MSSNYeNews: August 23, 2019 – Death Be Not Proud

Arthur Fougner MSSNY Presiident

PRESIDENT’S MESSAGE
Arthur Fougner, MD
MSSNY President

MSSNY eNews
August 23, 2019

Vol. 22  Number 32


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Colleagues:

I think suicide is sort of like cancer was 50 years ago. People don’t want to talk about it, they don’t want to know about it. People are frightened of it, and they don’t understand, when actually these issues are medically treatable. – Judy Collins

NYPD suicides have dominated the news cycle. This from the NY Post:

… The recent spate of suicides is devastating, but not shocking. Whereas 13 out of every 100,000 people will die by suicide in the general population, that number climbs to 17 in 100,000 for police officers, according to a 2018 report by the Ruderman Family Foundation, a disability advocacy nonprofit. Furthermore, the report found, officers are more likely to kill themselves than to be killed on the job — a result, experts believe, of high stress and traumatic encounters in their line of work.

“… Even when cops do seek therapy, they’ll often go to great lengths to make sure it’s off the books,” says Petrullo, an NYPD retiree. His volunteer group of retired cops man a 24-7 hotline (800-599-1085) and can confidentially refer police officers to professional psychologists or psychiatrists.

“… Some of them are so concerned, they’ll self-pay [instead of going through their insurance],” says Petrullo. “And then there are some people who think no matter who they go to, someone is going to find out.

Do you know who else has a suicide problem? Well, there’s this: One doctor commits suicide in the U.S. every day — the highest suicide rate of any profession. And the number of doctor suicides — 28 to 40 per 100,000 — is more than twice that of the general population, new research shows. The rate in the general population is 12.3 per 100,000.

You could rewrite the Post story, substituting “Doctor” for “Police Officer” and it would be eerily similar. Your Medical Society is working on a Peer to Peer Program to try to head some of these off at the pass, so to speak.

Fingers crossed and stay tuned.

Comments? comments@mssny.org; @mssnytweet; @sonodoc99

Arthur Fougner, MD
MSSNY President 



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eNews


Urgent Activism Requested on Federal Surprise Billing Legislation
Physicians are urged to continue advocating for a fair and common sense solution to the surprise billing issue. With federal legislators on summer recess, the time is now to set up meetings to discuss how the current bills winding through Congress (S1895/HR3630) will hurt access to care for our patients through narrower insurer networks and exacerbating shortages in needed specialty care in our hospital emergency departments.

Instead of these well-meaning but seriously misguided proposals, Congress should advance legislation that addresses out of network “surprise” bills through a balanced dispute resolution system like HR3502. This bill is similar to New York’s law which has proven to be cost-effective, fair and successful at reducing the burden of surprise bills on patients.

To understand why this legislation would be so harmful, please visit one of these articles which explains the issue in detail Congress, Don’t Harm Patients With The Wrong Surprise Medical Bills Solution & Congress Is About to Give Health Insurance Companies the Nuclear Weapon. While S1895 and HR 3630 would not immediately impact state-regulated plans in New York (it would only apply to ERISA-regulated plans), employer-sponsored plans make up a relatively large percentage of plans in NY. Further, it represents a startling precedent that the insurance lobby in New York would certainly attempt to capitalize upon. As such, it is extremely vital that physicians advocate for legislation that uses IDR instead of a benchmark that would create a downward spiral of fees for doctors and narrower networks for patients.

While they are on break from Washington, D.C., please reach out to your member of Congress’s (and any others that you may be acquainted with) district office to sit down and discuss this issue. You may also take direct action by utilizing the following tool that allows you to take quick action a variety of ways, including social media and phone calls https://www.freeroots.com/campaign/mssny-end-surprise-billing.

Additionally, physicians are requested to retweet MSSNY President Dr. Art Fougner’s message to members of Congress in NY and in leadership positions relevant to this issue. Please take a moment to retweet all 6 of these so that we can have our message heard en masse (links below).

http://tiny.cc/Tweet1  http://tiny.cc/Tweet2  http://tiny.cc/Tweet3

http://tiny.cc/Tweet4  http://tiny.cc/Tweet5  http://tiny.cc/Tweet6


Now Is the Time to Urge Your Members of Congress to Support Medicare Payment Increases
The American Medical Association has sent out a grassroots alert to physicians urging them to write your members of Congress today and support improvements to the Medicare Access and CHIP Reauthorization Act (MACRA), noting that when Congress returns to DC in September one item on their plate will be improving the MACRA.

After a 15 year fight to replace the flawed Sustainable Growth Rate (SGR) update system for Medicare reimbursement rates, Congress finally acted, and passed the MACRA law in 2015. Since its enactment, physician organizations have worked closely with both Congress and CMS to promote a smooth implementation of key components of the law.

Unfortunately, it has become clear that further refinements are needed to improve the program and ensure physicians can be successful moving forward. During the first five years, the law had provided for modest payment increases, but payment rates still have not kept up with inflation. To make matters worse, the statute calls for a 0% per year payment update for years 2020-2025.  Among the improvements being fought for by organized medicine:

  • Implementing positive payment adjustments for physicians in lieu of a payment freeze over the next six years;
  • Extending the Advanced Alternative Payment Models (APM) bonus payments for an additional six years, and;
  • Implementing additional technical improvements to MACRA

This problem is real and if Congress doesn’t act when they return, many physicians who see Medicare patients will be negatively affected.  This is even more important this year, given the significant shifts in Medicare physician payment (up and down) being proposed by CMS.

Please contact your members of Congress here.


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DOH Issues Emergency Regulations for Granting Medical Exemptions from Immunizations
Last Friday, the New York State Department of Health issued emergency regulations to strengthen and clarify the process by which physicians can grant medical exemptions under the new state law which repealed non-medical exemptions for children attending school or daycare.

The new regulations are effective immediately and provide clear, evidenced based guidance to physicians on appropriate issuance of medical exemptions.  The Department, in collaboration with the Office of Children and Family Services and the State Education Department, has issued a series of Frequently Asked Questions (FAQ) on the new law FAQ issue August 16, 2019.

Effective immediately, physicians who issue medical exemptions will be required to complete the applicable medical exemption form approved by the New York State Department of Health or New York City Department of Education, which specifically outlines the medical reason(s) that prevent a child from being vaccinated. Additionally, the regulations require physicians to outline specific justifications for each required vaccine in order to be able to grant an exemption.

Previously, regulations allowed for a physician to submit a signed statement to schools without having to document on an approved form stating why immunization may be detrimental to the child’s health. The emergency regulations apply to all children statewide, and they continue to require that medical exemptions must be reissued annually. By providing clear, evidence-based guidance to physicians regarding when immunization may be detrimental to a child’s health, this emergency regulation will help prevent medical exemptions from being issued for inappropriate reasons.

Public Health Law §2164, as amended by Chapter 35 of the Laws of 2019, applies to students attending all schools as defined in Public Health Law §2164 to include any public, private or parochial child-caring center, day nursery, day care agency, nursery school, kindergarten, elementary, intermediate, or secondary school. The NYS Department of Health encourages parents and guardians of all children who do not have their required immunizations to receive the first dose in each immunization series as soon as possible.

The deadline for obtaining first dose vaccinations in each immunization series for children attending school in the fall is 14 days from the first day of school or enrollment in child day care. Within 30 days of the first day of school, parents and guardians of such children must show that they have scheduled appointments for all required follow-up doses.

As of August 16, 2019, there were 1,044 cases of measles in New York State.   Measles is a reportable disease and physicians are encouraged to seek further information on the New York City Department of Health/Mental Hygiene website here or at the New York State Department of Health website here.

MSSNY has a free CME program on measles is available here.  Users new to the site will have to establish an account; all others will need to just log into the website and access the program entitled: The Continued Public Health Threat of Measles 2018.


Med Students: Learn How to be a Physician Advocate at AIM Conference in NYC
The second annual Advocacy in Medicine (AIM) Conference will bring
together healthcare advocates and trainees from various academic institutions interested in health advocacy for a full day of talks, interactive panels, breakout sessions and networking. The conference opens with keynote speakers addressing the role of physician advocacy followed by an interactive Q&A panel discussion with physicians on advocacy, activism, and their personal career trajectories. The afternoon will be dedicated to small workgroups with the opportunity to focus on skill-building and topic-focused content.

The conference will be held on Sunday, September 22, 2019 from 8:30 am-4:00 pm at The New York Academy of Medicine, 1216 Fifth Avenue, New York, NY 10029. For more information and a full list of speakers, click here. Admission is free for medical students and health professionals with a current ID.



