MSSNY-eNews: September 27, 2019 – Lean on Me

Arthur Fougner MSSNY Presiident

PRESIDENT’S MESSAGE
Arthur Fougner, MD
MSSNY President

MSSNY eNews
September 27, 2019

Vol. 22  Number 36


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Colleagues:

Please swallow your pride
If I have things you need to borrow
For no one can fill those of your needs
That you won’t let show

Bill Withers

Physician stress, burnout, abuse, moral injury – there are many names but one thing is true. It’s a thing. Many common pathways sometimes drive physicians over the edge – figuratively but all too often, literally. Suicide is not painless. That a professional with all that’s invested in a career of caring could get to that point of utter desperation is a tragedy of more than Shakespearean proportions.

Physician suicide is not a new development. That physicians run a higher risk of suicide than any other profession has been known since the 1800s. But as Mark Twain said about the weather, everybody talks about it but no one seems to do anything about it.  Of course, there are many “holes” in the Swiss cheese effect at play. Many moving parts clearly need to be addressed. Recent attention has been paid to wellness programs.

When an untoward event happens in one large Pediatric Oncology Department, the entire team gets together to discuss, commiserate, empathize with the caregivers. Other groups have social events, trying to restore the camaraderie of the old doctors’ lounge that seems to have disappeared. These efforts are clearly laudable, but they often can only take the edge off.

Physicians know that reaching out for help can come with a price – they can lose their hospital privileges and sometimes their career. While the safety of patients is at stake, the safety of the physician is also in jeopardy. Physician, heal thyself is unworkable. We need action.

I am happy to report that some help is on the way. But it will take effort. AMA (yes, I know) has a program that, in three states, has actually borne fruit. The Medical Society of the State of New York is about to come onboard with this program. You will be hearing more about these efforts in the coming weeks. But of course, then the real work begins – getting various groups to buy in.

Administrators must support the effort with more than a nodding of heads which in the past has only led to the “weeping and gnashing of teeth.” Legislators and regulators must see their way clear to smoothing the road to get this done. Various specialty boards must examine the added stresses they themselves have placed on their members. Physicians must also buy in. Otherwise, we’ll continue to see a mounting butcher’s bill.

It’s time.

Once again, I give you Bill Withers.

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

Arthur Fougner, MD
MSSNY President



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eNews

MSSNY Supports Call to Ban Menthol-Flavored E-Cigarettes
The following statement from MSSNY president Art Fougner, MD was released to the press on September 26:

“The physician community in New York applauds Governor Andrew Cuomo for taking steps to add menthol-flavored vape products to the emergency ban in New York, which took effect last week. We are hopeful that the regulations will be formally expanded when Health Commissioner Howard Zucker, MD, JD convenes another emergency meeting of the Public Health and Health Planning Council, possibly as early as next week.

While flavored vaping products like “Cotton Candy” and “Captain Crunch” are obviously targeted to entice teens to vape, menthol-flavored vape products are equally alluring and should not be available to our youth.

As we attempt to stop this growing public health crisis in New York, we fully support the ban on all flavored e-cigarettes. The health of our children is at stake.”


Cost of Employer-Based Family Health Coverage Hits Record High: $20,576
The cost of health insurance offered to workers through their employers is increasingly unaffordable, according to an annual report from the Kaiser Family Foundation.

The report, which included more than 2,000 interviews with nonfederal public and private firms, found annual premiums for employer-based family health insurance grew to $20,576 this year, surpassing $20,000 for the first time. Year over year, the cost of employer-sponsored family coverage is up 5 percent. On average, workers are paying $6,015 toward the cost of their coverage.

The average premium for family coverage has grown 22 percent over the past five years, according to KFF. Over the past decade, premiums have grown 54 percent. This growth has significantly outpaced growth in workers’ wages or inflation.
To view the full report, click here.


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FDA Commissioner Says Agency Should Have Taken Action On Vaping Sooner
The Wall Street Journal (9/25) reports FDA acting commissioner Ned Sharpless said the agency acted too slowly to address vaping. Sharpless’ comments follow reports of hundreds of cases of vaping-related lung injuries, including several deaths.

The Hill (9/25) reports Sharpless told members of the House, “In retrospect, the FDA should have acted sooner, we should have begun regulating these devices sooner. But we’re going to catch up.” Sharpless added that “the agency is working to finalize guidance that will force e-cigarette manufacturers to submit their flavored products for review,” and following that, “all current flavored e-cigarettes — except tobacco— will be removed from the market.”


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This Week: Nearly 300 New Cases of Vaping-Related Lung Disease
The CDC now reports 805 cases of confirmed or probable lung injury related to vaping, including e-cigarette use. This is an increase of 275 in the past week. Forty-six states have reported cases.

Some 38% of cases are in people aged 21 or younger. A total of 12 people in 10 states have died. CDC surveillance page for vaping-related lung illness


Appeals Court Orders Judge: Take New Look at Liver Donation Policy
Bloomberg Law (9/25) reports that the US Court of Appeals for the Eleventh Circuit “ordered a district court judge to take a fresh look at whether to temporarily block the Administration’s new policy for distributing donated livers to patients waiting for transplants.” The appellate court “said Sept. 25 the district court must go back and look at whether the Health and Human Services secretary legally had to refer the new policy to the Advisory Committee on Organ Transplantation and post it for public comment in the Federal Register before implementing it.” The new policy is currently on hold.


 


Research Looks Into Long-Term Effects of Hurricanes on Seniors with Diabetes
A study suggests that “long after the winds have died down and the flooding has subsided, huge hurricanes like Katrina may be shortening people’s lives, especially when it comes to seniors with chronic diseases like diabetes.”

Investigators “studying the short- and long-term effects of hurricanes Katrina and Rita found that older individuals with diabetes who lived in areas impacted by the storms had a 40% higher risk of mortality in the month following the storms compared to elderly diabetics who lived in unaffected counties.” The findings were published in Diabetes Care.


Majority of Data Breaches Involve Information That Could Enable Identity Theft
Reuters (9/23) reports researchers found that “more than 70% of healthcare data breaches in the U.S. have involved sensitive demographic or financial information that could fuel identity theft.” The findings were published in the Annals of Internal Medicine.



NY Society of Addiction Medicine Poster Contest
NYSAM (NY Society of Addiction Medicine) is once again proud to sponsor a competition for medical residents interested in addiction to submit a presentation addressing how addiction affects patients in their specialties. This is now our third year with this successful program. We have had excellent presentations the past two years, and would like to again encourage residents to submit a presentation. Submissions do not require original research, but should demonstrate thoughtful reflection, keen observation, and creativity about addiction and how you can address it through your specialty.

Please click here for competition details/rules. The deadline for submission is December 2, 2019. 

The prize is a chance to present at the 2020 NYSAM Annual Conference at the Crowne Plaza Hotel Times Square on February 7-8, 2020. Two winning entries from across New York State will receive free transportation to the conference, a hotel room at the Crowne Plaza for one night, a $250 honorarium, and a plaque.

CME

RSVP Now for Veterans Matters: PTSD & TBI At NY County Medical Society
MSSNY and the New York County Medical Society are proud to announce Veterans Matters: PTSD & TB in Veterans scheduled for October 10th 2019 at 5:30pm at the Manhattan Eye, Ear & Throat Hospital (MEETH).  It is suggested that people arrive early for the opportunity to sign-in and grab refreshments. Early arrivers will also have the opportunity to sit in on the brief meeting of the New York County Medical Society’s Public Health Committee.

Veterans Matters: PTSD & TBI in Veterans
Where:  MEETH 210 East 64th St., Manhattan, NY
When:   Thursday October 10, 2019 5:30-8:15pm

Faculty: Adolph Meyer, MD

Educational Objectives:

  • Identifying signs and symptoms of PTSD & TBI
  • Examining evidence-based treatment modalities
  • Exploring military culture and methods to overcome barriers to treatment.

