November 30, 2018 – Single Payor Update!

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

Thomas J. Madejski, MD
MSSNY President


MSSNY eNews
November 30, 2018
Volume 21  Number 43

MSSNYPAC Seal

Colleagues:

The MSSNY Enews staff had some well-deserved rest during the Thanksgiving holiday.  During the holiday, I spent some time with family and friends and many of my patients.  I also spent some time on MSSNY business and reflected on all I have to be thankful for.

I’m thankful for each and every one of our members.  Your support of MSSNY allows us to continue to advance the interests of our patients, the public health of the citizens of New York State, the best practice of medicine, and stewardship of our profession.  I’m thankful for each of our MSSNY Committee members, and especially my Committee Chairs. Their devotion to creating and crafting policy to improve care, and to promote the art of science and medicine, is critical to the lifespan and health span of our fellow New Yorkers.

Thanks to the MSSNY Council members. We truly are in a new Golden Age of medicine.  Your help in prioritization and refinement of the many activities that occur under the MSSNY umbrella is invaluable to me as we work to continue to expand our reach and impact on behalf of our patients. I’m especially thankful for the thoughts and efforts of my colleagues in the Office of the President, Dr. Bonnie Litvack, Dr. Arthur Fougner, and Dr. Charles Rothberg. They provide constant feedback and assistance to me as we represent MSSNY across the state and throughout the nation.

Finally, I’m most thankful for the MSSNY staff.  Mr. Phil Schuh, our MSSNY Executive Vice President, leads a talented and devoted team that supports and enhances our efforts on behalf of our members.

I hope that each of you were able to spend time with your families and have had some time to recharge your batteries for the important work you do for the people of New York.

I also had some time to catch up on some reading and recommend to you an article in Health Affairs which discusses how “to fix” primary care.

I’ve been practicing geriatric medicine for a number of years. Experts have been trying to fix primary care from the time I entered medical school. The solutions proposed haven’t changed much. However, we are always on the lookout for new solutions in this changing climate for physicians.

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

Excelsior!

Thomas J. Madejski, MD
MSSNY President


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eNews

Single Payor Legislation Update
With Democrats now in control of both Houses of the State Legislature, it significantly enhances the possibility of the enactment of the New York Health Act (NYHA), legislation to establish a single payer system. NYHA would provide universal insurance coverage without copays, deductibles or premiums for all New Yorkers. It would also prohibit health insurance companies from offering similar coverage.

According to the recent RAND study it would require $139 billion in new tax revenue (a 156% increase) by 2022. The bill has passed the Assembly several times in recent years but was never voted on in the previously Republican controlled Senate. Its current incarnation is sparse – just 23 pages of text – and does not include significant details sought by many stakeholders regarding how such an enormous proposal would be implemented.

Earlier this fall, MSSNY and New York County Medical Society leadership met with Assembly Health Committee Chair Richard Gottfried (and NYHA bill sponsor) to discuss questions expressed by physicians both in opposition and in support of the NYHA bill, including:

  • How burdensome will prior authorization requirements be?
  • What will be the process for patients to appeal when recommended care has been denied?
  • How meaningful will be the right for physicians to collectively negotiate with a NYHA Board?
  • Could state budget limitations result in a grossly inadequate Medicaid-type payment structure that would make it impossible for many physicians to remain in practice in New York?
  • Should liability reform be included given the enormous medical costs arising from “defensive medicine”?

In recent days leaders in New York state government have tempered expectations following the election.  Incoming Senate Majority Leader Andrea Stewart-Cousins stated this week that “It’s a conversation we have yet to have in the Senate…I can certainly commit to having it heard.”  Governor Cuomo has stated “Conceptually I think it’s the right way to go in. I believe it’s more feasible financially on the national level. No state has been able to finance the transition costs.”  Democratic Senator Elect Alessandra Biaggi, a strong supporter of the single payer concept stated “…that’s going to mean taking some time to be thoughtful about how we’re going to pay for it.” Bill Hammond, noted health policy expert and the Empire Center’s Director of Health Policy, has repeatedly voiced concerns over the many possible negative consequences of the proposal.

Senator Gustavo Rivera, who is widely expected to take over as Chair of the Senate Health Committee in 2019, stated this week that he and Assemblyman Gottfried would soon be releasing a new version of the New York Health Act to address concerns from “stakeholders”. He did acknowledge that it is an “incredibly complicated piece of legislation”, admitting that change would be gradual and would not take place overnight, stating “If it were to pass today, it would still take two to three years to put all the regulations together that would be necessary to make the transition.”

The NYHA seemingly has a path forward this year with Democrats controlling state government, but it remains to be seen if all sides will align, configuring the details necessary to make the system actually work and gathering enough support to bring it to fruition.  One “wild card” is the fact that there will be 14 new Democratic State Senators in Albany in 2019.  With the consideration of this issue so fluid, please remain alert for further updates.

NY Comptroller Tom DiNapoli Discrepancies Show I-STOP Needs to Be Better
A new audit has found about a third of New Yorkers on Medicaid being treated for opioid addiction received a prescription for narcotic painkillers over a four-year period — highlighting a potential problem nationwide with drug monitoring systems. The New York comptroller’s audit this week said of those addicts who found a doctor to prescribe them opioids between Oct. 1, 2013, and Sept. 30, 2017, 3 percent — or nearly 19,000 people –sought medical care for an overdose within a month of filling those prescriptions. Twelve died.

The audit found that treatment programs did not always check the state’s Internet System for Tracking Over-Prescribing (I-STOP) database. The study found a sample of 25 patients from three treatment programs received more than 1,000 Medicaid opioid prescriptions while in treatment for abuse over the four-year period. New York law requires treatment programs to check the I-STOP database every time a medication-assisted opioid was prescribed for take-home use.

DiNapoli recommended that the DOH develop a method for notifying treatment programs when the database shows Medicaid recipients receive potentially dangerous prescriptions. His office also suggested the programs upload their own patient info when accessing the database, and that the DOH conduct risk assessments for individuals receiving medication-assisted treatment.



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NY DFS Approves CVS-Aetna with Several Conditions
The New York State Department of Financial Services (DFS) announced their final approval of the massive proposed acquisition of Aetna by CVS, albeit with numerous conditions, paving the way for the consolidation of two of the nation’s largest healthcare companies. New York was one of the last states to approve the transaction after it was approved by the US Department of Justice and several other states.

The full list of conditions, designed to ensure fair business practices by the merged entity, can be found here. The conditions include:

  • Prohibiting use of funds from any Aetna company or affiliate covering New Yorkers to pay for its acquisition;
  • Prohibiting costs derived from the acquisition, including executive compensation, from being passed on to any domestic or foreign Aetna New York insurer;
  • Prohibiting increased health insurance rates to pay for the cost of the acquisition;
  • Prohibiting dividends to be paid by Aetna without the express prior approval of DFS for 3 years;
  • Prohibiting preferential PBM pricing to any Aetna-affiliated health insurer licensed in New York, to better ensure insurance competitors can continue to fairly purchase PBM services from Caremark;
  • Limiting changes to Aetna’s healthcare provider networks for 3 years, including maintaining access to non-chain New York pharmacies;
  • Contributing $40 million to New York State, to support health insurance education and enrollment activities and strengthen New York health care transformation activities, which may include payments to the New York State Health Care Transformation Fund
  • Requiring an independent third-party audit to assess whether Aetna employees have accessed Confidential Information in violation of firewall policies.

Moreover, the DFS press release noted that “CVS committed at the DFS public hearing in October and as part of the approval process that CVS Health and its subsidiaries will take no action to oppose” legislation requiring a New York license for PBMs to operate.

While the conditional approval agreement addresses to some degree some of the concerns raised by MSSNY over the last year, physicians remain very concerned about the adverse impact to the health care delivery system in New York given the enormous reach of this transaction.  MSSNY President Dr. Thomas Madejski stated “We thank the DFS for their efforts to push for legislation to control the ability of PBMs to limit patient access to needed medications. We applaud the extensive review that the DFS provided to this transaction and the conditions they imposed to help minimize the enormous impact that this merger will have on our health care system.  We do remain concerned, however, that there may not be sufficient steps imposed to control the enormous power that this merged entity could use to marginalize physician-led medical homes as it expands its corporate driven healthcare model. Physicians fully expect that the merger will further reduce competition in New York’s health insurance market.  This is one more reason why physicians deserve the right to collectively bargain against corporate behemoths that seek to limit our ability to deliver needed care to patients.”

MSSNY will also be providing testimony for a December 7 DFS hearing to express its similar concerns with the proposed acquisition of PBM Express Scripts by Cigna.


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MSSNY Raises Concern with DOH Proposal Regarding Office-Based Surgery Reports
MSSNY has written to the New York State Department of Health to express its concerns and suggested revisions to regulations proposed by the NYSDOH that would require Office-Based Surgery (“OBS”) practices to report cumulative procedural information to NYSDOH. The proposed reporting requirements were published in the New York State Register on October 17 with a 60-day comment period.