Our State Fair Is a Great State Fair!
Once again, the Onondaga County Medical Society is staffing the Medical Society of the State of New York/New York State Society of Anesthesiologists booth at the state fair with volunteer Medical Society physician members. The state fair runs through September 2.

Doctors and Phil Schuh at the State Fair

(left to right) Onondaga County Medical Society Director of Finance Debbie Colvin; Dawn Nendza, LPN; MSSNY Executive Vice President Philip A. Schuh, C.P.A., M.S.; and former MSSNY Councilor Jef Sneider, MD at the Medical Society of the State of New York/New York State Society of Anesthesiologists booth at the New York state fair.

Phil Schuh at the State Fair

MSSNY Executive Vice President Philip A. Schuh, C.P.A., M.S. utilizes the services provided to fair goers at the Medical Society of the State of New York/New York State Society of Anesthesiologists booth at the New York state fair.


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New Study Finds that Levels of Marijuana Use Disorder Continue to Rise
This week, the Substance Abuse and Mental Health Services Administration released the 2018 Annual National Survey on Drug Use and Health (NSDUH). According to the survey, 45,000 more teenagers are regularly using pot, marijuana users are more likely to abuse opioids than non-users, and levels of marijuana use disorder continue to rise.
The study found that an average of 8,400 Americans aged 12 or older tried marijuana for the first time each day in 2018. This is an increase of 100 users per day from last year’s study. Furthermore, the majority of people in 2018 who reported first time marijuana use were between the ages of 12-25.

Approximately 4.4 million people aged 12 and older had a marijuana use disorder in the last year. Breaking this out further, 2.1 percent of youths aged 12-17, 5.9 percent of young adults aged 18-25, and 0.9 percent of adults 26 and older suffered from a marijuana use disorder. The percentage of young adults with a marijuana use disorder is significantly higher than last year and is the highest it has been since 2004. Read more here.


Have You Visited MSSNY’s Podcast Site Yet?
MSSNY proudly announces the addition of two new podcasts to our podcast site here.  You will find podcasts on a variety of timely and relevant topics from the current measles outbreak to emergency preparedness to veteran’s matters and adult immunizations.  Our latest podcast productions include The Mental Health Needs of Women in the Military and Health Matters for Women: Endometriosis.  Go here and check out all of the podcast MSSNY has on offer.


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WCB – New Injured Worker Prescriptions Must Be Consistent with Formulary by December 5
The NYS Workers Compensation Board recently issued a Bulletin reminding physicians and other care providers that, pursuant to the recently-adopted WCB Drug Formulary, as of December 5, 2019, any newly prescribed medication to their injured worker patient must be for a medication listed on the Drug Formulary, unless the physician obtains prior authorization for the non-formulary medication.

On or after June 5, 2020, all refills or renewals of prescriptions must use a Drug Formulary medication unless prior authorization has been obtained before the date of the refill or renewal.

  • A refill means any subsequent fill of a prescription when the number of refills is explicitly included in the original prescription.
  • A renewal means a prescription that the injured worker has been taking but for which there are no available refills.

Insurers, self-insured employers and third-party administrators must notify medical providers and injured workers by December 5, 2019, that a currently prescribed drug is not included on the Drug Formulary.

With regard to opioid medications, the bulletin also notes that the Drug Formulary does not include narcotics/opioids after the first 30 days following an injury (except in the immediate pre- and post-operative period).  It also notes the following:

  • On or after December 5, 2019, during the 30 days following an injury, narcotics/opioids may not exceed a single seven-day supply; and,
  • Prior to June 5, 2020, medical providers and injured workers must plan for a transition to a Drug Formulary medication. If such a transition is not medically appropriate, the medical provider must obtain prior authorization for a refill or renewal of a non-formulary narcotic/opioid well in advance of June 5, 2020.

Some Hospitals Use Text Messaging For Communication With Patients
Modern Healthcare reports on the use of text messaging for clinicians to communicate with patients. The article highlights the experience at Goshen Health in Indiana where clinicians use secure messaging apps to communicate with patients. The article quotes clinicians from Goshen offering advice for hospitals considering similar moves.


New DOH Report on Cigarette Smoking Among Adults in New York State
The New York State Department of Health announced this week the release of a new report on Cigarette Smoking among adults in New York State. The report is based on data from New York’s Behavioral Risk Factor Surveillance System and found that an estimated 2 million adults, or 14.1% of the state’s adult population aged 18 years and older, are current smokers. Between 2011 and 2017 the prevalence of adult smoking decreased 22%. Since 2014, however, the prevalence of adult smoking has remained relatively unchanged.

Rates of smoking remain highest among adults reporting frequent mental distress, defined as adults who report problems with stress, depression, or emotions on at least 14 of the previous 30 days (formerly referred to as poor mental health) (25.5%); adults enrolled in Medicaid (22.1%); adults who are unemployed (22.0%); adults living with disability (21.6%); adults with less than a high school education (20.0%); and adults with an annual household income of less than $25,000 (19.7%). The full report can be accessed here.


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RENTAL/LEASING SPACE

Shared NYC Medical Space *Prime Flatiron Location* 17th Street and 5th Ave
Fantastic offering for shared sublease. Perfect for physician, physical therapist, psychotherapist, chiropractor, acupuncture, massage therapist, etcCentral HVAC system /High ceiling / Waiting area / Full-time use of the room /24/7 access and security. Up to 4 rooms for rent (for treatment or consultation) in shared medical office at prime NYC location. Telephone and Internet ready. Perfect for any medical professional. Included are: * Large reception area, fully equipped *Shared common areas *All utilities –electric, water, heat and A/C $ 4500 per month Part-time rates available Available September 1, 2019 Contact Information: jillian3335@gmail.com
Location: New York, NY, United States
17th Street and 5th Ave Main Lobby and Waiting Room



Ground Floor Office with Private Street Entrance in Luxury Park Avenue Building
Rental includes: two consultation rooms, private office, private bathroom.  Common waiting room, back office filing space and reception desks included.  Affordable rent.  Location East 60s between Park and Lexington.  Easy distance to Lenox Hill Hospital and New York Cornell.  Subway access within 1 block. Immediate 
occupancy available.  Call James: 917-710-7643


Fully Renovated Office Space for Part-Time Lease in Hauppauge
Available Tuesdays/Fridays, $450 half session, $750 full session. Elegant office space, beautiful waiting room with new stone and granite reception desk, custom molding, large windows, abundant natural light, TV, and refreshment counter.  Four new exam rooms and dictation room.  New stainless and granite kitchenette.  State-of-the-art network infrastructure meets HIPPA & PCI DSS compliance standards.  Digital X-ray room with PACS in each exam room available as an option.  Located in close proximity to LIE, Northern State Pkwy, and Vets Memorial Hwy. Contact us at (631) 486-8855;  Please see our listing
: https://www.loopnet.com/Listing/517-Route-111-Hauppauge-NY/15298633/



Office Rental 30 Central Park South
Two fully equipped exam, two certified operating, bathrooms and consultation room.  Shared secretarial and waiting rooms. Elegantly decorated, central a/c, hardwood floors. Next to Park Lane and Plaza hotels. $1250 for four days a month. Available full or part-time. 212.371.0468drdese@gmail.com.


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

Great Career Opportunities for Clinical Physicians
The NYS Department of Corrections and Community Supervision has great career opportunities for Clinical Physicians. You must have possession of a license and current registration to practice medicine in New York State, and have two years of post-licensure medical experience.

Starting salary is $143,381 – $171,631 *(Additional $10,000 or $20,000). Benefits include comprehensive health insurance, NYS retirement system, deferred compensation plan, flexible spending plan, and paid time off.

We have openings in the following counties offering a choice of urban, suburban or rural living:

Clinton*                  Clinton Correctional Facility (sporting and recreational outlets)
Dutchess                 Fishkill and Green Haven Correctional Facilities (Hudson River Valley Beauty)
Franklin*                 Franklin and Upstate Correctional Facility (North Country, 1 hour to Montreal)
Greene*                  Greene Correctional Facility (rural charm yet only 2 hours to New York City)
Oneida                    Mohawk Correctional Facility (Cooperstown, breweries)
Sullivan                   Woodbourne Correctional Facility (mountains, outlets, casinos and entertainment)
Seneca*                  Five Points Correctional Facility (heart of wine country)
St. Lawrence           Riverview Correctional Facility (hiking, boating and museums)
Washington             Great Meadow Correctional Facility (Between Vermont & the Green Mountains)
Westchester            Bedford Hills Correctional Facility (Less than 1 Hour to NYC)

Contact: www.doccs.ny.gov or DOCCS Personnel Office at (518) 457-8132 for more information and to apply.