RSVP to Lisa Joseph at (212) 684-46-98 or email ljoseph@nycms.org 

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

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


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New Podcasts on Health Matters for Women
MSSNY proudly announces the addition of three new podcasts on Health Matters for Women to our podcast site here.  The podcasts offer a variety of timely and relevant topics from health topics that concern women to emergency preparedness to veteran’s matters and adult immunizations.  MSSNY’s latest podcast productions on Health Matters for Women are listed below.

Listen to Dr. Lisa Eng discuss Health Matters for Women: Endometriosis here.
Listen to Dr. Florence Shum discuss Health Matters for Women: Fibromyalgia here.
Listen to Dr. Florence Shum discuss Health matters for Women: Chronic Fatigue Syndrome (Myalgic Encephalomyelitis) here.


 

 

33rd Annual Conference of Medical Society Executives

Attendees gather at the 2019 Annual New York State County and Specialty Society Executives Conference in Hunter, New York. It is a tradition that enables executives from around the state to learn from and support each other in helping doctors to win the battles they face each day. MSSNY president Arthur Fougner, MD spoke to the group about MSSNY’s strategic initiatives, while MSSNY’s Chief Legislative Counsel Moe Auster recapped the 2019-2020 MSSNY priorities, including single payer. James Beckner, executive director of the Richmond Academy of Medicine in Virginia, spoke about the county’s award-winning experience in engaging early career physicians in society activities

Attendees gather at the 2019 Annual New York State County and Specialty Society Executives Conference in Hunter, New York this week. It is a tradition that enables executives from around the state to learn from and support each other in helping doctors to win the battles they face each day. MSSNY president Arthur Fougner, MD spoke to the group about MSSNY’s strategic initiatives, while MSSNY’s Chief Legislative Counsel Moe Auster recapped the 2019-2020 MSSNY priorities, including single payer. James Beckner, executive director of the Richmond Academy of Medicine in Virginia, spoke about the county’s award-winning experience in engaging early career physicians in society activities.


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



Park Avenue – Private Street Entrance, Same Block as Subway
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 Supports Call to Ban Menthol-Flavored E-Cigarettes

For Immediate Release

September 26, 2019

 

MSSNY Supports Call to Ban Menthol-Flavored E-Cigarettes


Statement attributable to:

Art Fougner, MD
President, Medical Society of the State of New York

“The physician community in New York applauds Governor Andrew Cuomo for taking steps to add menthol-flavored vape products to the emergency ban in New York, which took effect last week. We are hopeful that the regulations will be formally expanded when Health Commissioner Howard Zucker, MD, JD convenes another emergency meeting of the Public Health and Health Planning Council, possibly as early as next week.

While flavored vaping products like “Cotton Candy” and “Captain Crunch” are obviously targeted to entice teens to vape, menthol-flavored vape products are equally alluring and should not be available to our youth.

As we attempt to stop this growing public health crisis in New York, we fully support the ban on all flavored e-cigarettes. The health of our children is at stake.”

# # #

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


Media Contact:
Roseann Raia

Communications / Marketing
Medical Society of the State of New York
865 Merrick Ave.
Westbury, New York 11590
516-488-6100 ext.  302

 

 

Health officials call on New Yorkers to stop vaping amid uptick in illnesses

State health officials reissued a warning to New Yorkers on Friday encouraging them to stop using e-cigarettes and other vaping products amid a rise in vaping-related lung illnesses and deaths reported across the country in recent weeks.

Health Commissioner Howard Zucker issued updated guidance for health care providers with clinical information about the 81 known cases of severe pulmonary illnesses confirmed in New York, procedures for reporting case information and instructions on collecting devices for testing at the state’s Wadsworth Center.

Zucker urged New Yorkers of all ages “to stop vaping until we have better information on what’s causing this public health crisis.”

The renewed warning came just days after the Public Health and Health Planning Council adopted emergency regulations banning the sale of most flavored e-cigarettes in New York. The state Department of Health will begin enforcing the temporary policy, which exempted menthol and tobacco-flavored products, beginning on Oct. 4, health officials said.

Zucker, in pushing for the flavor ban, argued that it was needed to crack down on the recent spike in youth e-cigarette use, as well as to prevent new cases of vaping-related lung illnesses.

But while most of the lung illnesses reported in New York have been tied to black market products containing cannabis, the health commissioner told reporters earlier this week that he was not too concerned about vaping devices regulated and sold through the state’s medical marijuana program.

“There’s a risk-benefit issue here: If it’s truly the only thing [patients] can do — using a vaping product — they should know that the medical marijuana program is very closely monitored, and we have not found a problem with it,” he said Tuesday. “We would ask them to speak with the health care provider — the physician, the nurse practitioner — who has actually recommended that they use medical marijuana and whether there’s an option not vaping, or something else.”

The health department recently issued guidance on the use of vaping products for medical marijuana patients, which also noted that all New Yorkers are encouraged to stop using vape products until the case of vaping-associated illnesses nationwide can be better determined.

“There have been no adverse events related to vaping associated with an approved NYS Medical Marijuana Program product since the investigation began. However, out of an abundance of caution, we are also urging patients in the medical marijuana program to consult with their health care providers on potential alternatives to vaping products while the investigation continues,” it stated.

Stephen Dahmer, the chief medical officer for Vireo Health, which participates in New York’s medical marijuana program, said in a statement that his company’s products undergo strict “third-party safety testing to ensure that it does not contain contaminants like mold, fungus, pesticides and heavy metals.”

Vireo also does not add vitamin E acetate, a compound linked to vaping-related illnesses, in its products, he said.

To view online:
https://subscriber.politicopro.com/states/new-york/city-hall/story/2019/09/20/health-officials-call-on-new-yorkers-to-stop-vaping-amid-uptick-in-illnesses-1203631

MSSNY eNews: Watching the Detectives – September 20, 2019

Arthur Fougner MSSNY Presiident

PRESIDENT’S MESSAGE
Arthur Fougner, MD
MSSNY President

MSSNY eNews
September 20, 2019

Vol. 22  Number 35


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Colleagues:

On Monday, MSSNY applauded Gov. Cuomo’s emergency executive action to ban the sale of flavored e-cigarettes in the state. Flavored vaping products like “cotton candy” and “Captain Crunch” are obviously targeted to entice teens to vape. The health of our children is at stake. It’s time to address this head on before it affects an entire generation.

Vape Lung, VALI (Vaping-Associated Lung injury), Allergic Pneumonitis, Lipoid Pneumonia – these are all names for an acute and sometimes fatal lung injury which leaped into our lexicon as summer was coming to an end.  Seven deaths and over 400 cases have been reported thus far in 36 states and the US Virgin Islands. Presentation is often fulminant, yet cases with slower onset have been reported. While clinical presentation resembles lipoid pneumonia, imaging is not typical for that disorder. Reports have been associated with street level THC products.

NY’s Department of Health issued an update on September 5th:

As of September 5, 2019, the Department has received 34 reports from New York State physicians of severe pulmonary illness among patients ranging from 15 to 46 years of age who were using at least one cannabis-containing vape product before they became ill. However, all patients reported recent use of various vape products.

Laboratory test results showed very high levels of vitamin E acetate in nearly all cannabis-containing samples analyzed by the Wadsworth Center as part of this investigation. At least one vitamin E acetate containing vape product has been linked to each patient who submitted a product for testing.

At our meeting with NY State’s Commissioner of Health Dr. Howard Zucker on Tuesday, we were assured the Wadsworth Laboratory had not isolated any vitamin E acetate in any of NY’s Dispensary Medical Cannabis product.

Other investigators are not so sure Vitamin E is the only etiologic factor in vape lung, suggesting some patients have not fit the street pot Vitamin E pattern.

Curiously, the cases appear to be limited to the US and its territories. For example, Canada, despite its proximity, has reported no cases. There have been no cases thus far in the UK as well. The UK had banned certain flavored nicotine vaporizer oils because they contained diacetyl which had been linked to lung disease. Michigan and now New York have banned flavored e-cigs. We can only hope this makes a dent in the incidence of these cases.

Eerily reminiscent of the 1980’s Tylenol murders, the FDA has launched a criminal investigation. (See story below.)