The proposed regulation would require each OBS practice to report in a “form and format specified by the Department” information including, but not limited to, practice identifiers, types of procedures, and number of each type of procedure performed in office-based surgery practices.  The proposed regulation would also set forth the manner for how adverse events are reported to DOH, as well as grant the DOH discretion to use the data gathered to develop and implement guidelines and criteria for quality improvement.

The MSSNY comments to the NYSDOH note its agreement with the goal of the proposed regulation to help place in context how frequent or rare particular adverse events are occurring in OBS settings, given the importance of quality improvement to assuring patient safety.  However, MSSNY expressed concerns with the lack of needed specificity in the proposed regulation, including the specific information OBS practices will be required to report to DOH on an ongoing basis.

Moreover, MSSNY’s comments raise concerns that some practices could find it difficult to report procedural information in a manner to be determined by DOH given that physicians are at different stages of implementing Electronic Health Record (“EHR”) systems.  Given the significant EHR implementation challenges facing many physicians, some physicians have either not implemented them or use very rudimentary systems, making a new requirement for the collection and reporting of information difficult to satisfy.  Furthermore, there were concerns with the possibility that procedures could be required to be reported by its CPT code, even though some OBS facilities do not internally track these services by CPT code (since they are not submitted to insurance).

Recognizing the goal of the regulation to facilitate quality improvement and patient safety, MSSNY has also suggested that DOH amend the regulation to permit OBS accrediting bodies to file these reports on the physician’s behalf since the information sought by DOH often overlaps with reports that many physicians are already making to their respective OBS accrediting bodies.

Physicians with comments on this proposal can send them to regsqna@health.ny.gov.


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US Life Expectancy Decreases Again, CDC Report Finds
On its front page, the Wall Street Journal (11/29) reports data from the Centers for Disease Control and Prevention show that life expectancy for Americans declined again last year by one-tenth of a year, to 78.6 years. An increase in suicides, as well as the continued effects of the opioid crisis, influenza, pneumonia, and diabetes factored into the statistics, the Journal explains.

The data “continued the longest sustained decline in expected life span at birth in a century, an appalling performance not seen in the United States since 1915 through 1918.” The report found “men could anticipate a life span of 76.1 years, down a tenth of a year from 2016,” and “life expectancy for women in 2017 was 81.1 years, unchanged from the previous year.” “Suicides and drug overdoses pushed up U.S. deaths last year, and drove a continuing decline in how long Americans are expected to live.” Dr. Robert Redfield, the director of the CDC, said, “These sobering statistics are a wake-up call that we are losing too many Americans, too early and too often, to conditions that are preventable.”


Claims Data Show Telemedicine Visits Surging in US
Woman doctor in telemedicine health conceptJAMA reported that telemedicine visits in the US “have increased sharply,” but “the vast majority of American adults still receive care from doctors in person rather than via remote technology.”

Thirty-two states had passed laws that required parity in insurance coverage and reimbursement for telemedicine by 2016, so the researchers looked at insurance claims data from OptumLabs Data Warehouse for the period from 2005 to 2017 to see how the laws affected those claims. They found telemedicine visits rose from 206 visits in 2005 to “more than 202,000 visits in 2017,” with most of the growth occurring in the last years of the study period. Those visits translated to “an average annual compound growth rate of 52 percent from 2005 to 2014 and an annual average compound growth rate of 261 percent from 2015 to 2017.”


New Online Tool Displays Cost Differences for Certain Surgical Procedures
CMS launched a new online tool that allows consumers to compare Medicare payments and copayments for certain procedures that are performed in both hospital outpatient departments and ambulatory surgical centers. The Procedure Price Lookup tool displays national averages for the amount Medicare pays the hospital or ambulatory surgical center and the national average copayment amount a beneficiary with no Medicare supplemental insurance would pay the provider.

“Price transparency in health care is a priority for the Trump Administration. Working with their clinicians, the Procedure Price Lookup will help patients with Medicare consider potential cost differences when choosing where to have a medical procedure that best meets their needs,” said CMS Administrator Seema Verma.

The Procedure Price Lookup tool is launching as required by Congress in the 21st Century Cures Act. Medicare’s statutes require that CMS maintain separate payment systems for different types of healthcare providers, meaning both CMS and patients may pay different amounts for the same service, depending on the site of care.

Procedure Price Lookup, part of the agency’s eMedicare initiative, joins other patient-oriented transparency tools, including an overhauled version of the agency’s drug pricing and spending dashboards, which provide patients with Medicare and Medicaid spending information for thousands more drugs than ever before and, for the first time, list the prescription drug manufacturers that were responsible for price increases.

CMS recently launched the eMedicare initiative to empower beneficiaries with cost and quality information. This announcement included the launch of an enhanced interactive online decision support feature to help people better understand and evaluate their Medicare coverage options. eMedicare also offers a mobile-optimized out-of-pocket cost calculator to provide beneficiaries with information on overall plan costs and prescription drug costs.

For a blog post on the Procedure Price Lookup took by Administrator Verma, please go here.

The Procedure Price Lookup tool is available here.


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Boston Partners Mandates Flu shots for All 74K employees
Boston-based Partners HealthCare is requiring all 74,000 employees to receive flu shots for the first time, reports The Boston Globe.

Under the mandatory flu shot policy, employees who don’t get vaccinated or provide a valid reason for skipping the flu shot could lose their jobs. The policy applies to all hospital-based workers, as well as thousands of employees who work at Partners’ corporate office in Somerville, Mass.

“If you are able and remain unwilling to protect yourself and protect our patients [from the flu], you probably should not be working in healthcare,” Gregg S. Meyer, MD, Partners’ chief clinical officer, told The Boston Globe. “My sincere hope is that absolutely no one will lose their job over it. … We will do everything we can to convince people.”

The policy took effect this fall. So far, 99 percent of employees have received a flu shot or an exemption for religious or medical reasons, Partners officials told The Boston Globe.

Partners modeled the system wide policy on a mandatory vaccination policy Boston-based Brigham and Women’s implemented in 2017.

Johns Hopkins All Children’s Hospital in St. Petersburg, Florida, has notified parents that if their children are not vaccinated, or if they follow an alternative vaccination schedule, that they will be denied medical services. They also notified parents that they will not honor Florida State law that allows for religious exemptions to vaccines.


Unitedhealth Group to Buy Seattle Primary Care Clinic
UnitedHealth Group will acquire a controlling stake in Polyclinic, a large physician-owned primary and specialty care clinic in Seattle — the latest move in the company’s push to expand its direct patient care business, according to The Seattle Times. Under the deal, Polyclinic’s 210-physician practice would merge with Optum Health, a subsidiary of UnitedHealth. The Optum business manages physician groups around the country.

Polyclinic was founded in 1917 by six Seattle physicians and has grown to become one of the largest multispecialty groups in the nation. Despite its ability to scale in size, the practice found it hard to compete with other Seattle area healthcare providers such as Swedish Medical Center and the University of Washington Medical Center.

By merging with Optum, Polyclinic will be able to tackle “the things that you just need to be big enough to afford to do,” UnitedHealth Group CEO David Wichmann told investors during a meeting in New York, according to the Times.

The deal also will expand the clinic’s access to technologies and other physician groups within Optum. The acquisition needs approval from the Federal Trade Commission and would supplement a separate deal with DaVita Medical Group to acquire the 500-physician Everett Clinic, a primary and specialty clinic based in Seattle, and Northwest Physicians Network, a 1,000-plus physician practice in Pierce County, Wash.


Romaine Lettuce

It’s OK to Eat Some Romaine Lettuce Again;
Just Check the Label
The FDA narrowed its blanket warning from last week, when it said people shouldn’t eat any romaine because of an E.coli outbreak. The agency reported on November 26 that the romaine linked to the outbreak appears to be from the California’s Central Coast region. It said romaine from elsewhere should soon be labeled with harvest dates and regions, so people know it is good to eat.

Consumers should not eat romaine that doesn’t have the label information, the FDA said. For romaine that doesn’t come in packaging, grocers and retailers are being asked to post the information by the register.

Romaine harvesting recently began shifting from California’s Central Coast to winter growing areas, primarily Arizona, Florida, Mexico and California’s Imperial Valley. Those winter regions weren’t yet shipping when the illnesses began. The FDA also noted that hydroponically grown romaine and romaine grown in greenhouses aren’t implicated in the outbreak.

The labeling arrangement was worked out as the produce industry called on the FDA to quickly narrow the scope of its warning so it would not have to waste freshly harvested romaine. Consumers can expect to start seeing labels as early as this week. It noted that the labels are voluntary and that it will monitor whether to expand the measure to other leafy greens and produce.

The FDA said the industry committed to making the labeling standard for romaine and is considering longer-term labeling options for other leafy greens.


