Enews: July 1, 2020


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Burnout at Record High for Many Primary Care Clinicians, Survey Finds
Nearly half of primary care clinicians reported that their burnout is at an all-time high, largely due to financial pressures caused by the covid-19 pandemic, a new survey found. The Larry A. Green center and primary care collaborative surveyed 763 practicing clinicians in 49 states from June 12-15. Respondents represented a broad range of primary care specialties, practice settings and types.

Five Survey Findings:

  1. 44% of respondents reported high levels of personal burnout, and 48 percent reported high levels of office burnout.
  2. 36% said their physical well-being has suffered, while 45 percent said their psychological state has declined.
  3. 63% of respondents said they have had “severe” or “near severe” stress levels the last four weeks.
  4. 39% said they have had to lay off or furlough staff members in the last month.
  5. 25% of respondents said they have skipped or deferred their salaries.

To view the full survey, Click Here.
(Editor’s Note: This article was updated June 30 at 11:00 A.M. CDT. Becker’s Hospital Review)


California Among 8 States Added to Gov. Cuomo’s Quarantine Order
Travelers from eight additional states, including California, will be subjected to a mandatory two-week quarantine upon entering New York, Gov. Andrew Cuomo announced on Tuesday.

The other states are Georgia, Iowa, Idaho, Louisiana, Mississippi, Nevada, and Tennessee.

Key context: Since Texas and Florida were among the eight states already on the quarantine list, now travelers from the country’s three most-populous states will be restricted in their ability to travel to the fourth-most populous state.

What comes next: Cuomo’s order applies to any state where more than 1 out of every 10,000 residents has tested positive on a seven-day rolling average or more than 10 percent of the tests come back positive. New Jersey and Connecticut joined New York in issuing the same restrictions and thresholds last week. (Politico, 6/30)


Dr. Fauci Predicts COVID-19 Cases Could Top 100K Cases A Day
“We can’t just focus on the areas that are having the surge. It puts the entire country at risk,” Dr. Fauci told the Senate Health, Education, Labor and Pensions Committee on a hearing focused on whether schools could reopen. “We are now having 40-plus thousand new cases a day. I would not be surprised if we go up to 100K a day if this does not turn around so I’m very concerned … I think it’s important to tell you and the American public that I’m very concerned because it could get very bad.”

He suggested that people who ignored social distancing and didn’t wear face coverings have contributed to community spread, even in states that have closely followed reopening guidelines laid out by the Centers for Disease Control. “I think we need to emphasize the responsibility we have as individuals and as part of a societal effort to end the epidemic and that we all have to play a part in that,” Dr. Fauci said. (Politico 6/30)

“It is critical that we all take the personal responsibility to slow the transmission of COVID-19, and embrace the universal use of face coverings,” Dr. Robert Redfield, director of the Centers for Disease Control and Prevention, said during his testimony Tuesday. “Specifically, I’m addressing the younger members of our society, the millennials and Generation Zs,” Redfield said. (KHN, 6/30)


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AHA Says: Hospitals Will Take $320B Hit This Year
Hospitals and health systems will lose over $320 billion in 2020 due to the COVID-19 pandemic, according to an American Hospital Association report Tuesday. More than $200 billion in financial losses occurred from March to June. But the AHA expects hospitals to lose another $120 billion—about $20 billion per month—through year-end, mostly driven by lower patient volumes. (Modern Healthcare, 6/30)

Local and state public health departments across the country work to ensure that people in their communities have healthy water to drink, their restaurants do not serve contaminated food and outbreaks of infectious diseases don’t spread. Those departments now find themselves at the forefront of fighting the coronavirus pandemic.

But years of budget and staffing cuts have left them unprepared to face the worst health crisis in a century.

KHN and The Associated Press sought to understand the scale of the cuts and how the decades-long starvation of public health departments by federal, state, and local governments has affected the system meant to protect the nation’s health. (Modern Healthcare)


Six Takeaways of KHN-AP Investigation into the Erosion of Public Health
Here are six key takeaways from the KHN-AP investigation:

  • Since 2010, spending for state public health departments has dropped by 16% per capita, and for local health departments by 18%. Local public health spending varies widely by county or town, even within the same state.
  • At least 38,000 state and local public health jobs have disappeared since the 2008 recession, leaving a skeletal workforce in what was once viewed as one of the world’s top public health systems.
  • Nearly two-thirds of Americans live in counties that spend more than twice as much on policing as they spend on non-hospital health care, which includes public health.
  • More than three-quarters of Americans live in states that spend less than $100 per person annually on public health. Spending ranges from $32 in Louisiana to $263 in Delaware.
  • Some public health workers earn so little that they qualify for government assistance. During the pandemic, many have found themselves disrespected, ignored or even vilified. At least 34 state and local public health leaders have announced their resignations, retired, or been fired in 17 states since April.
  • States, cities, and counties whose tax revenues have declined during the current recession have begun laying off and furloughing public health staffers. At least 14 states have cut health department budgets or positions, or were actively considering such cuts in June, even as coronavirus cases surged in several states.

Dr. Richard Izquierdo, 2019 AMA Nathan Davis Awardee, Dies at Age 90
The American Medical Association (AMA) presented Richard “Doc” Izquierdo, M.D., with the Dr. Nathan Davis Award for Outstanding Public Service. Dr. Izquierdo has served his Bronx community for nearly six decades as a physician, health care innovator, community leader and Medical Society advocate. He was chosen for the AMA’s top public service award for his lifetime of work, serving generations of Bronx residents.

Dr. Izquierdo has dedicated his entire career to furthering health and opportunity in his Bronx community. With a $3,000 down payment, he founded the San Juan Health Center, which in 1974 became Urban Health plan, Inc., and today is one of the largest health centers in New York State. Dr. Izquierdo also served as the first chairman of the Community Planning Board and as Chairman of the 41st Precinct Community Council for 14 years.

In 2010 Dr. Izquierdo fulfilled a lifelong dream when he opened the Dr. Richard Izquierdo Health and Science Charter School. The first school of its kind, it provides technical education geared specifically toward preparing students for jobs in the health care sector, including Emergency Medical Technician (EMT) certification.

“Dr. Izquierdo put down roots for good nearly 60 years ago when he opened his first practice two blocks from where he grew up in the Bronx,” said AMA Board Chair Jack Resneck, Jr., M.D. “Not only has he treated generations of patients from his community, but he has built, in his charter school and health center, a legacy that will serve the Bronx for years to come.”

Dr. Richard Izquierdo was one of eight honorees chosen this year to receive the Dr. Nathan Davis Award for Outstanding Public Service. The award, named for Dr. Nathan Davis, a member of the Medical Society for the State of New York, and the founding father of the AMA, recognizes those in service whose outstanding contributions have promoted the art and science of medicine and the betterment of public health.

Dr. Izquierdo attended University of Lausanne Medical School and completed his internship and residency at Fordham Hospital in New York. The AMA presented Dr. Izquierdo with the Dr. Nathan Davis Award last night at a ceremony in Washington, D.C. as part of the AMA’s National Advocacy Conference.

Dr. Izquierdo (known as “The People’s Doctor of the Bronx and Founder of the Urban Plan, Dead at 90)”) was also featured in the Bronx Journal.


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Dr. Fauci: Contact-Tracing ‘Not Going Well;’ Other Updates

  • National contact-tracing efforts are “not going well,”Anthony Fauci, MD, told CNBC.. Instead of creating a national contract-tracing strategy, the White House instructed states to develop infrastructure for broad COVID-19 testing and contact-tracing before reopening. Dr. Fauci, director of the National Institute of Allergy and Infectious Diseases, said some states have been slow to ramp up this capacity, which will be crucial before a potential second wave of coronavirus cases this fall. 
  • Federal officials are warning of fake mask exemption cards that say their owners are exempt from ordinances requiring masks in public due to a health condition, according to The New York Times. Some versions of the card feature a fake U.S. Justice Department logo and list a phone number to report violations of the Americans with Disabilities Act. A group called the Freedom to Breathe Agency was selling 500-count boxes of the fake cards online for $49.99, officials said.

US Warns that 2nd COVID-19 Wave Could Worsen Generic Drug Shortages
A federal intelligence report found that the U.S. is likely to see a worsening shortage of generic drugs if another round of shutdowns occurs due to the COVID-19 pandemic, according to ABC News. The federal report, created by the Department of Homeland Security and distributed to government agencies last week, found that the U.S. already is seeing shortages of more than 200 drugs and supplies due to international shutdowns. The report is warning that another round of shutdowns could further strain the system in a way that many U.S.-based drugmakers would be “unable to quickly offset,” according to ABC. 

