MSSNYeNews: March 13, 2020 – Triskaidekacovid Phobia

Arthur Fougner MSSNY Presiident

Arthur Fougner, MD
MSSNY President

March 13, 2020

Vol. 23  Number 11




Our Kevin Bacon Strategy is not working. While it’s probably too late for containment to hold off the spread of COVID-19, the goal shifts to mitigation – sufficient social distancing to slow down the virus and prevent overwhelming our medical resources. Testing, while not sufficiently scaled, is becoming increasingly available via health systems throughout the state. Some states, CT, CO, and WA are setting up “Drive Thru” testing facility, similar to New York State which initiates its first driving facility in New Rochelle. The Gates Foundation is funding a home test kit delivered by Amazon that could be mailed in. This is currently a pilot in the Seattle area but could be widely available soon. More information on SARS CoV2 and COVID-19 can be found here.

Every day, more cases are being found, especially now that testing is increasingly available. Our local health systems realized the importance of social distancing a while ago as medical staff meetings are now choosing Facetime over face time. As more large scientific meetings are canceled, our own House of Delegates has come under increasing scrutiny.  While further discussion and final decision is planned for early next week, it is far more likely than not that the House as we know it will not be held. The business of the House, however, will not be ended. It is the business model that will change. MSSNY’s Long Term Planning Committee has been working on a trial of virtual reference committees. What was once long-term planning may quickly become short term planning.

I’ve found humor to be a great salve for the worried brow. So, in that vein, on this Friday the 13th, take a few deep breaths and be of good cheer. We will get through this. This is a virus, not Ragnarok. We must be the adults in the room. While this is only Round 3 in a 12-round fight, we can do this. We have no choice. Our families, our colleagues and our patients are counting on us.  Fear is the mind killer. As former NY governor Franklin Roosevelt observed, “The only thing we have to fear is fear itself.”

Your Medical Society of the State of New York has taken the following steps to provide you with information:

  • Create a COVID-19 section on the MSSNY website
  • Participate in weekly conference calls with the New York State                    Department of Health
  • Create a physician resource page of valuable links to get information
  • Has created two podcasts on COVID 19 for physicians and patients—          both of which can be found on our website
  • Will conduct a COVID-19 webinar on March 18, 2020 for physicians.

All information can be found in the various articles below.

Comments?; @sonodoc99

Arthur Fougner, MD
MSSNY President

Capital Update

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WHO Declares COVID-19 Pandemic; Important Information Physicians Need to Know
The World Health Organization (WHO) has declared COVID-19 as a pandemic.  There are 421 cases of confirmed COVID-19 in New York State as of March 13, 2020.  According to Governor Andrew Cuomo, 50 patients have been hospitalized which is about a 12% hospitalization rate.  He also announced the approval of the federal government for New York labs to conduct up to 6,000 COVID-19 tests per day.  The governor on Thursday also banned gatherings of 500 or more in the state and any gathering under 500 individuals in attendance will be required to cut capacity by 50%.  There are also new limits on visitations to nursing homes – Only medically necessary visits will be allowed to protect the most vulnerable.  

The Medical Society of the State of New York has gathered information to aid physicians and has also developed communication tools for your patients on COVID-19.  MSSNY strongly recommends that physicians utilize the New York State Department of Health which has up-to-date information on COVID-19 and includes and includes information on known cases of COVID-19, cleaning and disinfection guidance, help for childcare providers and schools, and guidelines for individuals who have recently traveled internationally.

Since COVID-19 is a reportable disease, please ensure that you and your staff have the number of your local department of health.  Contact information can be found here.

MSSNY now has a Physician Resource Page on its website of important links and it can be accessed here.

Additionally, MSSNY has put together a physicians’ podcast on COVID-19 accessible here.

MSSNY has also provided for patients a podcast on COVID-19 here.

MSSNY has also developed patient specific information page that you can provide to patients and it can be accessed here.

Physicians are also encouraged to go to the MSSNY CME website and take the Physicians’ Emergency Tool Kit modules which contain educational programs on Office Surge, Crisis Communication and responding to public health emergencies.

The Governor has also indicated his hope to find retired physicians and other healthcare personnel to help at their former hospitals in the event they are needed to help with exceeded capacity at the facility.   (CLANCY, HOFFMAN)

State Agencies Sent Out Reminder that New York Law Covers Telemedicine
Both the New York State Department of Financial Services (DFS) and Department of Health (DOH) have sent out notifications relating to the Covid-19 outbreak reminding health insurers, physicians and hospitals that New York law requires coverage for telemedicine in the same manner as if care had been provided in an office setting.  To read the DFS circular letter, click here  () and to read the Medicaid guidance click here.  Moreover, Congress passed a law last week that reduces current restrictions on Medicare coverage for telemedicine but we are awaiting guidance from CMS as to how it will be implemented.                                            (AUSTER)

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DFS Announces Emergency Regulation to Prevent Insurer Cost-Sharing for Covid-19 Testing
The New York Department of Financial Services (DFS) today announced an emergency regulation that prohibits New York health insurers from imposing cost-sharing on emergency room visits, in-network outpatient physician office visits, in-network urgent care center visits, in-network telehealth visits, and in-network laboratory tests when the purpose of the visit or test is to diagnose novel coronavirus (COVID-19).   To read the regulation click here.

