September 28, 2018 – Back to the Future

Thomas J. Madejski, MD MSSNY President
PRESIDENT’S MESSAGE

Thomas J. Madejski, MD
MSSNY President


MSSNY eNews
September 28, 2018
Volume 20  Number 36

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Colleagues:

Last week I felt like the Flux Capacitor of the Delorean from the film Back to the Future –on a journey from the shores of Lake Erie to the North Shore of Long Island.

On Tuesday, I  joined the Erie County Medical Society at their golf outing in Hamburg, New York—and was pleased to stick a pitching wedge 5 feet from the pin on our second last hole to secure a birdie for our team and get to 8 below par.  We still ended up fourth.

The satisfaction of a well hit golf shot is substantial, but more important was the discussion I had with two of our prominent MSSNY members, Dr. Richard Vienne, a member of our AMA delegation and a medical director for Univera Health Care and Dr. Raghu Ram, a regional medical director for Landmark Care.  We discussed improving the care of our patients on an individual and population basis—from advancing communication across various sites and transitions of care to creating a collaborative team.

Innovative Ways to Improve Care

Dr. Ram and his colleagues explained some novel interventions they are attempting, using large data sets and analytics to improve care and avoid hospitalizations.    I think we also need to have further discussions with insurers on how to improve that interaction, particularly with a move to capitation in Western New York by some insurers that may paradoxically incentivize physicians to drop higher cost or more complex patients.

Challenges remain on integrating additional care without disrupting patients’ established care, but as I drove home that day I felt hopeful that there are opportunities to continue to refine and improve that approach.

Continuing Medical Education

Later in the week, I had the pleasure to meet with Dr. Graham McMahon, MD—MMSc  President and CEO of the Accreditation Council for Continuing Medical Education (ACCME)—along with our MSSNY CME Committee and staff.  We had an informal dinner on Thursday, and I provided opening remarks for our 2018 MSSNY CME Provider Conference on Friday.

I snuck in part of a teleconference with our MSSNY Committee for Physician Wellness and Resilience Committee prior to the opening of the CME conference.

Back to the Future

The various discussions of the multiple groups addressed issues that intersect in various, complicated ways.  Continuing professional development, MOC, quality improvement, a complex and fatiguing practice environment and value based care all affect patient care and physician satisfaction.

These streams of organizational activity flow to our Office of the President (the flux capacitor allusion) much faster than the 88 mph required to accelerate the DeLorean of the movie through time.  Our goal is to travel together to improve care for patients, and the practice environment for physicians.  I’ve tasked both our CME Committee and Wellness and Resilience Committee to focus on those goals with some new offerings to improve the professional and personal lives of our members.

I’d appreciate your thoughts and comments, and am always looking for active participation in achieving our mission.  Please contact me at comments@mssny.org.


Thomas J. Madejski, MD 
MSSNY President


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eNews

New York DFS Raises Concerns With CVS-Aetna Merger
New York Department of Financial Services (DFS) Superintendent Maria Vullo issued a letter this week expressing ‘significant concerns’ with the proposal of pharmacy and PBM behemoth CVS to acquire health insurer behemoth Aetna.  The letter was sent to Connecticut Insurance Department Commissioner Wade in advance of the Connecticut hearing examining this transaction next Thursday, October 4.

Among the concerns that Superintendent Vullo identified in her letter:

  • If approved, the proposed transaction “would create an incredibly large market share in the health care market for the combined company, in an already concentrated marketplace, and is likely to increase prices for members and reduce options for consumers, without any discernable increase in quality.”
  • CVS minute-clinics “might provide unfair competition to other medical providers and hospitals, which when combined with CVS’ proposed ownership of a major health insurer creates significant concerns for consumer choice and cost”; and
  • The $40 billion in debt that CVS is taking on to finance the transaction “could affect operating performance”, “will create pressure on Aetna to raise premiums or take other actions that negatively impact consumers”, and “impacting Aetna policyholders and providers alike”.

As MSSNY has made several public statements expressing its opposition to this merger, MSSNY President Dr. Thomas Madejski issued a statement thanking Superintendent Vullo for her comments.

The DFS also announced this week that it will be holding a public hearing on this proposed transaction on October 18 in New York City.  MSSNY will likely present testimony at this hearing, and has invited the American Medical Association to also present testimony.

Earlier this year, the AMA submitted to the US Department of Justice its own comprehensive analysis of the adverse impact of this proposed merger, and urging the DOJ to work to block the merger.

The merger has also been opposed by the California Insurance Department and the American Antitrust Institute.



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Governor Signs Legislation to Permit Medical Marijuana as Alternative to Opioids
This week Governor Cuomo signed into law legislation (A.11011-B/S.8987-A) that would permit physicians to certify patients for medical marijuana use as an alternative to prescribing opioids to patients who are experiencing “pain that degrades health and functional capability”, or substance abuse disorder.  Earlier in the year, the NYS Department of Health adopted similar regulations.  MSSNY had expressed strong concerns with these proposals, noting that while we “appreciate the extensive efforts being undertaken to be responsive to the opioid epidemic…MSSNY is very concerned that there is no evidence that using marijuana to treat opioid use disorder is an effective medical treatment for this condition”.  Instead, MSSNY advocated for a pilot program to be undertaken to determine what place if any there may be for medical marijuana for those with opioid use disorder.

Click here for more information about New York’s medical marijuana program.

MSSNY Member Dr. Mell, Age 33, Passed Away Suddenly
Thomas Mell, MD, 33, passed away suddenly on September 14.  A resident of Brooklyn, he was an anesthesiologist and affiliated with SUNY Downstate Medical Center University Hospital. Dr. Mell was a member of MSSNY and served as the Associate Treasurer and member of the Board of Censors for the Medical Society of the County of Kings. He had a strong interest in legislation, which was strengthened after attending his first MSSNY Advocacy Day in 2017.

Dr. Mell is survived by his wife Kacie McFarland, MD, Vascular & Intervention Radiology and currently a Fellow in year 3 of 4 of the DIRECT Pathway at SUNY Downstate Medical Center and their nine month old son, Maximus William Mell. Also a MSSNY member, Dr. McFarland served on MSSNY’s Committee on Emergency Preparedness and Bioterrorism.

In memory of Dr. Tom Mell, the family requests that in lieu of flowers donations be made to his son, Maximus William Mell. To donate, please go here.



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House, Senate Negotiators Agree to Compromise Opioid Addiction Package
The United States Congress is expected to pass comprehensive legislation (HR 6, the Support for Patient and Communities Act) to combat the opioid abuse epidemic across the country.  The 660-page bill is the product of a bi-partisan compromise between the US House and Senate, which had advanced separate proposals earlier in the year.

Please remain alert for a more in-depth summary, but among the noteworthy items in the agreed upon package include:

  • Expands Medicare coverage to include Opioid Treatment Programs (OTPs) for the purposes of delivering Medication-Assisted Treatment (MAT) to expand access to treatment options for Medicare beneficiaries.
  • Better enables states to share prescription monitoring program data with each other
  • Requires by 2021 e-prescribing for Schedule 2,3, and 4 controlled substances for Medicare Part D prescription (with exceptions);
  • Requiring FDA guidelines for prescribing for acute pain;
  • Authorizes clinical nurse specialists, certified nurse midwives, and certified registered nurse anesthetists to prescribe MAT for five years; codifies the ability for qualified physicians to prescribe MAT for up to 275 patients;
  • Authorizes grants to support the development of curriculum that will help health care practitioners obtain a waiver to prescribe MAT.
  • Requires the Secretary of HHS, no later than two years after effective date, to annually notify prescribers that they have been identified as an outlier prescriber of opioids compared to other prescribers in their specialty and geographic area.
  • Requires the Secretary of HHS, no later than two years after effective date, to annually notify prescribers that they have been identified as an outlier prescriber of opioids compared to other prescribers in their specialty and geographic area.

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Please Plan to Participate in NYS “Listening Sessions” on Legalizing Recreational Marijuana Use
As previously reported, New York Governor Andrew Cuomo has called for a series of “listening sessions” across New York State to receive public comment regarding a proposal to legalize and regulate the recreational use of marijuana in New York State.  As noted below, there are forums coming up next week on Monday (10/1) in Newburgh, Tuesday (10/2) in Binghamton, Wednesday (10/3) in Buffalo and Thursday (10/4) in Hempstead.   Local physician leaders are expected to testify at these forums.

This week, MSSNY President-elect Dr. Art Fougner testified at the Queens forum, and Nassau County Medical Society Vice President Dr. David Podwall testified at the Hempstead forum, to raise public health concerns with this proposal.  Dr. Fougner’s testimony noted MSSNY’s support for de-criminalizing marijuana possession, but also significant concerns with motor vehicles spiking in Colorado after legalization in 2014.  He also noted the need for investment in readily available emergency care, mental health as well as addiction resources to handle anticipated demand that will inevitably arise from legalization.  In addition, Dr. Fougner, an OB-GYN, noted that “systematic reviews reveal that marijuana use during pregnancy is associated with lower birthweight and increased admission to Special Care Nurseries. Moreover, there are also reports of increased risk of stillbirth.”

Last week, the New York State Association of County Officials (NYSACHO) – representing 58 local Health Departments across New York State – sent a letter to Governor Cuomo expressing their opposition to proposals to legalize recreational marijuana use. Their letter noted that “both research and experience of states with legalized marijuana (such as Colorado) have substantiated these concerns”.

Physicians are urged to register to participate and testify at these upcoming forums from the links below:

  • Newburgh – Monday, October 1, 2018 – Register
  • Binghamton – Tuesday, October 2, 2018 – Register
  • Buffalo – Wednesday, October 3, 2018 – Register
  • Rochester – Thursday, October 4, 2018 – Register
  • Syracuse – Tuesday, October 9, 2018 – Register
  • Utica – Wednesday, October 10, 2018 – Register
  • Watertown – Thursday, October 11, 2018 –Register
  • Ronkonkoma – Tuesday, October 16, 2018 – Register
  • New Rochelle – Wednesday, October 17, 2018 – Register

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4th Columbia Psychosomatics Conference – Oct 20-21, 2018 NYC (13.5 CME Category 1 credits)
If you can’t see this image please go to 4th Columbia Psychosomatics Conference website HERE.

4th Columbia Psychosomatics Conference

The Bureau of Psychiatric Services & Research Institute Support (BPSRIS) is accredited by the Medical Society of the State of New York (MSSNY) to provide continuing medical education for physicians. The Bureau of Psychiatric Services & Research Institute Support (BPSRIS) designates this live activity for a maximum of 13.5 AMA PRA Category 1 Credits™. Physicians should claim only the credit commensurate with the extent of their participation in the activity.


