MSSNY enews: September 9, 2020 – Congress Back to Business – Urge Them to Work for a Stimulus Deal!


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Congress Back to Business – Urge Them to Work for a Stimulus Deal!
With the U.S. Congress back in Session after its August recess, please urge our Senators and  Representatives to work to achieve a deal on a new stimulus package to assist community based physician practices in responding to the devastating losses from earlier this year. A letter/tweet can be sent from here.

A recent MSSNY survey demonstrates that New York physicians faced historic losses in their practices as a result of the COVID-19 outbreak, threatening the continuity of care for their patients and continued employment for hundreds of thousands of New Yorkers.  The CARES Act provided some needed funding to help somewhat offset these losses but nowhere near enough.

Please also urge Congress to reject misguided efforts pushed by the insurance industry to address surprise medical bills in a manner that is inconsistent with New York’s heralded approach.

Both the US House and US Senate have advanced their respective stimulus proposals, but they are still far apart in negotiations.  The House Democratic proposal, the HEROES Act, includes a number of positive items, including adding significantly more funds for the CARES Act health care provider relief pool, a re-starting of the Medicare Advance payment program and a significant bump in funding to assist state governments such as New York to prevent large cuts to Medicaid health care provider payments.

The Senate GOP proposal, which while more narrow also contains a number of important programs, such as re-starting the Medicare Advance payment program, increasing funding for the CARES Act health care provider relief pool and additional protections from medical liability arising from treatment or responding to the Covid-19 pandemic.

Please urge Congress to put aside partisan differences and work towards a deal to help protect patient access to community-based physician care.  Send a letter and/or tweet from here.


Urge Congress to Waive “Budget Neutrality” to Prevent Steep 2021 Medicare Cuts
The 2021 Medicare Physician payment rule advanced by CMS contains a number of important changes, including reduced documentation for E&M codes and long overdue increases for office visits.  However, of great concern it also sets forth an 11% cut to the Medicare conversion factor, greatly limiting the benefit of these other increases and potentially causing great harm to many practices.

The conversion factor cut is required due to statutory “budget neutrality” requirements that prohibit increases without corresponding decreases.  MSSNY and many other groups are urging Congress to pass legislation to waive these “budget neutrality” requirements to prevent devasting cuts and permit needed changes to go forward.  You can send a letter to supplement these efforts here: https://p2a.co/cm9Y24q

Recently, the AMA prepared a comprehensive summary of the proposed payment rule.  A few key points from the summary:

  • Of significant concern, the proposed CY 2021 Medicare Physician Fee Schedule (PFS) conversion factor is $32.26, which represents an almost 11% reduction from the CY 2020 conversion factor of $36.09.  This is the result of positive adjustments in other parts of the rule.  As a result, AMA and MSSNY and many other societies are pushing for Congress to waive these problematic budget neutrality requirements.
  • Similarly, the proposed CY 2021 anesthesia conversion factor is $19.96, down 10% from the CY 2020 anesthesia conversion factor of $22.20.
  • The AMA/Specialty Society RVS Update Committee (RUC)’s recommendations account for only half of the reduction.  The remaining spending increases and resulting conversion factor reduction is attributed to various CMS proposals to increase valuation for specific services.
  • CMS proposed to accept approximately 75% of the RUC recommendations for Physician Work RVU Updates. Updates to the direct practice expense inputs are proposed for individual codes based on RUC recommendations. The proposed rule does not include the 1.0 work geographic practice cost index (GPCI) floor.
  • CMS proposes to implement finalized CPT descriptors, guidelines and payment rates effective on January 1, 2021, which will be a significant modification to the coding, documentation, and payment of evaluation and management (E/M) services for office and outpatient visits: retain 5 levels of coding for established patients, reduce to 4 levels for new patients, and revise code definitions. CMS revalues services analogous to office outpatient E/M visits.
  • CMS proposes to allow the three G-codes used to report opioid use disorder (OUD) to also be used for monthly treatment reporting for patients with substance use disorder (SUD) as well. So that they could be used to report monthly treatment of patients with any SUD, not just OUD.
  • CMS has proposed to permanently keep several codes that were temporarily added to the Medicare telehealth list, including the prolonged office or outpatient E/M visit code and certain home visit services. CMS also proposes to keep additional services, including certain emergency department visits, on the Medicare telehealth list until the end of the calendar year in which the PHE ends to allow more time to study the benefit of providing these services using telecommunications technology outside the context of a pandemic.

