MSSNY Applauds Legislation to Expand Medicaid and CHIP Coverage for Telehealth to Include “Audio-Only” Services


MSSNY Seal
MEDICAL SOCIETY OF THE STATE OF NEW YORK
865 Merrick Avenue, Westbury, New York 11590-9007
www.mssny.org
Communications Division
Telephone: (516) 488-6100

 

For Immediate Release
May 28, 2020

MSSNY Applauds Legislation to Expand Medicaid and CHIP Coverage for Telehealth to Include “Audio-Only” Services

Statement Attributable to:
Bonnie Litvack, M.D.
President, Medical Society of the State of New York

“We applaud Senator Metzger and Assemblymember Rosenthal for advancing their legislation (A.10404-A/S.8416) to expand Medicaid and CHIP coverage for telehealth to include “audio-only” services.  During this pandemic, telemedicine availability has been an absolutely essential modality for our patients to continue to receive needed medical services from their physicians.

“The Cuomo Administration, through the New York State Department of Health (DOH) and Department of Financial Services (DFS), took critically important steps in mid-March to remove barriers to telehealth coverage for commercial and state-sponsored insurance programs, including ensuring that telephone conversations between patients and their physicians were covered.  This is particularly important for many of our patients who do not possess adequate video-enabled technology to conduct audio-visual telehealth visits with their physicians.  Recognizing this concern, CMS also took the step of expanding audio-only telehealth coverage for our senior patients covered by Medicare.

“As we enter a new phase in confronting the pandemic, and preventing against a second “surge”, MSSNY has been urging that this expanded coverage for telehealth be continued across the health insurance coverage spectrum.  This legislation would ensure that this expanded coverage continues for the Medicaid and CHIP programs, a standard which we would also urge DFS to continue to require of state-regulated commercial health insurance plans.”

# # #

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

 

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

 

Facebook Icon Twitter Icon

 

COVID-19 Update May 28, 2020

.

Gov. Cuomo’s Daily Press Conference Highlights

-Total hospitalizations and intubations is down
– 163 new COVD cases as of yesterday
– 74 lives lost yesterday (52 in hospitals, 22 in nursing homes)

Governor’s Opinion:
– I understand what states and Governors must do, but what is Washington going
to do?
– Analysis from May 4 shows that NYS only received about $24K per positive
COVID case, compared to Kentucky who received about $338K per positive case
– – Governor reiterated that corporations that accept federal aid, must rehire
the same amount employees that were fired

Reopening NYC:
– Contact Tracing needs to be worked on before reopening
– Focus on troubled areas
– More cases are coming from outer-borough, minority, lower income
communities with people who are currently unemployed

– NYS is partnering with Northwell Health to bring more healthcare
services to impacted communities
– There are more than 225 testing sites in NYC, but many are being underused
– 1M masks will be delivered to hard hit communities
– Executive order will be signed today authorizing businesses to deny entry to those
who do not wear face mask or coverings

Q&A:
Federal Aid:
– According to DeRosa, the state will realize a savings through a hiring freeze,
a voluntary pay increase deferment from unionized labor as well as from
management confidential employees

Testing & PPE:
– Perez commended today’s executive order stating that it will help decrease
instances in which conflict/anxiety occurs due to some customers not wearing masks
– According to DeRosa, only 10 states are currently providing probable and confirmed
death data


There Were 364,965 Confirmed COVID-19 Cases in New York as of Wednesday.


MSSNY President Voices Support for Bill to Curb Price Gouging of Essential Medical Supplies
MSSNY President, Dr. Bonnie Litvack, MD, voiced support for the passage of A.10270 (Rozic)/S.8189 (Hoylman), which would expand New York’s anti-“price gouging” statute to include “unconscionably excessive” prices charged by vendors for essential medical supplies used by physicians every day in their practices, such as PPE and hand sanitizer.  The bill passed the Senate and Assembly during its legislative session this week. “Even though the COVID19 acute crisis has begun to subside around the state, New York physicians still face enormous challenges as they work to fully reopen their practices to treat their patients,” said Dr. Bonnie Litvack, MD, President of the Medical Society of the State of New York (MSSNY).

“Chief among those challenges is the dangerous shortage of Personal Protective Equipment (PPE) due to a variety of factors including refusal by some suppliers to sell to smaller physician practices and/or charging enormously marked-up prices. This legislation sets forth important steps to better ensure that PPE sellers will deal more fairly with community physicians and other care providers to enable them to get the critical supplies they need to get back to treating their patients and serving the communities where they live.” (CARY, AUSTER)


Legislature Passes Measure to Expand Whistleblower Protections for Healthcare Workers
The Senate and Assembly passed a measure this week (S.8397-A, Savino/A.10326-A. Reyes), which would provide New York healthcare workers with greater “whistleblower” protections to reduce the risk of employers penalizing employees for filing complaints against them.

New York’s Labor Law provides healthcare workers with some whistleblower protections but does not specifically address disclosures to the public made via new platforms like social media. This legislation would provide medical professionals with greater legal protections against employer retaliation regarding public reports raising concerns with workplace safety conditions.   The sponsor’s memo in support of this legislation notes that the legislation is in response to concerns raised by many healthcare professionals during the pandemic that the institution where they practiced did not provide them sufficient PPE.

If signed into law by the Governor, the law would take effect immediately.
(CARY, AUSTER)


Legislature Passes Measure to Expand Medicaid Coverage for Audio-Only Telehealth
The Senate and Assembly passed a measure this week (A.10404-A, Rosenthal/S.8416) that permanently expands coverage for telemedicine in Medicaid and the Child Health Plus Insurance program to include “audio-only” services. Given the importance of making sure patients with limited access to video technological services could maintain continuity of care with their physician, Medicaid has been covering audio-only telehealth services since mid-March.  MSSNY President Dr. Bonnie Litvack issued a statement praising the legislation and urging that it be continued as well for all forms of insurance coverage.

“We applaud Senator Metzger and Assemblymember Rosenthal for advancing their legislation (A.10404-A/S.8416) to expand Medicaid and CHIP coverage for telehealth to include “audio-only” services.  During this pandemic, telemedicine availability has been an absolutely essential modality for our patients to continue to receive needed medical services from their physicians.

The Cuomo Administration, through the New York State Department of Health (DOH) and Department of Financial Services (DFS), took critically important steps in mid-March to remove barriers to telehealth coverage for commercial and state-sponsored insurance programs, including ensuring that telephone conversations between patients and their physicians were covered.

This is particularly important for many of our patients who do not possess adequate video-enabled technology to conduct audio-visual telehealth visits with their physicians.  Recognizing this concern, CMS also took the step of expanding audio-only telehealth coverage for our senior patients covered by Medicare.

As we enter a new phase in confronting the pandemic, and preventing against a second “surge”, MSSNY has been urging that this expanded coverage for telehealth be continued across the health insurance coverage spectrum.  This legislation would ensure that this expanded coverage continues for the Medicaid and CHIP programs, a standard which we would also urge DFS to continue to require of state-regulated commercial health insurance plans.” (AUSTER)


MLMIC Banner


Research Indicates Five-Day Course of Remdesivir Works as Well As 10-Day Course for Patients with Severe COVID-19
Reuters reports that “Gilead Sciences Inc, which has suggested that a shorter treatment duration could extend limited supplies of its drug remdesivir,” has “published results of a study showing no significant difference in outcomes between 5-and 10-day courses of the drug for patients with severe COVID-19.” The findings were published in the New England Journal of Medicine.


“2nd Wave ‘Is Not Inevitable,” Dr. Fauci Says; CDC Clarifies Message on Virus Transmission — 5 Covid-19 Updates
Reported U.S. deaths related to COVID-19 have surpassed 100,000, with 100,442 deaths and 1,699,933 COVID-19 cases reported as of 7:45 a.m. CDT May 28. Globally, there have been 5,716,570 reported cases and 356,131 deaths, while 2,367,292 have recovered.


Five Updates:

  1. The coronavirus can spread by touching a contaminated surface and then touching the mouth, nose or eyes, though this isn’t thought to be the main form of transmission, according to the CDC. The clarification comes after the agency updated its website last week to say that the virus doesn’t spread easily via surface transmission. The update was “to make it easier to read, and was not a result of any new science,” according to the CDC. The primary and most significant mode of transmission is close contact with others, the agency reiterated.
  2. A second wave “could happen but is not inevitable,” Anthony Fauci, MD, said during a May 27 interview on CNN‘s “Newsroom.” The nation’s top infectious disease physician said broad efforts to identify and isolate COVID-19 patients through contact tracing could help prevent the virus’s resurgence this fall. Dr. Fauci also commented on the use of the antimalarial drug hydroxychloroquine as a potential COVID-19 treatment during the interview. “The scientific data is really quite evident now about the lack of efficacy for it,” he told CNN.
  3. The WHO Foundation was created to broaden the World Health Organization’s donor base and achieve ‘sustainable and predictable’ funding, according to a May 27 announcement. The entity is legally separate from WHO and will facilitate contributions from the public, individual major donors, and corporate partners. After President Donald Trump said May 18 that he may pull all WHO funding from the U.S., agency officials voiced concern regarding emergency programs. The WHO Foundation will initially focus on emergencies and response to the pandemic.
  4. “The jury is still very much out” on whether COVID-19 antibodies provide immunity against reinfection, Mike Ryan, MD, executive director of the WHO’s emergencies program, said. May 26. Scientists are still learning about the virus SARS-CoV-2 and the disease COVID-19, including how immune systems respond once a person is exposed to the virus, according to WHO officials.
  5. More than 2.1 million Americans filed for unemployment last week, according to new data from the U.S. Department of Labor. This marks the eighth consecutive week of decline in unemployment figures, although the number of people seeking financial assistance is still about 10 times higher than before lockdowns started in March, according to The Wall Street Journal (Becker’s Hospital Review May 28)

Cuomo to Sign Executive Order Allowing Businesses to Deny Entry to Customers Without Masks
New York Gov. Andrew Cuomo said today he will sign an executive order allowing private businesses to deny entry to customers who are not wearing face coverings.

