MSSNY eNews September 25, 2020 – Gender Equality in Medicine: The Next Step Forward


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Gender Equality in Medicine:  The Next Step Forward

September is Women in Medicine Month and a good time to reflect on gender equity in our organization and in healthcare as a whole.

The Medical Society of the State of New York was established in 1807. However, it was nearly 2 centuries later, in 2002 before a female, Dr. Ann Cea was elected as president of our society. Fortunately, this is proving to be a century of change with Dr. Leah McCormack elected in 2010 and my election in 2020.

Supreme Court Judge Ruth Bader Ginsburg died this week but her legacy lives on in her court decisions that push us closer to the attainable goal of societal gender equity.  When Justice Ginsburg attended Harvard Law School in the 1950s, she confronted gender barriers including faculty members suggesting she was “taking a man’s spot.” Although I graduated medical school more than 30 years after Justice Ginsburg graduated law school and my medical school class was nearly 50% female, I still encountered comments about “being pretty good for a female” and some 50 years later still heard some profess that “men have families to support” as justification for pay inequity. 

MSSNY Women Physicians Committee Addressing Issues and Concerns

In MSSNY over the last few years we have made strides forward with the formation of the Women Physicians Committee in 2018 which is tasked with addressing women physician’s issues and concerns, including women’s health issues, work/life balance, pay disparities, sexual harassment, representation in leadership roles, and family-friendly employment policies.  In 2019, the committee put forth two resolutions to our MSSNY House of Delegates, Resolution 216, Advancing Gender Equity in Medicine and 217 MSSNY Policy on Gender Equity in Medicine. 

The passage of these resolutions was a step forward but over the next few years the committee will be working on the even more difficult task of bringing these ideas and directives to fruition, putting appropriate structures in place, process measures, and developing and monitoring outcomes.

Justice Ginsburg through her legal prowess helped to move the needle away from gender bias and narrow, gender-based expectations.  It is now up to us to lead our medical society and profession in that same direction so that pronouns don’t define or limit our careers or our health.

Bonnie Litvack, MD
MSSNY President


Mandatory OPMC Signage Legislation Delivered to Governor; Please Urge Veto
All physicians are urged to contact Governor Cuomo to request that he veto legislation (S.6678-A/A.7991-A) requiring every physician’s “practice setting” to post a sign regarding how a patient can file a misconduct complaint with the OPMC.  The bill was delivered to Governor Cuomo’s desk today, which means he has until Wednesday, October 7 to sign or veto.  You can send a letter and tweet to the Governor opposing this baffling legislation here.

Let the Governor know that this proposal would create unnecessary distrust in the physician-patient relationship and unfairly singles out physicians for this requirement as opposed to any other type of professional. This legislation is also unnecessary because information regarding how best to file such a complaint is already easily available through a simple Google search.  Moreover, with nearly 10,000 complaints already made each year to OPMC (resulting in only a few hundred actual disciplinary actions), it is clear there is already strong public awareness of this oversight body.


MSSNY Weekly Legislative Podcast

Separately, we are urging all physicians to send a letter to the Governor urging him to veto adverse legislation that would require all physician practice settings to post a notice showing the weblink for how a patient can file a complaint with the OPMC.  The bill was delivered to the Governor today for his consideration.  You can send a letter here.


Cuomo Says Task Force Will Review Safety of Vaccines Prior to Distribution
A new independent task force will review the safety of all COVID-19 vaccines authorized by the federal government and will plan their distribution in New York, Gov. Andrew Cuomo said Thursday.

Key context: Cuomo, who has raised concerns that the Trump administration could prematurely advance a vaccine ahead of the November election, said the task force will guide New York’s next steps in procuring and administering vaccines it deems to be safe and effective against the coronavirus.

The details: Cuomo said the review committee will also come up with a vaccine distribution and implementation plan that looks at: Prioritization based on clinical guidance; distribution network; qualified administration; data and IT infrastructure; and public education and procurement.

The goal of the panel — headed by the Department of Health and composed of scientists, doctors and health experts — is to ensure that New York has the best vaccination program in the nation, the governor told reporters at a morning news conference.