View of a doctor's office waiting area View of a doctor's office lobby

View of a doctor's office


 


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: chunt@mssny.org  Fax: (1-516) 833-4760 Equal Oppty Employer M/F


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

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 


MSSNY eNews: August 16, 2019 – There They Go Again

Arthur Fougner MSSNY Presiident

PRESIDENT’S MESSAGE
Arthur Fougner, MD
MSSNY President

MSSNY eNews
August 16, 2019

Vol. 22  Number 31


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Colleagues:

Divide et impera.” Julius Caesar

CMS has proposed a new fee schedule. True to form, some physicians will see an increase in Medicare payments. However, some will see a pay cut. Not unexpectedly, I received a call from an ophthalmologist about his 10% pay cut. He also noted that his colleagues in Endocrinology would receive a 10% increase and wondered if the Diabetologists would be splitting the difference for those patients with cataracts and retinal disease caused by their diabetes.

No matter where in this equation your particular practice is located, whether a “winner” or a “loser,” realize that in truth we are all losers. Echoing my comments from last week, when others are able to pit physician against physician, colleague against colleague, physicians lose. For many years now, this trend has made the practice of medicine less about profitability and more about viability. Rather than grumbling about whose slice of the pie is larger, we should be demanding (yes, demanding) a bigger pie.

For over a decade, Medicare payments have not kept up with inflation. It appears that Medicine has the dubious distinction of being an American endeavor which annually is treated to a cost of living decrease.

We need to stop being Only a Pawn In Their Game.

What say you? Please feel free to address your comments to: afougner@mssny.org.

And do follow me on Twitter: @sonodoc99

Arthur Fougner, MD
MSSNY President 



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eNews


New York Approves Increased Rate for Individual Insurance Market
Crain’s New York Business (8/9) reported that New York’s “state Department of Financial Services said Friday it would allow insurers selling health plans to individuals to raise their rates by 6.8% on average for 2020, a reduction of about one-quarter from the 9.2% insurers requested from the state in May.”

The proposed reduction “represented a less drastic cut than the state levied last year, when it cut insurers’ requests by about two-thirds and granted an average increase of 8.6% in the individual insurance market.” The article added, “The 6.8% increase for 2020 will be the lowest since 2015.”


Nursing Home Associations Call for State Payment Reforms
New York’s nonprofit nursing homes say action from state lawmakers is needed to slow the transfer of facilities to for-profit chains. An analysis Crain’s last week showed 48 nonprofit nursing homes were sold to for-profit operators between 2014 and 2018. It noted that the attorney general’s office was increasing its scrutiny of such sales in light of the trend.

Leaders of two of the largest nonprofit nursing home associations, the Continuing Care Leadership Coalition and LeadingAge New York, told Crain’s they believe the state must go further. “The attorney general’s laudable efforts must be part of a multipronged approach involving the highest levels of New York state leadership to prevent further sales and closures of mission-driven, not-for-profit nursing homes,” wrote Scott Amrhein, president of CCLC, and James Clyne Jr., president and CEO of LeadingAge.

Amrhein and Clyne recommended increasing Medicaid payments to nursing homes, noting that a study commissioned last year found payment rates resulted in a $64 per-patient shortfall.

They also said Medicaid nursing home payments should return to a fee-for-service model administered by the state rather than the managed-care approach that has been adopted. Similarly, the restoration of a $246 million cut in the state budget, which lowered Medicaid rate adjustments based on residents’ acuity, also could boost nonprofits. (Crain’s Health Pulse, Aug 8)


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USPSTF Proposes Screening All Adults for Illicit Drug Use
On  August 13, the U.S. Preventive Services Task Force (USPSTF) issued a draft recommendation that providers screen all adult patients for illicit drug use, marking the first time the task force has proposed such a recommendation. According to STAT News, the draft recommendation is intended to help combat the U.S. opioid epidemic. A federal survey in 2017 found one in 10 U.S. residents older than age 18 reported using drugs or prescription drugs illicitly, and other research has shown more than 70,000 U.S. residents in 2017 died from a drug overdose, STAT News reports. USPSTF in 2008 had concluded that there was insufficient evidence to recommend that providers screen all adult patients for illicit drug use.

However, based on new evidence, USPSTF on August 13 proposed that providers screen all patients ages 18 and older for illicit drug use if the providers can offer or refer patients to services to accurately diagnose and effectively treat substance use disorders. USPSTF in the draft recommendation defined illicit drug use as the use of illicit drugs or prescription drugs in amounts and for durations or frequencies other than prescribed.

Recommend Questions Not Drug Tests

According to the draft recommendation, USPSTF found new evidence showing screening tools can allow providers to detect whether a patient is using drugs illicitly and whether a patient might need to be assessed further. However, Karina Davidson, co-chair of USPSTF, noted that the task force is not recommending providers use drug tests to screen their patients. Instead, USPTF said providers could ask their patients a series of questions to determine whether they are using drugs illicitly.

Based on the evidence, USPSTF concluded “with moderate certainty” that screening adult patients for illicit drug use has a moderate net benefit when providers can offer or refer patients to services to diagnose and treat substance use disorders. USPSTF did not endorse a particular screening tool or treatment, which means providers who follow the recommendations can decide how they will screen and treat their patients.

USPSTF gave a “B” grade to the draft recommendation. Under the Affordable Care Act, insurers are required to cover preventive services that receive a “B” grade or higher from USPSTF without cost sharing.


USPSTF Draft Did Not Extend to Adolescent Patients between the of 12 and 17
The task force said there was insufficient evidence to determine whether screening tools and treatments are safe and effective for adolescents. According to STAT News, the long-term effects of certain treatments on the developing brains of adolescents are unknown, which is why treatments such as buprenorphine are approved only for use among patients 16 and older. USPSTF in the draft recommendation called for additional research on screening tools and treatments for adolescents who use drugs illicitly.



AMA Speaks Against Pres. Trump’s Proposal to End Sexual Orientation Protections
On Monday, August 12, the American Medical Association (AMA) spoke out against the Trump administration’s misguided proposal to remove anti-discrimination protections related to sexual orientation, gender identity, and the termination of pregnancy across a wide variety of health care programs and insurance plans.

The AMA noted that the proposal perverts the nondiscrimination provisions included in the Affordable Care Act by drastically limiting coverage protections despite decades of case law recognizing these protections. The letter said: “This proposal marks the rare occasion in which a federal agency seeks to remove civil rights protections. It legitimizes unequal treatment of patients by not only providers, health care organizations, and insurers, but also by the government itself—and it will harm patients. Such policy should not be permitted by the U.S. government, let alone proposed by it.” The letter concludes: “HHS should not finalize the proposed rule, but rather should redirect their efforts toward advancing health care access and equity for all. The AMA remains ready to assist with such efforts.”

The full text of the letter can be downloaded here.


Garfunkel Wild Offers Discount to MSSNY Members for Nov. Symposium in NYC
Garfunkel Wild is pleased to offer a discount to members of the Medical Society of the State of New York to attend Garfunkel Wild’s 6th Annual ASC and Healthcare Management Symposium on November 1, 2019 in NYC.  This has been a highly successful program and over the years it has grown in content, attendees and sponsors.  The agenda includes speakers from New York, Connecticut and New Jersey who will present timely and important topics that should be of great interest to your members.

Please see the attached flyer which we hope you can market to your members.  Please note this discount (off the normal $350 registration fee) is only effective until September 15, 2019.


Medical Groups Raise Outcry Over New Immigration Rule
The Trump Administration’s new “public charge” rule released Monday could keep noncitizen immigrants from seeking necessary medical care, according to healthcare experts.

Under the rule (clocking in at 837 pages), immigrants’ financial status and past use of public assistance programs will be taken into account in deciding whether to approve applications for permanent residency (“green cards”) and visa renewals. Those with low incomes or little education, and who have used benefits such as Medicaid, food stamps, and housing vouchers, may be turned down because they’d be seen as more likely to need future government assistance.

The rule quickly came under attack.

“Today’s changes to how ‘public charges’ are classified will discourage noncitizen immigrants from seeking the care and other services they need and to which they are legally entitled,” said David Skorton, MD, president and CEO of the Association of American Medical Colleges.

The administration’s actions could worsen health disparities, Skorton said: “The consequences of this action will be to potentially exacerbate illnesses and increase the costs of care when their condition becomes too severe to ignore.”