ADA and Your Medical Practice’s Website
MSSNY has been alerted to a serious concern for our physicians that have websites for their medical practices.  Recently, many health care providers in New York have been sued in the United States District Court, Southern District of New York, for alleged violations of the Americans with Disabilities Act concerning their websites.  MSSNY contacted our General Counsel, Garfunkel Wild, P.C., for advice and guidance.  Please refer to this link for the educational material.


New York’s Life Expectancy Has Decreased Past Two Years, Report Says
Crain’s New York Business (9/21, Henderson) reports the life expectancy of New York residents has decreased over the past two years in an “alarming reversal,” according to a report from the NYS Health Foundation. The report said that the state’s life expectancy is still above the national average, but the “increasing trajectory of death rates for most major causes of death, rising obesity rates and growing rates of so-called deaths of despair” are all cause for concern.



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Continuing Medical Education

Cybersecurity: A Daily Threat for Healthcare: CME webinar on November 14 at 7:30am Registration now open
Studies show that 88% of all ransomware attacks in 2017 occurred within the healthcare industry and 89% of studied healthcare organizations experienced a data breach.  Learn how to protect yourself, your patients and your workplace on November 14th at 7:30am.  Register here for Medical Matters: Cybersecurity: A Daily Threat for Healthcare.  Mahesh Nattanmai, Deborah Sottolano, MD of New York State Department of Health and Peter Bloniarz of the New York State Executive Chamber will serve as faculty for this program.

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

Educational objectives are:

  • Describe vulnerabilities within medical practices, hospitals and daily life
  • Identify methods to increase protection from cyberattacks
  • Review methods for reporting and responding to a cybersecurity incident

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

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


Influenza 2018-19: CME Webinar on October 17
Did you know that the World Health Organization (WHO) is predicting two new strains of influenza for the 2018-2019 season?  Learn about this and more at the first of MSSNY’s 2019 Medical Matters continuing medical education (CME) webinar series: “Influenza 2018-19” on Wednesday, October 17, 2018 at 7:30 a.m.  William Valenti, MD, chair of MSSNY Infectious Disease Committee and a member of the Emergency Preparedness and Disaster/Terrorism Response Committee will serve as faculty for this program. Registration is now open for this webinar here.

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

Educational objectives are:

  • Describe key indicators to look for when diagnosing patients presenting with flu-like symptoms
  • Describe clinical and laboratory diagnostic features and treatment specific to each flu season
  • Identify recommended immunizations and antiviral medications for treatment and how best to effectively encourage patients to get vaccinated

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

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


Member Benefit

Join MSSNY’s Member Perks Program and Enjoy $4,500 in Savings!
MSSNY is pleased to announce our newest member benefit!  Our new Abenity App provides members with exclusive perks and over $4,500 in savings on everything from restaurants, City Pass, AMC movie tickets, theme parks, hotels, car rentals, mortgage savings, auto care and much more!

Popular Features Include:

  • Nearby Offers: Use our show and save mobile coupons to quickly access savings on the go.
  • eTickets On Demand: Save up to 40% with no hidden fees.
  • Showtimes: Find movies, watch trailers, and save up to 40% at a theater near you.
  • Monthly Giveaways: Win cash, movie tickets, electronics and more with our monthly contests.

And, with over 302,000 available discounts across 10,000 cities in the United States and Canada, you’ll never be far from savings!

REGISTER & LOG IN

Click on the following link: http://mssny.abenity.com and then create a unique user name and password.


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RENTAL/LEASING SPACE


Magnificent Medical Suites for Lease 184 East 70th St. New York, NY
The space has just undergone a complete STATE OF THE ART renovation.
Located in a luxury building with a separate elevator entrance on the prestigious upper east side of Manhattan, this recently renovated space is conveniently situated steps from Lenox Hill Hospital, Cornell /Columbia Presbyterian, HSS and Memorial Sloan Kettering. Includes exam rooms, new custom cabinetry, new exam beds, scale, waiting area – new furniture, new TV, water cooler etc. Space A: one consultation room plus 2 exam rooms. $6000 per month
Space B: One consultation room plus one exam room. $4500 per month
Space C: one consultation plus one exam $4500. other combination may work as well. Available for sharing For full details and photos see listing at http://bit.ly/2E3Zvh0 or contact Karen Tamir at 917-865-1006 or KarenTamir@Yahoo.com184 East 70th St Waiting Room 184 East 70th St Front Desk

184 East 70th St Patient's Room 184 East 70th St hallway


West 57 St. – Shared Office Space to Rent
Lovely Garden view office with natural light. Located near Columbus Circle in a beautiful Art Deco building. Recently renovated office with additional exam room/ room with a sink. Wi-Fi, medical waste pickup and cleaning included.  Ideal location in desirable neighborhood. Contact Jason Faller 914-393-6583 goutmd@aol.com


Rare Find — Great Office Share
Wonderful office share in terrific location at great price. Choice of smaller windowed consultation room with adjoining exam room or big windowed consultation room with one or two exam rooms. Beautiful bright rooms, lovely reception area and front . First-rate building on 58th Street between Park and Lexington.  Rent by day (about $180) or by month ($5500). Front desk and office management available, along with many other amenities, including internet, ultrasound, EMG Kitchen, optional C Arm. Willing to make changes for new tenant. Call 646-642-0700.

58th Street Waiting Room 58th Street Patient's Room 58th Street Doctor's Office

 


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

PHYSICIAN OPPORTUNITIES

Medical Director in the NYS Office of Health Insurance Programs Division of Systems
The Medical Director position will be responsible to review prior approval requests and issue denials as indicated.  The incumbent will review pended claims and recommend whether payment should be made or denied and review requests for enhanced reimbursement for Out-of-State Hospital services.  The incumbent will participate in several external and internal committees including: Provider Enrollment Appeals Committee, Laboratory Policy Committee, Internal Benefit Review Committee, Irregular Billing Committee, Utilization Review Edit Committee, Quality Improvement Committee, Physician Administered Medication Committee, and Medical Coding Review and Coverage Decisions Committee.  The incumbent will also attend the Hearing Aid Dispensing Advisory Committee representing the Commissioner of Health and participate in the Evidence-Based Benefit Review.  The incumbent will a key stakeholder in monitoring the Radiology Utilization Management Contract and interacting with the Medical Director and clinical staff.  The incumbent will also be responsible to participate with other OHIP Medical Directors in meetings on topics about Medicaid Policy including DSRIP and VBP.

Interested candidates may submit a resume to Human Resources Management Group, Room 2276, Corning Tower Building, Empire State Plaza, Albany, New York 12237-0012, 

or by email to resume@health.state.ny.us with a subject line “OHIP Medical Director Position,” or by fax to (518) 474-6771.


Physicians Wanted to Help Shape the Future of Primary Care
98point6 is a healthcare technology startup committed to delivering more affordable, accessible, high-quality primary care. To support our mission, the insights of forward-thinking physicians like you are invaluable. Members of our exclusive Primary Care Council have no clinical responsibilities and are compensated for their participation, which requires only a few hours annually.

Interested? Learn more and apply today at www.98point6.com/pcc

 


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


 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

September 21, 2018 – MLMIC Deal Almost Complete

Thomas J. Madejski, MD MSSNY President
PRESIDENT’S MESSAGE

Thomas J. Madejski, MD
MSSNY President


MSSNY eNews
September 21, 2018
Volume 20  Number 35

MSSNYPAC

Colleagues:

As you may be aware, the MLMIC Berkshire Hathaway transaction is very close to completion. DFS Superintendent Maria Vullo has approved the demutualization application, the acquisition and the application for approval of the amendments to MLMIC’s charter and bylaws. MLMIC is currently in the process of being acquired by National Indemnity Company NICO, a Berkshire Hathaway subsidiary. Currently, MLMIC is a mutual insurance company, meaning it is owned by its policyholders/insured physicians. Once the sale to NICO is complete, however, the company will be transitioned to a stock insurance company owned by NICO’s shareholders.

Policy Holders Entitled to Distribution

Any physician who was a MLMIC policyholder between July 15, 2013 and July 14, 2016 will be entitled to a distribution from the NICO transaction. It is currently estimated that the distribution for each policyholder will equal approximately 1.9 times the annual premiums paid by that provider during the eligible period. For instance, if a physician was insured for the entire three-year period and paid total malpractice insurance premium of $100,000, the physician would be entitled to $190,000 from the distribution.

In the event that a proper objection to a distribution is received by MLMIC, upon the closing of the NICO transaction, the disputed distribution payment will be placed in an escrow account until the individual and employer agree on the manner of its release, or until MLMIC is ordered to release the funds by a court or arbitration panel.

Whether you are an employer who has employed providers insured through MLMIC between July 2013 and July 2016, or an individual provider who has been covered a MLMIC policy while employed by a practice, hospital, or other entity, you may want to promptly take affirmative steps to protect your potential interest in the distribution. For more information, visit www.mlmic.com.

MSSNY Testifies

On August 23, MSSNY Executive Vice-President Philip Schuh, CPA testified in support of MLMIC’s acquisition by Berkshire Hathaway, during a New York Department of Financial Services (DFS) hearing examining the proposed transaction. Mr. Schuh noted that “MLMIC’s alliance with Berkshire Hathaway will fortify its finances and enable MLMIC to continue its mission to assure physicians, dentists and hospitals have access to quality medical malpractice insurance coverage and risk management services long into the future”.

He noted that “some physicians have expressed concerns that entities with enormous resources at their disposal could coerce a physician to give up their statutory right to these proceeds because of the fear of excessive litigation costs.   He suggested that DFS impose a condition on the conversion approval “to assure a strict deadline for release of the funds from escrow following the closure of the transaction, whereby the funds will be awarded to the policyholder at the conclusion of such period if the process for resolving the dispute has not yet been completed.”

Final Steps

In the recent vote of Record Date Policyholders, 6,635 out of 6,979 of the ballots were in favor of the Conversion & Amended/Restated Charter. MLMIC & NICO, a subsidiary of Berkshire Hathaway, are now proceeding to finalize the closing arrangements.

Please share your thoughts and comments with me at comments@mssny.org.


Thomas J. Madejski, MD 
MSSNY President


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eNews

ADA and Your Medical Practice’s Website
MSSNY has been alerted to a serious concern for our physicians that have websites for their medical practices.  Recently, many health care providers in New York have been sued in the United States District Court, Southern District of New York, for alleged violations of the Americans with Disabilities Act concerning their websites.  MSSNY contacted our General Counsel, Garfunkel Wild, P.C., for advice and guidance.  Please refer to this link for the educational material.