This emergency regulation also requires that insurers notify their in-network health care providers not to collect any deductible, copayment, or coinsurance for diagnostic testing for COVID-19.

This regulation follows guidance issued on March 2nd, 2020 that outlined a series of other actions that New York health insurers are required or advised to take, including keeping New Yorkers informed regarding available benefits; offering, where possible, telehealth medical advice and treatment; preparing insurers to cover the costs of a COVID-19 immunization should one become available; and guaranteeing access to out-of-network providers at the in-network cost-sharing when no in-network provider can treat the insured.

The DFS Press release noted that Copayments, coinsurance, or annual deductibles may be imposed in accordance with the applicable policy for any follow-up care or treatment for the novel coronavirus (COVID-19), including an inpatient hospital admission, as otherwise permitted by law.         (AUSTER) 

MSSNY Governmental Affairs Team Prepares for Phase 2 in Budget Process
Since Governor Cuomo released his proposed budget for FY 2020 on January 21st, the MSSNY Governmental Affairs team has been working hard to build support in the legislature for the organization’s position on proposals that will have the greatest impact on physicians and public health. Included among these are:

  1. A ban on vaping products like flavored liquids used with e-cigarettes.
  1. Regulation of Pharmacy Benefit Managers (PBMs).
  1. Protecting funding for the state Excess Medical Malpractice Insurance Program.
  1. Opposing unnecessary, proposed changes to the physician disciplinary process administered by the Office of Professional Medical Conduct (OPMC), which could significantly curtail physician due process rights.
  1. Rejecting a steep across the board cut in reimbursements for physicians participating in the state Medicaid program.

As is traditionally done, the Assembly and Senate are expected to pass their own one house resolutions on March 18th, which will outline their budget priorities for FY 2020, followed by three-way negotiations between the Governor and leaders in the Assembly and Senate. The statutory deadline for lawmakers to have final agreement on a new budget is April 1st. However, it is possible this deadline could be delayed due to the COVID19 outbreak, which has hit New York state particularly hard, which may prevent the Legislature from meeting this deadline.

The Division of Governmental Affairs team will continue to push MSSNY’s budget priorities and monitor discussions between the Governor and legislative leaders in the coming weeks.                                                            (CARY, AUSTER)

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Medicaid Redesign Team II (MRT II) Discusses Possible Reform Proposals Including Several of Concern
The MRT II held its second public meeting this past week where it discussed the over 2,200 proposals that were submitted to the group, and which could be part of its final list of recommendations next week, March 19.   The MRTII is charged with finding $2.5 billion in savings to the Medicaid program as part of the State Budget that is scheduled to be finalized by April 1, just a few weeks away.

MSSNY continues to be concerned by a range of the MRT II proposals under consideration, chief among them:

  1. Eliminating or reducing funding for the Excess Medical Malpractice Insurance Program. Please send a letter to your legislators to oppose this cut here.
  1. Permitting nurse-anesthetists to deliver anesthesia care without adequate anesthesiologist supervision. Please send a letter to your legislators to oppose this policy change.
  1. A further Medicaid cut in addition to the 1% across-the-board cut to achieve desired Budget savings and what that means for physician reimbursements. Please send a letter to your legislators to oppose further Medicaid cuts here.
  1. Elimination of “Prescriber Prevails” policy in the Medicaid pharmacy benefit.
  1. Changes to the Patient Centered Medical Home (PCMH) program that may further tie payments to certain quality performance metrics. The Department of Health (DOH) has stated that patients enrolled in PCMH had significantly lower health costs overall than non-PCMH enrollees.

MSSNY’s Governmental Affairs team will continue to share our concerns with policymakers behind the scenes and will provide an update as new details become available. (CARY, AUSTER)

Registration Now Open for CME Series on Pain Management, Palliative Care & Addiction; NYS Requires Every Prescriber to Take 3 Hour Course By July 1, 2020
The Medical Society of the State of New York announces an updated series of three one-hour CME webinars on pain management, palliative care and addiction.  New York State statute requires all prescribers, holding a DEA license, to complete three hours of coursework every three years.  Coursework must include the following:

  • New York State and federal requirements for prescribing controlled substances
  • Pain management
  • Appropriate prescribing
  • Managing acute pain
  • Palliative medicine
  • Prevention, screening and signs of addiction
  • Responses to abuse and addiction
  • End of life care

These webinars are being offered FREE OF CHARGE to MSSNY members. A discount code was emailed to members on February 24, 2020. Please contact Melissa Hoffman at if you did not receive this discount code.