CME WEBINARS

“Evidence-Based Treatment for Tobacco Dependence”
WEBINAR December 4th
REGISTRATION NOW OPEN 

Register now for “Evidence-Based Treatment for Tobacco Dependence” webinar on, December 4, 2018 at 7:30 a.m.   This program is being jointly sponsored by St. Peter’s Health Partners Community Health Programs; the Medical Society of the State of New York and Glens Falls Hospital Health Promotion Center.

Michael B. Steinberg, MD, MPH, FACP, Director of Rutgers Robert Wood Johnson Medical School Tobacco Dependence Program will serve as faculty for this program.  The objectives are for physicians to: 1) Increase their knowledge of seven FDA-approved tobacco treatment pharmacotherapies. 2) Counsel smokers by prescribing tobacco treatment pharmacotherapy to improve their tobacco cessation attempt outcomes including the use of combination therapy. 3) Increase their knowledge in regard to public insurance plans that cover NRTs.  4) Understand the importance of implementing a tobacco dependence treatment policy within their practice which includes the 5As.

This program can be attended either via Webex or at a remote site in the North Country. View the flyer and register here.

This activity has been planned and implemented in accordance with the Accreditation Requirements and Policies of the Accreditation Council for Continuing Medical Education (ACCME) through the joint providership of the Medical Society of the State of New York (MSSNY) and St. Peters Health Partners.  MSSNY is accredited by the ACCME to provide continuing medical education for physicians.

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

Additional information or assistance with registration may be obtained by contacting Community Health Programs for Webex assistance: (518) 459-2550 – or- for remote site registration contact Shannon Morrison-Gaczol at smorrison-gaczol@glensfallshosp.org.


The Continued Public Health Threat of Measles: 2018 CME Webinar
December 12, 2018 at 7:30am – Registration now open

In response to the recent and expanding measles outbreaks in New York State, MSSNY has added a just-in-time Medical Matters webinar to our 2018-19 roster.  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 program here.

Educational Objectives:

  • Increase physician’s awareness of the role of measles as a re-emerging infection.
  • Discuss strategies to improve vaccination rates.
  • Explore herd immunity and the role it plays in recent measles outbreaks.

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. 


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For Rent or Share – Woodbury, Long Island
Beautiful recently renovated Plastic Surgery Class C-M AAAA-certified Operating Room available for part-time share and available for rent. Centrally located on Long Island. Close to expressways.
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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 or by month. Price is negotiable. 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.

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PHYSICIAN OPPORTUNITIES

Physician Insights Wanted to Help Shape the Future of Primary Care
98point6 is a healthcare technology company committed to delivering more affordable, accessible, high-quality primary care. To support our mission, we need the insights of forward-thinking physicians that have opinions about the current state of primary care and are interested in the role technology can play in healthcare. Members of our exclusive Primary Care Council have no clinical responsibilities and are generally compensated for participation, which requires only a few hours per year. Interested? Learn more and apply today at www.98point6.com/pcc


Internal Medicine Physician and Nurse Practitioner Wanted – Syracuse Area
Syracuse primary care practice recruiting for a highly motivated Internal Medicine Physician and Nurse Practitioner. Candidates should be interested in working closely with patients, care teams, and community partners, Send resume to neurosciencesgroup@gmail.com


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


 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

MSSNY STATEMENT ON DFS’ APPROVAL OF CVS-AETNA


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

 

November 26, 2018
For Immediate Release

MSSNY STATEMENT ON DFS’ APPROVAL OF CVS-AETNA
Statement attributable to:
Thomas Madejski, MD
President, Medical Society of the State of New York

“We are still reading through the final approval documents.  And we thank the DFS for their efforts to push for legislation to control the ability of PBMs to limit patient access to needed medications. We applaud the extensive review that the DFS provided to this transaction and the conditions they imposed to help minimize the enormous impact that this merger will have on our health care system.  We do remain concerned, however, that there may not be sufficient steps imposed to control the enormous power that this merged entity could use to marginalize physician-led medical homes as it expands its corporate driven healthcare model. Physicians fully expect that the merger will further reduce competition in New York’s health insurance market.  This is one more reason why physicians deserve the right to collectively bargain against corporate behemoths that seek to limit our ability to deliver needed care to patients.”

# # #

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

 

Media Contact:
Roseann Raia

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

 

November 16, 2018 – WSJ, AMA and Wild Fires

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

Thomas J. Madejski, MD
MSSNY President


MSSNY eNews
November 16, 2018
Volume 21  Number 42

MSSNYPAC Seal

Colleagues:

I spent last weekend in National Harbor, Maryland, at the Interim AMA Meeting with our hard working delegation. I am a member of the Council on Medical Service and at our meeting, the following item was discussed:

AMA’s CMS Report 4 addresses Site of Service Differential. The AMA supports Medicare payment for the same service routinely and safely provided in multiple outpatient settings (Office, HOPDs and ASCs) that are based on sufficient data regarding the actual cost in each setting. The AMA approved an amendment to its existing policy so that outpatient services are site neutral without lowering Medicare payments. 

Other major directives discussed are:

  • Physicians again forcefully spoke out on gun-violence policy as AMA delegates adopted policy calling for a better background-check system for firearms purchases, a ban on 3D-printed firearms, and “gun violence restraining orders” for people arrested or convicted of domestic violence or stalking.

The AMA’s actions stem from comprehensive policy adopted in previous House of Delegates meetings to stem the deadly toll of firearm violence.

  • Better data needed to guide suicide prevention efforts among physicians and medical students. Citing the high rate of suicide completion among medical professionals when compared with the general population and work-related stress as a risk factor for doctors, delegates want a better understanding of patterns linked to physician and medical student suicide. Long work hours are commonly cited as a reason for the prevalence of mental illness and burnout among physicians and medical students, but additional institutional factors can contribute to suicide.

  • Sex education should include age-appropriate content on bullying, consent. More than 11 percent of high-school girls are victims of forced sex, along with 3.5 percent of high-school boys, says a 2017 Centers for Disease Control and Prevention survey. To encourage this approach, delegates directed the AMA to “support state legislation mandating that public middle and high school health education programs include age-appropriate information on sexual assault education and prevention, including but not limited to topics of consent and sexual bullying.”

  • Help homeless people get the government ID cards often needed to access medical care. More than 3.5 million Americans will experience homelessness at some point in a given year—and nearly 80,000 are chronically homeless. Lack of government-issued identification remains a major barrier to seeking medical care. Delegates adopted new policy to: Recognize that among the homeless population, lack of identification serves as a barrier to accessing medical care and fundamental services that support health. Support legislative and policy changes that streamline, simplify and reduce or eliminate the cost of obtaining identification cards for the homeless population.

Other important issues:

  • Prescription-drug importation from Canada.
  • Improved access to preventive care.
  • Rural health disparities.

California Doctors

Our hearts go out to all those who have suffered tremendous losses in the California wild fires. Past President of the California Medical Association President Dick Thorpe, lost his house in Paradise, where his internal medicine practice is also located. They have kept their doors open by temporarily moving it to Chico. You can help our friends in California at their website.

Wall Street Journal and Marijuana

Finally, I made it into the Wall Street Journal. It was not for the usual reasons, but they actually published my letter to the editor regarding MSSNY’s stance on marijuana in response to an editorial from former Speaker of the House of Representatives, John Boehner, a consultant to the marijuana industry.

Contact me at comments@mssny.org.

Thomas J. Madejski, MD
MSSNY President


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eNews

NYU Langone to Open New Medical School on Long Island by September 2019
NYU Langone plans to open a new medical school on Long Island by September 2019 that would exclusively train primary care physicians, NYU President Andrew Hamilton announced at a University Senate meeting on Thursday.

“We have the opportunity to create a new medical school that would focus exclusively on primary care physicians,” Hamilton said. “It will be a three-year program focused on training physicians to become practicing doctors in primary care in communities.”

Over the last two years, Langone has merged with Winthrop Hospital on Long Island, and this would be the site of the new medical school. Hamilton mentioned an existing infrastructure of dormitories and educational facilities at Winthrop Hospital, which would make a transition into a full-blown medical school easier. There are several steps still to go before the medical school could be deemed official, such as receiving state approval. If approved, the school would enroll 40 students per semester, potentially by as early as September 2019 according to Hamilton.


FDA Increasing Scrutiny of Drug Manufacturing Processes In Light of Recalls
FDA Commissioner Scott Gottlieb, M.D., announced “the agency is increasing its focus on drug quality to guard against impurities such as the potentially cancer-causing chemicals that have been found in three commonly prescribed blood pressure medications.” Following the recall of valsartan, irbesartan, and losartan, Dr. Gottlieb said the FDA has recruited “dozens of chemists to review pharmaceutical companies and monitor for any changes in manufacturing techniques” to help “prevent drug impurities that may be harmful to consumers.” The article points out that the agency is currently “investigating the scope of the manufacturing problem that led to the recalls.” USA Today (11/14)


Older Age and Lack of Experience with Transgender May Hinder Caring
Findings published in the Annals of Family Medicine.(11/12,Subscription Publication) reports, “Older age and lack of personal experience with transgender individuals may correlate inversely with a clinician’s willingness to care for transgender patients,” The authors of an accompanying editorial write that transgender people often report feeling stigmatized or misunderstood by healthcare” professionals. The editorialists “use a hypothetical case scenario to show how physicians and their office staff can communicate with transgender patients in sensitive and respectful ways.”