“Chinese factories that produce raw ingredients for common antibiotics closed for weeks as of March, and India’s lockdown extended until the end of May,” the report said, according to ABC. “France, Germany, and China have also considered reimposing lockdown measures as COVID-19 cases have begun to reemerge.”


NEJM Study: 300 Cases Rare Inflammatory Disorder in COVID-19 Children
U.S. researchers have found nearly 300 cases of a rare inflammatory disorder linked to COVID-19 in children, according to two new studies cited by STAT. In the first study, researchers from Boston Children’s Hospital identified 186 children with the condition in 26 states. Eighty percent required intensive care, 20 percent were put on a ventilator, and 2 percent (four children) died. In a second study examining 99 cases in New York state, 63 percent needed mechanical ventilation, and two children died. Both studies were published in The New England Journal of Medicine.


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AMA Statement on U.S. Supreme Court Ruling in Louisiana Abortion Access Case

Statement Attributable to:
Susan R. Bailey, M.D.
President, American Medical Association

“Today’s decision is a victory for patients and a strike against government interference in the patient-physician relationship. There is no evidence that Louisiana’s admitting privileges requirement improves patients’ safety, and we are pleased by the U.S. Supreme Court’s finding that such regulations are constitutionally invalid.

“The AMA joined other leading national health organizations in an amicus brief to the Supreme Court, urging it to strike down a Louisiana law that interferes with clinical judgment and obstructs women’s access to abortion services in the state. We will always fight government intrusion that compromises access to safe clinical care.


Gilead Sets Remdesivir Price, Allocation Plan
Gilead Sciences will charge the U.S. government and other developed countries $2,340 for a five-day course of remdesivir. Commercial insurers in the U.S. will pay 33 percent more, or $3,120 for a five-day course, the drugmaker said June 29.

Most patients treated with remdesivir receive a five-day treatment course using six vials of remdesivir. The cost breaks down to $390 per vial for government insurers like Medicaid and $520 per vial for private insurers.

Gilead said while deciding on a pricing strategy for remdesivir, it wanted to create a one-price model to curb the need for country-by-country negotiations on price. While there are still no COVID-19 treatments approved by the FDA, remdesivir has been shown to shorten recovery time of hospitalized patients by about four days. Due to its potential to save lives and cut hospital spending, Gilead said its pricing is well below value. Gilead said due to the earlier hospital discharge, hospitals could save about $12,000 per patient.

“As with many other aspects of this pandemic, we are in uncharted territory in pricing remdesivir,” Daniel O’Day, chair and CEO of Gilead, wrote in a statement on the pricing decision. “Ultimately, we were guided by the need to do things differently. As the world continues to reel from the human, social and economic impact of this pandemic, we believe that pricing remdesivir well below value is the right and responsible thing to do.”

Gilead also said July 29 that HHS will continue to manage the allocation of remdesivir to U.S. hospitals through September. After that period, HHS will no longer manage allocation. (Open letter from Gilead CEO Daniel O’Day)


MSSNY Helpline for Physicians Experiencing COVID-19 Related Stress 518-292-0140


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For Sale:  715 Park Avenue
Medical office, 1,800 sq. ft. Rectangular, 11 1/2 ft ceilings, street level access. Private entrance on 70th Street, side of the building.  Windows on Park Avenue and 70th Street.  Excellent office space for plastic surgeon, dermatologist or dental practice. Central air conditioning, high voltage electric service, two bathrooms. *Sale could include active Cardiac / Medical Practice. Please contact Janet @ 212-288-5468.


Office Space and Quad-A Certified O.R. for Rent
Plastic surgery office and/or quad A – certified operating room available for rent. We welcome you to tour our facility, where safety and luxury are combined in the most prime location on the upper east side. We assure you will be delighted by what you discover. We take pride in our facility, where your patients’ safety and satisfaction are our number one priority.
  • Fully equipped operating room perfect for a board-certified plastic surgeon
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  • Full day office rental per week / O.R. rental per case

For inquiries please call 212.737.8700, email polina@specialtyaestheticsurgery.com
Office Space and Quad-A Certified O.R. for Rent


 

 

 

 

 

 

MSSNY Statement on Vice President Pence’s Comments About COVID-19 and PPE Availability

For Immediate Release
June 26, 2020

MSSNY Statement on Vice President Pence’s Comments About COVID-19 and PPE Availability

Statement Attributable to:
Bonnie Litvack, MD
President, Medical Society of the State of New York

“MSSNY is very concerned by the comments from the Vice-President today with regard to containment of the Covid-19 pandemic and availability of personal protective equipment (PPE). The record number of new cases across the country suggests that the curve, in fact, has not been flattened.

“New York’s physicians saw first-hand the suffering of patients and their families that occurred when there is a rapid incline in Covid-19 cases. We do not wish to return to such devastation. It took an enormous ‘team effort’ between our health care workers, Governor Cuomo and other government officials, and sadly of course, the sacrifices of the citizens of our great state, to not only flatten New York’s curve, but also to get to a point where we now have the lowest hospitalization levels since mid-March. With a disease that knows no state boundaries, we are deeply concerned by the significant increases in infection rates in other states.

“Additionally, physicians in New York State continue to face enormous challenges in obtaining PPE that is slowing the ability of community-based physicians to return to treating patients in-person on a regular basis again. Too many vendors sell only to government or large health systems—ignoring community physicians or make PPE available in minimal quantities at grossly inflated prices. Instead of asserting that there are ‘no outstanding requests’, we would ask Vice President Pence and the Trump Administration to confer with the physician community in New York and across the country to assess their challenges in obtaining PPE, and then, work to address these blatant supply chain problems.

“Given the incredibly infectious nature of Covid-19, now is not the time to rest on our laurels. We need all of our government officials to continue to work together to ‘reverse the curve’ in states where the numbers are rising and ‘protect the curve’ in states where Covid-19 infections and hospitalizations have receded.”

# # #

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

eNews June 26, 2020


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MSSNY Peer to Peer (P2P) Goes Live: We’re Here for You
Starting Monday, July 6, 2020, the Medical Society of the State of New York will offer physicians, residents, and medical students the opportunity to talk with a peer about their life stressors.  MSSNY’s Physician Wellness and Resiliency Committee has launched the long-awaited MSSNY Peer to Peer (P2P) program. We hope that colleagues will reach out to peer supporters to discuss daily stressors such as work, school, family, or financial issues.  With the advent of COVID-19 pandemic, there may also be some additional stress in our colleagues’ lives.

The P2P program is an opportunity for our colleagues to have a one-time confidential discussion with a peer supporter.  The peer supporter is a trained professional who can share experiences, listen without judgment, and can validate your feelings and provide you with Support, Empathy and Perspective.  Peer supporters can also provide information on specific organizations that can support you and will provide you with positive coping skills.  They can also help connect you to professionals should you need more focused assistance.

Any physician, resident, or medical student who wishes to chat with a peer supporter, may contact the Medical Society of the State of New York in the following ways:

  • Email your request to P2P@mssny.org to be connected with a peer supporter.
  • Or you can call MSSNY at (518) 465-8085, ext. 321 and request that you be connected with a peer supporter. The line is answered by MSSNY staff during regular business hours (Monday – Friday, 8:30-5 p.m.) After 5 p.m., the call will be answered by a live answering service that will take down your contact information and MSSNY staff will subsequently follow-up with you.
  • All calls and emails will remain strictly confidential.

It is well documented that physicians, residents, and medical students have enormous stressors that can range from the emotions arising in the context of patient care to the demanding environment in which we practice medicine.   Now, with the COVID-19 pandemic added into the mix, those stressors may be exacerbated.

Please know that whatever your situation, you are not alone.  MSSNY P2P is here to help.  Our trained peer supporters are ready, willing, and able to take time to talk with you.  Please reach out to us. We truly care about you and the difficult issues that you face.

The words “Be Well” apply to all of us.

Bonnie Litvack, MD
MSSNY President


NYS DOH COVID-19 Tracker


Daily US Cases Hit New High; White House Reconvenes Task Force
The U.S. reported more than 41,000 new COVID-19 cases June 25, the nation’s highest count since the pandemic began, according to data from Johns Hopkins University. The count surpassed previous records of 36,880 cases June 24 and 36,739 cases confirmed April 24, according to The New York Times.