“We made them mandatory in public settings, public transportation etc., but when we’re talking about reopening stores and places of business, we’re giving the store owners the right to say, ‘if you’re not wearing a mask, you can’t come in,” Cuomo said during his daily press briefing.

Store owners have a right to protect themselves and other patrons, he said.

“You don’t want to wear a mask? Fine, but you don’t have a right to then go into that store if that store owner doesn’t want you to,” the governor added.


Ad Banner for Health Connections Corp.


 

 

 

 

 

MSSNY COVID-19 Update – May 28, 2020 (Latest Alerts, SBA Loans, Health & Safety)

Physicians are required to report suspect cases to their local department of health.

Jump to: Alerts; Health; Finance; Volunteering and Donations; Testing; Telehealth; Patient Information; Statistics; Webinars; Fraud; Research; Additional Information;


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


Coronavirus Magnified

Alerts and Notifications


Please join the NYS Department of Health 

Thursday May 28th at 1-2PM for

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 

For audio only, please dial in: 844-512-2950


COVID-19 Updated Guidance for Hospital Operators Regarding Visitation


Contact Tracing Opportunities in NYS

Interim Guidance for Reopening the Health Care System & Best Practices for Reopening From COVID-19

CDC Weekly Key Messages (Updated May 1)

COVID-19 update for healthcare providers (Recorded)

MSSNY 2020 House of Delegates in Tarrytown Postponed (Updated April 21)

Physician’s Resource Page (Updated)


Health and Safety

Interim Guidance on Executive Orders 202.17 and 202.18 Requiring Face Coverings in Public During the COVID-19 Outbreak

Requiring Face Coverings for Public and Private Employees Interacting with the Public

COVID-19 and the Use of Cloth Face Coverings

Ensuring the Safety of Our Direct Caregivers

Nursing Home COVID-19 Preparedness Self-Assessment Checklist

Health Advisory: COVID-19 Updated Guidance for Hospital Operators Regarding Visitation

Advance Care Planning Recommendations During COVID-19


Finance

Applications for SBA Loans

FAQs on Medicare Fee-for-Service (FFS) Billing

CMS Approves Approximately $34 Billion for Providers with the Accelerated/Advance Payment Program for Medicare Providers in One Week

Request for Accelerated/Advance Payment

With $349 Billion in Emergency Small Business Capital Cleared, SBA and Treasury Begin Unprecedented Public-Private Mobilization Effort to Distribute Funds

Social Security Benefits Will be Paid on Time and Other Updates Related to the COVID-19 Pandemic

Trump Administration Provides Financial Relief for Medicare Providers

Trump Administration Approves 34th State Request for Medicaid Emergency Waivers

Special Coding Advice During the COVID-19 Crises

Tax Day now July 15: Treasury, IRS extends filing deadline and federal tax payments regardless of amount owed


Volunteering and Donations

Healthcare Workers! New York City Needs You Now!

Nasopharyngeal Swabs Urgent Appeal!

Do You Have Medical Services or Equipment to Donate?

PPE shortage – How to make a request, and steps to preserve equipment

Additional Qualified Health Professionals Needed


Testing

Guidance for Private Physician Practices Operating Specimen Collection Sites

Should ibuprofen be Used to Treat COVID-19?


Telehealth

How to Set Up Free Telemedicine for Your Patients (Video)

If you’re using Zoom for teleconferencing, read this FBI report on “zoom-bombing” which is on the increase.

Frequently Asked Questions Regarding Use of Telehealth Including
Telephonic Services During the COVID-19 State of Emergency

Humana Telehealth Update

Emergency Medical Aid and Telemedicine

Comprehensive Guidance Regarding Use of Telehealth 

Expansion of Medicare coverage for telehealth (so it is no longer limited to rural areas)

Assuring physicians can use Facetime and Skype for telehealth without worrying about HIPA

COVID-19 Physical, Occupational and Speech Therapy Telehealth

Telehealth Insurance Circular Letter No. 6 (2020)
Reminder that private insurers must cover telehealth services for patients (including those provided through a smartphone) and without patient cost-sharing.

COVID-19 Telephonic Communication Services
Since Medicare still requires telemedicine to be provided only to patients in a rural setting, you should look at “virtual check-in” services under codes  G2010, G2012, 99421, 99422 and 99423.

State regulated insurers re: required telehealth coverage for all health care services without patient cost-sharing “including technology commonly available on smartphones and other devices”.

Telehealth Benefits in Medicare are  a Lifeline for Patients During Coronavirus


May 27 Statistics

New York State: 364,965 confirmed cases, 23,643 deaths. New York City: 197,351 confirmed cases; 16,650 deaths; 40,034 Nassau; 39,258 Suffolk; 33,186 Westchester; 13,047 Rockland; 1,796 Albany. For a complete NYS county list, click here.

United States: 1,703,789 confirmed; 100,651 deaths; 70,337 recovered. World Count: 5,731,837 confirmed; 356,606 deaths.


SBL Frauds and Scams 

FBI Sees Rise in Fraud Schemes Related to the Coronavirus Pandemic

Small Business Scams and Fraud

New funding for Coronavirus SBA loans attracts scammers


Research

Authorization of Licensed Pharmacists to order COVID-19 Tests

Pediatric Multi-System Inflammatory Syndrome Temporally Associated with COVID-19 Interim Case Definition in New York State

Pediatric Multi-System Inflammatory Syndrome Potentially Associated with Coronavirus Disease (COVID-19) in Children


Webinars/Podcasts

Re-Opening Your Medical Practice in COVID-19 Era (Prerecorded)

Registration Now Open for Veterans Matters CME Webinar – June 3, 2020

Veterans Matters: PTSD in Returning Veterans Podcast Part I

Veterans Matters: PTSD in Returning Veterans Podcast Part II


Additional Information

Stimulus Package Passed by Congress Provided Several Programs to Aid Physicians Through this Crisis
As reported in an AMA summary of the $2 trillion stimulus package enacted into law last Friday, here are some of the key provisions to benefit physicians:

Small business loans. Small businesses, including physician practices, with no more than 500 employees are eligible to apply for the Small Business Administration’s (SBA) section 7(a) Payroll Protection Program. For more information on how physicians can access this program, click here.

This allows a small business to apply to an SBA-approved lender for a loan of up to 250% of the business’ average monthly payroll costs to cover 8 weeks of payroll as well as help with other expenses like rent, mortgage payments, and utilities. The maximum loan amount is $10 million. Sole-proprietors, independent contractors, and other self-employed individuals are eligible.

A loan can be forgiven based on maintaining employee and salary levels. For any portion of the loan that is not forgiven, the terms include a maximum term of 10 years, a maximum interest rate of four percent. Small businesses and organizations will be able to apply if they were harmed by COVID-19 between February 15, 2020 and June 30, 2020. This program is retroactive to February 15, 2020andare available through June 30, 2020.

Emergency loans.  Moreover, there was also Authorization for $10 billion in “emergency” Economic Injury Disaster Loan (EIDL) to eligible entities with not more than 500 employees. Allows an eligible entity that has applied for an EIDL loan to request an advance on that loan, of not more than $10,000, which the SBA must distribute within 3 days. Advance payments may be used for providing paid sick leave to employees, maintaining payroll, meeting increased costs to obtain materials, making rent or mortgage payments, and repaying obligations that cannot be met due to revenue losses

Financial support for hospitals, physicians, and others. Provides $100 billion through the Public Health and Social Services Emergency Fund to provide immediate financial relief by covering non-reimbursable expenses attributable to COVID-19. Health care entities, including physician practices, that provide health care, diagnoses, or testing are eligible. Non-reimbursable expenses attributable to COVID-19 qualify for funding.

Examples include increased staffing or training, personal protective equipment, and lost revenue. HHS is instructed to review applications and make payments on a rolling basis to get money into the health system as quickly as possible. HHS is given significant flexibility in determining how the funds are allocated and is expected to release guidance on the application process shortly.


Business Loan Forgiveness Included in CARES Act
Within the Coronavirus Aid, Recovery and Economic Security (CARES) Act that President Trump signed yesterday is a $350 billion Paycheck Protection Program that will allow businesses and nonprofits with fewer than 500 employees to apply for loans up to $10 million each to cover losses caused by the COVID-19 pandemic. 

What makes this relief even more significant is the possibility of loan forgiveness, which is available to employers who retain their workforce levels through the crisis. If you follow the guidelines carefully, you can essentially convert your business loan to a grant – even if you’ve already laid off employees.

Loan Forgiveness Requirements

Loans may be forgiven if businesses use the money to pay for payroll costs, salaries, benefits, mortgage interest, rent and/or utilities.  The forgiven amount would be equal to the amount actually paid for these expenses during the eight weeks following disbursement of the loan. Additional wages paid to tipped employees under Section 3(m)(2)(A) of the Fair Labor Standard Acts may also be forgiven.

