“Blinded by the light
Revved up like a deuce, another Runner in the Night
Blinded by the light.”
It was great to be back in Buffalo for the Erie County Annual Meeting as Dr. John Gillespie turned over the reins to Dr. Kenneth Eckert III, a third generation physician. In his inaugural, Dr. Eckhert shared several quotes from his grandfather – quotes that still ring true today.
The highlight of the evening was former Denver Broncos wide receiver Vance Johnson (I know – a Bronco in Bills country?) who shared with us his life outside the lines. His was a real Wide World of Sports story – from the thrill of victory to the agony of defeat, as he sank steadily into the quagmire of substance abuse and addiction. A few words can hardly recap the emotion of the evening as the man poured out his heart to all in attendance. Suddenly, agonizing about Managed Care or Reimbursement seemed such small matters indeed.
Mr. Johnson credited the care and tough love shown by a physician Mark Twardowski, DO, for the inspiration and the guts to turn his life around. “He cared about me,” Vance shared. Today, Vance Johnson is a substance abuse counselor and motivational speaker who is truly making an impact one life at a time.
After the meeting, I shared with Vance that I had had a hip replacement and had been prescribed powerful opioids. For some reason, I was somehow not susceptible to their allure. There but for good fortune, indeed. And we spoke about kids in sports and the influence their coaches and trainers have on them and how easily bad advice and unrealistic expectations can lead athletes to a path to self-destruction. As Mr. Vance was speaking, the realization hit like a ton of bricks that we must always strive to see the person behind the mask. For more about Vance Johnson, check out his video here.
Arthur Fougner, MD
Comments? firstname.lastname@example.org; @mssnytweet; @sonodoc99
This Week’s Podcast of MSSNY’s Legislative Priorities
Medical Organizations, Public Health and Patient Advocacy Groups Join Together to Urge Further Limits on Exemptions For Immunizations
This Monday, May 6, the Medical Society of the State of New York will join 25 other medical organizations, public health and patient advocacy groups urging the New York State Legislature to pass A.2371/S.2984 which ensures that medical reasons are the only exception to vaccination requirements. The legislation is sponsored by Assemblymember Dinowitz and Senator Hoylman and is in the Assembly and Senate Health Committees. Following the press conference, the groups will meet with various members of the legislature urging their support of the measure. With the number of measles cases exceeding 700 confirmed cases, all the groups are urging passage to ensure that measles, a vaccine preventable disease, does not gain a sustained foothold in New York and the nation. The following groups have joined onto a memo in support and many representatives will be attending the press conference:
American Academy of Pediatrics, NYS District II, Chapters 1, 2 & 3, American Nurses Association – New York (ANA-NY), Associated Medical Schools of New York, Autism Science Foundation, Citizen Committee for Children of New York, Inc., Children’s Defense Fund-New York, Ithaca Is Immunized, Kimberly Coffey Foundation, Nurses Who Vaccinate, March of Dimes, Meningitis B Action Project, Medical Society of the State of New York, Nurse Practitioner Association New York State, New York American College of Emergency Physicians, NY Chapter American College of Physicians, NYS Academy of Family Physicians, NYS Association of County Health Officials (NYSACHO), NY Occupational and Environmental Medical Association (NYOEMA) , NY State Neurological Society, NY State Neurosurgical Society, NYS Ophthalmological Society, NYS Society of Otolaryngology-Head and Neck Surgery, NYS Public Health Association, New York State Society of Anesthesiologists, Inc., The New York State Radiological Society
Schuyler Center For Analysis and Advocacy and The Children’s Agenda.
Physicians are encouraged to send a letter to their legislators urging support of A.2371 and S.2984 by going to MSSNY Grassroots Action Center (GAC). Please click here. (CLANCY)
Bill Requiring Physicians to Maintain Excessive Documentation of Discussion of Risks of Prescribing Opioids Moves to Senate Floor; Action Needed!
Legislation which would require physicians and health practitioners, who prescribe an opioid or other Schedule II Controlled Substance, to discuss with patients’ the risks prior to being prescribed a CSII drug, has moved to the Senate floor and can be voted on at any time. The measure, S.4277-A, is sponsored by Senator Harckham. There is now a companion measure, A.7285-A, sponsored by Assemblywoman Rosenthal. Specifically the legislation would require physicians to discuss and, by extension, document that such discussions took place: a) the risks of addiction and overdose associated with opioid medications, b) the reason why the prescription is necessary, c) alternative treatments that may be available and d) the risks associated with the use of these medications. Moreover it would require the physician each year to counsel the patient on the risks of overdose and the availability of an opioid antagonist.