At least 20 million Americans may have had COVID-19, according to a new CDC estimate cited by NBC News. The estimate is based on an analysis of blood samples from patients nationwide. “Our best estimate right now is that for every case that’s reported, there actually are 10 other infections,” CDC Director Robert Redfield, MD, said June 25.

The coronavirus task force is set to reconvene today for its first briefing since April 27, White House officials told The New York Times. Task force members are expected to share new data from areas seeing a surge in cases.

On Wednesday, the State tested 67,642 people. Of those tested, 749, or 1.1%, were positive.


Nationwide, Coronavirus Cases up 30% Compared to Beginning of June
There are 26 states seeing daily COVID cases increase over the past week. New York State is one of the exceptions. The travel advisory is now in effect for people arriving to New York, New Jersey and Connecticut from hotspot states.



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US Aim: ‘Take Flu Off The Table’ In Preparation For Second Wave of Coronavirus
Drugmakers are making millions of extra flu shots this year in preparation for a possible second wave of COVID-19 during the annual flu season, and in a rare move, the CDC has bought 7 million doses directly from them. The CDC usually buys about 500,000 doses of the flu shot to distribute to states but has spent $100 million to buy 7 million doses and has given $140 million to immunization programs across the U.S. to boost adult flu vaccination. Drugmakers are planning to boost production by about 10 percent to make 189 million doses this year, up from 170 million last year. Public health experts are expecting an “unprecedented” number of people to get a flu shot this year, according to the Post.

Experts have said lowering the number of people who catch the flu could free up critical hospital space to handle a potential second wave of COVID-19. Health officials are especially concerned about people at higher risk for both COVID-19 and the flu, the Post reported, such as residents and employees at long-term care facilities, African Americans, Hispanics, and people with comorbidities. Read the full article here.


Hospitalized COVID-19 Patients May Be More Prone to Major Organs Clotting
Modern Healthcare (6/25) reports, “Hospitalized COVID-19 patients may be more likely to develop clotting in their major organs, which researchers say may explain why some with the virus suffer heart attacks despite having no prior coronary damage.” According to findings published in the Lancet, “a series of 18 autopsies performed on NYU Winthrop Hospital patients who tested positive for COVID-19 discovered abnormal clotting and deposits of cells and proteins that cause clots in small blood vessels in their hearts, kidneys, lungs and livers.” Moreover, “clotting was also found in the heart veins rather than arteries, causing heart muscle damage.”


Five Regions of New York Are on Track to Enter Phase 4 of Reopening Today
The metrics in the Finger Lakes, Central New York, Southern Tier, Mohawk Valley, and the North Country continue trending in the right direction. Phase 4 permits indoor religious gatherings at 33% of capacity and allows low-risk indoor and outdoor arts and entertainment, film and TV production and professional sports without fans. Read more about Phase 4 here.

  • Social gatherings of up to 50 people will be allowed as part of Phase Currently, gatherings of up to 25 people are permitted in regions that are in Phase 3.
  • A note on malls, movie theaters and gyms. These industries are unusually risky from a health standpoint. The State is undertaking further study to ensure they make informed decisions before reopening these businesses.

The total number of COVID hospitalizations continues to decline. Total hospitalizations fell to 1,071, from 1,104 the previous day. Sadly, 17 people in New York died due to COVID-19 (June 24)

On June 23, the State tested 51,144 people. Only 581, or 1%, were positive.


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WHO Outlines COVID-19 Vaccine Distribution Plan
The World Health Organization has laid out a proposal for the distribution of  COVID-19 vaccines and said over 4 billion doses will be needed to vaccinate the world’s priority populations, Politico reported. In a document presented to WHO member countries June 18, the organization said the allocation framework’s goal should be to reduce COVID-19 deaths and to protect health systems.

The WHO said three groups should be prioritized to receive vaccines: healthcare workers, adults over 65 and adults with comorbidities including cancer, cardiovascular disease, and obesity. All countries should receive an initial shipment of vaccines, but the formula for how many vaccines each country will receive can change to reflect the prioritization of a specific region or a shifting risk assessment of a country’s vulnerability and COVID-19 threat, according to Politico. Read the full article here.


 

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Physicians, Do You Use Telemedicine?
CMS has asked MSSNY for a listing of physicians who do Telemedicine. They have heard from a numbers of community health care groups for seniors that some patients are hesitant about calling their physicians about needed appointments since they are fearful of having to go to the doctor’s office.

CMS is asking for MSSNY’s assistance for two reasons:

  • The first is to alert patients in communities where physicians can provide virtual care during this pandemic.
  • Second, regarding forward thinking, it would be helpful for CMS to know which and how many physicians can provide telemedicine. This information would be useful in making the argument of continuing the expanded telemedicine coverage in a post pandemic future.

If you can provide telemedicine, please provide MSSNY with your name, address, specialty, phone and NPI number. This information will be added to MSSNY’s website and shared with your county societies.  CMS would also help in disseminating the information to the patient community. Send info to rmcnally@mssny.org


MSSNY WEBINAR

Monday June 29, 2020 @ 7:30am Medical Matters CME Webinar Registration Now Open Questions & Answers Surrounding the COVID-19 Pandemic
Be sure to register now for MSSNY’s next webinar related to the COVID-19 pandemic.  Medical Matters: Questions & Answers Surrounding the COVID-19 Pandemic on Monday June 29th at 7:30am. Faculty for this program is William Valenti, MD, Arthur Cooper, MD, Marcus Friedrich, MD and Elizabeth Dufort, MD.

Educational objectives:

  • Identify frequently asked questions surrounding the COVID-19 pandemic
  • Examine the dynamic circumstances encompassing COVID-19

Click here to register

To view the companion pieces to this webinar, be sure to go here or go to the MSSNY podcast site and listen to the COVID-19 related podcasts available 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.


CMS

CMS Rule Promotes Payer Drug Price Negotiations Based on Clinical Outcomes
CMS issued a proposed rule June 17 that would make it easier for Medicaid to make payment models based on a drug’s clinical value.

Current regulations make it hard for drugmakers to report payments under value-based arrangements to the agency. The regulations hinder payers and drugmakers from designing new payment arrangements based on the value a drug provides to a patient and leads to prices based on the quantity of drugs sold rather than the quality of the drug, CMS said.

“CMS’s rules for ensuring that Medicaid receives the lowest price available for prescription drugs have not been updated in thirty years and are blocking the opportunity for markets to create innovative payment models,” said CMS Administrator Seema Verma. “By modernizing our rules, we are creating opportunities for drug manufacturers to have skin in the game through payment arrangements that challenge them to put their money where their mouth is.”

The new proposed rule seeks to modernize regulations to encourage innovation and encourage states, private payers and drugmakers to pay for prescription drugs based on clinical outcomes. Basing payment on clinical outcomes could foster innovation and reduce overall healthcare spending and hospital visits, CMS said.

Read the full news release here.


CMS Announces Relief for Clinicians Participating in the Quality Payment Program in 2020
In response to the 2019 Coronavirus (COVID-19) public health emergency, CMS) is announcing flexibilities for clinicians participating in the Quality Payment Program (QPP) Merit-based Incentive Payment System (MIPS) in 2020:

  • Clinicians significantly impacted by the public health emergency may submit an Extreme & Uncontrollable Circumstances Application to reweight any or all of the MIPS performance categories. Those requesting relief via the application will need to provide a justification of how their practice has been significantly impacted by the public health emergency.
  • Reminder: In April, CMS added a new COVID-19 clinical trials improvement activity. There are two ways MIPS eligible clinicians or groups can receive credit for this new improvement activity:
    • A clinician may participate in a COVID-19 clinical trial and have those data entered into a data platform for that study; or
    • A clinician participating in the care of COVID-19 patients may submit clinical COVID-19 patient data to a clinical data registry for purposes of future study.

For More Information


Veterans Matters Podcasts
Check out MSSNY’s Veterans Matters podcast series on Veterans’ healthcare topics including PTSD in Returning Veterans, TBI in Returning Veterans, Substance Use in Veterans, Suicide in Veterans, The Special Mental Health Needs of Women Veterans and Military Culture: Everything Physicians Need to Know about Veterans as Patients.

Click here to listen to Part 1 of PTSD in Returning Veterans with Dr. Frank Dowling.

Click here to listen to Part 2 of PTSD in Returning Veterans with Dr. Frank Dowling.

Click here to listen to TBI in Returning Veterans with Dr. David Podwall.

Click here to listen to Substance Use Disorders with Dr. Thomas Madejski.