Forgiveness will be scaled back if the business has a reduction in employees, salaries or wages. Reductions in workforce, salaries and wages that occur from February 15, 2020 to April 26, 2020 will be disregarded for purposes of reducing the forgiveness amount, as long as the reductions are eliminated by June 30, 2020.

For purposes of the loan forgiveness, a reduction in workforce and salary or wages will be calculated as follows:

  • Workforce reductions will be calculated by the initial forgiven amount multiplied by the quotient of average full-time equivalents (FTEs) during the eight-week period, divided by the average FTEs for the period from February 15, 2019 through June 30, 2019 or January 1, 2020 through February 29, 2020, as determined by the loan recipient.
  • Salary or wage reductions will be determined by the amount of any salary or wage decrease in excess of 25 percent of the total salary or wages during the most recent full quarter such employee was employed before the eight-week period. Only employees who did not receive, during any single pay period during 2019, wages or salary at an annualized rate of pay in excess of $100,000 are included in this calculation.

Advance Medicare Payments to Help Physicians Through this Period
Moreover, CMS announced over the weekend a process for physicians to receive 100% of predicted Medicare payments for a 3-month period ( Fact Sheet: Advanced Payment Program During COVID-19 Emergency).  Here is a recommended process for applying for these advanced payments shared with MSSNY by a medical practice, as well as some of the particulars of this program:
Process:

1. Go to your National Government Services (NGS) website and fill in, sign, and submit an Accelerated / Advance Payment request form for your practice.

2. Can request up to 100% of Medicare payment for a 3-month period.

3. Check box 2 (“Delay in provider/supplier billing process of an isolated temporary nature beyond the provider’s/supplier’s normal billing cycle and not attributable to other third-party payers or private patients.”); and

3. State that the request is for an accelerated/advance payment due to the COVID-19 pandemic

4. Will receive payment within seven calendar days from the request.

5. Recoupment will begin 120 days after payment issuance date.

 Eligibility:

1.     Have billed Medicare for claims within 180 days immediately prior to the date of signature on the provider’s/supplier’s request form,

2.     Not be in bankruptcy,

3.     Not be under active medical review or program integrity investigation, and

4.     Not have any outstanding delinquent Medicare overpayments.

For further information, contact Regina McNally, VP of MSSNY’s Socio-Economic

Division at 516-488-6100 ext.332 or email rmcnally@mssny.org.



Questions:

• NYS has a coronavirus hotline at 1-888-364-3065.
• The New York State Department of Health has established a provider email account for physicians to ask questions about COVID-19: Covidproviderinfo@health.ny.gov

COVID-19 Update May 27, 2020


Please Join NYSDOH Update for Physicians Tomorrow 1-2 PM 

For audio only, please dial in: 844-512-2950
Please share with your healthcare provider members- 

Please join the NYS Department of Health 

Thursday May 28th at 1-2PM forCOVID-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:

For audio only, please dial in: 844-512-2950


48% of Americans Delayed Care in Pandemic; Tests May Be Wrong Half the Time
The U.S. has reported 1,681,418 COVID-19 cases and 98,929 related deaths as of 7:45 a.m. CDT May 27. Globally, there have been 5,614,458 reported cases and 350,958 deaths, while 2,307,510 have recovered.


Five COVID-19 Updates:

1. COVID-19 antibody tests are wrong nearly half the time, according to the CDC. Serologic tests meant to measure past COVID-19 exposure or infection are not accurate enough to use to make policy decisions, the CDC said. Healthcare providers should use the most accurate antibody test available and may need to test people twice. If only a small percent of people being tested have been exposed to the virus, even a small margin of error can be significant — if 5 percent of the population tested has the virus, a test with more than 90 percent accuracy could still fail to detect half the cases.

2. Forty-eight percent of Americans said they or someone in their household have postponed or skipped medical care due to the pandemic, according to a poll by Kaiser Family Foundation. The phone survey was conducted May 13-18 among 1,189 U.S. adults. As restrictions ease, many (68 percent of those who delayed care; 32 percent of all adults) expect to receive the care they delayed over the next three months.

3. New cases are increasing in about a dozen states, according to The New York Times, at least half of these states — including Alabama, Florida, Georgia, South Carolina, and Tennessee — started reopening in late April and early May. NYT said the new cases could reflect increased testing capacity in some areas. Former FDA Commissioner Scott Gottlieb noted during an interview with CNBC‘s “Squawk Box” there is also “a small uptick” in hospitalizations that “is probably the result of reopening.”

“I’m concerned that there are people who think that this is the all-clear,” he said.

4. One-third of Americans show signs of clinical anxiety or depression, according to a U.S. Census Bureau survey cited by The Washington Post.The agency polled adults from more than 42,000 households between May 7-12. Twenty-four percent of Americans showed clinically significant symptoms of major depressive disorder and 30 percent had symptoms of generalized anxiety disorder. These figures demonstrate a large jump from depression and anxiety rates seen before the pandemic.

5. The CDC shared a new guidance on when confirmed or suspected COVID-19 patients can end self-isolation practices. Patients can be around others if they have gone three days with no fever, their symptoms have improved, and it has been 10 days since symptoms first appeared. Asymptomatic patients who tested positive for COVID-19 can be around others after 10 days. (Becker’s Hospital Review, May 27)


WHO Warns Of ‘Second Peak’ Before Second Wave
The world could see a “second peak” of COVID-19 cases before a presumed second wave comes this fall, Dr. Mike Ryan, executive director of the World Health Organization’s emergencies program, said during a May 25 media briefing.

Dr. Ryan said the world is still in the middle of the first wave, citing areas like Africa and South Asia where cases are steadily rising. He warned against making any assumptions about the pandemic’s trajectory just because cases are falling in some areas. Countries cannot assume they will have a few months to get ready for a second wave, Dr. Ryan said.

“We need to be cognizant of the fact that the disease can jump up at any time,” he said. “We may get a second peak in this wave… It is crucial for countries to implement a comprehensive strategy involving testing, surveillance, and other public health measures to “ensure we continue to have an immediate downward trajectory” in cases, Dr. Ryan concluded.

To view the full media briefing, click here. (Becker’s Hospital Review, May 26)


MLMIC Banner


Webinar: Re-Opening Your Medical Practice in COVID-19 Era
On June 4, MLMIC and HANYS will host “Emerging From COVID-19: Guidelines for Re-opening Healthcare.” This webinar will provide a strategic roadmap to help medical practices safely and efficiently return to normal operations. Read more at MLMIC.com


Zocdoc Concerns MSSNY Physicians, Again
Recently, the MSSNY leadership had a few meetings; whereby, many physician members expressed much dismay seeing their names on Zocdoc’s website/database.  MSSNY addressed a similar problem last year.  Many physicians who have no agreement with Zocdoc do NOT want to be listed on the Zocdoc website.

It is considered by many physicians to be inappropriate and misleading to the patient community.  MSSNY contacted Zocdoc to urge correction of this misleading information.  Physicians without a Zocdoc agreement should be removed from the website/database.  The statement that the physician has no online appointments available is misleading since the statement is used when a physician does not participate with Zocdoc.  Patients have no idea if a doctor has appointments outside of Zocdoc and may not take further steps to contact the physician.

Zocdoc has advised that they would remove individual pages at the applicable physician’s request.  Any physician who would prefer their page removed from Zocdoc’s website can contact Zocdoc, directly at service@zocdoc.com

Zocdoc will work directly with the physician to remove the physician’s page.

On a related note, MSSNY’s Task Force on Telemedicine is currently in the process of vetting vendors to partner with to offer a statewide telemedicine platform for our members.


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

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

The first is to alert patients in communities which physicians can provide virtual care during this pandemic.

Second, regarding forward thinking, it would be helpful for CMS to know which and how many physicians can provide telemedicine. This information would be useful in making the argument of continuing the expanded telemedicine coverage in a post pandemic future.

If you are capable of providing telemedicine, please provide MSSNY with your name, address, specialty, phone and NPI number. This information will be added to MSSNY’s website and shared with your county societies.  CMS would also help in disseminating the information to the patient community.


New York Pharmacist Arrested in N95 Profiteering Scheme
Richard Schirripa, a licensed pharmacist in New York City, was charged May 26 with violating the Defense Production Act by allegedly hoarding and hiking the price of thousands of N95 masks.  Mr. Schirripa allegedly bought $200,000 worth of N95 masks from the black market between February and April and sold thousands of them at severely inflated prices.

He often sold them out of his car and charged up to $25 for a mask that cost about $1.27, the U.S. Justice Department alleged. When the Defense Production Act was invoked March 25, it made it a crime to hoard or price gouge N95 masks. In a separate charge, Mr. Schirripa was also accused of falsely billing Medicare and Medicaid for thousands of doses of controlled substances that he kept for himself before closing his pharmacy in New York City earlier this year.

Mr. Schirripa is charged with violating the Defense Production Act, committing healthcare fraud, aggravated identity theft and exploiting the personal information of his pharmacy’s customers to fill prescriptions. Read the Justice Department’s full news release here.