Plan to Participate in NYS “Listening Sessions” on Legalizing Recreational Marijuana
As previously reported, New York Governor Andrew Cuomo has called for a series of “listening sessions” across New York State to receive public comment regarding a proposal to legalize and regulate the recreational use of marijuana in New York State.  As noted below, there are forums coming up next week on Monday (9/24) in Queens, Tuesday (9/25) in Brooklyn, Wednesday (9/26) in Staten Island and Thursday (9/27) in Hempstead.  MSSNY President-elect Dr. Fougner and MSSNY Councilor Dr. Saulius Skeivys will participate at the Queens Forum.

This week, MSSNY Councilor and Westchester neurosurgeon Dr. Thomas Lee testified at the Bronx forum to raise public health concerns with this proposal.  Dr. Lee’s testimony noted MSSNY’s support for de-criminalizing marijuana possession, but also significant concerns with outright permitting recreational use.   Specifically, he noted that “While marijuana offers potential benefits, one must always balance them against intoxication, carcinogenic effects, respiratory illnesses, altered mental status, depression, anxiety, and addiction.  In the era of narcotic dependence and associated catastrophic outcome, the State of New York is seeking to legalize this mind altering substance. We must have a more internally consistent and scientifically sound public health policy.

MSSNY Treasurer Dr. Joseph Sellers testified at the Albany forum on September 5.

This week Crains New York Business wrote an article about these forums that referenced MSSNY’s opposition while also noting the strong public commentary in support of legalization.

Physicians are urged to register to participate and testify at these upcoming forums from the links below:

  • Queens – Monday, September 24, 2018- Register
  • Brooklyn – Tuesday, September 25, 2018 – Register
  • Staten Island – Wednesday, September 26 – Register
  • Long Island – Thursday, September 27, 2018 – Register
  • Newburgh – Monday, October 1, 2018 – Register
  • Binghamton – Tuesday, October 2, 2018 – Register
  • Buffalo – Wednesday, October 3, 2018 – Register
  • Rochester – Thursday, October 4, 2018 – Register
  • Syracuse – Tuesday, October 9, 2018 – Register
  • Utica – Wednesday, October 10, 2018 – Register
  • Watertown – Thursday, October 11, 2018 –Register


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County Health Officials Urge Rejection of Legalized Recreational Marijuana
Noting that  “legalization of regulated marijuana will lead to dangerous public health outcomes”,  this week the New York State Association of County Officials (NYSACHO)  – representing 58 local Health Departments across New York State – sent a letter to Governor Cuomo expressing their opposition to proposals to legalize recreational marijuana use.

Their letter noted that “both research and experience of states with legalized marijuana (such as Colorado) have substantiated these concerns. Their list of public health concerns included: 

  • Risk of Addiction– evidence clearly indicates that long–term marijuana use can lead to addiction. There is also recognition of a bona fide cannabis withdrawal syndrome, which makes cessation difficult and contributes to relapse. Adolescents are particularly susceptible; as compared with persons who begin the use of marijuana in adulthood, those who begin in adolescence are approximately 2 to 4 times as likely to have symptoms of cannabis dependence within 2 years after first use
  • Possible Role as a Gateway Drug– data suggests that the use of marijuana in adolescence could influence multiple addictive behavior in adulthood
  • Cognitive and Academic Effects– weekly or more frequent marijuana use by adolescents and young adults is associated with impaired learning, memory, math and reading achievement, even 28 days after last use, and is strongly associated with failure to graduate from both high school and college
  • Relation to Mental Illness– regular marijuana use is associated with an increased risk of anxiety and depression, and is linked with psychoses, especially among people with a preexisting genetic vulnerability.
  • Adverse Cardiac and Respiratory effects– marijuana use may be associated with increased risk of stroke in individuals younger than 55 years of age, and may be associated with increased risk of heart attack among adults. Daily or near daily marijuana smoking is strongly associated with chronic bronchitis, including chronic cough, sputum production, and wheezing..
  • Unintentional Exposures in Children– legal marijuana access is strongly associated with increased numbers of unintentional exposures in children, which can lead to hospitalizations. In Colorado, at least 14,000 children are at risk of accidentally eating marijuana products that are not safely stored, and at least 16,000 are at risk of being exposed to secondhand marijuana smoke in the home1.
  • Risk of Motor Vehicle Accidents– both immediate exposure and long term exposure to marijuana impair driving ability; marijuana is the illicit drug most frequently reported in connection with impaired driving and accidents, including fatal accidents


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2019 Nominations for MSSNY Leadership
The list of nominations for 2019 MSSNY leadership positions is now available on the website. Click here to view the list.


Governor Urged to Sign Legislation to Require Greater Transparency of Insurer Compliance with Mental Health & SUD Parity Laws
Physicians are urged to send a letter to the Governor requesting that he sign into law legislation (S.1156-C, Ortt/A.3694-C, Gunther) which directs the NY Department of Financial Services (DFS) to collect certain key data points and elements from health insurers in order to scrutinize and analyze if they are in compliance with the federal and state mental health and substance use (MH/SUD) disorder parity laws.   A letter can be sent from here.

MSSNY, working together with the New York State Psychiatric Association and other specialty societies, had strongly supported this legislation as it passed the Legislature nearly unanimously.  While many physicians weighed in with their legislators in support earlier this year, advocacy should now be directed to the Governor’s office in support of this important measure.

If signed into law by the Governor, the information collected would be analyzed and used for the preparation of a parity compliance report that would be contained within in the annual “Consumer Guide to Health Insurers” issued by the DFS.

Although MH/SUD parity laws have been on the books for over a decade on the federal and state level, recent Attorney General settlements note that there continue to be patterns of disparity between coverage criteria imposed on MH/SUD care and treatment as compared to other covered services.  The goal of the legislation is to better ensure compliance with these laws.


Research Finds No Benefit of Low-Dose Aspirin For Primary Prevention
The Washington Post (9/16, Bernstein) reports that research indicates “a regimen of low-dose aspirin offers healthy, older people no benefit in staving off cardiovascular disease, dementia or disability and increases their risk of bleeding in the digestive tract and brain.” The findings were published in three articles in the New England Journal of Medicine. To view the NEJM articles, click here, here, and here.



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Marist College to Open Medical School 2022
New York’s Marist College is teaming up with a regional health care company to create a new medical school. The college announced that it will join forces with the hospital network Health Quest to create the Marist Health Quest School of Medicine. Marist is a private liberal arts college in Poughkeepsie, about 85 miles north of New York City. Marist President David Yellen says adding a medical school is “a natural next step” for the college.

The new medical school will be the only MD-granting institution between Westchester County and Albany. Marist and Health Quest say the college will open in July 2022 with 60 students. There will be an estimated 480 students when the schoolis running at full enrollment after six years.


Buying Life Insurance? Strap on Your Fitbit!
John Hancock insurance announced this week that it will stop selling traditional life insurance and instead sell only interactive policies that track data through wearable fitness devices and smartphones. Interactive life insurance is already well-established in South Africa and Britain and is becoming more widespread in the United States. Read more here.


Fetal Exposure to Environmental Pollutants May be Associated With Thyroid Functioning in Newborns
MedPage Today (9/14, Monaco) reports that “Fetal exposure to environmental pollutants was associated with thyroid functioning in newborns,” research indicated. In the “analysis of infants born in Los Angeles, those exposed in utero to greater amount of ambient pollution had higher levels of total thyroxine (TT4) levels as newborns,” the study found. The findings were published in JAMA Network Open.

Continuing Medical Education

HIV in 2018: Keeping the Vision on Women
Friday, October 12th, 2018
Hilton Garden Inn
235 Hoosick Street
Troy, NY 12180

This free full-day clinical conference will focus on HIV prevention and care for women of all experiences, highlighting the vital role medical providers play in women’s health. Click here for the agenda.

Register today! http://rebrand.ly/CEIOct12   

Registration is free of charge and is restricted to New York State medical providers including physicians, physician assistants, nurses, nurse practitioners, certified nurse midwives, dentists, and pharmacists. A light breakfast and lunch will be included.

6 free CME, CNE, and CPE credits!

Questions? Contact Jessica Steinke at jessica.steinke@mountsinai.org or 212-731-3789


Influenza 2018-19: CME Webinar on October 17
Did you know that the World Health Organization (WHO) is predicting two new strains of influenza for the 2018-2019 season?  Learn about this and more at the first of MSSNY’s 2019 Medical Matters continuing medical education (CME) webinar series: “Influenza 2018-19” on Wednesday, October 17, 2018 at 7:30 a.m.  William Valenti, MD, chair of MSSNY Infectious Disease Committee and a member of the Emergency Preparedness and Disaster/Terrorism Response Committee will serve as faculty for this program. Registration is now open for this webinar here.

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

Educational objectives are:

  • Describe key indicators to look for when diagnosing patients presenting with flu-like symptoms
  • Describe clinical and laboratory diagnostic features and treatment specific to each flu season
  • Identify recommended immunizations and antiviral medications for treatment and how best to effectively encourage patients to get vaccinated

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

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


Member Benefit

Join MSSNY’s Member Perks Program and Enjoy $4,500 in Savings!
MSSNY is pleased to announce our newest member benefit!  Our new Abenity App provides members with exclusive perks and over $4,500 in savings on everything from restaurants, City Pass, AMC movie tickets, theme parks, hotels, car rentals, mortgage savings, auto care and much more!

Popular Features Include:

  • Nearby Offers: Use our show and save mobile coupons to quickly access savings on the go.
  • eTickets On Demand: Save up to 40% with no hidden fees.
  • Showtimes: Find movies, watch trailers, and save up to 40% at a theater near you.
  • Monthly Giveaways: Win cash, movie tickets, electronics and more with our monthly contests.

And, with over 302,000 available discounts across 10,000 cities in the United States and Canada, you’ll never be far from savings!

REGISTER & LOG IN

Click on the following link: http://mssny.abenity.com and then create a unique user name and password


Workers Compensation

New TPAs for Workers’ Compensation, Volunteer Firefighter, and Volunteer Ambulance Claims
As of September 10, 2018, the Special Funds Conservation Committee (SFCC) will no longer be administering workers compensation, volunteer firefighter, and volunteer ambulance worker claims.

These claims are being transferred to new third-party administrators (TPAs), who will assume all claims administration services.

Notifying Injured Workers

Injured workers have been notified of the name and contact information of their new TPA, and have been advised to inform their legal representatives and medical providers of this change.

