MSSNYeNews: Child Abuse, Physician Abuse – January 31, 2020

Arthur Fougner MSSNY Presiident

PRESIDENT’S MESSAGE
Arthur Fougner, MD
MSSNY President

MSSNY eNews
January 31, 2020

Vol. 23  Number 5


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Colleagues:

Wisconsin Drs. John Cox and Sadie Dobrozsi had their adopted infant daughter taken away – apparently because a Nurse Practitioner with the hospital Child Abuse Team mistook what Pediatric Dermatologists felt were birthmarks for bruises. Additionally, the baby had a bruise on her heel – the same heel where blood was taken. Although the test results were available for the Nurse Practitioner, she missed that they pointed in the direction of a possible bleeding and clotting disorder which could easily lead to that bruise. Dr. Dobrozsi was especially upset since she is a Pediatric Hematologist-Oncologist. Yet, there you are and the case is now wending its way through the courts as the couple now face criminal charges.

For the sake of brevity, I am oversimplifying but the issue here is clear – despite the opinions of fifteen medical experts, their child is now a ward of the state.

But wait, there’s more.  In another case a Nurse Practitioner accused an employed Indiana Ob-Gyn of rendering patient care while being under the influence. Despite the hospital’s not following its own substance protocol, including due process, the employed physician’s medical group suspended her with partial pay and she had to enter into a five year treatment program with Indiana’s version of CPH in order to keep her license. Though this physician is still in the treatment program, she filed suit against the hospital, the medical group and the Nurse Practitioner and won a $4.75 M verdict.

So, if anyone who’s reading this still doesn’t understand the problem of independent practice by “NotExactlies ®” or the threat to your career from a government agency’s overreacting to an allegation without due process, please feel free to contact me. And do come to Albany March 4 and let them hear from all of us. After all, it’s only your career.

Take your place on The Great Mandala
As it moves through your brief moment of time.
Win or lose now you must choose now
And if you lose you’re only losing your life


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

Arthur Fougner, MD
MSSNY President


Get Updates for Healthcare Providers on the Novel Coronavirus from DOH – Monday, February 3, 2020 4:00 pm
The NYC DOHMH and the NYS DOH will present updates on the outbreak,
review new guidance from the Centers for Disease Control, and discuss infection control considerations.


Capital Update


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Plan to Be in Albany on March 4th for MSSNY’s “Physician Advocacy Day”
As we begin to unpack the Governor’s budget proposal and the legislative work at the Capitol continues, the need for physician advocacy and grassroots involvement is greater than ever. With the Governor’s budget proposal teeing up items for potential concern such as huge Medicaid cuts, legalized marijuana and unfair changes to the physician disciplinary process, while also supporting reforms such as regulating PBMs and a flavored tobacco ban, it is imperative that physicians be in contact with their local legislators to ensure the physician community’s message is well-represented.

One opportunity is to participate in MSSNY’s “Physician Advocacy Day” that will be held on Wednesday, March 4th in the Lewis Swyer Theatre in the Egg located at the Empire State Plaza, Albany NY. Click here to register!

Join your colleagues from all around New York State and come to MSSNY’s Physician Advocacy Day to speak with your legislators and key policymakers to ensure they’re making the right choices for New York’s physicians and their patients.

A brief luncheon to which members of each House are invited to speak with their constituents will follow the morning program.  Please work with your County Medical Societies to schedule appointments for physicians to meet with their elected representatives.

If you have any questions/comments, please contact Raza Ali at rali@mssny.org.                                                                (ALI)


Wuhan Coronavirus (2019-nCoV) Response & Preparation Efforts
With the World Health Organization declaring the Wuhan Coronavirus a global health emergency, MSSNY is participating in a bi-weekly conference call with the New York State Department of Health regarding preparation and response efforts.  Gov. Andrew Cuomo said that test results for seven suspected cases of the new coronavirus came back negative and the state is still waiting for results on three other cases.  DOH has issued guidance on January 17, 2020 and a copy of that guidance is at:  Please Click Here

The DOH also has a website dedicated to the corona virus : Please Click Here.

MSSNY will be conducting two webinars regarding public health emergencies.  The first is a virtual drill scheduled for Feb. 19, 2020 and is entitled, “Incident Command System and Crisis Communications”.  The webinar is scheduled for 6-8 p.m. and its main objective is to obtain information about local, state, and national chain of command in a public health emergency and to understand the importance of planning for medical surge.  On March 18, 2029, there will be a webinar on Wuhan coronavirus (2019-nCoV), conducted by William Valenti, MD, chair of MSSNY Infectious Disease Committee.  More information will be available shortly on this.

MSSNY Medical Matters on February 19th from 6:00 – 8:00pm is a virtual drill on the “Incident Command System and Crisis Communications”.   While this drill uses another biological scenario, it does provide essential information from NYS DOH on the incident command system and communications that will be employed should the coronavirus outbreak becomes much larger.

Faculty for this program are: Arthur Cooper, MD; Pat Anders, MS, MEP; William Valenti, MD and Lorraine Giordano, MD.

Educational Objectives are:

  • Obtain information about local, state and national chain of command in a public health emergency and learn how to access resources
  • Understand the importance of planning for medical surge and triage of patients, as well as staff and family considerations, in the office-based practice setting during a health emergency
  • Develop an understanding that all public health emergencies can potentially have mental health implications for survivors and others connected with the event
  • Acquire skills for the management of patients in a public health emergency

Please note that there are recommended pre-course materials to be viewed prior to this virtual drill. You will be sent a link with your registration confirmation. We encourage all participants to examine these prior to the Virtual Drill.  Register by clicking here:

Please Click Here.

Additional information or assistance with registration may be obtained by contacting Melissa Hoffman at mhoffman@mssny.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 2.0 AMA/PRA Category 1 credits™.  Physicians should claim only the credit commensurate with the extent of their participation in the activity.
(CLANCY, HOFFMAN)


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MSSNY Presents Testimony Raises Concerns with a Number of State Budget Proposals
MSSNY Senior Vice President Moe Auster presented testimony to a joint Senate-Assembly Committee meeting examining the proposed State Health Budget proposals for Fiscal Year 2020-2021.  Among the issues MSSNY raised:

  • Strong objections to proposals that would permit the bypassing of long-standing physician due process when a complaint is filed is OPMC;
  • Strong objections to the recent 1% cut to physician Medicaid payments, as well as concerns regarding even deeper cuts that could be imposed to meet a $2.5 Billion Medicaid savings target;
  • Support for funding to extend the Excess Medical Malpractice Insurance program, but strong objections to the failure to include historical language extending the program
  • Strong objections to a proposal to permit the sale of recreational or “adult use” marijuana
  • Strong objections to the significant expansion of the existing physician-pharmacist collaborative drug program to include nurse practitioners and physician assistants.
  • Support for proposals to regulate PBMs
  • Support for proposals to limit the sale of flavored tobacco products and to help prevent the health risks associated with vaping
  • Support for health insurance reforms, including creation of an administrative simplification task force and health claims denial transparency report.

To view a video of the testimony, click here: Please Click Here.  You can either advance to the 8:04    mark or scroll to the direct link to Mr. Auster’s testimony.    (AUSTER)


MSSNY Continues to Push Back Against Troubling Proposal to Bypass Disciplinary Due Process
With Part L of Governor’s proposed Health Budget bill containing extremely troubling measures to bypass important due process protections for physicians during disciplinary proceedings, all physicians are urged to contact their legislators Please Click Here to urge that the Legislature reject this unfair proposal.

The proposal would, among many other provisions, make it far easier for the Commissioner of Health to disclose to the public that a physician is under disciplinary investigation or summarily suspend a physician without going through existing due process protections.

That is particularly troubling that only a small percentage of complaints to OPMC result in a disciplinary sanction. MSSNY has indicated that we agree with the importance of acting quickly when it is imperative, but these proposals would completely undermine important and longstanding due process protections. Given that most complaints are dismissed without any sanction or action, this series of proposed changes to bypass these rights would create a substantial possibility of unfairly destroying an innocent physician’s career. 

Please urge your legislators to reject this proposal from the Budget.   (AUSTER)


                                                                  

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Surprise Bill Resolution Heats Up in Congress – Contact Your Representatives Today
With key US House of Representatives Committees likely to present a new draft to address the issue of surprise medical bills, all physicians are urged to contact New York’s Senators Schumer and Gillibrand, as well as their respective Representative, to request that they enact a fair surprise bill law similar to New York’s highly acclaimed law. A letter can be sent from here.

With Congress under pressure to find new revenue sources to help fund the federal Budget once the existing Budget resolution expires on May 22, the Congressional Budget Office has erroneously identified grossly unfair surprise billing legislation sponsored by Rep. Pallone and Sen. Alexander (H.R. 3630/S.1895) as one revenue source.  Unfortunately, this proposal would give insurers the power to pay for surprise out of network bills based upon insurers’ self-determined in-network rates, with little power to meaningfully to seek a more fair payment.

This is significant contrast to New York’s law, which sought to strike a fair balance to ensure that on-specialty care in hospital emergency departments was not jeopardized and would not eliminate incentives for insurers to put together comprehensive physician networks.

New York physician leaders will be having meetings with key members of New York’s Congressional delegation on Capitol Hill the week of February 10th.  Their message will be that physicians very much agree with the goal of the legislation to protect patients from facing these bills, but disagree strongly with the solutions being offered.

Please contact your representatives today: Please Click Here. (AUSTER, CARY)


MSSNY Joins Radiologists to Oppose Proposed Changes to Scope-of-Practice for Physician Assistants Operating Fluoroscopy Imaging Technology
MSSNY Albany staff recently joined leaders of the NYS Radiological Society for a day of meetings with key lawmakers, in Albany, to express concerns over a bill (S1812/A2982) that would allow physician assistants (PAs) who complete a brief training program to operate fluoroscopy imaging technology as part of a diagnostic or treatment procedure.

Fluoroscopy is an x-ray-based technique that allows continuous imaging of an instrument, a body part, or dye as each is used during a diagnostic or treatment procedure. In a fluoroscopy procedure, an e-ray is passed through the body and the images are transmitted to a monitor so that movement can be detected and evaluated, It is used in cardiac, orthopedic, and other surgeries, as well as in diagnostic studies, among other medical procedures. Concerns over medical radiation exposure has grown in recent years, with the issue earning national attention.

MSSNY opposes this legislation as it does not require adequate time for training or appropriate supervision by a qualified physician. We will continue to monitor the issue and share updates as they happen.   (CARY)


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MSSNY Staff Participates in Final Session of Department of Health (DOH) Workforce Workgroup
MSSNY Albany staff recently attended the latest session of one of the DOH’s workgroups charged with examining the workforce aspects related to the Delivery System Reform Incentive Payment (DSRIP) program. DSRIP is the main mechanism by which New York State implemented its Medicaid Redesign Team (MRT) in 2014.

DSRIP´s charge since then has been to fundamentally restructure the state’s health care delivery system by reinvesting in the Medicaid program, with the primary goal of reducing avoidable hospital use by 25% over 5 years. Up to $6.42 billion was allocated to the program, with payouts based on results in system transformation, clinical management and population health. The project included extensive work by the following subcommittees of the workforce workgroup:

·        Barriers to Effective Care Coordination

·        Care Coordination Curriculum

·        Care Coordination Training Guidelines

·        Health Care Data

·        Primary Care and Behavioral Health Integration

·        Workforce Compendium

Leaders from each subcommittee provided detailed updates on their most recent work, as well potential next steps as the move on to the next phase of the project. MSSNY Albany staff is a member of the main workgroup and will continue to participate and ensure the physician perspective is included in all discussions, as well as report back developments as they happen.       (CARY)


Registration now open for “Steps to Physician Wellness and Resiliency”
MSSNY Committee on Physician Wellness and Resiliency will hold its first webinar, entitled Steps to Physician Wellness and Resiliency on February 25th from 7:30-8:30am. Jeffrey Selzer, MD will serve as faculty for this webinar.

Educational Objectives are:

  • Review the warning signs that stress, depression, anxiety or substance use may impact work or personal life
  • Identify strategies to increase personal empowerment toward making positive change, including self-assessment tools
  • Recognize self-monitoring strategies for stress related problems and know when to seek professional assistance

Register by clicking here:

Please Click Here.

Additional information or assistance with registration may be obtained by contacting Melissa Hoffman at mhoffman@mssny.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.
(CLANCY, HOFFMAN, ALI)
                                                                                              

 pschuh@mssny.org mauster@mssny.org  pclancy@mssny.org  zcary@mssny.org
rali@mssny.org
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Get Updates for Healthcare Providers on the Novel Coronavirus from DOH – Monday, February 3, 2020, 4:00 pm
The NYC DOHMH and the NYS DOH will present updates on the outbreak,
review new guidance from the Centers for Disease Control, and discuss infection control considerations.


Council Notes-January 30, 2020

  • MSSNY Commissioner of Public Health and Education Dr. Joshua Cohen reported the following:
  • MSSNY is participating in a bi-weekly conference call with the New York State Department of Health regarding Wuhan coronavirus. MSSNY will be conducting two webinars: “Incident Command System and Crisis Communications” is a virtual drill and is scheduled for February 19, 6 pm – 8 pm. On March 18, Dr. William Valenti, Chair of MSSNY’s Infectious Disease Committee, will conduct a webinar on Wuhan coronavirus.
  • MSSNY will launch its educational program on Physician Wellness in February. The educational program “Steps to Physician Wellness and Resiliency” webinar will be held on February 25 at 7:30 am. A live seminar will also be available at the House of Delegates meeting in Tarrytown on April 23, 3-4 pm.
  • In February, MSSNY will select 4-7 practices interested in improving their practice operations and professional satisfaction through the AMA/Physician Foundation Practice Transformation. This opportunity is open to all types of physician practices and specialties and requires a 16-18-month commitment. Single and multispecialty groups with at least 30 physicians are welcome to submit a statement of interest. If interested, email Pat Clancy, MSSNY Senior VP of Public Health and Education at pclancy@mssny.org.
  • Steven Schwalbe, MD, was presented with a Certificate of Appreciation for his many years of dedicated service as Chair of MSSNY’s Interspecialty Committee. Dr. Schwalbe is Associate Professor of Anesthesiology and Associate Director, Department of Anesthesiology at Mount Sinai.
  • Marina Caskey, MD, was presented with the Albion Bernstein Award, which was endowed by the late Morris Bernstein in memory of his son, a physician who died in an accident while answering a hospital call in 1940. Dr. Caskey is an Associate Professor of Clinical Investigation at The Rockefeller University. Her research focuses on the development and testing of a promising new strategy that uses broadly neutralizing antibodies to prevent or treat HIV infection.
  • MSSNY Speaker Dr. Latrielle announced that March 11 at 5 pm is the hard deadline for House of Delegates (HOD) Resolution submissions. After the March 11 deadline, resolutions will have to be reviewed by the Rules Committee. The HOD will be held at the Tarrytown Marriot April 24-26, 2020.
  • Young Physicians Section (YPS) announced two upcoming events:
  • YPS Annual Meeting: 2/29/20, 8:30 am -12:30 pm at the New York Academy of Medicine, 1216 5th Ave, NYC. Keynote speaker AMA Board of Trustees Chair Jesse Ehrenfeld, MD will present “The Evolving Healthcare Landscape: Challenges and Opportunities for Young Physicians.”
  • MSSNY Young Physicians, Resident, Med Student Social: 2/28/20, 6 pm-9 pm at Sessions 73, 73rd St and 1st Ave, NYC. All physician trainees and attendings up to eight years in practice are invited. Come network with other medical trainees and young physicians.

State Department Advisory: DO NOT TRAVEL TO CHINA
Last night, the State Department issued a travel advisory telling Americans not to travel to China because of the public health threat posed by coronavirus. New York hospitals have stepped up preparations for the possibility that a patient with this year’s novel strain of coronavirus would walk into a local emergency room, as the U.S. Centers for Disease Control and Prevention reported the first case Thursday of person-to-person transmission within the United States.

A special page has been created at NEJM.org with a collection of articles and other resources on the 2019 Novel Coronavirus outbreak, including clinical reports, management guidelines, and commentary.
Visit NEJM.org/coronavirus today >>


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Novel Coronavirus Cases in China Pass SARS at Its Peak
Nearly 6000 confirmed cases of the novel coronavirus (2019-nCoV) have been reported in China, according to World Health Organization numbers released on Wednesday. The outbreak has officially surpassed the 2002–2003 outbreak of severe acute respiratory syndrome (SARS) coronavirus, which totaled 5327 cases in China, the Associated Press reports.

Over 9200 additional novel coronavirus cases in China are suspected, the WHO reports. There have been 132 related deaths, all in China. Outside of China, 68 cases have been confirmed. A WHO committee will reconsider whether to declare a Public Health Emergency of International Concern on Thursday.

Meanwhile in the Lancet, researchers report on a genomic analysis of 2019-nCoV from nine patients in Wuhan, China, all of whom had a connection to the Huanan seafood market. Genetic sequences from the patients’ samples were almost identical, which indicates that the virus emerged in humans very recently, the researchers note. Additionally, the virus appears most similar to two SARS-like coronaviruses that originated in bats. The researchers say that taken together, their findings suggest that bats are the original host and an animal sold at the market might have served as an intermediate host that facilitated transmission to humans.