Click here to listen to Suicide in Veterans podcast with Dr. Jack McIntyre.

Click here to listen to The Special Mental Health Needs of Women Veterans with Dr. Malene Ingram, Colonel, U.S. Army Reserves and Retired Chief Master Sergeant, U.S. Air Force, Marcelle Leis.

Click here to listen to Military Culture: Everything Physicians Need to Know about Veterans as Patients with Retired Lieutenant Colonel, U.S. Army, Lance Allen Wang and Retired Chief Master Sergeant, U.S. Air Force, Marcelle Leis.


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MSSNY Helpline for Physicians Experiencing COVID-19 Related Stress 518-292-0140


Classifieds

Upper East Side Office to Share
Includes waiting room, 2 exam rooms and room for medical assistants. Flexible schedule. Call Bianca at 212-327-1851.

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eNews: June 24, 2020


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NYSDOH June 24 Updates


Tri-State Govs Impose 14-Day Quarantine for Visitors from High Infection Rate States
The governors of New York, New Jersey and Connecticut announced on Wednesday that they would impose a 14-day quarantine on visitors from states with high coronavirus infection rates.

“We worked very hard to get the viral transmission down. We don’t want to see it go up,” said Governor Andrew Cuomo during a joint press conference with his fellow tri-state governors.

The order in New York, which will take the form of a travel advisory, will take effect at midnight. The standard for measuring states considered a risk will be those with more than 10 coronavirus cases per 100,000 people or whose infection rate is above 10 percent based on a seven-day rolling average.

As of today, Cuomo said there are nine states that fit that criteria: Alabama, Arkansas, Arizona, Florida, North Carolina, South Carolina, Washington, Utah, and Texas. But more than two dozen states are seeing surges in cases.

The advisory not only applies to out-of-state residents. Any New Yorker that leaves to visit those states would be subject to quarantine upon their return, Cuomo said. The infection rate in New York state is now 1.1 percent, while the number of total hospitalizations is now at 1,071, the lowest since March 19th.

Although it was not clear how the three states would enforce the quarantine, Cuomo denied that the measure was simply symbolic. “You violate the quarantine, you will have to do mandatory quarantine and you will be fined,” he said.

Violators may be asked to pay a minimum fine of $2,000 and up to $10,000 if they cause harm, according to the governor.


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Younger Adults Testing Positive for Coronavirus in More States
In several U.S. states, including Florida, Texas, Washington, California and Colorado, there are reports of a demographic shift in coronavirus case trends, with younger adults increasingly making up a greater share of cases, according to NPR.

There are many possible reasons for this shift, including the fact that more people are getting tested for the new virus, public health experts told NPR. But some experts attribute the rise in cases among adults in their 20s and 30s to their possible belief that they are at lower risk of contracting the virus and return to social gathering settings sooner than older adults.

In Washington, an analysis of state data showed that nearly half of new COVID-19 cases in Seattle were among people in their 20s and 30s. State data in California shows that adults younger than 35 years make up about 44 percent of new coronavirus cases, NPR reports.

“If you see these types of trends occurring in a state as large as California, it’s probably a very strong harbinger that this is actually happening nationally, too,” George Lemp, DrPH, an infectious disease epidemiologist and former director of the University of California’s HIV/AIDS Research Program, told NPR.

Many governors have blamed the uptick in cases on young adults, including Texas Gov. Greg Abbott, who tied the rise in new virus cases to reports of packed bars and young adults failing to socially distance.

Some local governments are trying to create public awareness campaigns aimed at young adults. Ken Welch, a county commissioner in Pinellas County, said the county thought about getting local athletes to talk about the importance of wearing a mask.

Wafaa El-Sadr, MD, a professor of epidemiology and medicine at New York City-based Columbia University, told NPR that identifying “trusted spokespeople” to create awareness among younger adults is key.

“I think young people can potentially have a very, very valuable role if we can harness their energy and attention,” she said. (Becker’s Hospital Review June 22)


Resistant Meningococcal Strain Circulating US, CDC Warns
The CDC is warning healthcare providers about a new resistant strain of Neisseria meningitidis, which causes meningococcal disease.

Meningococcal disease is a life-threatening infection of the brain and spinal cord or bloodstream. The infection is usually treated with penicillin or ciprofloxacin. The antibiotics are also used for prophylaxis in people who have had close contact with the infected patient.

However, the CDC has detected 11 meningococcal cases that occurred in nine states between 2019 and 2020 in which isolates contained a gene and mutations associated with resistance to these antibiotics. Another 22 cases reported from 2013 -20 contained the gene associated with penicillin resistance, but did not have mutations associated with ciprofloxacin resistance, according to the CDC’s Morbidity and Mortality Weekly Report published June 19.

The agency is urging clinicians to conduct antibiotic susceptibility testing before switching from empirical treatment to penicillin or ampicillin for patients with meningococcal disease.

To learn more, click here.


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AHA Urging HHS To Extend Health Emergency Declaration: Set to Expire July 25
The declaration grants healthcare providers certain resources and flexibilities to care for COVID-19 patients, which will be needed past July, AHA President and CEO Richard Pollack said in a letter to HHS Secretary Alex Azar. Mr. Pollack asked HHS to extend the declaration until various criteria are met related to supply chain, testing volume, intensive care unit capacity and death figures.


WEBINARS

June 29, 2020 @ 7:30am Medical Matters CME Webinar Registration Now Open Questions & Answers Surrounding the COVID-19 Pandemic 

Register now for MSSNY’s next webinar related to the COVID-19 pandemic on June 29th at 7:30am, Medical Matters: Questions & Answers Surrounding the COVID-19 Pandemic. The COVID-19 pandemic has generated myriad questions for health professionals.

This webinar will explore some of the most frequently asked of these questions and provide answers where they are available Faculty for this program is William Valenti, MD, Arthur Cooper, MD, Marcus Friedrich, MD and Elizabeth Dufort, MD.

Educational objectives:

  • Identify frequently asked questions surrounding the COVID-19 pandemic
  • Examine the dynamic circumstances encompassing COVID-19

Registration is now open for this webinar

To view the companion pieces to this webinar, be sure to go to cme.mssny.org or go to the MSSNY podcast site and listen to the COVID-19 related podcasts available here.

Additional information can be found here and 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.


IPRO QIN-QIO Community of Care Coalitions: Working Together to Improve Care and Reduce Burden Wednesday July 8, 2020 | 12PM – 1PM EDT

Register Here!

Join us for a presentation of the Community of Care Coalition program and the ways our work at the IPRO QIN-QIO aligns with multiple initiatives including the Merit Based Incentive Payment System (MIPS) and the Shared Savings Program (SSP).
Our presentation will include a short overview of the program, a panel discussion of experts describing how the IPRO QIN-QIO programs can help your practice, and an open Q and A.

Participating organizations in our Community of Care Coalition program will have access to:

Educational resources and tools: guide and support quality improvement processes.

·       Health information technology support: access clinical decision support tools; innovations in HIT to reduce opioid-related harm, improve opioid prescribing and pain management; and track and report adverse events.

·       Data analysis and reporting: enhance identification, tracking, and reporting opportunities for improvement; receive timely data on quality measure performance.

·       Peer to peer collaboration: learn about best practices from peers.

·       Person and family engagement: gain insight on how best to involve patients, residents and their family members and care partners in their care.

·       Online learning: join virtual collaborative and take advantage of online, self-paced educational programs.

Find out more about the IPRO QIN QIO program here.


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CMS

CMS Opens Office to Cut Red Tape for Providers
To determine where to trim red tape, CMS relied on input from 10 Requests for Information, along with listening sessions, site visits, feedback from more than 2,500 stakeholders.

CMS says it has already removed unnecessary and burdensome regulations that have saved providers 4.4 million paperwork hours and $800 million. The Centers for Medicare & Medicaid Services on Tuesday announced the creation of a new office designed to cut red tape for providers.

The regulatory reductions are expected to save providers $6.6 billion and 42 million unnecessary burden hours through 2021, CMS said. “The work of this new office will be targeted to help reduce unnecessary burden, increase efficiencies, continue administrative simplification, increase the use of health informatics, and improve the beneficiary experience,” CMS Administrator Seema Verma said.

To determine where to trim red tape, CMS relied on input from 10 Requests for Information, along with listening sessions, site visits, feedback from more than 2,500 providers, clinicians, administrative staff, and beneficiaries, and 15,000 comments from various stakeholders.

