MSSNY eNews: January 29, 2021 – Health Insurance Payment Delays


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Colleagues:

Over the past year, MSSNY has been made aware of an alarming trend with regard to some health insurers in our area. Physician practices provide necessary care to patients and file claims with the appropriate insurer.  The claims are then routed to the Health Insurer’s utilization review entity who requests that the physician’s office submit medical records.  The physician office submits the requested records and the utilization review company then denies the claim(s) as missing patient medical records.  The medical practice subsequently sends additional records to the location indicated in the request, often to be told when calling for a status update that the address used is incorrect.

MSSNY has taken a number of steps to resolve this issue. MSSNY has reached out directly to the Health Insurance companies involved and has spoken with Medical Directors and other health Insurance company staff. However, our MSSNY members continue to experience the same issues and recently the number of parent companies employing these unfair tactics has expanded.  Therefore, MSSNY conducted a recent statewide survey (take the survey here) to ascertain the scope of the problem. Our survey results show that the problem is ongoing and not isolated.

As direct discussions with the Health Insurance companies have not yielded the desired discontinuation of these unfair and in many cases illegal payment delays, MSSNY has escalated our advocacy and has sought assistance from the NYS Department of Financial Services (DFS).  DFS has regulatory authority over NYS regulated health plans/insurers and DFS has assigned an investigator to review these claims.

If you are experiencing these issues in your practice, please file a complaint/inquiry with DFS File a Complaint | Department of Financial Services (ny.gov). It is very important to include copies of all supporting documentation and all correspondence with the insurance entity.  DFS will work with individual providers to accept global complaint submissions as needed.  Also, please remember to send a copy of the DFS file number to Rmcnally@mssny.org, along with your practice name so that MSSNY can ensure that the DFS investigator has access to the aggregate of physician grievances.

We have heard that some physicians are concerned about filing a complaint with DFS due to concerns of retaliation by Health Insurance Companies.  Please note, NYS Law prohibits any retaliatory action against a physician for advocating in good faith on behalf of patients.

While physician offices have struggled to keep their doors open during the pandemic due to rising practice costs including PPE and decreased revenue due to seeing less patients, health insurers have seen record profits as less patients access care, making the current health insurance delay tactics unconscionable and intolerable. New York State has a strict Prompt Payment law.

Claims submitted electronically must be paid, denied or additional information requested within 30 days of submission (45 days for claims submitted by paper).  The law also provides that, if additional information has been requested, the claims should be either paid in part or denied in 30 days from the date the records were received. If managed care companies are violating the State’s Prompt Payment Law, there are financial consequences, and they should and will be held accountable.

Brief Update on Vaccines

Good news:

  • 96% of the 1st vaccine dosages received by NYS have been administered.
  • The Biden Administration will be increasing weekly allocations to NYS by 16% for the next three weeks.
  • All nursing home residents have been offered the vaccine with 72% vaccinated to date.
  • Healthcare Worker vaccination rates range from 62% in Western New York to 82% in Central New York.

Continued concerns:

  • Vaccine demand continues to far outstrip supply. At the current rate of vaccine availability, it will take 21 weeks to vaccinate the 7 million currently eligible 1b group.
  • Only 44% of nursing home staff has been vaccinated to date with all expected to be offered the vaccine by February 7. MSSNY has expressed concern and offered help to increase the number of nursing home staff vaccinations to > 70%.
  • Many physician offices have still not received any supply of vaccine and many patients are saying they are only willing to receive the vaccine from their physician. MSSNY has communicated this to DOH and the Governor’s office.

MSSNY has been in constant communication with the NYS Department of Health and the Governor’s office about vaccination administration and distribution.  We have been transmitting all your comments, concerns and frustrations and have been working with DOH and the Governor to continually improve the process and clear the bottlenecks.  The latest department updates can be found here.

Bonnie Litvack, MD
MSSNY President



Capital Update

MSSNY Weekly Podcast


Join Us for MSSNY’s Virtual Lobby Day on March 2
Please plan to put aside Tuesday, March 2 for MSSNY’s Annual Physician Advocacy Day – this time Virtual!  To register, click here: Webinar Registration – Zoom

The format will follow previous years formats, where assembled physicians and allies will hear from legislative leaders and MSSNY physician leaders in the morning (this year via Zoom) from 8 AM-11 AM, and then have virtual visits with their respective legislators in the afternoon (organized by their county medical societies).

With the Governor and the State Legislature needing to create tens of billions of savings to the state budget, any number of healthcare programs of interest to physicians could be on the table, not to mention concerns with the numerous problematic proposals that have already been advanced in the proposed Executive Budget, such as:

  • Significantly reducing physician due process when a complaint has been filed against them to the OPMC;
  • Forcing the 17,000 physicians insured through the Excess Medical Malpractice Insurance Program to bear 50% of the cost of these policies;
  • Inappropriately expanding scope of practice for various non-physicians including pharmacists and nurse practitioners;
  • Handing insurance companies enormous new powers to limit physicians providing telehealth services to their patients

As well as voicing your support for a number of proposals including:

  • Expanding the supply of PPE;
  • Regulation of Pharmacy Benefit Managers (PBMs);
  • Reducing the interest on court judgments to bring down exorbitant liability costs

Please plan to join hundreds of colleagues from around the State on March 2!       (ALI)


Please Urge Your Legislators to Oppose Balancing State Budget on Backs of Community Physicians
MSSNY has joined with 16 other specialty medical societies in a letter to the entire State Legislature that expresses our strong objection to a proposal contained in the Governor’s proposed State Budget (Part K of the Health/Mental Hygiene Article 7 bill) that would require the over 16,000 physicians enrolled in the Excess Medical Malpractice Insurance program to bear 50% of the cost of these policies.   Please urge your legislators to reject this proposal by sending a letter to them and/or a tweet from here.

This incredibly short-sighted proposal would thrust over $50 million of new costs on the backs of our community-based physicians who served on the front lines of responding to the pandemic.  For some physicians, particularly in Long Island and New York City, this could add up to tens of thousands of dollars per physician.  This new cost imposition would hit these practices at a time when many of these practices are already facing huge losses as a result of a substantial reduction in the number of patients receiving care during the pandemic.

A recent AMA survey reported that during the pandemic the average number of in-person visits to physician offices dropped nearly in half.  As a result, physicians averaged a 32% drop in revenue since February, with about one in five doctors seeing revenue drop by 50% or more, while nearly 1/3 saw a 25%-49% decrease.

It is important to remember that the Excess Insurance program exists because of New York’s disproportionately high medical liability insurance costs as compared to all other states.  The real solution to this problem is comprehensive medical liability reform, but in its absence, this program is absolutely essential to provide needed assurance to physicians that they will not risk losing everything they have worked for every time they treat a patient.  Please contact your legislators today to oppose this new cost imposition: contact here. (AUSTER)


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Urge Your NYS Legislators to Reject Proposal to Disregard Important Physician Due Process Protections
MSSNY has joined with 15 other specialty medical societies in a letter to the State Legislature expressing its strong opposition to an Executive Budget proposal (Part Q of the Health/Mental Hygiene Art. 7 bill) that would significantly reduce due process protections for physicians against whom a complaint has been filed with the Office of Professional Medical Conduct (OPMC), including making information public about a complaint even if no professional misconduct is found and greatly lessening the burden for imposing an interim suspension prior to the conclusion of disciplinary proceedings.

While New York’s physicians share the goal of assuring the State has ample power to protect the public when the conduct of a particular health care provider places patients at risk, the Commissioner already has authority to take summary action prior to the conclusion of a disciplinary hearing in the absence of a finding of misconduct.

You can assist us in these efforts by sending a letter and tweet in opposition to your local legislators click here.

The letter reminds the Legislature that, while the medical community is always ready to work to address gaps in our disciplinary system to protect patient safety, this proposal is far too broad.  Most complaints to OPMC of alleged misconduct do not become actual findings of misconduct. Indeed, most complaints to OPMC do not even get so far as advancing to a formal Investigation Committee review.  According to the 2018 OPMC Annual report, while over 9,000 complaints were received by OPMC, and 8,782 complaints closed, only 210 cases resulted in the filing of actual charges. This is 2% of filed complaints that ended in actual charges.  Of greatest concern is that information released to the public, even if there is no action ultimately taken, can remain available through Google searches forever, potentially unfairly destroying a physician’s professional reputation.

Please contact your legislators to urge that this measure be rejected as to the Legislature works to finalize a State Budget for the 2021-22 Fiscal Year.              (AUSTER)


Town Hall with Senator Rivera on COVID-19 Vaccine on Feb. 4, 2021
The Medical Society of the State of New York and the “Let’s Get Immunized New York” campaign is participating in a Town Hall with Senator Gustavo Rivera on Thursday, February 4 at 6:30 PM.

Panelists are:

Senator Gustavo Rivera
Lorraine Braithwaite-Harte, NYS NAACP
Bethsy Morales-Reid, Hispanic Federation
Dr. Sumir Sahgal, Essen Health Care and member of the Bronx County Medical Society
Dr. Barry S. Zingman, Clinical Director, Infectious Diseases, Moses Division, Montefiore Medical Center
Dr. Jane Ahn, Chief Medical Officer at Union Community Health Center.

Senator Rivera’s office has provided the following sign-up link which provides the event details, and directs participants to the Facebook Livestream or to register via Zoom.  bit.ly/RiveraVaccineTownHall

To register for the event directly via Zoom, please click here:  bit.ly/RiveraVaccineZoom Participants can also follow along at “Let’s Get Immunized NY” on Facebook and Twitter which is promoting the Town Hall and which is regularly sharing vaccine-related information and FAQs. Beyond social media promotion, questions can be submitted in advance at this sign-up link: bit.ly/RiveraVaccineTownHall. The Town Hall will also be live-streamed on Senator Rivera’s Facebook and Spanish closed captioning will be available for those joining via zoom.   (CLANCY)


Please Oppose Proposals That Facilitate Uncoordinated Siloed Care to be Provided by Pharmacists
Please contact your legislators to urge that they oppose several components of the Executive Budget that could upend the patient-centered medical home model and threaten patient safety by greatly expanding the scope of services provided to patients by pharmacists without coordination with patient care physicians.  You can send a letter from here: Send letter.  Please let them know these proposals would greatly enhance the power of corporate giants such as CVS and Walmart to control various aspects of patient care delivery not in coordination with community-based primary care and specialty care physicians that typically manage the care of their patients, but instead marginalizing their involvement.

Specifically, these Budget proposals would 1) permit pharmacists to order various lab tests without any physician oversight and without any requirement to coordinate with the patient’s physician for follow-up care; 2) greatly expand the physician-pharmacist Collaborative Drug Therapy Program to enable pharmacists to adjust the medications provided to entire classes of patients rather than individual patients and 3) permit pharmacists the power to administer any vaccination approved by the federal Advisory Commission on Immunization Practices (ACIP), including those which may be added in the future.  Some of these proposals have been rejected by the Legislature in previous Budget cycles.

All of these programs together could incentivize the development of health care silos at the expense of the patient centered medical home model we have worked so hard to develop in New York.   It would also marginalize community based primary care and specialty care physicians’ ability to continue to be able to manage their patients’ ongoing care needs.

Please urge your legislators to reject these measures as they finalize the State Budget for 2021-22.       (AUSTER)


 

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Physicians Raise Concerns that Executive Budget Proposal to Expand Telehealth Coverage May Actually Lessen Coverage
MSSNY is advocating together with several specialty societies to ensure patients can continue to have coverage for receiving needed health care services via telehealth, including providing payment parity between in-person and telehealth visits.  At the same time, we have raised concerns with a number of aspects of the Executive Budget proposal to expand Telehealth coverage and are seeking further clarification of these provisions.

We are particularly concerned that the Executive Budget proposal did not include a measure to ensure payment parity, which is a significant issue for community physicians and the patients that they serve. A recent survey of its members by MSSNY showed that 83% had incorporated telemedicine into their practice, with nearly half saying they were treating at least 25% of their patients remotely. However, insurers’ reimbursement for audio and video Telehealth services has not kept pace with those paid for in-office visits and the gap is wide. According to the survey, less than 1/4 of health plans had set their reimbursement levels for telehealth equal to what they pay for in-office visits, with audio-only visits the least compensated.

We are further concerned that the Budget proposal could be used by the insurance industry to actually reverse the telehealth gains we have made over the past year.  By linking coverage of telehealth services to insurers having a “so-called” adequate network together with the proposal to permit telehealth delivery services by out of state physicians, this could essentially empower insurers to limit who it will pay for telehealth services once it asserts it has an “adequate” network.

It is not hard to imagine a scenario where a health plan asserts it has an adequate network through a national telehealth service provider, and then excludes coverage of telehealth service by all or some of its in-network community-based physicians.  That is completely at odds with the expansive approach to telehealth coverage taken over the past year as a result of actions taken by the DFS and DOH.

MSSNY is also concerned that the Executive Budget proposal doesn’t expressly address payment parity in the state’s Medicaid program, which if not addressed, could create an inequity in the care that beneficiaries of Medicaid receive.

 MSSNY is continuing to work with a range of other patient and provider partner organizations to address our concerns and will update members as the issue unfolds.    (CARY)


MSSNY Opposes Measure To Legalize Adult Use Recreational Marijuana
MSSNY continues to oppose the Executive Budget proposal to authorize the sale of adult use or recreational use marijuana and to create an Office of Cannabis Management to regulate both the medical and adult-use of marijuana.  The governor has estimated that this proposal would generate more than $350 million in tax revenue—however, that revenue is not anticipated to be generated for several years.   The Medical Society of the State of New York has repeatedly expressed its opposition to the legalization of recreational marijuana because of the public harms that have occurred in other states that have legalized the sale of recreational use marijuana.