Also in the Lancet, researchers report on a cluster of 99 patients with 2019-nCoV at a Wuhan hospital. Roughly half had exposure to the market. Overall, 11 patients died — all from multiple organ failure following acute respiratory distress syndrome.


Low-Dose CT Scans Can Reduce Lung Cancer Death in Smokers, Ex-Smokers
 A study of smokers and ex-smokers in the Netherlands and Belgium is confirming that widespread screening using low-dose CT scans can dramatically lower the lung cancer death rate.” Researchers found that “after 10 years, the mortality rate for men who received regular screening was reduced by 24% compared to men who got no screening.” Reuters adds that “although women were under-represented in the study, the research team found that screening lowered their risk of dying from lung cancer by 33%.” The findings were published in the New England Journal of Medicine. Also covering the story are the Wall Street Journal (1/29) and CHEST Physician (1/29).


US Life Expectancy Increased for First Time in Four Years In 2018, Data Indicate
The New York Times (1/30) reports that “life expectancy increased for the first time in four years in 2018, the federal government said Thursday, raising hopes that a benchmark of the nation’s health may finally be stabilizing after a rare and troubling decline that was driven by a surge in drug overdoses.” According to the Times, “Improvements in cancer mortality rates represented the single largest share of the life expectancy gain in 2018, about 30 percent.” The Times adds, “Next came the decline in so-called unintentional injuries, which include deaths from car accidents and drug overdoses.”

“Life expectancy in the United States in 2018 was 78.7 years – an increase of 0.1 year compared with life expectancy of 78.6 years in 2017, the” US Centers for Disease Control and Prevention’s National Center for Health Statistics reported https://www.cdc.gov/nchs/products/databriefs/db355.htm



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Doctor Must Pay $1.1M to Settle Kickback and False Claim Allegations
An otolaryngologist in New York agreed to pay the federal government $1.1 million to settle allegations that he paid kickbacks and submitted false claims to Medicare for services provided in adult residential facilities, the Justice Department announced. Rajendra Bhayani allegedly paid cash tips, high rents, and other payments to medical management companies for exclusive access to facility residents — many of whom had disabilities or mental illnesses — so he could bill for allergy testing and other medical procedures that prosecutors said were unnecessary.


Barbershops Could Offer a Community Setting for Diabetes Testing
Having Black men tested for diabetes at barbershops could be a way to ensure more timely diagnoses, according to new research. Previous studies have shown that barbershops, as trusted community places among Black men, can be spots to diagnose high blood pressure by removing barriers to care — such as insurance and cost — that this population may face.

In the new study, researchers approached around 900 men who frequented one of eight barbershops in Brooklyn, N.Y. — a third of these men agreed to be tested, and almost 10% had blood sugar levels that would have resulted in a diabetes diagnosis in a doctor’s office.

Nearly 30% had prediabetes, which, with proper lifestyle changes, can be prevented from progressing. Although these results are promising, the small study group and its location could mean the findings are not generalizable.  (STAT, Jan.28)


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FL Surgeon Files Whistleblower Suit re Requiring in House Referrals
A Florida surgeon filed a whistleblower lawsuit against his former employer, Orlando Health, claiming it violated federal law by requiring him to perform surgeries and refer patients within the network’s facilities — and firing him when he did not obey. Ayman Daouk, MD, an orthopedic surgeon in Orlando, alleged in a lawsuit filed in early January that he was fired for performing surgeries at Florida Hospital, a facility unaffiliated with Orlando Health, and for referring patients to radiologists outside of the health system’s network.

Daouk sued Orlando Health and three of its subsidiaries — claiming that mandatory self-referrals violate “Stark law” and anti-kickback statutes, the lawsuit stated. The complaint said that because Orlando Health owns the facilities that it requires physicians to refer to, “there exists an unbroken chain of financial relationships that renders these referrals as violations” of Stark law, which prohibits doctors from referring patients to entities where they have financial interests.

Daouk also claimed that physicians received payments and benefits for referring to Orlando Health facilities, a direct violation of the federal anti-kickback statute.

Daouk was employed by Physician Associates for three years when it was acquired by Orlando Health in 2012. In the complaint, Daouk said that at the start of his employment, physician referrals in-network were highly suggested, but not required.

Daouk, too, was contacted by administration officials for performing surgeries at Florida Hospital. In November 2014, Daouk was informed that his employment would be terminated if he continued performing surgeries at other hospitals, the complaint stated. When Daouk objected to this restriction, Dennis Buhring, president of Physician Associates, allegedly said that he was “sending a very negative message to [his] employer.”

There are a number of reasons why hospitals may require referrals to be made within network, said Mollie Gelburd, JD, associate director of government affairs at the Medical Group Management Association. One reason may be promoting care coordination, as referring patients to doctors exclusively within network makes the transfer of medical records and information easier.

However, she said, there is concern that hospitals require doctors to practice medicine and make referrals in network for a profit motive.

Jay Wolfson, PhD, a health policy expert at the University of South Florida in Tampa, said this case “goes to the heart of physician clinical autonomy.” (Medpage 1/29/20)


Number of Smokers— 14%– at All-Time Low
The percentage of Americans who smoke — 14%, or 34 million people — is at an all-time low, but smoking still remains the number one cause of preventable disease, death, and disability, and doctors could be doing more to help patients quit, Surgeon General Jerome Adams, MD, MPH, said Thursday.

“Forty percent of smokers who see their physician aren’t advised by the provider to quit,” Adams said at a press conference announcing the release of a 700-page report on smoking cessation. “So why are 40% of our health providers out there not advising smokers to quit?”…”I often say you come into the orthopedist’s office because you’ve got a broken ankle, but you’re more likely to die from the fact that you’re smoking,” so even the orthopedist should be talking to that patient about quitting, Adams continued. “At every touchpoint, everyone should be. The tools that the CDC has put out are designed to help empower more people to know what they can do to help folks quit.”

Examples of tools physicians can look at include the Million Hearts protocol and the smokefree.gov website.

Adams also chided health insurers who require prior authorization or high copays for smoking cessation treatments, calling such policies “penny-wise and pound-foolish.” “According to the report, comprehensive, barrier-free coverage and promotion can increase the use of proven treatments and lead to higher rates of successful quitting,” he said.


AMA Foundation Launches New Initiative to Address LGBTQ Health Disparities
American Medical Association Foundation (AMAF) today announced that John D. Evans, telecommunications pioneer, internationally-recognized business executive and philanthropist, will lead a unique and innovative initiative designed to dramatically shape the future of LGBTQ health.

The new initiative will create a cadre of LGBTQ health specialists through the AMA Foundation LGBTQ Fellowship Program – a national fellowship program to promote best practices and shared outcomes, while exponentially improving the quality of LGBTQ health care across the nation.

“A key social determinant of health affecting sexual and gender minorities is a shortage of health care providers who are knowledgeable and culturally competent in LGBTQ health. This shortage underscores the immediate need for the AMA Foundation’s LGBTQ Fellowship Program which will train physicians to become LGBTQ Health Specialists,” said former AMAF president and founding donor of its LGBTQ endowment fund,  and MSSNY Councilor Joshua M. Cohen, MD, MPH, FAHS. Moreover, policies that permit the denial of services to LGBTQ people are linked to a 46 percent increase in the proportion of gay, lesbian, and bisexual adults who report mental distress and gay men account for more than two thirds of all people diagnosed with HIV each year in the United States, despite comprising only 2 percent of the general population. Establishing a national network of LGBTQ health specialist physicians who are formally trained to serve sexual and gender minorities will have a dramatic and positive impact on this community. The LGBTQ Fellowship cohort provides a transformative opportunity to:

  • Decrease LGBTQ health disparities;
  • Increase cultural and clinical competence amongst physicians in LGBTQ health;
  • Build capacity of LGBTQ health services sector to better identify and address the unique health needs of the LGBTQ community, such as the effects of anesthesia on transgender patients undergoing gender affirming surgery due to medications;
  • Improve basic quality of life (health and well-being) of LGBTQ communities;
  • Understand and address social determinants of health faced by this community through the promotion of research and supporting the dissemination of research findings across mediums such as medical journals; and,
  • Provide safe entry point to link individuals to broader health and wellness services.

2020 MSSNY Young Physicians Section Annual Meeting
Join us for the premiere annual meeting attended by your medical trainee and physician colleagues from across NY state. Earn CME* and learn from experts on how to succeed when starting practice and how to best advocate for your patients outside of the hospital and clinic.

WHEN: Feb 29, 8:30 AM – 12:30 PM
WHERE: New York Academy of Medicine, 1216 5th Ave, New York, NY 10029, USA

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

MSSNY designates this live activity for a maximum of 3.0 AMA PRA Category 1 Credits™. Physicians should claim only the credit commensurate with the extent of their participation in the activity. Limited space available. Preregistration required. Register here.
MSSNY Members FREE. Non-members $75
Click here for information on how to become a MSSNY member


MSSNY Young Physicians, Resident Fellow, Med Student Social
WHEN:   Friday, 2/28/2020, 6pm-9pm
WHERE: Sessions 73 – 73rd St. and 1st Ave. New York, NY
All physician trainees and attending physicians up to 8 years in practice are invited. Come network with other medical trainees, young physicians and learn about how you can impact the future of medicine in New York.
RSVP for social here


SIGN UP TO RECEIVE ALERTS FROM MSSNY’S GRASSROOTS ACTION CENTER 

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When you subscribe to the Medical Society of the State of New York Grassroots Action Center, the Division of Governmental Affairs will alert you when legislation and issues of importance to physicians and patients, either in the NYS legislature or in Congress, are at critical stages.

Accordingly, contact from constituents would be vital to influencing the path and future of that legislation or issue.

Alerts will be accompanied by recommended actions you or your designee can take to have maximum impact such as calling, tweeting and emailing a customizable letter to your legislators.

If you are concerned with health care policy formation in New York State, please subscribe today by texting MSSNY to 52886 and you will be prompted to enter your email address.  When you sign up, it is best to use your NY-based voting address or practice address (if you do not reside in NY) for your alerts.

Contact the Division of Governmental Affairs at 518-465-8085 or albany@mssny.org if you have questions or comments.  Thank you.
(WILKS)


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Great Career Opportunities for Clinical Physicians
Physicians, are you looking for a change?  Tired of working long shifts with an overwhelming patient load?  Come work at a well-equipped and staffed correctional facility where you can MAKE a difference, working with a smaller number of patients for reasonable hours.

Starting salary is $143,381 – $171,631 *Additional $20,000 geographical differential for Clinton & Franklin CF, and $10,000 for Five Points, Greene and Groveland CFs. We offer full-time, part-time & hourly/per-diem positions.

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

Clinton*                 Clinton Correctional Facility (sporting and recreational outlets)
Chemung               Elmira and Southport Corrl Facilities (Gateway to the Finger Lakes)
Columbia*             Hudson Correctional Facility (antiquing, arts & collectables)
Dutchess                Green Haven Correctional Facility (Hudson River Valley Beauty)
Franklin*                Franklin & Upstate Corrl Facilities (North Country, 1 hour to Montreal)
Greene*                 Greene Correctional Facility (rural charm yet only 2 hours to NY City)
Livingston*            Groveland Correctional Facility (State Parks, hiking, fishing)
Oneida                   Mohawk Correctional Facility (Cooperstown, breweries)
Orleans                  Albion Correctional Facility (Greater Niagara Region & Canal Town Culture)
Sullivan                  Woodbourne Correctional Facility (mountains, outlets, entertainment)
Seneca*                 Five Points Correctional Facility (heart of wine country)
St. Lawrence          Riverview Correctional Facility (hiking, boating and museums)
Ulster                     Shawangunk and Wallkill Corrl Facility (Catskill Mountains, Casinos)
Washington           Great Meadow Corrl Facility (Between Vermont & Green Mountains)
Westchester           Bedford Hills Correctional Facility (Less than 1 Hour to NYC)
Wyoming               Wyoming Correctional Facility (waterfalls, family farms, natural beauty)

NYS Corrections Personnel Ad

Inquire with the Facility Personnel Office regarding benefits and anticipated opportunities: http://www.doccs.ny.gov/faclist.html. Contact: www.doccs.ny.gov or DOCCS Personnel Office at (518) 457-8132 for more information and to apply.



 

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

 

MSSNYeNews: Richard Jewell and Scarlet Letters – January 24, 2020

Arthur Fougner MSSNY Presiident

PRESIDENT’S MESSAGE
Arthur Fougner, MD
MSSNY President

MSSNY eNews
January 24, 2020

Vol. 23  Number 4


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Colleagues:

No doubt you’re heard that the Governor’s proposed budget legislation is out.  In the Health and Mental Hygiene Section, there are many helpful proposals, among them reducing maternal mortality, regulation of PBMs, and removing flavored tobacco products. There are some that are unhelpful such as requiring more information in the physician profiles. Ironically, in the fiscal year 2015 budget, the Governor had actually proposed eliminating the profile website altogether. Quite a turnaround, no? 

But then we come to the poison pill –  Section L. Here, the Office of Professional Medical Conduct (OPMC) is further empowered to allow for “immediate publication of charges upon investigative requests.” Let that sink in for a moment. As if that isn’t enough, the powerful position of OPMC Executive Secretary is now removed from the Board Chair’s oversight and now overseen by the Commissioner directly. This similarly could shred due process.  

As I’ve previously shared, less than 3% of complaints to OPMC result in significant actions. Publication of charges prior to thorough investigation would effectively end a physician’s career. In 1976, Richard Jewell found a suspicious package in the Atlanta Olympic Park and alerted police, saving countless lives. For his effort, Jewell was hounded by the press and he became a person of interest. His life was ruined while attention was diverted from the real bomber.  Perhaps we could ask our Governor, as Raymond Donovan famously asked, to which office do physicians go to get their reputations back?  

I don’t know about you, but I feel that an MD or DO degree is a badge of honor. Section L of the Budget could turn your badges of honor into Scarlet Letters.  

Concerned? Upset? Outraged? Then, go here right now and tell Governor Cuomo and your legislators how you feel. Also, Lobby Day is March 4. Albany believes it’s a crisis ONLY when physicians act like it’s a crisis. Physicians, make no mistake – this IS a crisis. We need to pack the house. We need you. 

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

Arthur Fougner, MD
MSSNY President


Capital Update

The Week’s Legislative Podcast


Please Plan to Be in Albany for: MSSNY‘s Annual “Physician Advocacy Day” (3/4)
As we begin to unpack the Governor’s budget proposal and the legislative work at the Capitol continues, the need for physician advocacy and grassroots involvement is greater than ever. With the Governor’s budget proposal teeing up items for potential concern such as Medicaid cuts, legalized marijuana and changes to the physician disciplinary process, while also supporting reforms such as regulating PBMs and a flavored tobacco ban, it is imperative that physicians be in contact with their local legislators to ensure the physician community’s message is well-represented.

One opportunity is to participate in MSSNY’s “Physician Advocacy Day” that will be held on Wednesday, March 4th in the Lewis Swyer Theatre in the Egg located at the Empire State Plaza, Albany NY. Click here to register!

Join your colleagues from all around New York State and come to MSSNY’s Physician Advocacy Day to speak with your legislators and key policymakers to ensure they’re making the right choices for New York’s physicians and their patients.

A brief luncheon to which members of each House are invited to speak with their constituents will follow the morning program.  Please work with your County Medical Societies to schedule appointments for physicians to meet with their elected representatives.