While the legislation is well intended, it ignores existing law essentially requiring the patient’s informed consent under the Public Health Law—which means that when a patient needs treatment, the physician must give the patient the information regarding risks to make an informed decision. Additionally, this is duplicative of requirements that currently exist under the ISTOP law, whereby, after the physician prescribes the medication, the pharmacist is required to again inform the patient about the risks of taking a controlled substance. Moreover MSSNY is concerned that such requirements will further discourage physicians from prescribing pain medications for patients who need them – already a growing concern, as well as potentially scaring patients away from taking pain medications who may truly need them.
The Medical Society is opposed to this measure and encourages physicians to send a letter to their legislator at the MSSNY Grassroots Action Center (CAC) here.
Collective Negotiations Bill Advances in the Assembly
Assemblymember Gottfried’s bill A.2393, which would help to even the playing field between physicians and insurance companies, has been reported out of the health committee and is now on the Assembly Codes Committee agenda for next week. This bill would allow independently practicing physicians to communicate and negotiate collectively with health care plans in limited instances (when health plans have an undue advantage negotiating the terms of contracts with health care providers). Currently physicians are unable to do so due to federal antitrust law. However, a longstanding US Supreme Court precedent enables States to permit these negotiations via the State Action Doctrine.
Passage of this legislation would help to enable physicians to negotiate to limit burdensome prior authorization procedures and unfair network participation rules. It also contains protections to help ensure that negotiations do not impair access to patient care by prohibiting collective slowdowns/strikes and would ensure strict oversight of these negotiations by the Department of Health.
The same as bill, which is sponsored by Senator Rivera (S.3462) is currently in the Senate Health Committee.
Please urge your legislator to support this bill by clicking here.
Senate Health Committee to Consider Legislation to Reduce MOC Hassles
Legislation is on the agenda of the Senate Health Committee for next week (S.5280, Rivera) that would prohibit health insurance companies and hospitals from requiring that their participating network and staff physicians continue to complete often unnecessarily burdensome Maintenance of Certification requirements as a condition of participation in their panels and medical staffs. The Medical Society of the State of New York supports this legislation.
The cost of updating board certification status is increasingly becoming prohibitively expensive and excessively time-consuming for many physicians. With demands on physician time greater than ever before (which is leading to a significant increase in “burnout”), many physicians find that they do not have sufficient time to prepare for ever more cumbersome specialty recertification exams. While efforts are being made by some of the national specialty boards to simplify this re-credentialing process in response to an outcry from the physician community about these excessive requirements, the needed relief is not happening quickly enough. This bill would help to ensure that continuing board certification remains aspirational for physicians, but not mandatory, by ensuring that hospitals and health insurance companies cannot impose such ongoing requirements as a condition of participation, thereby reducing one barrier to delivering medical care in New York State.
Similar legislation (A.5140, Schimminger) is in the Assembly Health Committee. (AUSTER)
Bill to Restrict Physicians’ Defense in Medical Liability Cases Reported Out of Committee
The Assembly Codes Committee has reported Assemblymember Dinowitz’s bill A.2370 to the floor. The bill, which is opposed by MSSNY, would prohibit a physician’s defense counsel in a medical liability action from conducting an interview with the plaintiff’s treating physician.
This legislation would overturn a New York State Court of Appeals decision that affirmed a long-standing principle in our legal system that no party has a proprietary interest in a particular witness in a civil liability action. Were this Court of Appeals decision to be overturned through legislation, it would present significant problems for a physician defendant in seeking to defend him or herself in a medical liability action by unfairly limiting the opportunity to fully examine the plaintiff’s health condition to evaluate the merit of the plaintiff’s claim.