MSSNY continues to work with numerous public health advocacy organizations in opposing this measure such as the New York State Association of County Health Officials (NYSACHO), the New York State Sheriffs Association, the Mental Health Association of New York State, the NYS PTA, and Smart Approaches to Marijuana (SAM).  MSSNY believes that with the COVID-19 pandemic, this measure, if enacted would create an even greater stress on New York State’s public health system.  Physicians are encouraged to send a letter to their legislator and may do so by using the letter located at the MSSNY Grassroots Action Center here.            (CLANCY)   


MSSNY Opposes Repeal of Prescriber Prevails In Medicaid Fee for Service and Managed Care
MSSNY has joined with several specialty societies in a letter to the Legislature to express its opposition to an Executive Budget proposal to repeal the authority of physicians, and other qualified prescribers, to make the final determination about the medication prescribed to beneficiaries of New York’s Medicaid Fee-for-Service and Medicaid Managed Care programs, commonly referred to as “prescriber prevails.” The proposal is also ill-timed given the COVID-19 pandemic and the transition of the Medicaid pharmacy benefit from managed care back to fee-for-service as a result of a provision included in the final 2020-21 NYS budget.

Repealing this important patient protection not only jeopardizes patient care, but also undercuts the steps that New York has already taken to reduce unnecessary and avoidable hospitalizations, which have been trending downwards in the last several years. A key component in sustaining and accelerating such a trend is guaranteeing that individuals are able to obtain the medications prescribed by their physician to treat their disease.

The joint letter raises concerns that any projected savings based on the repeal of “prescriber prevails” in Medicaid Fee-For-Service and Managed Care would be dwarfed by the health care complications likely to arise as a result of individuals not having access to the most effective medications needed to remain healthy. For many conditions, finding the most effective treatment is not easy, making it even more important that once a treatment has been proven effective, patients continue to have unfettered access to that drug.

MSSNY is continuing to work in collaboration with a host of other provider and patient groups on this issue and will update its members as discussions with the Governor and legislature move forward.                                           (CARY)


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Registration Now Open
February 5, 2021 @ 7:30am Physician Wellness/Medical Matters COVID-19 & Mental Health of Physicians and Other Healthcare Providers

Click here to register

The COVID-19 pandemic has had a significant impact on the Mental health of physicians and other healthcare providers.  Learn more on February 5th at 7:30 am.  Dr. Craig Katz will serve as faculty.

Educational Objectives are:

  • Examine the mental health risks posed by COVID-19 for physicians;
  • Review the possible range of psychological and psychiatric responses to the pandemic; and
  • Discuss principles and interventions for helping ourselves, our families, and our colleagues

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 each 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. 


Registration Now Open
Medical Matters: COVID Vaccine Update February 17, 2021 @ 7:30am

Registration is now open for the next Medical Matters webinar: COVID Vaccine Update.  Learn more about the COVID-19 vaccine on February 17th @ 7:30am.  The discussion will include the types of vaccine in development, distribution priorities and barriers surrounding vaccine administration.  Dr. William Valenti will serve as faculty.

Click here to register

Educational Objectives:

  • Recognize the types of COVID-19 vaccine in development;
  • Discuss priorities for vaccine distribution; and
  • Identify barriers to COVID-19 immunization

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 each 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.      

eNews

Gov. Cuomo’s Jan. 28 Briefing

  • Total COVID hospitalizations fell to 8,520. 
  • Of the 250,668 tests reported yesterday, 13,398, or 5.34 percent were positive.
  • There were 1,584 patients in ICU yesterday, up 26 from the previous day. Of them, 1,024 are intubated.
  • Sadly, we lost 162 New Yorkers to the virus.

Workers’ Compensation and COVID-19
When a worker contracts COVID-19, it may be unclear to a medical provider (even one authorized to treat workers’ compensation claimants) whether it is work related. As discussed in greater detail below, it is possible for cases to be ‘established’ as compensable without having a medical report from an authorized provider indicating that the COVID-19 was work related.

The Workers’ Compensation Board published materials to provide basic information about COVID claims. The information is aggregated at: http://www.wcb.ny.gov/covid-19/

WCB Information Related To Novel Coronavirus (COVID-19) COVID-19 & Workers’ Compensation Video (October 2020) Letter From Chair Rodriguez to Carriers and Payers of Workers’ Comp: Speeding up the resolution process for COVID-19 claims (September 2020)

Among the documents are: a Q&A document, explaining how the Board evaluates claims; a bulletin by the Board’s Medical Director; letters from the Chair; and a video about COVID claims. We strongly encourage you to review the information as needed.

Regarding the role of the medical provider, let’s discuss the need for a medical report in the course of a COVID-19 claim in three phases: compensability, ongoing medical treatment, and ongoing lost time awards. Please see this letter from the Board to MSSNY which will provide additional insight.



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Response to NYT Jan. 22 Article “Filing Suit for Wrongful Life
I am compelled to react to Paula Span’s article Filing Suit for ‘Wrongful Life’ published in the new Old Age section of the New York Times on 1/22/2021 from several lens. Without conducting a thorough review of the medical records, I cannot comment on the specific merits of the case. However, I can clarify the differences between advance directives and MOLST and offer NYSeMOLSTregistry.com as a risk management tool to prevent similar future litigation in NY.

As a board-certified geriatrician, trained, licensed and practicing in New York for more than forty years, the emergence of litigation for providing unwanted life-sustaining treatment is no surprise. For decades, all life-sustaining treatment was provided, as death viewed as failure could potentially result in a lawsuit. I anticipate more litigation as baby boomers are avid consumers of health information, recognize faults in our health care delivery system, are proactive setting expectations with their physician, NP, or PA, and serve as their own self advocates.

Every American has a right to accept and/or refuse treatment, including life-sustaining treatment. The right does not end when a patient loses the capacity to make medical decisions. These rights are a result of the Patient Self Determination Act (PSDA), a federal law, passed in 1990 and instituted on December 1, 1991. Compliance with PSDA is mandatory.

Advance directives are legal documents that identify future care preferences. Each state has different laws, regulations, and state-specific advance directive documents to ensure this right. The New York Health Care Proxy (HCP) ensures a health care agent (HCA) may make decisions for the patient determined to lack capacity. In the absence of a HCP, the decision falls to a surrogate identified in Family Health Care Decisions Act (FHCDA). Both HCAs and surrogates are required to make decisions according to the patient’s known wishes or best interests. While living wills provide “clear and convincing evidence” and are recognized under case law, they cannot be followed in an emergency and are difficult to interpret in the acute care setting due to the coexistence of a terminal illness and potentially reversible acute illness.

MOLST is a set of medical orders that defines life-sustaining treatment the patient wants to receive or avoid now. It is created after a thoughtful discussion between the patient (or HCA or surrogate) with a physician, NP or PA. Medical orders must be followed by all health care professionals in all settings. NY created the MOLST program twenty years ago and is a founding member of National POLST.

Each state has different laws that govern the legal requirements for making end-of-life decisions, different portable forms, and years of experience. NY’s public health laws (PHL) integrate the ethical framework for making such decisions and provide broad patient and provider protections under HCP law and FHCDA, as well as the process outlined §SCPA 1750-b for individuals with intellectual and developmental disabilities who lack capacity. The NY DOH MOLST Checklists and OPWDD Checklist outline the law. Physicians, NPs, PAs, and health systems must be compliant.

As a knowledgeable baby boomer physician, I know my rights. I will speak with my physician when I am appropriate for a thoughtful MOLST discussion and include my health care agent and family virtually. I will insist my physician 1) complete my MOLST in NYSeMOLSTregistry.com explaining eMOLST is a risk management tool, and 2) include my personal statement in the ‘Other Instructions’ section of the MOLST form, “If my MOLST orders are not followed, my attorney will sue for battery, pain and suffering, and make sure the insurance company does not pay for unwanted treatment.”

Patricia A. Bomba, MD, MACP, FRCP
NY MOLST and eMOLST Program Director, 2001-present
(Note: Dr. Bomba is a longtime MSSNY member)


Social Distancing Rates in the U.S. Fell Drastically as the Pandemic Continued
Social distancing rates in the U.S. fell drastically as the pandemic continued according to a study published Jan. 22 in JAMANetwork. Researchers analyzed survey responses from 7,705 participants completed between April 1 and Nov. 24, 2020. All U.S. regions experienced decreases in COVID-19 mitigation efforts from early April to late November, with adherence in the final survey week significantly lower in the Midwest than all other regions. Protective behaviors that had the largest reported decreases included having no close contact with non-household members and avoiding eating at restaurants. Read more here.


Five Stats on Physician Burnout In 2021: 42% Feeling Burned Out
For the report, Medscape surveyed 12,339 physicians in more than 29 specialties from Aug. 30 to Nov. 5, 2020.

Five report findings:

  1. Sixty-nine percent of physicians said they were somewhat or very happy in 2020 before the pandemic started. This figure fell to 49 percent during the pandemic.
  2. While female physicians have historically reported higher rates of burnout than their male peers, this gap grew in 2020. Fifty-one percent of women said they were burnt out, compared to 36 percent of men.
  3. Critical care physicians had the highest rates of burnout among all specialties, at 51 percent. In 2019, urologists reported the highest burnout rates.
  4. Seventy-nine percent of physicians said their burnout began before the COVID-19 pandemic.
  5. The three most common contributing factors to burnout that physicians cited were too many bureaucratic tasks (58 percent); spending too many hours at work (37 percent); and lack of response from leaders or colleagues (37 percent).

To view the full report, click here.


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Center for Healthcare Workforce: Racial Composition of New York NPS
A recent study conducted by CHWS examined the racial/ethnic composition of New York’s nurse practitioner (NP) workforce. Researchers examined key demographic, educational, and practice characteristics of the state’s active NPs.

Statewide, Hispanic NPs are underrepresented in the state’s NP workforce, while the percentage of Black NPs is close to the percentage of Blacks in the state’s population.

On the regional level, CHWS staff found that Hispanic NPs were underrepresented in most regions of the state when compared to the Hispanic population in those regions. New York City saw the largest disparity between Hispanic NPs (8%) and the local Hispanic population (29%). On the other hand, in the North Country region, Hispanic NPs nearly mirrored their presence in the regional population.

Black NPs were also underrepresented in many regions of the state, with the greatest disparities between Black NPs and the regional Black population observed in the Western New York, Finger Lakes, and Central New York regions.

Other key findings include:

NPs younger than 50 tended to be more racially and ethnically diverse.

Black and Hispanic NPs complete their NP training at older ages compared to all other NPs.

Nearly half of Black NPs work in primary care health professional shortage areas (HPSAs).

Read our latest research brief to learn more about the key findings!


US Reports 1st Cases of South Africa Variant: 7 things to Know
South Carolina officials have confirmed two cases of the coronavirus variant first identified in South Africa, the first known cases in the U.S.

Seven things to know:

  1. The infected individuals live in different counties, the South Carolina Department of Health and Environmental Control said Jan. 28. Neither individual had a recent history of travel, suggesting community spread of the variant, known as B.1.351.
  2. The variant is believed to be highly transmissible and shares some mutations with the U.K. variant, B.1.1.7.
  3. “At this time, we have no evidence that infections by this variant cause more severe disease. Like the U.K. and Brazilian variants, preliminary data suggests this variant may spread more easily and quickly than other variants,” the CDC said Jan. 28.
  4. COVID-19 vaccines appear to be less effective against the variant, according to three new studies cited by The Wall Street Journal.
  5. Moderna is developing a new form of its COVID-19 vaccine that could be used as a booster shot to specifically target the South Africa variant.
  6. new study indicates that the South Africa variant evades antibody treatment. The study, published Jan. 26 on the pre-print server bioRxiv, has yet to be peer-reviewed.
  7. President Joe Biden implemented a new travel ban for South Africa Jan. 25.

HHS to Allow Retired Nurses, Physicians to Give COVID-19 Shots
Jeff Zients, the new White House COVID-19 response coordinator, said during a news briefing that HHS will amend the Public Readiness and Preparedness Act to allow retired physicians and nurses to administer shots, according to the Journal. The rules will also be amended to allow licensed physicians and nurses to administer shots across state lines.

The decision to allow retired physicians and nurses to administer COVID-19 shots is in addition to other efforts related to vaccine distribution. Acting CMS Administrator Andy Slavitt said Jan. 27 that the White House is considering ways to produce shots by use of the Defense Production Act. Mr. Slavitt has also said the federal government would increase vaccine supply to states by 16 percent each week for the next three weeks. (Becker’s Hospital Review, Jan 28)


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MSSNY eNews: January 27, 2021 – COVID: Bronx and Long Island Have Highest Positivity

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Notes from Governor Cuomo’s Briefing:

COVID-19 Data:
Day 333
– Statewide positivity rate: 5.44%
– 202,661 tests conducted
– 170 deaths
– 8,771 hospitalizations (-60)
– 1,588 ICU patients (+14)
– 1,027 intubations (+21)

Hospitalizations by Region:
Finger Lakes: 662 (0.05%)
Western NY: 426 (0.03%)
Southern Tier: 240 (0.04%)
Mid-Hudson: 1,056 (0.05%)
Central New York: 250 (0.03%)
Mohawk Valley: 240 (0.05%)
Capital Region: 474 (0.04%)
NYC: 3,771 (0.04%)
Long Island: 1,553 (0.05%)
North Country: 99 (0.02%)

Positivity by Region:
Finger Lakes: 4.85%
Western NY: 5.54%
Southern Tier: 2.72%
Mid-Hudson: 6.70%
Central New York: 4.31%
Mohawk Valley: 6.02%
Capital Region: 6.16%
NYC: 5.39%
Long Island: 6.83%
North Country: 6.45%
Manhattan: 3.36%
Bronx: 6.98%
Queens: 5.73%
Staten Island: 5.64%
Brooklyn: 5.54%

COVID-19 General:
– Positivity rate over the holidays went from 2.93% to 12.46%
– Gov says holiday surge is over
– Hospitalizations, positivity rates on the decline statewide
– Red line capacity for hospitals is 15% availability or less

Federal:
– President Biden: NY to receive 16% more vaccine allocation for the next 3 weeks
– President Biden announced to NGA more FEMA, providing funding to states to perform vaccines ($450 million advance for NY)
– Funding assistance for National Guard
– More federal vaccine purchasing to meet supply shortage (est. 200 million more doses, which will arrive in 6-9 months)

Vaccines:
– 96% of dosages received have been administered over the last 6 weeks
– Gov calls on local governments to vaccinate more hospital staff
– Federal LTCF Program: 72% of residents in nursing homes have been vaccinated to date
– 44% of nursing home staff have been vaccinated overall
– All staff will have been offered vaccination by February 7th
– Gov calls for local governments to maintain social equity in vaccine distribution
– State will partner with local governments to open vaccination sites
– For example, Gov is partnering w/NYC to open a site at Yankee Stadium

Q&A:

  • Is the UK variant spreading widely? What is being done to detect variants?