Garfunkel Wild Ad


COVID-19 IN CHILDREN:  They Have Lower Levels of ACE2 Gene Expression
Mount Sinai Health System said Friday that a group of its researchers have found that children have lower levels of ACE2 gene expression than adults, which may explain children’s lower risk of Covid-19 infection and mortality. The virus that causes Covid-19 uses ACE2, which is found on the surface of certain cells in the body, to enter victims, Mount Sinai said. A new study on the findings was published in JAMA. (Crain’s Pulse, May 27)


 

 

 

 

 

 

COVID-19 Update May 26, 2020

.
.
CORONAVIRUS COUNT — There were 362,764 confirmed cases in New York as of Monday. (NYSDOH MAP)


Notes from Governor Cuomo’s COVID-19 Briefing TODAY
– Hospitalizations down, net change down, intubations down. New COVID
cases in hospitals down.

Lives lost on May 26th: 73 – 52 in hospitals, 21 in nursing homes

Monitor the Re-openings
– Mid-Hudson Region opens today
– Long Island opens tomorrow
– Regional Control Groups monitor and respond to the numbers
– NYC is not ready to reopen
– Focus on data to get NYC reopened
– Focus on neighborhoods within NYC that are suffering the most

Supercharge Reopening
– Gov believes the economy bounces back differently
– Top end will be fine
– American workers and small businesses will be hurt
– Government can stimulate the economy
– Provides examples
– Hoover Damn
– Lincoln Tunnel
– Overseas Highway
– Have major infrastructure work to do that is long overdue
– NOW IS THE TIME TO BUILD
– Gov will travel to DC tomorrow to meet with President
Q&A:
Financial Situation for State and NYC:
– Asked about legislation allowing NYC to borrow $7 billion and
whether raising taxes on the wealthy was an option
– Reiterates without funding from feds the state will have a financial
problem
– Gov says Borrowing for operating expenses “fiscally questionable”


New York Forward Loan Fund Supports NYS Small Businesses
New York Forward Loan Fund (NYFLF) is a new economic recovery loan program aimed at supporting New York State small businesses, nonprofits and small landlords as they reopen after the COVID-19 outbreak and NYS on PAUSE.

NYFLF targets the state’s small businesses with 20 or fewer full-time equivalent (FTE) employees (90% of all businesses), nonprofits and small landlords that have seen a loss of rental income.

NYFLF is providing working capital loans so that small businesses, nonprofits and small landlords have access to credit as they reopen. These loans are available to small businesses, nonprofits, and small landlords that did not receive a loan from either the U.S. Small Business Administration (SBA) Paycheck Protection Program (PPP) or SBA Economic Injury Disaster Loans (EIDL) for COVID-19 in 2020.  The loans are not forgivable in part or whole.  The loans will need to be paid back over a 5-year term with interest.

The working capital loans are timed to support businesses and organizations as they proceed to reopen and have upfront expenses to comply with guidelines (e.g., inventory, marketing, refitting for new social distancing guidelines) under the New York Forward Plan.


 


NY1: Why Independent Physician Practices are Devastated by COVID-19 Pandemic


MLMIC Banner


Trump Administration Announces Changes to Medicare Advantage and Part D to Provide Better Coverage and Increase Access for Medicare Beneficiaries

Final Rule continues to strengthen the popular private Medicare health and drug plans

CMS today finalized requirements that will increase access to telehealth for seniors in Medicare Advantage (MA) plans, expand the types of supplemental benefits available for beneficiaries with an MA plan who have chronic diseases, provide support for more MA options for beneficiaries in rural communities, and expand access to MA for patients with End Stage Renal Disease (ESRD). Together, the changes advance President Trump’s Executive Orders on Protecting and Improving Medicare for Our Nation’s Seniors and Advancing American Kidney Health as well as several of the CMS strategic initiatives.

Due to the upcoming June 1, 2020, MA and Part D bid deadlines for the 2021 plan year, CMS is finalizing a subset of the proposed policies before the MA and Part D plans’ bids are due. CMS plans to address the remaining proposals for plans later in 2020 for the 2022 plan year.

We understand that the entire healthcare sector is focused on caring for patients and providing coverage related to coronavirus disease 2019 (COVID-19), and we believe this approach provides plans with adequate time and information to design the best coverage for Medicare beneficiaries.

“CMS’s rapid changes to telehealth are a godsend to patients and providers and allows people to be treated in the safety of their home,” said CMS Administrator Seema Verma. “The changes we are making will help make telehealth more widely available in Medicare Advantage and are part of larger efforts to advance telehealth.”

Building on actions that the Trump Administration has taken to expand access to telehealth so beneficiaries can get care at home instead of traveling to a healthcare facility, today’s rule encourages MA plans to increase their telehealth benefits and increase plan options for beneficiaries living in rural areas.

CMS is giving MA plans more flexibility to count telehealth providers in certain specialty areas (such as Dermatology, Psychiatry, Cardiology, Ophthalmology, Nephrology, Primary Care, Gynecology, Endocrinology, and Infectious Diseases) towards meeting CMS network adequacy standards. This flexibility will encourage plans to enhance their benefits to give beneficiaries access to the latest telehealth technologies and increase plan choices for beneficiaries residing in rural areas.

Today’s rule gives beneficiaries with ESRD more coverage choices in the Medicare program. Previously, beneficiaries with ESRD were only allowed to enroll in MA plans in limited circumstances. The rule implements the changes made by the 21st Century Cures Act to give all beneficiaries with ESRD the option to enroll in an MA plan starting in 2021. This will give beneficiaries with ESRD access to more affordable Medicare coverage options that may include extra benefits such as health and wellness programs, transportation, or home-delivered meals that are not available in Medicare Fee-For-Service.

CMS is also finalizing proposals to enhance the MA and Part D Star Ratings system to further increase the impact that patient experience and access measures have on a plan’s overall Star Rating. The Star Ratings system helps people with Medicare, their families, and their caregivers compare the quality of health and drug plans being offered.

One of the best indicators of a plan’s quality is how its enrollees feel about their coverage experience. This decision reflects CMS’s commitment to put patients first and improves incentives for plans to focus on what patients value and feel is important. Additionally, CMS adopted a series of changes in the March 31, 2020, Interim Final Rule with Comment Period (CMS-1744-IFC) for the 2021 and 2022 Star Ratings to accommodate challenges arising from the COVID-19 public health emergency.

For a fact sheet on the Contract Year 2021 Medicare Advantage and Part D Final Rule (CMS-4190-F1), please click here.

The final rule can be downloaded from the Federal Register here.


About 35 Percent of COVID-19 Patients Do Not Show Symptoms, the CDC Estimates
In a new guidance that outlines five pandemic planning scenarios, according to CNN. The scenarios are designed to inform decisions by mathematical modelers and public health officials.

In its “best estimate” the CDC states 40 percent of coronavirus transmission is happening before people start to feel sick, and 0.4 percent of those who contract COVID-19 and show symptoms will die. (Becker’s Hospital Report)


Flu, Pneumonia, COVID-19 Deaths Drop and other CDC Updates
Deaths attributed to pneumonia, influenza or COVID-19 dropped by about 6 percentage points for the week ending May 16 compared to the week prior, but were still high compared to previous flu seasons, according to the CDC’s weekly COVID View report.

Four things to know:

  1. The percentage of respiratory specimens testing positive for the new coronavirus decreased at public, commercial and clinical laboratories for the week ending May 16. Public labs reported the biggest drop — from 10.7 percent during the week ending May 9 to 8.5 percent during the week ending May 16.
  2. About 12 percent of deaths across the country were attributed to pneumonia, flu or COVID-19 in the week ending May 16, down from 18.5 percent the week before. The percentage remains high compared with any flu season before the pandemic and may change as additional death certificates are processed, the CDC said.
  3. The cumulative COVID-19-associated hospitalization rate for all age groups is 67.9 hospitalizations per 100,000 population, with the highest rates in people ages 65 years and older (214.4 hospitalizations per 100,000 population).
  4. Visits to outpatient providers and emergency departments for symptoms linked to COVID-19 continue to decline, and outpatient visit for flu-like illness was 1.1 percent the week ending May 16, below the national baseline of 2.4 percent. (CDC)

NYEC Banner


Gilead Releases Full Results of Remdesivir Trial
Remdesivir quickened the recovery time for COVID-19 patients but did little to benefit patients on ventilators, according to study results from Gilead’s clinical trial of the drug, the first given emergency approval to treat COVID-19, STAT reports.

The full data from Gilead’s clinical trial, being run by the National Institute of Allergy and Infectious Diseases, was released May 22 in the New England Journal of Medicine

The trial included 1,063 patients, with 538 receiving remdesivir and 521 being given a placebo. The patients given remdesivir recovered in a median of 11 days, compared to 15 days for the placebo group, STAT reported. Mortality in the remdesivir group was 7.1 percent, compared to 11.9 percent for the placebo group, slightly better than previous results.

“It’s a very safe and effective drug,” Eric Topol, MD, founder, and director of the Scripps Research Translational Institute, told STAT. “We now have a definite first efficacious drug for COVID-19, which is a major step forward and will be built upon with other drugs [and drug] combinations.”

There was no sign of benefit for patients who began taking remdesivir while on ventilators or who were receiving extracorporeal membrane oxygenation, a treatment in which oxygen is added to the blood outside the body, according to STAT. Knowing which patients benefit from remdesivir the most could be important for deciding who gets the drug, as it has been in short supplySTAT reports. In the full study results, the benefit of remdesivir appeared to be much larger for patients who were less sick.