Medical Reporting and Billing

All requests for treatment authorization on and after September 10, 2018, must be sent to the correct TPA for the injured worker.

All medical bills received by SFCC in error during this period of transition will be forwarded to the proper TPA for resolution and payment.

Finding the New TPA

If you are providing medical treatment or legal representation for an injured worker who lists SFCC as their insurer on or after September 10, 2018, please inquire further, as the SFCC will no longer be the claims administrator at that time.

For information about the new TPA, the injured worker (or your office if you have previously submitted Form OC-400 or medical bills to the Workers Compensation Board for that person in that workers compensation case) may contact SFCC or the Workers Compensation Board.

Contact SFCC
Buffalo: (716) 686-5700
Dewitt: (315) 445-9405
New York City: (212) 883-3900

Contact the Workers Compensation Board
(877) 632-4996
general_information@wcb.ny.gov


4th Columbia Psychosomatics Conference – Oct 20-21, 2018 NYC
If you can’t see this image please go to 4th Columbia Psychosomatics Conference website HERE.

4th Columbia Psychosomatics Conference


 

Join MSSNY

Classified

RENTAL/LEASING SPACE


Magnificent Medical Suites for Lease 184 East 70th St. New York, NY
The space has just undergone a complete STATE OF THE ART renovation.
Located in a luxury building with a separate elevator entrance on the prestigious upper east side of Manhattan, this recently renovated space is conveniently situated steps from Lenox Hill Hospital, Cornell /Columbia Presbyterian, HSS and Memorial Sloan Kettering. Includes exam rooms, new custom cabinetry, new exam beds, scale, waiting area – new furniture, new TV, water cooler etc. Space A: one consultation room plus 2 exam rooms. $6000 per month
Space B: One consultation room plus one exam room. $4500 per month
Space C: one consultation plus one exam $4500. other combination may work as well. Available for sharing For full details and photos see listing at http://bit.ly/2E3Zvh0 or contact Karen Tamir at 917-865-1006 or KarenTamir@Yahoo.com184 East 70th St Waiting Room 184 East 70th St Front Desk

184 East 70th St Patient's Room 184 East 70th St Hallway


West 57 St. – Shared Office Space to Rent
Lovely Garden view office with natural light. Located near Columbus Circle in a beautiful Art Deco building. Recently renovated office with additional exam room/ room with a sink. Wi-Fi, medical waste pickup and cleaning included.  Ideal location in desirable neighborhood. Contact Jason Faller 914-393-6583 goutmd@aol.com


Rare Find — Great Office Share
Wonderful office share in terrific location at great price. Choice of smaller windowed consultation room with adjoining exam room or big windowed consultation room with one or two exam rooms. Beautiful bright rooms, lovely reception area and front . First-rate building on 58th Street between Park and Lexington.  Rent by day (about $180) or by month ($5500). Front desk and office management available, along with many other amenities, including internet, ultrasound, EMG Kitchen, optional C Arm. Willing to make changes for new tenant. Call 646-642-0700.

58th Street Waiting Room 58th Street Doctor's Office 58th Street Patient's Room


 


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

PHYSICIAN OPPORTUNITIES

Medical Director in the NYS Office of Health Insurance Programs Division of Systems
The Medical Director position will be responsible to review prior approval requests and issue denials as indicated.  The incumbent will review pended claims and recommend whether payment should be made or denied and review requests for enhanced reimbursement for Out-of-State Hospital services.  The incumbent will participate in several external and internal committees including: Provider Enrollment Appeals Committee, Laboratory Policy Committee, Internal Benefit Review Committee, Irregular Billing Committee, Utilization Review Edit Committee, Quality Improvement Committee, Physician Administered Medication Committee, and Medical Coding Review and Coverage Decisions Committee.  The incumbent will also attend the Hearing Aid Dispensing Advisory Committee representing the Commissioner of Health and participate in the Evidence-Based Benefit Review.  The incumbent will a key stakeholder in monitoring the Radiology Utilization Management Contract and interacting with the Medical Director and clinical staff.  The incumbent will also be responsible to participate with other OHIP Medical Directors in meetings on topics about Medicaid Policy including DSRIP and VBP.

Interested candidates may submit a resume to Human Resources Management Group, Room 2276, Corning Tower Building, Empire State Plaza, Albany, New York 12237-0012, 

or by email to resume@health.state.ny.us with a subject line “OHIP Medical Director Position,” or by fax to (518) 474-6771.


Physicians Wanted to Help Shape the Future of Primary Care
98point6 is a healthcare technology startup committed to delivering more affordable, accessible, high-quality primary care. To support our mission, the insights of forward-thinking physicians like you are invaluable. Members of our exclusive Primary Care Council have no clinical responsibilities and are compensated for their participation, which requires only a few hours annually.

Interested? Learn more and apply today at www.98point6.com/pcc

 


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


 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Sept. 14, 2018 – MSSNYeNews: Do No Harm: The Movie

Thomas J. Madejski, MD MSSNY President
PRESIDENT’S MESSAGE

Thomas J. Madejski, MD
MSSNY President


MSSNY eNews
September 14, 2018
Volume 20  Number 34

MSSNYPAC


Do No Harm Movie

MSSNY President Thomas Madejski, MD (far right) speaks to panel (L-R) Michael Myers, MD; Pamela Wible, MD; Michele and John Dietl; Hawkins M., MD

Colleagues:

This week’s travels brought me back to New York City to attend the MSSNY Board of Trustees meeting and to preside (that’s what Presidents do best) at the MSSNY Council meeting. Physician wellness is one of the key components of MSSNY’s agenda.  Fortuitous timing allowed me to attend the World Premiere of Do No Harm, a heartrending film documentary focused primarily on the negative transformation of some students during medical school leading too often to depression and, in some cases—to suicide.

The filmmaker, Robyn Symon is the daughter of a physician. Ms. Symon’s film is a sensitive depiction of some of the factors that may lead to despondency, and lethality, and is especially powerful due to the narrative provided by Michele and John Dietl who lost their son, Kevin, to a self-inflicted gunshot wound; and Hawkins M., a 1st year resident, who attempted to end his life, and fortunately has recovered and is doing well.  I was honored to represent MSSNY at a post-screening   panel discussion along with these three courageous individuals, MSSNY member Dr. Michael Myers, professor of Psychiatry at SUNY Downstate, an expert on physician mental health and suicide and a member of the CPH Advisory Committee and Dr. Pam Wible, a family physician and advocate.

Fear of Stigma

Versions of the Hippocratic Oath and the Declaration of Geneva require a commitment to personal wellness and an obligation to care for our brothers and sisters within our profession, yet too often stigma and fear of negative impact on our work prevents physicians from seeking assistance for stress, depression or substance use disorders.  The film starts out by suggesting there is hypocrisy towards the oath due to a potentially toxic combination of factors that physicians encounter along their career path.  We had a robust discussion about the complex issues involved and potential solutions. I explained MSSNY’s commitment to physician wellness and the resources we have available currently. The discussion session was wide ranging and the audience, a mix of physicians and interested non-physicians, came away with a better sense of the adverse environmental stressors and other factors.

Dr. Frank Dowling, MSSNY secretary and member of the Committee on Wellness and Resilience explained our efforts to develop a statewide confidential Peer-to-Peer Support Program.

The most moving part of the evening was the courage of the Dietl family and Hawkins who in sharing their pain, hopefully, will help us come together to improve the care of our caregivers.  Do No Harm is a powerful, encouraging start to expand the conversation about medical student and physician suicide outside of our profession that includes our entire community.

Watch the film trailer here.

Non nobus solum nati sumus

Please share your thoughts and comments with me at comments@mssny.org.


Thomas J. Madejski, MD 
MSSNY President


eNews

Please Plan to Participate in NYS “Listening Sessions” on Legalizing Recreational Marijuana Use
As reported last week, New York Governor Andrew Cuomo has called for a series of “listening sessions” across New York State to receive public comment regarding a proposal to legalize and regulate the recreational use of marijuana in New York State.  As noted below, there are forums coming up next week on Monday (9/17) in the Bronx and Thursday (9/20) in Manhattan.

Last week, MSSNY Treasurer Dr. Joseph Sellers testified at an Albany forum to raise public health concerns with this proposal.  Dr. Sellers’ testimony noted MSSNY’s support for de-criminalizing marijuana possession, but also significant concerns with outright permitting recreational use noting that “data from jurisdictions that legalized cannabis demonstrated concerns particularly around unintentional pediatric exposures resulting in increased calls to poison control centers and ED visits as well as an increase in traffic deaths due to cannabis-related impaired driving.

Physicians are urged to register to participate and testify at these upcoming forums from the links below:

  • Bronx – Monday, September 17, 2018 – Register
  • Manhattan – Thursday, September 20, 2018 – Register
  • Queens – Monday, September 24, 2018 – Register
  • Brooklyn – Tuesday, September 25, 2018 – Register
  • Staten Island – Wednesday, September 26 – Register
  • Long Island – Thursday, September 27, 2018 – Register
  • Newburgh – Monday, October 1, 2018 – Register
  • Binghamton – Tuesday, October 2, 2018 – Register
  • Buffalo – Wednesday, October 3, 2018 – Register
  • Rochester – Thursday, October 4, 2018 – Register
  • Syracuse – Tuesday, October 9, 2018 – Register
  • Utica – Wednesday, October 10, 2018 – Register
  • Watertown – Thursday, October 11, 2018 – Register


Council Notes-September 13, 2018

  • MLMIC Vice President and Assistant Secretary Donald Fager reported to Council that the Berkshire Hathaway transaction is very close to completion and thanked MSSNY for its support. Department of Financial Services Superintendent Maria Vullo has approved the Demutualization Application, the Acquisition Application and the application for approval of the amendments to MLMIC’s Charter and By-laws. Mr. Fager noted that the final step is policyholder approval.
  • Council approved the MSSNYPAC Endorsement recommendations for candidates running for re-election to the New York State Legislature and to the US Congress. Click here to view the list.
  • Physicians’ Day at the Races, which took place at the Saratoga Race Track in July, was a great success and raised $13,000 for MSSNYPAC. Plan to join the fun next summer for another Physicians’ Day at the Races!
  • MSSNY President Dr. Tom Madejski and New York County Medical Society president Dr. Naheed Van de Walle reported on a September 5 meeting in which MSSNY and New York County Medical Society leaders met with NYS Assembly Health Committee Chair Richard Gottfried to discuss and raise questions about various aspects of his legislation (A.4738) that would create a single payor system in New York State.
  • Elizabeth Amato, Vice President, SHIN-NY Programs at New York eHealth Collaborative (NYeC) provided an update on the Data Exchange Incentive Program (DEIP), which provides physicians with up to $13,000 to help connect to the SHIN-NY. Overview documents are available online at nyehealth.org/deip. Or contact NYeC with any questions at deip@nyehealth.org.