For now, the take home message from WarGames applies – “The only winning move is not to play.”

We’ll all be watching the detectives.

Late-breaking news: Governor Andrew M. Cuomo and State Department of Health Commissioner Dr. Howard Zucker today re-issued a warning to New Yorkers to continue to refrain from using e-cigarette or vaping products as the number of vaping-associated illnesses sharply increases both nationally and in New York State. https://www.governor.ny.gov/news/governor-cuomo-and-health-commissioner-zucker-issue-renewed-warning-vaping-associated-illnesses

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

Arthur Fougner, MD
MSSNY President



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FDA Launches Criminal Probe as Vaping-Related Illnesses Top 500
In an update on the vaping crisis, federal health officials said today that, as of September 17, the number of confirmed and probable cases of lung injury associated with e-cigarettes and vaping products has climbed to 530 in 38 states and one territory, prompting the FDA to launch a criminal investigation into the possible causes.

“Sadly,” seven patients from six states have died as a result of their illness and “we do expect others,” Anne Schuchat, MD, principal deputy director, US Centers for Disease Control and Prevention (CDC), told reporters in a telebriefing.

She said the CDC will update case counts every Thursday going forward.

Earlier this week, the CDC activated its emergency operations center to help coordinate the investigation into the growing number of cases of severe lung illnesses linked to e-cigarette use.

The exact cause of vaping-related lung illness remains elusive. This investigation is “dynamic and complex and I wish we had more answers,” Schuchat said. “States are classifying cases and reporting them to CDC on a regular basis.”

She emphasized that “no consistent e-cigarette or vaping product, substance, additive, or brand has been identified in all cases; nor has any one product or substance been conclusively linked to lung injury.” Many patients reported using multiple types of products, some containing tetrahydrocannabinol (THC), THC plus nicotine, or nicotine only.

Based on available data, Schuchat said three quarters of the cases are males, two thirds are in people 18-34 years of age, 16% are younger than 18 years of age, and 17% are age 35 years or older. In all, more than half of the cases are under 25 years of age. Patients typically have reported cough, shortness of breath, and/or chest pain, gastrointestinal symptoms (nausea, vomiting, or diarrhea) as well as fatigue and fever.

The CDC continues to recommend that people consider not using e-cigarette products while investigations are ongoing.


Council Notes—September 19, 2019
Council approved the following:

  • MSSNY will recommend that the AMA seek legislation to ban anti-assignment provisions in health insurance plans and to support legislation requiring health insurers to issue payment directly to the physician when the patient or patient representative signs an agreement that permits payment directly to the physician.
  • MSSNY will advocate for increased payment for office based afterhours CPT Codes.
  • MSSNY will advocate for legislation and regulation requiring ALL credentialed physicians (employed and voluntary) be equally included on their hospital websites and Find-a-Doctor sites of the hospitals and other health care facilities and will recommend the AMA do the same.
  • MSSNY commends the Governor and the DOH Commissioner for their action to protect patients by banning sale of flavored e-cigarettes; recommends a moratorium on dispensing of vaporized products to new certificate holders for medical marijuana until data on long term safety is available; recommends rescheduling marijuana to Schedule II; and recommends funding in the State Budget for study of efficacy and harms of the current medical marijuana program.
  • MSSNY will create a Scope of Practice Ad Hoc Committee with the following members: Rose Berkun, MD, Co-Chair; Lisa Eng, DO, Co-Chair; Inderpal Chhabra, MD; Atul Kumar Gupta, MD; Richard Wissler, MD.
  • MSSNY will adopt the Accreditation Council for Continuing Medical Education (ACCME) Menu of New Criteria for Accreditation with Commendation. This year marks the end of a transition period in which CME providers had a choice between demonstrating the old commendation criteria and the new.  Additionally, MSSNY will adopt the revised CME Annual-Reporting Requirements for MSSNY-accredited CME providers.

Bills Signings Ramping Up – Physician Action Needed!
As of today, there were still 617 bills that passed both houses in 2019 that were awaiting delivery to the governor. In the past week alone, 59 bills were chaptered into law – the flurry of bill signings has begun. Of those 617, there are a few that stand out as priorities for MSSNY. When these bills arrive at the governor’s desk, he has to decide whether to sign them into law or to veto them and as such there is still a strong opportunity to influence the decision-making process.

Physicians can quickly and easily send a letter to the Governor here on these issues by using the MSSNY Grassroots Advocacy Center at http://tiny.cc/MSSNYGAC (direct links to these priority items are listed below). Please take a moment to voice your support/concerns on these very important issues!

  • Mid-year formulary changes – would prohibit a health insurer from removing a prescription drug from a formulary during the patient’s policy year.  Moreover, if the plan’s drug formulary has two or more tiers of drug benefits with different deductibles, copayments or coinsurance, the plan may not move a drug to a tier with higher patient cost sharing during the policy year. It also prohibits the plan from adding new or additional formulary restrictions during the policy year. Please reach out to the governor and let him know how helpful this bill would be by clicking here.
  • Partial prescription fills – would allow prescribers, in consultation with their patients, to prescribe up to a 30-day supply of a controlled substance with a notation to the pharmacist that they should only dispense the amount agreed to by patient and prescriber. Each partial fill would be dispensed and recorded in the same manner as a normal refill and the aggregate quantity dispensed across partial fillings may not exceed the overall total quantity prescribed. This measure should help to address patients’ pain while reducing the amount of leftover medication in households. Please encourage the governor to sign this legislation by clicking here.
  • Malpractice expansion – two bills passed the legislature that will further tip the scales in lawsuits against physicians and others, adding costs and potentially increasing your liability premiums while doing nothing to reform the current broken system. One would force physician defendants into making a “blind gamble” in cases involving multiple defendants where one defendant settles prior to trial and would enable in many cases the total payout to a plaintiff to actually exceed a jury’s award. The other would allow plaintiffs to collect a judgment from a third party that is not a direct party to the lawsuit in question. The bill would permit this to occur even though the plaintiff had not sued or perhaps could not have sued the third-party defendant in the first instance. Please let the governor know how destructive these bills would be by clicking here.


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Please Continue the Fight for a Fair Solution to Surprise Medical Bills; NY Law a Great Success
Please continue to contact Senators Schumer and Gillibrand, as well as your local Representative in Congress, in support of a fair federal legislative solution to the issue of surprise medical bills.  By clicking here, you can send a letter, make a tweet and make a phone call to your elected officials. It only takes a few minutes and contains all of the details necessary to get our point across.

This week, the NY Department of Financial Services released a report detailing the great success of New York’s surprise bill law enacted in 2014. In particular, the report found that between 2015 and 2018, consumers over $400 million and reduced out-of-network billing by 34%, in part through a reduction in costs associated with emergency services and an increased incentive for network participation.  Moreover, it noted that there were a total of 2,595 IDR decisions reached.  With regard to IDR for out of network hospital “surprise” bills, 815 IDR decisions were rendered. Health plans prevailed in 13% of the cases, while physicians prevailed in 48% of the cases. There were split decisions in 39% of the cases.   With regard to IDR for out of network emergency care services, 43% of decisions were in favor of the health plan, 24% were in favor of the provider, and 33% were split between the health plan and provider.

While MSSNY together with physician groups across the country are working diligently to refute the lies and half-truths expressed by the insurance lobby, more physician advocacy is urgently needed. MSSNY leadership and physician advocates have been meeting with key members of Congress to advocate for passage of legislation that emulates New York’s successful model, such as H.R.3502, sponsored by Representatives Ruiz and Roe. At the same time, grave concerns have been raised about the alternative being pushed by insurance companies (H.R.3630, sponsored by Representative Pallone, and S.1895-Alexander/Murray), that would limit payment in these surprise bill situations to an insurer controlled “median contracting rate”.

When California enacted a similar law a few years ago, what followed was a 48% increase in patient access to care complaints including delays in obtaining care or securing physician appointments, inadequate selection of providers, and problems accessing facilities.