The study was stopped after a data safety and monitoring board told NIAID that there was a statistically significant benefit of remdesivir, and critics have said the study should have continued to better discern if remdesivir reduces the death rate, STAT reports. (May 26)


Survey: Consumers Still Feel Comfortable Picking Up Scripts at Pharmacies
The pandemic has not significantly shaped Americans’ feelings about in-person pharmacy visits, according to survey responses released May 21 by the Alliance of Community Health Plans.

The survey, which involved 1,263 adults from ages 18 to 74, found that 41 percent of respondents had delayed nonemergency healthcare appointments and 42 percent felt uncomfortable visiting the hospital for treatment.

However, the survey also revealed the following insights about respondents’ attitudes toward pharmacies during the pandemic:

  • Forty-nine percent reported feeling “very comfortable” picking up prescriptions at their pharmacy and speaking with their pharmacists.
  • Forty-seven percent received a new prescription in the last 90 days.
  • Ninety percent of respondents who received a new prescription in the last 90 days did so at a local retail pharmacy.
  • Thirty-nine percent of respondents reported feeling comfortable undergoing COVID-19 testing at a pharmacy.
  • Twenty-four percent used a mail-order pharmacy service in the last 90 days.
  • Nine percent used their local pharmacy’s home delivery service in the last 90 days.

COVID-19 Update May 22, 2020



Lean on Me: MSSNY Launches COVID Helpline and Recruits Peer Supporters

You just call on me brother, when you need a hand 
We all need somebody to lean on
 
I just might have a problem that you’ll understand
 
We all need somebody to lean on”
  … written and recorded by American singer-songwriter Bill Withers, released in April 1972

Hit songs typically come and go but this song has had enduring longevity.  The lyrics speak to us now touching our soul, expressing exactly how we feel. The music resonates in our heart, mind, and spirit lifting us to another dimension.

Physician stress and moral injury have been plaguing our profession for years and solutions have been a top MSSNY priority.  Our MSSNY committee on Physician Wellness and Resiliency has been working with the AMA and local medical groups and hospital medical staffs on solutions and implementation of a peer to peer support program. The COVID-19 pandemic has added previously unimaginable stressors exacerbating the problem and threatening a professional crisis.  In response, our MSSNY committee jumped into action to accelerate timelines to get needed help to our colleagues.

Last Friday, MSSNY launched the 24/7 Physician COVID Helpline for NYS physicians experiencing COVID 19 related stress.

The Helpline number is: 518-292-0140

Phase Two of the MSSNY Physician Wellness and Resiliency Committee response is the MSSNY Peer to Peer (P2P) support program intended to provide an opportunity for physicians, residents and medical students to talk with a peer about life stressors both work and family related. MSSNY is currently seeking volunteer peer supporters at all career stages who will be trained to listen without judgment, validate feelings and provide support, empathy, and perspective. When needed, peers may also provide a confidential referral for treatment.

Consider volunteering yourself or nominating a colleague. Nominations can be sent to pclancy@mssny.org. More information here.

As we lean on each other, may we all find comfort and peace this Memorial Day Weekend.


HEALTH ADVISORY: Ensuring Access to Health Care Services During COVID-19
Please distribute to the Chief Medical Officer, Family Medicine and Pediatric Departments, Director of Medicine,Director of Nursing and all primary care clinics.


Health Advisory: COVID-19 Updated Guidance for Hospital Operators Regarding Visitation


8 COVID-19-Related Diagnostic Errors to Know
The COVID-19 pandemic could increase the risk of diagnostic errors due to staffing shortages, chaotic work environments and high levels of clinician stress and fatigue, two healthcare quality experts wrote in an article published in the Journal of Hospital Medicine.

The article’s authors are:

  • Tejal Gandhi, MD, chief safety and transformation officer at Press Ganey
  • Hardeep Singh, MD, chief of health policy, quality, and informatics at the Michael E. DeBakey VA Medical Center in Houston.

Drs. Gandhi and Singh identified eight diagnostic errors that may occur in the COVID-19 era based on emerging research and discussions with experts worldwide. The errors are defined below.

  1. Classic: Missed or delayed COVID-19 diagnosis in patients with respiratory symptoms.
  2. Anomalous: Missed or delayed COVID-19 diagnosis in patients who do not have respiratory symptoms.
  3. Anchor: Missed or delayed diagnosis of a different condition because clinicians assume the patient has COVID-19.
  4. Secondary: Missed or delayed diagnosis of a secondary condition in a patient being treated for COVID-19.
  5. Acute collateral: Delayed diagnosis of an acute condition because patients are not seeking care due to fear of contracting COVID-19 in a hospital or emergency department.
  6. Chronic collateral: Delayed diagnosis of ambulatory conditions due to canceled appointments or elective procedures.
  7. Strain: Missed or delayed diagnosis of a different condition because hospitals are overwhelmed, potentially limiting the time and attention clinicians spend on non-COVID-19 patients.
  8. Unintended: Missed or delayed diagnosis because clinicians are using telemedicine more instead of interacting with patients in person.

To view the full article, click here. (Becker’s Hospital May 20)


1 in 5 COVID-19 patients in NYC hospitals were Critically Ill: 5 Things About Them
About 22 percent of COVID-19 patients admitted to two New York City hospitals were critically ill, and nearly all had at least one chronic illness, a new study shows. The study, published in The Lancet, examined the clinical characteristics of critically ill COVID-19 patients admitted to two New York-Presbyterian hospitals affiliated with Columbia University Irving Medical Center in New York City from March 2 to April 1. Of the 1,150 COVID-19 patients admitted to both hospitals, 257 (22 percent) were critically ill.

Five study findings:

  1. The median age of the critically ill patients was 62 years.
  2. Sixty-seven percent were men.
  3. Eighty-two percent of the patients had at least one chronic illness — most commonly hypertension (63 percent) and diabetes (36 percent).
  4. About 46 percent were obese.
  5. Seventy-nine percent of the patients received invasive mechanical ventilation for a median of 18 days.
  6. The researchers conducted a follow-up April 28 and found 39 percent of the patients had died and 37 percent remained hospitalized.

(Becker’s Hospital Review May 20)


MLMIC Banner


Endocrinologists Share Perspective on Pandemic as Patients with Diabetes Who Contract The Virus Can Face Higher Risk For Hospitalization And Mortality
Endocrine News (5/21) reports, “As the COVID-19 pandemic continues to roil the world’s healthcare systems, endocrinologists may have unique insights that could save lives and improve outcomes in these patients who present with elevated glucose levels and other underlying comorbidities such as obesity and diabetes.”

Endocrine News adds, “Patients with diabetes who contract COVID-19 are at a higher risk for hospitalization and even mortality.” Endocrine News highlights a paper published in Endocrine Reviews last month that examined “how the pathophysiology of diabetes and obesity might intersect with COVID-19 biology and found key shared pathways and mechanisms linked to the development and treatment of” T2D.


Garfunkel Wild Ad


Re-Opening Your Medical Practice in COVID-19 Era; Tuesday, May 26, 12 Noon-1 PM
As physicians are now considering re-opening their practices, they need to appreciate that they cannot simply “go back to normal”.  With furloughs, layoffs, severe limitations of medical services, decreased revenues and office closures, physicians need to consider strategies to maximize the success of their practices going forward.  These include financial analysis and planning, how to best protect and treat patients and employees, and what needs to be done to ensure that their practices operate efficiently, safely, and profitably.  Topics addressed will include:

What you need to consider before re-opening?

  • What financial issues must be considered to better prepare your practice to move forward?
  • How can you ensure your practice operates appropriately as it relates to patients?
  • Is there a continued role for telehealth?
  • What will the new practice culture look like going forward?
  • What reasonable accommodations and workplace safety precautions should be made for employees?
  • What are potential discrimination issues that can arise, including, for example, from a phased re-opening, or gradual return of employees from furlough?
  • Given that employees have had a furlough period, and there may be a backlog of work, can/should employers make changes to or limit their PTO policies for the remainder of the year?
  • How do we handle/resolve employment contract breach issues?

Presented by:
Barry B. Cepelewicz, M.D., Esq.
Partner/Director
Garfunkel Wild, P.C. 

Roy W. Breitenbach, Esq.
Partner/Director
Garfunkel Wild, P.C.


CDC Estimates About One-Third of Coronavirus Patients Don’t Have Symptoms
In new guidance for mathematical modelers and public health officials, the US Centers for Disease Control and Prevention is estimating that about a third of coronavirus infections are asymptomatic. CNN (5/22, Azad) reports that in its “new guidance for mathematical modelers and public health officials,” the CDC “is estimating that about a third of coronavirus infections are asymptomatic.”

The agency also “says its ‘best estimate’ is that 0.4% of people who show symptoms and have Covid-19 will die, and the agency estimates that 40% of coronavirus transmission is occurring before people feel sick.” The CDC “cautions that those numbers are subject to change as more is learned about Covid-19, and it warns that the information is intended for planning purposes.”


Veterans Matters: TBI in Returning Veterans Podcast
Check out MSSNY’s Veterans Matters newest podcast entitled TBI in Returning Veterans.  Dr. David Podwall discusses how to identify and diagnose mild TBI in veterans, along with a discussion on prevention and treatment options. Click here to listen.


COVID-19 Map – Johns Hopkins Coronavirus Resource Center

COVID-19 Update May 21, 2020

 

Notes from Governor Cuomo’s COVID-19 Briefing

· Hospitalizations are down to 5,187

· Net change in hospitalizations and intubations are down.

· Amount of new hospitalizations: 246

· 105 lives lost yesterday: 78 in hospitals, 27 in nursing homes.