Primaries: Strong Wins for Cuomo and Hochul; Defeat Many Senate IDC Members
While New York Governor Andrew Cuomo and Lt. Governor Kathy Hochul each won decisive victories this week, several incumbent state legislators lost in their respective primary elections to represent their parties for the upcoming November 6 general election.

Governor Cuomo defeated challenger Cynthia Nixon for the Democrat nod for Governor by a 64%-34% margin.     Lt. Governor Hochul defeated challenger Jumaane Williams by a 53%-47% margin.  They will face Republican gubernatorial candidate Marc Molinaro and Lt. Governor candidate Julie Killian in the general election.

New York City Public Advocate Leticia James won a four-way primary battle to get the Democratic line for New York State Attorney General.    She will face Republican Keith Wofford in the general election.

Six of the 8 members of the former New York State Senate Independent Democratic Conference (IDC) lost their Democratic primaries:

  • In the 11th Senate District (Queens), John Liu defeated Senator Tony Avella
  • In the 13th Senate District (Queens), Jessica Ramos defeated Senator Jose Peralta
  • In the 20th Senate District (Brooklyn), Zellnor Myrie defeated Senator Jesse Hamilton
  • In the 31st Senate District (Manhattan/Bronx), Robert Jackson defeated Senator Marisol Alcantara
  • In the 34th Senate District (Bronx/Westchester), Alessandra Biaggi defeated Senator Jeff Klein
  • In the 53rd Senate District (Onondaga/Madison), Rachel May defeated Senator David Valesky.

The only former IDC members to win their primaries were Senator Diane Savino (Staten Island) and Senator David Carlucci (Rockland/Westchester).

In addition, Democratic Senator Martin Dilan lost his primary to challenger Julia Salazar.

Currently, the NYS Senate is divided between 31 elected Republicans and 32 elected Democrats, with one of the Democrats Simcha Felder aligning with the Republicans to create GOP Majority. As a result, there is an intense campaign battle as to which party will have majority control after the upcoming November elections.


Advocacy Organizations Express Concern re Proposed E&M Payment Changes
Several news articles (such as here and here) have highlighted the strong concern of physician advocacy organizations, including MSSNY, with the CMS proposal to contract Medicare payment rates different levels of E&M services. 

As previously reported, MSSNY sent a letter to CMS, as well as joining on to multiple group letters, to raise serious concern with CMS’ proposal to collapse evaluation and management (E/M) payments as part of its Medicare payment rule for 2019.  These letters express appreciation for the CMS “Patients Over Paperwork” initiative to reduce the extraordinary documentation burden facing physicians, but also note that any benefit to be gained would be sizably outweighed by the likely significant reductions in payments.  Under the proposal, payments for E&M codes 99202-99205 would be $134 (instead of ranging from $76 to $211) and payments for E&M codes 99212-99215 would be $92 ($45 to $148).

MSSNY signed on to a letter initiated by the AMA and 170 other medical associations.  That letter that noted medicine’s support for CMS’ “goal of reducing administrative burdens for physicians and other health care professionals so that they can devote more time to patient care”, but also that there are “unanswered questions and potential unintended consequences that would result from the coding policies in the proposed rule.”  Moreover, it expressed concerns that the policy change “could hurt physicians and other health care professionals in specialties that treat the sickest patients, as well as those who provide comprehensive primary care, ultimately jeopardizing patients’ access to care.”

MSSNY also signed on to a letter initiated by the Coalition of State Medical Societies (consisting of the medical societies of AZ, CA, FLA, LA, NC, NJ, OK, SC and TX together with MSSNY), which articulated the following concerns:

  • Eliminating incentives for physicians to care for complex or complicated patients including those with disabilities and those with serious or terminal illnesses;
  • Making treating patients covered by Medicare even more financially challenging for physicians, leading more physicians to limit the number of Medicare patients they see or to opt out of the program entirely; and
  • Similar changes being imposed by commercial insurance companies that tend to follow CMS’ lead on payment matters.

Abentity


Heart Group Updates Guidelines on Resistant Hypertension
The American Heart Association has updated its 2008 guidelines on detecting and managing resistant hypertension — defined as above-goal blood pressure (≥130/80 mm Hg) despite use of three antihypertensive drugs, or controlled BP on a four-drug regimen.The guidelines, published in Hypertension, contain numerous practical diagnostic and clinical management tips. Among the most notable:

  • Healthcare providers should regularly ask patients with resistant hypertension about their sleep patterns. Poor sleep duration and quality trigger the sympathetic and renin-angiotensin systems and, thus, can interfere with BP control.
  • The role of lifestyle is emphasized as part of first-line management of resistant hypertension. Clinicians should advise patients to follow a low-sodium diet (
  • If BP is above goal despite an optimal lifestyle and adherence to a three-drug regimen, providers should consider switching from hydrochlorothiazide to chlorthalidone or indapamide. If BP is still high after that, spironolactone may be considered as a fourth drug.

AHA guideline in Hypertension https://www.ahajournals.org/doi/10.1161/HYP.0000000000000084


NY Sepsis Deaths May Have Declined In Since State Mandate Implemented
Medscape (9/7) reported researchers found that “deaths from sepsis declined during the [two] years following implementation of a [New York] state mandate requiring hospitals to follow sepsis care bundles and report on patient outcomes.” The findings were published in the American Journal of Respiratory and Critical Care Medicine.


Study: More Documentation Should be Required to Show Need of Opioids
Research published Monday in the Annals of Internal Medicine state that a review of medical records from 2006 to 2015 “showed that a physician gave no explanation at all for writing an opioid prescription in 29 percent of the cases.” The findings by researchers at Harvard Medical School and the Rand Corp. “help support criticism by the Centers for Disease Control and Prevention, the Food and Drug Administration and others that say inappropriate prescribing practices have helped drive the opioid crisis.”

Researchers examined 32,000 clinician visits in which an opioid was prescribed to adults. Of these visits, 5% were documented as related to cancer-associated pain, 66% were coded for non-cancer pain, and 29% had no recorded pain diagnosis. Lack of a recorded pain diagnosis was more common among continuing rather than new opioid prescriptions (31% vs. 23%).The Boston Globe (9/10) reports “inappropriate prescribing, bad recordkeeping, or a combination of both were possible reasons for the missing data, according to the researchers.” Study author Tisamarie Sherry said, “Whatever the reasons, lack of robust documentation undermines our efforts to understand physician prescribing patterns and curtails our ability to stem overprescribing.”



Medical Society of NY Classifieds


Three Hospitals Earn Through Captive Insurers Despite Settlement with State
Modern Healthcare (9/8) reported that Maimonides Medical Center, Montefiore Medical Center, and Mount Sinai Hospital “continue to make money – about $64 million this year – off a revamped version of an insurance maneuver that New York regulators last year characterized as a hidden scheme to funnel hundreds of millions of dollars back to the hospitals.”

Last year, New York’s Department of Financial Services “found that the professional liability insurer Hospitals Insurance Co. illegally kept secret the fact that its offshore captive insurance company soaked up more than $160 million in premium payments that yielded more than $200 million in investment income over a two-decade period, all while avoiding domestic regulation.” Despite a settlement with the state, however, “the latest financial filings from” the three hospitals “indicate” they “have kept a version of the operation running.”

CME Webinar

 “Influenza 2018-19” CME Webinar on October 17; Registration Now Open
The first of MSSNY’s 2019 Medical Matters continuing medical education (CME) webinar series is: “Influenza 2018-19” on Wednesday, October 17, 2018 at 7:30 a.m.  William Valenti, MD, chair of MSSNY Infectious Disease Committee and a member of the Emergency Preparedness and Disaster/Terrorism Response Committee will serve as faculty for this program. Registration is now open for this webinar here.

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

Educational objectives are:

  • Describe key indicators to look for when diagnosing patients presenting with flu-like symptoms
  • Describe clinical and laboratory diagnostic features and treatment specific to each flu season
  • Identify recommended immunizations and antiviral medications for treatment and how best to effectively encourage patients to get vaccinated

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

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


CMS Updates 2017 MIPS Performance Feedback
Recently, CMS released performance feedback for clinicians included in the Merit-based Incentive Payment System (MIPS) during the 2017 performance year. As we’ve previously announced, we saw a very high 91 percent participation rate for the first performance year (2017) of MIPS. Over the last several weeks, individual clinicians, groups, and eligible clinicians in certain Alternative Payment Models (APMs) have had access to this feedback on the Quality Payment Program website, which provides a comprehensive overview of their MIPS final score, performance category details, and 2019 MIPS payment adjustment.

Along with releasing performance feedback, we launched a process known as targeted review. A targeted review provides the opportunity for clinicians, groups, or those participating in certain APMs to request that we review their MIPS payment adjustment factor(s), if they believe there is an error with the 2019 MIPS payment adjustment calculation.

The requests that we received through targeted review caused us to take a closer look at a few prevailing concerns. Those concerns included the application of the 2017 Advancing Care Information (ACI) and Extreme and Uncontrollable Circumstances hardship exceptions, the awarding of Improvement Activity credit for successful participation in the Improvement Activities (IA) Burden Reduction Study, and the addition of the All-Cause Readmission (ACR) measure to the MIPS final score. Based on these requests, we reviewed the concerns, identified a few errors in the scoring logic, and implemented solutions. The targeted review process worked exactly as intended, as the incoming requests quickly alerted us to these issues and allowed us to take immediate action.

Addressing and correcting for the above elements resulted in changes to the 2017 MIPS final score and associated 2019 MIPS payment adjustment for the clinicians who were impacted by the identified issues. Additionally, in order to ensure that we maintain the budget neutrality that is required by law under the Medicare Access and CHIP Reauthorization Act of 2015 (MACRA), some clinicians will see slight changes in their payment adjustment as a result of the reapplication of budget neutrality.  These revisions were made to the performance feedback on the Quality Payment Program website on September 13, 2018. We encourage you to sign-in to the Quality Payment Program website as soon as possible to review your performance feedback. If you believe an error still exists with your 2019 MIPS payment adjustment calculation, the targeted review process is available for you.