United, Empire Aetna and many of the other market dominant companies already hold enormous power over physicians and their patients to dictate the terms of care delivery.  Please do not give them any more power.  Please contact your Senators and Representatives today!


New York’s Opioid Tax Creating Concerns
Fortune (9/16) reports that New York “became the first state to place an excise tax on opioids sold to or within the state,” with supporters expecting “the tax to generate $100 million in revenue for the state, which Gov. Andrew Cuomo and his administration have said will be plowed into helping victims of the opioid crisis.”

The idea behind the tax “was to punish pharmaceutical companies for their role in the opioid epidemic,” but “the tax, which went into effect July 1, has already set off a ripple effect across the entire supply chain, as manufacturers and distributors have either stopped shipping to the state altogether or passed the tax onto each other.” Additionally, regarding the fear of social costs, health officials are concerned “the tax could drive patients to seek out opioids on the black market.”

If you have patients who are having difficulty obtaining their opioid prescriptions, MSSNY wants to hear from you so that we can ascertain how widespread this problem is. Please email mauster@mssny.org with any information you have regarding this situation.


Weill Cornell: Free for Students Who Qualify
On Monday, Weill Cornell Medicine in New York City, announced that all students who qualify for financial aid will get a full ride: All costs will be covered by scholarships, including tuition, room and board, books and other educational expenses. “Student debt has been in the national discussion for a long time, and we have been planning, strategizing and raising money,” said Dr. Augustine M.K. Choi, the dean of Weill Cornell Medicine and provost for medical affairs at Cornell University. “It’s the right time to offer debt-free medical education.”

In 2017, Columbia University announced a new endowment that it said would eliminate the need for medical students to take out loans for tuition; the neediest would also have living expenses covered. The David Geffen School of Medicine at the University of California, Los Angeles, offers full rides to about 20 percent of its entering classes, though the awards are based on merit, not need. In August 2018, the New York University School of Medicine said it would cover tuition for all its current and future students.

Of Weill Cornell’s 373 students, 52 percent qualify for need-based aid. A single year at the school — which sits in one of America’s most expensive ZIP codes, on the Upper East Side of Manhattan — costs more than $90,000, according to Weill Cornell. With need-based grants for the last academic year averaging about $38,000, students often relied on federal loans to bridge the difference. The average debt for a graduate of the program this year was $156,851. (NYT Sept.16)


Zocdoc Gets Federal OK to Book Medicare and Medicaid Visits
Zocdoc would not violate the federal anti-kickback statue by charging physicians for each Medicare or Medicaid beneficiary who books an appointment through its website, according to an advisory opinion issued by the U.S. Department of Health and Human Services’ Office of the Inspector General.

The opinion does not mention Zocdoc by name but Dr. Oliver Kharraz, Zocdoc’s CEO, wrote a blog post sharing the opinion. Kharraz said Zocdoc will restore access to its appointment-booking service for all Medicare beneficiaries and Medicaid beneficiaries in certain states including New York on Sept. 18. Zocdoc began charging doctors per new patient booking earlier this year, frustrating New York doctors who had grown accustomed to paying a flat monthly fee for access to the services. At that time, it restricted Medicare and Medicaid beneficiaries from using the service to book appointments to avoid running afoul of federal law.

It has now received guidance from the state Attorney General, state Department of Health and HHS that its pricing policy wouldn’t violate the law with certain caveats. (Crain’s Sept.17)


Most Not Screening Patients for All Five Social Needs Recommended by Feds
Researchers found that “most U.S. physician practices and hospitals are screening patients for at least one social need, but only a small percentage are screening for all five social needs recommended by the federal government.” The five social needs are: Food Insecurity, Housing Instability, Utility Needs, Transportation Needs, and Interpersonal Violence.

The findings were published in JAMA.


CME

Sign Up for the Morning Briefing on October 17 in Binghamton
Strengthening Community and Health Care Provider

Resiliency to Adverse Childhood Experiences

Thursday, October 17, 2019 • 12 – 2 pm
UHS Binghamton General Hospital
Russell Community Room
10-42 Mitchell Avenue
Binghamton, NY 13903

The session will also be archived on the Department of Health website. The event is free of charge and available to all interested providers throughout New York State. Participants are eligible for 2.0 CME credits. Flyer.


MLMIC Presentation: Hot Topics in Healthcare: LIVE CME EVENT
Presenters:  MLMIC and MAGNACARE

When:           Tuesday, September 24, 2019
Time:             9:00 AM to 12:30 PM

Where:          Long Island Marriott, 101 James Doolittle Blvd. Uniondale, NY 11553 

Register online at www.mlmic.com/exclusive or e-mail your full name to pjorge@mlmic.com


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CMS

The Deadline to Submit a MIPS Targeted Review Request is 2 Weeks Away
If you participated in the Merit-based Incentive Payment System (MIPS) in 2018, your performance feedback, which includes your MIPS final score and payment adjustment factor(s), are now available for review on the Quality Payment Program website. The MIPS payment adjustment you will receive in 2020 is based on your final score. A positive, negative, or neutral payment adjustment will be applied to the Medicare paid amount for covered professional services furnished under the Medicare Physician Fee Schedule in 2020.

MIPS eligible clinicians or groups (along with their designated support staff or authorized third-party intermediary), including APM participants, may request for CMS to review their performance feedback and final score calculation through a process called targeted review. The deadline to submit your request is September 30, 2019 at 8:00 PM (EDT) – which is just 2 weeks away.

When to Request a Targeted Review

If you believe an error has been made in your 2020 MIPS payment adjustment factor(s) calculation, you can request a targeted review until September 30, 2019 at 8:00 PM (EDT). The following are examples of circumstances in which you may wish to request a targeted review:

Errors or data quality issues for the measures and activities you submitted

Eligibility and special status issues (e.g., you fall below the low-volume threshold and should not have received a payment adjustment)

Being erroneously excluded from the APM participation list and not being scored under the APM scoring standard

Note: This is not a comprehensive list of circumstances. CMS encourages you to contact the Quality Payment Program if you believe a targeted review of your MIPS payment adjustment (or additional MIPS payment adjustment) is warranted. We’ll help you to determine if you need to submit a targeted review request.

How to Request a Targeted Review

You can access your MIPS final score and performance feedback and request a targeted review by going to the Quality Payment Program website


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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

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 


MSSNY Applauds Governor Cuomo for Pursuing Emergency Regulations to Ban the Sale of Flavored E-Cigarettes 


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
September 16, 2019

MSSNY Applauds Governor Cuomo for Pursuing Emergency Regulations
to Ban the Sale of Flavored E-Cigarettes
 

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

“The physician community in New York thanks Governor Cuomo for his efforts to issue emergency regulations this week to quickly ban the sale of flavored e-cigarettes. The governor’s announcement came as health officials across the country investigate a rash of pulmonary illnesses and several deaths associated with vaping.

As the Governor pointed out in his announcement yesterday, the use of e-cigarettes among high schoolers more than doubled between 2014-2018 with 27% of high school students vaping. Flavored vaping products like “Cotton Candy” and “Captain Crunch” are obviously targeted to entice teens to vape.

The health of our children is at stake. It’s time to address this head on before it affects an entire generation.”

# # #

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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MSSNY eNews: September 13, 2019 – MSSNY Responds to Washington Post OpEd

Arthur Fougner MSSNY Presiident

PRESIDENT’S MESSAGE
Arthur Fougner, MD
MSSNY President

MSSNY eNews
September 13, 2019

Vol. 22  Number 34


MSSNYPAC Seal


Colleagues:

The following letter to the editor was submitted to the Washington Post on September 6, 2019.

To the Editor:

Physicians agree with the goal of legislation before Congress to protect patients from “surprise” medical bills.  It is unfortunate Dr. Ezekiel (Re “No One Likes Surprise Medical Bills…”, 9/5/19) failed to recognize the need for a balanced solution. Instead, he promotes the interests of the health insurance industry.