REOPENING: – Rockland County is eligible for elective surgery and ambulatory care.

-NY Coronavirus Hotline: 1-888-364-3065 -Report employers if they are not following proper reopening procedures. – State beaches open tomorrow. – Beaches are limited to 50% capacity. – Social distancing must be followed. – Concessions will remain closed. – No contact sports are allowed. TRACING: – NYS tracers will call infected people. -Caller-ID will read: “NYS Contact Tracing” CHILDREN: – NYSDOH is now investigating 157 cases of COVID-related illness in children. -Today, 13 countries and 25 states and Washington D.C. have reported cases. – Gov reiterated that it is still too early to decide if schools will open in the Fall. -The state will issues guidelines to schools in June. -Schools will submit plans to the state in July. – Summer school will be conducted via distance learning. Q&A: CAMPS:

– Gov: until we have more information on COVID-related illness, it might be a bad idea to send children to camps. REOPENING:

– Reporter said NYC Mayor de Blasio says NYC has to reopen by early to mid- June. – There are metrics that will guide reopening for NYC just like every other region.


Some N.Y. Hospitals Will Allow Visitors as Part of State Pilot
COVID-19 patients will be allowed visitors in some New York hospitals and small Memorial Day ceremonies will be allowed, Gov. Andrew Cuomo said. Sixteen hospitals in New York state will allow visitors as part of a pilot program addressing the heartbreak of COVID-19 patients suffering while isolated from their families and friends.

Cuomo said visits under the two-week pilot program will be time limited. Visitors will need to wear protective equipment and will be subject to temperature and symptom checks. Strict visitation rules were adopted to check the spread of the virus, but they have resulted in painful scenes of patients relying on phones or tablets for emotional conversations with loved ones.

“It is terrible to have someone in the hospital and then that person is isolated, not being able to see their family and friends,” Cuomo said. Nine of the hospitals participating are in New York City, with the rest spread out around the state. Cuomo made the announcement as COVID-19-related hospitalizations and deaths continue to decline. There is an average of 335 new hospitals admissions a day. (Modern Healthcare 5/21)


Strokes May Be Less Frequent, More Deadly Than Previously Thought
Fewer than 1% of hospitalized patients who tested positive for COVID-19 also suffered a stroke, a rate much lower than the 2% to 5% reported in China and Italy, said a news release on a study led by the NYU Grossman School of Medicine.

But the people who had a stroke and the virus were younger, had worse symptoms and were seven times more likely to die, according to the release.

“Our study suggests that stroke is an uncommon yet important complication of coronavirus given that these strokes are more severe when compared with strokes occurring in patients who tested negative for the virus,” says study lead author Dr. Shadi Yaghi, an assistant professor in the Department of Neurology at NYU Langone Health, in the release. Modern Healthcare (5/21)


Mount Sinai Uses AI to Analyze COVID-19 Patients
Mount Sinai researchers have created an algorithm that can detect COVID-19 based on how lungs look in CT scans combined with patient information like age, symptoms, bloodwork, and possible contact with others infected with the coronavirus. “Imaging can help give a rapid and accurate diagnosis—lab tests can take up to two days, and there is the possibility of false negatives—meaning imaging can help isolate patients immediately if needed and manage hospital resources effectively. The high sensitivity of our AI model can provide a ‘second opinion’ to physicians in cases where CT is either negative (in the early course of infection) or shows nonspecific findings, which can be common,” said Zahi Fayad, director of the BioMedical Engineering and Imaging Institute at the Icahn School of Medicine at Mount Sinai. (Modern Healthcare, 5/20)


Brooklyn Clinic to Provide Follow-up Care for Discharged Covid-19 Patients
SUNY Downstate Health Sciences University in East Flatbush has established a dedicated outpatient clinic that is providing ongoing care for discharged Covid-19 patients. The clinic opened May 7 at University Hospital of Brooklyn. Follow-up care is especially important given that nearly 90% of Covid-19 patients treated at SUNY Downstate have had at least two comorbidities, and 30% have had three. The vast majority of patients have been people of color, and many don’t have an established relationship with a primary care physician, said Dr. Mafuzur Rahman, vice chair of medicine at SUNY Downstate. “These patients are dischargeable because they don’t have to be in the hospital, but they’re in no condition to resume normal life,” Rahman said.

There is constantly changing information about how Covid-19 affects different parts of the body beyond the lungs, Rahman said. That has included gastrointestinal symptoms, headaches, stroke like symptoms, heart attacks, nerve damage and multisystem inflammatory syndrome in children.

The clinic plans to follow up with patients on symptoms that may develop once they have left the hospital, Rahman said. And because Covid-19 has no standard of care, the clinic will monitor patients for any serious side effects from medications used to treat the disease while they were in the hospital. SUNY Downstate is in the process of contacting more than 1,000 discharged Covid-19 patients for an initial telehealth appointment. Those who need to come in for an in-person assessment will have priority access to primary and specialty care.

SUNY Downstate has reallocated existing resources to get the clinic up and running, including designating several physicians from each subspecialty—such as pulmonologists and heart and kidney specialists—to provide care as needed. The clinic will care for patients for a month or more following discharge. It will continue operation should there be additional waves of Covid-19 patients, Rahman said. Aside from follow-up care, the clinic will focus on tracking the incidence of post-Covid-19 health impacts over time as well as the success of various therapeutic treatments during recovery, SUNY Downstate said.

The mental health of patients also will be a focus, Rahman said. Rahman and a team of leaders from SUNY Downstate already have been working to help address the mental health needs of frontline health care workers. Dr. Ayman Fanous, chairman of psychiatry, recently told Crain’s that isolating patients from their loved ones has taken an emotional toll on doctors and nurses. The solitude is also affecting patients. Many have been isolated and even intubated for weeks on end, Rahman said. And they may struggle to get back to their everyday activities due to the long-term physical effects of the disease.” (Crain’s 10/20)


MLMIC Banner


Patients with Obesity May Be At Least Three Times More Likely to Have SevereCOVID-19 Symptoms Than Those with Normal Weight, Studies Indicate

Healio (5/20) reports, “In two cohorts of Chinese adults with COVID-19, those with obesity were at least three times more likely to have a severe case of the disease than those with normal weight, according to two studies published in Diabetes Care.” Furthermore, “increasing obesity was associated with increasing odds of severe COVID-19, and the association between obesity and symptom severity was stronger for men than for women.” In one study, the researchers found “median hospital stay was 23 days for patients with obesity vs. 18 days for those with normal weight.” In a second study, the results indicate “men with obesity were more than five times as likely to develop severe symptoms vs. men with normal weight.”


Speeding in New York City? Yes, Really!
In New York City, cameras captured 296,000 speeders during a five-week stretch beginning in mid-March, an 81% increase from the same period in 2019, according to data collected by the city’s speed-camera vendor. The city says traffic deaths are sharply lower.…Roads in the 10 biggest US metro areas have emptied, with volume down 63% in the New York City region. Meanwhile, cars are going faster during morning and evening rush hours, Inrix found in comparing April 13-17 with the first two weeks of March. (WSJ, May 21)


May 28 Webinar: Leading Causes of Million-Dollar Claims in NYS!
On Thursday, May 28, at 7:30 a.m., MLMIC will host “Million Dollar Claims: A Closer Look,” a complimentary webinar examining major causes of million-dollar claims in New York State. As the State’s leading medical professional liability carrier, MLMIC is well-positioned to provide guidance to medical organizations on reducing the risk of high-exposure claims. These recommendations and strategies are informed by an analysis of factors contributing to $1,000,000 claims over a five-year period.

Presenters Joyce McCormack, a MLMIC risk management consultant and registered professional nurse, and Danielle Mikalajunas Fogel, a medical malpractice litigation expert with Fager Amsler Keller & Schoppmann, will educate participants on:

  • identifying the leading causes of loss in million-dollar claims;
  • analyzing the key factors leading to significant payments in these claims;
  • recognizing the chief medical factors identified in these files; and
  • implementing risk management strategies to lessen the risks of high-exposure professional liability claims within your organization.

Policyholders can sign up for this event via the webinar registration form.

This webinar is designed to offer risk management perspectives to physicians and other healthcare providers, risk managers, quality improvement managers, medical directors, office practice administrators/managers, office practice staff, nurse administrators, patient safety officers and healthcare counsel.

MLMIC is accredited by the Medical Society of the State of New York (MSSNY) to provide continuing medical education for physicians and designates this live activity for a maximum of 1.0 AMA PRA Category 1 Credit™. Physicians should claim only the credit commensurate with the extent of their participation in the activity. 


Health Connections Banner


Veterans Matters: PTSD in Returning Veterans Podcast
Check out MSSNY’s Veterans Matters newest two-part podcast entitled PTSD in Returning Veterans. In Part One, Dr. Frank Dowling, Secretary of MSSNY discusses how to identify PTSD in veterans, leading causes of PTSD and common comorbidities. Click here to listen to Part One.

In Part Two, Dr. Dowling discusses treatment options along with how PTSD affects family members and provides advice to physicians on providing better care for veteran patients with PTSD. Click here to listen to Part Two.


Registration Now Open for Veterans Matters CME Webinar

PTSD in Returning Veterans on June 3, 2020 @ 8:30 am

The Medical Society of the State of New York, along with Cobleskill Regional Hospital are hosting a CME live webinar entitled Veterans Matters: PTSD in Returning Veterans on Wednesday, June 3, 2020.