To offer additional time for clinicians, groups, and APM entities and their participants to access and review their performance feedback, we are extending the targeted review deadline to October 15, 2018 at 8:00pm (EDT). We also have a number of resources available on our Quality Payment Program Resource Library to help you understand your performance feedback and the targeted review process. If you are in-need of additional assistance, please reach out to the Quality Payment Program Service Center by phone at 1-866-288-8292, (TTY) 1-877-715-6222 or by email at QPP@cms.hhs.gov, or contact your local technical assistance organization for no-cost support.

From the onset of the Quality Payment Program, goals have included creating a program that is fully transparent and provides accurate information. We believe that the above steps are essential to achieving that goal for the first performance year (2017), also referred to as the “transition” year. We will continue to work closely with the clinician community to learn from one another and ensure operational excellence in implementation.


4th Columbia Psychosomatics Conference – Oct 20-21, 2018 NYC

If you can’t see this image please go to 4th Columbia Psychosomatics Conference website HERE.


Medicaid

DOH Hosts Medicaid Drug Cap
The Department of Health will be hosting a webinar on the SFY 18-19 Medicaid Drug Cap on September 17, 2018 at 2:00 pm. There will be an email address provided at the end of the webinar for questions and answers. Materials will be made available after the webinar at: https://www.health.ny.gov/health_care/medicaid/regulations/global_cap/. To register please follow the instructions below. This event requires registration.

Topic: SFY 18-19 Medicaid Drug
Host:  Office of Health Insurance Programs
Date:  Monday, September 17, 2018 2:00 pm
To register for the online event:
  1. https://meetny.webex.com/meetny/onstage/g.php?MTID=ee02c8551d0ed9d5a9948b31aef96c3cb
    2. Click “Register”.
    3. On the registration form, enter your information and then click “Submit”. 

Meaningful Use Attestations Due Oct. 15 for NY Medicaid EHR Incentive
Don’t delay! The deadline to attest 2017 Meaningful Use is October 15, 2018. All attestations for the NY Medicaid EHR Incentive Program must be submitted through MEIPASS at https://meipass.emedny.org/ehr/login.xhtml. Eligible professionals (EPs) no longer have to mail hard copies of their attestations – Everything is submitted online!

Note: Extensions will be automatically granted to EPs whose 2016 attestations are still pending state review. Those EPs will be notified via email about their extended deadlines, so they have sufficient time to attest 2017 Meaningful Use in MEIPASS.

Need assistance with MEIPASS? Check out our video tutorials and walkthrough to help you with the attestation process. For additional assistance, please contact program support at 1-877-646-5410 or hit@health.ny.gov.


 

Join MSSNY

Classified

RENTAL/LEASING SPACE


Magnificent Medical Suites for Lease 184 East 70th St. New York, NY
The space has just undergone a complete STATE OF THE ART renovation.
Located in a luxury building with a separate elevator entrance on the prestigious upper east side of Manhattan, this recently renovated space is conveniently situated steps from Lenox Hill Hospital, Cornell /Columbia Presbyterian, HSS and Memorial Sloan Kettering. Includes exam rooms, new custom cabinetry, new exam beds, scale, waiting area – new furniture, new TV, water cooler etc. Space A: one consultation room plus 2 exam rooms. $6000 per month
Space B: One consultation room plus one exam room. $4500 per month
Space C: one consultation plus one exam $4500. other combination may work as well. Available for sharing For full details and photos see listing at http://bit.ly/2E3Zvh0 or contact Karen Tamir at 917-865-1006 or KarenTamir@Yahoo.com 


West 57 St. – Shared Office Space to Rent
Lovely Garden view office with natural light. Located near Columbus Circle in a beautiful Art Deco building. Recently renovated office with additional exam room/ room with a sink. Wi-Fi, medical waste pickup and cleaning included.  Ideal location in desirable neighborhood. Contact Jason Faller 914-393-6583 goutmd@aol.com


Rare Find — Great Office Share
Wonderful office share in terrific location at great price. Choice of smaller windowed consultation room with adjoining exam room or big windowed consultation room with one or two exam rooms. Beautiful bright rooms, lovely reception area and front . First-rate building on 58th Street between Park and Lexington.  Rent by day (about $180) or by month ($5500). Front desk and office management available, along with many other amenities, including internet, ultrasound, EMG Kitchen, optional C Arm. Willing to make changes for new tenant. Call 646-642-0700.



 


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

PHYSICIAN OPPORTUNITIES

Medical Director in the NYS Office of Health Insurance Programs Division of Systems
The Medical Director position will be responsible to review prior approval requests and issue denials as indicated.  The incumbent will review pended claims and recommend whether payment should be made or denied and review requests for enhanced reimbursement for Out-of-State Hospital services.  The incumbent will participate in several external and internal committees including: Provider Enrollment Appeals Committee, Laboratory Policy Committee, Internal Benefit Review Committee, Irregular Billing Committee, Utilization Review Edit Committee, Quality Improvement Committee, Physician Administered Medication Committee, and Medical Coding Review and Coverage Decisions Committee.  The incumbent will also attend the Hearing Aid Dispensing Advisory Committee representing the Commissioner of Health and participate in the Evidence-Based Benefit Review.  The incumbent will a key stakeholder in monitoring the Radiology Utilization Management Contract and interacting with the Medical Director and clinical staff.  The incumbent will also be responsible to participate with other OHIP Medical Directors in meetings on topics about Medicaid Policy including DSRIP and VBP.

Interested candidates may submit a resume to Human Resources Management Group, Room 2276, Corning Tower Building, Empire State Plaza, Albany, New York 12237-0012, 

or by email to resume@health.state.ny.us with a subject line “OHIP Medical Director Position,” or by fax to (518) 474-6771.


Physicians Wanted to Help Shape the Future of Primary Care
98point6 is a healthcare technology startup committed to delivering more affordable, accessible, high-quality primary care. To support our mission, the insights of forward-thinking physicians like you are invaluable. Members of our exclusive Primary Care Council have no clinical responsibilities and are compensated for their participation, which requires only a few hours annually.

Interested? Learn more and apply today at www.98point6.com/pcc

 


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


 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

MSSNY eNews: Talking Marijuana/Single Payor

Thomas J. Madejski, MD MSSNY President
PRESIDENT’S MESSAGE

Thomas J. Madejski, MD
MSSNY President


MSSNY eNews
September 7, 2018
Volume 20  Number 33

MSSNYPAC

Dear Colleagues:

Being MSSNY President is a new adventure every day.  Your leadership and staff have been active this week on many fronts.  Many of you are aware that the Governor and Health Department are considering legalization of marijuana for recreational use.  MSSNY and the AMA have extensive policy on a scientific approach to evaluating marijuana as a therapeutic agent, as well as for recreational use.  Just before the Labor Day Holiday, Governor Cuomo announced a series of public comment opportunities throughout the state.

Pundits often joke about public policy— “you can lead the train, be on the train, or be under the train.”  I’m concerned that further expansion of non-medicinal marijuana usage in New York State may lead to a train wreck.  We have some data with regards to increased use of marijuana that is troubling.  The AMA Council on Science and Public Health recently reviewed Clinical Implications and Policy Considerations of Cannabis Use (read here, beginning on page 25) in response to the request of AMA and MSSNY members last fall.  I encourage you to read it.  After discussion with our leadership team, MSSNY in conjunction with some of our specialty and County Society leaders will provide comment to hopefully keep the train on track.  We want our patients to arrive safely at their destination, prevent the inappropriate expansion of drug use, misuse, and abuse, and avoid the development of a ‘new tobacco’ industry that exploits our most vulnerable citizens. 

Medical Marijuana

Thanks to Dr. Joe Sellers, our MSSNY Treasurer who was able to pinch hit for me in Albany on Wednesday, where he represented MSSNY at the Governor’s listening session on medical marijuana.  Read the full statement here.

While Dr. Sellers was covering for me in Albany, I was in New York at the MLMIC Executive Committee meeting.  MSSNY provided testimony at the recent public hearing with regards to the proposed sale of MLMIC to Berkshire Hathaway.

Single Payor

Later in the day, President Elect Dr. Arthur Fougner and I along with colleagues from New York County, spent a couple of hours with Assemblyman Richard Gottfried—who has been a great advocate for patients and physicians. He provided insight into his proposed single payer legislation.  We came away with a better understanding of the general workings of the plan and how it could affect your practice.  We agreed to continue dialogue on the evolution of the plan.  You can find our policy with regards to single payer here. I will keep you updated periodically on those discussions.

Your membership and personal contributions allow us to be effective advocates on behalf of our patients and our profession. Click here to join or contribute to MSSNYPAC.

Excelsior!

Please share your thoughts and comments with me at comments@mssny.org.


Thomas J. Madejski, MD 
MSSNY President


eNews

DOH HIV Prevention and Partner Service to Aid “End the Epidemic”
The NYS Department of Health’s HIV Prevention and Partner Service programming is highlighted in the attached document. NYS and County health department staff can assist in locating and re-engaging individuals with diagnosed HIV infection into HIV-related medical care. Staff also actively refer HIV status unknown or negative persons with syphilis or other STDs to clinicians offering PrEP and facilitate access to these services.

A new HIV/STI prevention approach works with individuals in rapidly growing transmission clusters to ensure their partners are linked to HIV and STI testing, medical care, PrEP and other prevention services. Finally, electronic clinician reporting is included in the document to improve efforts for expedited partner services to aid in the efforts to End the Epidemic.

MIPS, NO MIPS, HATE MIPS? TELL US!
Please take the three-question survey on your use/non-use of MIPS! https://www.surveymonkey.com/r/MIPS_Survey

Governor Announces Series of Listening Tour for Regulated Marijuana
Governor Andrew Cuomo has announced a series of listening sessions on regulated marijuana slated for September and October.  The purpose of these sessions is to garner input from community members and key stakeholders on the implementation of a regulated marijuana program in New York State. This input will assist the regulated marijuana workgroup in drafting legislation for an adult-use marijuana program for the legislature to consider in the upcoming session.  A copy of the governor’s press announcement is available here.

MSSNY will have representation at each listening session. NOTE: Although the dates are finalized, several of the venues have not been finalized.

The listening dates and registration is required for the sessions:

– Monday, September 17 –    Bronx

– Thursday, September 20 – Manhattan

– Monday, September 24 –    Queens

– Tuesday, September 25 –    Brooklyn

– Wednesday, Sept. 26 –       Staten Island

– Thursday, September 27    Long Island

– Monday, October 1 –          Newburgh

– Tuesday, October 2 –         Binghamton

– Wednesday, October 3 –     Buffalo

– Thursday, October 4 –        Rochester

– Tuesday, October 9 –         Syracuse

– Wednesday, Oct.  10 –       Utica

– Thursday, October 11 –     Watertown

Registration for individual listening sessions: https://tinyurl.com/y9sh5j9k

DFS’ Report Ranking Health Insurers Based Upon Complaints and Care Access
This week, the NY Department of Financial Services released it 2018 Consumer’s Guide to Health Insurers, which provide consumers information regarding the complaints, appeals and grievances filed against insurance companies during 2017, as well as out of network independent dispute resolution (IDR) statistics for 2017.