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Workers with Highest Suicide Rates Have Construction, Mining, and Drilling Jobs
On November 16, The Centers for Disease Control and Prevention published in their Morbidity and Mortality Weekly Report that “workers with the highest suicide rates have construction, mining and drilling jobs.”  The findings corrected “an earlier study that mistakenly said farmers, lumberjacks and fishermen killed themselves most often.” In arriving at these conclusions, investigators examined data on “22,000 people who died of suicide in 2012 and 2015, and what jobs they held.”


SAVE THE DATE for the MSSNY Sections Annual Meeting: Young Physicians, Residents and Fellows, and Medical Students. Saturday, February 9, 2019. Contact sbennett@mssny.org

SYMPOSIUM/CME

Cybersecurity: A Daily Threat for Healthcare” CME webinar RESCHEDULED

November 28, 2018 at 7:30am Registration now openThe originally scheduled Medical Matters free CME webinar: Cybersecurity: A Daily Threat for Healthcare was unexpectedly cancelled owing to insurmountable weather and traffic conditions in the Capital District on November 14, 2018.

There were multiple road closures leading into Albany from every direction, preventing MSSNY staff and program faculty from reaching the MSSNY offices.  This was additionally compounded by technical difficulties that prevented MSSNY staff from accessing email remotely.

MSSNY has rescheduled this program for November 28th at 7:30am.  Register here for Medical Matters: Cybersecurity: A Daily Threat for Healthcare.  Mahesh Nattanmai, Deborah Sottolano, PhD of New York State Department of Health and Peter Bloniarz of the New York State Cyber Security Advisory Board 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. 


“The Continued Public Health Threat of Measles 2018” CME webinar
December 12, 2018 at 7:30am – Registration now open

In lieu of the recent measles outbreaks in New York State, MSSNY has added a just-in-time Medical Matters webinar to our 2018-19 schedule.  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 program here.

Educational Objectives:

  • Increase physician’s awareness of the role of measles as re-emerging infection.
  • Discuss strategies to improve vaccination rates.
  • Explore herd immunity and the role it plays in recent measles outbreaks.

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. 


Alzheimer’s Disease Research Symposium at Stonybrook on November 19
Learn from key experts about the important research being conducted at Stony Brook Medicine in the field of Alzheimer’s disease. The Stony Brook Center of Excellence for Alzheimer’s Disease will present a symposium on Monday, November 19, from 12 pm to 2 pm in the Health Sciences Tower, Galleria, Level 3.

No registration is required. For more information, email Daphne.Perry@stonybrookmedicine.edu or call (631) 632-3074.


Garfunkel Ad


FDA

FDA Approved Supplemental Application for Gardasil 9
The US Food and Drug Administration (FDA) has approved a supplemental application for Merck’s 9-valent human papillomavirus vaccine (Gardasil 9) to include women and men aged 27 through 45 years.

The CDC has stated that HPV vaccination prior to becoming infected with the HPV types covered by the vaccine has the potential to prevent more than 90% of these cancers, or 31,200 cases every year, from ever developing. The CDC estimates that every year about 14 million Americans become infected with HPV. About 12,000 women are diagnosed with cervical cancer and about 4000 women die from cervical cancer caused by certain HPV viruses. HPV is also associated with several other forms of cancer affecting men and women.

In 2014, the FDA approved Gardasil 9, which covers the same four HPV types as Gardasil as well as five additional types (31, 33, 45, 52, and 58). Gardasil 9 was first approved for use in males and females aged 9 through 26 years.

According to the FDA, in a study in roughly 3200 women aged between 27 and 45 years followed for an average of 3.5 years, Gardasil was 88% effective in preventing the combined endpoint of persistent infection, genital warts, vulvar and vaginal precancerous lesions, cervical precancerous lesions, and cervical cancer related to HPV types covered by the vaccine.

The safety of Gardasil 9 was evaluated in a total of about 13,000 males and females. The most commonly reported adverse reactions were injection-site pain, swelling, redness, and headaches.

The FDA granted the Gardasil 9 application priority review status, a program that facilitates and expedites the review of medical products that address a serious or life-threatening condition.


Dr. First Banner


NYS Mediciad

Continuous Recruitment for NYS DUR Board Membership
Federal legislation requires States to maintain a DUR program and establish a Drug Utilization Review (DUR) Board.  The NYS Medicaid DUR Board provides recommendations to the Health Department associated with establishing clinical standards for Medicaid’s pharmacy program. The composition of the DUR Board can be found on pages 1 & 2 of the General Operating Procedures.

Responsibilities of the DURB include:

  • The establishment and implementation of medical standards and criteria for the retrospective and prospective DUR program.
  • The development, selection, application, and assessment of educational interventions for physicians, pharmacists and recipients that improve care.
  • The collaboration with managed care organizations to address drug utilization concerns and to implement consistent management strategies across the fee-for-service and managed care pharmacy benefits.
  • The review of therapeutic classes subject to the Preferred Drug Program.

CVs associated with interest in becoming a DUR Board member are accepted continuously and can be submitted to the DUR Board mail-box at dur@health.ny.gov. If no vacancies exist, CVs will be kept on file for consideration once a position becomes available. Questions on membership and candidacy can be directed to the DUR Board Member Liaison, Robert Sheehan, at dur@health.ny.gov or 518-486-3209.

For more information about the NYS Medicaid DUR Board please go here.


 


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Classified

RENTAL/LEASING SPACE


For Rent or Share – Woodbury, Long Island
Beautiful recently renovated Plastic Surgery Class C-M AAAA-certified Operating Room available for part-time share and available for rent. Centrally located on Long Island. Close to expressways.
1 exam room /OR. Waiting room & break room. Available for full or half-days. Free WIFI. Suits Plastic/Cosmetic Surgeons/Derm/ENT/ObGyn/Podiatry or other Medical MDs. Contact Kendra at Kendra@drmadnani.com or 516-226-1080


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 or by month. Price is negotiable. 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 room1 58th Street room2 58th Street room3


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

Internal Medicine Physician and Nurse Practitioner Wanted – Syracuse Area
Syracuse primary care practice recruiting for a highly motivated Internal Medicine Physician and Nurse Practitioner. Candidates should be interested in working closely with patients, care teams, and

community partners, Send resume to neurosciencesgroup@gmail.com


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


 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

November 9, 2018 – Winners and Losers

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

Thomas J. Madejski, MD
MSSNY President


MSSNY eNews
November 9, 2018
Volume 20  Number 42

MSSNYPAC

Colleagues:

The Arena

Apart from personal thoughts, beliefs and policy implications, I was fascinated and intrigued by the run up to the elections Tuesday night. I was encouraged, and my faith in our system was strengthened by the level of participation and engagement of all of us in the electoral process.  Democracy is a terribly inefficient system of government, but there is none better.

Then national, and importantly for MSSNY and our members, New York State political landscapes have changed (See article below). Subsequent to this, I had an email chat with some of our members on the importance of political activity and participation in MSSNYPAC. (Please see my contribution to the discussion below.)

The President of MSSNY is responsible for executing the MSSNY agenda (which changes depending on our members’ thoughts and desires) and, with the direction of the HOD and Council, the operation of the organization to attempt to achieve that agenda. Part of that Presidential responsibility is to try and get us to all pull together and craft a team of physician leaders to have the best chance of achieving our goals.

The PAC

PAC activity was created by our broader society as a mechanism for advocacy, and former wise leaders created MSSNYPAC to complete our advocacy efforts. It is a helpful tool; it would be more helpful if it was if better funded. When I came into the Presidency, one of my goals was to make us as effective as possible, building on the work of my predecessors. I asked staff to provide me data on PAC participation. We have excellent, but not uniform participation within leadership and committees. I also want to be sure that our committee members are committed to success for their efforts by participating personally and financially in our advocacy efforts.  While everyone’s personal circumstances differ, it should be a rare exception to not participate at all. There are a few instances that I can contemplate for not participating. Having said that it does raise a question of cognitive dissonance for achieving our mission.

Part of leadership is to lead by doing. We will reach out to every member, especially our new members who are becoming engaged (For example, I spoke with a new member who is excited to join us and will participate on our Legislative and CME committees) and ask them to participate in MSSNYPAC and the MSSNY Physicians Advocacy Liaison (PAL) Network.