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Want to Attend MSSNY’s HOD on Sunday 1-4PM ?
The MSSNY 2020 House of Delegates will be held this coming Sunday, September 13 from 1-4 PM. Please check the MSSNY website at www.mssny.org for the posting of the YouTube link at 12:30 PM


Gov. Cuomo’s COVID-19 Press Briefing Today

– Day 193
– 463 new hospitalizations
– 121 new ICU
– 59 new intubations
– 3 lives lost yesterday
– Infection rate 0.91% yesterday
– WNY positive rates up on Tuesday to 1.5%
– Gov. stressed that more testing does not cause more cases
– SLA / State Police report 99.2% compliance from over 36,000 establishments

RESTAURANTS:

– The state will allow indoor dining to resume at 25% capacity, starting Sept. 30th
– Patrons must provide contact information, take temperature checks, and wear masks when not seated
– On compliance: Restaurant Association will run PSA’s asking NY to report violations
– Report compliance issues by calling 833-208-4160 or text 855-904-5036

GENERAL:

– Today, the state will release $88.6 million in funding for childcare providers
– Gov encouraged people to try public transportation

FEDERAL:

– Current US Senate proposed relief package is insufficient
– Gov warned that without proper aid, the state will have to make budget cuts, raise taxes, and borrow funding


AstraZeneca Halts COVID-19 Vaccine Trial After Adverse Reaction in UK Patient
AstraZeneca said Sept. 9 it has taken a “voluntary pause” of its phase 3 COVID-19 vaccine trial after an adverse reaction in a patient in the U.K. The drugmaker, which has been conducting its vaccine trials with the University of Oxford in England, said the delay is routine when there is a potentially unexplained illness in a trial.

“In large clinical trials, illnesses will happen by chance and must be independently reviewed. AstraZeneca is working to expedite the review of the single event to minimize any potential impact on the trial timeline. We are committed to the safety of our participants and the highest standards of conduct in our trials,” the drugmaker stated. The nature of the adverse reaction and when it happened is unclear, as is the length of the trial delay.

Pascal Soriot, AstraZeneca’s CEO, said: “At AstraZeneca we put science, safety and the interests of society at the heart of our work. This temporary pause is living proof that we follow those principles while a single event at one of our trial sites is assessed by a committee of independent experts. We will be guided by this committee as to when the trials could restart, so that we can continue our work at the earliest opportunity to provide this vaccine broadly, equitably and at no profit during this pandemic.”

HealthPartners, a Bloomington, Minn.-based health system, said it has suspended recruiting participants in its trial testing AstraZeneca’s vaccine(Astra Zeneca. Sept. 9)


NYSDOH COVID-19 Update TOMORROW at 1-2 PM
Please join the NYS Department of Health Thursday, September 10th at 1-2PM for a COVID-19 update for healthcare providers. To accommodate the large number of participants, find our webinar streaming via YouTube Live (and available for viewing immediately thereafter) on the NYSDOH COVID website:

For audio only, please dial in: 844-512-2950 and Access Code: 5375187


Three Hour Pain Management, Palliative Care and Addiction Coursework Due October 1st Available at MSSNY CME Website
The Medical Society of the State of New York updated 2020 Pain Management, Palliative Care and Addiction modules are now available on-line at: https://cme.mssny.org .  The three-hour program must be completed by all physicians and providers who hold a DEA license by October 1, 2020.  The requirement was delayed from July to October due to the COVID 19 pandemic.

The three one-hour modules are being offered free of charge to all MSSNY members.  Physicians who are new users to the MSSNY CME site will be required to register as a new user.

These online programs cover all eight topics required in the New York State statute:

  • 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

MSSNY developed the program with the NYS Office of Alcoholism and Substance Abuse Services (OASAS).  MSSNY is listed as an accrediting organization by the NYS DOH Bureau of Narcotic Enforcement. These courses are entitled:

  • PM, PC & A 2020: Understanding the Current Legal Landscape in New York State
  • PM, PC & A 2020: When to Consider Opioid Therapy for Chronic Non-Cancer Pain and in Palliative Care
  • PM, PC & A 2020: Patients with Opioid Use Disorders 

Additional information or technical support may be obtained by contacting cme@mssny.org


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Attestation Process for Mandatory Prescribers
Prescribers must attest to the completion of the pain management, palliative care and addiction course work or training by July 1, 2017, and again every three years thereafter. The prescriber should only attest after completion of at least three hours of course work or training covering all eight topics.  The process is described in the Frequently Asked Questions.

Further information may be obtained by contacting BNE at 1-866-811-7957 or narcotic@health.ny.gov or here.