New York already has the most burdensome liability environment for physicians in the entire nation, leading to escalating costs and driving physicians out of the state. Analyses have repeatedly stated that New York is the worst state in the country in which to be a doctor, in large part due to its overwhelming liability exposure as compared to other states. Indeed a recent report by LeverageRx showed that New York once again overwhelmingly had the highest liability costs in the country and up 11% between 2017 and 2018. This legislation would exacerbate these already onerous costs, further drive increases in defensive medicine costs and would make worse the imbalance in our medical liability adjudication system. (AVELLA, AUSTER)
Patient Formulary Protection Bill Advances in Senate
Senator Breslin’s bill S.2849, which would prohibit a health care plan from making prescription drug formulary changes during the contract year, has been reported out of the Senate Insurance Committee for the first time. While patients are locked into an insurance plan for the contract year – and often choose their plan based on their prescription co-pays – insurance companies are able to modify their formulary and often move drugs into a higher cost-sharing tier mid-contract. This legislation would ensure that patients are able to access the drugs they need without unexpected cost increases mid-year.
The bill, which is sponsored by Assemblymember People-Stokes (A.2969), has passed the Assembly every year since 2015 and is currently in the Assembly Insurance Committee awaiting movement.
Please urge your legislator to support this bill by clicking here. (AVELLA)
Measles Outbreak in New York State Continues to Spread
Webinar Available at MSSNY CME Website
The number of measles cases in New York State continues to rise with approximately 665 of the 706 confirmed cases nationwide in New York State (423 in New York City, 206 in Rockland, 23 in Orange, 10 in Westchester, 2 in Sullivan, 1 in Suffolk and 1 in Greene counties) as of May 1st. MSSNY conducted a just-in-time Medical Matters webinar entitled “The Continued Public Health Threat of Measles 2018” in December, 2018. This webinar has now been posted to the MSSNY CME website. You can also view MSSNY’s latest Medical Matters webinar entitled “What’s Your Diagnosis? Infectious Diseases” which involves a patient with a fever and a rash. Please check these out and keep yourself informed about the growing measles outbreak throughout New York State. You can also listen to MSSNY’s brief; podcast on the Measles, Mumps and Rubella vaccine here. (HOFFMAN, CLANCY)
Registration Now Open for Medical Matters Webinar on May 15, 2019 @ 7:30am
The Medical Society of the State of New York will host its final Medical Matters webinar of 2019, The Importance of Resilience After a Disaster on May 15th @ 7:30am. Encouraging post traumatic growth is an essential part of recovery from any type of disaster. Learn more about how best to encourage resilience behaviors in patients.
When: Wednesday, May 15 2019 at 7:30am
Faculty: Craig Katz, MD
- Define resilience and post traumatic growth
- Describe how best to measure resilience and post traumatic growth
- Explore resilience behaviors and how to encourage them in your patients
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.
Registration Now Open for Veterans Matters CME Webinar on June 5th
Register now for MSSNY’s next Veterans Matters webinar June 5th at 7:30am. This webinar is entitled Substance Use Disorders in Veterans. Register for this program here.
Veterans Matters: Substance Use Disorders in Veterans
When: Wednesday June 5 2019 at 7:30am
Faculty: Frank Dowling, MD
- Define Substance Use Disorders (SUDs), symptoms, warning signs, comorbidities
- Explore evidence-based intervention and treatment options for SUDs among veterans
- Identify barriers to diagnosis and treatment and methods to overcome them
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. Physician should only claim credit commensurate with the extent of their participation in the activity. (HOFFMAN)
Zocdoc – The Concern About Their Directory
MSSNY continues to raise concerns on behalf of our member physicians. Most recently, MSSNY had a conversation with the NYS AG’s office regarding the propriety of the Zocdoc new pricing arrangement. The AG’s staff agreed with the decision of the NYS DOH indicating that the new pricing protocol does not equate to fee splitting.
We also raised concerns about Zocdoc’s directory. We know that Zocdoc lists the names of physicians who have never had an agreement or who have chosen to non-renew their agreement. These physician names appear in the Zocdoc directory. This present Zocdoc system of listing physicians without an agreement appears to steer patients to physicians with Zocdoc agreements. This process is unacceptable. We have enlisted our General Counsel, Garfunkel Wild, to ask that Zocdoc amend their directory to include only those physicians who have a Zocdoc agreement. As soon as we receive a response from Zocdoc, we will inform the membership.