Click here to register for the webinar

Adolph Meyer, MD will serve as faculty for this program and the educational objectives are:

· Identify diagnostic criteria for PTSD

· Discuss medical and psychiatric comorbidities of military related PTSD

· 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 each of these live activities for a maximum of 1.0 AMA PRA Category 1 credits™. Physicians should claim only the credit commensurate with the extent of their participation in the activity.


COVID-19 Map – Johns Hopkins Coronavirus Resource Center

COVID-19 Update May 20, 2020


.

Please Join NYS DOH’s Webinar Update on COVID-19 Tomorrow!
Please join the NYS Department of Health Thursday May 21st at 1:00 PM – 2:00 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:

For audio only, please dial in: 844-512-2950


PPE Source for MSSNY Members Only!
MSSNY is now able to provide members with access to a PPE supply chain, in a collaborative effort with the American Society of Plastic Surgeons.

Items available range from N95 masks and face shields to hand sanitizer and alcohol wipes. New items are consistently being added and restocked.  Shipment times may vary from several days to several weeks. Some orders may be fulfilled by outside vendors with longer shipping times.

MSSNY members have been sent details on linking to the ASPS, where they can see available supplies and create an account to purchase items.  If you are not currently a MSSNY member you can renew for 2020 or apply online here.

MSSNY is proud to offer this benefit to our members and grateful to ASPS for extending this opportunity to help medical practices and patients in our state resume practice swiftly and safely.


NYSDOH Reducing Medicaid by 1.5% Effective for Service after April 2
As a practical matter, with a 1% cut having already been imposed for claims with dates of service between January 1, 2020 and April 1, 2020, physicians can expect that their payments will be 0.5% less for claims with dates of service 4/2/20 and after, when compared to claims with dates of service between 1/1/20-4/1/20.

The announcement from DOH notes the cuts are not applicable to physician administered drugs. These cuts are one way New York State is seeking to address its enormous revenue shortfall as a result of the Covid-19 pandemic.   MSSNY has been working together with the federation of medicine in support of legislation before Congress that would, among many other provisions, provide additional Medicaid funding to states to prevent against further Medicaid cuts.


HEALTH ADVISORY: Ensuring Access to Health Care Services During COVID-19
It is critical to maintain access to health care services during the COVID-19 public health emergency, including routine preventive care and follow-up services. • Healthcare providers should continue to ensure infection prevention and control measures are in place to prevent the spread of COVID-19. Healthcare providers should contact patients who may have missed routine preventive care or follow-up appointments during the COVID-19 public health emergency, including ensuring children, adolescents, and adults receive doses of recommended vaccines they may have otherwise missed.


MLMIC Banner


Re-Opening Your Medical Practice in the COVID-19 Era on May 26 12 Noon – 1 PM
As physicians are now considering re-opening their practices, they need to appreciate that they cannot simply “go back to normal”.  With furloughs, layoffs, severe limitations of medical services, decreased revenues and office closures, physicians need to consider strategies to maximize the success of their practices going forward.  These include financial analysis and planning, how to best protect and treat patients and employees, and what needs to be done to ensure that their practices operate efficiently, safely, and profitably.  Topics addressed will include:

What you need to consider before re-opening?

  • What financial issues must be considered to better prepare your practice to move forward?
  • How can you ensure your practice operates appropriately as it relates to patients?
  • Is there a continued role for telehealth?
  • What will the new practice culture look like going forward?
  • What reasonable accommodations and workplace safety precautions should be made for employees?
  • What are potential discrimination issues that can arise, including, for example, from a phased re-opening, or gradual return of employees from furlough?

Given that employees have had a furlough period, and there may be a backlog of work, can/should employers make changes to or limit their PTO policies for the remainder of the year?

  • How do we handle/resolve employment contract breach issues?
  • Is there liability to the practices for exposing employees or employees’ family to Coronavirus? Wrongful reopening?

Register in advance for this webinar: https://mssny.zoom.us/webinar/register/WN_8YjCTCssTq6fVgwn404Bw

Presented by:
Barry B. Cepelewicz, M.D., Esq.
Partner/Director
Garfunkel Wild, P.C. 

Roy W. Breitenbach, Esq.
Partner/Director
Garfunkel Wild, P.C.


Tomorrow, Thursday, May 21 Nassau County Medical Society Webinar @ 7PM

DATE: May 21, 2020
Time:   7pm

Zoom Webinar Link https://us02web.zoom.us/webinar/register/WN_sPTtUWRVSxqJrZqKWBumFA

Guest Speaker: Dr. David A. Hirschwerk
                          Attending-Infectious Diseases
                          Executive Vice Chair-Dept. of Medicine
                         North Shore University Hospital/LIJ Medical Center


May 28 Webinar: Leading Causes of Million-Dollar Claims in NYS!
On Thursday, May 28, at 7:30 a.m., MLMIC will host “Million Dollar Claims: A Closer Look,” a complimentary webinar examining major causes of million-dollar claims in New York State. As the State’s leading medical professional liability carrier, MLMIC is well-positioned to provide guidance to medical organizations on reducing the risk of high-exposure claims. These recommendations and strategies are informed by an analysis of factors contributing to $1,000,000 claims over a five-year period.

Presenters Joyce McCormack, a MLMIC risk management consultant and registered professional nurse, and Danielle Mikalajunas Fogel, a medical malpractice litigation expert with Fager Amsler Keller & Schoppmann, will educate participants on:

  • identifying the leading causes of loss in million-dollar claims;
  • analyzing the key factors leading to significant payments in these claims;
  • recognizing the chief medical factors identified in these files; and
  • implementing risk management strategies to lessen the risks of high-exposure professional liability claims within your organization.

Policyholders can sign up for this event via the webinar registration form.

This webinar is designed to offer risk management perspectives to physicians and other healthcare providers, risk managers, quality improvement managers, medical directors, office practice administrators/managers, office practice staff, nurse administrators, patient safety officers and healthcare counsel.

MLMIC is accredited by the Medical Society of the State of New York (MSSNY) to provide continuing medical education for physicians and designates this live activity for a maximum of 1.0 AMA PRA Category 1 Credit™. Physicians should claim only the credit commensurate with the extent of their participation in the activity.


Registration Now Open for Veterans Matters CME Webinar PTSD in Returning
Veterans on June 3, 2020 @ 8:30 am

The Medical Society of the State of New York, along with Cobleskill Regional Hospital are hosting a CME live webinar entitled Veterans Matters: PTSD in Returning Veterans on Wednesday, June 3, 2020.

Click here to register for the webinar

Adolph Meyer, MD will serve as faculty for this program and the educational objectives are:

  • Identify diagnostic criteria for PTSD
  • Discuss medical and psychiatric comorbidities of military related PTSD
  • 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 each of these live activities for a maximum of 1.0 AMA PRA Category 1 credits™.  Physicians should claim only the credit commensurate with the extent of their participation in the activity.


Garfunkel Wild Ad


Surgeon/Colleagues Make N95 Mask Disinfection Facility for Under $15,000
VCU Health shares step-by-step instructions, quality controls, and blueprints for an innovation it created to disinfect and reuse up to 12,000 masks a day.

DOCTORS CREATE

KEY TAKEAWAYS

  • A VCU Health orthopaedic surgeon and his colleagues created this innovation.
  • The rack system enables the high throughput necessary to disinfect thousands of masks daily
  • Other health systems can replicate this initiative for about $15,000. While other methods exist to sterilize the masks, VCU Health chose UV-C light because it relies on electricity rather than supplies that might run short during the pandemic.

The COVID-19 crisis has spawned a new era of innovation at hospitals and health systems to adapt to changing demands. Inspiration comes from many sources.

In Richmond, Virginia, an anticipated N95 mask shortage at VCU health sent orthopaedic surgeon Stephen Kates, MD, into his personal machine shop, where he has fabricated items for the operating room, his car, and even parts for a friend’s old Ford tractor. This time, working with an anesthesiologist, two residents, and two PhDs from Virginia Commonwealth University, the professor and chairman of orthopaedic surgery produced a trellis rack to hang and sterilize masks with UV-C light. The design amplifies an already proven sterilization process, enabling high throughput. The health system is now using the system to decontaminate and reuse up to 12,000 N95 masks a day.

The process is based on a concept from the University of Nebraska and adheres to Centers for Disease Control and Prevention guidelines. It involves a commonly used UV-C light robot that VCU already had on hand to decontaminate hospital rooms and employs materials which the VCU team sourced from The Home Depot, Lowe’s, and a tractor supply store.

To help other health systems replicate this initiative, Richmond, Virginia–based VCU Health, which includes an academic medical center and is affiliated with Virginia Commonwealth University, offers a free 28-page downloadable instruction manual. The booklet outlines each step in the process, including quality controls with pictures and a video link providing added details. Kates estimates a similar system can be fabricated for as little as $15,000, provided a facility already has a proper UV-C light source that can be redeployed for this purpose.

Kates was called into action by a group from the university, which had produced a white paper on the topic of disinfecting N95 masks. While other methods exist to sterilize the masks, including hydrogen peroxide vapor, VCU Health chose UV-C light because it relies on electricity rather than supplies that might run short during the pandemic. In addition, exposure to the light source does not structurally degrade the mask as quickly as other methods, Kates says.

“The concept of sterilizing things with UV lights is not new; we didn’t come up with that,” says Kates. “The question was, ‘How to you actualize it and make it work?’ ” he says. “How do we have a high throughput process that can deal with a surge of patients that otherwise is overwhelming health systems across the country?”