If you have any questions/comments, please contact Raza Ali at rali@mssny.org.       (ALI)


Governor Announces Proposed Budget
Governor Cuomo this week released his proposed $178 Billion Budget for the 2020-21 State Fiscal year, including measures to close a $6.1 billion Budget deficit, through creating a new Medicaid Redesign Team (MRT) to recommend $2.5 Billion in Medicaid savings, assuming an additional $2 billion in new tax revenue, and $1.8 billion in reduced payments to localities.  While we are still poring through the tens of thousands of pages of Budget bills, among the most notable items for physicians upon initial review:

Items of Significant Concern Include:

  • As previously announced, expanding the ability of the Commissioner of Health to notify the public that a physician is under investigation and to make it easier for the Commissioner to summarily suspend a physician license during a disciplinary investigation.  Send a letter to your legislators here: Please click here
  • Expanding the information on the physician profile to include office hours, whether accepting new patients, insurance participation information, and mandatory completion of a workforce survey.
  • Legalizing, regulating and taxing the production, distribution, transportation, and sale of recreational or “adult-use” marijuana.
  • Expanding the list of adult immunizations that can be provided by pharmacists to all those recommended by the ACIP.
  • Expanding the existing physician-pharmacist collaborative drug therapy program to include nurse practitioners and physician assistants 

Positive Items Under the Proposed Budget

  • Require the regulation of Pharmaceutical Benefit Managers (PBMs) with the Department of Financial Services (DFS) and to disclose financial incentives they receive
  • A comprehensive anti-smoking package including: prohibiting the sale or distribution of e-cigarettes or vapor products that have a characterizing flavor; prohibiting the sale of tobacco products  in all pharmacies; expanding the definition of “place of employment” to define indoor space and limit second hand smoke exposure;  restricting the advertising of vapor products;  requires manufacturers of vapor products to disclose to the DOH Commissioner and the public, information regarding the ingredients, by-products, or contaminants in vapor products; bans coupons and manufacturer discounts and displays in shops; and increases penalties for illegally selling tobacco products to minors.
  • Creating an administrative simplification work group to address health insurance hassles and to expedite physician credentialing applications.
  • Establishing the Behavioral Health Parity Compliance Fund for the collection of penalties imposed on insurance carriers who violate New York’s Behavioral Health Parity laws, which will be used to support the Substance Use Disorder and Mental Health Ombudsman program
  • Significantly reduce the interest rate on medical malpractice and other court judgments, from 9% to a market-based rate
  • Reduce the business income tax rate from 6.5% to 4% for businesses with 100 or fewer employees and with net income below $390,000 that file under Article 9-A.
  • $14.2 million in funding to ensure access to a full array of reproductive services for women due to the loss of Title X funding.
  • $8 million to improve maternal health outcomes and for the implementation bias training and incentives for an expansion of community health workers related to Maternal Mortality.
  • Continuation of funding for the Excess Medical Malpractice Insurance Program
  • Continuation of funding for the Committee for Physicians’ Health

Other Items of Note

  • Expanding the scope of New York surprise bill law to include in-patient services following an emergency admission.
  • Convene a new Medicaid Redesign Team (MRT) to come up with $2.5 billion in savings
  • DFS will be authorized to investigate pricing of any prescription drug if the price of such drug has increased by more than 100% within a one-year time period.
  • Capping the co-payments required of insured patients at $100 for a one-month supply of insulin.
  • Development of “NYHealthCareCompare”, a website that will allow New Yorkers to look up charges for medical services, the quality of services provided, and access information about financial assistance programs, as well as what to do about a surprise medical bill.
  • Local governments will be required to stay within 2% property tax increase, or be held accountable for excess growth in Medicaid costs

Several items of concern from previous Budgets, proposed but rejected, such as cuts to Medicaid payments for treating dual eligible patients, elimination of “prescriber prevails” under Medicaid, and expansion of CRNA scope of practice WERE NOT included (but could be brought up under the new MRT).
(DIVISION OF GOVERNMENTAL AFFAIRS)


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Marijuana Legalization Gains Additional Support in State Senate; MSSNY Continues to Raise Strong Concerns with Public Health Impacts
In a press conference held on Thursday Senator Pete Harckham (D-Westchester County) announced his support behind an amended recreational or ‘adult use” marijuana legalization bill sponsored by Senator Liz Krueger (D- Manhattan). Senator Harckham, thought to be one of the Senators that had previously opposed the legalization of marijuana, explained his support is the result of a key provision of the bill which would allocate roughly 25% of the revenue generated from the legalization to mental health and substance abuse prevention and treatment. Senator Harckham is the chair on the Senate Alcoholism and Substance Abuse committee.

Senator Krueger also indicated during the press conference that, if a consensus was not reached between lawmakers and the governor, she would be willing to put the issue aside until after the budget was passed.

MSSNY continues to oppose the legalization of recreational marijuana and we urge our members to send a letter to the legislature and to the governor opposing this legislation (please click here).  Last week, MSSNY joined with the New York State Association of County Health Officials in a statement (please click here ) re-iterating our groups opposition to the legalization of recreational or “adult use” marijuana given the recent CDC report confirming a direct link between legally obtained adult use cannabis and the nation’s outbreak of vaping related illnesses and deaths.   (ALI)


MSSNY Statement by Dr. Art Fougner on the Release of the State Budget
“The proposed Budget importantly advances several positive steps to promote public health, including restricting the sale of flavored tobacco products, regulating PBMs, and facilitating the ability of physicians to be more quickly approved into plan networks.

However, we are extremely concerned about the scope of the Budget proposals that would essentially strip physicians of important due process rights when a complaint has been filed with the Office of Professional Medical Conduct. We agree with the importance of acting quickly when it is imperative, but these proposals would completely undermine important and longstanding due process protections. Given that most complaints are dismissed without any sanction or action, this series of proposed changes to bypass these rights would create a substantial possibility of unfairly destroying an innocent physician’s career.

Due to our enormous liability costs and excessive regulations, New York already has the dubious reputation of being the worst state in the country to be a physician. Proposals like this will make it even more unattractive for physicians to choose New York to deliver patient care.

We welcome discussions to improve our disciplinary system to address gaps to help protect the public. However, these proposed changes are startling. We urge the Senate and Assembly to take a critical eye towards these overreaching proposals to assure patients can continue to receive the care they need.”                                                       (AUSTER)


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Forum Examines Prescription Drugs & Health Care Costs
On Wednesday, January 22, MSSNY Albany staff attended a forum hosted by the New York Health Plan Association (HPA), at the Empire State Plaza Convention Center, in Albany. The event, “Access to Innovation: How are States Addressing Prescription Drug Costs?”, looked at current spending trends associated with prescription drugs, and health care, and outlined potential policy options to address a range of issues. Among them were the use of comparative effectiveness in measuring the value and pricing of prescription drugs.

Leading the discussion was HPA”s President & CEO, Eric Linzer, who was joined by panelists Sarah Emond, from the Institute for Clinical and Economic Review (ICER), Assemblyman Daniel Rosenthal, Chair of the Subcommittee on Intergenerational Care, Helen Schaub from 1199SEIU, Charles Bell with Consumer Reports, and Eileen F. Wood, representing Capital District Physicians’ Health Plan.

Governor Cuomo has introduced several proposals in his budget for 2021 related to prescription drugs, which the MSSNY Albany staff is reviewing, including a requirement that Pharmaceutical Benefit Managers (PBMs) disclose financial incentives received to the Department of Financial Services (DFS) and giving the Department of Financial Services power to investigate sudden large jumps in drug prices. We will update members as budget discussions move forward in the coming weeks.         (CARY)


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Partial Fill Prescribing on Senate Calendar
A measure that would enable the dispensing of a partially filled controlled substances prescription, is now on the Senate calendar for a vote.  The measure, S. 7115/A.9034, sponsored by Senator Gustav Rivera and Assemblymember John McDonald, would allow a prescriber to issue a partially filled prescription for a Controlled Substance II, III, IV, V to a patient.

The prescription would be recorded in the same manner as a refill and the remaining quantity of the prescription may be dispensed separately.   In 2016, Congress passed legislation that would enable partial fill prescription under the Comprehensive Addiction and Recover Act (CARA).  This state measure would allow New York State to conform to what is allowable under federal law.

A similar measure had passed during the 2019 legislative session, but was vetoed by Governor Andrew Cuomo.  This new bill addresses concerns expressed by the administration.  The Medical Society supports this measure and believes that it will help to reduce the amount of unused pain medication that can accumulate in home medicine cabinets and will allow prescribers to help patients balance the need to relive pain with an adequate supply of medication.    (CLANCY)


NYS DOH Issues Guidance on 2019 Novel Coronavirus (2019-nCoV)
The New York State Department of Health issued guidance on the 2019 novel coronavirus (2019-nCoV) and this includes healthcare providers and facilities collecting a travel history for patients presenting with febrile illness and remain aware of current outbreaks overseas. Patients who meet either of the following criteria should be evaluated as a person under investigation (PUI) in association with the 2019-nCoV outbreak.

Fever AND symptoms of lower respiratory illness (e.g., cough, shortness of breath) and in the last 14 days before symptom onset had:

▪ A history of travel from Wuhan City, China OR  Close contact with a person who is under investigation for 2019-nCOV while that person was ill. Fever OR symptoms of lower respiratory illness (e.g., cough, shortness of breath) and in the last 14 days before symptom onset:

▪ Had close contact with an ill laboratory-confirmed 2019-nCoV patient. A copy of the NYS DOH guidance is here.

MSSNY is planning to conduct a webinar on 2019 Novel Coronavirus (2019-nCov) in March.  More information will be available shortly.          (CLANCY)


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Registration Now Open for Steps to Physician Wellness and Resiliency
MSSNY is proud to announce our first webinar entitled Steps to Physician Wellness and Resiliency on February 25th from 7:30-8:30am. Jeffrey Selzer, MD will serve as faculty for this webinar.

Educational Objectives are:

  • Review the warning signs that stress, depression, anxiety or substance use may impact work or personal life
  • Identify strategies to increase personal empowerment toward making positive change, including self-assessment tools
  • Recognize self-monitoring strategies for stress related problems and know when to seek professional assistance

Register by clicking here.

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


Registration Now Open for Medical Matters: Virtual Drill: Incident Command System & Crisis Communications
MSSNY’s next Medical Matters will feature a Virtual Drill on the Incident Command System and Crisis Communications on February 19th from 6:00-8:00pm. Faculty for this program are: Arthur Cooper, MD; Pat Anders, MS, MEP; William Valenti, MD and Lorraine Giordano, MD.

Educational Objectives are:

  • Obtain information about local, state and national chain of command in a public health emergency and learn how to access resources
  • Understand the importance of planning for medical surge and triage of patients, as well as staff and family considerations, in the office-based practice setting during a health emergency
  • Develop an understanding that all public health emergencies can potentially have mental health implications for survivors and others connected with the event
  • Acquire skills for the management of patients in a public health emergency

Please note that there are recommended pre-course materials to be viewed prior to this virtual drill. You will be sent a link with your registration confirmation. We encourage all participants to examine these prior to the Virtual Drill.  Register by clicking here:  please click here

Additional information or assistance with registration may be obtained by contacting Melissa Hoffman at mhoffman@mssny.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 2.0 AMA/PRA Category 1 credits™.  Physicians should claim only the credit commensurate with the extent of their participation in the activity.   (HOFFMAN)                                                                                                                                                                                                  

 pschuh@mssny.org mauster@mssny.org  pclancy@mssny.org  zcary@mssny.org
rali@mssny.org
eNews


Transplant Policy That Will Help New Yorkers Clears Legal Hurdle 
A federal judge has denied a second motion for a preliminary injunction that would have halted a new liver transplant policy from taking effect. The policy, which could now be implemented in as soon as days barring an appeal from the plaintiffs, prioritizes the sickest patients over geographic location when it comes to organ allocation.  

“This is a big deal because it allows patients all over the country to be prioritized based on how sick they are, not on where they live,” said Motty Shulman, a partner at Boies Schiller Flexner, who has championed fair-organ allocation and spearheaded litigation to that end. “It’s consistent with the law, but it’s also fair. It removes any barriers for equitable allocation.” Plaintiffs that have challenged the policy’s implementation include a number of major hospitals and transplant centers in the South and Midwest that have benefited from the existing system.  

The court’s order denying the plaintiffs’ motion for a preliminary injunction noted that the Organ Procurement and Transplantation Network, which put forth the new policy, is not an agency subject to the Administrative Procedure Act. The act oversees federal agencies’ issuance of regulations.  

Proponents have remained steadfast that the new policy is a much-needed reform that helps to ensure every patient in need of an organ stands an equal chance of receiving one. A 2018 lawsuit that was led by Shulman and spurred the new policy included a plaintiff who lived in New York City and lacked the financial means to travel outside the area to transplant centers that historically have had much shorter wait times.
(Crain’s Health Pulse, Jan. 2)


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One More Vaping Death: Now, There Are Four
The NYSDOH has confirmed two more deaths in New York from vaping-associated illness: a woman in her 20s from the city and a woman in her 50s from Ontario County. To date, Gov. Andrew Cuomo said in a statement, that brings the number of vaping-related deaths in New York to four. He added that the department and its Wadworth Center Laboratory are working to get to the bottom of the situation, and that the state “will continue using every tool at our disposal until these illnesses and deaths stop.”


Deadline for abstract submission is 4 pm, Monday, February 3, 2020
MSSNY is very pleased to announce the 15th Resident/Fellow/Medical Student Poster Symposium. 

When:   Friday, April 24, 2020
Where:  Westchester MarriottTarrytown, New York
Time:     1:30 pm – 4:00 pm 

Click here for detailed guidelines 

We welcome the participation of residents and fellows. Participants must be MSSNY members, and membership is free for first-time resident members. Join online.


Many Physicians Would Give Up $20K+ for Better Work-Life Balance
Almost half of physicians would take a pay cut to work fewer hours, according to a survey conducted by Medscape. The top three factors physicians cited as contributing to burnout were bureaucratic tasks like charting and paperwork; spending too many hours at work; and lack of respect from administrators, employers, colleagues or staff. The online survey was conducted among more than 15,000 physicians in 29 specialties. Respondents represented three main age groups: millennials (ages 25-39), Generation X (ages 40-54), and baby boomers (ages 55-73). More than a quarter of physicians in each age group would give up between $20,000 and $50,000 per year in salary to work 20 percent fewer hours. Another third in each age group said they would give up $10,000 to $20,000 a year to work fewer hours.  

Medscape writes that these results are “a powerful statement” on behalf of physicians, suggesting that they want greater balance.  

This desire for more balance may partially contribute to the relatively high rates of burnout in the profession, experienced by 42 percent of survey respondents. Burnout was highest among Generation X physicians (48 percent), compared to millennials (38 percent) and baby boomers (39 percent). Read more here 



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Poor Glycemic Control in Childhood May Be Tied to T1D-Related Premature Death in Young Adulthood
Medwire News (1/23) reports, “People who die in young adulthood from acute complications of type 1 diabetes [T1D] are characterized by poor glycemic control during childhood,” researchers concluded in a study of 12,652 patients. The study revealed that “overall, people with diabetes were nearly three times more likely to die before the age of 30 years than those without.” The findings were published online in Pediatric Diabetes


Unhealthy LCD/LFD Scores May Be Associated with Higher Total Mortality in US
Clinical Endocrinology News (1/22) reports, “The health consequences of diet don’t largely depend on whether a person eats a high or low level of carbohydrates or a diet high or low in fat,” research suggests. What appears to be “more important is where the carbs and fats come from, according to an analysis that related diet and mortality rates in more than 37,000 American adults.” The study revealed that “unhealthy low carbohydrate diet [LCD] and low-fat diet [LFD] scores were associated with higher total mortality, whereas healthy LCD and LFD scores were associated with lower total mortality.” The findings were published online in JAMA Internal Medicine.  



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CMS

New Medical Narrative Report Template for Form CMS-1500 Submissions
To further assist medical providers in the implementation of the CMS-1500 for workers’ compensation patients, the Board has created a medical narrative report template that can be used to create the medical narrative that must accompany all CMS-1500 submissions. 

The top of the template includes the three elements most narratives require: the patient’s work status, the causal relationship of the injury to the patient’s work activities, and the patient’s percentage of temporary impairment. A medical narrative report may be found legally defective if these elements are missing. Medical providers must also include examination findings within their narrative, including the history of the injury/illness, objective findings based on the clinical evaluation, the patient’s plan of care and the diagnosis(es)/assessment of the patient. 

A link to the new template, as well as line-by-line instructions, can be found on the CMS-1500 section of the Board’s website at http://www.wcb.ny.gov/CMS-1500/requirements.jsp. A chart outlining the specific narrative requirements for each specialty is located on the same page.  

If you have any questions regarding use of the medical narrative report template, please write to the CMS-1500 mailbox at CMS1500@wcb.ny.gov.(  Jan.22,2020)


New 2019 Data Submission Resources Now Available on QPP Resource Library
CMS has posted the following new Quality Payment Program (QPP) resources to the QPP Resource Library to help eligible clinicians submit their 2019 Merit-based Incentive Payment System (MIPS) data until the submission period closes at 8:00 p.m. EDT on March 31, 2020.  

  • 2019 Data Submission FAQs – Answers commonly asked questions about data submission for the 2019 performance period. 
  • 2019 Data Submission Demonstration Videos 
  • Manual Attestation of Improvement Activities – Provides an overview of how a third-party intermediary can report MIPS data on behalf of a group within the QPP portal and how to modify the Improvement Activity score by manually attesting to measures. 
  • Manual Attestation of Promoting Interoperability Measures – Shows how a third-party intermediary can submit MIPS data on behalf of a group within the QPP portal and how to modify the Promoting Interoperability score by manually attesting to measures. 

SIGN UP TO RECEIVE ALERTS FROM MSSNY’S GRASSROOTS ACTION CENTER 

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When you subscribe to the Medical Society of the State of New York Grassroots Action Center, the Division of Governmental Affairs will alert you when legislation and issues of importance to physicians and patients, either in the NYS legislature or in Congress, are at critical stages.

Accordingly, contact from constituents would be vital to influencing the path and future of that legislation or issue.

Alerts will be accompanied by recommended actions you or your designee can take to have maximum impact such as calling, tweeting and emailing a customizable letter to your legislators.

If you are concerned with health care policy formation in New York State, please subscribe today by texting MSSNY to 52886 and you will be prompted to enter your email address.  When you sign up, it is best to use your NY-based voting address or practice address (if you do not reside in NY) for your alerts.

Contact the Division of Governmental Affairs at 518-465-8085 or albany@mssny.org if you have questions or comments.  Thank you.
(WILKS)


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RENTAL/LEASING SPACE

Midtown Medical Office for Rent
Beautiful office for rent in midtown Manhattan located opposite Grand Central Station on 42nd Street and Madison avenue. ideal for medical and surgical specialists as there are five spacious exam rooms with an accredited quad a certified operating room with anesthesia services. You can perform procedures and see patients. Rent for three days a week is $3,200 and 4 days a week is $4,100 Interested physicians please email cpmgman@gmail.com or call 914-582-0749.