Check Vaccination History if Born Between 1957 through 1989
The total number of U.S. measles cases reported so far in 2019 has reached the highest level in a single year since 1994, according to a CDC report released this week. CDC now is recommending that all U.S. residents check to ensure they have been adequately vaccinated against measles—particularly, individuals who were born in the years 1957 through 1989, since it is likely they were given a weaker version of the vaccine and, during those years, it was common for children to receive just one dose of the immunization. (Source: Vox,4/29)
New York Trails in Toddler Vaccination Rate
New York state ranked 43rd in the rate of children 19 months old to 35 months old who have received the full course of recommended immunizations, at 67.5% in 2017, according to data from the CDC. The U.S. average was 70.4%, and Massachusetts had the highest rate, 82.1%. The data come from the 2017 National Immunization Survey, which tracks whether children have received vaccines against 14 illnesses, such as diphtheria, hepatitis B, measles, meningitis and pneumonia.
FDA Approves First Vaccine to Prevent Dengue Disease
The US Food and Drug Administration (FDA) has approved the first vaccine to prevent dengue disease caused by all dengue virus serotypes (1, 2, 3, and 4) for people aged 9 through 16 years who have previously had laboratory-confirmed dengue infection and who live in endemic areas. The vaccine, Dengvaxia (Sanofi Pasteur), is a live, attenuated vaccine given in three injections. The initial dose is followed by two additional injections 6 and 12 months later.
“Dengue disease is the most common mosquito-borne viral disease in the world and global incidence has increased in recent decades. While there is no cure for dengue disease, [this] approval is an important step toward helping to reduce the impact of this virus in endemic regions of the United States,” Anna Abram, FDA deputy commissioner for policy, legislation, and international affairs, said in a news release. Dengue is endemic in the US territories of American Samoa, Guam, Puerto Rico, and the US Virgin Islands.
Enrollment Declines in Medicaid or Children’s Health Insurance Program
The latest CMS data show that nationally 2.2 million fewer people were enrolled in Medicaid or the Children’s Health Insurance Program from January 2018 to January 2019. CMS says the decline could stem from the improving economy, but other health experts say the drop could stem from stricter eligibility redetermination processes. The New York stats are:
|Total Medicaid and CHIP Enrollment||6,527,141||1|
|· Medicaid Enrollment||5,883,397|
|· CHIP Enrollment||643,744|
|Total Medicaid Child and CHIP Enrollment||2,499,955||1|
Doctors Without Borders Informational Session in NYC
On Wednesday, May 22nd, 2019 physicians are invited to join Doctors Without Borders/Médecins Sans Frontières (MSF) for a recruitment information session in New York, NY. This is your opportunity to meet our recruitment team and learn about how you can join our pool of dedicated aid workers. We’re currently recruiting a variety of positions. Recruitment Information Session Doctors Without Borders 40 Rector St 16th Floor New York, NY 10006 Wednesday, May 22nd, 2019 at 7:00 – 8:30 pm.
Investors Sue UnitedHealth Directors: Four Things to Know
Central Laborers Pension Fund and a set of investment funds managed by Amalgamated Bank LongView sued UnitedHealth Group’s directors and former CEO in Delaware Chancery Court, according to Law360.
Four things to know:
- The derivative action, filed April 24, alleges 15 current or past UnitedHealth directors permitted the company to submit inflated risk adjustment claims to CMS for Medicare Advantage patients.
- The lawsuit accuses the directors of breaching their corporate duty, according to Law360.
- The lawsuit includes specific allegations against Stephen J. Hemsley, UnitedHealth Group executive chairman and former CEO. He “bore ultimate responsibility for overseeing and executing UHG’s efforts to improperly increase revenues by defrauding Medicare,” the lawsuit states, according to Law360.
- The pension fund and bank-managed investment funds are seeking damages on behalf of UnitedHealth for the alleged billing violations. The damages include liabilities for practices dating back roughly 13 years to 2006.becker’s hospital review Ap 30
Millennials’ Health: One-Third Have Lower Life Expectancy
One-third of millennials have a health condition that will lower their life expectancy and quality of life, according to a recent study from the Blue Cross Blue Shield Health Index published last week. The Health Index found that “millennials as a group were living at about 95% of their optimal health.”
Conscience Rule Finalized to Protect Healthcare Workers’ Religious Beliefs
The Trump administration on Thursday finalized a “conscience rule” to protect healthcare workers who refuse to perform certain services—such as abortion—due to religious beliefs.