– Zucker: we are looking at 3,000 samples to detect variants
– There are cases of variants in all parts of the state
– Gov: 42 positives for the UK variant in NY

  • How concerned is the Gov on lifting restrictions given the UK strain?

– Gov says the measures are justified but the facts may change
– If experts discover more information about strains, NY will adapt.


NY State of Health Open Enrollment for New Yorkers Extended Through March 31
NY State of Health, the state’s official health plan Marketplace allows consumers to shop for, compare and enroll in quality, affordable health insurance plans. The Marketplace remains the only place where consumers can qualify for financial assistance for coverage. Open enrollment for Qualified Health Plans for 2021 is happening now. As part of New York’s ongoing response to the COVID-19 pandemic, Governor Andrew M. Cuomo announced that the Open Enrollment Period for uninsured New Yorkers has been extended through March 31, 2021. New Yorkers can apply for coverage through NY State of Health, or directly through insurers. Coverage start dates will vary:

  • Enroll by February 15: Coverage starts March 1
  • Enroll March 15: Coverage starts April 1
  • Enroll by March 31: Coverage starts May 1

Extending the Open Enrollment Period to March 31, 2021 helps to align New York with the federal Public Health Emergency which was recently extended to April 20, 2021. This extension allows individuals enrolling in Qualified Health Plan coverage additional time to enroll for coverage in 2021 and means that enrollment remains open for all NY State of Health programs, which is especially important during the ongoing public health emergency. Individuals who are eligible for other NY State of Health programs – Medicaid, Essential Plan and Child Health Plus – can enroll year-round.  As always, New Yorkers can apply for coverage through NY State of Health online at nystateofhealth.ny.gov, by phone at 1-855-355-5777, and by connecting with an assistor for free assistance over the phone.

To request free NY State of Health educational materials to display at your practice, please go here.


For All Enrolled in NYSDOH COVID-19 Vaccination Program Outside NYC
To all providers enrolled in the NYSDOH (not NYCDOHMH) COVID-19 Vaccination Program. These technical instructions for NYSIIS are for non-NYC providers.  This message (and the linked NYSIIS instructions document) repeats, clarifies and expands upon the guidance that was sent out 1/14/21.


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Elective Surgeries Can Resume in New York State
Gov. Andrew Cuomo told a briefing at Roswell Park Comprehensive Cancer Center Monday afternoon that Western New York is doing much better in dealing with COVID-19 than it had been. He said that means the ban on elective surgery has been lifted and the state Health Department on Wednesday may ease the restrictions of Orange status for most of the region.

Winter has brought New York’s worst stretch of the coronavirus crisis since May, with at least 4,800 dead from the virus in the past 30 days. But some numbers are improving, including plenty of capacity in regional hospitals.

Doctors have been writing to the governor, pleading with him to lift the ban on elective surgery. With the ban now lifted, hospitals are rushing to get patients prepared for surgery.

The vice president of the Erie County Medical Society said “elective” is a really misleading term. Anesthesiologist Dr. Rose Berkun said delay can make sick patients even sicker.
“If they don’t have that surgery — somebody has a gall bladder issue and delayed by one month or by two months — that becomes an acute issue at some point, where the patient will have a burst gall bladder and get really sick,” Berkun said, “and that can lead to terrible complications and in-patient visits, hospitalization.” (WBFO/NPR Buffalo)


USA Today Network: MSSNY Against Legalizing Marijuana in NY
Among the organizations that have argued against it are the state Parent-Teacher Association, various police organizations and the Medical Society of the State of New York, which represents doctors.

In a joint statement last October, the Medical Society organizations from New York, Delaware, Ohio, New Jersey, and Pennsylvania issued a joint statement urging caution as their respective states consider legalizing the drug, suggesting more research needs to be done about the long-term public health impacts of the decision.

“We appreciate the enormous challenges state policymakers face to address burgeoning budget deficits, but we strongly believe that further detailed research must be undertaken and assessed regarding the effects legalization of cannabis will have on important public health markers, such as emergency department visits and hospitalizations, impaired driving arrests, and the prevalence of psychiatric and addiction disorders,” the statement reads. (USA Today network)


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Mask Stickers Could Help Detect Early COVID-19 Infections
Researchers at the University of California San Diego are developing a color-changing mask sticker to detect early COVID-19 infections.

The sticker is a test strip that sticks to a user’s N95, surgical or cloth mask and is meant to detect SARS-CoV-2 in the wearer’s breath or saliva. After removing their mask, the wearer conducts the test by squeezing the contents of a blister pack onto the test strip, which changes color in the presence of SARS-CoV-2 protein-cleaving molecules. The test works like a home pregnancy test, with a control line on the test strip showing what a positive result looks like, according to the news release.

“Think of this as a surveillance approach, similar to having a smoke detector in your house,” said Jesse Jokerst, PhD, lead principal investigator of the project and nanoengineering professor at UC San Diego Jacobs School of Engineering. “This would just sit in the background every day and if it gets triggered, then you know there’s a problem and that’s when you would look into it with more sophisticated testing.”

Researchers anticipate the test strips could be produced for a few cents each, making them affordable for daily surveillance in high-risk settings for infection such as group homes, prisons, and homeless shelters, among others.

Dr. Jokerst is working with researchers from UC San Diego School of Medicine to test the first strips on positive COVID-19 saliva samples before testing them on patients and healthcare workers at Veterans Affairs San Diego Healthcare System.

To read the full news release, click here.


 

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CDC Clinical & Epidemiologic Characteristics of Case Reports of Allergic Reactions
A CDC report summarizes the clinical and epidemiologic characteristics of case reports of allergic reactions, including anaphylaxis and nonanaphylaxis allergic reactions, after receipt of the first dose of Moderna COVID-CDC COVID-19 Response Team; Food and Drug Administration. Allergic Reactions Including Anaphylaxis After Receipt of the First Dose of Moderna COVID-19 Vaccine — United States, December 21, 2020–January 10, 2021 MMWR. 2021;70 (Early release).


 

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MSSNY eNews: January 22, 2021 – NYS BUDGET The Good, The Bad and The UGLY


.MSSNY’s Partnership with Premier Group Purchasing

Colleagues:

With a $14.9 billion 2-year deficit and a $39 billion 4-year deficit looming, it is no surprise that Budget cuts and new sources of potential revenue are proposed. However, the share of cuts proposed on the backs of New York State’s physician heroes and proposals that will jeopardize the health and well-being of physicians and New Yorkers in the middle of a pandemic is baffling.

The Good

While the good is overshadowed by the bad and the ugly, there are some welcome aspects in the proposed budget.  State oversight of Pharmacy Benefit Managers (PBMs) is again included and is sorely needed.  An expansion of the manufacturing of personal protective equipment (PPE) could shore up supply and help fend off future shortages like we saw this spring.  Additional funding to increase reimbursements to providers in the state’s Essential Plan program, and to cover premiums for those in need will help enhance access to care for New York’s most vulnerable populations.

The Bad

 A requirement that the 16,000 or so physicians insured through the Excess Medical Malpractice Insurance program bear 50% of the cost of a policy was dusted off from last year.  This is both ill timed and shortsighted. Physician practices in the pandemic have been struggling to keep the doors open.  If imposed, this will be the final straw for many practices and additional patients will lose access to care at a time when they and their communities need their physicians most. The excess program exists in the first place due to New York’s dysfunctional medical malpractice adjudication system (the worst in the country) and is akin to treating cancer with pain medications only. It is time to use tried and true remedies like caps on pain and suffering, expert witness reform and certificate of merit reform.  These have worked in other states that are similar in size such as California and Texas and if enacted in our state, New York can put the entire amount of the excess fund toward other uses. You can send a letter of opposition and tweet at your elected officials here: Don’t Balance the Budget on the Backs of Physicians (p2a.co)

Cutting the appropriation of MSSNY’s Committee for Physicians Health by 20% is another perplexing proposal contained in the budget.  This program provides essential counseling services for physicians confronting alcoholism, substance abuse, or mental illness. We have had at least two physician suicides in NYS in the past year, we have physicians suffering from COVID-related PTSD and nearly all physicians are under significantly increased stress related to the pandemic. It is hard to conceive of a worse time to impose cuts on a program that is a lifeline for physician wellbeing. This proposed cut endangers physician health and well-being as well as public safety.

Other problematic proposals include a continuation of the authority for an additional 6 years for certain nurse practitioners to practice without a written collaborative agreement of a physician provided there is proof of “collaborative arrangements” with physicians in that specialty of practice and proposals that would greatly enhance the ability of pharmacists to provide patients with lab tests and provide other healthcare services to patients (including the right to prescribe!) without any physician oversight. Additional tethers to physician led team care and safeguards for our patients must be inserted into these proposals, or they must be rejected altogether. Patient safety is paramount.

The Ugly

Another proposal recycled from last year is comprehensive “Office of Professional Medical Conduct modernization”. While we are committed to working to identify gaps in the NYS disciplinary, this Budget proposal would give the Commissioner of Health the authority in their sole discretion to disclose to the public that a complaint has been filed against a particular physician, despite the fact that very few complaints ever actually result in a finding of professional misconduct. This information can remain on the Internet forever, potentially ruining a physician’s professional reputation. The law already permits the Commissioner to disclose information to the public when there is a public health threat. This provision would eliminate important due process protections for physicians against whom a complaint has been filed with the Office of Professional Medical Conduct.

You can send a letter in opposition and tweet at your elected officials here.

It is time to take action:  Here is your checklist:

  • Go to the above links to send letters and tweet at your state legislators to urge that they reject these problematic proposals.
  • Text 52886 to sign up for Text Grass action updates.
  • Are you friends with or a relative of an elected official?  Sign up here to become a part of the MSSNY PAL (Physician Advocacy Liaison) Network  
  • Sign up here for MSSNY Virtual Advocacy Day March 2, 2021. The location will be virtual, but our presence must be very real!

Click here to donate to MSSNY PAC or text MSSNY PAC to 52886

With a $14.9 billion 2-year deficit and a $39 billion 4-year deficit looming, it is no surprise that Budget cuts and new sources of potential revenue are proposed. However, the share of cuts proposed on the backs of New York State’s physician heroes and proposals that will jeopardize the health and well being of physicians and New Yorkers in the middle of a pandemic is baffling.

Bonnie Litvack, MD
MSSNY President


 


Capital Update

MSSNY Weekly Podcast


Statement of MSSNY President Dr. Bonnie Litvack, MD, on the Litany of Concerning Proposals in the Executive Budget
“Over the last year, tens of thousands of physicians across the State of New York put their health and the health of their families at risk to ensure patients receive the care they needed. Many of them became sick themselves and, sadly, some even passed away from COVID-19.

Yet these physicians continue their work on the front lines every day to be there for their patients.

That is why we are stunned by the litany of proposals in the Executive Budget that will make it even harder for physicians to continue to provide the care our patients need. We note that there are some positive aspects in this State Budget proposal, including to provide needed regulation over PBM practices and expanding the state’s capacity to manufacture personal protective equipment (PPE) that physicians often lacked and have been the subject of enormous cost increases. However, we are extremely concerned with several other Budget proposals.

One State Budget proposal would foist tens of thousands of dollars of new costs on physicians (totaling over $50 million) for keeping liability insurance protections that are absolutely necessary due to New York’s excessive medical liability premium costs. These liability costs far exceed any other state in the country. The substantial new costs will be near-impossible for many physicians to absorb given the enormous drop in patient visits and revenue experienced by physicians across the State over the last year. As an example, it would impose an approximate $20,000 new cost for an OB-GYN practicing on Long Island. If the Excess Insurance program is eliminated or reduced, then we need comprehensive medical liability reform instead.

We are also perplexed by proposals to eliminate important due process protections for physicians against whom a complaint has been filed with the Office of Professional Medical Conduct. As we have previously stated, while we are anxious to work to identify gaps in our disciplinary system to protect the public, this Budget proposal would give the Commissioner of Health the authority in their sole discretion to disclose to the public that a complaint has been filed against a particular physician, despite the fact that very few complaints ever actually result in a finding of professional misconduct. This information can remain on the internet forever, potentially ruining a physician’s professional reputation. The law already permits the Commissioner to disclose information to the public when there is a public health threat.

Another Budget proposal would impose huge cuts to the Committee for Physicians Health (CPH), a successful long-standing organization that provides essential counseling services for physicians confronting alcoholism, substance abuse, or mental illness. Many of these conditions have been exacerbated by the pandemic, making CPH more essential than ever. CPH provides important confidential peer to peer services to physicians in need of support for their health and well-being. Studies that review the long-term model effect of physician health programs show that physician recovery rates are markedly higher than the general population—even when extended into five years or more. If these cuts were to go through, it would substantially limit the work CPH can provide for physicians – and indirectly the public at large – at a time when the program is needed more than ever.

These are just a few of the very concerning proposals in the state Budget. While we understand that the State is responding to the huge drop in revenue arising from the pandemic, these proposals will be the “last straw” for many physicians who already are finding it difficult to remain in practice to deliver patient care due to New York’s already notoriously hostile practice environment.

We urge the Legislature to reject these unfair proposals in the State Budget.” (AUSTER)


Governor Cuomo Releases State Budget Proposal – Contains a Number of Problematic Proposals to Impose New Costs on Doctors, Expand Pharmacy Scope, and Reduce Due Process
Governor Cuomo released his proposed 2021-22 State Budget to address a 2-year $14.9 billion deficit and a 4-year $39 billion deficit.  The presentation identified that the Budget submission was based upon the likely receipt of additional $6 billion from the federal government but noted that $15 billion was needed to avoid the combination of Budget cuts and revenue increases in the Budget he proposed.  As has been previously discussed, new revenue sources included $500 million through mobile sports betting and $350 million through the sale of adult use cannabis (when fully implemented), as well as higher taxes for those making more than $5 million per year.  The Governor further noted that while he was hopeful to receive additional funding from the federal government, they would examine the possibility of litigation to ensure New York receives it fair share.