So far, CMS said, the red tape reductions have:

·       Removed unnecessary, obsolete, or excessively burdensome conditions of participation for providers saving 4.4 million paperwork hours and total projected savings to providers of $800 million annually.

·       Removed 235 data elements from 33 items on the Outcomes and Assessment Information Set assessment instrument for home health.

·       Established within the Quality Payment Program consolidated data submission for the Merit-based Incentive Payment System, removing a requirement that clinicians submit data in multiple systems.

·       Eliminated 79 measures under the Meaningful Measures Initiative, resulting in projected savings of $128 million and an anticipated reduction of 3.3 million burden hours through 2020.

·       Accelerated processing state requests to make program or benefit changes to their Medicaid programs through the state plan amendment and section 1915 waiver. (Health Leaders, June 23)


Physician Compare Preview Period is Now Open
The Physician Compare 60-day Preview Period is officially open as of June 22, 2020 at 10 a.m. ET (7 a.m. PT). You can now preview your 2018 Quality Payment Program performance information before it will appear on Physician Compare profile pages and in the Downloadable Database. You can access the secured Preview through the Quality Payment Program website.

Access the resource below on how to preview your data:

·        Physician Compare Preview Period User Guide

For additional assistance with accessing the Quality Payment Program website, or obtaining your EIDM user role, contact the Quality Payment Program service center at QPP@cms.hhs.gov.

To learn more about the 2018 Quality Payment Program performance information that is available for preview as well as the 2017 clinician utilization data that will be added to the Downloadable Database, download these documents from the Physician Compare Initiative page:

·        Clinician Performance Information on Physician Compare: Performance Year 2018 Preview Period

·        Group Performance Information on Physician Compare: Performance Year 2018 Preview Period

The 60-day Preview Period will close on August 20, 2020 at 8 p.m. ET (5 p.m. PT).


MSSNY Helpline for Physicians Experiencing COVID-19 Related Stress 518-292-0140


Classifieds

Upper East Side Office to Share
Includes waiting room, 2 exam rooms and room for medical assistants. Flexible schedule. Call Bianca at 212-327-1851.

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MSSNY Tough in Tough Times


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MSSNY in Action:  The Cliff Note Version
This week brings some good news in New York as our infection rates, hospitalization rates and death rates and from COVID-19 continue to decline amidst reopening the state. As we, as a profession, settle into new practice paradigms, I know that our email inboxes have often suffered from neglect. With that in mind, this week’s column aims to provide a quick update on society activities.  Throughout the crisis MSSNY has been in daily contact with the Governor’s office, the DOH and our state legislature providing input, seeking help, and getting the changes necessary for physician practices to see patients. We were successful in getting rapid changes to payment for telehealth, immunity for COVID treatment, pushing to get elective surgery and care reinstituted throughout the state, practical changes to everything from COVID testing requirements to changes in the date for completion of the mandated pain management course and innumerable other needed small and large flexibilities.

Your MSSNY has written articles, emails, done press releases, given testimony, written letters to our Governor, our congressional delegation, and other national leaders.  We have also given print and TV interviews on the plight of our physicians that have aired locally and nationally. We have done 2 polls on the economic impact of COVID-19 on physician practices in NY that have garnered significant press and our data was corroborated by a Fair Health report released this week. MSSNY has also given testimony to our NY State Senate and Assembly, most recently on Wednesday, on the economic impact on physician practices and the need for additional funds to be made available to sustain them.

Throughout the crisis and now during re-opening, we have reiterated to our State Government the very important roles that our physicians and our medical society have played.  MSSNY has repeatedly stressed that all state task forces dealing with healthcare must include practicing community physicians and that not doing so is to the detriment of the health and wellbeing of NYS residents.

Our May member email on physician PPE needs resulted in over 700 responses. MSSNY has taken this issue extremely seriously and continues to pursue every angle to get NY physicians the needed, affordable, reliable supplies necessary to take care of their patients and keep their offices open. National shortages persist, there are significant delivery delays and the major manufacturers will not sell directly to the society. We have been in contact with the Governor’s office, our NYS legislature, the major manufacturers, distributors, Vice President Pence, Congress, and the AMA.  We have made our members aware of the many counterfeit products on the market and have been sending out information on availability of legitimate sources as we hear of them; all while directly trying to procure PPE. Within the past week alone we have spoken with the NYS legislature about mandating insurers to cover the increased cost of PPE, done an interview that will air nationally, spoke with numerous distributors and sent letters to the AMA Chief Executive, Dr. Madara, our NYS health commissioner, Howard Zucker, and to our congressional delegation.

Through everything, the health and wellbeing of our physicians is of paramount importance. We have all been through a lot personally and professionally and many of us need an ear to listen and a colleague to lean on. MSSNY is here for you. Our helpline is up and running at 518-292-0140 and our first class of Peer to Peer supporters has been trained.

While these are the Cliff Notes, MSSNY has outsized, ongoing efforts on a multitude of fronts to help sustain you and your practice and to move our society forward.

Bonnie Litvack, MD
MSSNY President


MSSNYs Weekly Podcast


Notes from Governor Cuomo’s COVID-19 Final Daily Address

DATA:

– 1,284 total hospitalizations.

– The state conducted 79,000 tests yesterday.

– We continue to have the lowest infection rate since the beginning of the outbreak.

– 25 lives lost yesterday. 

GOV PERSPECTIVE:

– Gov thanked all those involved in COVID-19 mitigation efforts.

– Gov shared a story about his daughter missing her graduation ceremony, and how he similarly regrets not celebrating the unveiling of the new state seal.

– “Why did it take a crisis to bring us together?”


MSSNY Statement on U.S. Supreme Court’s DACA Ruling
Statement Attributable to:
Bonnie Litvack, MD
President, Medical Society of the State of New York

“Yesterday’s US Supreme Court decision will allow medical students and medical residents with Deferred Action for Childhood Arrivals (DACA) status to continue their education and training in the United States.

“The Medical Society of the State of New York (MSSNY) believes that this action by the Supreme Court will help medical schools and teaching hospitals to produce a diverse and culturally responsive health care workforce to meet the needs of underserved populations, improve cultural awareness, and promote health equity.

“As this nation’s population grows and becomes much more diverse, it is crucial that the physician workforce reflect the changing demographics of the country to mitigate racial, ethnic, and socioeconomic health disparities.

“The Medical Society of the State of New York urges that Congress work towards a permanent resolution for the individuals here in this country under DACA.”


MSSNY Chairman of the Board and Past President Dr. Kleinman in JAMA on Crushing Effects of COVID-19 on Medical Practices
In a JAMA article about the crushing effects of COVID-19 on medical practices across the country, Andrew Kleinman, MD, a past president of MSSNY, said “Unfortunately, I think this [pandemic] is going to accelerate the closure of the smaller practices. With a lot of practices, 40% or more of their revenue goes just to overhead.”

In a survey of 558 US primary care physicians fielded May 29 through June 1—nearly 3 months into the pandemic—6% of respondents said their practices were closed, perhaps temporarily, and 35% said they’ve furloughed staff, according to the nonprofit Primary Care Collaborative (PCC) and the Larry A. Green Center.

Dr. Kleinman, a past president of the Medical Society of the State of New York, said he reduced his malpractice coverage to half-time, but he still had to pay two-thirds of his prepandemic premium. “For a plastic surgeon, it’s still expensive when there’s no income.” And he still had to pay other overhead costs—phones and electronic medical records, to name 2—for his temporarily closed practice.

“If this happened to me 20 years ago, I would be bankrupt,” said Dr. Kleinman, who, at age 66 years, was able to draw on savings to help his practice survive. “When this whole thing started, I strongly considered just retiring now.” While he’s heard of physicians retiring early rather than waiting out the pandemic, Kleinman said, he decided he’s not yet ready to follow suit.


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Have You Used Your MSSNY Member Benefits Lately?


HHS Portal Now Open for Eligible Physician to Apply for CARES Act Grant funds
As noted in the MSSNY e-news a few days ago, the US Department of Health and Human Services (HHS) announced it will distribute approximately $15 billion to eligible physicians and organizations that a)  participate in state Medicaid and CHIP programs and b) have not received a payment from the Provider Relief Fund General Allocation established in the CARES Act.  Last evening, HHS opened the portal that will allow these eligible physicians to report their annual patient revenue data and other necessary information to receive a payment equal to at least 2% of reported gross revenues from patient care.

To apply, click here.

For an HHS FAQ regarding who may be eligible for this distribution, click here.