You look for inspiration when you participate in an organization. I think that is one of the hardest things for a President to do. I felt honored to be able to have my Presidential Reception at the Theodore Roosevelt inaugural site. TR spoke about the responsibilities of citizenship in Paris in 1910:

It is not the critic who counts; not the man who points out how the strong man stumbles, or where the doer of deeds could have done them better. The credit belongs to the man who is actually in the arena, whose face is marred by dust and sweat and blood; who strives valiantly; who errs, who comes short again and again, because there is no effort without error and shortcoming; but who does actually strive to do the deeds; who knows great enthusiasms, the great devotions; who spends himself in a worthy cause; who at the best knows in the end the triumph of high achievement, and who at the worst, if he fails, at least fails while daring greatly, so that his place shall never be with those cold and timid souls who neither know victory nor defeat.

As physicians, we have a responsibility to the profession.  I’d like all members to dare greatly, inspire other non-members to join us as we try and make the practice of medicine, and the arena we live in—a better place.

Dare greatly!

Join MSSNYPAC http://www.mssnypac.org/contribute.

Contact me at comments@mssny.org.

Thomas J. Madejski, MD
MSSNY President


MLMIC Insurance for Doctors


 

eNews

Election Results Could Bring Major Change to Albany
This week’s election will bring many familiar faces back to Albany in 2019 but many new ones as well.  Overall, there will be nearly 40 new state legislators come 2019.

Democratic Governor Andrew Cuomo, Lieutenant Governor Kathy Hochul and Comptroller Tom DiNapoli were all re-elected for new four year terms. In the race for Attorney General, Democrat Letitia James defeated Republican Keith Wofford, to succeed current interim AG Barbara Underwood.

Perhaps the most significant aspect of this week’s elections is that Democrats will now have control of the New York State Senate for the first time in a decade and for only the second time in the last 50 years. Democrats appear to have picked up 8 new seats in the State Senate that had previously been held by Republicans, though ballots from some of these races are still being counted.  If the numbers hold as they are now, Democrats will outnumber Republicans 39-24.  These potential pick-ups include:

  • SD-3 (Suffolk): Monica Martinez (D) defeating Dean Murray (R) to replace Sen. Tom Croci (R)
  • SD-5 (Nassau/Suffolk): James Gaughran defeating Sen. Carl Marcellino (R)
  • SD-6 (Nassau): Kevin Thomas (D) defeating Senate Health Committee Chair Kemp Hannon (R)
  • SD-7 (Nassau): Anna Kaplan (D) defeating Sen. Elaine Phillips (R)
  • SD-22 (Kings): Andrew Gournardes (D) defeating Sen. Martin Golden (R)
  • SD-39 (Orange/Ulster): James Skoufis (D) defeating Tom Basile to replace Sen. Bill Larkin (R)
  • SD-40 (Putnam/Westchester): Peter Harckham (D) defeating Sen. Terence Murphy (R)
  • SD-42 (Orange/Sullivan/Ulster): Jen Metzger (D) defeating Anne Rabbit (D) to replace Sen. John Bonancic (R)

For more information about the still contested races, click here.

In the State Assembly, Democrats held their wide majority, 106-44. Three incumbent Democrats (Pellegrino, Jenne, and Magee) lost their seats to Republican challengers (LiPetri, Walczyk, and Salka). Two Republican incumbents (Curran, Walter) were defeated by Democratic challengers (Griffin and McMahon).

With so many new Assemblymembers and Senators coming to Albany next year, the need for physician grassroots involvement is greater than ever.

With the Democrats taking control of both the New York Senate in addition to the Assembly, there could be significant change in the approach to health care legislation. For example, many Democrats in their campaigns pushed for many progressive changes, including single payer healthcare. While that bill has overwhelmingly passed the Assembly multiple times, those votes were taken when it was likely the legislation would not be approved by the Senate.  Other health care issues likely to be acted upon include legalizing recreational marijuana, and expanding access to contraception.

There has never been a greater need for MSSNY members to become active both politically and at the grassroots level. It cannot just be left to a relative few individuals to participate and be active in MSSNYPAC and the MSSNYPAL. Many are part of our efforts but we need far more. We must broaden our network of active physicians. If you are not a member of MSSNYPAC, or would like to increase your contribution, you can do so at www.mssnypac.org/contribute.

Moreover, with some new faces in the Legislature, it is a perfect time to join MSSNY’s Physician Advocacy Liaison (PAL) program to commit to engaging with your local legislators on an ongoing basis to assure they are familiar with the concerns of physicians and their patients.  For more information about the PAL, contact Carrie Harring at charring@mssny.org, or join today at PAL Sign Up.


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Federal Elections Bring Change to Washington for New York House Seats
At the federal level, party control of the U.S. House of Representatives switched from Republican to Democrat as Democrats across the country won at least 30 seats. However, the Republicans increased their majority in the U.S. Senate, defeating Democratic incumbents in Florida, Indiana and North Dakota.

In New York’s House races, 22 of its 27 incumbent Representatives won re-election.  However, two incumbent Republican Congressmen, Dan Donovan and John Faso, lost their re-election bids to Democrat challengers Max Rose and Antonio Delgado, while a third, Democrat Anthony Brindisi, appeared to have defeated Republican incumbent Claudia Tenney with ballots still to be counted.   Also of note, current Assembly Democratic Majority Leader Joe Morelle defeated Republican Dr. Jim Maxwell to become Representative for the 25th Congressional District which is presently vacant following the death of Congresswoman Louise Slaughter (D).

New York’s U.S. Senator Kirsten Gillibrand was easily re-elected to another 6-year term, defeating Republican Chele Farley.


NYC Marathon Hero!
MSSNY Member and NYC Marathoner Theodore Strange MD, Stopped at Mile 16 to Save a Life

Dr. Theodore Strange, an IM from Richmond County (Staten Island), was running his 25th NYC Marathon last Sunday. At mile 16, Dr. Strange answered a call for help for a downed female runner. She was not breathing; he started performing CPR and called for an officer to bring him a defibrillator. On the fourth shock, the woman breathed and was finally taken to the hospital. “People have been calling me a hero, but I was doing what I was trained to do,” he said. Read the full story here.


Garfunkel Ad


Gov. Raises Medicaid Rates for Hospitals and Nursing Homes before Election
Gov. Andrew Cuomo “quietly increased Medicaid rates to hospitals and nursing homes” just a few days before the election. In the New York State Register, “the state Health Department notified the public of a two percent hike for hospitals and 1.5 percent nursing homes on page 90.”


Gov. Signs Measure to Eliminate Patient Cost-Sharing for Prostate Cancer Screening
Governor Cuomo signed into law this week legislation passed earlier in the year (S.6882-A, Tedisco/A.8683-A, Gottfried) and supported by MSSNY to ensure that health insurers provide coverage for diagnostic testing for prostate cancer for men 40 and over with a family history, and men 50 and over who are asymptomatic, without such care being subject to annual deductibles or coinsurance.

The bill would also require the inclusion of information regarding the availability of insurance coverage for prostate cancer screening without cost sharing in the standardized written summary prepared by the Commissioner of Health.  New York has for many years required insurance coverage for these tests, but were subject to patient cost-sharing.  The new law, effective for insurance policies initiated or modified after January 1, 2019, would provide coverage without patient cost-sharing to a greater cohort of men for necessary prostate cancer screening than what has been recommended by the US Preventative Services Task Force. 


Would You Like to Share MSSNY’s The Daily  with Other Professionals in your Practice?
MSSNY is ready to extend this popular member benefit to the PAs and NPs on your staff. If you’re interested, please send the email addresses of the appropriate professionals in your office to rraia@mssny.org so they can begin to enjoy this daily sweep of healthcare news.


Medical Society of NY Classifieds


The Best Test is the One That Gets Done: Colorectal Cancer Screening
“How to Save Lives and Resources by Matching the Test with the Patient,” featuring Dr. Dorado Brooks, VP Cancer Control Interventions, American Cancer Society; and Dr. Heather Dacus, Director, Bureau of Cancer Prevention and Control, NYS Department of Health.

WHEN: November 13th, 2018, from Noon to 1:00 pm. To register click or copy this link. Register today while lines are still available!


Nine Cases of Flaccid Myelitis Suspected in New York
New York health officials say there are now nine suspected cases of acute flaccid myelitis in the state, a mysterious condition that’s paralyzing children nationwide.

The last known report from state Department of Health officials put the number of suspected cases at five in late October. On Wednesday, they confirmed four additional cases are under investigation. They declined to say where the suspected cases originated, other than outside of New York City, citing patient confidentiality laws.

None of the nine cases have been confirmed yet, said spokesman Jeffrey Hammond. So far this year, the CDC has confirmed   80 out of 219 suspected cases of acute flaccid myelitis. The cases have been reported across 25 states, with an increase occurring in August and continuing through September and October — similar to other spike years.