Among the positive items in the proposed Budget include:

  • A call once again to require state oversight over Pharmacy Benefit Managers (PBMs),
  • To significantly expand the manufacturing of personal protective equipment (PPE) and
  • Additional funding to increase reimbursements to providers in the state’s Essential Plan program, and to cover premiums to ensure those enrolled stay enrolled if they are eligible.

However, the Executive Budget contains a number of significantly problematic initiatives, including several rejected by the State Legislature in previous Budget cycles. These include:

  • Requiring the 16,000 or so physicians insured through the Excess Medical Malpractice Insurance program to bear 50% of the cost of a policy. This proposal was a recommendation from the Medicaid Redesign Team last spring, and was advanced during State Budget negotiations last March, but rejected by the State Legislature.  Given the huge financial losses faced by many physicians practice across the State arising from the pandemic, this “Budget savings measure” could not come at a worse time!  You can send a letter/tweet in opposition here: Don’t Balance the Budget on the Backs of Physicians (p2a.co)
  • A comprehensive “OPMC modernization” proposal which would take away important due process for physicians for whom a complaint is filed with the OPMC, despite the fact that most complaints do not result in any findings of misconduct. Specifically, it would permit the Commissioner the discretion to public identify a physician against whom a complaint has been filed prior to the conclusion of an investigation and hearing, and greatly increase the authority to impose a “summary suspension” prior to the conclusion of an investigation and hearing.  This was also proposed in last year’s Executive Budget and rejected by the State Legislature.  You can send a letter/tweet in opposition here: Reject Governor’s Physician Disciplinary Proposal (p2a.co)
  • Cutting the appropriation to MSSNY’s successful Committee for Physicians Health (CPH) – a decades’ old program that has assisted countless physicians in overcoming addiction and return safely to medical practice – by hundreds of thousands of dollars.  As a result of all the stressors caused by the pandemic, this program is needed more than ever.
  • Permitting pharmacists to act as a “referring healthcare provider” for providing to patients asthma and diabetes self-management, and permitting them to order various lab tests – without any requirement to engage in meaningful coordination with the patient’s physician.
  • Greatly expanding the existing physician-pharmacist collaborative drug therapy program to permit pharmacists to “prescribe” and inclusion of nurse practitioners. This was also proposed in last year’s State Budget and rejected by the State Legislature.
  • Continuation of the authority for an additional 6 years for certain nurse practitioners to practice without a written collaborative agreement of a physician provided there is proof of “collaborative arrangements” with physicians in that specialty of practice.
  • Giving health insurance companies the power to bring in out of state health care professionals to deliver telehealth services to their enrollees, potentially preventing community physicians from being able to provide telehealth services to their patients. While MSSNY greatly supports efforts to maintain the telehealth flexibilities for patients adopted during the pandemic, we are concerned that this proposal could actually prevent some physicians from continuing to provide telehealth services to their patients and/or to be reimbursed fairly for these services.

It is important than ever as well that physicians plan to participate in MSSNY’s virtual Physician Advocacy Day on March 2.  You can register here.
(DIVISION OF GOVERNMENTAL AFFAIRS)


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Join Us for MSSNY’s Virtual Lobby Day on March 2
Please plan to put aside Tuesday, March 2 for MSSNY’s Annual Physician Advocacy Day – this time Virtual!  To register, click here.

The format will follow previous years formats, where assembled physicians and allies will hear from legislative leaders in the morning (this year via Zoom), and then have virtual visits with their respective legislators in the afternoon.

With the Governor and the State Legislature needing to create tens of billions of savings to the State Budget, any number of healthcare programs of interest to physicians could be on the table, not to mention concerns with the numerous proposals to inappropriately expand the scope of practice for various non-physicians as well as numerous proposals to mandate how physicians provide care to their patients.

Please plan to join hundreds of colleagues from around the State on March 2!
(DIVISION OF GOVERNMENTAL AFFAIRS)


Registration Now Open: Veterans Matters: PTSD in Returning Veterans Webinar
Tuesday, January 26th @ 7:30 am
The Medical Society of the State of New York is hosting a Continuing Medical Education (CME) program entitled Veterans Matters: PTSD in Returning Veterans live webinar on Tuesday, January 26, 2020 at 7:30 am.

Click HERE to register for the program! View the program flyer HERE

When:                 January 26, 2020 at 7:30 am
Faculty:               Frank Dowling, MD

Educational Objectives:

Identify diagnostic criteria for PTSD
Discuss medical and psychiatric comorbidities of military-related PSTD
Discuss evidence-based treatment modalities for PTSD including medications and psychotherapy
Discuss strategies to help veterans overcome stigma to seek and accept treatment for military-related trauma

For more information, contact Jangmu Sherpa at jsherpa@mssny.org or call (518) 465-8085.

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

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


 

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Registration Now Open – Physician Wellness/Medical Matters COVID-19 & Mental Health of Physicians and Other Healthcare Providers

Friday February 5, 2021 @ 7:30am

Click here to register 

The COVID-19 pandemic has had a significant impact on the Mental health of physicians and other healthcare providers.  Learn more on February 5th at 7:30am.  Dr. Craig Katz will serve as faculty.

Educational Objectives are:

  • Examine the mental health risks posed by COVID-19 for physicians
  • Review the possible range of psychological and psychiatric responses to the pandemic
  • Discuss principles and interventions for helping ourselves, our families, and our colleagues

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 each live activity for a maximum of 1.0 AMA/PRA Category 1 credits™.  Physicians should claim only the credit commensurate with the extent of their participation in the activity. (Hoffman)


Registration Now Open – Medical Matters: COVID Vaccine Update

Wednesday February 17, 2021 @ 7:30am

Click here to register

Registration is now open for the next Medical Matters webinar: COVID Vaccine Update.  Learn more about the COVID-19 vaccine on February 17th @ 7:30am.  The discussion will include the types of vaccine in development, distribution priorities and barriers surrounding vaccine administration.  Dr. William Valenti will serve as faculty.

Educational Objectives:

  • Recognize the types of COVID-19 vaccine in development
  • Discuss priorities for vaccine distribution
  • Identify barriers to COVID-19 immunization

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 each live activity for a maximum of 1.0 AMA/PRA Category 1 credits™.  Physicians should claim only the credit commensurate with the extent of their participation in the activity. (Hoffman)

 


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eNews

NYS Vaccine Information
New York Gov. Andrew Cuomo said the state is administering about 65,000 doses a day — a rate that will deplete its current supply in two or three days. “What’s clear now is that we will be going from week to week and you will see a constant pattern of basically running out, waiting for the next week’s allocation and then starting up again,” Cuomo said.

The state will receive 250,400 doses next week, but Cuomo urged President Biden to increase the supply to states immediately…”At this current rate of supply, it takes seven and a half months to get enough vaccine for the currently eligible population,” Cuomo said.


Please Take Statewide UHC/OPTUM Survey Now
MSSNY is addressing an issue brought to our attention by a large group of medical practices.  The issue involves claims filed on behalf of United Healthcare (UHC) patients. 

We have been advised that often, once the claims are filed, the medical practice receives a request for additional medical information, either from UHC or its utilization review entity, Optum.
Subsequently, the practice calls to request the status of the claim based on the additional information submitted.  Regrettably, the practice is often advised that the records were not received.  Based on further discussion during the call, the practice is told the records were sent to an incorrect address.

MSSNY has been interacting with UHC on behalf of our members in reference to this problem since June 2019.

Due to the length of this ongoing burden, MSSNY is now seeking assistance from the NYS Department of Financial Services (DFS).  Therefore, we are asking you for further information to address this matter.  DFS is regulatory authority over NYS regulated health plans/insurers. https://www.surveymonkey.com/results/SM-B9CWXYX57/


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See our flyer here. Learn about us here.

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Office of Pharmacy Benefits Investigates Drug Price Spikes During Pandemic
The new Office of Pharmacy Benefits announced it has initiated investigations into significant price spikes for six drugs that were connected to the COVID-19 pandemic. The Office will send a demand, related to New York Insurance Law Section 111, requiring a statement from the manufacturer explaining the causes of the spikes.

“Throughout the COVID-19 pandemic, we’ve seen too many instances of pharmaceutical companies taking advantage of those in need and significantly raising the prices on life-saving prescription drugs,” Governor Cuomo said. “This shameful behavior cannot stand and needs to be rooted out at all costs. Companies should be on notice – if you attempt to capitalize on the health needs of New Yorkers, we will investigate you and hold you fully accountable.” Since these drugs are sometimes the difference between life and death, an extreme price spike can be a barrier to lifesaving treatment, particularly during a global health emergency.

The Department of Financial Services’ (DFS) Office of Pharmacy Benefits (OPB) has examined changes in drug prices during the state of emergency to identify spikes in price worthy of further investigation.  On Thursday, the OPB commenced investigations into price spikes for six drugs, including:

  • Ascor (ascorbic acid) 25,000 mg/50 mL bulk vial – Ascor is a formulation of Vitamin C for IV injection manufactured by McGuff Pharmaceuticals. McGuff raised the price of this drug by 110% about a week after clinical trials were announced for use of the drug to treat COVID-19 patients suffering acute symptoms.
  • Budesonide 0.5 mg/2 mL inhalation (60 mL) – One of two corticosteroids to be investigated, a generic formulation produced by Cipla USA Inc. increased in price by over 1350% in the midst of the first wave of COVID-19 cases in the U.S. and on the heels of an announcement of international clinical trials for its use to treat COVID-19 patients.
  • Dexonto (dexamethasone) 5 mL vial of a 0.4% solution – Dexonto is the other corticosteroid under investigation and is a branded generic drug manufactured by Nubratori, Inc.  This manufacturer announced a price increase of over 65% at the beginning of the pandemic, just 11 days before clinical trials for treating COVID-19 patients with the drug were announced in China.
  • Mytesi (crofelemer) 125 mg delayed release tablet, 60s – Manufactured by Jaguar Health, Mytesi is a drug used to treat gastrointestinal side effects of antiretroviral therapies used by HIV patients.  Jaguar increased the price of the drug by 230% just days after it applied for an emergency use authorization for use to treat COVID-19 patients.
  • Duramorph (morphine sulfate) 1 mg/1 ml (10 mL 10s) – While most morphine formulations experienced modest increases in price during the early months of the pandemic, this branded product manufactured by Hikma Pharmaceuticals experienced an anomalous increase of nearly 60%.
  • Chloroquine phosphate 250 mg tablets – The chloroquine family of drugs has made many headlines during the pandemic, but Rising Pharmaceuticals appears to have attempted to capitalize on unsubstantiated reports of its effectiveness in treating COVID-19 patients early in the pandemic when it raised its price by 97.8%.

Each of these manufacturers will now be required to provide a justification for each spike the OPB identified.  Pursuant to the demands, the manufacturers will provide DFS with written responses to questions such as the dates pricing decisions were made, the officers or employees involved in the decisions, any analyses conducted prior to the price spike, and the reasons for the price spike given internally.  The OPB is authorized to collect additional information, including by examining witnesses or issuing subpoenas.

The beginning of an investigation does not mean that a price spike was unlawful or even unjustified. It means that DFS has determined the circumstances need a closer look.  If the investigation finds that illegal conduct occurred or that a price spike was not justified, it will be memorialized in a report of the Drug Accountability Board. If it is determined that a valid reason for the spike exists, DFS will announce that development and close the investigation.

For more information or to report a drug price spike, visit the DFS Website.


Altfest Interactive Webinar: New COVID Stimulus Package: Opps for Physicians
We have been monitoring the Coronavirus stimulus bill and its contents very closely in recent weeks. This bill, as you may know, attempts to alleviate some of the financial burdens that individuals and businesses may be facing.

Join Altfest Personal Wealth Management on Tuesday, January 26 for The New COVID Stimulus Package: Opportunities for Physicians an interactive webinar highlighting specific opportunities available for physicians and their businesses.Topics to be discussed: 

·        The second round of PPP Loans
·        Employee Retention Credit
·        Opportunities for Physicians
·        What will the future bring?

Date: Tuesday, January 26, 2021 @12:00pm ET

Speakers:

Ekta Patel, CFP®
Director and Advisor, Altfest Personal Wealth Management
Ryan Graham, CFA, CFP®
Senior Financial Advisor, Altfest Personal Wealth Management

CLICK HERE TO REGISTER

There is no fee to attend this webinar. Enrollment is limited.


Inspector General Urges CMS to Take Action Against 100 “Error-Prone” Providers
CMS should take action against 100 healthcare providers who had high rates of improper Medicare payments, the HHS Office of Inspector General said in a report released Jan. 19.

Using comprehensive error rate testing program data, the inspector general identified 100 “error-prone” providers from 2014 through 2017. Of $5.8 million reviewed, $3.5 million was incorrect, an improper payment rate of 60.7 percent. From 2014 through 2017, Medicare made $19.1 billion in payments to the 100 “error-prone” providers, according to the OIG.

Based on its findings, the inspector general recommended that CMS review the list of 100 providers and “take specific action” such as prior authorization, prepayment, and post payment reviews. The report also recommended that CMS use annual comprehensive error rate testing data to identify providers that have an increased risk of receiving improper payments and apply more program integrity tools to them.

In written comments on the draft report, CMS did not agree with the inspector general’s recommendations. CMS also disagreed with the inspector general’s methodology for identifying error-prone providers. CMS said it has tried to use comprehensive error rate testing data to identify error-prone providers but found that the data was ineffective for this purpose.