“I think the way we have handled COVID has been a model for this country. I want New Yorkers to do the same thing with vaccines,” he said. “We should be the model vaccination program in the country. I also think there’s a tremendous advantage for any state that could be the first COVID-free state.”

Dr. William Valenti will be representing MSSNY on this Task Force. Dr. Valenti is Clinical Associate Professor of Medicine (Infectious Diseases) at the University of Rochester School of Medicine in New York. He is Chair of the Infectious Diseases subcommittee of the Medical Society of the State of New York and Fellow of the Infectious Disease Society of America. Dr. Valenti stated, “I am delighted and honored to represent MSSNY in this effort. “

Background: Cuomo said in late August that his administration was reviewing whether DOH would have the authority to overrule FDA approval of a COVID-19 vaccine that’s not fully vetted. The governor later doubled down on that assertion, saying New York would not endorse a federally backed Covid-19 vaccine until it was reviewed by state health officials. (Politico Pro, 9/24)



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Commissioner’s Sept. 30 Medical Grand Rounds: NYSDOH Update on COVID-19
We are excited to share the marketing materials for a special session of our 2020-2021 Commissioner’s Medical Grand Rounds series, which will take place on Wednesday, September 30th. This session, entitled NYSDOH Update on COVID-19: Current Knowledge and Best Practices for Primary Care During the COVID-19 Pandemic, we will bring together providers from various perspectives to discuss the unique and ongoing challenges in addressing primary care needs during a pandemic.

Two primary care physicians who responded to the COVID-19 crisis in some of the earliest and hardest-hit areas of New York will discuss their experiences, recommendations, and lessons learned. Our speakers will discuss the most up-to-date, evidence-based best practices for delivering care, addressing patient needs, and COVID-19 testing. A flyer is attached—please feel free to share liberally among your network.

This virtual session will take place on Wednesday, September 30th from 1:30 – 3:00pm, and will be streamed via live webcast. The session will also be archived on the NYSDOH Website. The event is free-of-charge and open to all interested providers across New York State. The link to register can be found here.
Click here for the flyer.


Half of Physicians Report Anger, Anxiety Over Pandemic: 5 Survey Findings
The COVID-19 is placing a heavy burden on U.S. physicians, with many reporting feeling hopeless, angry or burned out, according to a survey from the Physicians Foundation.

The foundation surveyed 2,334 physicians nationwide Aug. 17-25 about how the pandemic has affected their well-being. Thirty-six percent of them practiced primary care, and 64 percent were in other specialties.

Five survey findings:

  1. Half of physicians said they have experienced inappropriate anger, tearfulness, or anxiety over how the pandemic is affecting their practice or employment.
  2. Thirty percent said they feel hopeless or that they have no purpose due to the pandemic’s effects on their practice or work.
  3. Fifty-eight percent of physicians expressed feelings of burnout, up from 40 percent in 2018.
  4. A majority of respondents (78 percent) cited the public’s lack of compliance with social- distancing measures or mask-wearing was their biggest source of frustration amid the pandemic.
  5. Thirteen percent of physicians have sought care for mental health issues related to the pandemic.View the full survey here.

MSSNY is a signatory medical society member of The Physicians Foundation.


During COVID-19, Lung Cancer Screening Declined
The COVID-19 pandemic has caused disruption across cancer care, including the declines in lung cancer diagnoses across the US. As MSSNY’s physicians continue to balance treating COVID-19 patients and conducting routine health diagnostics, they may have noticed a decline in the number of patients receiving lung cancer screenings. Now more than ever, it is important to remind everyone to continue seeking care during COVID-19 because, even in the face of a global pandemic, cancer won’t wait.

To help raise awareness around the decline in lung cancer diagnoses and its impact on patient care, AstraZeneca has developed a toolkit of resources that physicians can use to communicate with individuals about the importance of continuing to seek care and keeping in close contact with their doctor teams during the pandemic.

It is crucial that everyone, particularly those at risk for lung cancer, remain watchful for any new symptoms and contact their health care provider for evaluation and treatment, if warranted. Recent data show that states have been experiencing declines in the number of lung cancer diagnoses by an average of 30%-60% as of May 2020 – (55% decline for New York in May 2020).