Big Employers Will Use Online Startup To Save On Medicine Costs 
A group of large employers plans to use a new online prescription-savings tool as they confront high drug costs and try to steer patients to the most cost-effective medicines. The Health Transformation Alliance, a coalition of more than 40 big companies that includes IBM Corp., Verizon Communications Inc. and American Express Co., has agreed to use a new online tool from startup Rx Savings Solutions to help the millions of people who work for the group’s members get better deals on their medications. (Bloomberg, 11/1)


CVS to Test Stores with More Health Services after Aetna Deal Closes
Consumers will soon start to see CVS Health’s vision for the future of health care. CVS expects its roughly $69 billion acquisition of health insurer Aetna to close before Thanksgiving, the company said Tuesday when announcing third-quarter financial results. The combined company has pledged to improve health services and outcomes and lower costs. CVS plans to open its first concept stores early next year, CEO Larry Merlo told Wall Street analysts Tuesday. (CNBC, 11/6)

As previously reported, MSSNY Past-President Dr. Charles Rothberg testified at a NY Department of Financial Services hearing expressing MSSNY’s opposition to this acquisition.  NYDFS Superintendent Mario Vullo expressed many concerns about this transaction at the hearing.


Dr. First Banner


CMS

Review Comprehensive 2019 Summary of Medicare/MIPS Physician Payment Rule
As reported last week, CMS finalized its Medicare physician payment rule for 2019.  Please click here for a comprehensive summary of the rule by the American Medical Association.

According to the AMA summary, the 2019 PFS conversion factor will be $36.0391. The Anesthesia conversion factor is $22.2730. The 2019 conversion factors reflect a statutory update of .25%, (as required by MACRA), offset by a budget neutrality adjustment of -0.14%, resulting in a 0.11% update.

According to the summary, it was noted that CMS has postponed any coding and payment-related changes for E/M office visit services until CY2021.   But CMS will be implementing new documentation policies for E&M claims which will significantly reduce administrative burden.   These include:

  • The requirement to document medical necessity of furnishing visits in the home rather than office will be eliminated.
  • Physicians will no longer be required to re-record elements of history and physical exam when there is evidence that the information has been reviewed and updated.
  • Physicians must only document that they reviewed and verified information regarding chief complaint and history that is already recorded by ancillary staff or the patient.

It was also noted that the following policies opposed by the AMA will not be implemented by CMS:

  • Payment reductions by 50% for office visits that occur on the same date as procedures (or a physician in the same group practice); and
  • Condensed practice expense payment for the E/M office visits, by creating a new indirect practice expense category solely for office visits, overriding the current methodology for these services by treating Office E/M as a separate Medicare Designated Specialty.

It was also noted that CMS is expanding access to medical care using telecommunications technology by finalizing coverage of several new services, including three new CMS-created HCPCS codes for: brief, non-face-to-face appointments via communications technology (virtual check-ins); evaluation of patient-submitted photos; and the foregoing codes bundled together for use by federally qualified health centers and rural health clinics.

It was also noted that CMS reduces reimbursements for new Part B drugs. Currently paid with an add-on payment of 6% (before sequester), CMS will reduce the add-on payment to 3% (before sequester) for all drugs with Wholesale Acquisition Cost (WAC)-based payment rates.

The AMA summary also includes an extensive summary of changes to the MIPS program for 2019, which will effect Medicare payment for 2021. The Quality category will now comprise 45% of the score.   The promoting interoperability category (formerly Advancing Care Information) will now comprise 25%.  The performance improvement category will now comprise 15%, as will the cost efficiency category.  Performance on these measures will effect Medicare physician payment in 2021.

CMS projects that 97.8% of MIPS eligible clinicians will submit performance data in 2019. Of those submitting data, 91.2% are projected to receive a positive or neutral payment adjustment in 2021, with the remaining 8.8% receiving a penalty in 2021. Nearly two-thirds of those projected to receive a positive or neutral payment adjustment are projected to score high enough for an “exceptional” payment adjustment.


CMS: Most Physicians Will Receive Positive Medicare MIPS Payment Adjustment; Still Concerns for Smaller Practices

CMS Administrator Seema Verma announced this week that 93% of clinicians eligible for the Merit-based Incentive Payment System (MIPS) received a positive payment adjustment for their performance in 2017.  Moreover, she announced that 95% overall avoided a negative payment adjustment while nearly 100,000 eligible clinicians earned Qualifying APM Participant status under the Advanced Alternative Payment Model track.

However, the press release also noted that only 73% of “small practices” received a positive payment adjustment, while 19% received a negative payment adjustment.

The 2017 performance will affect Medicare payments for 2019.

The press release further noted Administrator Verma acknowledged that the MIPS “positive payment adjustments are modest,” while noting that 2017 was a transition year.  She indicated that CMS expects that gradual increases in performance thresholds in the future “will create an evolving distribution of payment adjustments for high performing clinicians who continue to invest in improving quality and outcomes for beneficiaries.”  She also pledged customized technical assistance, at no-cost, for clinicians who received a negative payment adjustment,” and to continue assistance to providers in solo, small and rural practices.


CME WEBINAR

Cybersecurity: A Daily Threat for Healthcare” CME Webinar
November 14 @7:30am_ Registration Now Open

It’s not too late to register! Do you know how best to protect your office against a cyberattack?  Are you aware of your vulnerabilities?  Learn how to protect yourself, your patients and your workplace on November 14 at 7:30am.  Register here for Medical Matters: Cybersecurity: A Daily Threat for Healthcare.  Mahesh Nattanmai, Deborah Sottolano, PhD of New York State Department of Health and Peter Bloniarz of the New York State Cyber Security Advisory Board 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. 


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Classified

RENTAL/LEASING SPACE


For Rent or Share – Woodbury, Long Island
Beautiful recently renovated Plastic Surgery Class C-M AAAA-certified Operating Room available for part-time share and available for rent. Centrally located on Long Island. Close to expressways.
1 exam room /OR. Waiting room & break room. Available for full or half-days. Free WIFI. Suits Plastic/Cosmetic Surgeons/Derm/ENT/ObGyn/Podiatry or other Medical MDs.

Contact Kendra at Kendra@drmadnani.com or 516-226-1080


All-Inclusive Medical Office Space for Rent-5 Locations: Elmhurst, Ozone Park, Lawrence, Lindenhurst & East Setauket
Starting up, slowing down or growing your practice? Interested in trying out
a new town or opening a satellite site, with no long term commitment? Come
look into one of our 5 locations throughout Queens and Long Island.

MedPlex is an all-inclusive medical office rental company dedicated to the medical
field. We offer low daily rates ($106-$191 per room, per day), with over 100
customizable rooms available for rent. You have the freedom to choose the days,
times & locations that best suite you and your practice.

We are open 24/7 and offer individual rooms or private suites to rent, with
leasing options as little as 1 year. Each option includes all utilities, exam room set up
with furniture & a list of medical equipment, medical waste pick-up, office cleaning,
common areas, basic consumables, a fully stocked reception station (equipped with
computer, phone, fax and copier) and lockable storage.

For more information please log on to www.MedPlexLLC.com, Loop-Net/Co-Star, or call Carla Scalici, Operations manager, @ 516-797-7735, cscalici@MedPlexLLC.com

ozone park room1 ozone

ozone


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.comnyc nyc room2

nyc room3 nyc room4


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

West 57th St. Office West 57th Doctors Office

West 57th St Doctors Lobby


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 or by month. Price is negotiable. 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 room1 58th Street room2 58th Street room3

 


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

Internal Medicine Physician and Nurse Practitioner Wanted – Syracuse Area
Syracuse primary care practice recruiting for a highly motivated Internal Medicine Physician and Nurse Practitioner. Candidates should be interested in working closely with patients, care teams, and

community partners, Send resume to neurosciencesgroup@gmail.com


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


 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Nov. 2, 2018 – Leading & Learning

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

Thomas J. Madejski, MD
MSSNY President


MSSNY eNews
November 2, 2018
Volume 20  Number 41

MSSNYPAC

Colleagues:

Meeting the Presidents

I experienced a fortuitous concatenation of meetings recently.   The common theme- Current and Former Presidents of the AMA and State Medical Societies.

Last Thursday evening I had dinner with AMA Past President Nancy Nielsen (and MSSNY Past Speaker) and two other friends at my home.  Friday afternoon, I saw my good friend and AMA Past President Andy Gurman.  Saturday morning, Dr. Barbara McAneny, current AMA President, treated me to breakfast while we were attending the Pennsylvania Medical Society House of Delegates Annual Meeting.  My wife Sandra and I were there to represent New York at the meeting.

Attending other states’ HODs allows me to see different approaches to problems, brainstorm with other leaders of the House of Medicine, and share our successes and challenges with colleagues from other states.  Pennsylvania is fortunate to have a number of great leaders at the local and national level.  Incoming president Danae Powers shared with me some of the opportunities and potential problems for physicians in the PAMED society. We have similar challenges and I was pleased to see that they have begun a successful marketing campaign and had substantial membership growth last year, particularly in some under-represented demographic groups.

Some of this was due to the activity and leadership of their outgoing President, Ted Christopher.  He has been a tireless advocate for patients and physicians this last year, crisscrossing the state and engaging with members and non-members.  Ted also focused on bringing to light issues with social determinants of health.  He transformed his personal experience as an emergency room physician into policy and advocacy that will improve the health and lives of his patients, and the joy of medicine for his colleagues.  I was also fortunate to meet new Indiana Medical Society President, Dr. Stacie Wenk, and Massachusetts President Alain Chaoui.