In 2014, New York physicians worked with state regulators and patient groups to enact a law protecting patients from surprise medical bills and established a balanced approach to determine fair payment.  When an insurer and physician cannot agree, the solution is decided through a low cost, simplified dispute resolution system. The arbitrator chooses the side that is more reasonable based upon a number of factors.  New York’s system has discouraged unreasonable billing and encourages negotiated compromises between physicians and insurers.

Importantly, New York’s law also addressed a key factor often leading to surprise medical bills – new rules to protect against narrow insurer networks. Legislation before Congress (HR 3502-Ruiz-Roe) would emulate New York’s acclaimed system.  It would take patients out of the middle while employing a simplified dispute resolution system.

We are very concerned with Congressional approaches that give insurers unilateral control to determine payment for surprise bills. It would undoubtedly be manipulated by market-dominant insurers to reduce their physician networks.  Worse, it could produce shortages in hospital emergency departments, a concern New York sought to prevent.

This is a serious problem that requires a thoughtful solution—not a one-sided giveaway to the insurance industry.

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

Arthur Fougner, MD
MSSNY President



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eNews

Assemblyman Walter Mosley Campaign Event

Dr. Moore, Council Leader Cumbo, Dr. Sweeney at the Assemblyman Walter Mosley Campaign Event

Dr. Donald Moore, Council Leader Laurie Cumbo, Dr. Monica Sweeney

Drs. Moore, Sweeney and Assemblyman Mosley at the Walter Mosley Campaign Event

Drs. Donald Moore, Monica Sweeney, and Assemblyman Walter Mosley


New York War on E-Cigarettes Breaks Out
Local state and now federal officials have declared war on e-cigarettes amid an outbreak of respiratory illnesses tied to vaping, but with little data to go on, it’s unclear regulatory efforts will stymie the health problems that have captured the public’s attention. In New York, the health complications from vaping are associated with cannabis oil, Health Commissioner Howard Zucker said, during a press conference Monday where Gov. Andrew Cuomo called for legislation banning flavored pods. Cannabis oil, and other recreational marijuana products, remain black-market items and would not be affected by curbing the availability of over-the-counter e-cigarettes and flavored pods.  (Politico New York Health Sept. 12)


NYCDOHMH: Nearly 15% of Middle School Students Used E Cigs
The New York City Health Department “revealed alarming new information Tuesday about the use of electronic cigarettes among New York adolescents and teens, and pushed the city to crack down on the device’s availability to the youth.” Last year, “about 13,000 middle school students, roughly 6.7%, reported using e-cigarettes and 29,000 students, about 14.4%, said they had tried them. Health Commissioner Dr. Oxiris Barbot said the numbers are concerning, particularly in light of recent studies that have shown that e-cig use leads to long term health problems.”


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DFS: Insurance Cannot Be Canceled for Carrying a Script for Naxalone
The state’s top insurance regulator said on September 6 that it’s illegal for insurance companies to deny life, disability income or long-term care insurance to applicants based solely on whether they carry a prescription for naloxone, a drug that reverses opioid overdoses.

The updated guidance from the state Department of Financial Services comes four months after Gov. Andrew Cuomo directed an investigation into reports that nurses and other first responders were being denied life insurance because they had a prescription for the drug known by the brand name Narcan.

Many had prescriptions as a preventative measure — in case they encountered someone in the field who overdosed and needed to be revived. But the department’s investigation found that insurers’ underwriting practices and guidelines did not distinguish between circumstances where an applicant had naloxone for their own use, or when they had naloxone for encounters with other individuals at risk of overdose.

The distinction is important, at least with insurance law, because companies are prohibited from discriminating against people of the same class and of “equal expectation of life” when approving coverage and setting rates. Carrying naloxone to prevent your own overdose could be seen as an indicator of shorter life expectancy, but carrying it to protect others would not.

“In the midst of a national opioid crisis, it is common sense for our nurses and first responders who work every day to keep New Yorkers safe to carry naloxone,” Cuomo said. “Denying them insurance coverage for doing their job to save lives is unacceptable, and today we correct this discriminatory practice.”

And it’s not just medical professionals who have taken to carrying it. Family members and friends of people struggling with addiction are also increasingly seeking prescriptions for naloxone as a way to keep their loved ones safe. In some cases, a prescription is not needed if individuals request it from a pharmacist or other official who has a “standing order” to dispense it without a prescription.

In guidance published, however, Deputy Superintendent for Insurance James Regalbuto instructed any insurer who has improperly denied coverage to “immediately reach out” to the rejected applicants to provide them with an opportunity to reapply for coverage. He also instructed insurers to “correct or remove” any record or report that may have been made to a third-party consumer reporting agency regarding an improper insurance denial.

First responders who have been denied coverage should contact the Department of Financial Services via its consumer complaint website (www.dfs.ny.gov/complaint) or by phone at 212-480-6400 or toll-free at 1-800-342-3736.


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FDA Experts Warn Medical Devices Are Vulnerable to Hacking, Errors
Experts attending a meeting of the FDA’s Patient Engagement Advisory Committee on Sept. 10 warned medical devices like insulin pumps and pacemakers can be prone to hacking and errors. At least two speakers at the meeting “described how easy it was to hack their own medical devices by reverse-engineering them.” Committee members also “repeatedly said that many devices and the instructions that come with them are cumbersome and difficult to understand.” One attendee also stated that the “fact that it is impossible to predict which types of cybersecurity risks can affect a given medical device can make it more difficult for healthcare providers to have meaningful conversations about risks and benefits.” Medscape (9/12)


Webinars

Health Matters for Women: Endometriosis

REGISTRATION NOW OPEN

The Medical Society of the State of New York will host a live continuing medical education (CME) webinar on women’s health topics entitled “Health Matters for Women: Endometriosison Friday, September 20th, 2019 from 7:30 AM to 8:30 AM.

To register for “Health Matters for Women: Endometriosis, please click here.  The faculty will be Lisa Eng, DO.   The educational objectives are: 1) Review potential causes of pelvic pain and discuss how to identify endometriosis. 2) Discuss the benefits and risks as well as the efficacy and limitations of available medical therapies for long-term treatment of endometriosis. 3) Discuss implementation of individualized endometriosis treatment plans and options.

For assistance in registering or any other questions, please contact Melissa Hoffman at mhoffman@mssny.org or call (518) 465-8085.

The Medical Society for 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 credit TM. Physicians should claim only the credit commensurate with the extent of their participation in the activity.



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CMS

CMS-1500 Resources: Video Available and Q&A Webinars Next Week
The Workers’ Compensation Board is offering new resources to assist in the transition to Form CMS-1500, which will streamline medical billing and reduce the paperwork requirements currently in the workers’ compensation system. To help you prepare, the Board has developed a training video to show health care providers, and all others who will be using Form CMS-1500, how to use the form and the required narrative reports to bill for their services to workers ‘compensation patients.

Next week, the Board is also holding two follow-up Q&A webinars so that you can get answers to any questions you may have after viewing the training video and reading the CMS-1500 FAQ’s on the Board’s website.

With that in mind, we encourage you to view the training video before attending one of the webinars. As you view the training video, take note of questions that come up so that you’ll be prepared for the Q&A webinar. This will enable you to take full advantage of both resources.

To view the training video, follow this link: CMS-1500 Training Video

The webinars will be held next week on:

In the meantime, please see CMS-1500 Initiative and the CMS-1500 FAQ for information. Please direct questions to CMS1500@wcb.ny.gov

Revalidate before your due date to avoid a hold on your Medicare payments and deactivation of your Medicare billing privileges.

There are several ways to find your revalidation due date:

Centers for Medicare & Medicaid Services (CMS) Revalidation List Tool

Search by National Provider Identifier (NPI) or name.

A due date of “TBD” (to be determined) means a revalidation due date has not been assigned by CMS.

You can access the YouTube video, “How to use the CMS Medicare Revalidation Tool

Revalidation notice mailed by National Government Services

Mailed in yellow envelope

Internet-Based Provider Enrollment, Chain and Ownership System (PECOS)

Sign in with user ID and password.

Generally, the due date will remain with the provider/supplier throughout subsequent revalidation cycles. So you will not have to wonder about the due date the next time you need to revalidate.