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Furnished Luxury Park Avenue East 70’s Medical Office Rental Available.
Voted most beautiful block on UES. Private Entrance. Central A/C.
Dedicated consultation room, exam room, procedure room, reception and nurse areas in a multispecialty office setting. Suitable for all subspecialties. Walk to Lenox Hill Hospital and NY Cornell. Proximate to Mt Sinai Hospital. Subway 2 blocks away. Full Time/Part Time. No fee.
START SEEING PATIENTS IMMEDIATELY!!!
Please call or text 929 316-1032

JOB OPPORTUNITIES

NYS Job opportunity headline

ANNOUNCEMENT OF ANTICIPATED JOB OPPORTUNITY
Open to the Public Community Health Program Manager 3 – 24123 $109,956 – $138,763 / M-4
NEGOTIATING UNIT Management Confidential (06)
LOCATION Division of Family Health Corning Tower, Empire State Plaza Albany, NY 12237
MINIMUM QUALIFICATIONS TRANSFER: Current NYS employee with one year or more of contingent-permanent or permanent competitive service in a title at or above Grade 29/M-3 and eligible for transfer under Section 52.6 of the Civil Service Law.
PROVISIONAL*: a bachelor’s degree AND seven years professional public health experience in a governmental public health agency or public health program* that receives funding from a public health governmental agency. Of the seven years required experience, three years must include supervision of professional staff and the following management responsibilities: program planning and implementation, AND program evaluation and monitoring, AND development and implementation of policies and procedures.
The required professional experience must include either:

  1. Designing or implementing a public health outreach, promotion, or disease prevention program; OR
  2. Conducting disease surveillance or a disease control

For the purposes of this recruitment, a public health program focuses primarily on the prevention of disease through outreach and public health education or health promotion, including population-based plans of care, not just plans of care for individual patients, or the study of the prevalence or causes of disease through population-based studies. Examples of non-qualifying experience include, but are not limited to: Read More


Pediatric Board Tutor
Looking for a tutor for Initial Pediatric Board Exam
Flexible hours, Negotiable rate. If interested please email at: pedboardhelp@gmail.com


 

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Great Career Opportunities for Clinical Physicians
Physicians, are you looking for a change?  Tired of working long shifts with an overwhelming patient load?  Come work at a well-equipped and staffed correctional facility where you can MAKE a difference, working with a smaller number of patients for reasonable hours.

Starting salary is $143,381 – $171,631 *Additional $20,000 geographical differential for Clinton & Franklin CF, and $10,000 for Five Points, Greene and Groveland CFs. We offer full-time, part-time & hourly/per-diem positions.

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

Clinton*                 Clinton Correctional Facility (sporting and recreational outlets)
Chemung               Elmira and Southport Corrl Facilities (Gateway to the Finger Lakes)
Columbia*             Hudson Correctional Facility (antiquing, arts & collectables)
Dutchess                Green Haven Correctional Facility (Hudson River Valley Beauty)
Franklin*                Franklin & Upstate Corrl Facilities (North Country, 1 hour to Montreal)
Greene*                 Greene Correctional Facility (rural charm yet only 2 hours to NY City)
Livingston*            Groveland Correctional Facility (State Parks, hiking, fishing)
Oneida                   Mohawk Correctional Facility (Cooperstown, breweries)
Orleans                  Albion Correctional Facility (Greater Niagara Region & Canal Town Culture)
Sullivan                  Woodbourne Correctional Facility (mountains, outlets, entertainment)
Seneca*                 Five Points Correctional Facility (heart of wine country)
St. Lawrence          Riverview Correctional Facility (hiking, boating and museums)
Ulster                     Shawangunk and Wallkill Corrl Facility (Catskill Mountains, Casinos)
Washington           Great Meadow Corrl Facility (Between Vermont & Green Mountains)
Westchester           Bedford Hills Correctional Facility (Less than 1 Hour to NYC)
Wyoming               Wyoming Correctional Facility (waterfalls, family farms, natural beauty)

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Inquire with the Facility Personnel Office regarding benefits and anticipated opportunities: http://www.doccs.ny.gov/faclist.html. Contact: www.doccs.ny.gov or DOCCS Personnel Office at (518) 457-8132 for more information and to apply.



 

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

 

Council January 30, 2020

AGENDA
MSSNY Council Meeting
Thursday, January 30, 2020 at 9:00 a.m.
Courtyard Marriott, Westbury Long Island
1800 Privado Road
Westbury, NY  11590

A.  Call to Order and Roll Call

B. Council Minutes of November 7, 2019

C.  New Business (All Informational/Action Items)

1 President’s Report:

a. Appointment of Mark Jajkowski, MD, New Eighth District Councilor to complete Dr. Bartels term which ends in 2021. (For Council Approval)

b. Honoring Dr. Steven Schwalbe with a Certificate of Appreciation for his many years of dedicated service as Chair of MSSNY’s Interspecialty Committee

c. Honoring Dr. Marina Caskey with the Albion Bernstein Award

Dr. Caskey is an Associate Professor of Clinical Investigation at The Rockefeller University. Her research focuses on the development and testing of a promising new strategy that uses broadly neutralizing antibodies to prevent or treat HIV infection. Dr. Caskey graduated from medical school at the Federal University of Sergipe, Brazil, in 1998. She then completed an internal medicine residency at Saint Luke’s Roosevelt Hospital, in New York, followed by fellowship training in infectious diseases at New York Presbyterian-Weill Cornell Medical Center.

Dr. Caskey has led a series of early-phase clinical studies to evaluate the safety and efficacy of broadly neutralizing anti-HIV antibodies. These antibodies were isolated and characterized from patient blood cells by sophisticated cloning methods developed in the laboratory of Dr. Michel Nussenzweig.  The studies led by Dr. Caskey have revitalized this area of HIV research, which had been abandoned after first-generation antibodies failed to show significant effects in humans.  Broadly neutralizing antibodies are now considered one of the most promising strategies to achieve HIV remission, as well as potential alternatives to antiretrovirals for both therapy and prevention. Her seminal studies have shaped this new area of research and several groups in the US and abroad are now studying the antiviral and immune modifying effects of these molecules in combination with other strategies.

Dr. Caskey is also an attending physician in infectious diseases at New York Presbyterian-Weill Cornell Medical Center. She was recently elected for membership in the American Society of Clinical Investigation.

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 the report (verbal)

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

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

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

D.  Reports of Officers  

  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 1/1/19 to 1/3019
    (For Council Approval)
  5. Office of the Speaker – William R. Latreille, Jr., MD

E.  Presentation

Mr. Tom D’Angelo, President-Elect of the Pharmacists Society of the State of New York
Verbal Discussion – “Pharmacy Benefit Managers and How They Affect the Capability to Fill Prescriptions”

F.  Reports of Councilors (Informational Items)

  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
  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
  10. Seventh District Branch Report – Janine L. Fogarty, MD
  11. Eighth District Branch Report – Mark Jajkowski, MD
  12. Ninth District Branch Report – Thomas T. Lee, MD
  13. Medical Student Section Report – Peter Joo
         (no written report submitted)
  14. Organized Medical Staff Section – Stephen F. Coccaro, MD
         (no written report submitted)
  15. Resident & Fellow Section Report – Catherine E. Steger, MD
         (no written report submitted)
  16. Young Physician Section Report – L. Carlos Zapata, MD
         

G.  Commissioners (Informational Items)

  1. Commissioner of Continuing Medical Education, Mark J. Adams, MD
    a) Report from the Office of CME
  1. Commissioner of Communications, Maria A. Basile, MD, MBA
    a) Report from the Division of Communications
  1. Commissioner of Governmental Relations, Gregory Pinto, MD
    a)Scope of Practice Minutes, November 20, 2019
    b)Report from the Division of Governmental Affairs
  1. Commissioner of Membership, Parag H. Mehta, MD
    a) Membership Presentation
  1. Commissioner of Science & Public Health, Joshua M. Cohen, MD
        (no written report submitted)
  1. Commissioner of Socio Medical Economics, Howard H. Huang, MD
       a) Interspecialty Minutes, October 24, 2019

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

I.  Report of the General Counsel, Garfunkel Wild, P.C. Andrew Zwerling, Esq.
    (no written report submitted)

J. Report of the Alliance, Barbara Ellman, AMSSNY Co-President
Alliance Report

K. Other Information/Announcements
1. Scope of Practice Letters

L.  Adjournment

 

 

 

 

MSSNY Calls on NYS Legislature to Ensure Due Process For Innocent Physicians  

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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
January 22, 2020

MSSNY CALLS ON NYS LEGISLATURE TO ENSURE DUE PROCESS FOR INNOCENT PHYSICIANS
 

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

“The proposed Budget importantly advances several positive steps to promote public health, including restricting the sale of flavored tobacco products, regulating PBMs, and facilitating the ability of physicians to be more quickly approved into plan networks.

However, we are extremely concerned about the scope of the Budget proposals that would essentially strip physicians of important due process rights when a complaint has been filed with the Office of Professional Medical Conduct. We agree with the importance of acting quickly when it is imperative, but these proposals would completely undermine important and longstanding due process protections. Given that most complaints are dismissed without any sanction or action, this series of proposed changes to bypass these rights would create a substantial possibility of unfairly destroying an innocent physician’s career.

Due to our enormous liability costs and excessive regulations, New York already has the dubious reputation of being the worst state in the country to be a physician. Proposals like this will make it even more unattractive for physicians to choose New York to deliver patient care.

We welcome discussions to improve our disciplinary system to address gaps to help protect the public. However, these proposed changes are startling. We urge the Senate and Assembly to take a critical eye towards these overreaching proposals to assure patients can continue to receive the care they need.”

# # #

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

 

Media Contact:
Roseann Raia
Medical Society of the State of New York
516.488.6100 x 302
rraia@mssny.org

 

MSSNYeNews: Raymond J. Donovan’s Good Name – January 17, 2019

Arthur Fougner MSSNY Presiident

PRESIDENT’S MESSAGE
Arthur Fougner, MD
MSSNY President

MSSNY eNews
January 17, 2020

Vol. 23  Number 3


MSSNYPAC Seal


Colleagues:

In 1987, Reagan’s former Secretary of Labor Raymond J. Donovan was accused of corruption and mob connections in a case involving NY subway contracts. Needless to say, the press had a field day with a Reagan cabinet official linked to organized crime. After a brief trial, in which the defense called no witnesses, the jury quickly returned an acquittal on all counts. Following the verdict, Donovan famously asked, “Which office do I go to to get my reputation back?

In his State of the State, Governor Andrew Cuomo announced he was calling for streamlined physician discipline proceedings with transparency as well. While no details have been revealed as of yet, this seems at first blush, quite concerning. And sure enough, right on cue, the media is already jumping in. The Syracuse Post-Dispatch featured anecdotes of physicians’ criminal activity, damning with a broad brush. So, I call out the media here and now— “Balance, Reporters – You Need Balance.”

Let me assist in providing such balance. There are over 100,000 physicians in NY State. In 2016, about 10,000 reports were made to NY’s Office of Professional Medical Conduct. Out of those, about 300 resulted in serious actions. You read it right – 300 out of 10,000 or less than 3%. And the time it took was the result of painstaking investigation with full due process rights provided.

Again, without details, it is difficult to know just what cases would trigger this transparency or result in summary loss of license. A physician’s license can already be pulled if he/she is deemed an imminent threat to public safety. I am quite sure no one would argue. However, plastering a physician’s name on the front page of every newspaper in the state for any claim by a disgruntled patient is quite a different matter, especially before all the facts are known. The allegations against Donovan were serious, yet a jury quickly concluded after the prosecutors’ weak case that the indictments should never have been brought. Should all NY physicians be now treated as badly as Donovan? A claim of misconduct from the state is more than just a bad Yelp Review. It can be a career ending. Is this truly what the governor is asking for? Drop a dime and cover a doctor with slime?

In these days of record physician burnout, the last thing NY State needs is a Salem, Part Deux. Feel free to let me know how you feel. I urge everyone reading this to make plans to let all of Albany know how we feel on March 4.

We must all hang together for assuredly we will all hang separately.
Benjamin Franklin

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

Arthur Fougner, MD
MSSNY President


Capital Update

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The Week’s Legislative Podcast


SAVE THE DATE: MSSNY‘s Annual “Physician Advocacy Day” (3/4) Please Plan to be in Albany!
On January 8th the New York State Legislature returned to Albany for the 2020 session. As the New Year rings in and a new session begins, the need for physician advocacy and grassroots involvement is greater than ever. With the Governor’s State of the State Address teeing up items for potential concern such as Medicaid cuts, legalized marijuana and changes to the physician disciplinary process, but also supported reforms such as regulating PBMs and a flavored tobacco ban, it is imperative that physicians be in contact with their local legislators to ensure the physician community’s message is well-represented.

One opportunity is to participate in MSSNY’s “Physician Advocacy Day” that will be held on Wednesday, March 4th in the Lewis Swyer Theatre in the Egg located at the Empire State Plaza, Albany NY. Click here to register!

Join your colleagues from all around New York State and come to MSSNY’s Physician Advocacy Day to speak with your legislators and key policymakers to ensure they’re making the right choices for New York’s physicians and their patients.

A brief luncheon to which members of each House are invited to speak with their constituents will follow the morning program.  Please work with your County Medical Societies to schedule appointments for physicians to meet with their elected representatives.  If you have any questions/comments, please contact Raza Ali at rali@mssny.org.                  (ALI)


MSSNY Continues to Push Back Against Troubling Proposal to Bypass Disciplinary Due Process
With the Governor’s proposal to bypass important due process protections for physicians during disciplinary proceedings likely to be part of the 2020-21 Executive Budget, all physicians are urged to contact their legislators please click here to urge that the Legislature reject this proposal.

MSSNY President Dr. Art Fougner issued a statement (statement) and has been quoted in numerous media outlets across the State of New York (read here) that MSSNY is anxious to work to address gaps in the disciplinary process to protect the public, but also has strong objections to what has been publicly announced.

“Recognizing that there are enormous professional implications when disciplinary action is taken against a physician, or even when there has been an accusation, we must also ensure that fair due process is provided when a physician is accused of professional misconduct” Dr. Fougner stated. In fact, very few complaints made to the Office of Professional Medical Conduct ever result in any findings of misconduct.

More information about this proposal will be released next week.  (AUSTER)


Please Urge Your Legislators to Reject Unfair Medicaid Cuts
With the Governor’s soon to be released Executive Budget likely to include significant cuts to the State’s Medicaid program to address its estimated $4 billion Budget deficit, physicians are urged to contact their legislators (here) ask that they restore the recent 1% cut to Medicaid payments and to reject further cuts.

MSSNY recently joined on to a letter with several other physician and health care provider associations to protest the recent 1% across the Board Medicaid cuts announced New Years’ Eve.  MSSNY has publicly stated (MSSNY response) that these cuts are particularly offensive given the already grossly inadequate payments for physician care under Medicaid and Medicaid Managed Care in New York, and that New York physicians were not the beneficiaries of increases given last year to other health care sectors.  Indeed, New York Medicaid physician payment is a microscopic part of New York’s overall Medicaid Budget, with New York ranking 46th in the nation for reimbursement for Medicaid physician payment generally and 47th for primary care.   In short, the already tiny amount we currently spend for community based physician care helps to reduce costs in the Medicaid program, and should not be forced to share in the burden of addressing this deficit.

We must do more to assure patients have access to timely needed care.  However, this cut will do nothing to assure adequate care for New York’s neediest patients, and in fact, make this problem even worse.  Please urge your legislators to reverse the cuts, and to prevent future cuts (click here)                                                                                      (AUSTER)


MSSNY Joins Effort to Enact Comprehensive Law to Prohibit Flavored Nicotine and Tobacco Products
Gregory Threatte, MD, President of Albany County Medical Society and MSSNY President Arthur Fougner, MD participated in a press conference this week calling upon the NYS Legislature to enact bills that would ban all flavored e-cigarettes, including menthol. The groups also called for legislation that would also ban all flavored tobacco products, such as chewing tobacco and cigarillos. The press conference included Senator Brad Hoylman, Assemblymembers Linda Rosenthal, Rodneyse Bichotte and Tremaine Wright and other public health groups. MSSNY supports S. 428-B/A. 47-
A, sponsored by Senator Hoylman and Assemblywoman Rosenthal, which would prohibit the sale of flavored e-cigarettes, including menthol, and S.6809/A.8808, sponsored by Senator Hoylman and Assemblymember Bichotte, which would ban flavored tobacco products.  Passage of this legislation is now more critical since a state Supreme Court judge struck down New York State regulations called for by Governor Cuomo that would have banned flavored vaping products.  Physicians are encouraged to send a letter to their legislators and to the Governor about these bills through MSSNY Grassroots Action Center (GAC) here.
(CLANCY,CARY,ALI)  


NYS Senate Health Committee Moves Package of Bills on E-cigarettes
The Senate Health Committee this week moved several legislative e-cigarette proposals to the Senate Rules Committee.   S.428B, sponsored by Senator Brad Hoylman, would prohibit the sale and distribution of flavored e-cigarettes.  S.3905A, sponsored by Senator Gustavo Rivera, would regulate electronic cigarettes in the same way as tobacco products to prevent access to products by persons younger than 21 years. S.4249A, sponsored by the Senator Monica Martinez, would create restrictions for the locations of tobacco stores and electronic cigarette stores to be at least 200 feet away from a school or place of worship.              (CLANCY)


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Legislation to Expand Mandate For Pain Management For All DEA Prescribers on Senate Calendar
A measure that would expand the coursework under the current pain management requirement has moved to the Senate calendar.  S.7102, sponsored by Senator Brian Benjamin, would expand the topics within the three hour course to include techniques that would reduce the likelihood of overdose and spread of blood-borne diseases by those who use drugs; medications used for the treatment of addiction and information about becoming a buprenorphine prescriber.