The final rule expands the definition of “public charge” to include the use of non-cash programs that previously had been excluded, according to Samantha Artiga, director of the Disparities Policy Project for the Kaiser Family Foundation. Even before the rule was finalized, Artiga said anecdotal reports came from providers that immigrant families were not enrolling in certain public programs, despite being eligible. Providers said they also noticed women dropping out from the Women Infants and Children (WIC) supplemental nutrition program, even though that program isn’t included under the rule, she noted.

According to Ken Cuccinelli, acting director of the U.S. Citizenship and Immigration Services (USCIS), during a press briefing Monday, Cuccinelli said “self-reliance” has been a “core principle” of America for decades. He said his family came to the U.S. from Italy and “worked together to ensure that they could provide for their own needs and they never expected the government to do it for them.”

Public benefits that are part of the rule would include “general assistance,” such as supplemental security income, Supplemental Nutrition Assistance Program (SNAP, a.k.a. food stamps), most forms of Medicaid, and certain subsidized housing programs…The rule will apply prospectively to applications and petitions received starting on Oct. 15, 2019 of this year, Cuccinelli noted.

“Make no mistake — this rule is a threat to the health of immigrant children and families,” said Mark Del Monte, JD, CEO and interim executive vice president for the American Academy of Pediatrics. “The rule considers the use of public programs like Medicaid, SNAP, and housing assistance in this definition, forcing immigrant families into an impossible choice: keep your family healthy but risk being separated, or forgo vital services so your family can remain together in this country. This is really not a choice at all,” Del Monte said.

“The public charge rule further intimidates these families and expands on the chilling effects pediatricians have seen across the country ever since the proposed rule was issued, with families disenrolling from or avoiding critical health programs and services they are eligible for,” Del Monte added. (Medpage, August 12)


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How Anthem, UnitedHealth + 4 Other Payers Fared in Q2
Anthem, Centene, Cigna, Humana and UnitedHealth Group all reported higher profits in the second quarter of fiscal year 2019, while Molina Healthcare saw profits decline.

Here’s how the six payers fared in the three-month period ended June 30:

  1. Anthem reported total revenues of $25.5 billion, up 11 percent from $22.9 billion recorded in the same period a year prior. Anthem ended the second quarter with a $1.1 billion profit, up 8.1 percent year over year.
  2. Centene posted total revenues of $18.4 billion in the second quarter of this year, up 29.4 percent from $14.2 billion reported in the same period last year. Centene ended the quarter with a $495 million profit, up 65 percent from $300 million reported in the same period in 2018.
  3. Cigna saw its total revenues climb 238 percent year over year to $38.8 billion, compared to $11.5 billion in the year prior. Cigna ended the second quarter with net income of $1.4 billion, compared to $808 million reported in the same period a year prior.
  4. Humana saw its total revenues climb to $16.2 billion, up 13.9 percent from $14.3 billion recorded in the same period a year prior. The payer boosted its net income 387 percent in the second quarter of this year to $940 million, up from $193 million in the same period a year prior.
  5. Molina Healthcare‘s total revenue fell 14.1 percent to $4.2 billion, compared to $4.9 billion in the same quarter a year prior. Molina ended the quarter with net income of $196 million, down 3 percent from $202 million reported in the same period a year prior.
    6. UnitedHealth Group recorded total revenues of $60.6 billion, up 8 percent from $56.1 billion in the same quarter a year prior. After accounting for expenses, UnitedHealth ended the second quarter with net income of $3.3 billion, up 12.7 percent from $2.9 billion recorded in the same quarter of 2018. (Becker’s Payer Issues, Aug. 13)

21 companies affected by AMCA breach
Three more health care companies have notified patients that their personal information might have been exposed in a data breach at the American Medical Collection Agency. The companies’ announcements bring the total number of health care companies known to have been affected by the data breach to 21, and the total number of patients potentially affected by the breach to at least 24.4 million. (HIPAA Journal, 8/8)


Physicians Invited to DoctHERS 4th Annual Symposium in Buffalo on 9/21
The Jacobs School of Medicine and Biomedical Sciences’ Medical Alumni Association is proud to present the 4th Annual DoctHERS Symposium.

When;             Saturday, September 21, 2019
What time?     8:00 a.m. – 12:00 p.m.

Where?           The Westin Buffalo, 250 Delaware Avenue, Buffalo, NY 14202
Cost:               $25 general admissions; students and residents are free

Join us for a morning of networking, information, enrichment and resources for pay, promotions and equity in the workplace and support for females in the healthcare profession.

Dr. Rose Berkun, Co-Chair of MSSNYPAC, is the Chair of DoctHERS and is a Clinical Assistant Professor of Anesthesiology Jacobs School of Medicine and Biomedical Sciences.

2019 Symposium Registration
Registration is now open or the 2019 DoctHERS Symposium!

Learn more about DoctHERS here.

Keynote Speaker
 Susan Bailey MD Keynote Speaker

Susan R. Bailey, MD
President-Elect, American Medical Association
Allergist in private practice, Fort Worth, TX
Distinguished Fellow of the American College of
Allergy, Asthma, and Immunology

 

 

 


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Classified

RENTAL/LEASING SPACE

Shared NYC Medical Space *Prime Flatiron Location* 17th Street and 5th Ave
Fantastic offering for shared sublease. Perfect for physician, physical therapist, psychotherapist, chiropractor, acupuncture, massage therapist, etcCentral HVAC system /High ceiling / Waiting area / Full-time use of the room /24/7 access and security. Up to 4 rooms for rent (for treatment or consultation) in shared medical office at prime NYC location. Telephone and Internet ready. Perfect for any medical professional. Included are: * Large reception area, fully equipped *Shared common areas *All utilities –electric, water, heat and A/C $ 4500 per month Part-time rates available Available September 1, 2019 Contact Information: jillian3335@gmail.com
Location: New York, NY, United States
17th Street and 5th Ave Main Lobby and Waiting Room



Ground Floor Office with Private Street Entrance in Luxury Park Avenue Building
Rental includes: two consultation rooms, private office, private bathroom.  Common waiting room, back office filing space and reception desks included.  Affordable rent.  Location East 60s between Park and Lexington.  Easy distance to Lenox Hill Hospital and New York Cornell.  Subway access within 1 block. Immediate 
occupancy available.  Call James: 917-710-7643

Fully Renovated Office Space for Part-Time Lease in Hauppauge
Available Tuesdays/Fridays, $450 half session, $750 full session. Elegant office space, beautiful waiting room with new stone and granite reception desk, custom molding, large windows, abundant natural light, TV, and refreshment counter.  Four new exam rooms and dictation room.  New stainless and granite kitchenette.  State-of-the-art network infrastructure meets HIPPA & PCI DSS compliance standards.  Digital X-ray room with PACS in each exam room available as an option.  Located in close proximity to LIE, Northern State Pkwy, and Vets Memorial Hwy. Contact us at (631) 486-8855;  Please see our listing
: https://www.loopnet.com/Listing/517-Route-111-Hauppauge-NY/15298633/



Office Rental 30 Central Park South
Two fully equipped exam, two certified operating, bathrooms and consultation room.  Shared secretarial and waiting rooms. Elegantly decorated, central a/c, hardwood floors. Next to Park Lane and Plaza hotels. $1250 for four days a month. Available full or part-time. 212.371.0468drdese@gmail.com.


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

Great Career Opportunities for Clinical Physicians
The NYS Department of Corrections and Community Supervision has great career opportunities for Clinical Physicians. You must have possession of a license and current registration to practice medicine in New York State, and have two years of post-licensure medical experience.

Starting salary is $143,381 – $171,631 *(Additional $10,000 or $20,000). Benefits include comprehensive health insurance, NYS retirement system, deferred compensation plan, flexible spending plan, and paid time off.

We have openings in the following counties offering a choice of urban, suburban or rural living:

Clinton*                  Clinton Correctional Facility (sporting and recreational outlets)
Dutchess                 Fishkill and Green Haven Correctional Facilities (Hudson River Valley Beauty)
Franklin*                 Franklin and Upstate Correctional Facility (North Country, 1 hour to Montreal)
Greene*                  Greene Correctional Facility (rural charm yet only 2 hours to New York City)
Oneida                    Mohawk Correctional Facility (Cooperstown, breweries)
Sullivan                   Woodbourne Correctional Facility (mountains, outlets, casinos and entertainment)
Seneca*                  Five Points Correctional Facility (heart of wine country)
St. Lawrence           Riverview Correctional Facility (hiking, boating and museums)
Washington             Great Meadow Correctional Facility (Between Vermont & the Green Mountains)
Westchester            Bedford Hills Correctional Facility (Less than 1 Hour to NYC)

Contact: www.doccs.ny.gov or DOCCS Personnel Office at (518) 457-8132 for more information and to apply.

