Troy Oechsner Named Executive VP of Medical Society
February 17, 2021, Westbury, NY—The Medical Society of the State of New York (MSSNY) today announced that it has named Troy Oechsner as its new Executive Vice President. Oechsner is a veteran of State government who served as lead regulator of commercial health insurance at the Department of Financial Services as well as prosecutor of illegal and deceptive health care business practices with the New York State Attorney General. Most recently, Oechsner has been a partner at the consulting firm Manatt, Phelps and Phillips.
“We are thrilled to have Troy on board at MSSNY. He brings proven ability to effectively advocate for positive reforms that will protect the rights of doctors and their patients to affordable, accessible quality health care,” said Dr. Bonnie Litvack, MSSNY President. “Troy has a track record of effective management and leadership, and the ability to build coalitions among a broad section of health care professionals and consumers.”
“The Medical Society has worked successfully with Troy for decades,” said Dr. Andrew Kleinman, Chair of the MSSNY Board of Trustees. “He brings passion, knowledge and skill to the job that will help further the cause of physicians and patients. Troy is a welcome addition to the important work of the Society.”
“As a former insurance regulator and prosecutor, I recognize the many challenges faced by both physicians and patients,” said Oechsner. “Physicians have been leaders in the frontline battle against COVID. I am excited and honored to join the MSSNY team in our common fight to support doctors and patients seeking improved access to quality, affordable health care, guided by the physician’s training, experience and best practices.”
During over 30 years in State government, Oechsner helped lead many actions to improve health care for physicians and consumers. Oechsner was part of a team leading the implementation of the Affordable Care Act in New York, including the successful establishment of the state’s health insurance exchange marketplace – the New York State of Health. Oechsner was also instrumental in drafting and negotiating New York’s landmark Surprise Balance Billing Law that protected consumers from surprise bills from out-of-network doctors with a dispute resolution system fair to physicians and insurers.
Mr. Oechsner led an investigation by the New York Attorney General’s office into improper denials of specialty care by Aetna when it failed to acknowledge appropriate referrals to specialists. These actions resulted in a negotiated settlement with Aetna that assured fair reimbursement to the impacted physicians. Oechsner also helped initiate the investigation of Ingenix, which ultimately produced action by then Attorney General Cuomo to stop the manipulation of physician fee data, which was inappropriately increasing patient cost-sharing responsibilities for out-of-network care.
Oechsner succeeds Philip Schuh, CPA, who is retiring from MSSNY after a 35-year career at the Medical Society.
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 email@example.com
AMA Acknowledges that Founder, Dr. Nathan Davis, Allowed and Upheld Racism Today, the American Medical Association (AMA) is taking an important step to reconcile AMA’s past by acknowledging the harms that one of their founders, Dr. Nathan Davis, had in their organization’s history that allowed and upheld racism within the medical profession.
This Viewpoint from AMA CEO James L. Madara, MD, provides important details and context for this acknowledgment including AMA’s 2008 apology, recent actions by their Board and House of Delegates, and the work underway through the AMA Center for Health Equity. By acknowledging the past, the AMA is embracing a discussion about how to begin to heal past harms.
Pfizer COVID-19 Vaccine Cuts Symptomatic Cases By 94%, Data Shows COVID-19 infections fell by 94 percent among people who received two doses of Pfizer’s vaccine, according to a study by Clalit, the largest healthcare provider in Israel. Clalit studied symptomatic COVID-19 infections among 600,000 people who received two doses of Pfizer’s vaccine and compared them to an unvaccinated group of the same size (WSJ) reported Feb. 15. The study included 430,000 participants between ages 16 and 59 and 170,000 participants ages 60 and older, Clalit said.
The study also found that Pfizer’s vaccine reduced cases of severe illness from COVID-19 by 92 percent. (Becker’s Hospital 2/18)
Physicians See Spike in Rare Inflammatory Condition Linked to COVID-19 Physicians are reporting a significant uptick in cases of multisystem inflammatory syndrome in children, a rare inflammatory condition potentially linked to COVID-19, reports The New York Times. The condition, known as MIS-C, typically emerges several weeks after COVID-19 infection and causes symptoms like fever, inflammation and poor organ function. Physicians said these cases are not just becoming more common, but also more severe.