Listening, Learning, Leading

Dr. Christopher’s farewell address to the Pennsylvania House of Delegates emphasized his goals of listening, learning and leading.  That is a common theme of this group.  Dr. Nielsen had periods during which her family was uninsured and struggled with healthcare and economic insecurity.  Dr. McAneny continues to fight against consolidation of insurers and healthcare institutions and their unfair business practices that harm physicians and make care more expensive for her patients.  Dr. Chaoui is fighting the same battle with his practice against health systems and insurers in Massachusetts.

Their personal experiences and challenges are the crucible that helped to form these leaders.  They channeled their passion with the help of likeminded physicians, local medical students from their state, specialty or national medical societies to focus their energies for the good of their patients and our profession.  I’m grateful to them for sharing their time, talent, treasure and passion. I’m hopeful they inspire all of us to stand firm with our loins girt with truth, staff in hand, ready to battle for the health of our patients and improving the practice of medicine.

MSSNY, the AMA, and our County and Specialty Societies are the forge that created these great leaders.  Your involvement in creating policy and advocating for it is essential for your patients and your ability to care for them properly.  MSSNY has a strong focus on developing leaders (Physician Leadership Program on November 30-Dec.1 in Syracuse).

Let MSSNY help you forge your leadership skills.  Contact me at comments@mssny.org.

Ductus exemplo!

Thomas J. Madejski, MD
MSSNY President


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Legislator Scorecard Now Available
Before you vote next week, take a moment to view the MSSNYPAC Legislator Scorecard to see how your elected representatives have voted on issues that are of importance to physicians and feel free to share with your colleagues.  We’ve received such positive response from physicians who wish to access MSSNYPAC’s Legislator Scorecard that we are now offering it to all MSSNY members for free even if you are not yet a supporter of MSSNYPAC.  Please use this tool to make your best choices at the polls!

Click here to view the Legislator Scorecard now.  

eNews

MSSNY Seeking Info: Have You Received Letter from Walmart Re Prescribing Practices?
The Medical Society of the State of New York and the American Medical Association Task Force on Opioids is interested in hearing from physicians who may have received a letter from Walmart in regards to the prescribing practices for controlled substances.  Walmart, Walgreens, and CVS pharmacies has implemented the CDC Guidelines for Prescribing Opioids for Chronic Pain as corporate policy.  MSSNY and the AMA learned that Walmart has sent letters to physicians throughout the country about their prescribing practices.

In the letters, Walmart indicated that it will no longer be accepting physicians’ prescriptions for Controlled Substances II-V where it believes it is warranted based upon Walmart’s review of a physician’s prescribing practice. MSSNY and the AMA Task Force on Opioids are extremely concerned about corporate policies that could result in refusal to fill prescriptions above certain doses and to refuse to fill prescriptions from certain physicians based on the corporation’s arbitrary definitions of questionable prescribing patterns.

MSSNY is aware nationally there have been physicians who have received this letter; an example of the letters can be found here. MSSNY will meet with state officials from the NYS Bureau of Narcotic Enforcement within the next few weeks to discuss this corporate policy and its impact on NYS physicians and patients.  Any physician who may have received this letter, please contact Pat Clancy, Sr. Vice President, Public Health and Education/Managing Director, at pclancy@mssny.org or by phone at 518-465-8085.

Physicians may also ask the NYS Office of Professional Discipline (OPD) to review this matter. To file a complaint, please complete the OPD complaint form and list the contact information for the New York pharmacy(s) that is involved along with the details of the complaint. This completed form along with any additional information may be emailed to the OPD directly at conduct@nysed.gov   Please copy Pat Clancy when filing the complaint.


Contraction of Medicare E&M Payments Will Not Be Implemented in 2019
Among the many highlights of the final 2019 Medicare physician payment rule released this week is that CMS will not be implementing a proposal that had been opposed by MSSNY, the AMA and many other state and specialty medical associations to condense E&M payments for Level 2-5 visits.

According to an initial summary from the AMA of the 2,300 page payment rule, it noted that CMS will be implementing new documentation policies for E&M claims which will significantly reduce administrative burden.  Importantly, however, the CMS has acknowledged the work of the AMA’s CPT/RUC Workgroup on E/M by postponing any coding and payment-related changes for E/M office visit services until CY2021.  

The changes to E/M documentation guidelines for 2019 which were strongly supported by the AMA and other members of the Federation include:

  • The requirement to document medical necessity of furnishing visits in the home rather than office will be eliminated.

  • Physicians will no longer be required to re-record elements of history and physical exam when there is evidence that the information has been reviewed and updated.

  • Physicians must only document that they reviewed and verified information regarding chief complaint and history that is already recorded by ancillary staff or the patient.

It was also noted that the following policies opposed by the AMA and will not be implemented by CMS:

  • Payment reductions by 50% for office visits that occur on the same date as procedures (or a physician in the same group practice). The AMA brought attention to the fact that duplicative resources have already been removed from the underlying procedure through the current valuation process; and

  • Condensed practice expense payment for the E/M office visits, by creating a new indirect practice expense category solely for office visits, overriding the current methodology for these services by treating Office E/M as a separate Medicare Designated Specialty. This change would also have resulted in the exclusion of the indirect practice costs for office visits when deriving every other specialty’s indirect practice expense amount for all other services that they perform, which would have resulted in large changes in payment for many specialties (such as a greater than 10% payment reduction for chemotherapy services).

However, of concern, the final Medicare payment rule did include a reduction of the “add-on” amount for the wholesale acquisition cost (WAC)-based payment for Part B drugs.  Effective January 1, 2019, WAC-based payments for Part B drugs – during the first quarter of sales when ASP is unavailable – will be “subject to a 3 percent add-on in place of the 6 percent add-on that is currently being used.”  CMS stated that this “change in policy will help curb excessive spending, especially for new drugs with high launch prices, and will also decrease beneficiary cost sharing.”

Review of the final payment rule is ongoing and further updates will be provided.  To read the CMS press discussing highlights of the final 2019 Medicare payment rule, click here.


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November Council Meeting Voted on 2019 Legislative Program
At the meeting on November 1, Council approved the following:

  • MSSNY will support and co-sponsor the Gay and Lesbian Medical Association (GLMA) resolution regarding an amendment to the AMA policy on Medical Spectrum of Gender. The resolution calls for the AMA to work with appropriate medical organizations and community based organizations to inform and educate the medical community and public on the medical spectrum of gender identity; educate state and federal legislators on the medical spectrum of gender identity to ensure access to quality health care; and affirm that gender is not fixed and may differ from the sex assigned at birth.
  • MSSNY’s 2019 Legislative Program

  • MSSNY will advocate for legislation, regulation or other appropriate means to assure that needle electromyography and nerve conduction studies are performed by licensed physicians only, or those who are directly supervised by a physician.

  • MSSNY will work with the NYS Society of Orthopedic Surgeons to educate physicians regarding existing clinical data registries that collect data regarding poorly performing cobalt/chromium metal-on-hip implants to better assure physicians have necessary information to inform their patients. MSSNY will urge the AMA to work with the American Academy of Orthopedic Surgeons (AAOS) to increase the adoption of musculoskeletal registries so as to aid early detection capabilities of poorly performing implants and report to the public on clinical statistics, and inform quality improvement and educational activities.

Speaker of the House Dr. Kira Geraci announced the following important dates regarding the 2019 House of Delegates at the Tarrytown Marriot:

  • April 11-CMS Programs

  • April 12-14-House of Delegates

  • Resolution submissions: February 8-March 8 @ 5 pm

Mark your Calendars! The 3rd and 4th District Retreat will be held on January 26, 2019 at the Mirror Lake Inn in Lake Placid.


Garfunkel Ad


Extortion Scam Targeting DEA Registrants
DEA is aware that registrants are receiving telephone calls and emails by criminals identifying themselves as DEA employees or other law enforcement personnel.  The criminals have masked their telephone number on caller id by showing the DEA Registration Support 800 number.  Please be aware that a DEA employee would not contact a registrant and demand money or threaten to suspend a registrant’s DEA registration.

If you are contacted by a person purporting to work for DEA and seeking money or threatening to suspend your DEA registration, submit the information through “Extortion Scam Online Reporting” posted on the DEA Diversion Control Division’s website, www.DEADiversion.usdoj.gov.

For more information contact:
Locate DEA Field Office for your area – https://apps.deadiversion.usdoj.gov/contactDea/spring/fullSearch
Registration Service Center – 1-800-882-9539
Email – DEA.Registration.Help@usdoj.gov


Three-Year-Old State Billing Law Leads to Fewer Surprises for New Yorkers
Three years after New York implemented a landmark law to prevent patients from getting surprise bills, many consumers have been shielded from disputes between doctors and insurers. The out-of-network consumer protection law holds patients harmless in emergency cases when they are treated by out-of-network physicians, except for any in-network payment responsibility. It also removes patient liability in cases when a person attempts to use an in network provider but still receives an out-of-network bill from an anesthesiologist or pathologist, for example.