The Medical Society of the State of New York is opposed to this measure.  MSSNY staff has been discussing the implications of this measure with Senators and Senate staff and its effect on prescribers who may have already taken course work to meet the requirement.   Physicians and other health care providers who have a DEA license were required to take a three hour course on pain management, palliative care, addiction that included the state and federal requirement for prescribing controlled substances, appropriate prescribing, managing acute pain, palliative medicine, prevention, screening and signs of addiction, responses to abuse and addiction and end of life care.

This requirement passed the Legislature in 2016 and physicians were required to have taken this program by July 1, 2017.  The law also requires that DEA prescribers take the course every three years—2020 is the start of a new cycle and physicians are again required to take this course.      (CLANCY)


MSSNY Opposes Legislation to Allow Estheticians & Others to Perform Laser Hair Removal
A bill (S.2834/A.821) that would allow estheticians, and others, to perform laser hair removal with only minimal physician oversight, was reported out of the Senate Committee on Consumer Protection at its first meeting of 2020, on Tuesday, January 14. MSSNY has long opposed this legislation as it would essentially legitimize a currently unregulated practice to perform a procedure that should only be done by an appropriately trained and educated individual, under physician supervision.

MSSNY indicated in its’ memo of opposition that it appreciates the intent of the legislation to increase safety and oversight and is working with the sponsors to make changes to the bill that establishes critical physician oversight and ensures patients’ safety.          (CARY)


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Partial Fill Prescribing Moves Forward in Senate
Legislation that would enable the dispensing of a partially filled controlled substances prescription, is moving forward quickly and is now on the Senate calendar for a vote.  The measure, S. 7115/A.9034, sponsored by Senator Gustav Rivera and Assemblymember John McDonald, would allow a prescriber to issue a partially filled prescription for a Controlled Substance II, III, IV, V to a patient.  The prescription would be recorded in the same manner as a refill and the remaining quantity of the prescription may be dispensed separately.

In 2016, Congress passed legislation that would enable partial fill prescription under the Comprehensive Addiction and Recover Act (CARA).  This state measure would allow New York State to conform to what is allowable under federal law.   A similar measure had passed during the 2019 legislative session, but was vetoed by Governor Andrew Cuomo.  This new bill addresses concerns expressed by the administration in its veto message. The Medical Society supports this measure and believes that it will help to reduce the amount of unused pain medication and will allow prescribers to help patients balance the need to relive pain with an adequate supply of medication.   (CLANCY)


Physicians Ordering Home Care for Your Patients – Are You Aware of the Impact of the New Medicare PDGM Methodology?
Physicians should be aware that Medicare has just implemented a new system for how it pays for patient home care services through a new methodology known as the Patient-Driven Groupings Model (PDGM).  The PDGM relies more heavily on clinical characteristics and other patient data to classify home health services into defined payment categories. While part of CMS’ effort to shift Medicare payment away from volume-based payment towards value-based payment, it could also produce new documentation responsibilities for physicians.

In particular, the PDGM will break up the standard 60-day episode of care into one of two 30-day periods. That means 30-day periods will be implemented as a basis for payment vs. the 60-day periods used now. Each 30-day period is grouped into one of 12 clinical categories based on the patient’s main diagnosis. Moreover, the PDGM will increase the number of payment groupings and unique case-mix potential from 153 to 432. The current system allowed for 153 combinations, but with PDGM each 30-day period can be categorized into one of 432 case-mix groups.

The Home Care Association of New York State has shared with MSSNY a suite of resources for physicians interested in learning more about the PDGM.  To read more about what physicians ordering home care services need to know about this program, please review: Brochure  and Physicians Toolkit Guide

At the November 7, 2019 meeting of the MSSNY Council, a resolution was adopted to monitor implementation of the PDGM “to determine whether this new program will impose additional administrative burdens on physicians certifying home care services for their patients, and/or whether it will impede patients from receiving needed home care services”.  To that end, please let us know if this system is causing new difficulties in ensuring your patients get the home care services they need.         (AUSTER)


Registration now open for Medical Matters: Virtual Drill: Incident Command System & Crisis Communications
MSSNY’s next Medical Matters will feature a Virtual Drill on the Incident Command System and Crisis Communications on February 19th from 6:00-8:00pm. Faculty for this program are: Arthur Cooper, MD; Pat Anders, MS, MEP; William Valenti, MD and Lorraine Giordano, MD.

Educational Objectives are:

  • Obtain information about local, state and national chain of command in a public health emergency and learn how to access resources
  • Understand the importance of planning for medical surge and triage of patients, as well as staff and family considerations, in the office-based practice setting during a health emergency
  • Develop an understanding that all public health emergencies can potentially have mental health implications for survivors and others connected with the event
  • Acquire skills for the management of patients in a public health emergency

Please note that there are recommended pre-course materials to be viewed prior to this virtual drill. You will be sent a link with your registration confirmation. We encourage all participants to examine these prior to the Virtual Drill.  Register by clicking   here Additional information or assistance with registration may be obtained by contacting Melissa Hoffman at mhoffman@mssny.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 2.0 AMA/PRA Category 1 credits™.  Physicians should claim only the credit commensurate with the extent of their participation in the activity.

 pschuh@mssny.org mauster@mssny.org  pclancy@mssny.org  zcary@mssny.org
rali@mssny.org

 

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Three US Airports (JFK Included) Screen for Novel Virus from China
Today, in response to an outbreak of novel coronavirus, public health screening will begin at three major U.S. airports that receive travelers from Wuhan, China, the CDC announced. Starting today, airports in San Francisco (SFO), New York (JFK), and Los Angeles (LAX) will screen for symptoms associated with this virus in travelers arriving from direct or connecting flights from Wuhan, where the outbreak originated, the agency said in a statement.

Officials said that they expect to see cases of this novel virus “around the world” as people start to look for it more and that it is highly plausible at least one case will occur in the U.S.

Screening will begin Friday night at JFK for a flight that arrives around 10 p.m., CDC officials said in a conference call on Friday. JFK is one of two airports, along with SFO in San Francisco, that receive travelers on flights directly from Wuhan. Officials said that LAX was included because of the large volume of passengers coming from indirect flights.

Passengers will be screened about symptoms and fever at the airport and people of concern will be triaged for evaluation, including a more detailed exam and questions about exposures. Then, they will be referred to a facility where, ultimately, diagnostic tests can be performed. CDC said its lab “already has the ability to identify the pathogen,” with the exact sequence of the virus, which is publicly available. They added that they are working on a test to identify the virus to distribute to state health departments.

In the statement, CDC said it is deploying about 100 additional staff at the three airports to supplement staff at CDC quarantine stations.


SIGN UP TO RECEIVE ALERTS FROM MSSNY’S GRASSROOTS ACTION CENTER 

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When you subscribe to the Medical Society of the State of New York Grassroots Action Center, the Division of Governmental Affairs will alert you when legislation and issues of importance to physicians and patients, either in the NYS legislature or in Congress, are at critical stages.

Accordingly, contact from constituents would be vital to influencing the path and future of that legislation or issue.

Alerts will be accompanied by recommended actions you or your designee can take to have maximum impact such as calling, tweeting and emailing a customizable letter to your legislators.

If you are concerned with health care policy formation in New York State, please subscribe today by texting MSSNY to 52886 and you will be prompted to enter your email address.  When you sign up, it is best to use your NY-based voting address or practice address (if you do not reside in NY) for your alerts.

Contact the Division of Governmental Affairs at 518-465-8085 or albany@mssny.org if you have questions or comments.  Thank you.
(WILKS)


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Survey: Gen-X physicians More Likely to Report Burnout
Physicians ages 40 to 54, grouped together as Generation X, were more likely to report feeling burned out than the millennial and baby boomer doctors surveyed by Medscape in its latest report on job-related stress and suicide risk among doctors.

The survey was completed by about 15,000 physicians in 29 specialties. Medscape defines burnout as “long-term, unresolved, job-related stress leading to exhaustion, cynicism, detachment from job responsibilities and lacking a sense of personal accomplishment.”

Dr. Carol Bernstein, vice chair of faculty development and well-being at Montefiore Medical Center and the Albert Einstein College of Medicine, said in the report that the midcareer period, which Gen Xers are in, can be particularly stressful.

“In addition, I suspect that group is juggling multiple roles outside of work, including caring for children as well as elderly parents, and working as well as planning for retirement,” Bernstein said in the report.

Overall, the rate of physician burnout, at 42%, has fallen slightly from a rate of 46% five years ago. Forty-eight percent of women said they felt burned out, compared with 37% of men. About half of physicians said they would take a pay cut if it meant more free time.

Doctors said bureaucratic tasks such as charting and long hours were leading drivers of stress.

Specialists in urology, neurology and nephrology reported the highest rates of burnout, with about half of those respondents saying they have experienced it. (Crain’s Health Plus Jan. 15) Public health and preventive medicine doctors, ophthalmologists and orthopedists reported the lowest rates, approximately 3 in 10.


First Study by CDC: Evidence of Links Between Lung Injury with Use of E-Cigarettes
The Centers for Disease Control and Prevention said Tuesday that a new study, along with state-based evidence, strengthens the link between lung injury associated with the use of e-cigarettes or vaping products and the use of THC-containing products obtained from informal sources, including family and friends as well as online sellers.


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Statistics Indicate Alcohol Use Been Rising for Two Decades
The AP (1/14) reports a new federal health statistic indicates “Americans are drinking more now than when Prohibition was enacted;” moreover, “it’s been rising for two decades, and it’s not clear when it will fall again.” The stats “show a rise in per-person consumption and increases in emergency room visits, hospitalizations and deaths tied to drinking,” but teen drinking is down. The article details history of alcohol use in the U.S., and cultural attitudes surrounding drinking.

The Hill (1/14) reports “Americans drink, on average, 2.3 gallons of alcohol per year in the form of beer, wine and mixed beverages, according to a new analysis of federal health statistics.” This “news comes just a day after it was announced by beverage industry trackers that U.S. wine consumption dropped in 2019 for the first time since 1994.”



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As of December 5, 2019, Influenza is Prevalent in NYS
At this time, Section 2.59 of the New York State Sanitary Code (10 NYCRR § 2.59) requires all health care and residential facilities and agencies regulated pursuant to Article 28, 36, or 40 of the Public Health Law to ensure that all personnel, as defined in the regulation, not vaccinated against influenza for the current influenza season wear a surgical or procedure mask while in areas where patients or residents are typically present. https://www.health.ny.gov/diseases/communicable/influenza/seasonal/providers/prevention_of_influenza_transmission/ See Influenza Activity, Surveillance and Reports for to access the full weekly report. For information about the “flu mask regulation” and the current status of the Commissioner’s declaration, please visit www.health.ny.gov/FluMaskReg. Download the data used in this dashboard at Health Data NY.


Pan-Resistant Candida auris in New York Detailed
Three cases of pan-resistant Candida auris in New York highlight the need for continued C. auris surveillance, researchers write in MMWR.

From August 2016 through June 2019, some 800 cases of C. auris were identified in the state. Of isolates that underwent susceptibility testing, nearly all were resistant to fluconazole, two-thirds to amphotericin B, and 4% to echinocandins. For three patients, isolates were resistant to all three antifungal classes:

  • The three patients were 50 or older with multiple comorbidities; none had traveled recently.
  • Pan resistance appeared to develop after treatment with echinocandins, the first-line treatment for C. auris.
  • There was no epidemiologic link among the three.
  • These patients did not appear to transmit pan-resistant C. auris to others or to the environment.

The authors advise, “Patients on antifungal treatment for C. auris should be monitored closely for clinical improvement, and follow-up cultures should be obtained. Repeat susceptibility testing should also be conducted, especially in patients previously treated with echinocandins.”

MMWR article (Free)
Background: HIV and ID Observations post on C. auris and antimicrobial resistance (Free)


DEA Data: More Than 100 Billion Pain Pills Saturated the Nation Over Nine Years
The Washington Post (1/14) reports that data from the Drug Enforcement Administration “shows that more than 100 billion doses of oxycodone and hydrocodone were shipped nationwide from 2006 through 2014 – 24 billion more doses of the highly addictive pain pills than previously known to the public.” In July, The Post “reported that the data revealed that the nation’s drug companies had manufactured and distributed more than 76 billion pain pills.” The “two additional years of information – 2013 and 2014 – was recently posted by a data analytics company managed by lawyers for the plaintiffs in a massive lawsuit against the opioid industry.”



press conference on January 13
Dr. Gregory Threatte, president of the Albany County Medical Society and Dr. Art Fougner, MSSNY President, participated in a press conference on January 13 calling for the elimination of all flavored e-cigarettes and tobacco products, including menthol flavors.   Dr. Hazel Dukes, President of the NAACP New York State conference, Senator Brad Hoylman, Assemblymembers Linda Rosenthal, Rodneyses Bichotte and Tremaine Wright, joined with more than 40 organizations from across the state to call for a full and immediate end to the sale of flavored tobacco products in NYS.

Doctors and NAACP President: Ban All Forms of Flavored Tobacco
Public health officials, leaders of the state NAACP and other advocates urged Albany lawmakers on Monday to target all forms of flavored tobacco — including menthol combustible cigarettes — in their expected crackdown on vaping.

With the Senate and Assembly set to advance a package of e-cigarette bills as early as next week, advocates said that menthol cigarettes, smokeless tobacco, hookah and other products should be included in any statewide flavor ban.

“Don’t confuse the delivery device with the underlying toxin,” Gregory Threatte, president of the Medical Society of the County of Albany, told lawmakers during an afternoon news conference at the Legislative Office Building.

Hazel Dukes, president of the NAACP New York State Conference, argued that a ban on all flavored tobacco products “is long overdue” given the industry’s history of using these products to target children and minorities.

“This is nothing new,” she said at the news conference. “The device may have evolved but the deceptions have not. For generations the tobacco industry has been targeting our youth, and particularly African American kids, with flavor products, especially menthols.”

Dukes urged lawmakers to “immediately end this immoral, discriminatory practice of targeting kids” by ending sales of all flavored tobacco products in New York.


CMS

Upcoming QPP Service Center Hold Times
Due to the opening of the 2019 MIPS data submission period, the Quality Payment Program (QPP) Service Center is projecting an increase in volume of calls and emails between January and March 2020, resulting in longer wait times.

CMS recommends the following to minimize wait times and ensure successful 2019 submission:

  • Use One Method to Report Issues— Due to the increase in volume at the QPP Service Center, to minimize backlog, please use only one method of reporting for the same issue (email or phone). Note: Cases are processed in the order in that they are received regardless of the manner in which the Service Center was contacted. Please allow time for processing.
  • Submit Your Data Early— We encourage you to submit your 2019 MIPS performance period data early during the submission period. Early submission will allow you plenty of time for Service Center assistance if needed.
  • Call the Service Center at Off-Peak Hours— We strongly recommend calling the Service Center during off-peak hours (8:00 AM-10:00 AM ET OR 2:00 PM-8:00 PM ET).

For More Information

  • Visit the QPP Resource Library to review new and existing QPP resources.
  • Contact the Quality Payment Program at 1-866-288-8292, Monday through Friday, 8:00 AM-8:00 PM ET or by e-mail at: QPP@cms.hhs.gov. Reminder: to receive assistance more quickly, consider calling during non-peak hours—before 10:00 AM and after 2:00 PM ET.
  • Customers who are hearing impaired can dial 711 to be connected to a TRS Communications Assistant.

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Great Career Opportunities for Clinical Physicians
Physicians, are you looking for a change?  Tired of working long shifts with an overwhelming patient load?  Come work at a well-equipped and staffed correctional facility where you can MAKE a difference, working with a smaller number of patients for reasonable hours.

Starting salary is $143,381 – $171,631 *Additional $20,000 geographical differential for Clinton & Franklin CF, and $10,000 for Five Points, Greene and Groveland CFs. We offer full-time, part-time & hourly/per-diem positions.

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

Clinton*                 Clinton Correctional Facility (sporting and recreational outlets)
Chemung               Elmira and Southport Corrl Facilities (Gateway to the Finger Lakes)
Columbia*             Hudson Correctional Facility (antiquing, arts & collectables)
Dutchess                Green Haven Correctional Facility (Hudson River Valley Beauty)
Franklin*                Franklin & Upstate Corrl Facilities (North Country, 1 hour to Montreal)
Greene*                 Greene Correctional Facility (rural charm yet only 2 hours to NY City)
Livingston*            Groveland Correctional Facility (State Parks, hiking, fishing)
Oneida                   Mohawk Correctional Facility (Cooperstown, breweries)
Orleans                  Albion Correctional Facility (Greater Niagara Region & Canal Town Culture)
Sullivan                  Woodbourne Correctional Facility (mountains, outlets, entertainment)
Seneca*                 Five Points Correctional Facility (heart of wine country)
St. Lawrence          Riverview Correctional Facility (hiking, boating and museums)
Ulster                     Shawangunk and Wallkill Corrl Facility (Catskill Mountains, Casinos)
Washington           Great Meadow Corrl Facility (Between Vermont & Green Mountains)
Westchester           Bedford Hills Correctional Facility (Less than 1 Hour to NYC)
Wyoming               Wyoming Correctional Facility (waterfalls, family farms, natural beauty)

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Inquire with the Facility Personnel Office regarding benefits and anticipated opportunities: http://www.doccs.ny.gov/faclist.html. Contact: www.doccs.ny.gov or DOCCS Personnel Office at (518) 457-8132 for more information and to apply.