View of a doctor's office waiting area View of a doctor's office lobby

View of a doctor's office


 


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: chunt@mssny.org  Fax: (1-516) 833-4760 Equal Oppty Employer M/F


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

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 


MSSNYeNews: August 9, 2019 – House of Medicine Divided Cannot Stand

Arthur Fougner MSSNY Presiident

PRESIDENT’S MESSAGE
Arthur Fougner, MD
MSSNY President

MSSNY eNews
August 9, 2019

Vol. 22  Number 30


MSSNYPAC Seal


Colleagues:

“We must indeed all hang together, or most assuredly, we shall all hang separately.”
Benjamin Franklin

This week, famed physician-author Dr. Eric Topol generated quite a buzz with a piece in The New Yorker entitled “Why Doctors Should Organize.” Beginning with the recent #ThisIsOurLane pushback against a snarky NRA piece, Dr. Topol outlines past history of successes achieved when doctors organized. He rightly notes the rise of physician burnout engendered in no small part by electronic medical records which reduce caring professionals to data-entry clerks. The severing of the patient-physician relationship is also noted, thanks to the efforts of Regulators and Managed Care. Physicians, if organized, could be a powerful force but “the profession is balkanized.”

Where Dr. Topol and I part company is his assertion that Medical Societies should not be concerned with “protecting the interests of doctors.” While he is correct in recommending that a medical organization should promote the interests of the public, he’s somehow missed the history of, for example, the AMA post-Sunbeam. Eric, Medical Societies can and should do both. I’ll simply say that if physicians don’t stand up for ourselves and represent, who will?

So Dr. Topol, I am happy to continue this dialogue because you have clearly diagnosed the illness and the cure IS organizing. We must tear down the silos. We agree more than we disagree and I feel we can all work together for the good of our noble profession. We must. Our patients are counting on it.

Or, as Billy Joel put it, we will all go down together.

Arthur Fougner, MD
MSSNY President 

Comments? comments@mssny.org; @mssnytweet; @sonodoc99



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eNews

Physicians Must Make Their Voices Heard on Surprise Billing Proposals
Discussions are still ongoing regarding a national solution to surprise bills and the current incarnation winding its way through Congress would use a disastrous benchmarking system that would leave all of the power in insurers’ hands. Legislation such as S1895 and HR3630 would allow insurers to create an artificial ceiling for payment, giving market dominant insurers new incentives to drop physicians from their networks (as they have in California) and potentially limiting patient access to needed specialty care in in hospital emergency departments.

Given these threats, please take the time to send a letter to your members of Congress by going here. The letter is pre-populated and allows you to get the message to the right individuals in just a few short minutes.  Please also work with your local county medical society to arrange to meet with your Representative of Congress, as legislators are now home in their districts until the end of September.  To find your representative, go here, where you can find their contact information including phone number and Twitter handle. Please speak with their staffs and if possible, request a meeting to discuss the issue in more detail.

For more information about why this legislation is worrisome, check out the following articles. Congress is About to Give Health Insurance Companies the Nuclear Weapon discusses how it would control surprise billing mediation for any patient in an ERISA-regulated health plan and why that would likely lead to a massive cut in physician compensation. Congress, Don’t Harm Patients With The Wrong Surprise Medical Bills Solution also provides a strong overview of the topic.

MSSNY supports an approach such as HR 3502 (Ruiz-Roe-Morelle) that is modeled after New York’s acclaimed law which has shown to be remarkably effective and fair.   It mandates use of an independent dispute resolution system similar to New York’s instead of utilizing an insurer-determined benchmark.

Please do not let Congress give insurers even more ability to implement abusive tactics that interfere with needed patient care.


Five Measles Cases Reported in Mennonite Community in Wyoming County
Health officials say they’ve confirmed five cases of measles in a Mennonite community in western New York. The DOH says Thursday the cases were recorded in Wyoming County. The department has issued an advisory to notify regional health care providers of the potential for exposure.

Amid the nation’s worst measles outbreak in decades, Gov. Cuomo in June signed a law ending all non-medical exemptions for vaccines required for children to attend school in the state. The CDC Control has counted nearly 1,200 cases of measles in 30 states so far this year. About three-quarters of the cases are linked to outbreaks in New York.



FDA Investigating 127 Cases of Seizures After Vaping
The Food and Drug Administration is investigating 127 cases of people suffering from seizures after vaping, the agency announced Wednesday.

The agency received about 92 new reports of people, especially kids and young adults, experiencing seizures after using e-cigarettes since it first announced its investigation into the issue in April. The FDA said it’s unclear whether e-cigarettes caused the seizures and cautioned these cases occurred over a 10-year period.

When the FDA announced its investigation in the spring, it asked for people to let the agency know if they had ever experienced this. The FDA on Wednesday again encouraged people to report if they had seizures after vaping.

“We appreciate the public response to our initial call for reports, and we strongly encourage the public to submit new or follow-up reports with as much detail as possible,” acting FDA Commissioner Ned Sharpless said in a statement.

“Additional reports or more detailed information about these incidents are vital to help inform our analysis and may help us identify common risk factors and determine whether any specific e-cigarette product attributes, such as nicotine content or formulation, may be more likely to contribute to seizures,” he added.


Veterans’ Care Claims Inappropriately Denied
Veteran Affairs (VA) claims processors inappropriately processed claims for emergency care received at non-VA hospitals, resulting in denied or rejected claims for tens of thousands of veterans, according to a VA Office of Inspector General (OIG) report released this week. VA’s OIG noted that denied or rejected claims can leave veterans on the hook for the total costs of their care.



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Play Ball! Baseball Players May Live Longer than Other Pros and American Men
Professional baseball players may live longer than other professional athletes or American men overall, study indicates the New York Times (8/7) reports on a study published in JAMA Internal Medicine, in which researchers found that professional baseball players may have greater life expectancy than other professional athletes “and American men in general.”

The researchers also found that professional baseball players with long careers are less likely to die from cardiovascular disease and certain other diseases, but more likely to die from cancer, especially lung and skin cancer.


New Apps Give Updates to Waiting Family Members During Surgery
The Wall Street Journal (8/6) reports that startups and large healthcare companies are developing tools designed to give family members updates on the status of their relatives during surgery or hospital stays.


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USPSTF Recommends Against Pancreatic Cancer Screening
Reaffirming its 2004 statement, the U.S. Preventive Services Task Force (USPSTF) has issued a ‘D’ recommendation against screening for pancreatic cancer in low-risk adults with no signs or symptoms of this lethal disease.” The USPSTF authors wrote in their recommendation statement  published online in JAMA that “the USPSTF found no new substantial evidence that would change its recommendation and therefore reaffirms its recommendation against screening for pancreatic cancer in asymptomatic adults.”

The task force “concluded that screening has the potential for significant harm owing to the low prevalence of pancreatic cancer (12.9 cases per 100,00 person-years), the poor outcomes of treatment (5-year survival rate of only 9.3%), the limited accuracy of screening tests, and the invasive nature of diagnostic tests.”


Review Suggests Chronic Hepatitis Can Be Eliminated Globally
MedPage Today reports that “chronic hepatitis is a major public health challenge that can be eliminated globally, according to an infectious disease expert” who conducted a review study. The review study found that “although progress has been made in the prevention and treatment of chronic hepatitis C virus (HCV) and hepatitis B virus (HBV) infections, challenges remain.”

The author suggests one step to achieving elimination of hepatitis is that, “all patients with risk factors should be tested for HCV and HBV and all persons born between 1945 and 1965 should be routinely tested for HCV to prevent liver disease and hepatitis transmission.” Moreover, the researcher “advised that ‘all who are positive for HBsAg or HCV should be evaluated for treatment and those susceptible to HBV or HAV should be vaccinated.’” The findings were published in the New England Journal of Medicine. https://bit.ly/2OMkY8h


CMS Releases Proposed 2020 Medicare Rule; Significant Up & Down Specialty Impacts
CMS recently released a 1700-page proposed rule for the 2020 Medicare physician fee schedule (PFS). CMS notes that “with the budget neutrality adjustment to account for changes in RVUs, as required by law, the proposed CY 2020 PFS conversion factor is $36.09, a slight increase above the CY 2019 PFS conversion factor of $36.04.