“We’re now getting more of these MIS-C kids, but this time, it just seems that a higher percentage of them are really critically ill,” Roberta DeBiasi, MD, chief of infectious diseases at Children’s National Hospital in Washington, D.C., told the Times. About 80 percent to 90 percent of Children’s National patients with MIS-C need intensive care, up from about half of patients in the spring, according to Dr. DeBiasi. Children’s Hospital & Medical Center in Omaha saw about two MIS-C cases per month between April and October 2020, with about 30 percent of patients needing intensive care. This jumped to 10 cases in December and another 12 in January, with about 60 percent needing ICU care.
It is unclear why cases are rising, and experts say it is too early to speculate whether virus variants are influencing these numbers. Overall, MIS-C is still a rare condition. As of Feb. 8, the CDC had confirmed 2,060 cases nationwide, including 30 deaths.
Vaccine Will Be Available to All Americans By Late July, President Biden Says For the first time in 2021, no state is reporting a seven-day COVID-19 case average higher than 10,000 as of Feb. 16, reports The COVID Tracking Project.
President Joe Biden also said that every American who wants to receive a COVID-19 vaccine will be able to get one by the end of July during a town hall meeting hosted by CNN Feb. 16.
The federal government will increase states’ collective vaccine allocation to 13.5 million doses each week, White House Press Secretary Jen Psaki said Feb. 16. The U.S. is also doubling its supply for pharmacies to 2 million doses weekly through a new federal program, Ms. Psaki said.
Moderna expects to deliver 300 million vaccines to the U.S. government by the end of July, according to a Feb. 16 update. About 25.5 million doses of the Moderna vaccine have been administered in the U.S. thus far, according to a CDC communication with Moderna.
2021 E/M Coding Changes: Are You Leaving Money on the Table? Limited to 25 Attendees
Two convenient time slots for “2021 E/M Guideline Changes Course Description Many physicians are still struggling when it comes to implementing these historic changes into their day-to-day workflow. Garfunkel Health Advisors is offering an interactive event on Documentation & Coding Compliance following the new E/M Coding Guidelines.To help ensure you get the most out of the live session, participation will be limited to 25 participants and you may submit questions in advance, specific to your practice and specialty. During the event we will:
Share our knowledge and experience
• Answer your questions
• Discuss tips and best practices
• Review Time vs MDM opportunities
• Wave the caution flag in areas of potential audit risk
Alicia Shickle President, Documentation and Coding/Audit Division of Garfunkel Health Advisors, Inc
Discounted pricing for MSSNY members:
◊ Member rate $150
◊ Non-member rate $300
Garfunkel Health Advisors, Inc. Garfunkel Wild is pleased to announce the launch of Garfunkel Health Advisors, Inc., a healthcare consulting subsidiary providing strategic and operational advice to the healthcare industry
43% of Patients Check a Pharmacy Comparison App for Prescription Savings Americans are becoming increasingly curious about ways to lower their prescription drug costs, according to recent survey results released by healthcare software company CoverMyMeds.
CoverMyMeds surveyed patients, providers and pharmacists during September and October. One thousand patients, 400 providers and 328 pharmacists participated in the survey, the results of which were released Jan. 25.
Sixty-two percent of patients seek information from their provider about medication costs and affordability options.
Forty-three percent of patients said they checked a pharmacy comparison app to find cheaper medication prices, up from 28 percent the previous year.
More than a third of pharmacists said they saw patients use prescription price shopping tools on a daily basis. (Feb. 15 Becker’s Hospital Review)
Northwell Sues Insurers for Denying Pandemic-Related Claims
New York’s largest health care provider is suing two out-of-state insurance companies for denying claims related to business-interruption insurance policies and the Covid-19 pandemic.