“Making stuff out of metal is a hobby of mine, so I went to work on it that day and made a sample,” he says. “Everyone liked the appearance of it, so the next day we made seven more. Once we found a good design, we had local welders and machinists fabricate the rest of them.”

RAMPING UP PRODUCTION

N95 Masks

Photo Courtesy of VCU Health

VCU created a mask decontamination facility in a building adjacent to the hospital and painted the treatment room with reflective white paint at the recommendation of its UV-C robot manufacturer to facilitate light measurement.

The final design includes six racks on wheels, each containing 42 masks. The racks are arranged in a hexagonal pattern around the robot.

 

 

 


COVID-19 Map – Johns Hopkins Coronavirus Resource Center

COVID-19 Update May 19, 2020


.

PPE SOURCE FOR MSSNY MEMBERS ONLY!
MSSNY is now able to provide members with access to a PPE supply chain, in a collaborative effort with the American Society of Plastic Surgeons.

Items available range from N95 masks and face shields to hand sanitizer and alcohol wipes. New items are consistently being added and restocked.  Shipment times may vary from several days to several weeks. Some orders may be fulfilled by outside vendors with longer shipping times.

MSSNY members have been sent details on linking to the ASPS, where they can see available supplies and create an account to purchase items.  If you are not currently a MSSNY member you can renew for 2020 or apply online here.

MSSNY is proud to offer this benefit to our members and grateful to ASPS for extending this opportunity to help medical practices and patients in our state resume practice swiftly and safely.


Physicians: Join NYSDOH for COVID-19 Update 1-2 PM

Please join the NYS Department of Health Thursday May 21st at 1:00 PM – 2:00 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: 

For audio only, please dial in: 844-512-2950


Guidance for Office Based Surgery Practices
This Guidance is directed at Ambulatory Surgery Centers (ASC) Office Based Surgery practices (OBS), and Diagnostic and Treatment Centers (DTC) that are in counties without a significant risk of COVID-19 surge and are deemed eligible to perform Deferred Procedures, (i.e., elective surgeries and non-urgent procedures).

These centers and practices are required to meet the same provisions required of hospitals in these eligible counties that are also resuming deferred procedures.

Any ASC, OBS, or DTC that fails to comply with this Guidance may be subject to civil penalties. The guidance from the NYS Department of Health regarding the resumption of elective surgery in the 49 counties across the State where such surgery has been permitted, including in ASCs and OBS.


Moderna Releases Positive Data on Early COVID-19 Vaccine Trial
Moderna reported May 18 that its COVID-19 vaccine, the first of its kind to test human subjects, safely creates an immune response against coronavirus, according to The New York Times. The vaccine stimulates the creation of antibodies that can stop coronavirus from replicating, and the levels of those neutralizing antibodies were found to match the levels in recovered COVID-19 patients. The biotech company’s findings are based on results from the first trial beginning in March, in which eight volunteers each received two doses.

The Food and Drug Administration approved Moderna’s second phase of the trial, which will begin soon and involve 600 people. A third phase is planned for July and is slated to include thousands of volunteers. Depending on the success of the coming trials, the vaccine could become available for widespread use by the year’s end or early 2021. (Becker’s Hospital Review) May 18.


US Reopening Doesn’t Hinge on Coronavirus Vaccine, HHS Chief Says
Echoing President Donald Trump’s recent comments that the U.S. will reopen whether a COVID-19 vaccine is available or not, HHS Secretary Alex Azar said “everything does not depend on a vaccine,” according to CNN.

Mr. Azar said that while the White House is committed to delivering a vaccine, it is only one part of a “multi-factorial response program,” during a CNN interview.

Other parts of the plan include testing symptomatic people, broader surveillance of cases, containing surges and therapeutics, Mr. Azar said.

On May 15, President Trump and HHS unveiled a vaccine effort called Operation Warp Speed, a program designed to drastically reduce the time it takes to get a COVID-19 vaccine to U.S. residents. The program is a collaboration between HHS, the U.S. Defense Department, private firms, and other federal agencies, including the U.S. Department of Agriculture, the U.S. Energy Department, and the U.S. Department of Veterans Affairs. Read HHS’ full news release here.(Becker’s Hospital Review Leadership & Management May 18)


MLMIC Banner


Trump Inks Deal to Create Nation’s First Strategic Stockpile of COVID-19 Drugs
President Donald Trump signed a four-year $345 million contract with Richmond, Va.-based drugmaker Phlow Corp. May 19 to create a national COVID-19 medication stockpile, according to The New York Times. The Biomedical Advanced Research and Development Authority awarded Phlow with the contract to manufacture the raw pharmaceutical ingredients needed to make popular generics and drugs that treat COVID-19, most of which are now produced in India and China.

The contract “will not only help bring our essential medicines home but actually do so in a way that is cost competitive with the sweatshops and pollution havens of the world,” said Peter Navarro, Mr. Trump’s trade advisor. Phlow has partnered with nonprofit drugmaker Civica Rx to produce the stockpile. They will first focus on manufacturing critical care medicine for COVID-19 patients, such as antibiotics and medicines used for ventilator support and pain, according to Eric Edwards, MD, PhD, CEO, and president of Phlow. (May 19, Becker’s Hospital Review)


AMA Answers Questions re CARES Act Provider Relief Fund
The AMA has received many questions from physicians and medical societies related to the CARES Act Provider Relief Fund, and we have been in touch with senior HHS officials about them. Certain formulas that were previously on the HHS website led some physicians to believe they may have received more money from this fund than they were supposed to, and they were worried that it will be recouped by HHS. Because the AMA informed the administration of the concerns and alarm the previous formulas and language about overpayments were causing many physicians, HHS removed it from the website.

HHS was concerned that many physicians were using the formulas to calculate for themselves what they thought HHS intended for them to receive from the CARES Act Provider Relief Fund, and then deciding on the basis of their own calculations that they were going to be in trouble. HHS has asked for people to provide documentation of certain revenue information so that it can make the calculations specific to each TIN (Taxpayer Identification Number).

HHS removed the formula and overpayments language from the portal last week to allay concerns from physicians who had done their own estimates and reached conclusions about potential overpayments instead of relying on HHS to do the calculations. Unfortunately, in some cases these changes with formulas appearing and disappearing from the website heightened rather than allayed concerns. On Friday, May 15th, HHS posted revised FAQs on the Provider Relief Fund General Distribution Portal.

Several of the FAQs are dated May 14th, and seek to clarify some of the recent confusion, particularly these two questions: 

How Did HHS Determine the Additional Payments Under the General Distribution?

HHS is distributing an additional $20 billion of the General Distribution to providers to augment their initial allocation so that $50 billion is allocated proportional to providers’ share of 2018 net patient revenue. The allocation methodology is designed to provide relief to providers, who bill Medicare fee-for-service, with at least 2% of that provider’s net patient revenue regardless of the provider’s payer mix.

Payments are determined based on the lesser of 2% of a provider’s 2018 (or most recent complete tax year) net patient revenue or the sum of incurred losses for March and April. If the initial General Distribution payment you received between April 10 and April 17 was determined to be at least 2% of your annual patient revenue, you will not receive additional General Distribution payments. 

How Can I Estimate 2% Of Patient Revenue to Determine My Approximate General Distribution Payment? (Added 5/14/2020)

In general, providers can estimate payments from the General Distribution of approximately 2% of 2018 (or most recent complete tax year) patient revenue. To estimate your payment, use this equation:

  • (Individual Provider Revenues/$2.5 Trillion) X $50 Billion = Expected Combined General Distribution.
  • To estimate your payment, you may need to use “Gross Receipts or Sales” or “Program Service Revenue.” Providers should work with a tax professional for accurate submission.

This includes any payments under the first $30 billion general distribution as well as under the $20 billion general distribution allocations. Providers may not receive a second distribution payment if the provider received a first distribution payment of equal to or more than 2% of patient revenue.

Additional information that has recently been added notes that HHS is making a list publicly available of the providers who have received and accepted money from the Provider Relief Fund here.

Other questions have arisen regarding what HHS views as the appropriate use of the CARES Act funds. We have not seen additional guidance beyond that provided on the website and we think it would be difficult for HHS to craft language in a way that would be relevant to each practice’s individual needs.

We believe that the key thing is that each practice is able to clearly document the revenue losses and expenses it is incurring that are directly due to COVID-19, which could include losses related to social distancing (such as cancellation of visits and procedures, Part B drugs that have passed their expiration date), costs of new infection control practices, PPE, digital health equipment, etc., and that are not reimbursable from other sources (excluding loans that have to be repaid).



Registration Now Open for Veterans Matters CME Webinar PTSD in Returning
Veterans on June 3, 2020 @ 8:30 am

The Medical Society of the State of New York, along with Cobleskill Regional Hospital are hosting a CME live webinar entitled Veterans Matters: PTSD in Returning Veterans on Wednesday, June 3, 2020.

Click here to register for the webinar

Adolph Meyer, MD will serve as faculty for this program and the educational objectives are:

  • Identify diagnostic criteria for PTSD
  • Discuss medical and psychiatric comorbidities of military related PTSD
  • 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 each of these live activities for a maximum of 1.0 AMA PRA Category 1 credits™.  Physicians should claim only the credit commensurate with the extent of their participation in the activity.


NYEC Banner


COVID-19 Map – Johns Hopkins Coronavirus Resource Center

1 2 3 43