On a positive note, the 3-year review of Medicare GPCIs would produce a slight upward adjustment to the Geographic Adjustment Factors for the 5 New York Medicare payment localities.

However, it should be noted that the proposed changes to Medicare payment proposed in this rule could produce some significant upward and downward adjustments to Medicare physician payment, based upon specialty, if CMS finalizes the proposal without modification. Please see Table 111 on pp.1187-1188 of the proposed rule for a possible specialty by specialty impact.

For example, it predicts an overall +16% increase for Endocrinology, +15% for Rheumatology, +12% for Family Practice and Hematology/Oncology, +8% for Urology and Neurology, and +7% for Ob-GYN and Allergy/Immunology.  On the other hand, it predicts an overall -10% decrease for ophthalmology, -8% for Radiology and Cardiac Surgery, and -7% for Anesthesiology, Emergency Medicine and Thoracic Surgery.  The AMA notes that this impact table “should be viewed with caution” as they believe it may contain some errors.

For more information from CMS on the proposed rule, click here.  For a comprehensive AMA summary of the proposed rule, click here.

The AMA provided state medical societies with an overview of 2 of the key components of this rule:

Changes to E&M Coding and the MIPS Program

  • Office Visits – Evaluation and Management – While retaining the important modifications to reduce documentation burden, CMS will implement coding and payment modifications in 2021 that are based on the resources required to perform various levels of office visits. This will ensure that physicians treating the sickest patients are not unfairly penalized, while providing simpler solutions to coding and documentation.

Following CMS’ proposal last year to collapse payment for office visits, the AMA coordinated a response from 170 national medical specialty societies and state medical associations urging a different solution. The CPT Editorial Panel and AMA/Specialty Society RVS Update Committee (RUC) convened a Workgroup, that adopted changes in February 2019, to document office visits on either medical decision making or time spent on the date of the encounter.  According to AMA, CMS accepted most of the CPT framework and RUC recommendations.  Among the key aspects of the Office Visit Proposed Rule:

  • Effective January 1, 2021, CMS will adopt the CPT guidelines to report office visits based on either medical decision making or physician time.
  • CMS adopted the RUC work recommendations for the office visit codes. The work value increases represent $3 billion in redistributed spending, resulting in a 3% reduction in the conversion factor.
  • CMS adopted the RUC physician time recommendations. Coupled with the work value increases and some modifications in direct practice costs, these changes lead to an additional $2 billion in redistributed spending, resulting in an additional 2% across-the-board reduction.
  • Two departures from the CPT and RUC recommendations that we will need to be addressed:
    • CMS would implement an add-on payment for office visits for primary care and patients with serious or complex conditions. This proposal redistributes an additional $2 billion, resulting in an additional 2% reduction to the Medicare conversion factor.
    • Although the surgical specialties participated in the RUC survey and their data and vignettes were incorporated into the RUC recommendations, CMS proposes not to apply the office visit increases to the global surgery packages.
  • Merit-based Incentive Payment System (MIPS) – The AMA noted that it is encouraged by results showing 95% of eligible clinicians successfully participated in MIPS in 2017, increasing to 98% in 2018 based on initial results. However, many physicians report that the current program is too costly and requires reporting for reporting’s sake, diverting time from patient care.

The AMA noted that, in the 2020 proposed rule, CMS embraced the AMA’s proposed concept for streamlining MIPS. The agency outlined a high-level framework and seeks feedback on an episode-based approach to MIPS, which it is calling the MIPS Value Pathways (MVP). The attached MVP diagram is included in the rule.

In the AMA’s view, an MVP-type approach could be a turning point for the program because an option that ties MIPS to episodes of care has the potential to be more clinically relevant, less burdensome, and a stepping stone to alternative payment models.  The AMA does have concerns with several specific aspects of MVP that CMS has proposed, such as a return to the use of controversial population health administrative claims measures that the AMA successfully fought to eliminate from the initial MIPS program.  CMS does not plan initial implementation of an MVP approach until 2021.

 

Classified

RENTAL/LEASING SPACE

Shared NYC Medical Space *Prime Flatiron Location* 17th Street and 5th Ave
Fantastic offering for shared sublease. Perfect for physician, physical therapist, psychotherapist, chiropractor, acupuncture, massage therapist, etcCentral HVAC system /High ceiling / Waiting area / Full-time use of the room /24/7 access and security. Up to 4 rooms for rent (for treatment or consultation) in shared medical office at prime NYC location. Telephone and Internet ready. Perfect for any medical professional. Included are: * Large reception area, fully equipped *Shared common areas *All utilities –electric, water, heat and A/C $ 4500 per month Part-time rates available Available September 1, 2019 Contact Information: jillian3335@gmail.com
Location: New York, NY, United States
17th Street and 5th Ave Main Lobby and Waiting Room


Ground Floor Office with Private Street Entrance in Luxury Park Avenue Building
Rental includes: two consultation rooms, private office, private bathroom.  Common waiting room, back office filing space and reception desks included.  Affordable rent.  Location East 60s between Park and Lexington.  Easy distance to Lenox Hill Hospital and New York Cornell.  Subway access within 1 block. Immediate 
occupancy available.  Call James: 917-710-7643

Fully Renovated Office Space for Part-Time Lease in Hauppauge
Available Tuesdays/Fridays, $450 half session, $750 full session. Elegant office space, beautiful waiting room with new stone and granite reception desk, custom molding, large windows, abundant natural light, TV, and refreshment counter.  Four new exam rooms and dictation room.  New stainless and granite kitchenette.  State-of-the-art network infrastructure meets HIPPA & PCI DSS compliance standards.  Digital X-ray room with PACS in each exam room available as an option.  Located in close proximity to LIE, Northern State Pkwy, and Vets Memorial Hwy. Contact us at (631) 486-8855;  Please see our listing
: https://www.loopnet.com/Listing/517-Route-111-Hauppauge-NY/15298633/



Office Rental 30 Central Park South
Two fully equipped exam, two certified operating, bathrooms and consultation room.  Shared secretarial and waiting rooms. Elegantly decorated, central a/c, hardwood floors. Next to Park Lane and Plaza hotels. $1250 for four days a month. Available full or part-time. 212.371.0468drdese@gmail.com.


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

Great Career Opportunities for Clinical Physicians
The NYS Department of Corrections and Community Supervision has great career opportunities for Clinical Physicians. You must have possession of a license and current registration to practice medicine in New York State, and have two years of post-licensure medical experience.

Starting salary is $143,381 – $171,631 *(Additional $10,000 or $20,000). Benefits include comprehensive health insurance, NYS retirement system, deferred compensation plan, flexible spending plan, and paid time off.

We have openings in the following counties offering a choice of urban, suburban or rural living:

Clinton*                  Clinton Correctional Facility (sporting and recreational outlets)
Dutchess                 Fishkill and Green Haven Correctional Facilities (Hudson River Valley Beauty)
Franklin*                 Franklin and Upstate Correctional Facility (North Country, 1 hour to Montreal)
Greene*                  Greene Correctional Facility (rural charm yet only 2 hours to New York City)
Oneida                    Mohawk Correctional Facility (Cooperstown, breweries)
Sullivan                   Woodbourne Correctional Facility (mountains, outlets, casinos and entertainment)
Seneca*                  Five Points Correctional Facility (heart of wine country)
St. Lawrence           Riverview Correctional Facility (hiking, boating and museums)
Washington             Great Meadow Correctional Facility (Between Vermont & the Green Mountains)
Westchester            Bedford Hills Correctional Facility (Less than 1 Hour to NYC)

Contact: www.doccs.ny.gov or DOCCS Personnel Office at (518) 457-8132 for more information and to apply.

View of a doctor's office waiting area View of a doctor's office lobby

View of a doctor's office


 


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: chunt@mssny.org  Fax: (1-516) 833-4760 Equal Oppty Employer M/F


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

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 


MSSNY eNews: August 2, 2019 – Yes! We Are Role Models!

Arthur Fougner MSSNY Presiident

PRESIDENT’S MESSAGE
Arthur Fougner, MD
MSSNY PresidentMSSNY eNews
August 2, 2019

Vol. 22  Number 29


MSSNYPAC Seal


Colleagues:

The Impossible Dream
To dream the impossible dream,
To fight the unbeatable foe,
To bear with unbearable sorrow,
To run where the brave dare not go.

Yesterday, I had the good fortune, thanks to Queens County’s own Dr. Allen Small, to attend a presentation on Cultural Competence – “When East Meets West” – presented under the auspices of the Chinese American Coalition for Compassionate Care. Familiarity with other backgrounds and perspectives is often the difference between success or failure of a doctor-patient relationship. That is one reason why one of our Past Presidents, Dr. Charles Rothberg, made diversity one of MSSNY’s pillars.