NOTE: Unsolicited applications received seven months prior to the revalidation due date will be returned to the provider.

Need assistance? Providers and suppliers can register for our provider enrollment webinars by either using the following links, Part A/Part B or by visiting the NGSMedicare.com website. The webinars below can be found under the Education Tab by selecting Webinars, Teleconference and Events.

Provider Enrollment Revalidation Overview
Getting Connected to PECOS
Submitting Revalidation via PECOS Application
Submitting Revalidation via CMS-855A Paper Application for a Part A providers
Submitting Revalidation via CMS-855B Paper Application for a Part B providers
Submitting Revalidation via CMS-855I Paper Application for a Part B providers
Let’s Chat about Provider Enrollment Revalidation
PECOS: View and Manage Reassignments through Group Enrollment


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Conferences / Events

Public Health Impact of Legalizing Cannabis
You are invited to join the New York State Public Health Association and the New York State Association of County Health Officials for the “Public Health Impact of Legalizing Cannabis.” Program content will address implications for public health, cannabis policy and health equity resulting from a legalized program. As New York State considers the passage of policy to establish an adult-use cannabis program, it is imperative that public health stakeholders unite to prepare for potential implications and learn about policy, regulatory and governance aspects related to legalization.

When:     17 Oct. 2019
TIME:      8:30 AM – 4:00 PM
WHERE: Hilton Westchester

Hear from nationally-recognized experts in partnership with your colleagues in the public health sector. Throughout this meeting, there will be plenty of opportunities for networking with professionals representing local health departments; academia; clinical care settings; community-based organizations and others who value the health and safety of communities in New York. For more information and to register, please click here.


2019 AIM: Advocacy in Medicine Conference

Sunday, September 22, 2019

Time:     8:30AM-4:00PM

Venue:   New York Academy of Medicine, 1216 Fifth Avenue &103rd Street, NYC             

Cost : Free for medical students and health professionals with current ID; advance online registration is required. REGISTER

The second annual Advocacy in Medicine (AIM) Conference will bring together healthcare advocates and trainees from various local academic institutions interested in health advocacy for 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.


4th Annual U of Buffalo DoctHERS Symposium; A Time of Urgency: Health Care Leaders Needed

When: Saturday, September 21, 2019

Time    8:00 am – 12:00 pm

Where: The Westin Buffalo, 250 Delaware Avenue, Buffalo, NY 14202

Join us for a morning of networking, empowerment, and education about
leadership development for women in health care professions.

Cost: $25 for General Alumni and Non-Alumni Guests; free for Students/Residents

More Details: The Jacobs School of Medicine and Biomedical Sciences’ Medical Alumni Association is proud to present the 4th Annual DoctHERS Symposium, featuring keynote speaker Dr. Susan R. Bailey, President-Elect, American Medical Association. We hope you will 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. MSSNYPAC Co-Chair Rose Berkun, MD is Chair of the event.

For more information on schedule and speaker biographies, please visit www.medicine.buffalo.edu/docthersnow


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

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 


Council – September 19, 2019

AGENDA
MSSNY Council Meeting
Thursday, September 19, 2019, 9:00 a.m.
Courtyard Marriott, Westbury Long Island
1800 Privado Road
Westbury, NY  11590

A.  Call to Order and Roll Call

B.  APPROVAL of the Council Minutes of May 30, 2019

C.  New Business (All Action & Informational Items)

    1. President’s Report
     a. Creation of Scope of Practice AD HOC Committee (For Council Approval)

Rose Berkun, MD, Co-Chair
Lisa Eng, DO, Co-Chair
Inderpal Chhabra, MD, Member
Atul Kumar Gupta, MD, Member
Julie Vieth, MD, Member
Richard Wissler, MD, Member

b. AMA Resolutions submitted by Dr. Michael Brisman
(For Council Approval)

  • Resolution 1&2 – AMA Position on Payment Provisions in Health Insurance Policies
  • Resolution 4 – AMA Should Provide a Summary of Its Advocacy Efforts on Surprise Medical Bills
  • Resolution 21 – AMA Will Specifically Seek to Improve the Current Medicare Fee Schedule for Physicians

2.  Board of Trustees Report – Dr. Sam Unterricht will present the report (handout)

3.  Secretary’s Report – Dr. Frank Dowling will present the report

4.  MLMIC Update  –  Dr. John Lombardo will present a verbal report

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

6.  MSSNYPAC Report – Dr. Thomas Lee will present the report (handout)

7.  MESF Update – Dr. Thomas Madejski will present the report

8.  County Federation Report – Dr. Aaron Kumar will present the report

9. Commissioners/Councilors (Action Items – (For Council Approval)

a. Commissioner of Socio Medical Economics, Howard H. Huang, MD
Committee on Health Insurance Resolutions

          Resolution 2019-255 Urgent Care in the Doctor’s Office
          Resolution 2019-266 Medicare Plan Survey for Patients

Committee on Workers’ Compensation & No Fault Resolution
(For Council Approval)

Resolution 2019-271 Shortage of Specialists in Workers’ Compensation System

b. Organized Medical Staff Section Resolution (For Council Approval)
Presented by:  Stephen Coccaro, MD, OMSS Councilor
Resolution SC 1 (AMA I-19) Hospital Website Voluntary Physician Inclusion

10. PresentationDr. Mitchell Katz, President and CEO of NYC Health & Hospitals
Verbal update on the following two topics:

  • Update on Physician Wellness
  • Update on the Health & Hospitals Access Program

D. Reports of Officers (Verbal Reports)

1. Office of the President – Arthur C. Fougner, MD
2. Office of the President-Elect – Bonnie L. Litvack, MD
3. Office of the Vice-President – Joseph R. Sellers, MD
4. Office of the Treasurer – Mark J. Adams, MD – Financial Statement for the period
(For Council Approval)

5. Office of the Speaker – William R. Latreille, Jr., MD
6. Report of the Immediate Past-President – Thomas J. Madejski, MD – MSSNY Committee Goals

E.  Reports of Councilors (Informational)

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

F. Commissioners (Informational Items)
1.   Commissioner of Communications, Maria A. Basile, MD, MBA
Report from the Division of Communications

2.Commissioner of Continuing Medical Education, Mark J. Adams, MD
Presented by Dr. Paul Pipia (on behalf of Dr. Mark Adams)

a. Report from the Office of CME (For Council Information)
b. MSSNY’s Annual Reporting Policy for MSSNY Accredited CME Providers
(For Council Approval)
c. Annual Fee for MSSNY Accredited Providers
(For Council Information – Discussed at the MSSNY BOT Meeting)
d. ACCME’s Menu of New Criteria for Accreditation with Commendation
(For Council Approval)

3. Commissioner of Governmental Relations, Gregory Pinto, MD
   a. Division of Governmental Affairs 2019 Legislative Summary

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

 5. Commissioner of Science & Public Health, Joshua M. Cohen, MD
   a. Committee on Emergency Preparedness & Disaster/Terrorism Minutes 6/27/19
     b. Task Force on End of Life Care Minutes 7/19/19

   6. Commissioner of Socio Medical Economics, Howard H. Huang, MD 
                (No written report submitted)

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

H. Report of the General Counsel, Barry Cepelewicz, MD, Esq. Garfunkel Wild, P.C.
(No written report submitted)

I. Report of the Alliance, Helena Mirza, Co-President
Alliance Report

J. Other Information/Announcements
1. MACRA Sign-on Letter
2. 2019 PDMP Update
3. Surprise Bill Sign-On Letter

4. The Physicians Foundation Board Meeting, August 2019
5. Accreditation Council for CME Letter & Highlights
6. AMA Letter – Nondiscrimination in Health & Health Education Programs or Activities
7. Coalition of State Medical Societies Letter – Request for Comment on Consumer Inflation Measures Produced by Federal Statistical Agencies
8. Amicus Brief Regarding Public Charge Rule

9. MSSNY Letter re IHA Anesthesia policy to DFS
10. Buffalo News – Another Voice: Protect against surprise medical bills, but preserve access, too, by Dr. Fougner
11.MSSNY Surprise Bill Letter to Senators Alexander & Murry

K. Adjournment

 

 

 

 

MSSNY eNews: September 6, 2019 – Consent of the Governed

Arthur Fougner MSSNY Presiident

PRESIDENT’S MESSAGE
Arthur Fougner, MD
MSSNY President

MSSNY eNews
September 6, 2019

Vol. 22  Number 33


MSSNYPAC Seal


Colleagues:

“To secure these rights, governments are instituted among men, deriving their just powers from the consent of the governed.” Thomas Jefferson, “Declaration of Independence”

Credit my colleague from the Great White North, Dr. Shawn Whatley, for this piece. Your Medical Society is your membership organization. While those in leadership may be quite learned in many ways, we are not you. We may think we know what you need but only you truly know what you need. From time to time, we all must reflect on what matters in our day to day lives. Views from 30,000 feet are never quite the same as they are on the ground.