 

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

 

MSSNY Responds to Governor’s Statement on Physician Discipline Proposal


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
January 10, 2020 

MSSNY RESPONDS TO GOVERNOR’S STATEMENT ON PHYSICIAN DISCIPLINE PROPOSAL 

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

“New York’s Physicians have a great interest in working with the State Health Department to ensure that New York’s disciplinary process moves swiftly when necessary to remove those from practice that present a threat to the public.  To that end, we have worked proactively with the Administration and Legislature on laws to enhance the ability of OPMC to “summarily suspend” physicians in certain instances where it would be imprudent to wait for a final action.  And it is imperative that we work for improvements to this system as issues arise that interfere with its mission to protect the public.

At the same time, an appropriate balance is needed.  Recognizing that there are enormous professional implications when disciplinary action is taken against a physician, or even when there has been an accusation, we must also ensure that fair due process is provided when a physician is accused of professional misconduct.  Indeed, most complaints of alleged misconduct do not become actual findings of misconduct. Yet with Google and Yahoo search functions, an unproven allegation could linger forever in cyberspace, and permanently and unfairly scar a reputation.  We look forward to reviewing the text of this proposal as it becomes available and working with the Legislature and Governor to ensure we maintain the critical balance of protecting the Public while also protecting against the consequences of unfounded allegations.”

# # #

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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MSSNYeNews: A Hard Rain’s A ‘Gonna Fall – January 10, 2020

Arthur Fougner MSSNY Presiident

PRESIDENT’S MESSAGE
Arthur Fougner, MD
MSSNY President

MSSNY eNews
January 10, 2020

Vol. 23  Number 2


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Colleagues:

As I wing my way toward the AMA’s State Legislation Advocacy Meeting in Florida, I keep thinking about Governor Cuomo’s State of the State speech. While there are things we most certainly can support, when he got to healthcare, the tone shifted. As I wrote previously, Medicaid is the largest item responsible for NY’s $6B budget deficit. The Governor had already cut payments 1%, but he went further. He blamed local spending for much of the problem and offered that his initial Medicaid Redesign would need Redesign.

We also learned that he would propose legislation to boost OPMC and physician discipline. As it so happens, on Monday, MSSNY will be meeting with DOH and OPMC and will learn more about specifics.

All too often, we hear about physician burnout, physician suicide and how physician wellness is on the DOH agenda. It appears ironic to talk about burnout and wellness when the state is cutting payments and talking about streamlining physician discipline. If physicians feel that someone has stuck a “Kick Me” sign on their backs, it is understandable. Medicine has become a profession of Rodney Dangerfields. I can hear him now – “When I see patients, I get no respect. After Press Ganey gets me, the Insurers, Trial Lawyers and Government get their licks in, too.”

Getting physicians to join together has been likened to herding cats. However, in the coming weeks and days, we all really do need to band together. Stay tuned to MSSNY updates as many devilish details remain to be hashed out. Trust me, this is serious. If we don’t work collegially and collectively, we are sunk. The 1% Medicaid Cut was but a test of our resolve. Far worse may be coming down I-87.  Please consider this year’s March 4th Lobby Day in Albany, our day to make them hear all of us. I call on all NY’s physicians, Medical Staff Societies, Specialty Societies, Ethnic Societies to text MSSNY to 52886 to get our Grassroots alerts and updates. Also, please contribute to our MSSNY-PAC as well. No contribution is too small. We need all the help we can get. Quoting David Byrne as I have previously: “This ain’t no party. This ain’t no disco. This ain’t no foolin’ around.”

And it’s a hard, it’s a hard
It’s a hard, it’s a hard
It’s a hard rain’s a gonna fall.
Bob Dylan, A Hard Rain’s A Gonna Fall

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

Arthur Fougner, MD
MSSNY President


Capital Update

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Governor Cuomo Proposes Changes to OPMC Processes; MSSNY Expresses Strong Objections
Governor Cuomo released his 36th proposal as part of a package of policy changes in 2020. The plan calls for changes in the way that DOH investigates, disciplines and monitor physicians, physician assistants and specialist assistants licensed in New York. Details of the proposed changes include:

  • Making investigations public “when the Commissioner of Health deems it warranted”, as well as, making administrative warning actions public.
  • Eliminating lifetime licensure to ensure out of state physicians with a NY license periodically renew.
  • Amend the Public Health law to allow the State Health Commissioner to suspend a physician’s license, at the start of an investigation, if the commissioner deems that physician to be a risk to the public. This would be a lessened standard from the current “imminent danger” standard currently required for a summary suspension.

In response, MSSNY released the following statement:  “New York’s Physicians have a great interest in working with the State Health Department to ensure that New York’s disciplinary process moves swiftly when necessary to remove those from practice that present a threat to the public. To that end, we have worked proactively with the administration and legislature on laws to enhance the ability of OPMC to “summarily suspend” physicians in certain instances where it would be imprudent to wait for a final action. And it is imperative that we work for improvements to this system as issues arise that interfere with its mission to protect the public.

At the same time, an appropriate balance is needed. Recognizing that there are enormous professional implications when disciplinary action is taken against a physician, or even when there has been an accusation, we must also ensure that fair due process is provided when a physician is accused of professional misconduct. Indeed, most complaints of alleged misconduct do not become actual findings of misconduct. Yet with Google and Yahoo search functions, an unproven allegation could linger forever in cyberspace, and permanently and unfairly scar a reputation. We look forward to reviewing the text of this proposal as it becomes available and working with the Legislature and Governor to ensure we maintain the critical balance of protecting the Public while also protecting against the consequences of unfounded allegations.”

MSSNY Division of Governmental Affairs Staff will keep our members updated as discussions move forward, in the coming months, in Albany.                               (DIVISION OF GOVERNMENTAL AFFAIRS)             


Governor Cuomo Outlines 2020 Health Priorities at State-of-the-State
On Wednesday, January 8th, members of the New York State Senate, Assembly, and other governmental dignitaries, gathered in the Convention Center for Governor Cuomo’s State-of-the-State speech, where he outlined his 2020 agenda, including his health priorities. MSSNY will likely support many of these initiatives, while other items raise serious concerns, at first glance, and require close monitoring, this session. The following is the full list of issues MSSNY Staff will closely follow, and potentially take action if necessary, in the coming months:

  • Proposal for legislation to address the OPMC disciplinary process that would enact periodic renewal requirements for New York physicians, physician assistants and specialist assistants to maintain their licenses and ability to practice in the state if they practice out of state. He will also seek to update the public health law to strengthen disciplinary oversight and allow for quick removal of providers who present a risk to patients; ensure the public can access up-to-date information about physicians and any professional conduct concerns; and give the Office of Professional Medical Conduct authority to increase patient safety and physician accountability.
  • Reducing the small business tax from 6.5% to 4%.
  • Expands Access to Buprenorphine, an important advance in Medication Assisted Treatment, which, like methadone and injectable naltrexone, is used in combination with counseling, to help people reach and sustain recovery from Opioid Use Disorder.
  • Governor Cuomo will direct the Department of Health (DOH), to require all hospitals statewide to develop protocols for their emergency departments to address Opioid Use Disorder based on the standard of care for treatment or referral for treatment. The Enacted Budget also prohibits health plans from requiring prior authorization for Medication Assisted Treatment.
  • Legalizing Gestational Surrogacy Current state law creates legal uncertainty for parents of children conceived by reproductive technology. The governor’s proposal establishes criteria for surrogacy contracts, providing for the nation’s strongest protections for parents and surrogates. His proposal will also streamline the “second parent” adoption process, removing outdated barriers and extending common-sense protections for New York families.
  • A proposal to legalize recreational marijuana.
  • Proposal to ban all flavored nicotine vaping product, including menthol flavors. The governor has also proposed banning vaping advertisements aimed and youth and to authorize the NYS Department of Health to regulate the sale of chemicals used in vaping-related products and ban the sale of vaping product carrier oils deemed a hazard to public health. His proposal also includes legislation that would prohibit the online, phone and mail order sale of e-cigarettes and would require that only registered retailers be allowed to purchase e-cigarettes using these methods.
  • Legislation to crack down on retailers that illegally sell untaxed cigarettes and other tobacco products in New York State. Under the Governor’s proposal, retailers who acquire untaxed cigarettes from other states or other sources and sell them illegally in New York would face possible closure. The Governor is also proposing strengthening penalties and fines for retailers that sell tobacco products to people under 21 years of age.
  • A proposal for the Department of Health, the Department of Financial Services, and the New York State Digital and Media Services Center- a joint enterprise of the Office of Information Technology Services and Office of General Services – to create a consumer-friendly website, called NYHealthcareCompare, where New Yorkers can easily compare the cost and quality of healthcare procedures at hospitals around the state. The platform will also provide consumers with educational resources designed to help consumers know their rights including financial assistance options, what to do about a surprise bill and more.
  • Require the registration of all PBMs and oversight by DFS.
  • Proposal to develop a three part plan to lower prescription drug costs for all New Yorkers. The Governor’s proposal would cap insulin co-payments at $100 per month for insured patients to help address the rising cost of insulin that has resulted in diabetes patients rationing, skipping doses and not filling prescriptions.
  • A call for legislation banning fentanyl analogs — a deadly synthetic opioid that is 50 to 100 times more potent than morphine — by making them subject to the same criminal sale or possession penalties as other controlled substances. The legislation will also empower the New York State Health Commissioner to ban any new fentanyl analogs that have been added to the federal schedule of controlled substances, allowing the State to deal with these deadly substances in real time rather than play catch up.
  • A proposal calling for legislation to prevent individuals from receiving New York State gun licenses if they commit a crime in another state that is similar to a crime that would disqualify them from owning a gun in New York State. New York law currently prohibits individuals from obtaining a gun license if they commit certain New York misdemeanors that are deemed “serious offenses.” However, the law does not prohibit individuals from obtaining a New York gun license after committing comparable misdemeanors in another state.
  • Expanding the surprise bill law to: prohibit billing of patients by out of network physicians and hospitals for emergency care for amounts above the applicable cost-sharing amounts; and to require disclosure of facility fees to patients in Article 28 and Office-Based surgery settings.

Proposed Cuts to Medicaid
On January 1, 2020, Governor Cuomo implemented a 1% across-the-board cut to the state’s Medicaid program & we anticipate additional proposed reductions to the program when his budget is released. The Governor did not provide more details about his plans to address the $6 Billion Budget deficit, except for his goal to convene a new Medicaid Redesign Team (MRT). More details will come when Governor Cuomo releases in his New York State Budget on this cut and the other proposals contained in his State of the State. MSSNY Division of Governmental Affairs staff will follow with more information as it becomes available. At this time, it is unclear whether each of these initiatives will be pursued in the State Budget or through stand alone “program” legislation.
(DIVISION OF GOVERNMENTAL AFFAIRS)        


MSSNY Calls for a Reversal of Medicaid Cut; Please Join Our Efforts
MSSNY joined several other specialty societies and health care provider associations in a letter to Governor Cuomo this week urging that the recently enacted 1% cut to Medicaid physician payments be reversed.  The letter noted that “The State’s Medicaid program has not adequately reimbursed for increased costs and critical policy initiatives since the Medicaid Redesign Team (MRT) changes began to take effect” and that “In spite of these cost increases in the past decade, providers have not had a trend factor to recognize the basic expenses of providing care to the poor, elderly and disabled in our State.”

In MSSNY’s own statement on this cut (click here for MSSNY statement), MSSNY President Dr. Art Fougner noted that physicians are “confounded by the announced cuts”, given that “Medicaid physician payment remains a very small part of New York’s overall Medicaid Budget” and that “New York has one of the lowest Medicaid to Medicare physician payment ratios in the country”. With New York State facing a $6 Billion Budget deficit for the 2020-21 fiscal year, further steep cuts could be proposed in the soon-to-be released Governor’s Executive Budget.  Physicians are urged to contact their legislators to act to reverse these cuts, and prevent further cuts. click here.                                                                        (AUSTER)


Senate Health Committee To Act on Package of Bills Regarding E-Cigarettes
On Monday, January 13th, the Senate Health Committee will take action on several legislative e-cigarette proposals.  S. 428B, sponsored by Senator Brad Hoylman, which would prohibit the sale and distribution for use in e-cigarettes.  S. 3905A, sponsored by Senator Gustav Rivera, which would regulate electronic cigarettes in the same way as tobacco products to prevent access to products by persons younger than 21 years.  S. 4249A, sponsored by the Senator Monica Martinez, which would create restrictions for the locations of tobacco stores and electronic cigarette stores to be at least 200 feet away from a school or place of worship.

The Medical Society of the State of New York supports banning all flavored e-cigarettes, including menthol and supports legislation that would also ban all flavored tobacco products, such as chewing tobacco and cigarillos.  On January 13th, MSSNY President Arthur Fougner, MD, and Gregory Threatte, MD, President of the Albany County Medical Society will participate in an Albany press conference on e-cigarettes with members of the Legislature and will join with other public health groups, in advocating for measures that would prohibit the sale of flavored tobacco products and e-cigarettes, including menthol.   

In December,  MSSNY has joined with other public health organizations that called upon the Governor, the Senate and Assembly leaders, and members to pass legislation that would prohibiting the sale of flavored nicotine and tobacco products which will protect our young people from the scourge of the myriad health problems and addictions caused by flavored tobacco products and e-cigarettes. Physicians are encouraged to send a letter through MSSNY Grassroots Action Center (GAC)  here.>
(CLANCY)


Legislation to Expand Mandate For Pain Management for All DEA Prescribers
A measure that would expand the coursework under the pain management requirement will be acted upon by the Senate Health Committee next week.  S. 7102, sponsored by Senator Brian Benjamin, would include requirements that would reduce the likelihood of overdose and spread of blood-borne diseases by those who use drugs; medications used for the treatment of addiction and information about becoming a buprenorphine prescriber.  Additionally, the bill requires prescribers to update standards and approvals as necessary according to best practices for providing patient centered care with the consideration of social determinants of health and co-occurring disorders.

The Medical Society of the State of New York is opposed to this measure.  Physicians and other health care providers who have a DEA license were required to take a three hour course on pain management, palliative care, addiction that included the state and federal requirement for prescribing controlled substances, appropriate prescribing, managing acute pain, palliative medicine, prevention, screening and signs of addiction, responses to abuse and addiction and end of life care.

This requirement passed the Legislature in 2016 and physicians were required to have taken this program by July 1, 2017.  The law also requires that DEA prescribers take the course every three years—2020 is the start of a new cycle and physicians are again required to take this course.  MSSNY is in the process of updating its current pain management program and it will be available by spring. (CLANCY)


MSSNY Opposes Legislation to Allow Estheticians & Others to Perform Laser Hair Removal
A bill that would allow estheticians, and others, to perform laser hair removal with only minimal physician oversight, was reintroduced in 2019 and is on the agenda for next week’s Senate Committee on Consumer Protection. MSSNY has long opposed this legislation as it legitimizes in statute a currently unregulated practice to perform a procedure that should only be done by an appropriately trained and educated individual, under physician supervision. Procedures involving lasers have the potential to cause painful burns and permanent scarring if not used properly.

A 2013 article in the Journal of the American Medical Association (JAMA) reported on a study that showed that, despite the fact that approximately only 1/3 of laser hair removal procedures are performed by non-physicians, 75.5% of hair removal lawsuits from 2004 to 2012 were performed by non-physicians, and that from 2008 to 2012, this percentage increased to 85.7%. MSSNY appreciates the efforts of the sponsors to provide greater regulation of a currently unregulated practice, but in its current form, MSSNY opposes this legislation. We will continue to work with the sponsors to ensure the bill is amended to establish necessary oversight of this practice and to ensure patients’ safety.                      (CARY)


Barclay Elected as New Assembly Minority Leader
Assemblymember Will Barclay (R-Pulaski) has been elected by the Assembly Republican Conference as the new Minority Leader of the New York State Assembly.  Assemblyman Barclay previously served as Ranking Member of Assembly Ways & Means Committee and, prior to that, as Ranking Member of the Assembly Insurance Committee.  He replaces Assemblymember Brian Kolb in this post.  MSSNY congratulates Assemblymember Barclay on this new position, and looks forward to working with him.                                          (AUSTER)


AG James Stops Public Charge Rule From Taking Effect
The United States Court of Appeals for the Second Circuit denied the Trump Administration’s efforts to immediately reverse preliminary injunction on the president’s Public Charge Rule. In September 2019, Attorney General James filed a motion to seek a preliminary injunction to stop the Trump Administration’s public charge rule from going into effect. In August 2019, Attorney General James and a coalition that included the attorney general of Connecticut and Vermont, as well as the City of New York filed a lawsuit challenging the Trump Administration’s Public Charge rule which aimed to deny green cards and visas to immigrants who use government assistance programs.