The thought occurred to me during a break that cultural perspectives often define future career choices. Such was the story of Carl Allamby of Cleveland. Carl’s family was of modest means and Carl got a job while in high school selling auto parts. He soon was working on cars after school and found he was really skilled at auto repair. Carl related that no one had ever spoken to him about college. The conversations were always about factory work or the military.

Carl kept at it and soon had his own garage, then another, while also selling used cars. His customers raved about him. Still something was missing, and Carl finally began taking college courses to get a business degree. He kept putting off one class – Biology. However, he finally relented when told it was mandatory for his degree. The class was pretty basic, taught by Dr. Micah Watts, resident in interventional radiology at Cleveland Clinic. The first class was a Eureka moment. Carl knew from that moment on that his true calling was medicine. He’d never really thought about it that much as a child – he had no role models. But now he did, as he befriended two African-American physicians at the gym. They told him to aim high, that he could do it.

Jaime Escalante, who taught advanced placement calculus in East Los Angeles, advised his students not to let anyone tell them what they would be. They alone determined their future. We should remember this when we interact with patients and their families. We should strive to be that role model.

Today, meet Carl Allamby, MD, Emergency Medicine Resident. As Paul Harvey would have put it, now you know the rest of the story.

“Don’t give up. Don’t ever give up.” Jim Valvano

Arthur Fougner, MD
MSSNY President 

Comments? comments@mssny.org; @mssnytweet; @sonodoc99


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eNews

MSSNY’s Statement re Creation of Maternal Mortality Review Board
“The Medical Society of the State of New York thanks Governor Andrew Cuomo and the Legislature for passing and signing into law the creation of a Maternal Mortality Review Board. The creation of a maternal mortality review board will assist the state in developing and creating new strategies to improve maternal health and lessen the impact of maternal mortality and morbidity. Under this law, the review board would allow multidisciplinary experts to conduct a review process of causes of maternal death, factors leading to death, preventability and opportunities for intervention.

It requires the board to report aggregate findings and recommendations in order to share best practices on the prevention of maternal deaths.  The law embraces national best practices on maternal health and ensures accountability and sustainability of a maternal review board.  It ensures that the board is diverse, multi-disciplinary and includes experts who serve and are representative of the diversity of women in medically underserved areas of the state. It also ensures confidentiality protections regarding the board’s proceeding and requires the board to report on its aggregate findings and recommendations,” stated Dr. Arthur Fougner, MSSNY President.


NY Physicians Still Have a Chance to Impact Surprise Billing Legislation
With federal legislators now on recess until the second week of September, it is prime time to contact them and set up meetings to discuss the surprise billing legislation that is making its way through Congress. If you are familiar with a member of Congress in your area, it is incumbent upon you to discuss this issue with them. And even if you’re not, as a constituent and a fellow New Yorker you have the right and duty to let them know how disastrous the policy in its current incarnation would be for doctors and their patients. To find your representative, click here. Please speak with their staffs and if possible, request a meeting to discuss the issue in more detail.

As stated in a highly informative article published recently, “Congress is About to Give Health Insurance Companies the Nuclear Weapon” as elected officials at the federal level continue to move legislation that would control surprise billing mediation for any patient in an ERISA-regulated health plan.

This bill is clearly slanted toward favoring insurance companies as it would utilize a benchmark of the “Median In-Network Price” to determine reimbursement for “surprise bills”. The reasons for which this would be disastrous to the physician community are outlined quite clearly in the above referenced article and it is estimated that this could cut physician compensation by greater than 60%.

There is hope however, that physician advocacy could move the needle as negotiations continue to occur. In addition to calling and meeting with them, please also take a moment to send a letter to your members of Congress by going to http://tiny.cc/SurpriseBIlling. The letter is pre-populated and allows you to get the message to the right individuals in just a few short minutes.



Be Sure to Listen to MSSNY’s Latest Podcast: Mental Health & Women in Military
MSSNY proudly announces our latest podcast entitled The Mental Health Needs of Women in the Military. Dr. Frank Dowling, MSSNY Secretary, discusses the history and challenges faced by women in the military with Dr. Malene Ingram, Colonel, US Army Reserves and Marcelle Leis, CMS (Ret.) USAF/ANG and Lance Allen Want, Lt. Col. (Ret.) USA.  Listen here.


Webinar for Measles and Repeal of Non-Medical Exemptions
New York State Health Commissioner, Dr. Howard Zucker, invites physicians to attend a webinar on the recent measles outbreak and information pertaining to the new law regarding non-medical exemptions for vaccinations and existing requirements for authorizing medical exemption.

During this presentation, New York State Department of Health staff will review the current status of New York’s measles outbreak, discuss current reporting requirements, the importance of case investigations and monitoring of exposed individuals and control strategies in healthcare facilities. This webinar is an opportunity to partner with the provider community to prepare for the upcoming school season and discuss activities underway to implement the new legislation.

Date: Tuesday, August 13th 3-4PM 

When we have more information, we will let you know.



 

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RFK Files Second Suit Challenging “Medical Exemptions Only” Vaccine Law
Robert F. Kennedy Jr. and other opponents of a law ending New York’s religious vaccination exemption have filed their second lawsuit challenging the repeal. The challenge, filed in the U.S. District Court for the Eastern District of New York on behalf of several unnamed children, contends that the legislation should be overturned because it violates the Individuals with Disabilities Education Act. (Politico July 29)


MSSNY Past President Dr. Robt. Goldberg Appointed to AMA Guides Editorial Panel
MSSNY is proud to report that Dr. Robert Goldberg has been selected by the American Medical Association (AMA) to serve on the AMA Guides Editorial Panel. Dr. Goldberg was nominated by MSSNY for the position, and was selected by the AMA from a large pool of candidates who submitted their resumes for the position.

Dr. Goldberg will work to modernize the AMA Guides to the Evaluation of Permanent Impairment.  The panel ‘s goal is to deliver the most current evidence-based medicine to the community in ways that address the most common challenges experienced by physicians, workers’ compensation organizations and the broad stakeholder community.

The Editorial Panel—which is comprised of physician experts in the field of impairment and disability and impairment experts from the legal and workers’ compensation community—will work based on published guidelines and acceptance criteria, and will utilize a stakeholder comment process similar to that used in CPT.

Dr. Goldberg has a strong background in the area of physician impairment and workers compensation policy. He currently serves as a consultant to the Workers’ Compensation Board of the State of New York. In addition to his private practice work in the area of Physical Medicine & Rehabilitation, Dr. Goldberg provides Rehabilitation Services at Beth Israel Hospital in New York City.


Garfunkel Ad


United: “Average Price for Treating Primary Care Conditions in ED? $2,032”
Each time a patient enters the emergency department with a condition that can be treated in a primary care setting, it comes at an average cost of $2,032 to the healthcare system, according to an analysis published by UnitedHealth Group.

UnitedHealth said the average cost is 12 times higher than visiting a physician office, which costs an average of $167. It also said the $2,032 price tag is 10 times higher than an urgent care visit, which costs an average of $193. “In other words, visiting either a physician’s office or an urgent care facility instead of a hospital would save an average of more than $1,800 per visit — creating a $32 billion annual savings opportunity system wide,” according to UnitedHealth.

UnitedHealth said the 10 most common conditions treated in the ED that could be treated in a primary care setting are bronchitis, cough, dizziness, f­lu, headache, low back pain, nausea, sore throat, strep throat and upper respiratory infection. UnitedHealth projects 18 million of the 27 million ED visits made by privately insured Americans each year are avoidable.


Garfunkel Wild: PRE-SYMPOSIUM WEBINAR on Resolving Payer Obstacles

Date:         Thursday, August 8, 2019
Time:         12:00 PM – 1:00 PM EDT

Overview: Providers are finding it increasingly difficult to administer and maximize the reimbursement available through their payer contracts. This webinar will discuss practical tools and strategies that providers can adopt to best overcome these obstacles.

Speakers: Garfunkel Wild Partner-Directors

Debra A. Silverman and Roy W. Breitenbach,  Grassi Healthcare Advisors, and LLC Senior Manager Alicia Shickle

Registration: Click Here To Register

Limited space available additional information please visit our website at nymetroasc.com on November 1,2019 in Manhattan or call 516-393-2294


AAP Issues Policy Statement on Racism in Child and Adolescent Health
The American Academy of Pediatrics has issued a policy statement on the role of racism in developmental and health outcomes among children and adolescents.