PAI Releases Independent Physician Survey on High-Deductible Health Plans
A survey of independent physicians from the Physicians Advocacy Institute (PAI), conducted by NORC at the University of Chicago, shows the challenges in patient care caused by high-deductible health plans.

Before the COVID-19 pandemic hit the United States, patients’ large and growing share of out-of-pocket healthcare costs posed challenges for individuals, families, and independent physicians. When the epidemic became a pandemic, the federal government and certain insurance companies acted quickly to make coronavirus-related care widely accessible by ensuring it was affordable to everyone who needed it.

Key findings include:

  • 79 percent of physicians believe that high health insurance deductibles are a key driver of patients’ cost concerns.
  • 80 percent of physicians believe their patients often or sometimes refuse or delay care due to cost concerns.
  • More than half of physicians report that patient delay of care caused capacity or schedule issues for their practice.
  • 77 percent of providers say it takes more than a month to receive any payment.
  • Three out of four physicians say they do not have most of the information they need in order to have cost of care discussions with patients
  • Most physicians say their office staff spends more than 300 hours per year educating patients on their coverage.

More information on the study is available on PAI’s website.


Veterans Matters Podcasts
Check out MSSNY’s Veterans Matters podcast series on Veterans’ healthcare topics including PTSD in Returning Veterans, TBI in Returning Veterans, Substance Use in Veterans, Suicide in Veterans, The Special Mental Health Needs of Women Veterans and Military Culture: Everything Physicians Need to Know about Veterans as Patients.

Click here to listen to Part 1 of PTSD in Returning Veterans with Dr. Frank Dowling.

Click here to listen to Part 2 of PTSD in Returning Veterans with Dr. Frank Dowling.

Click here to listen to TBI in Returning Veterans with Dr. David Podwall.

Click here to listen to Substance Use Disorders with Dr. Thomas Madejski.

Click here to listen to Suicide in Veterans podcast with Dr. Jack McIntyre.

Click here to listen to The Special Mental Health Needs of Women Veterans with Dr. Malene Ingram, Colonel, U.S. Army Reserves and Retired Chief Master Sergeant, U.S. Air Force, Marcelle Leis.

Click here to listen to Military Culture: Everything Physicians Need to Know about Veterans as Patients with Retired Lieutenant Colonel, U.S. Army, Lance Allen Wang and Retired Chief Master Sergeant, U.S. Air Force, Marcelle Leis.


Third COVID-19 Study Released by FAIR Health
In April 2020, in the midst of the COVID-19 pandemic, healthcare professional services declined 68 percent in utilization and 48 percent in revenue based on total estimated in-network amounts compared to April 2019 nationally.

In the Northeast, the region hit hardest at that time by the pandemic, professionals experienced particularly sharp drops in utilization (80 percent) and revenue (79 percent) in April 2020. These are among the findings of FAIR Health’s third COVID-19 study, Healthcare Professionals and the Impact of COVID-19: A Comparative Study of Revenue and Utilization



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June 29, 2020 @ 7:30am Medical Matters CME Webinar Registration Now Open Questions & Answers Surrounding the COVID-19 Pandemic
Registration is now open for MSSNY’s next webinar related to the COVID-19 pandemic.  Medical Matters: Questions & Answers Surrounding the COVID-19 Pandemic on Monday June 29th at 7:30am.  Faculty for this program is William Valenti, MD, Arthur Cooper, MD, Marcus Friedrich, MD and Elizabeth Dufort, MD.

Educational objectives:

  • Identify frequently asked questions surrounding the COVID-19 pandemic
  • Examine the dynamic circumstances encompassing COVID-19

Click here to register

To view the companion pieces to this webinar, be sure to go to https://cme.mssny.org or go to the MSSNY podcast site and listen to the COVID-19 related podcasts available at https://www.buzzsprout.com/51522.

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 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.


SBA Revised Paycheck Protection
This week, the U.S. Small Business Administration, in consultation with the U.S. Department of the Treasury, posted a revised, user-friendly Paycheck Protection Program loan forgiveness application implementing the PPP Flexibility Act of 2020. In addition to revising the full forgiveness application, the SBA also published a new “EZ” version of the forgiveness application applying to borrowers who:

  • Are self-employed and have no employees; OR
  • Did not reduce the salaries or wages of their employees by more than 25%, and did not reduce the number or hours of their employees; OR
  • Experienced reductions in business activity as a result of health directives related to COVID-19 and did not reduce the salaries or wages of their employees by more than 25%

“This is great news for small businesses,” said SBA Regional Administrator Steve Bulger, who oversees agency operations in the Atlantic and Mid-Atlantic regions. “The EZ application requires fewer calculations and less documentation, which makes the process much less intimidating. I’m sure this will go a long way toward improving access and helping us distribute the remaining PPP appropriations to support small business owners and their employees.”

Details regarding the applicability of these provisions are available in the instructions to the new EZ application form.  Both applications give borrowers the option of using the original 8-week covered period (if their loan was made before June 5, 2020) or an extended 24-week covered period.  These changes will result in a more efficient process and make it easier for businesses to realize full forgiveness of their PPP loan.

Click here to view the EZ Forgiveness Application.

Click here to view the Full Forgiveness Application.


MSSNY Helpline for Physicians Experiencing COVID-19 Related Stress 518-292-0140


Classifieds

Upper East Side Office to Share
Includes waiting room, 2 exam rooms and room for medical assistants. Flexible schedule. Call Bianca at 212-327-1851.

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MSSNY Statement on U.S. Supreme Court’s DACA Ruling

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For Immediate Release
June 19, 2020 

MSSNY Statement on U.S. Supreme Court’s DACA Ruling

Statement Attributable to:
Bonnie Litvack, MD
President, Medical Society of the State of New York

“Yesterday’s US Supreme Court decision will allow medical students and medical residents with Deferred Action for Childhood Arrivals (DACA) status to continue their education and training in the United States.

“The Medical Society of the State of New York (MSSNY) believes that this action by the Supreme Court will help medical schools and teaching hospitals to produce a diverse and culturally responsive health care workforce to meet the needs of under served populations, improve cultural awareness, and promote health equity.

“As this nation’s population grows and becomes much more diverse, it is crucial that the physician workforce reflect the changing demographics of the country to mitigate racial, ethnic, and socioeconomic health disparities.

“The Medical Society of the State of New York urges that Congress work towards a permanent resolution for the individuals here in this country under DACA.”

# # #

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

 

COVID-19 Update June 18, 2020

.
.
Notes from Governor Cuomo’s Daily Briefing:

Day 110 of COVID-19 / Day 25 of civil unrest
DATA:
– The state conducted 68,541 COVID-19 tests yesterday.
– 618 tests were positive (0.9%).
– Central NY has seen a significant uptick in positive cases:
– 0.6% on Saturday to 3% on Wednesday
– 1,358 total hospitalizations
– 29 lives lost yesterday: 22 in hospitals, 7 in nursing homes.

REOPENING:
– Gov reiterated that NYC will enter Phase II on Monday.
– Gov restated the guidelines for Phase II, available at
https://www.forward.ny.gov/phase-two-industries.
– Gov announced he will increase the penalty for violating reopening
rules.
– Gov will sign an executive order dictating that businesses
that violate the rules can be shutdown, liquor licenses may be revoked.
– Gov will also sign an executive order allowing SLA to expand
enforcement areas for businesses.

EDUCATION
– NYS will issue guidance to colleges to allow some in-person
programming for the Fall Semester.
– Gov stressed that without proper mitigation in other states, more
people will die.

Q&A:
MISCELLANEOUS:
– On the Supreme Court: Gov is surprised by the results of recent
LGBT rulings.
REOPENING:
– Gov said he is considering imposing quarantines on travelers from
other states where COVID-19 is growing.
– Zucker, on herd immunity, claimed that we do not have enough people
with antibodies to satisfy the conditions necessary (70-80% of
individuals with antibodies).
– Gov said that statistically, we will likely see an increase in the
infection rate.


HHS through the Provider Relief Fund, expects to distribute $15 billion to eligible Medicaid and CHIP Providers
Join our webcast to learn more about the application process.
Please pre-register to reserve a spot.


MSSNY President, Dr. Bonnie Litvack, MD, Testifies Before Assembly Committee on Small Business About Devastating Impact of COVID19 on Community Physician Practices
MSSNY President, Dr. Bonnie Litvack, MD, testified before the state Assembly Committee on Small Business, on Wednesday, June 17, about the devastating impact that COVID19 has had on community physician practices, across New York State, and federal efforts to help small businesses. The Committee is chaired by Assemblyman Albert Stirpe and the hearing was a joint event with the Assembly Committees on Ways & Means, Agriculture, Banks, Office of State-Federal Relations, Task Force on Food, and Farm & Nutrition Policy.