The preliminary injunction seeks to stop the public charge rule from taking effect arguing that it would harm millions of non-citizens and their family members by deterring them from accessing public benefits that they are lawfully entitled to receive. As New York braces to confront the $6 billion dollar budget gap with DOH’s decision to cut Medicaid payments by 1% in 2020 as well as overall Medicaid enrollment decline, individuals who would have otherwise had access to healthcare are at risk of living with undiagnosed and untreated conditions.                                                                              (ALI)


SAVE THE DATE: MSSNY‘s Annual “Physician Advocacy Day” (3/4)
On January 8th the New York State Legislature welcomed back returning members to Albany! As the new session begins, the need for physician advocacy and grassroots involvement is greater than ever.  Physicians can sign up to participate in MSSNY’s “Physician Advocacy Day” which will be held on Wednesday, March 4th in the Lewis Swyer Theatre in the Egg, Empire State Plaza, Albany NY. Click here to register!

Join your colleagues from all around New York State and come to MSSNY’s Physician Advocacy Day to speak with your legislators and key policymakers to ensure they’re making the right choices for New York’s physicians and their patients.

A brief luncheon to which members of the NYS Legislature are invited to speak with their constituents will follow the morning program. County medical societies will also be scheduling appointments for physicians to meet with their elected representatives.

If you have any questions/comments, please contact Raza Ali at rali@mssny.org.                                                               (ALI)


“Doctor Are You Ready?” CME Webinar on January 15; Registration Now Open
Disasters big and small happen every day.  Be sure to find out how best to be prepared at MSSNY’s next Medical Matters webinar: Doctor Are You Ready? on January 15th at 7:30am.  Kira Geraci-Ciardullo, MD, MPH immediate past speaker of the house and a member of the Emergency Preparedness and Disaster/Terrorism Response Committee will serve as faculty for this program. Registration is now open for this webinar here

Educational objectives are:

  • Explore core preparedness competencies every physician should possess
  • Describe emergency situations that arise on a regular basis
  • Identify resources to acquire preparedness training

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


MSSNY & St. Peter’s Health Partners to Host Four Grand Rounds Seminars
The Medical Society of the State of New York and St. Peter’s Health Partners are providing four CME live seminars for the Veterans Matters programs. The following seminars will take place at St. Peter’s Hospital in Mercy Conference Rooms 1 – 4, 315 S Manning Blvd, Albany, NY 12208.

  • The Special Mental Health Needs of Women Veterans
        When: January 15, 2020 at 7:00 am
    Faculty: Malene Ingram, MD (Col., US Army Reserves)
  • Substance Use Disorders (SUDs) in Veterans
        When: January 22, 2020 at 7:00 am
    Faculty: Thomas Madejski, MD
  • PTSD in Returning Veterans
        When: January 29, 2020 at 7:00 am
    Faculty: Adolph Meyer, MD
  • Military Culture: Everything Physicians Need to Know about Veterans as Patients
        When: February 5, 2020 at 7:00 am
    Faculty: Lt. Cl. Lance Allen Wang

Reservations can be made by contacting Lori Weaver at Lori.Weaver@sphp.com or (518) 874-6914. Please click here to view the flyer.

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 each of these live activities 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. (SHERPA)


eNews

TODAY!
MSSNY Responds To Gov.’s Statement on Physician Discipline Proposal
“New York’s Physicians have a great interest in working with the State Health Department to ensure that New York’s disciplinary process moves swiftly when necessary to remove those from practice that present a threat to the public.  To that end, we have worked proactively with the Administration and Legislature on laws to enhance the ability of OPMC to “summarily suspend” physicians in certain instances where it would be imprudent to wait for a final action. And it is imperative that we work for improvements to this system as issues arise that interfere with its mission to protect the public.

At the same time, an appropriate balance is needed. Recognizing that there are enormous professional implications when disciplinary action is taken against a physician, or even when there has been an accusation, we must also ensure that fair due process is provided when a physician is accused of professional misconduct.  Indeed, most complaints of alleged misconduct do not become actual findings of misconduct. Yet with Google and Yahoo search functions, an unproven allegation could linger forever in cyberspace, and permanently and unfairly scar a reputation.  We look forward to reviewing the text of this proposal as it becomes available and working with the Legislature and Governor to ensure we maintain the critical balance of protecting the Public while also protecting against the consequences of unfounded allegations.”


MSSNY President Criticizes Governor Cuomo’s Medicaid Cuts
Politico Pro (1/6) reports that healthcare providers, insurers, and others are pushing back against “the state’s new 1 percent across-the-board reduction in Medicaid spending” calling for Gov. Cuomo “to take a more targeted approach as it looks to close a $4 billion budget gap in the coming months.”

Dr. Art Fougner, the president of the Medical Society of the State of New York (MSSNY), said,Physicians are confounded by the announced cuts to their payments for care delivered to Medicaid beneficiaries… This is particularly difficult to accept given that they were not the beneficiaries of increases to Medicaid payments recently granted to other parts of the health care system. In fact, Medicaid physician payment remains a very small part of New York’s overall Medicaid Budget.”


WSJ: Former MSSNY President Warns Risks of Expanding Marijuana Industry
In a letter for the Wall Street Journal (1/6) former President of the Medical Society of the State of New York Dr. Thomas J. Madejski, wrote:

Regarding your editorial “The Vaping-Marijuana Nexus” (Dec. 26): Tobacco, marijuana and vaping companies mislead the public on the clear harms associated with wider use of today’s higher-THC-content marijuana and inhaling substances other than clean air. Opponents of expansion of marijuana availability acknowledge concerns about disparate enforcement of drug laws. But the costs to society from legitimizing the addiction industry far outweigh the benefits. Meanwhile, proponents of recreational marijuana push the false narrative of a tax windfall for governments and improved safety for users while ignoring the harms: mental-health issues, addiction, acute and chronic lung disease, domestic violence and more.”

Thomas J. Madejski, M.D.
Albion, N.Y.
Jan. 7, 2020
Dr. Madejski Is the Immediate Past President of MSSNY.


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Staten Island Hospital Opens Opioid Treatment Center for Teens, Young Adults
Richmond University Medical Center in Staten Island has opened a medication-assisted treatment center for people ages 16 to 24 who are struggling with opioid-use disorder.

The center, funded by a Statewide Health Care Facility Transformation Program grant, is in the Center for Integrative Behavioral Medicine, also known as the Silberstein Clinic, at 1130 South Ave.

The opening comes about a year after the Staten Island Mental Health Society became a division of the medical center in a merger.

A substance-use program has existed for adolescents ages 11 and older and their families, said Dr. Joel Idowu, chairman of psychiatry and behavioral health sciences at the medical center. However, he said, older people with opioid-use disorder also can benefit from medication-assisted treatment.

The treatment “offers something that frees you to be able to go to work and live your life like any other person,” Idowu said. “The medication is effective and helps people to stay sober, and it reduces the risk of overdose.”

An injectable form of one such medication, buprenorphine, is available through the new program, he said, adding that it comes in convenient monthly doses.

For most patients, insurance covers the treatment.

The medical center noted in a filing with the state that opioid misuse, including heroin misuse, among adolescents and young adults has “risen dramatically in the past two decades.” However, it said, treatment capacity for the population remains “extremely low,” and Staten Island has the highest incidence of opioid use and related deaths in the city.

The new program is aimed at addressing those gaps in care and aligning with the state’s Medicaid reform priority of integrating medication-assisted treatment into primary-care settings. (Crains’ Health Plus) Jan 6


NYS Flu Statistics for Week of January 4
During the week ending January 4, 2020

• Influenza activity level was categorized as geographically widespread. This is the sixth consecutive week that widespread activity has been reported.
• There were 10,085 laboratory-confirmed influenza reports, a 9% increase over last week.
• The number of patients hospitalized with laboratory-confirmed influenza was 1,964, a 34% increase over last week.
• There were no influenza-associated pediatric deaths reported this week. There has been one influenza-associated pediatric death reported this season.
https://www.health.ny.gov/diseases/communicable/influenza/surveillance/2019-2020/flu_report_current_week.pdf

Widespread Flu Activity Reported in 46 States

As of the last week of December, “widespread” flu activity was reported by health departments in 46 states. More ominously, a second measure — the percentage of patients with flu symptoms visiting medical clinics — shot up almost to the peak reached at the height of the 2017-18 flu season, which was the most severe in a decade. About 61,000 Americans died of flu that season, the CDC said. (The original estimate of 79,000 was revised downward last year; the agency said the number changed as more death certificate information became available.)

This year’s flu vaccine may not be particularly effective against the strain of the virus now widespread in the United States, experts said. According to the CDC, it is worth getting the shot because people who are vaccinated fare better if struck by the flu than those who are not.


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CDC Updates Guidelines for Discharging Vaping Patients
After a new study found at least one quarter of vaping-related rehospitalizations and deaths occurred within two days of discharge, the CDC now recommends outpatient follow-up within 48 hours, according to the CDC’s Morbidity and Mortality Weekly Report published Jan. 2.

A recent analysis of previously hospitalized EVALI patients found common comorbidities among patients who were readmitted or died after discharge. The findings prompted the CDC, in consultation with the Lung Injury Response Clinical Working Group, to revise EVALI patient guidelines, which previously recommended outpatient visits within two weeks of discharge.

Guideline updates for providers include:

  1. Confirming that vital signs have not significantly changed for at least 24 to 48 hours before discharge.
  2. Ensuring outpatient primary care or pulmonary specialist follow-up, ideally within 48 hours of discharge.
  3. Planning discharge care, early follow-up and management of any comorbidities.
  4. Following best practices for medication adherence.
  5. Ensuring access to mental health and substance use disorder services.

US Cancer Death Rates See Largest Single-Year Drop on Record
Overall cancer death rates in the U.S. fell by 2.2 percent from 2016 to 2017, the largest single‐year drop ever recorded, according to a report from the American Cancer Society. The annual report estimates the numbers of new cancer cases and deaths expected this year. It also compiles the most recent data on cancer occurrence from the Surveillance, Epidemiology, and End Results Program; the National Program of Cancer Registries and the North American Association of Central Cancer Registries.


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CMS

CMS Releases MIPS Results for 2018: 5 Things to Know
CMS published 2018 results for the Merit-Based Incentive Payments System program Jan. 6.

Five things to know about the results:
1. CMS Administrator Seema Verma said 2018 participation in MIPS, created under the 2015 Medicare Access and CHIP Reauthorization Act, exceeded participation rates in 2017.
2. More clinicians will receive a positive payment adjustment compared to the 2017 performance year, with nearly all eligible clinicians participating in MIPS getting a payment boost in 2020.
3. In total, 889,995 clinicians saw a MIPS payment adjustment, whether negative, neutral or positive. Ninety-eight percent of those clinicians will receive a neutral or positive payment adjustment.
4. Additionally, more rural and small practices will see positive payment adjustments compared to the 2017 performance year.
5. More clinicians are earning Qualifying Alternative Payment Model Participant status under the Advanced APM path than in the previous reporting year.

“Positive payment adjustment will remain modest in part because, under the MACRA law, the positive and negative payment adjustments must be budget neutral,” Ms. Verma said. “This means that the funds available for positive payment adjustments are limited to the estimated decrease in payments resulting from the negative payment adjustments. However, because the thresholds have been lower, many providers have qualified. As the program matures, we expect that the increases in the performance thresholds in future program years will create a smaller distribution of positive payment adjustments for high performing clinicians who continue to invest in improving quality and outcomes for beneficiaries and positive adjustments will increase.”

To view the full results, click here.


MSSNY Benefit – Protect your hearing with American Hearing Benefits


Deadline to Submit 2019 Registration and Attestation Info for MIPS Is March 2
The deadline to submit 2019 data for (CMS) Medicare Promoting Interoperability Program is March 2, 2020. 

As a reminder, in 2018, CMS transitioned to the QualityNet System (also known as CMS’s Hospital Quality Reporting [HQR] system) for hospitals that attest to CMS for the Medicare Promoting Interoperability Program. By transitioning to one system, CMS continues in their effort to streamline data submission methods.

Specific submission details for each program are listed below.

  • Medicare Eligible Hospitals and Critical Access Hospitals (CAHs) – These participants must attest to CMS through the QualityNet Secure Portal.
  • Medicaid Eligible Professionals (EPs), Eligible Hospitals, CAHs – These participants should follow the requirements of their State Medicaid agencies to submit their meaningful use attestation.
  • Dual-Eligible Hospitals and CAHs – Those who qualify for both the Medicare and Medicaid Promoting Interoperability Programs are required to demonstrate meaningful use to CMS through the QualityNet Secure Portal (not their State Medicaid agency).

Registering on Behalf of a Medicaid EP?
An EP can designate a third party to register and attest on his or her behalf. To do so, users working on behalf of an EP must have an Identity and Access Management System (I&A) web user account (User ID/Password) and be associated with the EP’s National Provider Identifier (NPI). If you are working on behalf of one or more EPs and do not have an I&A web user account, please visit I&A Security Check to create one.

Note: States and territories will not necessarily offer the same functionality for registration and attestation in the Medicaid Promoting Interoperability Program. Check with your state or territory’s Promoting Interoperability Program to see what functionality is offered.

Additional Resources

For More Information

Visit the Registration and Attestation page on the CMS Promoting Interoperability Programs website.

Medicare & dual-eligible hospitals participating in the Medicare & Medicaid Promoting Interoperability Programs may contact the QualityNet help desk for assistance at 1 (866) 288-8912 or qnetsupport@hcqis.org.


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PAI Comments on Stark Law and Anti-Kickback Proposed Rules
On December 31, PAI submitted comment letters in response to two proposed rules proposing modifications to the Anti-Kickback (AKS) Statute and the Physician Self-Referral (Stark) Law. The letters are attached and summarized below. Please share widely with your medical association staff and physician members.

PAI was generally supportive of both the Centers for Medicare and Medicaid Services’ (CMS’s) and the HHS Office of the Inspector General’s (OIG’s) efforts to remove regulatory barriers and create alignment between the Stark Law and AKS exceptions and safe harbors to encourage participation in APMs and innovative payment arrangements. We were also supportive of the new definitions related to value-based arrangements, including Value-Based Enterprise (VBE), VBE Participant, Value-Based Activity, Value-Based Purpose, etc., bought sought additional clarification on what would/would not satisfy these definitions and whether existing arrangements could be used to satisfy these definitions for the safe harbors and exclusions. PAI’s specific comments in response to each proposed rule are summarized below.

Anti-Kickback Statute Proposed Rule
PAI was supportive of the following proposed new safe harbors and updates to existing safe harbors, and made additional recommendations in response to each:

  • Care Coordination Arrangements (CCAs) – PAI sought additional clarification on the “commercially reasonable” standard under AKS
  • VBAs with Substantial Downside Risk – PAI recommended a more flexible definition for “risk-sharing”
  • VBAs with Full Financial Risk – PAI expressed concerns that the VBAs with Full Financial Risk safe harbor would only be made available to larger, more integrated systems, and that smaller and rural practices may not be able to enter traditionally defined “full risk” models even though they are embracing downside risk
  • Patient Engagement and Support Arrangements – PAI strongly supported focusing on improving access to items, services, and supports that address social determinants of health (SDOH)
  • Blanket Safe Harbor for CMMI Model Participants
  • Donation of Certain Cybersecurity Technology and Related Services – PAI urged the OIG to ensure that the donors must donate the technology with “no strings attached” tied to future upgrades, maintenance costs, etc.
  • Outcomes-Based Payment Arrangements – PAI encouraged the OIG to also include full and partial capitation payments
  • Updates to the EHR Safe Harbor – PAI opposed proposals that would allow the safe harbor exception to apply if the items or services were “deemed” to be interoperable, and urged how important it is for the OIG to continue focusing on how the data and systems are actually being used and information is being shared to ensure that information blocking is not occurring.
  • Updates to the Warranties Safe Harbor
  • Updates to the Local Transportation Safe Harbor – PAI supported expansion of this safe harbor to include ride-sharing services and urged the OIG to further expand the safe harbor to be inclusive of urban areas as well as “provide a ride” and telephonic-related programs and services
  • Updates to the ACO Beneficiary Incentive Program – PAI codifying protections for beneficiaries but requested additional guidance on what is required for such protected beneficiary remunerations
  • Exceptions for Telehealth Technology Definitions for In-Home Dialysis – PAI did not support the requirement that donations of such technology must be made available to all eligible Part B beneficiaries, as this may restrict small and rural providers from offering such donations entirely 

Stark Law Proposed Rule
PAI was supportive of the following proposed exceptions and made additional recommendations in response to each:

  • Exceptions for Full-Risk Models – PAI commented that full-risk should be more inclusive of other types of arrangements in addition to capitated payments, including bundled and episodic payments, and that additional flexibility should be considered for demonstrating “full-risk” arrangements
  • Exceptions for VBAs with Meaningful Downside Financial Risk to the Physician – PAI expressed concerns with defining “meaningful downside risk” and believed that the 25% threshold is too high and should be decreased to 5%
  • Exceptions for General VBAs – PAI supported general exceptions for VBAs, regardless of risk, as we believe this exception will be most applicable for independent, small, and rural practices. However, PAI did support the contribution requirement of 15% for VBAs under such exceptions as it could adversely impact the same group of physicians and practices.
  • Price Transparency – PAI believes that any information to be made public should first be shared with physicians and others to ensure that it is accurate, and that physicians have appropriate time to review and correct the information.