Here are some of the many recommendations for clinicians, published in Pediatrics:

  • Establish a “culturally safe medical home” for patients in which “providers acknowledge and are sensitive to the racism that children and families experience.” This should include screening patients for perceived and experienced racism.
  • Evaluate patients reporting racism for mental health sequelae, including post-traumatic stress, anxiety, depression and grief. Make referrals for mental health care as appropriate.
  • Educate clinicians and office staff about providing culturally and linguistically appropriate care (see second link below for Health and Human Services guidance).

The AAP’s policy statement, linked below, offers numerous resources for clinicians.

Separately in Pediatrics, researchers report evidence that infants of color generally receive worse neonatal intensive care — in particular, neonatal mortality rates are higher at minority-serving hospitals.

LINK(S):
AAP policy statement in Pediatrics; HHS guidance on providing culturally appropriate healthcarePediatrics article on racial/ethnic disparities in the NICU


HHS Unveils Drug-Importation Plan
The Trump Administration announced yesterday that it will “create a way for Americans to legally and safely import lower-cost prescription drugs from Canada for the first time, reversing years of refusals by health authorities amid a public outcry over high prices for life-sustaining medications.”

In addition, HHS “also said it would allow drugmakers to bring drugs that they sell more cheaply in foreign countries into the United States for sale here.” The New York Times (7/31) reports, “The proposed rule would not apply to high-priced drugs like insulin or other biologic drugs…because of exceptions included in earlier legislation.” Moreover, “the separate F.D.A. guidance would permit importation of drugs, including insulin, only if the drug makers agreed to take part in the plan.”


CMS’ 2020 Proposed Rule Released that Will Reduce Paperwork
On July 29, CMS proposed major policy changes to ensure clinicians spend more time providing high-value care for patients instead of filing cumbersome paperwork. As part of CMS’s annual changes to the Medicare Physician Fee Schedule and Quality Payment Program, the agency’s proposals are aimed at reducing burden, recognizing clinicians for the time they spend with patients, removing unnecessary measures and making it easier for them to be on the path towards value-based care. This proposed rule builds on the Trump Administration’s efforts to establish a patient-driven healthcare system that focuses on better health outcomes, and is projected to save 2.3 million hours per year in burden reduction.

For the full press release describing this announcement, please visit here.

For a fact sheet on the CY 2020 Physician Fee Schedule proposed rule, please visit here.

To view the CY 2020 Physician Fee Schedule and Quality Payment Program proposed rule, please visit here.



MSSNYPAC’s Day at the Saratoga Races
Photo of doctors who attended A Day at the Races in SaratogaDr. Tom Madejski and Sandra Madejski; Paul and Patricia Hartigan; Don Young and Grace Young; Dr. Greg Pinto; Natalie Adler; Dominique Oliveria Adamec Michael Adamec; and MSSNY’s Alliance Co-Chair Barbara Ellman


Classified

RENTAL/LEASING SPACE

Photo of Park Ave building facadePrestigious Park Ave Office Near Lenox Hill Hospital for Sale
2,400 sq/ft on two levels with a separate 6×12 ft. storage closet. Fireplace in waiting room and consult room. Perfect for plastic surgeons, cosmetic dermatologists or other. $2,950,000 Call for details and appoint to view. 212-570-6060


 

 


Ground Floor Office with Private Street Entrance in Luxury Park Avenue Building
Rental includes: two consultation rooms, private office, private bathroom.  Common waiting room, back office filing space and reception desks included.  Affordable rent.  Location East 60s between Park and Lexington.  Easy distance to Lenox Hill Hospital and New York Cornell.  Subway access within 1 block. Immediate 
occupancy available.  Call James: 917-710-7643


Upper East Side Medical Office Space for Rent Part–Time
Beautiful, newly renovated medical office on the Upper East Side between Lexington and Park Ave. Full service building with 2 entrances, conveniently located near all public transportation. Office includes 2 consult rooms, 3 exam rooms, treatment area, 2 bathrooms, kitchenette and reception area with waiting room. The office is available on a part-time basis. Please call 212-288-2278 or e-mail eastsidemedical@usa.net for further information.
Upper East Side Office lobby and receptions area


Park Avenue Office Share-3 Days Per Week
Tasteful, bright, well-maintained medical office in prestigious building on Park Avenue at 94th Street.  Large waiting room and reception area, consultation room and 2 exam rooms available 3 days per week. Room for an
assistant or clerical help 5 days per week. 


Please email abgmdpc@gmail.com or call 987-5000


Medical Office Space for Rent!
Beautiful Newly Renovated Medical Office on the Upper East Side between Madison and Park Avenue! Conveniently located near all public transportation and Mount Sinai Hospital. Consult and Exam room available for rent part time or full time (see pictures). Please call 212-860-0300 or email
carnegiehill0062@gmail.com <for further information.
Pictures of office space for rent on Madison Ave




Fully Renovated Office Space for Part-Time Lease in Hauppauge
Available Tuesdays/Fridays, $450 half session, $750 full session. Elegant office space, beautiful waiting room with new stone and granite reception desk, custom molding, large windows, abundant natural light, TV, and refreshment counter.  Four new exam rooms and dictation room.  New stainless and granite kitchenette.  State-of-the-art network infrastructure meets HIPPA & PCI DSS compliance standards.  Digital X-ray room with PACS in each exam room available as an option.  Located in close proximity to LIE, Northern State Pkwy, and Vets Memorial Hwy. Contact us at (631) 486-8855;  Please see our listing
: https://www.loopnet.com/Listing/517-Route-111-Hauppauge-NY/15298633/



Office Rental 30 Central Park South
Two fully equipped exam, two certified operating, bathrooms and consultation room.  Shared secretarial and waiting rooms. Elegantly decorated, central a/c, hardwood floors. Next to Park Lane and Plaza hotels. $1250 for four days a month. Available full or part-time. 212.371.0468drdese@gmail.com.


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

Great Career Opportunities for Clinical Physicians
The NYS Department of Corrections and Community Supervision has great career opportunities for Clinical Physicians. You must have possession of a license and current registration to practice medicine in New York State, and have two years of post-licensure medical experience.

Starting salary is $143,381 – $171,631 *(Additional $10,000 or $20,000). Benefits include comprehensive health insurance, NYS retirement system, deferred compensation plan, flexible spending plan, and paid time off.

We have openings in the following counties offering a choice of urban, suburban or rural living:

Clinton*                  Clinton Correctional Facility (sporting and recreational outlets)
Dutchess                 Fishkill and Green Haven Correctional Facilities (Hudson River Valley Beauty)
Franklin*                 Franklin and Upstate Correctional Facility (North Country, 1 hour to Montreal)
Greene*                  Greene Correctional Facility (rural charm yet only 2 hours to New York City)
Oneida                    Mohawk Correctional Facility (Cooperstown, breweries)
Sullivan                   Woodbourne Correctional Facility (mountains, outlets, casinos and entertainment)
Seneca*                  Five Points Correctional Facility (heart of wine country)
St. Lawrence           Riverview Correctional Facility (hiking, boating and museums)
Washington             Great Meadow Correctional Facility (Between Vermont & the Green Mountains)
Westchester            Bedford Hills Correctional Facility (Less than 1 Hour to NYC)

Contact: www.doccs.ny.gov or DOCCS Personnel Office at (518) 457-8132 for more information and to apply.

View of a doctor's office waiting area View of a doctor's office lobby

View of a doctor's office


 


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: chunt@mssny.org  Fax: (1-516) 833-4760 Equal Oppty Employer M/F


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

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 


Medical Society Supports Creation of Maternal Mortality Review Board 


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

 

For Immediate Release
August 2, 2019

Medical Society Supports Creation of Maternal Mortality Review Board 

Statement attributable to:
Arthur Fougner, MD
President, Medical Society of the State of New York

“The Medical Society of the State of New York thanks Governor Andrew Cuomo and the Legislature for passing and signing into law the creation of a Maternal Mortality Review Board. The creation of a maternal mortality review board will assist the state in developing and creating new strategies to improve maternal health and lessen the impact of maternal mortality and morbidity.  The law embraces national best practices on maternal health and ensures accountability and sustainability of a maternal review board.  Maternal mortality is an important public health issue that must be addressed and the creation of this board is the first step.” Arthur Fougner, MD, MSSNY President.

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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.

MSSNY Contact:
Roseann Raia
Communications / Marketing
Medical Society of the State of New York
865 Merrick Ave.
Westbury, New York
516-488-6100 ext 302
rraia@mssny.org

 

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