After reviewing CMS’ comments, the inspector general maintained its findings and recommendations. (Becker’s Hospital Review, Jan.21)


AMA Program: Release the Pressure! Blood Pressure Control in Blacks; 7 pm
Jan. 27
The American Medical Association is a member of the Release the Pressure (RTP) coalition which is focused on blood pressure control in Blacks. They are launching the 2021 campaign with an RTP Wellness Wednesday event, which airs January 27th at 8:00 p.m EST via ReleaseThePressure.org. During this special episode, Tom Joyner will host an all-Black male panel discussion on racism in health care. It’s a conversation you don’t want to miss! Join radio icon @TomJoynerMorningShow as he leads an all-Black male panel on racism in health care ReleaseThePressure.org


Optum Expects to Add 10,000 Physicians This Year
OptumCare, the part of UnitedHealth Group that provides direct patient care, plans on adding thousands of physicians in the next year, UnitedHealth’s CEO said during a Jan. 20 earnings call.

Currently, OptumCare employs or is affiliated with 50,000 physicians and 1,400 clinics. OptumCare expects that its employed and affiliated physicians will grow by at least 10,000 during 2021, according to UnitedHealth CEO David Wichmann.

“This work of building local, physician-led systems of care continues to be central to our mission and is accelerating with notable progress in the Northeast, Pacific Northwest and Southern California in 2020,” Mr. Wichmann said.

The statement comes as UnitedHealth posted a profit of $2.2 billion in the fourth quarter of 2020, down about 38 percent from $3.5 billion in the same period of 2019. In its Jan. 20 financial release, UnitedHealth said the declines were expected as care patterns normalized and costs related to COVID-19 care grew. (Becker’s Hospital Review, Jan 21)


J&J COVID-19 Single-dose Vaccine Candidate Shows Promise
A single-dose coronavirus disease 2019 (COVID-19) vaccine candidate in development by Johnson & Johnson’s Janssen Pharmaceutical Companies appears to provide a sustained response against the virus based on phase 1/2a trial data, according to a company press release.

Those interim results, published ahead of phase 3 findings anticipated later this month, demonstrated that the J&J vaccine (JNJ-78436735) provided an immune response that lasted for at least 71 days, the duration of time measured in this study in participants aged 18 to 55 years.

The interim analysis appeared this week online in the New England Journal of Medicine.

Data demonstrated that, after a single vaccination, neutralizing antibodies against COVID-19 were detected in more than 90% of study participants at day 29 and in 100% of participants aged 18 to 55 years at day 57. These neutralizing antibodies remained stable through day 71, the latest timepoint available in the ongoing study.

Data on durability of immune responses in trial participants aged >65 years will be available in late January and longer-term follow-up to one year is planned. Top line data from the company’s phase 3 ENSEMBLE trial of a single dose is due later this month, although this timing may change due to disease events. The ENSMBLE trial will evaluate the vaccine’s safety and efficacy vs placebo in up to 60 000 adults aged 18 years and older and will include a significant proportion of adults aged >60 years.

The most frequent solicited adverse events (mild-to-moderate side effects typically associated with vaccinations) in the vaccine study arms were fatigue, headache, myalgia, and injection site pain. Reactogenicity was lower in the older age group. The study also evaluated a two-dose regimen, in which reactogenicity was observed to be lower after the second vaccine dose. (Patientcare Online, Jan.15)


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New York Physicians: From Healthcare Heroes to Healthcare Zeros 

For Immediate Release
January 20, 2021
 

New York Physicians: From Healthcare Heroes to Healthcare Zeros


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

“Over the last year, tens of thousands of physicians across the State of New York put their health and the health of their families at risk to ensure patients receive the care they needed. Many of them became sick themselves and, sadly, some even passed away from COVID-19.

“Yet these physicians continue their work on the front lines every day to be there for their patients.

“That is why we are stunned by the litany of proposals in the Executive Budget that will make it even harder for physicians to continue to provide the care our patients need. We note that there are some positive aspects in this State Budget proposal, including to provide needed regulation over PBM practices and expanding the state’s capacity to manufacture personal protective equipment (PPE) that physicians often lacked and have been the subject of enormous cost increases. However, we are extremely concerned with several other Budget proposals.

“One State Budget proposal would foist tens of thousands of dollars of new costs on physicians (totaling over $50 million) for keeping liability insurance protections that are absolutely necessary due to New York’s excessive medical liability premium costs. These liability costs far exceed any other state in the country. The substantial new costs will be near-impossible for many physicians to absorb given the enormous drop in patient visits and revenue experienced by physicians across the State over the last year. As an example, it would impose an approximate $20,000 new cost for an OB-GYN practicing on Long Island. If the Excess Insurance program is eliminated or reduced, then we need comprehensive medical liability reform instead.

“We are also perplexed by proposals to eliminate important due process protections for physicians against whom a complaint has been filed with the Office of Professional Medical Conduct. As we have previously stated, while we are anxious to work to identify gaps in our disciplinary system to protect the public, this Budget proposal would give the Commissioner of Health the authority in their sole discretion to disclose to the public that a complaint has been filed against a particular physician, despite the fact that very few complaints ever actually result in a finding of professional misconduct. This information can remain on the internet forever, potentially ruining a physician’s professional reputation. The law already permits the Commissioner to disclose information to the public when there is a public health threat.

“Another Budget proposal would impose huge cuts to the Committee for Physicians Health (CPH), a successful long-standing organization that provides essential counseling services for physicians confronting alcoholism, substance abuse, or mental illness. Many of these conditions have been exacerbated by the pandemic, making CPH more essential than ever. CPH provides important confidential peer to peer services to physicians in need of support for their health and well-being. Studies that review the long-term model effect of physician health programs show that physician recovery rates are markedly higher than the general population—even when extended into five years or more. If these cuts were to go through, it would substantially limit the work CPH can provide for physicians – and indirectly the public at large – at a time when the program is needed more than ever.

“These are just a few of the very concerning proposals in the state Budget. While we understand that the State is responding to the huge drop in revenue arising from the pandemic, these proposals will be the “last straw” for many physicians who already are finding it difficult to remain in practice to deliver patient care due to New York’s already notoriously hostile practice environment.

“We urge the Legislature to reject these unfair proposals in the State Budget.”

# # #

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

 

MSSNY eNews: January 20, 2021 – Gov.‘s Budget Proposes New Costs on Doctors, Expand Pharm Scope and Reduce Due Process

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COVID-19 STATs
New York: 6.3
New daily cases: 12,721
Tests per 100,000: 1,190.7

It is not only Inauguration Day: Today also marks a full year since the first known coronavirus patient in the United States was admitted to the hospital.

The U.S. on Tuesday passed 400,000 COVID-19-related deaths — less than a year since the pandemic took hold here.


Governor Cuomo Releases State Budget Proposal – Contains a Number of Problematic Proposals to Impose New Costs on Doctors, Expand Pharmacy Scope, and Reduce Due Process
Governor Cuomo released his proposed 2021-22 State Budget to address a 2-year $14.9 billion deficit and a 4-year $39 billion deficit.  The presentation identified that the Budget submission was based upon the likely receipt of additional $6 billion from the federal government but noted that $15 billion was needed to avoid the combination of Budget cuts and revenue increases in the Budget he proposed.

As has been previously discussed, new revenue sources included $500 million through mobile sports betting and $350 million through the sale of adult use cannabis (when fully implemented), as well as higher taxes for those making more than $5 million per year.  The Governor further noted that while he was hopeful to receive additional funding from the federal government, they would examine the possibility of litigation to ensure New York receives it fair share.

The Budget does include some positive items including:

  • a call once again to require state oversight over Pharmacy Benefit Managers (PBMs),
  • to significantly expand the manufacturing of personal protective equipment (PPE) and
  • additional funding to increase reimbursements to providers in the state’s Essential Plan program, and to cover premiums to ensure those enrolled stay enrolled if they are eligible.

However, the Executive Budget contains a number of significantly problematic initiatives, including several rejected by the State Legislature in previous Budget cycles. These include:

  • requiring the 16,000 or so physicians insured through the Excess Medical Malpractice Insurance program to bear 50% of the cost of a policy.  This proposal was a recommendation from the Medicaid Redesign Team last spring, and was advanced during State Budget negotiations last March, but rejected by the State Legislature.  You can send a letter/tweet in opposition to your state legislators here: Don’t Balance the Budget on the Backs of Physicians (p2a.co)
  • A comprehensive “OPMC modernization” proposal which would have the effect of significantly reducing due process for physicians for whom a complaint is filed with the OPMC.  It would permit the Commissioner the discretion to public identify a physician against whom a complaint has been filed prior to the conclusion of an investigation and hearing, and greatly increase the authority to impose a “summary suspension” prior to the conclusion of an investigation and hearing.  This was also proposed in last year’s Executive Budget and rejected by the State Legislature.  You can send a letter/tweet in opposition to your state legislators here: Reject Governor’s Physician Disciplinary Proposal (p2a.co)
  • Permitting pharmacists to act as a “referring healthcare provider” for providing to patient’s asthma and disease self-management, and permitting them to order various lab tests
  • Greatly expanding the existing physician-pharmacist collaborative drug therapy program to permit pharmacists to “prescribe” and inclusion of nurse practitioners.  This was also proposed in last year’s State Budget and rejected by the State Legislature.
  • Continuation of the authority for an additional 6 years for certain nurse practitioners to practice without a written collaborative agreement of a physician provided there is proof of “collaborative arrangements” with physicians in that specialty of practice.  Cutting the appropriation of MSSNY’s successful Committee for Physicians Health by 20%

We are still continuing to go through the thousands of pages of Budget language, but we will be coordinating with the specialty societies and developing grassroots materials to assist physicians in fighting back to push the Legislature to reject these initiatives when the final Budget is enacted on March 31.  It is important than ever as well that physicians plan to participate in MSSNY’s virtual Physician Advocacy Day on March 2.  You can register here: Webinar Registration – Zoom


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Nearly 40% Still Hesitant to Visit Physician’s Office Due to COVID-19
Nearly 40 percent of Americans said they still feel unsafe visiting a physician’s office during the COVID-19 pandemic, according to research published Jan. 13 from the Society for Cardiovascular Angiography and Interventions.

The society conducted three surveys in late December 2020 to better understand Americans’ COVID-19 fears. The first survey included responses from a nationally representative group of 1,005 U.S. adults. The second included insights from a sample of 1,023 LatinX adults, and the third featured responses from 1,041 Black adults.   

Four survey findings:

  1. More than 30 percent of respondents said they have not had a routine checkup since the pandemic started, and 38.4 percent said they still feel unsafe going to a physician’s office.
  2. Overall, 51 percent said they do not feel comfortable scheduling a medical procedure during the pandemic. Twenty-five percent of Black respondents and 29 percent of LatinX respondents said the same.
  3. Thirty-three percent of Black respondents and 34 percent of Latinx respondents said they would feel comfortable going to a hospital for emergency care during the pandemic, compared to 58 percent of the general population.
  4. More respondents said they were afraid of COVID-19 (58 percent) than having a heart attack

 

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Medicare Part B 2021 Important Update from Anthem
When: Friday, January 22, 2021, 12:00 – 2:00 PM EST

Registration 

MSSNY will be partnering with National Government Services to conduct a webinar on important changes for the Medicare Program in 2021.

Agenda Topics to include:

  • COVID-19 Public Health Emergency (PHE)
  • Telehealth
  • Evaluation & Management coding Changes in CY2021
  • 2021 Medicare Physician Fee Schedule (MPFS)
  • Final Policy, Payment, and Quality Provisions Changes to the MPFS for Calendar Year 2021
  • Quality Payment Program
  • Contact Information/Resources

James D. Bavoso
Provider Outreach & Education, Manager

National Government Services
Office: (718) 351-2098| Fax: (315) 442-4103 |

james.bavoso@anthem.com | www.NGSMedicare.com |  www.NGSConnex.com


CMS is Working to Expand COVID-19 Vaccine Outreach
CMS is working to expand our COVID-19 vaccine outreach efforts in the community with the goals of building vaccine confidence, preparing people to be vaccinated, and slowing the spread of the virus.  We want to help reach membership and Medicare beneficiaries with information and resources about the COVID-19 vaccine.  I know that MSSNY is already communicating with its members about COVID-19, but I hope that you can use some of the resources we will be making available, and that we can be helpful to your efforts.

We/HHS will have communication toolkits soon to help you do that and as those are developed, we will share them and hope that you will share on your website and in your newsletters if possible.  The toolkits will include talking points to speak accurately and confidently about COVID-19 prevention measures, videos, customizable social media messages, a standard PowerPoint presentation, content for community webinars, blog content, blurbs for newsletters and websites, fact sheets, and flyers.

Right now, our key messages for Medicare beneficiaries are:

  1. Vaccines are approved but are in limited supply. Medicare beneficiaries should check with their state or jurisdiction for when and where to receive the vaccine.   Look for updates from your state and local officials as more doses of the vaccine become available for additional priority groups.
  2. Do not give out your Medicare number and don’t pay for the vaccine.  It will be at no cost to you. You cannot pay to get quicker access.
  3. Remember that you need 2 doses for the COVID-19 vaccine to be effective, so be sure to schedule your second dose when you receive your first one.  Be on the lookout for COVID-19 vaccine scam efforts.
  4. The vaccine will help keep you from getting COVID-19. Learn more about the benefits of the vaccine.
  5. Unfortunately, there are some myths about the COVID-19 Vaccine and vaccination in general.  Here is more information to bust COVID-19 vaccine myths.

More information can be found at our COVID-19 Vaccine Policies & Guidance page, and the COVID-19 Partner Resources Page

In February 2021, CMS Local Engagement Staff will join HHS to promote and distribute to specific partner groups tailored toolkits that include talking points to speak accurately and confidently about COVID-19 prevention measures, culturally relevant videos, customizable social media messages, a standard PowerPoint presentation, content for community webinars, blog content, blurbs for newsletters and websites, and fact sheets.  We will continue to engage these partners to reach vulnerable populations, adapting to new messaging as needed.

Please keep an eye out for the toolkits and continue to share the links I mentioned as you see fit.  Also, let me know if there is anything we can do to assist you and your membership, and whether it would be good to touch base by phone/conference call or Zoom sometime soon.

Thanks, and Happy New Year!
Frank Winter CMS/OPOLE


NEJM Covid-19 Vaccine Resource Center
A collection of resources on Covid-19 vaccines, including frequently asked questions, continuing medical education, published research, and commentary.