In addition to the above, PAI also provided comments on additional technical changes proposed in the rule.

http://www.mssnyenews.org/wp-content/uploads/2020/01/PAI-2019-AKS-Proposed-Rule-Comment-Letter.pdf

http://www.mssnyenews.org/wp-content/uploads/2020/01/PAI-2019-AKS-Proposed-Rule-Comment-Letter.pdf


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Dedicated consultation room, exam room, procedure room, reception and nurse areas in a multispecialty office setting. Suitable for all subspecialties.Walk to Lenox Hill Hospital and NY Cornell. Proximate to Mt Sinai Hospital. Subway 2 blocks away. Full Time/Part Time. No fee.
START SEEING PATIENTS IMMEDIATELY!!!
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PHYSICIAN OPPORTUNITIES

Pediatric Board Tutor
Looking for a tutor for Initial Pediatric Board Exam
Flexible hours, Negotiable rate. If interested please email at: pedboardhelp@gmail.com


 

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Great Career Opportunities for Clinical Physicians
Physicians, are you looking for a change?  Tired of working long shifts with an overwhelming patient load?  Come work at a well-equipped and staffed correctional facility where you can MAKE a difference, working with a smaller number of patients for reasonable hours.

Starting salary is $143,381 – $171,631 *Additional $20,000 geographical differential for Clinton & Franklin CF, and $10,000 for Five Points, Greene and Groveland CFs. We offer full-time, part-time & hourly/per-diem positions.

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

Clinton*                 Clinton Correctional Facility (sporting and recreational outlets)
Chemung               Elmira and Southport Corrl Facilities (Gateway to the Finger Lakes)
Columbia*             Hudson Correctional Facility (antiquing, arts & collectables)
Dutchess                Green Haven Correctional Facility (Hudson River Valley Beauty)
Franklin*                Franklin & Upstate Corrl Facilities (North Country, 1 hour to Montreal)
Greene*                 Greene Correctional Facility (rural charm yet only 2 hours to NY City)
Livingston*            Groveland Correctional Facility (State Parks, hiking, fishing)
Oneida                   Mohawk Correctional Facility (Cooperstown, breweries)
Orleans                  Albion Correctional Facility (Greater Niagara Region & Canal Town Culture)
Sullivan                  Woodbourne Correctional Facility (mountains, outlets, entertainment)
Seneca*                 Five Points Correctional Facility (heart of wine country)
St. Lawrence          Riverview Correctional Facility (hiking, boating and museums)
Ulster                     Shawangunk and Wallkill Corrl Facility (Catskill Mountains, Casinos)
Washington           Great Meadow Corrl Facility (Between Vermont & Green Mountains)
Westchester           Bedford Hills Correctional Facility (Less than 1 Hour to NYC)
Wyoming               Wyoming Correctional Facility (waterfalls, family farms, natural beauty)

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Inquire with the Facility Personnel Office regarding benefits and anticipated opportunities: http://www.doccs.ny.gov/faclist.html. Contact: www.doccs.ny.gov or DOCCS Personnel Office at (518) 457-8132 for more information and to apply.



 

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MSSNYeNews: Iceberg Right Ahead – January 3, 2020

Arthur Fougner MSSNY Presiident

PRESIDENT’S MESSAGE
Arthur Fougner, MD
MSSNY President

MSSNY eNews
January 3, 2020

Vol. 23  Number 1


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Colleagues:

We all remember the scene from Jim Cameron’s Titanic when the lookouts first notice the looming iceberg. Well, that is how I felt when I opened my email before getting ready to celebrate the coming of the New Year. Then, I saw this on my twitter feed:

Doctor's Tweet

That is right— once again, the government’s first solution to a healthcare budget deficit is to cut doctors’ payments. We clearly are regarded as low-hanging fruit here. Imagine the response of say the TWU if the solution to MTA fiscal problems were to first cut the workers’ pay? Right. Well, it’s 2020 and our issue clearly comes into 20-20 focus.

It is as obvious today as it has ever been. Medicine is the only US enterprise that regularly gets to enjoy a Cost of Living DECREASE. While we await further budget details to be hashed out, this is time for real New Year’s resolutions.

Let me be clear – we all need to come together. A House of Medicine divided cannot stand. And so, I call for a gathering – a Summit— if you will. We will put out an invite for our many groups – our ethnic societies, our specialty societies, employed physicians, independent physicians – everyone should be present.

As the Doors put it: “The time to hesitate is through. No time to wallow in the mire.”

Let’s Do It!

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

Arthur Fougner, MD
MSSNY President


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FLU ADVISORY
Due to elevated influenza activity in New York State (NYS), this advisory provides updated influenza prevention, surveillance and control guidance along with links and references to influenza resources.


MSSNY’s Weekly Legislative Podcasts


Governor Vetoes Liability Expansion Bills Opposed by MSSNY
Governor Cuomo has vetoed two bills passed by the State Legislature that had been opposed by MSSNY and MLMIC that, if enacted, could have produced further increases to New York’s already exorbitant medical liability insurance costs.  The bills had also been opposed by many other groups who could have been adversely impacted.

The first bill (S.6081/A.2373) would have forced physician defendants into making a “blind gamble” regarding the selection of how a particular court award should be reduced in cases involving multiple defendants where one of the defendants settles prior to trial.

MSSNY raised concerns that this legislation could create the possibility of a plaintiff being unjustly enriched by collecting more than the jury ultimately determined the award to be.  The second bill (S.6552/A.2373) would have allowed plaintiffs to collect a judgment from a third party that is not a direct party to the lawsuit in question but had been sued by the original defendant.  MSSNY raised concerns that it could encourage those parties who are unable to satisfy their apportioned share of liability to dodge their responsibility, while allowing a plaintiff to target deep-pocketed third parties.

MSSNY thanks Governor Cuomo for vetoing these problematic bills, given the enormous liability exposure physicians already face.


Governor Vetoes Patient Protection Bills
At the end of 2019, Governor Cuomo vetoed two pieces of legislation strongly supported by MSSNY, and other patient advocacy groups, that would have protected patients from harmful business practices by Pharmacy Benefit Manager (PBMS), and health insurers, in New York.

  • Cracking Down on PBMs

The first bill, S.6531, would have increased the oversight, transparency and accountability of Pharmacy Benefit Managers (PBMS).

Although, similar protections in the 2019 budget were agreed to for Medicaid beneficiaries, and Governor Cuomo had proposed additional requirements for PBMs used by commercial plans, he vetoed the bill because of concerns that provisions could be pre-empted by ERISA, and invite scrutiny from the FTC and DOJ and “sweep in plans that are not true PBMs, but rather health benefit funds only.”

  • Ending Plans’ Ability to Make Mid-Year Changes to Drug Formularies

A second bill, S.2849, would have created a list of safeguards designed to protect patients with private, commercial health insurance plans seeking to remove drugs from their pharmacy benefit formularies, in the middle of a contract year. New York’s current law puts thousands of patients at risk of losing access to therapies for such chronic and life-threatening diseases as epilepsy, rheumatoid arthritis, multiple sclerosis, among many others. It also usurps decisions by physicians as to what the most effective therapy is to treat a patient’s condition.

The Governor vetoed the bill because of concerns that “Insurers would have to anticipate and set rates for hypothetical future drug price increases, causing higher premiums for everyone, while pharmaceutical companies would be able to raise their prices with impunity”.

MSSNY pushed hard for passage of both these bills and will continue to advocate for these patient protections in the new legislative session.


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Governor Signs MAT Access Bill for Commercial Insurers and Vetoes MAT Access Bill for Medicaid
As the year came to an end Governor Cuomo signed and vetoed bills that would expand access for patients to Medication Assisted Treatment (MAT), both bills that had been strongly supported by MSSNY and the American Medical Association.

The first bill (A.2904/S.4808) that was signed into law requires commercial health insurance companies to eliminate prior authorization requirements for all MAT.  A provision enacted earlier in the year removed prior auth requirements for formulary approved MAT, but not all forms of MAT.  This gap was particularly problematic if a patient was stabilized on a particular form of MAT, but switched insurance company coverage.  Medical evidence shows that MAT promotes recovery from opioid use disorders, saves the health care system money. Prior authorization requirements for MAT delay access to evidence-based care.

However, the Governor vetoed similar legislation (A.7246/S.5935) that would have required Medicaid and Medicaid Managed Care plans to cover all MAT without prior authorization requirements. The lengthy veto message noted concerns that  the bill would “provide  a  statutorily-authorized  unfair  competitive advantage to one pharmaceutical manufacturer” which failed to “offer  sufficient  competitive  pricing  to be included on the preferred drug list or on many  managed  care  organization  formularies,  and  in lobbying  for this legislation to eliminate prior authorization requirements, requires Medicaid plans and the State to pay whatever price  this manufacturer charges.”


MSSNY’s Lobby Day – Wednesday, March 4th, 2020
Please plan to join your colleagues in Albany for MSSNY’s ‘Physician Advocacy Day’, which will take place at the Lewis Swyer Theater at The Egg in Albany on Wednesday, March 4, 2020.

Physician participation in this event is critical.  With a $6 billion Budget deficit likely to produce a swath of adverse proposals in the name of achieving “savings”, it is imperative that physicians let their legislators know of the potential adverse consequences to patient care in their communities. As with past years, the morning program will provide 3.0 Continuing Medical Education hours for physicians. To learn more about MSSNY’s Lobby Day click here and to sign up for the event click here.


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Gov. Cuomo Proposes to Ban Flavored Nicotine Vaping Products in State of State
Governor Andrew Cuomo has proposed in his State of the State agenda to ban all flavored nicotine vaping product, including menthol flavors.  The governor has also proposed banning vaping advertisements aimed and youth and authorized the NYS Department of Health to regulate the sale of chemicals used in vaping-related products and ban the sale of vaping product carrier oils deemed a hazard to public health. His proposal also includes legislation that would prohibit the online, phone and mail order sale of e-cigarettes and would require that only registered retailers be allowed to purchase e-cigarettes using these methods.

On the federal level, the Trump Administration and the FDA announced a limited ban of flavored e-cigarettes and the sale of all sweet and fruity flavored vape pods and cartridges, but allows gas stations and convenience stores to continue to sells menthol cartridges and vapes.

MSSNY supports banning all flavored e-cigarettes, including menthol and supports legislation that would also ban all flavored tobacco products, such as chewing tobacco and cigarillos. In December, MSSNY has joined with other public health organizations that called upon the Governor, the Senate and Assembly leaders, and members to pass legislation that would prohibiting the sale of flavored nicotine and tobacco products which will protect our young people from the scourge of the myriad health problems and addictions caused by flavored tobacco products and e-cigarettes. Physicians are encouraged to send a letter through MSSNY Grassroots Action Center (GAC) at: https://p2a.co/hn9SSVu

Additionally, MSSNY supported legislative efforts to increase the legal purchase age for tobacco and e-cigarette products and in November 2019, Governor Cuomo signed into law legislation that accomplished this goal.  In December, Congress passed the Federal Food, Drug and Cosmetic Act that raised the federal minimum age to purchase tobacco products from 18-19; President Trump signed the measure on December 20, 2019.  According to a statement on the FDA’s website, “it is now illegal for a retailor to sell any tobacco product—including cigarettes, cigars and e-cigarettes—to anyone under 21”.


Albany Memorial and Samaritan Hospitals Merge Albany Memorial Hospital and Samaritan Hospital in Troy, N.Y., merged Jan. 1.
Albany Memorial is now a third campus of Samaritan Hospital and has been renamed Samaritan Hospital-Albany Memorial Campus. The hospitals are part of Albany-based St. Peter’s Health Partners, which is a member of Livonia, Mich.-based Trinity Health. “The long-planned and previously announced merger of Samaritan and Albany Memorial represents the fulfillment of our always top-of-mind goal, which is to provide the highest quality, most compassionate, and most accessible care, to all who need it, in Albany, Troy and across the Capital Region,” Michael Finegan, president of acute care at SPHP, said in a news release.


Female Surgeons Face Fertility Issues; Radiation, Surgical Smoke, Exposures
The Telegraph (UK) (1/2) reports research suggests “female surgeons are more than twice as likely to suffer fertility problems due to radiation and the other hazards of operating theatres.”

The study published in JAMA Surgery indicates “there are direct medical risks from working as a surgeon, including from radiation, surgical smoke, anaesthetic gases and other toxic substances.” The researchers point “to a survey of 1,021 US females surgeons across different specialisms that found 32 per cent of respondents reporting difficulty with fertility, compared to 10.9 per cent in the general population,” and “the same study saw a pregnancy complication rate of 35.3 per cent, compared to 14.5 per cent generally.”


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Mysterious Pneumonia Cases in China Prompt International Concern
Infectious disease experts are keeping a close eye on a mysterious outbreak of pneumonia in central China that has sickened more than three dozen people, reports Bloomberg.

As of Jan. 3, 44 pneumonia cases have been confirmed in Wuhan, China, according to a statement from the city’s health agency cited by the publication.

The World Health Organization is working with the Chinese government to investigate the outbreak. Health officials have ruled out common respiratory illnesses like the flu, but the exact cause of the illness is still unknown.

Several of the sickened individuals worked at a local market that sold animals like birds and pheasants. This detail is prompting concerns that an unknown animal virus may have spread to humans, reminiscent of the 2003 SARS outbreak, which killed nearly 800 people.


WEBINAR

“Doctor Are You Ready?” CME Webinar on January 15; Registration Now Open
Disasters big and small happen every day.  Be sure to find out how best to be prepared at MSSNY’s next Medical Matters webinar: Doctor Are You Ready? on January 15th at 7:30am.  Kira Geraci-Ciardullo, MD, MPH immediate past speaker of the house and a member of the Emergency Preparedness and Disaster/Terrorism Response Committee will serve as faculty for this program. Registration is now open for this webinar here.  Please click here to view the flyer for this program.

Educational objectives are:

  • Explore core preparedness competencies every physician should possess
  • Describe emergency situations that arise on a regular basis
  • Identify resources to acquire preparedness training

Additional information or assistance with registration may be obtained by contacting Melissa Hoffman at mhoffman@mssny.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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Furnished Luxury Park Avenue East 70’s Medical Office Rental Available.
Voted most beautiful block on UES. Private Entrance. Central A/C.
Dedicated consultation room, exam room, procedure room, reception and nurse areas in a multispecialty office setting. Suitable for all subspecialties.Walk to Lenox Hill Hospital and NY Cornell. Proximate to Mt Sinai Hospital. Subway 2 blocks away. Full Time/Part Time. No fee.
START SEEING PATIENTS IMMEDIATELY!!!
Please call or text 929 316-1032


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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

Pediatric Board Tutor
Looking for a tutor for Initial Pediatric Board Exam
Flexible hours, Negotiable rate. If interested please email at: pedboardhelp@gmail.com


 

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Great Career Opportunities for Clinical Physicians
Physicians, are you looking for a change?  Tired of working long shifts with an overwhelming patient load?  Come work at a well-equipped and staffed correctional facility where you can MAKE a difference, working with a smaller number of patients for reasonable hours.

Starting salary is $143,381 – $171,631 *Additional $20,000 geographical differential for Clinton & Franklin CF, and $10,000 for Five Points, Greene and Groveland CFs. We offer full-time, part-time & hourly/per-diem positions.

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

Clinton*                 Clinton Correctional Facility (sporting and recreational outlets)
Chemung               Elmira and Southport Corrl Facilities (Gateway to the Finger Lakes)
Columbia*             Hudson Correctional Facility (antiquing, arts & collectables)
Dutchess                Green Haven Correctional Facility (Hudson River Valley Beauty)
Franklin*                Franklin & Upstate Corrl Facilities (North Country, 1 hour to Montreal)
Greene*                 Greene Correctional Facility (rural charm yet only 2 hours to NY City)
Livingston*            Groveland Correctional Facility (State Parks, hiking, fishing)
Oneida                   Mohawk Correctional Facility (Cooperstown, breweries)
Orleans                  Albion Correctional Facility (Greater Niagara Region & Canal Town Culture)
Sullivan                  Woodbourne Correctional Facility (mountains, outlets, entertainment)
Seneca*                 Five Points Correctional Facility (heart of wine country)
St. Lawrence          Riverview Correctional Facility (hiking, boating and museums)
Ulster                     Shawangunk and Wallkill Corrl Facility (Catskill Mountains, Casinos)
Washington           Great Meadow Corrl Facility (Between Vermont & Green Mountains)
Westchester           Bedford Hills Correctional Facility (Less than 1 Hour to NYC)
Wyoming               Wyoming Correctional Facility (waterfalls, family farms, natural beauty)

NYS Corrections Personnel Ad

Inquire with the Facility Personnel Office regarding benefits and anticipated opportunities: http://www.doccs.ny.gov/faclist.html. Contact: www.doccs.ny.gov or DOCCS Personnel Office at (518) 457-8132 for more information and to apply.


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


 

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

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 


MSSNY Responds to Announcement of New York’s Medicaid Cuts


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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
January 2, 2020

MSSNY RESPONDS TO ANNOUNCEMENT OF NEW YORK’S MEDICAID CUTS 

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

“While we understand the need to address significant Budget deficits, physicians across New York are confounded by the announced cuts to their payments for care delivered to their patients insured by Medicaid.  This is particularly difficult to accept given that they were not the beneficiaries of increases to Medicaid payments recently granted to other parts of the health care system.  In fact, Medicaid physician payment remains a very small part of New York’s overall Medicaid Budget.  No wonder, given that New York has one of the lowest Medicaid to Medicare physician payment ratios in the country.

As we try to address system health costs, and assure patients get the right care at the right time in the right setting, we should be taking steps to expand the availability of community primary and specialty care physicians in Medicaid Managed Care and traditional Medicaid. Further reductions in inadequate compensation will not accomplish that objective.”

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


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

 

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