Among the range of important issues that Dr. Litvack raised, was that the COVID19 crisis has tested the medical profession like never before, and how the physician community has rallied to confront the once in a century enemy. She also focused on the devastating financial impact of the crisis for community physicians and how the COVID19 outbreak exacerbated several, already startling trends affecting physicians’ like excessive liability insurance costs and ratcheting down on payments, to physicians, by health insurance companies.

Dr. Litvack also shared some key takeaways from two statewide surveys that MSSNY conducted of its members, over the last two months, among them that 79% have seen a reduction of more than 50% in their volume of patient visits and more than a quarter have had to lay off, or furlough, more than 50% of their staff. She also noted the significant challenges physicians have faced with obtaining personal protective equipment (PPE), and how that is adversely impacting physicians’ ability to re-open their practices to their patients.

She also urged a number of different policy changes, including requiring health insurers to help cover the significantly increased costs of PPE, maintaining expanded Telehealth coverage rules, and additional funding from the federal government to prevent Medicaid cuts and provide relief to hard-hit community physician practices.

MSSNY’s Governmental Affairs Team will continue to work on these issues and keep members updated. CARY, AUSTER)


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Governor Signs Measure to Continue Medicaid Coverage for Audio-Only Telehealth; Also Continues Coverage Without Patient Cost Sharing
Governor Cuomo has signed into law legislation (a.10404-a, Rosenthal/s.8416) supported by MSSNY that permanently expands coverage for telemedicine in Medicaid and the child health plus insurance program to include “audio-only” services. Given the importance of making sure patients with limited access to video technological services could maintain continuity of care with their physician, Medicaid has been covering audio-only telehealth services since mid-March.  When the bill was passed by the state legislature 3 weeks ago, MSSNY President Dr. Bonnie Litvack issued a statement praising the legislation and urging that it be continued as well for all forms of insurance coverage.

MSSNY has also urged that the New York Department of Financial Services continue to require commercial health insurance plans to follow expanded telehealth coverage rules that have been required since mid-March. This week, the DFS advanced a regulation that continues until at least September 9 emergency rules that require commercial health insurance coverage for telehealth services without imposing any cost-sharing on patients.


Steroid Could Reduce COVID-19 Deaths: 5 Things to Know
A new U.K.-led study posits the steroid dexamethasone could be a life-saving treatment for patients with severe COVID-19, according to STAT.

Here are five key details:

  • Dexamethasone is an inexpensive, on-the-shelf steroid used to treat conditions such as asthma, rheumatoid arthritis, and certain cancers.
  • The study, called RECOVERY, randomly prescribed 2,104 COVID-19 patients 6 milligrams of dexamethasone daily, which they took intravenously or by mouth. They were compared to 4,321 patients who received only standard care.
  • Dexamethasone reduced the death rate by 35 percent in patients who needed to be on a ventilator and 20 percent in patients who needed oxygen but not a ventilator.
  • The study did not find dexamethasone to be statistically beneficial in patients who did not require oxygen.
  • The full study has yet to be published or face scientific scrutiny.
    (Becker’s Hospital Report, June 16)

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100 Days in ‘Hell’: Gov. Andrew Cuomo on His Pandemic Performance 
New York Gov. Andrew Cuomo called the federal government’s early coronavirus tracking a “terrible blunder” in an interview with “Good Morning America,” said he would not accept a cabinet position in a Joe Biden administration and insisted that his gradual but disciplined approach to shutting down New York state was the best course — then and now. “We went from the worst infection rate [in the nation] to the best infection rate,” Cuomo told ABC News’ Amy Robach in an illuminating interview on Tuesday in Albany, New York, about the first 100 days of New York’s response to COVID-19 – which began with New York’s first confirmed case on March 1 and ended on a small note of triumph June 8, with the partial re-opening of New York City. (ABC News (6/17)


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MSSNY Helpline for Physicians Experiencing COVID-19 Related Stress 518-292-0140


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COVID-19 Update June 17, 2020

.
.
Notes from Governor Cuomo’s Daily Briefing:

Day 109 of COVID-19
COVID-19 Data:
-1,479 total hospitalizations.
-17 lives lost yesterday – 15 in hospitals, 2 in nursing homes
-Yesterday, the state conducted 59,341 tests for COVID-19.
– 567 people tested positive for COVID-19 (0.96%).
-White House models are projecting a higher amount of deaths by August.
– In April, the estimated amount of deaths by August was 60,308.
– As of June 15th, the estimate amount of deaths is now 149,690.
Reopening:
-Gov reiterated that other states without phased reopenings are seeing spikes in COVID-19 cases.
-Gov said other states could spread the virus to NY.
-Gov stressed that increased testing is not the cause of increases in COVID-19 cases.
-Westchester and Rockland County will enter Phase III on Tuesday (6/23).
-Long Island will enter Phase III on Wednesday (6/24).
-NYC will enter Phase II on Monday (6/22).
-Gov announced today he will sign legislation protecting the rights of health care workers who speak out against improper patient care or workplace safety.
Gov announced this Friday will be the last daily briefing.
Q&A:
Nursing Homes:
-Gov said concerns over nursing home deaths are primarily a Republican talking point.
-Gov reiterated that during the outbreak, the state followed the guidance of the federal government.


MSSNY President, Dr. Bonnie Litvack, MD, Testifies Before Assembly Committee on Small Business About Devastating Impact of COVID-19 on Community Physician Practices 

MSSNY President, Dr. Bonnie Litvack, MD, testified before the state Assembly Committee on Small Business, on Wednesday, June 17th, about the devastating impact that COVID19 has had on community physician practices, across New York State, and federal efforts to help small businesses. The Committee is chaired by Assemblyman Albert Stirpe and the hearing was a joint event with the Assembly Committees on Ways & Means, Agriculture, Banks, Office Of State-Federal Relations, Task Force on Food, and Farm & Nutrition Policy.

Among the range of important issues that Dr. Litvack raised, was that the COVID19 crisis has tested the medical profession like never before, and how the physician community has rallied to confront the once in a century enemy. She also focused on the devastating financial impact of the crisis for community physicians and how the COVID19 outbreak exacerbated several, already startling trends affecting physicians’ like excessive liability insurance costs and ratcheting down on payments, to physicians, by health insurance companies.

Dr. Litvack also shared some key takeaways from two statewide surveys that MSSNY conducted of its members, over the last two months, among them that 79% have seen a reduction of more than 50% in their volume of patient visits and more than a quarter have had to lay off, or furlough, more than 50% of their staff. She also noted the significant challenges physicians have faced with obtaining personal protective equipment (PPE), and how that is adversely impacting physicians’ ability to re-open their practices to their patients.

She also urged a number of different policy changes, including requiring health insurers to help cover the significantly increased costs of PPE, maintaining expanded Telehealth coverage rules, and additional funding from the federal government to prevent Medicaid cuts and provide relief to hard-hit community physician practices.

MSSNY’s Governmental Affairs Team will continue to work on these issues and keep members updated.

CARY, AUSTER


Governor to Sign Legislation Expanding “Whistleblower” Protections
Governor Cuomo announced during his press conference today that he was going to sign into law legislation passed by the State Legislature (S.8397-A, Savino/A.10326-A. Reyes) to provide New York healthcare employees with greater “whistleblower” protections to reduce the risk of employers penalizing employees for filing complaints against them.

New York’s Labor Law provides healthcare employees with some whistleblower protections, but does not specifically address disclosures to the public made via new platforms like social media. The legislation provides medical professionals with greater legal protections against employer retaliation regarding public reports raising concerns with workplace safety conditions.


Crain’s Health Pulse Reports on State Medical Society Joint Letter Urging Congress to Help Physician Practices
A group that includes the Medical Society of the State of New York is urging Congress to continue to press for federal funding to help community physician practices keep their doors open.

Additional funds in the next stimulus package are critical to stemming some of the staggering financial losses incurred during the Covid-19 crisis, the group said. The medical societies of Connecticut, Delaware, Maryland, New Jersey and Ohio are also part of the group.

The medical societies said Tuesday that they are seeking federal relief, including a restart of the Medicare Advance Payment Program and dedicated grant funding for community physician practices without size restrictions or employee thresholds. The group pointed to a recent survey from MSSNY that found that nearly three-quarters of physicians had seen a greater than 50% drop in revenue.