CORONAVIRUS (COVID19)
VACCINE FAQ

https://www.nejm.org/covid-vaccine?cid=DM108098_&bid=353276889

All information and resources on the Covid-19 Vaccine Resource Center will be updated on an ongoing basis as medical science evolves and will remain freely available to all.


 

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MSSNYeNews: January 15, 2021 – State of State


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Colleagues:

Governor Cuomo gave four separate speeches over the course of this past week illuminating initiatives that he believes New York State should pursue in 2021. Several topics discussed are of particular interest to physicians.

Covid-19 Vaccine

Our MSSNY shares the governor’s goal of defeating Covid-19 in 2021 and the physicians of this state stand ready to help bring this to fruition.  Practices have signed up to distribute the vaccine and many received doses this week to begin vaccinating the 1a and 1b qualified New Yorkers. Scores of individual physicians (practicing and retired) and medical students have heeded the calls to action and have signed up to help in the vaccination campaign through ServNY.

Currently, there is more capacity in the system than there are vaccines. We stand with the Governor in his call for an increase in Covid-19 vaccine supply to our state.  Hiccups continue in the vaccine roll out process and MSSNY remains in close communication with our Department of Health (DOH), communicating the issues that have been raised so that solutions can be expedited. Yesterday alone MSSNY sent communications to DOH regarding questions about eligibility under the immunocompromised 1b category, issues concerning scheduling of second doses, portal navigation issues for seniors, same household scheduling and ability to cancel appointments, among other issues. Together we will refine the process quickly and safely to achieve herd immunity.

Emergency Preparedness

MSSNY shares the Governor’s goal of Emergency Preparedness.  Our MSSNY committee on Emergency Preparedness has been active and engaged in this arena long before COVID-19. The Governor has proposed the creation of a Medical Supplies Act to ensure that New York State has the necessary personal protective equipment during a medical emergency.  MSSNY stands supportive of this concept. Medical professionals must never again be asked to risk their lives and those of their loved ones due to a lack of protective gear.

Telehealth

MSSNY welcomes efforts announced by the Governor to expand Telehealth coverage in 2021. The Governor and state agencies took very important steps during the pandemic to help facilitate the ability of patients to receive needed treatment in a virtual office visit.

This was an important lifeline for patients and for physician practices and has helped to significantly transform the delivery of care. MSSNY has been working with a number of different health care advocacy groups in support of legislation that would help to make permanent some of these temporary changes, as well as ensure “payment parity” for delivery of care via Telehealth. Yesterday, MSSNY signed an agreement to offer a new exciting MSSNY benefit through CareClix.  This is a telehealth platform with the ability to provide remote patient monitoring. More detailed information can be found here. To sign up, click here.

Legalization of Adult Use Marijuana

The Governor’s proposal also includes plans to legalize marijuana in New York State.  MSSNY along with other groups such as the NYSPTA, the New York State Sheriffs Association, the Mental Health Association, the New York State Association of County Health Officials, and Smart Approaches to Marijuana remain opposed.  MSSNY reiterates our concern that the public health effects of cannabis will likely outweigh any revenue the state secures by legalizing marijuana.

OPMC Due Process

While not mentioned in the State of the State message itself, the Governor issued a disturbing press release this week in which he announced a proposal for Office of Professional Medical Conduct (OPMC) “modernization that sounds similar to the proposal advanced last year in the Executive Budget. In any year, an effort to eliminate due process protections for physicians would be disheartening and demoralizing; however, in a year where physicians have been working around the clock on the front lines in every region of the State responding to the pandemic and where they have put their health and their lives at risk, it is particularly egregious to again be faced with a proposal to eliminate essential due process rights when a complaint has been filed against a physician with the Office of Professional Medical Conduct. Only 2-3% of complaints filed with OPMC actually result in a disciplinary action.

MSSNY remains committed to working with the Governor and the New York State Department of Health to protect our patients by maintaining a strong disciplinary process, and addressing identified gaps.  However, we strongly oppose overbroad measures that hold serious potential to unfairly destroy a physician’s career through the release of allegations that have not been proven yet could remain easily “searchable” on the internet forever.

MSSNY stands ready to work with our Governor to ensure the health of New Yorkers in 2021 and beyond.

Bonnie Litvack, MD
MSSNY President


Capital Update

MSSNY Weekly Podcast


Join Us for MSSNY’s Virtual Lobby Day on March 2
Please plan to put aside Tuesday, March 2 for MSSNY’s Annual Physician Advocacy Day – this time Virtual!  To register, click here: Webinar Registration – Zoom

The format will follow previous years formats, where assembled physicians and allies will hear from legislative leaders in the morning (this year via Zoom), and then have virtual visits with their respective legislators in the afternoon.

With the Governor and the State Legislature needing to create tens of billions of savings to the State Budget, any number of healthcare programs of interest to physicians could be on the table, not to mention concerns with the numerous proposals to inappropriately expand the scope of practice for various non-physicians as well as numerous proposals to mandate how physicians provide care to their patients.

Please plan to join hundreds of colleagues from around the State on March 2!


Important Information for Physicians Regarding COVID-19 Vaccine
As has been widely reported and consistent with CDC recommendations, Governor Cuomo this week expanded eligibility to seven million New Yorkers, including those 65 and over, and those under 65 with immunocompromising conditions.  It is important for physicians to know that New York State is currently only receiving 300,000 doses of the vaccine a week and this has created significant wait time, with many needing to wait months to receive the vaccine based upon the anticipated supply.   

MSSNY has been in constant communication with the DOH and the Governor’s office to raise questions brought by physicians and to obtain key information for physicians to better educate their staffs and their patients. The following information was provided to MSSNY today from the Governor’s Vaccine Task Force:

  1. Second Dose Appointments: Second dose appointments must be scheduled at the time the first dose is administered. Those who receive the first dose must return to the same location to receive the second dose. It is important to send frequent reminders about when and where to receive the second dose. Individuals must receive two doses of the same vaccine (e.g., you must receive two doses of the Pfizer vaccine or two doses of the Moderna vaccine). They are not interchangeable.
  2. Second Doses:  Second doses will automatically be shipped to providers based on first dose allocations.  The New York State Health Department sends out information regarding the timing and quantity of second dose orders.  Please note that the boxes are not labeled as second doses and must be tracked and reserved for second dose administration ONLY.  You cannot use ANY PORTION of your second dose shipment for first doses. You must reserve all second doses and attempt to contact patients until all second doses are administered.  Entities that redistributed first doses must follow the same redistribution process for second doses to ensure all providers have the second doses they need to complete the vaccine series.
  3. Vaccine Tracker:  New York State DOH requires all facilities receiving and administering COVID-19 vaccine to submit administration and inventory data to the ‘Daily Vaccine Tracker’. Vaccine tracker information is due every day by 10 amunless a facility is closed or has zero doses on hand. The information collected is used by the State to analyze throughput for your staff and other eligible priority populations, facility specific inventory, and is the basis for determining eligibility for future allocations. Further, inaccurate reporting could slow your ability to access additional vaccine when needed. As a reminder all redistributions must be reflected in the daily tracker and no vaccine should be reallocated or redistributed between providers unless approved by the New York State Health Department and you should notify the state of any extra doses that you are unable to use during a weekly allocation period at:  CovidVaccineNotUsed@health.ny.gov.
  4. Vaccine Form: Each individual being vaccinated must complete the NYS Vaccine Form prior to vaccination. Executive Order 202.86 requires ALL vaccine providers to ensure individuals have completed the NYS Vaccine form and accompanying attestation that they are eligible to be vaccinated.

New York State also authorized administration of the COVID-19 vaccine to adults 65 and older and for those under 65 with a medical condition.  It is anticipated that the New York State Department of Health will issue guidance shortly on what constitutes a medical condition.  Providers are still expected to prioritize health care workers, and hospitals must continue to prioritize unvaccinated health care workers from the 1A groups, though they may vaccinate any eligible person in 1A or 1B.  Retail pharmacies or physician networks or practice groups, after vaccinating their own patient-facing staff, should only vaccinate persons over the aged 65 years or older.  Local Health Departments must prioritize the essential worker population in 1B.  A copy of the January 12, 2021 guidance can be found here.

Physicians can find additional guidance and current information from the NYS Department of Health here.

To Check Vaccine Eligibility, go here (CLANCY) 



MSSNY Raises Serious Objections with Proposal to Take Away Due Process for Physicians
MSSNY President Dr. Bonnie Litvack raised significant concerns with a 2021 proposal announced by the Governor this past Sunday that appears to be very similar to last year’s proposal to significantly reduce essential due process protections for physicians against whom a complaint has been filed with the Office of Professional Medical Conduct (OPMC).  That proposal would have permitted the Commissioner of Health to publicly release information about a physician against whom a complaint has been filed with OPMC prior to the conclusion of a disciplinary proceeding despite the fact that very few complaints result in actual findings of misconduct. 

It would also give huge new powers to the Commissioner to “summarily suspend” a physician from medical practice prior to the conclusion of an investigation and disciplinary hearing.  These proposals were advanced in the 2020-21 Executive Budget but were rejected by the State Legislature in the final enacted State Budget.

Dr. Litvack’s statement noted that “It is stunning that after a year of physicians working on the front lines in every region of the State responding to the pandemic – in which many physicians themselves became very sick and some even passed away – that they are again faced with the proposal to eliminate essential due process rights when a complaint has been filed against them with the Office of Professional Medical Conduct.  When a similar proposal was advanced last year in the Executive Budget, we highlighted that very few complaints filed with the disciplinary board (roughly 2-3%) actually result in a disciplinary action.

“We remain committed to working with the Governor and the New York State Department of Health to protect our patients through maintaining a strong disciplinary process and addressing identified gaps. However, we remain extremely concerned with overbroad measures that hold serious potential to unfairly destroy a physician’s career through the release of allegations that have not been proven yet could remain easily “searchable” on the internet forever.”    (AUSTER)


Governor Cuomo Unveils Plan to Expand Telehealth Services at 2021 State of the State
At his initial State of the State address on Monday, Governor Cuomo announced plans to expand Telehealth coverage in 2021. Key proposed reforms include adjusting reimbursement incentives to encourage Telehealth, eliminating outdated regulatory prohibitions on the delivery of Telehealth, removing outdated location requirements, addressing lack of technical proficiency among both patients and providers through training programs, and establishing other policies that incentivize the use of Telehealth. However, we are awaiting further details – likely in next week’s Executive Budget proposal – as to how exactly these expansions would occur. More on the Governor’s proposals here: Click Here

The Governor and state agencies took very important steps early on in the pandemic to help provide patients needed treatment from their physicians, virtually, by removing several barriers to the receipt of care through Telehealth. This was not only an important lifeline for patients and physicians, it has also helped transform how care is delivered in New York.

MSSNY is working with a range of health care advocacy groups on passing comprehensive reform of New York’s Telehealth policies and we look forward to working with the Governor and the Legislature on this critical issue. (Click Here)                        (CARY)


Keep Patient Safety Standards For Ophthalmological Care Intact!
Physicians are urged to contact their Senators to express their opposition to legislation (S.1519) before the Senate Higher Education Committee on Tuesday, January 19 that deviates significantly from a carefully negotiated compromise between the New York State Ophthalmological Society and the New York State Optometric Association.  Physicians can send a letter to their legislators Here. Specifically, the legislation would allow optometrists with appropriate training and oversight, to prescribe certain oral medications for the treatment of ophthalmic conditions. However, amendments made this to the legislation depart significantly from what had been negotiated between the two associations and would weaken optometrist training requirements that had been designed to ensure patient safety.

Same-as legislation (A.1921) has been introduced and referred to the Assembly Higher Education Committee.

The bill sets a terrible precedent as it would undermine collaborative efforts among various healthcare provider types working together to expand access to care to patients while also protecting patient safety. Please urge your legislators to reject this legislation and instead urge that the bill be amended to previous versions to reflect what the groups together negotiated.        (AUSTER) 


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MSSNY Working to Reduce Administrative Burdens in Physician-Health Plan Interactions
Representatives of MSSNY and the New York Medical Group Managers Association (NYMGMA) have been participating in the Department of Financial Services Administrative Simplification Work Group.  The meetings began in November and have been occurring on a bi-weekly basis since that time.  The Work Group – consisting of representatives of physicians, hospitals, health plans, and consumer groups – have so far been working to achieve consensus on ways to reduce the unnecessary delays in credentialing physicians and other care providers to be approved to be network participating providers.  The Task Force has also begun discussing ways to reduce the excessive hassles that patients, physicians, and hospitals experience in obtaining prior authorization for needed medical care, including addressing excessive time spent waiting on the phone and excessive medical record requests.  The Work Group will continue to meet throughout the spring and summer with a report due to the State Legislature in October.                                                              (AUSTER, CARY)


State Tax Department – PPP Forgivable Loans Not Considered Income
The New York State Tax Department has issued a FAQ list to address questions many have raised regarding the NYS tax implications of various federal stimulus program.  Click Here.  Of particular note for physicians who have received a PPP loan/grant, the FAQ notes that with regard to Paycheck Protection Program (PPP) forgivable loans, the state tax department follows the federal rule so that they are exempted from income calculation and expenses paid for with the PPP award may still continue to be deducted.  As part of the Congressional year-end Covid relief package, a provision was contained to clarify that, for federal tax purposes, expenses paid for with a PPP award could continue to be deducted as a business expense.  More on this issue here: Click Here    (AUSTER)


Regulatory Changes Allow Physicians to Prescribe Buprenorphine Without a Waiver
This week, the U.S. Department of Health and Human Services announced that it will expand access to treatment for opioid use disorder by, in part, eliminating the x-waiver requirement for DEA-registered physicians. Click Here.  The American Medical Association and its Opioid Task Force strongly supported this decision and has been urging HHS to change the regulation for several years.