Half a million US children have been diagnosed with Covid-19, according to the American Academy of Pediatrics and the Children’s Hospital Association.


More Students Back to School as Covid-19 Among Children and Colleges Rise
The groups said 70,630 new child cases were reported from August 20 through September 3. This is a 16% increase in child cases over two weeks, bringing up the total to at least 513,415 cases, the groups said in their weekly report on pediatric coronavirus cases.

The AAP recommends that any child 6 months or older get a flu shot — in line with recommendations from the US Centers for Disease Control and Prevention.

Pediatricians say it is more important than ever to make sure kids get either the flu shot or the protective nasal spray before the end of October.

That is because having two respiratory disease circulating at the same time — flu and coronavirus — will be confusing to doctors, parents, and caregivers. Plus, hospitals and clinics could become overwhelmed with the double burden.

The two viruses cause similar symptoms but a study published Tuesday in JAMA Network Open found that children hospitalized with Covid-19 were more likely to have fever, aches, diarrhea and vomiting than were children with influenza.

Children with Covid-19 also tended to be older and have at least one underlying health condition.

Covid-19 and seasonal flu in children lead to similar rates of hospitalization, intensive care admission, and need for a ventilator to help breathing, the study found. The CDC says 188 children died from flu over the 2019-2020 season.


Two Additional CPT Codes Added in Response to COVID-19
The AMA published an update to the Current Procedural Terminology (CPT®) code set that includes two code additions for reporting medical services sparked by the public health response to the COVID-19 pandemic.

The first addition, CPT code 99072, was approved in response to sweeping measures adopted by medical practices and health care organizations to stem the spread of the novel coronavirus (SARS-CoV-2), while safely providing patients with access to high-quality care during in-person interactions with health care professionals.

The additional supplies and clinical staff time to perform safety protocols described by code 99072 allow for the provision of evaluation, treatment or procedural services during a public health emergency in a setting where extra precautions are taken to ensure the safety of patients as well as health care professionals.

The second addition, CPT code 86413, was approved in response to the development of laboratory tests that provide quantitative measurements of SARS-CoV-2 antibodies, as opposed to a qualitative assessment (positive/negative) of SAR-CoV-2 antibodies provided by laboratory tests reported by other CPT codes. By measuring antibodies to SARS-CoV-2, the tests reported by 86413 can investigate a person’s adaptive immune response to the virus and help access the effectiveness of treatments used against the infection. (9/9/HIT Consult)


Classifieds

Elegant, Custom Built Home with Unparalleled Craftsmanship – Rhinebeck, NY
Set on 10.6 acres in one of the most sought-after neighborhoods in Rhinebeck, this stunning home borders Drayton Grant Park at Burger Hill (a conservation land and the highest point in Rhinebeck). Features beautifully landscaped gardens with sweeping hilltop views and a well established vegetable garden and barn. This handsome home is generously proportioned throughout, with an inviting foyer entry with tastefully designed staircase, millwork, high ceilings, cherry wood floors and custom windows.Rhinebeck Estate for SaleA world class kitchen with a marble counter-topped island, enjoys both a cozy fireside seating area perfect for winter evenings, and glass doors in the hexagonal eat-in-kitchen opening onto the expansive stone terrace for three season enjoyment and entertaining.A luxurious Master suite, with high vaulted ceiling design, his and hers walk-in closets and a gorgeous master bath with cast iron clawfoot tub. The second floor also includes two spacious bedrooms with generous closets and 2 full bathrooms, An additional large sitting room/office could easily make a lovely fourth bedroom. Lower level features a media room, exercise room, bar, wine cellar and full bathroom. Additionally there is a two story barn equipped with water and electricity.
The house is located 7 minutes to the charming center of Rhinebeck village with its many superb restaurants, boutiques & shops. The highly rated Northern Dutchess Hospital, the excellent Rhinebeck schools and the County Fairgrounds, a most desirable venue destination throughout the year, are all nearby. Rhinecliff train station is a mile beyond with Amtrak service south to NYC(1hour 40 minutes) and north to Hudson, Albany, Niagara Falls and Montreal. View full listing Contact Nader Kayal, MD, 845-518-7780 / entdoc53@aol.com or Joshua M. Briggs at Heather Croner RE-Sotheby’s 917 213-9042 / jmb@jmbfineart.com.


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.

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
  • Pre-op and recovery areas
  • A bright and modern waiting area
  • 3 consultation rooms, administrative room, kitchenette, and 2 bathrooms
  • 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