In 1911, Robert Michels coined the Iron Law of Oligarchyall forms of organization, regardless of how democratic they may be at the start, will eventually and inevitably develop oligarchic tendencies. Over time, motivation shifts from that which is good for the members to that which is good for the preservation of the organization. Much of the time, motivation is in sync. However, some of the time, it is not. This is how organizations fail. Service organizations all too easily forget whom they serve. Leadership may be far more knowledgeable at the organizational level, yet deaf, dumb and blind to members’ daily lives.

Next week, we begin fashioning the MSSNY Legislative Agenda for 2020. So here is your opportunity to weigh in. What are YOUR asks – positive and negative? Please weigh in. What matters to you matters to us all. We may be your voice but we need your vibe.

So what say you?

  • Surprise Billing Interview: Dr. Ira Nash recently interviewed me on the subject of surprise billing for his radio program, Well Said with Dr. Ira Nash. Tune into WRHU 88.7FM this coming Monday, September 9 at 4 pm to listen to the program. 

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

Arthur Fougner, MD
MSSNY President



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eNews

Physician Advocacy Urged on Priority Bills Awaiting Governor’s Signature
As we move into fall, bills that passed during the 2019 session will begin to make their way to the Governor’s desk for action – to either be vetoed or signed into law. Currently, a few priority items for MSSNY that passed both houses this year are awaiting delivery to the. Physicians can quickly and easily send a letter to the Governor here on these issues by using the MSSNY Grassroots Advocacy Center here (direct links to these priority items are listed below):

  • Mid-year formulary changes – would prohibit a health insurer from removing a prescription drug from a formulary during the patient’s policy year. Moreover, if the plan’s drug formulary has two or more tiers of drug benefits with different deductibles, copayments or coinsurance, the plan may not move a drug to a tier with higher patient cost sharing during the policy year. It also prohibits the plan from adding new or additional formulary restrictions during the policy year. Please reach out to the governor and let him know how helpful this bill would be for patients by clicking here.
  • Partial prescription fills – would allow prescribers, in consultation with their patients, to prescribe up to a 30-day supply of a controlled substance with a notation to the pharmacist that they should only dispense the amount agreed to by patient and prescriber. Each partial fill would be dispensed and recorded in the same manner as a normal refill and the aggregate quantity dispensed across partial fillings may not exceed the overall total quantity prescribed. This measure would help to reduce unnecessary accumulation of leftover medication in households, and prevent diversion. Please encourage the governor to sign this legislation by clicking here. 
  • Malpractice expansion – two bills passed the legislature that will further tip the scales in lawsuits against physicians and others, adding costs and potentially increasing your liability premiums while doing nothing to reform the current broken system. One would force physician defendants into making a “blind gamble” in cases involving multiple defendants where one defendant settles prior to trial and would enable in many cases the total payout to a plaintiff to actually exceed a jury’s award. The other would allow plaintiffs to collect a judgment from a third party that is not a direct party to the lawsuit in question. The bill would permit this to occur even though the plaintiff had not sued or perhaps could not have sued the third-party defendant in the first instance. Please let the governor know how harmful these bills would be by clicking here.
  • Surprise Billing Legislation Poised to Move: Physician Action Urgently Needed!
  • With Congress set to return to DC, all eyes are on the competing pieces of surprise billing legislation that are up for debate. Rhetoric is heating up with insurance company hit pieces being posted in national media outlets such as the Washington Post in support of legislation to pad their bottom lines while potentially harming patient access to care through network terminations and inadequate specialty coverage in hospitals. It is imperative that physicians send a letter to Senators Schumer and Gillibrand, as well as their local Representative in Congress here. This link allows you to participate in a grassroots campaign that sends a message to your elected officials, through a letter, tweet and phone call. It only takes a few minutes and contains all of the details necessary to get our point across.
  • While MSSNY is working diligently with partners to refute the lies and half-truths expressed by the insurance lobby, more physician advocacy is urgently needed. MSSNY leadership and physician advocates have been meeting with key members of Congress to advocate for passage of the effective, sensible and bipartisan bill H.R.3502, sponsored by Representatives Ruiz and Roe. Further, grave concerns have been raised about the alternative being pushed by insurance companies (H.R.3630, sponsored by Representative Pallone, and S.1895-Alexander/Murray).
  •         New York’s acclaimed system is clearly working, with patients being removed from the fight, while physicians and insurance companies work payment out fairly via an independent dispute resolution process. This process is closely mirrored by H.R.3502, which is why MSSNY and physician groups across the nation support this legislation. Conversely, H.R.3630 is similar to California’s disastrous benchmarking system that has resulted in significant physician network terminations and reduced on-call specialty care access in emergency departments.
  • Moreover, this week a study was released attacking the Congressional Budget Office’s dubious claim about the savings that would accrue through disastrous proposals like HR 3630/S.1895
  • In particular, the report notes that the savings will not be what CBO has projected due to a) increased health system costs arising from an acceleration of hospital purchase of physician practices b) decreased tax revenue from physician practices and c) the premise of savings resulting decreased corporate health insurance premiums being faulty.
  • For more about the intense advocacy on this issue, please read this article in The Hill.
  • Please contact your Senators and Representatives today! 


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Responding to Physician Pushback, ABIM Announces New Option for MOC
Physicians certified by the American Board of Internal Medicine (ABIM) will soon have a new option that takes some of the pain out of maintaining their certification. In a letter sent to its diplomates, the ABIM board of directors announced that it plans to add a longitudinal assessment option for Maintenance of Certification (MOC) that will allow physicians to take shorter, more frequent tests online.

“As a result, the ABIM board in August committed to providing a longitudinal assessment option that will allow physicians to take tests online to maintain their board certification.

“We recognize that some physicians may prefer a more continuous process that easily integrates into their lives and allows them to engage seamlessly at their preferred pace while being able to access the resources they use in practice,” Marianne Green, M.D., chair of the board of directors, and Richard Baron, M.D., president and CEO said.

The American Board of Medical Specialties (ABMS), made up of 24 medical specialty boards including ABIM, has faced a backlash in recent years from physicians over tougher requirements and costs of MOC. That prompted changes in the process by those certifying boards, including the ability to take the exam online as well as allowing doctors to use clinical references to answer questions as they do in practice.

The ABIM said it is developing the new option, and, in the meantime, its current MOC program with the choice of its two-year “knowledge check-in” and traditional long-form exam physicians take every 10 years will remain in effect. The board, which certifies internal medicine doctors to practice in the specialty, said more details about the new option will be revealed in the months ahead as it looks for physicians to play an active role in providing feedback.

The ABMS said other boards have developed a longitudinal assessment option including the American Board of Colon and Rectal Surgery, the American Board of Dermatology, the American Board of Medical Genetics and Genomics, the American Board of Nuclear Medicine, the American Board of Otolaryngology-Head and Neck Surgery, the American Board of Pathology and the American Board of Physical Medicine and Rehabilitation.

The longitudinal assessment option will offer “a self-paced pathway for physicians to acquire and demonstrate ongoing knowledge,” said Green and Baron. However, the traditional long-form assessment will remain an option as some physicians prefer a point-in-time exam taken less frequently.