“So far community physicians have only received a microscopic portion of the billions in grant funding allocated by Congress in the Cares Act, which has mostly benefited large health systems,” the group said in a statement. “While our hospitals must be protected and strengthened, so too must our community physicians, [on] whom our patients depend.”

In addition to dedicated funding, the group called for the next stimulus bill to include provisions to ensure expanded telehealth coverage rules are maintained. Hazard pay and student loan relief for those who have served on the front lines during the crisis are also a priority.

The medical societies further turned their attention to how insurers could help.

“We also urge that the market-dominant health insurers who faced a significant drop in claim submissions ensure that their windfall profits are shared with their contracted physicians, including through support for the huge increase in personal protective equipment costs,” the group said. —(Crain’s Health Pulse, 6/17)


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Politico New York Reports MSSNY’s Support of NYSDOH Guidance on Elective Surgery Time Frame for Coronavirus Testing
POLITICO New York (6/16, Young, Eisenberg) reports MSSNY President Dr. Bonnie Litvack praised the state health department’s “guidance on elective surgeries, which changed the time frame in which a patient must have received a negative [SARS-CoV-2] test prior to a non-emergency procedure from three to five days.” Dr. Litvack said, “This change is essential because of the difficulty many physicians and patients were having with obtaining and receiving the results of a Covid-19 test within 72 hours of a planned elective surgery.”


MSSNY Statement on U.S. Supreme Court’s Ruling on Title VII Cases
“The Medical Society of the State of New York (MSSNY) applauds the U.S. Supreme Court decision affirming that federal workplace discrimination protections apply to LGBTQ+ individuals.

“As physicians, we believe that workplace discrimination can lead to negative health outcomes, and therefore, LGBTQ+ individuals must be protected from any and all discrimination.

“MSSNY members played key roles in the passage of AMA policies over the last two years that led to the amicus brief the AMA wrote to the Supreme Court, urging it to confirm that discrimination protections under Title VII of the Civil Rights Act of 1964 cover sexual orientation and gender identity.”

Statement Attributable to:
Bonnie Litvack, MD
President, Medical Society of the State of New York
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SBA and Treasury Announce New PPP EZ Forgiveness Application
Today, the U.S. Small Business Administration, in consultation with the U.S. Department of the Treasury, posted a revised, user-friendly Paycheck Protection Program loan forgiveness application implementing the PPP Flexibility Act of 2020. In addition to revising the full forgiveness application, the SBA also published a new “EZ” version of the forgiveness application applying to borrowers who:

  • Are self-employed and have no employees; OR
  • Did not reduce the salaries or wages of their employees by more than 25%, and did not reduce the number or hours of their employees; OR
  • Experienced reductions in business activity as a result of health directives related to COVID-19 and did not reduce the salaries or wages of their employees
    by more than 25%

Interim Guidance for Pools and Recreational Aquatic Spray Grounds During the COVID-19 Public Health Emergency
NYSDOH issued interim guidance for the public and private owners and operators of pools and recreational aquatic spray grounds, including but not limited to cities, villages, towns, campgrounds, children’s camps, day cares, hotels, assisted living facilities, schools, colleges, universities, mobile home parks, homeowners’ associations, and apartment complexes. This guidance does not apply to private homeowner’s pools. For owners and operators that also provide other activities on premise (e.g. food service, retail, etc.), they must consult and adhere to guidance set forth on the New York Forward website as it applies to their operations.



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Governor Cuomo Announces Visitors Will Be Allowed to Return to Hospitals and Group Homes this Week
Governor Andrew Cuomo announced visitors will be allowed to return to hospitals and group homes across New York starting this week. Cuomo said visitors would be allowed at hospitals on Tuesday, and group homes certified by the state’s Office for People With Developmental Disabilities can begin accepting visitors on Friday. “This was always a balance of public health versus the personal relationships and people who are in hospitals who desperately want to see loved ones and loved ones who want to see people in hospitals,” said Cuomo at this daily press briefing.


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MSSNY Helpline for Physicians Experiencing COVID-19 Related Stress 518-292-0140

 

 

 

 

 

 

 

 

 

 

State Medical Societies Urge Congress to Fight for Funding for Community Physician Practices in Next Stimulus Package

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For Immediate Release
June 16, 2020 

CONNECTICUT STATE MEDICAL SOCIETY
MEDICAL SOCIETY OF DELAWARE
MED CHI, THE MARYLAND STATE MEDICAL SOCIETY
MEDICAL SOCIETY OF NEW JERSEY
MEDICAL SOCIETY OF THE STATE OF NEW YORK
OHIO STATE MEDICAL ASSOCIATION 

State Medical Societies Urge Congress to Fight for Funding for Community Physician Practices in Next Stimulus Package

On behalf of the tens of thousands of physicians collectively represented by our associations, and the millions of patients we treat, we are urging that Congress continue to fight for needed funding in the next “stimulus” package to assist community physician practices to be able to keep their doors open for their patients.  Like many businesses, our physicians have faced a devastating impact on their practices as a result of the Covid-19 outbreak.

At stake is access to care for the patients we serve and the staff we employ. With patients having appropriately limited their trips out of the house including to their doctor’s offices along with all elective procedures being suspended for months, the impact has devastated practices and the hundreds of thousands of those physicians employed by community physician practice.

For example, a survey by the Medical Society of the State of NY found that: 79% of physicians had seen a reduction of more than 50% in the volume of patients visiting their practices; Nearly 3/4 had a greater than 50% drop in practice revenue; and 40% had to lay off or furlough at least 25% of their staff.  While the survey also demonstrated that the CARES Act enacted by Congress in March and supplemented in April helped to marginally offset some of these enormous deficits, it has been nowhere near enough to ensure the survival of many physician practices across the state.

We urge that you fight to ensure that the final package includes important protections, including a re-start of the Medicare Advance Payment Program and ensuring that grant funding is dedicated to community physician practices without size restrictions or employee thresholds. So far, community physicians have only received a microscopic portion of the billions in grant funding allocated by Congress in the CARES Act, which has mostly benefitted large health systems.  While our hospitals must be protected and strengthened, so too must our community physicians for whom our patients depend.

We also urge that the next stimulus bill include provisions to ensure that critically important expanded telehealth coverage rules are maintained – including required coverage by ERISA plans not subject to state regulation but also rejecting industry efforts to fulfill network adequacy requirements only through telehealth at the expense of in-person care.

We also urge that the market dominant health insurers who faced a significant drop in claim submissions ensure that their windfall profits are shared with their contracted physicians including through support for the huge increase in Personal Protective equipment (PPE) costs.  For example, Aetna recently announced that its claims submission had dropped by 30% during April at the height of the pandemic.

Moreover, it is critically important that any proposal to address surprise out of network medical bills are consistent with demonstrated successful laws such as New York’s groundbreaking solution, rather than one-sided solutions advanced by the market-dominant health insurance industry that could potentially adversely impact patient access to essential on-call specialty care in emergency departments across the State.  Now is not the time to disrupt our health care safety net.

Critically important as well is providing support for those physicians, residents and students who provided on the front lines who provided needed care to patients while putting their life and health at risk, including hazard pay and/or student loan relief.  Representative Maloney has advanced important legislation (HR 6720) that would achieve this goal.

To repeat  – we are extremely concerned about the stability of our health care system given these enormous losses. The next package coming out of Congress must help to preserve our States’ health care infrastructure, including community physician practices.  This is not only essential for the hundreds of thousands of jobs we provide but most importantly to ensure we can continue to be able to treat our patients who continue to depend upon as begin to recover from this crisis.

# # #

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

 

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

 

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MSSNY Statement on U.S. Supreme Court’s Ruling on Title VII Cases


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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
June 16, 2020

MSSNY Statement on U.S. Supreme Court’s Ruling on Title VII Cases

Statement Attributable to:
Bonnie Litvack, MD
President, Medical Society of the State of New York

“The Medical Society of the State of New York (MSSNY) applauds the U.S. Supreme Court decision affirming that federal workplace discrimination protections apply to LGBTQ+ individuals.

“As physicians, we believe that workplace discrimination can lead to negative health outcomes. LGBTQ+ individuals must be protected from any and all discrimination.

“MSSNY members played key roles in the passage of AMA policies over the last two years that led to the amicus brief the AMA wrote to the Supreme Court, urging it to confirm that discrimination protections under Title VII of the Civil Rights Act of 1964 cover sexual orientation and gender identity.”

# # #

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

 

Facebook Icon Twitter Icon

 

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