Northwell Health, home to more than 21 hospitals in the metropolitan area, is suing Boston-based Lexington Insurance Co. and Chicago-based Interstate Fire & Casualty Co. for breach of contract for their refusal to honor an “all risk” property policy.
In the lawsuit, filed in the Southern District of New York, Northwell contends it suffered “significant property and business-interruption losses arising out of the novel coronavirus outbreak and ongoing Covid-19 pandemic,” and the defendants “have refused to compensate Northwell for its losses.”
Northwell alleges that the defendants denied coverage in its entirety Oct. 30 based on a “pollution” exclusion endorsement. The health system says the defendants’ interpretation of the pollution exclusion contravenes the plain meaning of the language, and the policy contains coverage for communicable diseases, confirming that a virus can cause loss of or damage to property.
Northwell says both defendants have refused to pay any amount to date, with currently assessed damages listed as “hundreds of millions of dollars.” The health care provider alleges its policies with the defendants provide almost $1.3 billion in coverage, with Lexington covering 90% of the share, and Interstate covering 10%. (Crain’s Feb. 16)
The Importance of Community-Based Organizations During the Pandemic With the COVID-19 national emergency, many people are facing unprecedented challenges. Some have lost their jobs and have lost health insurance coverage for themselves and their families. Others may be underinsured with unaffordable health coverage, or may have health insurance, but are not sure how to access the services that they need for their health problems.
With these uncertainties, Community-Based Organizations (CBOs) are key players who can help link community members to valuable resources, including how and where to obtain health insurance. CBOs also play a major role in educating community members about COVID-19 vaccines, raising awareness about the benefits of vaccination, and addressing common questions and concerns. As many communities are waiting for their turn to get the vaccine, CBOs can encourage them to take the time to consider their health insurance coverage.
What can CBOs do now to help your community access valuable resources on the vaccine and health insurance coverage?
Use the NEW Community-Based Organizations COVID-19 Vaccine Toolkit. Soon the communities you serve will have access to vaccines to help protect against COVID-19. CDC has designed a toolkit to help CBOs educate communities about this important new prevention tool. This toolkit is designed for staff of organizations serving communities affected by COVID-19.
Share COVID-19 Vaccine information and Resources with the communities that you serve. Here’s some messaging to share with your communities through newsletters, e-mail listserv announcements or other channels:
You can receive the COVID-19 vaccine at no cost. People without health insurance or whose insurance does not provide coverage of the vaccine can also get the COVID-19 vaccine at no cost.
Link community members to information on how to obtain health insurance or use their existing coverage:
Consumers can take advantage of a special enrollment period (SEP) for individuals and families to apply and enroll in the coverage they need starting February 15, 2021 through May 15, 2021. This SEP will be available to consumers in the 36 states served by Marketplaces that use gov. Read the press releasehere.
Those in states with State Based Exchanges should check their state’s exchange website to find out specific enrollment options for their state. Go to gov to find out more information or be directed to your state’s exchange.
The From Coverage to Care initiative, has resources such as the Roadmap to Better Care to help consumers understand their health coverage and connect to primary care and the preventive services that are right for them.
Continue to promote safe practices and vaccine safety and encourage your community members to get the vaccineonce it becomes available to them:
Remind them to continue practicing the 3Ws (Wear a Mask, Watch your distance, Wash your hands).
CMS: What Partners Need to Know Now About Health Insurance During Pandemic As COVID-19 vaccines begin rolling out across the country, CMS is taking action to protect the health and safety of our nation’s patients and providers and keeping you updated on the latest COVID-19 resources from HHS, CDC, and CMS.
With information coming from many different sources, CMS has compiled resources and materials to help you share important and relevant information on the COVID-19 vaccine with the people that you serve. You can find these and more resources on the COVID-19 Partner Resources Page and the HHS COVID Education Campaign page. We look forward to partnering with you to promote vaccine safety and encourage our beneficiaries to get vaccinated when they have the opportunity.
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