Section to make the most of the House of Delegates’ decision to offer free membership to medical students.  We would like to be able to take advantage of the energy being focused on medical student recruitment in our contacts with international students during the nearly three years it will take for a Bylaws amendment to be passed.

    Therefore it has been suggested that we consider other ways to appeal to international students and make them feel welcome in the meantime.

    I propose that as a pilot project in participating counties, MSSNY and the county medical society offer member benefits and services to international medical students engaged locally in New York State-approved clinical rotations free of charge until such time as they are eligible for student or other membership in the societies.  This would include invitations to county and state medical society meetings, without the right to vote unless and until formal membership is obtained.  (FOR COUNCIL APPROVAL)

  1. Commissioner of Science and Pubic Health, Joshua M. Cohen, MD
  1. Commissioner of Socio Medical Economics, Howard H. Huang, MD
        Interspecialty Committee Minutes, March 1, 2018

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

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

H. Report of the General Counsel, Garfunkel Wild, P.C.
     Request for assistance as amicus curiae (handout)

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

J. Other Information/Announcements

  1. PAI Letters to U.S. House of Representatives – Improving 340B Program Transparency, Child Site Eligibility and the Patient Definition
  2. Final E-Prescribing Controlled Substances Letter
  3. NYS Society of Plastic Surgeons/Opposition to MOC Bill

K. Adjournment