It is important to help people understand that this decline does not mean that fewer people are getting lung cancer. Rather, more people are going undiagnosed, many of whom will end up finally presenting with a more advanced stage of the disease when outcomes are poorer.  The toolkit can be accessed here.



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Colleges Reopened: How Many COVID Cases Resulted? What New Study Found
Reopening colleges and universities for in-person instruction has been linked to tens of thousands of additional cases of Covid-19, according to a draft study released Tuesday. For the study, which was published preprint on medRxiv and has not yet been peer reviewed, researchers from the University of North Carolina-Greensboro, Indiana University, and the University of Washington and Davidson College examined whether the reopening of 1,400 U.S. colleges and universities affected rates of COVID-19, the disease caused by the new coronavirus, in the surrounding counties.

To determine the impact, the researchers examined cellphone GPS tracking data, county-level Covid-19 data, and campus reopening schedules from July 15 to Sept. 13, which is before and after students returned to their schools. The researchers focused their study on how colleges and universities implemented classes and not on student behavior.

The researchers found the reopening of colleges and universities for in-person instruction correlated with an increase in new cases of Covid-19, ranging from a minimum of nearly 1,100 extra cases per day to a maximum of 5,300 extra cases per day. The researchers estimated 3,200 additional Covid-19 cases per day—or 2.4 cases per 100,000 residents a day—as the midpoint range for the projected daily increase in infections.

The researchers found reopening one university alone for in-person instruction led to an additional 1.7 new cases per day per 100,000 residents in a county. However, the researchers said they found “[n]o such increase … in counties with no colleges, closed colleges or those that opened primarily online.”

According to the Journal, the researchers found a slight uptick in new Covid-19 cases in communities where students moved near their college campuses but took their classes online. When the researchers factored in whether students had traveled from places with high disease incidence rates, they found neighboring counties added 1.2 coronavirus cases per day per 100,000 residents, Kaiser Health News (KHN) reports.

Ana Bento—an assistant professor of infectious diseases at Indiana University, who co-authored the study—noted that, “[w]hile this study estimates around a 3,000 increase in daily cases, we have to take into account that this is actually likely an underestimate, because we still don’t see” people with Covid-19 who are asymptomatic.

Discussion

Some observers applauded the study, but others said it left many unanswered questions.

For example, the study did not determine whether cases spiked mainly as a result of students catching Covid-19 when they arrived at their campuses or if they were already unknowingly infected upon their return, KHN reports. In addition, Jason Christie, a pulmonologist and epidemiologist at the University of Pennsylvania’s Perelman School of Medicine, said the study may have missed some of the other underlying factors driving up infections rates, including trends unrelated to the reopening of college and university campuses.

Bento acknowledged some of the uptick in cases could be potentially attributed to increase in coronavirus testing in counties where students returned to campus for in-person instruction. However, in such an event, Bento said the researchers would have likely seen a quick rise in infections and then either a plateau or decline, instead of an increase two weeks after schools reopened and a continued surge.

Bento added that it would be “slightly unfair” to assume that cases spiked because students did not follow social distancing guidelines or engaged in other “bad behaviors.” Bento said, “I think it’s more this idea of when you see a huge influx from all over the country, or from different counties, into a college town that we know had a very low burden of COVID throughout the first months, all of a sudden we have this increased probability of infection, because we have a large community of individuals that were susceptible still.”

As colleges and universities prepare for the spring semester, Bento recommended administrators consider a variety of instructional approaches. “In order for you to open online, hybrid or meet face to face, there needs to be a different combination of strategies that allows you to catch [cases] early so you’re able to control community spread, which is the biggest problem here,” Bento said (McAuliff, Kaiser Health News, 9/23; Korn/Abbott, Wall Street Journal, 9/22; Budryk, The Hill, 9/22).


Pilot Dr. Inderpahl Chhabra Seeking Donations for Patient Airlift Service

Dear Friends:

I am writing this to solicit donations for a charity organization.

I consider myself extremely lucky in that in my professional arena, I am able to help a multitude of patients and that gives me great professional satisfaction. On the personal side, I am able to fulfill my childhood dream of flying an airplane.