The Medical Society of the State of New York, is a member of the AMA Opioid Task Force and also supports this change.  The new regulations allow physicians to prescribe buprenorphine without a waiver. Buprenorphine is a highly effective medication for the treatment of opioid use disorder.  The Centers for Disease Control and Prevention Click Here an acceleration of overdose deaths during the COVID-19 pandemic, which has made accessing care more challenging.  Read the full Click Here  Dr. Frank Dowling, secretary of the Medical Society of the State of New York and Pat Clancy, Sr. Vice President of MSSNY Public Health and Education, are the MSSNY representatives to the AMA’s Opioid Task Force.        (CLANCY)


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Registration Now Open: Veterans Matters: PTSD in Returning Veterans Webinar
Tuesday, January 26th @ 7:30 am 

The Medical Society of the State of New York is hosting a Continuing Medical Education (CME) program entitled Veterans Matters: PTSD in Returning Veterans live webinar on Tuesday, January 26, 2020 at 7:30 am.

Click HERE to register for the program! View the program flyer HERE

When:                 January 26, 2020 at 7:30 am
Faculty:               Frank Dowling, MD

Educational Objectives:

Identify diagnostic criteria for PTSD
Discuss medical and psychiatric comorbidities of military related PSTD
Discuss evidence-based treatment modalities for PTSD including medications and psychotherapy
Discuss strategies to help veterans overcome stigma to seek and accept treatment for military related trauma

For more information, contact Jangmu Sherpa at jsherpa@mssny.org or call (518) 465-8085.

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.


COVID-19 & Mental Health: Registration Now Open for Two CME Webinars
January 20, 2021 @ 7:30am Medical Matters: COVID-19 & Mental Health of Patients Click here to register

February 5, 2021 @ 7:30am Physician Wellness/Medical Matters COVID-19 & Mental Health of Physicians and Other Healthcare Providers Click here to register

The COVID-19 pandemic has contributed to countless health problems over the past year.  Not the least of which are mental health related.  Learn more about how the COVID-19 pandemic has affected the mental health of patients on January 20th at 7:30am and how it has affected physicians and other healthcare workers on February 5th at 7:30am.

Dr. Craig Katz will serve as faculty for both webinars. 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 each 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. 


eNews

Gov. Cuomo Updates on State’s Progress During Covid-19 Pandemic
Jan 14 6:30 PM data is summarized briefly below:

  • Test Results Reported – 212,589
  • Total Positive – 13,661
  • Percent Positive – 6.42%
  • Patient Hospitalization – 8,823 (-106)
  • Patients Newly Admitted – 1,120
  • Hospital Counties – 56
  • Number ICU – 1,536 (+35)
  • Number ICU with Intubation – 956 (+32)
  • Total Discharges – 112,979 (+956)
  • Deaths – 202
  • Total Deaths – 32,379
  • Each region’s 7-day average percentage of positive test results reported over the last three days is as follows:

REGION

MONDAY

TUESDAY

WEDNESDAY

Capital Region

9.01%

8.67%

8.45%

Central New York

7.20%

6.77%

6.74%

Finger Lakes

9.01%

8.72%

8.28%

Long Island

9.07%

8.90%

8.69%

Mid-Hudson

7.86%

7.95%

7.81%

Mohawk Valley

9.51%

9.24%

9.18%

New York City

5.96%

5.92%

5.83%

North Country

7.62%

7.62%

7.69%

Southern Tier

4.67%

4.61%

4.33%

Western New York

7.67%

7.26%

7.43%

Statewide

7.21%

7.08%

6.95%

  • Total hospitalizations fell to 8,823. Of the 212,589 tests reported yesterday, 13,661, or 6.42 percent, were positive. There were 1,536 patients in ICU yesterday, up 35 from the previous day. Of them, 956 are intubated. Sadly, we lost 202 New Yorkers to the virus.
  • New State-run vaccination sites are coming soon. Today the first vaccinations began at a drive-thru vaccination site at Jones Beach on Long Island. More sites will come online shortly, including sites in Buffalo, Rochester, and Plattsburgh. All vaccination sites are by appointment only. For New York State-run sites, if you are eligible you can make an appointment at gov/vaccine if there are appointments available.
  • The Finger Lakes has the highest rate of COVID hospitalizations by population. There are 830 hospitalizations in the Finger Lakes, which represents 0.07 percent of the region’s population. The Capital Region has 520 hospitalizations (0.05 percent); Central New York has 323 hospitalizations (0.04 percent); Long Island has 1,658 hospitalizations (0.06 percent); the Mid-Hudson Region has 1,015 hospitalizations (0.04 percent); Mohawk Valley has 309 hospitalizations (0.06 percent); New York City has 3,292 hospitalizations (0.04 percent); Southern Tier has 249 hospitalizations (0.04 percent); and Western New York has 517 hospitalizations (0.04 percent of its population). The North Country, with 110 hospitalizations (0.03 percent), has the lowest rate of hospitalizations due to COVID.
  • New York has conducted over 28 million tests to date. Getting tested regularly is a good way to help ensure your health and the health of those around you. If you are experiencing COVID symptoms or believe you may have been exposed to someone positive for COVID, get tested. Find a testing site near you. You can also call 1-888-364-3065 to make a free appointment at a New York State-run testing location.

Council Notes-January 14
Council approved the following:

  • Recommendations for Lowering Healthcare Costs: MSSNY will continue to work with the AMA to advocate for measures that help reduce healthcare costs and to more fully educate legislators, the media, and the public of data showing that spending on physician services represents only a small component of overall healthcare costs.
  • Office of Professional Medical Conduct Reform: MSSNY will continue to support the right of physicians who have been the subject of a disciplinary procedure, based on information that was knowingly false when the complaint was filed, to be able to sue the parties responsible for that false information; and will continue to oppose legislation that would permit the public release of complaints to the OPMC where the complaint allegations have not resulted in a determination of misconduct.
  • Piloting Use of Financial Incentives to Reduce Unnecessary Emergency Room Visits: MSSNY will introduce a resolution asking the AMA to study and report on the positive and negative experiences of programs in various states that provide Medicaid beneficiaries with incentives for choosing alternative sites of care, instead of hospital emergency departments when it is appropriate to their symptoms and/or condition.
  • Physician Assistance Parity with Lawyers: MSSNY will continue its development and rollout of a program that provides confidential peer-to-peer support for physicians, medical residents, and medical students and will continue to seek legislation or regulation to ensure confidentiality and non-discoverability for both the trained peer and physician or student seeking assistance in peer-to-peer interactions.
  • Addressing the Adverse Health Effects of Climate Change in New York State: Recommendations for Protecting New Yorkers’ Health and Safety from Global Warming and Climate Instability paper was presented by MSSNY’s Preventive Medicine and Family Health Committee and approved by Council.

MLMIC’s Chief Medical Officer Dr. John Lombardo announced a new Preferred Savings Program for New York physicians who qualify. Contact Lori Hertz at lhertz@mlmic.com for more information.

An in-person House of Delegates meeting is planned for September 18, tentatively in Saratoga. MSSNY Speakers will send a letter on the 26th of each month with updates on the HOD. March 31 is the deadline for resolutions that will be referred to the AMA; June 25 is the deadline for MSSNY HOD resolutions.


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NY County Physician’s Response to WSJ Editorial on Doctor Shortage
How to Address the Doctor Shortage

Regarding your editorial “Congress’s Doctor Shortage” (Jan. 5): The government’s micromanagement of health care has had many unintended consequences. Spending $900 million to add 1,000 post-graduate medical-education slots seems excessive. That is $900,000 per slot or over three times the four-year tuition costs of medical school. Graduate medical education (GME) has mostly been hospital based while medical care is increasingly provided outside the hospital setting. Restructuring graduate medical education by increasing the focus on community-based care and ambulatory-based surgery to supplement hospital-based care would result in a more cost-effective method for achieving this goal.

The second problem of health-care consolidation has been a result of obsolete antitrust laws that encourage health-care consolidation resulting in less competition. As far back as 2010 a report by the attorney general of Massachusetts found up to a 300% difference in costs based on bargaining power and not quality. Consolidation raises prices. We need greater flexibility in our antitrust laws to foster and preserve competition.

Physician substitutes including physicians’ assistants and nurse practitioners can often provide adequate but not equivalent care to board-certified physicians. If these substitutes were in fact equivalent, we should stop spending time and money educating physicians.

Approximately one-third of practicing physicians are over the age of 60 and more likely to retire. COVID-19 has accelerated retirements for two reasons: Many older physicians who are at higher risk of dying from COVID-19 have reduced or stopped seeing patients. As physicians age, many continue to enjoy practicing but at a reduced practice load. The further reduction in practice volume, elective procedures and elective surgery since COVID-19 is making these smaller practices unprofitable. Earlier retirement by older physicians will lead to physician shortages sooner than has been previously estimated.


Michael T. Goldstein, M.D., J.D.


The New York Society of Addiction Medicine Invites You to A Webinar
“Expanding Use of Medications for Opioid Use Disorder Treatment in New York’s Jails and Prison”

When:     Wednesday January 20th, 2021 at 7:30-8:45 pm

Join   :    https://mssny.zoom.us/webinar/register/WN_x1TdhOyjSGKqzityllf82A

Costs :   Free (requires pre-registration)

Speakers:

Kevin Fiscella, MD MPH, Professor, Dept of Family Medicine, University of Rochester Medical Center
Jill Harrington, RN BSN CCHP-RN, Health Services Administrator, Albany County Correctional Facility
Jasdeep Mangat, MD, Medical Director, Substance Use Treatment, Correctional Health Services (New York City)
John Morley, MD, Chief Medical Office, New York State Department of Corrections and Community Supervision

In the two weeks following their release, people coming home from prison are 129 times more likely to die from a drug overdose than the general population. We have known this for years, but people across New York State are working to change this!

Please join us to learn about the American Society of Addiction Medicine’s policy statement on “Treatment of Opioid Use Disorder in Correctional Settings” and the progress being made in New York State to expand access to life-saving medications for opioid use disorder (MOUD) in jails and prisons.

Aaron Fox
Chair, Policy and Advocacy Committee
New York Society of Addiction Medicine


Palliative Care Linked to A 10% Drop in ICU Use for Terminal Patients
Offering palliative care services to patients with terminal conditions can help reduce their use of the intensive care unit, a study published in JAMA Network Open shows.

Researchers studied 51 hospitals in New York that either did or did not implement a palliative care program between 2008 and 2014. They examined data for 73,370 patients who died during their hospitalizations. Of the total number of patients included in the study, 51.3 percent received care in hospitals that implemented palliative care services, and 48.7 percent received care in a hospital that did not.

Researchers found that patients who received the palliative care services were less likely to be admitted to the ICU than patients admitted to the same hospitals before the palliative care program was implemented. The implementation of palliative care programs was associated with a 10 percent reduction in ICU use during hospitalizations where the patients died, compared to hospitals that did not implement palliative care services.

MSSNY – Medicare Part B 2021 Important Update from Anthem
When: Friday, January 22, 2021 12:00 – 2:00 PM EST
Registration  

The MSSNY will be partnering with National Government Services to conduct a webinar on important changes for the Medicare Program in 2021.

Agenda Topics to include:

  • COVID-19 Public Health Emergency (PHE)
  • Telehealth
  • Evaluation & Management coding Changes in CY2021
  • 2021 Medicare Physician Fee Schedule (MPFS)
  • Final Policy, Payment, and Quality Provisions Changes to the MPFS for Calendar Year 2021
  • Quality Payment Program
  • Contact Information/Resources

James D. Bavoso
Provider Outreach & Education, Manager

National Government Services
Office: (718) 351-2098| Fax: (315) 442-4103 |

james.bavoso@anthem.com | www.NGSMedicare.com |  www.NGSConnex.com



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CDC: Cases Among Younger Children Remains Low Even After Schools Reopen
A new CDC report “found that COVID-19 cases among younger children remained low even after schools restarted for in-person learning. To safely reopen schools, however, transmission in communities must be kept in check.” The report, “published Wednesday in the CDC’s Morbidity and Mortality Weekly Report, considered more than 2.8 million laboratory-confirmed COVID-19 cases in people ages zero to 24 from March 1 through December 12.”

Minority Health Institute and UCLA BRITE Center


COVID-19 Pandemic Highlights Importance of Cyber Insurance
By Kathleen Sellers, JD, CLU©
Vice President, Charles J. Sellers & Co., Inc.

In addition to all the other challenges that businesses have faced in 2020, cybercrime has been increasing, as cyber criminals have exploited vulnerabilities created by the Covid-19 pandemic.  The pandemic has changed how many businesses, including medical practices, do business.

More people are working from home, using home networks and sometimes personal devices, which tend to be less secure than dedicated office networks and equipment.
We are all increasingly reliant on online communication tools, with people working from different locations and some face-to-face interactions limited.  The use of telehealth services has grown exponentially since the pandemic started.  All of these changes – resulting in more business taking place online — translate into new opportunities for bad cyber actors.

Some of these bad actors are taking advantage of pandemic-related anxiety, sending emails in which they pretend to be from a health authority like the CDC, or from a government loan program.  The most common cyber threat that businesses face continues to be ransomware attacks, which are increasing in number and severity.  In a ransomware attack, a cybercriminal introduces malicious software that blocks access to a computer system and demands a ransom for unblocking it.  According to an insurance industry study, ransomware attacks grew by nearly 50 percent in the second quarter of 2020 (after the pandemic began) as compared to the first quarter.[1]  The amount of ransom demands is increasing, as is the average length of time it takes for a business to restore its systems and resume operations.

Healthcare businesses are a particular target during the pandemic.  In October 2020, a Joint Cybersecurity Advisory was issued by the Cybersecurity and Infrastructure Security Agency (CISA), the Federal Bureau of Investigation (FBI), and the Department of Health and Human Services (HHS) titled “Ransomware Activity Targeting the Healthcare and Public Health Sector.”[2]  The advisory alerted the healthcare sector to “tactics, techniques, and procedures (TTPs) used by cybercriminals against targets in the Healthcare and Public Health Sector (HPH) to infect systems with ransomware, notably Ryuk and Conti, for financial gain.”  While ransomware attacks against large hospital systems, health insurers, and public health entities grab headlines, medical practices of all sizes are at risk as well.