The New York State Health Foundation hosted a panel Monday to review the law’s successes and shortcomings. Troy Oechsner, deputy superintendent for health at the state Department of Financial Services, shared data about outcomes in the independent dispute-resolution process. In emergency cases, health plans were more likely to prevail than providers by a margin of 534 to 289. Plastic surgeons represented about one-quarter of the 2,104 cases that have gone through the resolution process, followed by emergency medicine physicians and orthopedic surgeons. Meanwhile, in cases of non-emergency, surprise bills, providers won the disputes more often, by a margin of 272 to 84, in cases where decisions were rendered. Those disputes most often involved neurosurgeons and anesthesiologists.

The law does have limitations, though. About half of New York’s commercially insured population is covered by self-insured employer health plans regulated by federal law, Oechsner said. “As a result, all these great protections that we’re working on for the state don’t apply to nearly half the commercial market,” he said. “That’s a huge problem.” He said the state is working to improve its enforcement of standards around the type and quantity of providers insurers must include in their networks. (Crains NY Business Oct 3).


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Urge Gov. to Sign Legislation to Expand Access to Prostate Cancer Screening
Physicians are urged to contact Governor Cuomo to encourage him to sign into law legislation (S.6882/A.8683­) that would ensure that health insurers provide coverage for diagnostic testing for prostate cancer without such care being subject to annual deductibles or coinsurance. In particular, men over 40 with family history and men over 50 who are asymptomatic would be enabled to receive this care without being subject to annual deductibles or coinsurance. Additionally, the bill would require the information regarding the availability of insurance coverage for prostate cancer screenings without cost sharing, to also be included in the standardized written summary prepared by the Commissioner of Health. New York has for many years required insurance coverage for these tests, but were subject to cost-sharing. This undoubtedly will encourage even more men to have this often life-saving test. You can send a letter in support here.


Life Expectancy in New York Lowered: Obesity and Opioids Are Factors
Life expectancy in New York State is going in the wrong direction, an alarming reversal after years of steady increases. A report produced by the NYS Health Foundation’s internal policy and research department shows that, after peaking in 2014 at 80.7 years, life expectancy decreased in both 2015 and 2016 https://bit.ly/2Jz8bjf. The report found that a combination of factors–including the growing obesity epidemic and the opioid crisis–is likely contributing to declining life expectancy.


Rockland County: 33 Cases of Measles; Five More Suspected
Rockland County officials confirmed that 33 people have measles and five more suspected cases are under investigation. More than 2,000 people in the county have gotten the measles, mumps, 


Medical Society of NY Classifieds


Nassau County DOH Named Local Health Department of the Year
The Nassau County Department of Health (NCDOH) has been named “Local Health Department of the Year” for 2018 by the National Association of City and County Health Officials. The NACCHO represents the nation’s nearly 3,000 local governmental health departments.

The announcement was made at the NACCHO Annual Conference. NCDOH earned the tile by successfully bringing together providers, hospitals, and community-based organizations to evaluate the needs of residents, and together created a county-wide Community Health Assessment and Community Health Improvement Plan. NCDOH is a founding member of the Long Island Health Collaborative, which has grown from a three-agency online database to a grant-funded health initiative with almost 100 agencies.

In recent years, the County Health Department has created initiatives such as an Office of Minority Health Affairs, participation in the “Cribs for Kids” program, programs that screen infants for developmental delays, sending “Newborn Welcome Mailings” with pertinent newborn health information to the families of all 14,000 babies born in the county each year and serving as the grantee for the Long Island Ryan White HIV Service grant.

The Department’s Public Health Emergency Preparedness unit leads a troop of almost 1,000 volunteer medical professionals in a Medical Reserve Corps who train for emergencies and provide on-site medical coverage for the Games for the Physically Challenged and the Long Island Marathon.


Flu Vaccine: One Year Doesn’t Reduce Effectiveness the Next Year
Getting the flu vaccine every year doesn’t reduce its effectiveness — and might even boost its performance — suggests a study in JAMA Network Open. Researchers examined the vaccination status of nearly 3400 children who presented with acute febrile respiratory illness during one of three successive flu seasons between 2013 and 2016. About one-fourth had flu confirmed on reverse-transcription polymerase chain reaction testing; the rest were considered negative for flu.

The researchers found that while vaccine effectiveness varied by vaccine type (e.g., live attenuated influenza vaccine [LAIV) or inactivated influenza vaccine) and flu virus strain, past-season vaccination did not reduce vaccine effectiveness. In fact, in some cases — for example, the effectiveness of LAIV against influenza A (H3N2) — previous vaccination appeared to improve the vaccine’s effectiveness.

Of note, residual protection from past-season flu vaccine alone was observed only for influenza B.

A commentator writes, “The results thus suggest additional support for the current Advisory Committee on Immunization Practices’ recommendation that children be vaccinated annually against influenza.” article; JAMA (Free)


Dr. First Banner


CME

Cybersecurity: A Daily Threat for Healthcare” CME Webinar
November 14 @7:30am_ Registration Now Open

Do you know how best to protect your office against a cyberattack?  Are you aware of your vulnerabilities?  Learn how to protect yourself, your patients and your workplace on November 14 at 7:30am.  Register here for Medical Matters: Cybersecurity: A Daily Threat for Healthcare.  Mahesh Nattanmai, Deborah Sottolano, PhD of New York State Department of Health and Peter Bloniarz of the New York State Cyber Security Advisory Board 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. 


Be Sure to Check Out All of MSSNY’s Podcasts and CME Programs
Did you know that MSSNY has created several podcasts and CME programs on current topics such as influenza and measles to name just two?  Click here for MSSNY’s podcast on Measles, Mumps and Rubella and click here to listen to a podcast on Influenza Vaccines.  And you can listen to all of our podcasts here.

MSSNY also has several free CME programs at https://cme.mssny.org concerning influenza, including our most recent Medical Matters: Influenza 2018-19.

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


CMS

The Quality Payment Program Resource Library is Back on QPP.CMS.GOV
CMS has moved Quality Payment Program (QPP) resources from CMS.gov to the newly redesigned Quality Payment Program Resource Library on qpp.cms.gov. Following feedback from clinicians and others in the health care community, we wanted to make Quality Payment Program information and resources available in one place. We’ve also made it easier for you to find the resources you’re looking for by including a search function that allows you to search for resources by year, reporting track, performance category, and by document type (e.g., fact sheet, user guide, measure specifications).

Additional resources including materials from educational webinars will be added to the new Quality Payment Program Resource Library soon. Stay tuned for more information!

For More Information:

Questions? Contact the Quality Payment Program at QPP@cms.hhs.gov or 1-866-288-8292.


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RENTAL/LEASING SPACE


For Rent or Share – Woodbury, Long Island
Beautiful recently renovated Plastic Surgery Class C-M AAAA-certified Operating Room available for part-time share and available for rent. Centrally located on Long Island. Close to expressways.
1 exam room /OR. Waiting room & break room. Available for full or half-days. Free WIFI. Suits Plastic/Cosmetic Surgeons/Derm/ENT/ObGyn/Podiatry or other Medical MDs.

Contact Kendra at Kendra@drmadnani.com or 516-226-1080


All-Inclusive Medical Office Space for Rent-5 Locations: Elmhurst, Ozone Park, Lawrence, Lindenhurst & East Setauket
Starting up, slowing down or growing your practice? Interested in trying out
a new town or opening a satellite site, with no long term commitment? Come
look into one of our 5 locations throughout Queens and Long Island.

MedPlex is an all-inclusive medical office rental company dedicated to the medical
field. We offer low daily rates ($106-$191 per room, per day), with over 100
customizable rooms available for rent. You have the freedom to choose the days,
times & locations that best suite you and your practice.

We are open 24/7 and offer individual rooms or private suites to rent, with
leasing options as little as 1 year. Each option includes all utilities, exam room set up
with furniture & a list of medical equipment, medical waste pick-up, office cleaning,
common areas, basic consumables, a fully stocked reception station (equipped with
computer, phone, fax and copier) and lockable storage.

For more information please log on to www.MedPlexLLC.com, Loop-Net/Co-Star, or call Carla Scalici, Operations manager, @ 516-797-7735, cscalici@MedPlexLLC.com

ozone park room1 ozone

ozone


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.comnyc nyc room2

nyc room3 nyc room4


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

West 57th St. Office West 57th Doctors Office

West 57th St Doctors Lobby


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 or by month. Price is negotiable. 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 room1 58th Street room2 58th Street room3

 


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

Internal Medicine Physician and Nurse Practitioner Wanted – Syracuse Area
Syracuse primary care practice recruiting for a highly motivated Internal Medicine Physician and Nurse Practitioner. Candidates should be interested in working closely with patients, care teams, and

community partners, Send resume to neurosciencesgroup@gmail.com


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