The Medical Society of the State of New York has worked with the New York State Office for Alcoholism and Substance Abuse Services (OASAS) in the development of these programs.  Following the webinars, the courses will be offered on-line on the MSSNY CME site.   The programs will be offered to MSSNY members free of charge and there is a non-member fee of $50 per session.

The three webinars cover all issues required in the New York State statute and participation is only by computer, or with the Webex app.

Two Remaining Webinars will be held on:

Tuesday March 17, 2020—7:30-8:30am
When to Consider Opioid Therapy for Chronic Non-Cancer Pain & in Palliative Care

Faculty: Charles Argoff, MD
Educational Objectives:

  • Discuss evidence based best practice recommendations for opioid therapy for chronic pain, patient risk assessments and documentation
  • Describe palliative medical care and end-of-life care

Register for this webinar here 

Tuesday March 24, 2020—7:30-8:30am
Patients with Opioid Use Disorders: Identification, Treatment, and Management of Co-occurring Pain

Faculty: Jeffrey Selzer, MD, Marc Manseau, MD, MPH, NYS OASAS Medical Director
Educational Objectives:

  • Describe the Potential for Addiction, Patient Screening, Diagnosis and Subsequent Treatment or Referral
  • Recommend Tools to Assist in the Identification of High-Risk Patients for Whom Opioids are Indicated and Prescribed
  • Describe Strategies for Treating Pain in Patients with Substance Use Disorders

Register for this webinar here. 

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.

Additional information or assistance with registration may be obtained by contacting Melissa Hoffman at or 518-465-8085


This Week’s Legislative Podcast

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“Coronaviruses 2020: COVID-19 An Evolving Story” CME Webinar on March 18th Registration Now Open
Included in MSSNY’s response to the COVID-19 outbreak is Matters: Coronaviruses 2020: COVID-19 An Evolving Story on March 18th at 7:30am.  Faculty for this program are William Valenti, MD, chair of MSSNY Infectious Disease Committee and a member of the Emergency Preparedness and Disaster/Terrorism Response Committee along with Elizabeth DuFort, MD, Medical Director in the Division of Epidemiology at the New York State Department of Health will serve as faculty for this program. And Marcus Freidrich, MD, MBA, Chief Medical Officer – Office of Quality of Patient Safety – New York State Department of Health will be present to answer questions.

Registration is now open for this webinar. Click here to register

Educational objectives are:

  • Become familiar with the epidemiology and clinical features of coronaviruses
  • Understand the physician’s role int eh public health response to an infectious disease outbreak
  • Identify the circumstances that have contributed to the rapid spread of COVID-19

Additional information or assistance with registration may be obtained by contacting Melissa Hoffman at

For more information prior to this webinar, be sure to go to and view Principles of Isolation and Quarantine: Epidemiology as a Decision Maker for more information on the public health response to infectious diseases.

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)

Veterans Matters: The Special Mental Health Needs of Women Veterans Live Seminar in Saratoga
The Medical Society of the State of New York and the Saratoga County Medical Society are hosting a CME live seminar entitled Veterans Matters: The Special Mental Health Needs of Women Veterans on Wednesday, March 18, 2020 at 6:45 pm.

Nove Restaurant
707 Saratoga Road
Wilton, NY  12831

When:                  Sign-in/Reception at 6:00pm – Program begins at 6:45pm
Faculty:                Malene Ingram, MD & Colonel, U.S. Army Reserves

Educational Objectives:

  • Review how the increased role of women in the military has impacted their mental health
  • Describe mental health concerns unique to women veterans and how to identify them
  • Identify the barriers that women veterans face in getting the specific care they need

Reservations can be made by contacting Gregory Pinto, MD at or (518) 587-0772. Dinner charge for non-MSSNY member is $35.00 and no charge for MSSNY members and their spouses.

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)     

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Gov. Andrew Cuomo is banning all gatherings of 500 people or more as of 5 p.m yesterday.  All businesses or facilities with capacities up to 500 — including restaurants and bars — must also reduce their occupancy by 50 percent. The state is also allowing schools that close to provide up to two meals per day to low-income students. The Trump administration also announced this morning that the FDA will allow New York state to authorize public and private labs to begin testing.

Today, Gov. Andrew Cuomo said New York state could be dealing with virus response for six months or more, during the opening of a New Rochelle drive-thru facility that will test for Covid-19. He said that could mean six, seven, eight or nine months that the state will be responding to the outbreak.

The governor said the facility, operated by Northwell Health, will have six lanes and will be able to process 200 people today with plans to increase its capacity to 500 in the next few days.