For 2017, the insurers with the highest overall ranking based on the lowest number of complaints were:

  • MVP Health Services Corp.
  • Independent Health
  • Genworth Life Insurance Company
  • Community Blue (Health Now)

Some of the most noteworthy findings of the report:

  • For Prompt Payment complaints, CDPHP had the best ranking among HMO plans and MVP the best among EPO/PPO plans. Empire had the worst ranking among HMO plans, and GHI the worst among EPO/PPO plans.
  • For Overall complaints, Independent Health had the best ranking among HMO plans and MVP the best among EPO/PPO plans. Empire had the worst ranking among HMO plans, and GHI had the worst among EPO/PPO plans.
  • There were 1,512 external appeals of health insurer denials of care, of which approximately 38% where reversed entirely or in part.
  • For “Access and Service”, CDPHP had the highest ranking among HMOs and Empire had the highest among PPOs. However, Empire had the lowest ranking among HMOs and MVP had the lowest among PPOs.
  • Regarding IDR for “surprise” medical bills, of the 332 resolutions reached, the provider’s charge was found more reasonable in 141 claims, the plan’s payment more reasonable in 49 claims, a “split decision” in 75 claims, and a settlement in 67 claims.
  • Regarding IDR for out of network emergency care bill, of the 475 resolutions reached, the provider’s charge was found more reasonable in 61 claims, the plan’s payment more reasonable in 2013 claims, a “split decision” in 102 claims, and a settlement in 109 claims.

MSSNY Joins Patient Advocacy Organizations to Protest CMS Authorization of Step Therapy for Part B Medications
MSSNY this week joined nearly 200 patient and physician advocacy association in a letter to US House and Senate leaders expressing strong concerns about the Center for Medicare and Medicaid Services’ (CMS) recent notification to Medicare Advantage plans that they will no longer be prohibited from utilizing step therapy protocols for physician administered drugs covered under Medicare Part B beginning in 2019.   It would in effect overturn a 2012 CMS policy that had prohibited the use of step therapy for Part B covered medications.

Last week, MSSNY also joined many other national specialty and state medical societies in a similar letter initiated by the American Medical Association to CMS.

Numerous states across the country, including New York, fought for the enactment of strong patient protection laws that put strict guardrails around the insurer/PBM use of “step therapy” for needed medications.  However, this policy would go in the opposite direction.  In particular, the group letter expressed concerns that “CMS’ sudden and disruptive decision to allow the inappropriate use of step therapy policies is inconsistent with the requirement that MA plans provide coverage consistent with Original Medicare and threatens to restrict access and decrease therapy choices for patients. This could put patients’ health at risk and potentially creates long-term health care issues in the process.”

The measure was advanced <by CMS as part of its “Blueprint” to lower prescription costs.

4th Columbia Psychosomatics Conference – Oct 20-21, 2018 NYC
Healing “Unexplainable” Pain: Advances in Multidisciplinary Integrated Psychosomatic Care”
Columbia University Medical Center & Office of Mental Health of the State of New York present: 4th Columbia Psychosomatics Conference.

Healing “Unexplainable” Pain: Advances in Multidisciplinary Integrated Psychosomatic Care Lectures and workshops by multidisciplinary world experts in research and treatment of psychosomatic disordersConference Chairs: Alla Landa, PhD, Harald Gündel, MD, Brian A. Fallon, MD, Philip R. Muskin, MD

When: Sat-Sun, October 20 – October 21, 2018
Where: New York State Psychiatric Institute at Columbia University Medical Center,
 1051 Riverside Drive, NY, NY
Advanced registration is encouraged at the number of seats is limited!
For information on CME, complete program, and to register please visit conference website here.

CME Programs

FREE BUPRENORPHINE WAIVER TRAINING: Sept. 22, 2018 in White Plains
Saturday, September 22nd, 2018 9:00AM – 2:00PM

The NYSDOH AIDS Institute in partnership with Westchester Medical Center (WMC) Health Network Performing Provider System (PPS), Westchester County Department of Health and Hudson Valley Community Services is sponsoring a free Buprenorphine Waiver Eligibility Training for Clinical Providers at Westchester County Center, 198 Central Ave, 2nd Floor, Room E, White Plains, NY 10606. Parking: available on the street and in a paid parking lot across the street. Light refreshments will be provided. Directions.  Online Registration.

Under current regulations, authorized practitioners (MDs, DOs, NPs, and PAs) are required to obtain a ‘waiver’ to prescribe buprenorphine. To acquire this waiver, physicians are required to complete a standardized buprenorphine waiver 8-hour training. Nurse Practitioners (NPs) and Physician Assistants (PAs) are required to complete the standardized buprenorphine waiver 8-hour training as well as an additional 16 hours of online training as established by the Comprehensive Addiction and Recovery Act (CARA). Residents may also take the course and apply for their waiver once they receive their DEA license. The buprenorphine waiver 8-hour training is offered in a ‘half and-half’ format [4.5 hours of in-person training followed up by 3.5 hours of online training]. Upon completion of the required training, providers will meet the requirement of the DATA 2000 to apply for a waiver to prescribe buprenorphine for opioid-dependent patients. Please contact us for further information.

Questions: NYSDOH, AIDS Institute, Office of Drug User Health

Stephen Crowe, 212-417-4558, stephen.crowe@health.ny.gov Belinda Duncan, 212-417-4553, buprenorphine@health.ny.gov

ACCREDITATION: This activity has been planned and implemented by NYSDOH, AIDS Institute in accordance with the accreditation requirements and policies of the American Academy of Addiction Psychiatry (AAAP) and in partnership with Westchester Medical Center (WMC) Health Network Performing Provider System (PPS), Westchester County Department of Health and Hudson Valley Community Services.

“Influenza 2018-19” CME Webinar on October 17; Registration Now Open
The first of MSSNY’s 2019 Medical Matters continuing medical education (CME) webinar series is: “Influenza 2018-19” on Wednesday, October 17, 2018 at 7:30 a.m.  William Valenti, MD, chair of MSSNY Infectious Disease Committee and a member of the Emergency Preparedness and Disaster/Terrorism Response Committee will serve as faculty for this program. Registration is now open for this webinar here.

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

Educational objectives are:

  • Describe key indicators to look for when diagnosing patients presenting with flu-like symptoms
  • Describe clinical and laboratory diagnostic features and treatment specific to each flu season
  • Identify recommended immunizations and antiviral medications for treatment and how best to effectively encourage patients to get vaccinated

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

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

2018 MSSNY Continuing Medical Education Provider Conference
To meet the challenges facing planners, providers, and participants of CME, MSSNY recognizes the need for ongoing education and training of its Accredited Providers as well as physicians and other healthcare professionals in NYS. This conference will inspire participants to explore new developments in continuing medical education, including compliance with the changing accreditation criteria that clearly address practice gaps and practice-based needs while creating opportunities for measurable change in physicians and reinforcing the undeniable link between a successful CME activity and quality improvement for physicians and patients alike.

Conference will take place on Friday, September 21, 2018, at the Courtyard Westbury Long Island (adjacent to the MSSNY Westbury Office).  Registration links and more information are available here.  Graham McMahon, MD, President and CEO of the Accreditation Council for Continuing Medical Education (ACCME) will deliver the keynote speech, as well as leading an educational session on “Better Methods” for planning and implementing CME activities.  MSSNY President Thomas Madejski, MD will deliver the welcome and opening remarks.  For more information, please contact Miriam Hardin at mhardin@mssny.org.

Two Studies Doubt Benefits of Commercialized Probiotic Products
Two studies published Thursday in the journal Cell “cast further doubt on the benefits of the highly-commercialized probiotic products.” Because they are “marketed as dietary supplements, not drugs,” probiotics do not need to be approved by the FDA for claims that they prevent or treat any health conditions, such as “preventing the common cold to treating allergic disorders.”

In the first study, “25 healthy volunteers ate a generic probiotic with 11 strains of ‘good’ bacteria,” and while each had “probiotic bacteria in their stool,” when physicians “did the endoscopy to evaluate their intestines, they found that probiotics had only actually ‘stuck’ and grown in a few people.” In the second study, the researchers tested what happens when a patient takes probiotics after a course of antibiotics and discovered the probiotics colonized their gastrointestinal tracts “at the expense of the normal gut microbiome, delaying the return to its normal, pre-antibiotic state by several months.”

CMS Medicare

MSSNY Joins House of Medicine to Urge CMS to Reject Proposal to Collapse E&M Payments
MSSNY has joined on to multiple letters to the Center for Medicare & Medicaid Services (CMS) to raise serious concern with CMS’ proposal to collapse evaluation and management (E/M) payments as part of its Medicare payment rule for 2019.  Both letters express appreciation for the CMS “Patients Over Paperwork” initiative to reduce the extraordinary documentation burden facing physicians, but also note that any benefit to be gained would be sizably outweighed by the likely significant reductions in payments.  Under the proposal, payments for E&M codes 99202-99205 would be $134 (instead of ranging from $76 to $211) and payments for E&M codes 99212-99215 would be $92 ($45 to $148).

Register for September 12 All-Payer Combination Option Overview Webinar
Join CMS for 9/12 Webinar on All-Payer Combination Option Overview on Wednesday, September 12, 2018 at 2:00 PM ET to provide an overview of the All-Payer Combination Option, which allows clinicians to become a Qualifying APM Participant (QP), and therefore eligible for the 5% APM Incentive payment, through participation in a combination of Medicare Advanced Alternative Payment Models (APMs) and Other-Payer Advanced APMs, including Medicaid, Medicare Advantage and commercial payers.

During the webinar, CMS will discuss:

  • Overview of APMs and Advanced APMs
  • All-Payer Combination Option Basics
  • Determinations of Other Payer Advanced APMs (Payer and Eligible Clinician Initiated Processes)
  • Determinations for QPs under the All-Payer Combination Option
  • Frequently Asked Questions
  • Additional Resources

CMS will address questions from participants at the end of the webinar, as time allows.

Webinar Details

The audio portion of this webinar will be broadcast through the web. You can listen to the presentation through your computer speakers. CMS will open the phone line for the Q&A portion. If you cannot hear audio through your computer speakers, please contact CMSQualityTeam@ketchum.com.