There are many steps that a business can take to improve its security, including stepping up employee training, hardening IT defenses, and implementing security patches on a timely basis.  It’s also an important time to purchase cyber insurance, if it isn’t already in place, and to review cyber coverage, if it is.  (In a recent survey by Travelers Insurance, 51% of businesses surveyed reported having purchased a cyber insurance policy.[3])  Cyber insurance packages together a broad range of coverages, including:

  • Coverage for business interruption losses arising from a computer network outage
  • Cybercrime coverage, covering losses from social engineering, phishing, and other types of financial fraud
  • Cyber extortion and ransomware coverage, including coverage for payment of a ransom demand
  • Coverage for third party claims alleging legal liability for damages related to a cyber event
  • Breach response and remediation expenses, including the cost to notify individuals affected by a breach, along with IT and attorney costs incurred to investigate and remediate a breach

The terms of cyber insurance policies can vary, so it’s important to consult with an agent or broker who’s knowledgeable about the coverage, and who can help you select coverages and limits that properly address the risks that a particular business faces.  Most cyber insurance policies also provide pre-loss mitigation services, to help avoid or mitigate a cyber event, at no or reduced cost, such as employee training or identification of network vulnerabilities.  In addition to reviewing the types of coverage offered, it’s important to review coverage limits in light of the business’s particular circumstances.

Cyber insurance, which has become increasingly important in recent years, is now more critical to have than ever, with changes brought about by the Covid-19 pandemic.  All businesses, and healthcare businesses, need to review their cyber insurance coverage, so that if a cyber incident occurs, the right resources are available to restore operations and minimize financial loss.

[1] Frequency of Cyber Events Targeting Businesses Increasing: Travelers, Insurance Journal, Dec. 11, 2020.

[2] Joint Cybersecurity Advisory – AA20-302A – Ransomware Activity Targeting the Healthcare and Public Health Sector (cisa.gov)

[3] Frequency of Cyber Events Targeting Businesses Increasing: Travelers, Insurance Journal, Dec. 11, 2020


 

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Physician & Other Healthcare Jobs. P/T & F/T – Check Us Out


Unique Rheumatology Practice Opportunity – Great Neck, NY
Partnership opportunity available at an established rheumatology practice in Great Neck, NY. Looking for a dedicated physician to join our practice or merge practices. Contact 516-972-2986 / susanrita1@msn.com for more info.

 

 

 

 

 

 

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MSSNY eNews: January 13, 2021 – Guidance for NYS COVID-19 Vaccination Program Effective 1/12/21

Guidance for NYS COVID-19 Vaccination Program Effective January 12, 2021


Gov. Cuomo Unveils Plan to Expand Telehealth Services at 2021 State of the State
At his initial State of the State address on Monday, Governor Cuomo announced plans to expand Telehealth coverage in 2021. Key proposed reforms include adjusting reimbursement incentives to encourage Telehealth, eliminating outdated regulatory prohibitions on the delivery of Telehealth, removing outdated location requirements, addressing lack of technical proficiency among both patients and providers through training programs, and establishing other policies that incentivize the use of Telehealth. However, we are awaiting further details – likely in next week’s Executive Budget proposal – as to how exactly these expansions would occur. More on the Governor’s proposals here:

Governor Cuomo Announces Proposal to Expand Access to Telehealth for All as Part of 2021 State of the State | Governor Andrew M. Cuomo (ny.gov)

The Governor and state agencies took very important steps early in the pandemic to help provide patients needed treatment from their physicians, virtually, by removing several barriers to the receipt of care through Telehealth. This was not only an important lifeline for patients and physicians, but it has also helped transform how care is delivered in New York.

MSSNY is working with a range of health care advocacy groups on passing comprehensive reform of New York’s Telehealth policies and we look forward to working with the Governor and the Legislature on this critical issue. (Joint Telehealth Letter)
(CARY)


DOH COVID-19 Update for Physicians Tomorrow January 14 @ 1-2 PM
Please join the NYS Department of Health Thursday, January 14th at 1-2 PM 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 providers:

https://coronavirus.health.ny.gov/weekly-healthcare-provider-update

Audio number and code: 844-512-2950 Access code 2191361#


DOH Webinar Recording of Vaccination Task Force Webinar
DOH and senior members of New York Governor Andrew Cuomo’s Vaccination Task Force held a webinar on Monday, January 11. The recording is available here.



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Cuomo One of Eight Govs Urging HHS To Give States More COVID-19 Vaccines
Eight governors signed a letter sent to HHS Secretary Alex Azar demanding that the federal government distribute more COVID-19 vaccines from its stockpile to the states.

In the Jan. 8 letter, the governors wrote their need for more vaccines is becoming more urgent each day as COVID-19 case surges continue and new variants of the coronavirus spread across the country.

“According to publicly reported information, the federal government currently has upwards of 50 percent of currently produced vaccines held back by the administration for reasons unknown,” the governors wrote. “While some of these life-saving vaccines are sitting in Pfizer freezers, our nation is losing 2,661 Americans each day, according to the latest seven-day average.”

The governors also wrote that the federal government’s failure to distribute more vaccines to states that request them is “unconscionable and unacceptable.”

It appears HHS is unlikely to heed the governors’ request, as a department spokesperson responded to the letter by telling Politico “there will always be a lag between shots allocated and those ordered, between those ordered and those delivered, between those delivered and those administered, and between those administered and reported as administered.”

The eight states with governors who signed the letter are New York, California, Illinois, Michigan, Wisconsin, Minnesota, Washington, and Kansas.


COVID-19 & Mental Health: Registration Now Open for Two CME Webinars
January 20, 2021 @ 7:30am Medical Matters: COVID-19 & Mental Health of Patients Click here to register

February 5, 2021 @ 7:30am Physician Wellness/Medical Matters COVID-19 & Mental Health of Physicians and Other Healthcare Providers Click here to register 

The COVID-19 pandemic has contributed to countless health problems over the past year, not the least of which are mental health related.  Learn more about how the COVID-19 pandemic has affected the mental health of patients on January 20th at 7:30am and how it has affected physicians and other healthcare workers on February 5th at 7:30am.  Dr. Craig Katz will serve as faculty for both webinars.

COVID-19 & Mental Health of Patients
January 20, 2021 @ 7:30am

  • Identify the usual scope of mental health reactions to disasters
  • Examine what is known so far about the mental health impact of COVID-19 on a range of populations!
  • Appraise the scope of COVID-19’s long term mental health impact on our communities!

COVID-19 & Mental Health of Physicians and Other Healthcare Providers
February 5, 2021 @ 7:30am

  • Examine the mental health risks posed by COVID-19 for physicians
  • Review the possible range of psychological and psychiatric responses to the pandemic!
  • Discuss principles and interventions for helping ourselves, our families, and our colleagues

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 each 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.


MSSNY – Medicare Part B 2021 Important Update from Anthem

MSSNY will be partnering with National Government Services to conduct a webinar on important changes for the Medicare Program in 2021.

Agenda Topics to include:

  • COVID-19 Public Health Emergency (PHE)
  • Telehealth
  • Evaluation & Management coding Changes in CY2021
  • 2021 Medicare Physician Fee Schedule (MPFS)
  • Final Policy, Payment, and Quality Provisions Changes to the MPFS for Calendar Year 2021
  • Quality Payment Program
  • Contact Information/Resources

James D. Bavoso
Provider Outreach & Education, Manager 

National Government Services
Office: (718) 351-2098| Fax: (315) 442-4103 |

james.bavoso@anthem.com | www.NGSMedicare.com |  www.NGSConnex.com


 

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The New York Society of Addiction Medicine (NYSAM) Invites You to a Webinar
“Expanding Use of Medications for Opioid Use Disorder Treatment in New York’s Jails and Prison”

When:     Wednesday January 20th, 2021 at 7:30-8:45 pm
Join   :     https://mssny.zoom.us/webinar/register/WN_x1TdhOyjSGKqzityllf82A
Costs:      Free (requires pre-registration)

Speakers:

Kevin Fiscella, MD MPH, Professor, Dept of Family Medicine, University of Rochester Medical Center

Jill Harrington, RN BSN CCHP-RN, Health Services Administrator, Albany County Correctional Facility

Jasdeep Mangat, MD, Medical Director, Substance Use Treatment, Correctional Health Services (New York City)

John Morley, MD, Chief Medical Office, New York State Department of Corrections and Community Supervision

In the two weeks following their release, people coming home from prison are 129 times more likely to die from a drug overdose than the general population. We have known this for years, but people across New York State are working to change this!

Please join us to learn about the American Society of Addiction Medicine’s policy statement on “Treatment of Opioid Use Disorder in Correctional Settings” and the progress being made in New York State to expand access to life-saving medications for opioid use disorder (MOUD) in jails and prisons.

Aaron Fox
Chair, Policy and Advocacy Committee
New York Society of Addiction Medicine


What the Incoming CDC Director Dr. Walensky Wants People to Know
Incoming CDC Director Rochelle Walensky, MD, said in a NY Times op-ed that she will lead “with facts, science and integrity” and work to restore public trust in the agency that she said has been undermined. Dr. Walensky rebuked White House interference in CDC guidance over the past year and said in the op-ed that on her first day she would ask Anne Schuchat, MD, the agency’s principal deputy director, “to begin a comprehensive review to ensure that all existing guidance related to Covid-19 is evidence-based and free of politics.”

She also said the nation needs to redouble its vaccination efforts, that she would inform elected officials and the public about pressing scientific information “even when the news is bleak,” that American public health infrastructure needs to be better funded, and that she would work to address healthcare inequities faced by communities of color.

“I promise to work with my colleagues at the C.D.C. to harness the power of American science and confront these challenges,” Dr. Walensky said. (Becker’s Hospital Review, Jan 12)


Scammers Selling COVID-19 Vaccines on the Dark Web
Sellers on the dark web are advertising COVID-19 vaccines for the price of hundreds and thousands of dollars in bitcoin but failing to deliver the product, according to a Jan. 13 CNBC report.

Cybersecurity firm Check Point found listings for COVID-19 vaccines on the dark web for as high as $1,000, with some advertisements contradicting official medical guidance on the number of shots required. After performing a search query for vaccines, Check Point found more than 340 ads on 34 pages on the dark web. The average median price of $250 for an unspecified vaccine dose has now risen to $500 to $1,000.

Firm researchers placed an order for a vaccine dose from a vendor they contacted on an encrypted messaging app and were offered a vaccine, developed in China, for $750 in bitcoin. After paying and sending their delivery address, the seller’s account was deleted and the package was never delivered, according to the report.

There were also several sellers who claimed to supply vaccine doses in bulk. One vendor advertised a 10,000-vial order for $30,000. Another vendor Check Point contacted offered to sell an unspecified COVID-19 vaccine for around $300 in bitcoin and claimed 14 doses were required. Click here to view the full report.


 

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Physicians’ search services • allied medical placements • locum tenens • practice valuation • practice brokerage • practice consulting • real estate

For help, information or to place your ad, call Christina Southard 516-488-6100 x355 • fax 516-488-2188


Physician & Other Healthcare Jobs. P/T & F/T  
Check us out @….bit.ly/38xkgDv


Unique Rheumatology Practice Opportunity – Great Neck, NY
Partnership opportunity available at an established rheumatology practice in Great Neck, NY. Looking for a dedicated physician to join our practice or merge practices. Contact 516-972-2986 / susanrita1@msn.com for more info.


 

 

 

 

 

 

 

 

 

MSSNY Welcomes Governor Cuomo’s Efforts to Expand Telehealth Services in New York

For Immediate Release
January 11, 2021 

 

MSSNY Welcomes Governor Cuomo’s Efforts to Expand
Telehealth Services in New York

 

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

“The physician community welcomes efforts announced by the Governor to expand Telehealth coverage in 2021. The Governor and state agencies took very important steps during the pandemic to help facilitate the ability of patients to receive needed treatment virtually from their physicians. This was not only an important lifeline for these patients and for these practices, it also has helped to significantly transform the delivery of care in the future.

“MSSNY has been working with a number of different health care advocacy groups in support of legislation that would help to make permanent some of these temporary changes, as well as ensure ‘payment parity’ for delivery of care via Telehealth.  Read Joint Telehealth Letter

“We look forward to working with the Governor and the Legislature on ensuring fair coverage for Telehealth services.”

# # #

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

 

Medical Society of New York (MSSNY) Welcomes Governor Cuomo’s Efforts to Expand Telehealth Services in New York

or Immediate Release
January 11, 2021

Medical Society of New York (MSSNY) Welcomes Governor Cuomo’s Efforts to Expand Telehealth Services in New York 

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

“The physician community welcomes efforts announced by the Governor to expand Telehealth coverage in 2021. The Governor and state agencies took very important steps during the pandemic to help facilitate the ability of patients to receive needed treatment virtually from their physicians. This was not only an important lifeline for these patients and for these practices, it also has helped to significantly transform the delivery of care in the future. MSSNY has been working with a number of different health care advocacy groups in support of legislation that would help to make permanent some of these temporary changes, as well as ensure ‘payment parity’ for delivery of care via Telehealth (http://www.mssnyenews.org/wp-content/uploads/2021/01/Joint-Telehealth-Letter-FINAL-2021-01-07-18_47_15-1.pdf)

“We look forward to working with the Governor and the Legislature on ensuring fair coverage for Telehealth services.”

# # #

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

 

Docs Upset by Nixing Due Process When Patients Make Unproven Allegations

For Immediate Release
January 10, 2021

 

Docs Upset by Nixing Due Process When Patients
Make Unproven Allegations

 

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

“It is stunning that after a year of physicians working on the front lines in every region of the State responding to the pandemic – in which many physicians themselves became very sick and some even passed away – that they are again faced with the proposal to eliminate essential due process rights when a complaint has been filed against them with the Office of Professional Medical Conduct.  When a similar proposal was advanced last year in the Executive Budget, we highlighted that very few complaints filed with the disciplinary board (roughly 2-3%) actually result in a disciplinary action.

“We remain committed to working with the Governor and the New York State Department of Health to protect our patients through maintaining a strong disciplinary process and addressing identified gaps. However, we remain extremely concerned with overbroad measures that hold serious potential to unfairly destroy a physician’s career through the release of allegations that have not been proven yet could remain easily “searchable” on the internet forever.”

# # #

 

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

 

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