The HHS’ Office for Civil Rights issued the 440-page final rule, which offers protections for providers, health insurers and employers that decline to provide, participate in, pay for, provide coverage of or offer referrals for services that violate their religious or moral beliefs. The rule also covers healthcare staff that “assist in the performance” of such services, including schedulers and those who prepare rooms.
The rule is meant to protect individuals and healthcare organizations in HHS-funded programs from discriminating on the basis of religion, according to Roger Severino, director of the OCR. “Finally, laws prohibiting government-funded discrimination against conscience and religious freedom will be enforced like every other civil rights law,” he said.
The OCR said that the rule largely reinforces current laws and regulations that protect a medical provider’s rights to refuse to perform certain procedures, while adding new standards that Medicare and Medicaid providers will need to follow to comply with. Under the rule, applicants for HHS funding must provide assurances and certifications that they are complying with its regulations.
“No new law is being made here,” Severino said on a call with reporters Thursday. “What is being done is the provision of enforcement tools for existing conscience and religious freedom protections in healthcare.”
If providers don’t comply with the conscience regulations, they could lose federal funding. The OCR’s Conscience and Religious Freedom Division, which the office established in 2018, will oversee complaints from providers that feel their rights have not been respected.
Open Payments Data Available for Review
Pre-publication Review and dispute for the Program Year 2018 Open Payments data publication began on April 1, 2019 and will end on May 15, 2019. The Centers for Medicare & Medicaid Services (CMS) will publish the Open Payments Program Year 2018 data and updates to the previous program years’ data in June 2019.
Physician and teaching hospital review of the data is voluntary, but strongly encouraged. Please keep in mind the following:
- Records eligible for review and dispute: all records submitted during the submission period of the current calendar year, including newly edited, submitted, and re-attested records from previous calendar years. For detailed information refer to the Physician and Teaching Hospital Review and Dispute Tutorial
- Disputes must be initiated by May 15, 2019 in order to be reflected in the June 2019 data publication. For more information on review and dispute timing and publication refer to the Review and Dispute Timing and Data Publication Quick Reference Guide.
- CMS does not meditate or facilitate disputes. Physicians and teaching hospitals should work directly with reporting entities to resolve disputes.
- Registration in the Open Payments system is required in order to participate in review and dispute activities.
If you have never registered with Open Payments before:
Make sure you have your National Provider Identifier (NPI) number and State License Number (SLN). Initial registration is a two-step process:
- Register in the CMS Enterprise Identity Management System (EIDM);
- Register in the Open Payments system
New Study on Physician Compensation
“2019 Physician Compensation Report“: Doximity, March 2019
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Multi-Specialty Medical Office Looking To Bring On More Doctors
New York Medicine Doctors Center is a multi-specialty Medical Agency networking some of the best medical professionals and specialists in the New York Tri-State area. Our offices currently serve both Manhattan and Queens, providing a variety of advanced technological on site testing, imaging, and services for the most rapid results.
We are actively looking to bring on board an array of Doctors specializing in Primary Care, Gynecology, Gastroenterology, ENT, Urology, Podiatry, and Dermatology.
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Seeking Executive Director of the Onondaga County Medical Society
Concept: An exciting opportunity for the right person to provide leadership for physicians Salary: Commensurate with experience Job Description: Direct day-to-day operations of the Onondaga County Medical Society Some evening meetings, travel required. Requirements: Experience with leading political advocacy; political sophistication. Must know how to interface with government officials. Good networking and communication skills. Conversant with budgets and finance. Excellent media relations skills, including electronic, social media, and written communications. Familiar with medical issues and comfortable discussing them. Education: BA/BS required. MPH or MBA desirable. We expect innovation and project initiation. The Executive Director will receive a contract that increases remuneration commensurate with membership growth. Application Instructions: Please direct your application to: Dr. Brian Johnson, firstname.lastname@example.org.
Nurse, RN Utilization Review Full-Time-Westbury, NY (In-office position only)
Excellent opportunity for a RN who is seeking a position performing utilization review. We require 1-2 years recent experience in hospital and/or insurer utilization review and experience using Interqual criteria and/or MCG Guidelines. Data entry/PC skills a plus. Benefits include 401(k), paid vacation and holidays. Send resume and salary requirements to: Empire State Medical Scientific and Educational Foundation, Inc. Human Resource Department e-mail: email@example.com Fax: (1-516) 833-4760 Equal Oppty Employer M/F
Pediatrician BC, P/T
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