More on Medicare Revalidation
Previously, MSSNY has reminded physicians of the requirement to revalidate their enrollment with the Medicare program. Once a timeframe is established for the physician or group, revalidation will occur every 5 years.  Physicians need to know that CMS/NGS Medicare reserves the right to perform off cycle revalidations in addition to the regular 5–year revalidations and may request that a provider or supplier recertify the accuracy of the enrollment information when warranted to assess and confirm the validity of the enrollment information maintained by CMS. Off cycle revalidations may be triggered as a result of random checks, information indicating local health care fraud problems, national initiatives, complaints, or other reasons that cause CMS to question the compliance of the provider or supplier with Medicare enrollment requirements. Off cycle revalidations may be accompanied by site visits.

In addition, physicians, non-physician practitioners, and physician and non-physician practitioner organizations must report the following reportable events to their Medicare contractor within the specified timeframes:

(1) Within 30 days—

(i) A change of ownership;

(ii) Any adverse legal action; or

(iii) A change in practice location.

(2) All other changes in enrollment must be reported within 90 days.

The law further provides that no payment will be made (by the program or the Medicare beneficiary) for an otherwise Medicare covered item or service during the period of deactivation of billing privileges.

Physician Fee Schedule Year 3 Proposed Rule: Comments Due September 10
On July 12, CMS released proposed changes to the Physician Fee Schedule and Quality Payment Program. CMS seeks comment on various proposals by 5 pm ET on September 10. See the proposed rule for information on how to submit your comments. If you haven’t yet done so but would like to, you can submit your comments on the CMS Proposed Rule electronically here – look for the green box, see below: This document has a comment period that ends (09/10/2018) SUBMIT A FORMAL COMMENT

NOTE: Personalized comments have the highest impact on CMS’ decision making process, so the public is encouraged to submit separate comments and add information about how this rule will uniquely impact the medical practice and patients. 

Classified

RENTAL/LEASING SPACE


Magnificent Medical Suites for Lease 184 East 70th St . New York, NY
The space has just undergone a complete STATE OF THE ART renovation.
Located in a luxury building with a separate elevator entrance on the prestigious upper east side of Manhattan, this recently renovated space is conveniently situated steps from Lenox Hill Hospital , Cornell /Columbia Presbyterian, HSS and Memorial Sloan Kettering. Includes exam rooms, new custom cabinetry, new exam beds, scale, waiting area – new furniture, new TV, water cooler etc. Space A: one consultation room plus 2 exam rooms. $6000 per month
Space B: One consultation room plus one exam room. $4500 per month
Space C: one consultation plus one exam $4500. other combination may work as well. Available for sharingFor full details and photos see listing at http://bit.ly/2E3Zvh0 or contact Karen Tamir at 917-865-1006 or KarenTamir@Yahoo.com

 


West 57 St. – Shared Office Space to Rent
Lovely Garden view office with natural light. Located near Columbus Circle in a beautiful Art Deco building. Recently renovated office with additional exam room/ room with a sink. Wi-Fi, medical waste pickup and cleaning included.  Ideal location in desirable neighborhood. Contact Jason Faller 914-393-6583 goutmd@aol.com


Rare Find — Great Office Share
Wonderful office share in terrific location at great price. Choice of smaller windowed consultation room with adjoining exam room or big windowed consultation room with one or two exam rooms. . Beautiful bright rooms, lovely reception area and front . First-rate building on 58th Street between Park and Lexington.  Rent by day (about $180) or by month ($5500). Front desk and office management available, along with many other amenities, including internet, ultrasound, EMG Kitchen, optional C Arm. Willing to make changes for new tenant. Call 646-642-0700.


 


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

PHYSICIAN OPPORTUNITIES

Medical Director in the NYS Office of Health Insurance Programs Division of Systems
The Medical Director position will be responsible to review prior approval requests and issue denials as indicated.  The incumbent will review pended claims and recommend whether payment should be made or denied and review requests for enhanced reimbursement for Out-of-State Hospital services.  The incumbent will participate in several external and internal committees including: Provider Enrollment Appeals Committee, Laboratory Policy Committee, Internal Benefit Review Committee, Irregular Billing Committee, Utilization Review Edit Committee, Quality Improvement Committee, Physician Administered Medication Committee, and Medical Coding Review and Coverage Decisions Committee.  The incumbent will also attend the Hearing Aid Dispensing Advisory Committee representing the Commissioner of Health and participate in the Evidence-Based Benefit Review.  The incumbent will a key stakeholder in monitoring the Radiology Utilization Management Contract and interacting with the Medical Director and clinical staff.  The incumbent will also be responsible to participate with other OHIP Medical Directors in meetings on topics about Medicaid Policy including DSRIP and VBP.

Interested candidates may submit a resume to Human Resources Management Group, Room 2276, Corning Tower Building, Empire State Plaza, Albany, New York 12237-0012, 

or by email to resume@health.state.ny.us with a subject line “OHIP Medical Director Position,” or by fax to (518) 474-6771.


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Interested? Learn more and apply today at www.98point6.com/pcc

 


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


 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Council – September 13, 2018

AGENDA
MSSNY Council Meeting
Thursday, September 13, 2018, 9:00 a.m.
Courtyard Marriott, Westbury Long Island
1800 Privado Road
Westbury, NY  11590


A. Call to Order and Roll Call
B. APPROVAL of Council Minutes of May 10, 2018
C. New Business (All Action & Informational Items)

1. President’s Report
a. Minutes of the MSSNY Executive Committee Teleconference, August 20, 2018
b. Talking Points on the Membership Agreement with Northwell Hospitals
c. DRAFT Summary – Meeting with Assemblyman Gottfried

d. Long Range Planning Committee Grid

2. Board of Trustees Report –   Dr. Robert Hughes will present the report (handout)

3. Secretary’s Report – Dr. Frank Dowling will present the report for Nominations for   Life Membership, Dues Remissions & Special Life Membership request

4. MLMIC Update  –  Donald Fager will present a verbal report

5. AMA Report – Dr. John Kennedy will present the report

6. MSSNYPAC Report – Dr. Joseph Sellers will present the report (handout) 
       MSSNYPAC Executive Committee Action Item
    Approval of the MSSNYPAC Endorsement recommendations for candidates
    running for  re-election to the New York State Legislature and to the US Congress
    (FOR COUNCIL APPROVAL)

7. MESF Report – Dr. Charles Rothberg will present the report

8. CME Report – On behalf of Dr. Mark Adams, Dr. Paul Pipia will present the report

9. Presentation – Elizabeth Amato, Vice President, SHIN-NY Programs New York     eHealth Collaborative (NYeC)
Update on the Data Exchange Incentive Program (DEIP). The program which provides   physicians with up to $13,000 to help connect to the SHIN-NY).

10.    Councilors’ Action Reports (No written reports submitted)

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 7/31/18
  5. Office of the Speaker – Kira A. Geraci-Ciradullo, MD

E. Reports of Councilors (Informational)

  1.          Kings & Richmond Report – Parag H. Mehta, MD
  2.          Manhattan & 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 & Fellow Section Report – Justin Fuehrer, DO
                  (no written report submitted)
  16.        Young Physician Section Report – L. Carlos Zapata, MD
                  (no written report submitted)

F.  Commissioners (Committee Informational Items)

    1. Commissioner of Communications, Maria A. Basile, MD, MBA
           Report from the Division of Communications

    2. Commissioner of Governmental Relations, Gregory Pinto, MD

        1. MSSNY’s 2018 Legislative Summary (handout)
2. HIT Committee Minutes, June 1, 2018

    3. Commissioner of Membership, Parag H. Mehta, MD
       (No written report submitted)

    4. Commissioner of Science & Public Health, Joshua M. Cohen, MD
     1. Bio Ethics Committee Minutes, May 11, 2018
     2. Eliminate Health Disparities Committee Minutes, April 27, 2018
     3. Preventive Medicine & Family Health Minutes, May 3, 2018
     4. Division of Public Health & Education Report

5.Commissioner of Socio Medical Economics, Howard H. Huang, MD 
      1. Interspecialty Committee Minutes, June 28, 2018
      2. Workers’ Compensation & No Fault Minutes, June 6, 2018

G. Report of the Executive Vice President, Philip Schuh, CPA, MS
        1. Membership Dues Revenue Schedule
        2. Group Institutional Dues Comparison Report

H. Report of the General Counsel, Garfunkel Wild, P.C.

1.   Amendment to the Bylaws of the Nassau County Medical Society
An amendment to the bylaws of the Nassau County Medical Society was reviewed. A review confirms that the amendment relates to the internal governance of the Nassau County Medical Society, and does not conflict with the bylaws of  MSSNY.  Accordingly, it is recommended that the Council approve the amendment to the bylaws of the Nassau County Medical Society. (FOR COUNCIL APPROVAL)

2.    Amendments to the Bylaws of the New York County Medical Society

       The amendments to the bylaws of the New York County Medical Society were presented for review.  A review shows that the amendments relate solely to internal matters of the county medical society, which do not conflict with the bylaws of MSSNY. Accordingly, it is recommended that the amendments be approved.
(FOR COUNCIL APPROVAL)

3.     Amendments to the Bylaws of the Richmond County Medical Society
The amendments to the bylaws of the Richmond County Medical Society were
presented for review. A review shows that the bylaws are not in conflict with the bylaws of MSSNY.  Accordingly, it is recommended that Council approve the amendments.
(FOR COUNCIL APPROVAL)

I. Report of the Alliance, Valerie Semeran, Co-President
    Alliance Report

J. Other Information/Announcements  (all attached

1. Continuing Board Certification: Vision for the Future Commission Summary of Testimony July, 2018

    2. Department of Health & Human Services Letter to the AMA regarding changes in reimbursement rates for laboratory services on the Medicare Clinical Laboratory Fee Schedule and CMS Clinical Laboratory Fee Schedule Sign-On Letter.

3. Dr. Madejski’s Letter to Department of Health & Human Services – E&M Services & Coalition of State Medical Societies Sign-On E&M Letter

4. Dr. Madejski’s Letter to Workers’ Comp Board – Increase in the Workers’ Comp Medical Fee Schedule

5.  National Council of State Boards of Nursing Sign-On Letter – A request to reconsider certain provisions of the Advanced Practice Registered Nurse(APRN) Compact that alter state laws related to the scope of practice of APRNs

6. AMA Letter to the CEO of Walmart – Walmart Opioid Policy

7. Physician Advocacy Institute Letter to CMS & PAI Statement – Physician Self-Referral Law 

K. Adjournment