The state is working with BioReference Laboratories with the aim of processing 5,000 tests per day by next week. It has contracted with 28 public and private labs in New York as well as out-of-state labs to increase the number of samples it can process. Some are still waiting on federal approval to begin testing.

Testing will be done by appointment-only, with priority given to people in New Rochelle and to vulnerable populations, such as those with underlying illnesses, particularly respiratory diseases. Appointments can be made by calling 888-364-3065. The governor said the logjam in testing is not related to a lack of test kits but limited approvals for labs conducting testing. The state Health Commissioner said Thursday afternoon that about 2,300 people had been tested in the state.

There had been 328 people diagnosed with Covid-19 in New York as of Thursday afternoon, with 95 of those individuals living in New York City.

New Rochelle has been a focal point for the outbreak, with more than 100 people testing positive there.

Information Centers for Physicians

Current CDC Info for Professionals:

CMS News

CMS Emergency Info

CDC Travel Info


COVID-19 MAC Test Pricing
Today, CMS is posting a fact sheet to the website to aid Medicare providers with information relating to the pricing of both the CDC and non-CDC tests.  You can find the fact sheet here.

Clinical: Dr. Anthony Fauci on Talking with Patients About COVID-19
Dr. Anthony Fauci, director of the National Institute of Allergy and Infectious Diseases, talks with Clinical Conversations about novel coronavirus disease (COVID-19). Listen in here.

EPA’s Registered Antimicrobial Products for Use Against Novel Coronavirus SARS-CoV-2

NYSDOH Issues Special Edition of Medicaid Update Re Corona Virus
The New York State Department of Health issued a special edition of the Medicaid Update on March 10 featuring New York State Medicaid Coverage and Reimbursement Policy for Services Related to Coronavirus Disease 2019 (COVID–19).  This Medicaid Update can be found here.

FDA Approves Generic Version of Asthma Inhaler
The FDA has approved a generic version of albuterol sulfate inhalation aerosol, the asthma inhaler marketed as ProAir HFA. The drug is indicated to treat reversible obstructive airway disease and prevent exercise-induced bronchospasm in both adults and children aged 4 years and older.

This is the first generic metered-dose inhaler to be approved in almost two decades and should be available in late 2020. FDA news release

Ways to Deal With Sleep Deprivation in Residents and Early-Career Clinicians
Endocrine News examined “ways to help” medical residents and early-career clinicians “cope with sleep deprivation so” they can give their “patients the best care possible, as well as take care of” their own personal health. The article interviewed Fariha Abbasi-Feinberg, MD, FAASM, FAAN, “board member of the American Academy of Sleep Medicine (AASM) and a practicing sleep medicine physician and medical director of Sleep Medicine with Millennium Physician Group, and board certified in sleep medicine and neurology, in Fort Meyers,” FL, and Timothy P. Brigham, MDiv, PhD, “the chief of staff and chief education and organizational development officer for the” Accreditation Council for Graduate Medical Education.

Q4 2019: 50% Increase in Ransomware Attacks Against Healthcare Providers
HealthIT Security (3/9) reports “ransomware attacks against healthcare providers increased a whopping 350 percent during the last quarter of 2019 with the rapid pace of attacks already continuing throughout 2020, according to a new report from Corvus.” The “findings mirror similar reports, which also noted that these numbers are likely lower than the actual number of attacks – as some ransomware victims do not report the incidents to the public.” The research found “one of the most common exposure types is through the remote desktop protocol, which is associated with a 37 percent greater likelihood of a successful ransomware attack.

HHS: In 2022, Patients Can Download Electronic Health Records
On March 9, Federal officials released groundbreaking rules that will let patients download their electronic health records and other health care data onto their smartphones. “Patients should have control of their records, period. Now that’s becoming a reality,” said Health and Human Services Secretary Alex Azar. “These rules are the start of a new chapter in how patients experience American health care.”

Many of the provisions are set to take effect in 2022.

“The days of patients being kept in the dark are over,” said Centers for Medicare & Medicaid Services Administrator Seema Verma. “In today’s digital age, our health system’s data-sharing capacity shouldn’t be mired in the Stone Age.” Yet the new rules also have raised concerns about privacy as technology companies, such as Google, Microsoft, Apple and Amazon, open up new markets for providing medical records through mobile apps. Major EHR vendor Epic, for instance, has warned that freer flow of medical records could spur the unwanted sale of data or other unauthorized uses.

Verma said the nation’s health care system remains “hugely expensive and inefficient as repeat tests drive up costs and, perhaps most importantly, doctors are forced to provide care with an incomplete clinical picture, especially at a time when the health care systems could be under stress…With the handling of the COVID virus, the urgent need for coordinated integrated care could not be clearer,” she said. (March 10, KHN)


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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 if youThank you. (WILKS)

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