With the new option, physicians will be able to answer a question and receive immediate feedback as to whether it was correct, along with rationale and links to educational material. “By engaging in such a pathway, physicians can assure their medical knowledge is up to date and utilize—in real time—learning activities to address gaps,” they said.

The ABIM said it developed the new option based on feedback from internal medicine physicians including focus groups and interviews as well as information from other ABMS boards.

The ABMS said its member boards are exploring and piloting longitudinal assessment as part of their continuing certification programs. Longitudinal assessment draws on the principles of adult learning combined with modern technology to promote learning, retention and transfer of information, the group said. (Fierce Healthcare)


NY AG Leading Coalition to Allow Stays for Immigrants in Extreme Medical Need
New York Attorney General Letitia James is leading a coalition of 19 attorneys general in calling on the U.S. Citizenship and Immigration Services and U.S. Immigration and Customs Enforcement to provide answers regarding the status and oversight of the federal medical deferred action program, which has allowed immigrants to apply to remain in the United States if they are in extreme medical need. The attorneys general wrote a letter to the acting directors of the agencies that they are “deeply concerned by USCIS’s apparent decision to stop considering requests for medical deferred action.”




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.

For more information, please see the flyer. MSSNY members will receive a discount ($285) if you register before September 15! After September 15, the cost is $350.


New York Law Ends Religious Exemptions to Vaccinations
Opponents challenging the constitutionality of a New York law that ends religious exemptions to school vaccination requirements hit another roadblock this week as a state appellate court rejected their request to block the repeal. A four-judge panel of the State Supreme Court Appellate Division’s Third Judicial Department on Thursday denied Attorneys Michael Sussman and Robert F. Kennedy Jr.’s motion for a preliminary injunction in the case.

The New York Times (9/3) reports that as the new school year begins this week in New York, the parents of about 26,000 children “who previously had obtained religious exemptions to vaccinations, are facing a moment of reckoning.” A state law, “enacted amid a measles outbreak…ended religious exemptions to vaccinations for children in all schools and child care centers.”


 

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Physicians More Likely to Prescribe Opioids Later in the Day or Running Late
study published in JAMA Network Open on August 30 reveals that physicians were more likely to prescribe opioids later in the day and when appointments were running behind schedule.

The study utilized claims and electronic health data in 2017 for 678,319 patients with new pain who saw 5,603 physicians at health care clinics. The patients’ complaints ranged from back pain and headaches to muscle and joint aches. The researchers looked at the order of appointments and whether an appointment started at its scheduled time. Opioid prescriptions were compared to prescriptions of non-steroidal anti-inflammatory drugs and physical therapy.

Overall, physicians were 33% more likely to prescribe opioids later in the day and 17% more likely to do so if the appointment was running later than its scheduled time. NSAIDs and physical therapy prescribing did not change throughout the day.

When working with patients in pain who want opioids, offering them alternative therapies such as NSAIDs or physical therapy can require time-consuming discussions, Neprash said. “Prescribing opioids may be the quick fix when they do not have enough time to discuss non-opioid options.”

In 2017 there were six times the number of opioid related deaths compared to 1999. While much of the opioid epidemic is due to illicit drug use, prescription opioids still play a large role. The authors note that if prescribing practices remained constant throughout the day, 4,459 opioid prescriptions would not have been written in 2017.

Dr. Mark Linzer, director of the Office of Professional Worklife at Hennepin Healthcare in Minneapolis, “I suspect this is the tip of the iceberg: that time pressure has numerous adverse consequences…The conversation that avoids narcotics just takes time,” he said.


Feds Eyeing Unauthorized Vaping Products in Outbreak of Severe Lung Disease
Health officials are warning against the use of black market or unauthorized products for vaping as they investigate at least 215 cases of pulmonary illness potentially related to e-cigarette use. The Washington Post reports that authorities are investigating whether contaminants may be involved.

Officials also caution against using e-cigarettes in ways that are not intended by the makers, like dripping or dabbing. For dripping, users drop e-cigarette solvents onto the hot coils of the e-cigarette, resulting in more concentrated compounds. For dabbing, substances containing high levels of tetrahydrocannabinol (THC) or cannabidiol (CBD) are superheated in the device. THC and CBD use has been reported in many, but not all, cases.

Some patients who have developed pulmonary disease improved with corticosteroids. Antibiotics have not demonstrated a consistent effect. Several patients were diagnosed with lipoid pneumonia.

The CDC is recommending that clinicians:

      • Ask all patients who have used e-cigarettes in the past 90 days about whether they have had pulmonary illness.
      • Obtain a detailed history — including the substance, device, and methods used, and where products were purchased — in cases of severe pulmonary disease where e-cigarette use is suspected.
      • Coordinate testing with the appropriate health department if e-cigarette products are available for testing.

FDA MedWatch safety alert; CDC health advisory


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Surgeon General Warns About Marijuana’s Effects on Young Brains
U.S. Surgeon General Jerome Adams is warning about the dangers that marijuana poses to the developing brains of youth and fetuses. In an advisory released Thursday, he writes: “No amount of marijuana use during pregnancy or adolescence is known to be safe.

Until and unless more is known about the long-term impact, the safest choice for pregnant women and adolescents is not to use marijuana. “The percentage of pregnant women who said they had used marijuana in the past month doubled between 2002 and 2017 (from 3.4% to 7%). In 2017, over 9 million young people aged 12 to 25 said they had used marijuana in the past month. The Surgeon General says that frequent marijuana use during adolescence is tied to brain changes related to memory, attention, decision-making, and motivation. Fetal exposure is linked to disruption of the endocannabinoid system and lower birth weight. Surgeon General’s advisory HHS news release; Background: NEJM Journal Watch Women’s Health coverage of marijuana use in pregnancy


3500 Kidneys Discarded Every Year Due to Intense Regulations
There are 93,000 people in the United States waiting for a kidney transplant, and kidney disease kills about 5,000 U.S. residents on the kidney waiting list annually. Yet, a study published last week in JAMA Internal Medicine estimated the United States throws away at least 3,500 donated kidneys every year, mainly because of the “intense regulatory scrutiny of U.S. transplant programs.”


AMA Releases 2020 CPT Code Set
Updates to medicine’s common language reflect tech-enabled patient services

The AMA announced the release of the 2020 Current Procedural Terminology (CPT®) code set containing identifiers and descriptors assigned to each medical, surgical, and diagnostic services available to patients. There are 394 code changes in the 2020 CPT code set, including 248 new codes, 71 deletions, and 75 revisions. In making these updates, the CPT Editorial Panel considered broad input from physicians, medical specialty societies and the greater health care community.

Among this year’s important additions to CPT are new medical services sparked by novel digital communication tools, such as patient portals, that allow health care professionals to more efficiently connect with patients at home and exchange information. CPT has responded by adding six new codes to report online digital evaluation services, or e-visits. These codes describe patient-initiated digital communications provided by physician or other qualified health care professional (99421, 99422, 99423), or a non-physician health care professional (98970, 98971, 98972).

Additional CPT changes for 2020 include the new codes for health and behavior assessment and intervention services (96156, 96158, 96164, 96167, 96170 and add-on codes 96159, 96165, 96168, 96171). These codes replace six older codes to more accurately reflect current clinical practice that increasingly emphasizes interdisciplinary care coordination and teamwork with physicians in primary care and specialty settings.

New CPT category I codes are effective for reporting as of Jan. 1, 2020. To assist the health care system in an orderly annual transition to a new CPT code set, the AMA releases each new edition four months ahead of the Jan. 1 operational date and develops an insider’s view with detailed information on the new code changes.

The 2020 CPT codes and descriptors can be imported straight into existing claims and billing software using the downloadable CPT 2020 Data File.


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.

When:  Sunday, September 22, 2019

Where: New York Academy of Medicine, 1216 Fifth Avenue, NY, NY 10029

Time:    8:30 am-4:00 pm

For more information and a full list of speakers, click here. Admission is free for medical students and health professionals with a current ID.


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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