As we get closer to the end of this terrible year, we think about all our patients who are afflicted with illnesses that require them to travel far and wide for the best care that is available in this great country. An organization that helps make it happen is PALS. A lot of my pilot friends are affiliated with this organization. As a physician, I recently made use of their services by referring a patient who needed to travel to Cleveland, Ohio for a transplant evaluation. An air transport company quoted them a price of $25,000. As it stands, the head of the household works at a coffee shop, there was no way they could afford it. With Patient Airlift Service (PALS), their out of pocket cost was absolutely zero.

I am going to join my other pilot friend in flying missions for PALS very soon.

I’m hoping you will join me in supporting this fantastic organization by donating at their upcoming fundraiser. I have committed $1000 out of my own personal funds for this cause.

The details are on the website here.

Here is a short video about the impact this organization has on people it touches.



Unitedhealth Accused of Illegally Deflating Reimbursements
Two hospital-based physician groups have filed a lawsuit accusing UnitedHealth Group of improperly cutting reimbursements to out-of-network providers, according to Law360.  In a complaint filed Sept. 15, Emergency Care Services of Pennsylvania and Emergency Physician Associates of Pennsylvania allege UnitedHealth hired a data analysis firm to develop market-based reimbursement rates. However, the plaintiffs allege the tool used to come up with the rates, called Data iSight, does not use information about services or rates in local markets.

“It does not use the local information it purports to, and exists simply to paper over the naked, unexcused, and illicit greed of the United defendants, whose growth in profit comes at the direct expense of front-line emergency room physicians,” states the complaint.

The plaintiffs allege UnitedHealth paid them between 75 percent and 90 percent of billed value for out-of-network claims for years. After implementing Data iSight, the reimbursement rate allegedly dropped to between 15 percent and 20 percent of billed value for claims. The complaint includes several claims, including breach of implied contract and civil conspiracy, according to Law360. Counsel information for UnitedHealth wasn’t immediately available, according to the report. The case is pending in the Court of Common Pleas of Philadelphia County.


U.S. Medical School Applications Soar in COVID-19 Era
Global pandemic is prompting more young people to become doctors.

NYU said applications have jumped since it said in 2018 that it would make medical school free. Medical schools are reporting record application numbers as the coronavirus sparks a new wave of prospective students to become doctors.

Through the end of August, the number of applicants rose nearly 17% from a year earlier, marking an interest not seen in more than a decade, according to the Association of American Medical Colleges, which administers the main medical-school entry exam. Compared with past years, this year’s numbers are unprecedented, said Patrick Fritz, a senior director with AAMC.

Coronavirus has put a spotlight on health professions, prompting young people to apply to medical school earlier than they might have before, schools and admissions coaches said. Some applicants may be looking to take advantage of less strict application requirements this year. Many schools have dropped the Medical College Admission Test, or MCAT, exam requirement, or have pushed application deadlines further into the fall. In a year of massive job losses, some may be lured by what appears to be a stable career path. (WSJ Sept. 2)



CMS Unable to Disburse Incentive Payment Due to Inaccurate Billing Info
For the second year in a row, CMS is again unable to disburse the 5% APM incentive payment to some clinicians due to inaccurate or outdated billing information. This Medicare incentive payment should have been disbursed earlier this year to clinicians who participated in Advanced APMs and met all criteria to become “qualifying APM participants” under the 2018 Quality Payment Program.

Of the 183,306 clinicians who qualified nationally, CMS is unable to verify billing information for 22,256 clinicians, up from 2,767 last year. This number seems high and is very concerning. Of note, the incentive is paid in one lump sum and given the COVID-19 circumstances, I’m sure many clinicians desperately need that money. According to the attached QPP notice, CMS is giving clinicians until Nov. 10 to update their billing information and claim their incentive payment by email.

Please see the attached APM Incentive Payment Notice here.

Please see the excel spreadsheet for affected NPIs and names involved here.


Employee Sick Leave Requirements Go into Effect September 30 for 2021 Use
Earlier this year, the New York State Legislature enacted a new law that requires all New York employers to provide sick leave to employees. The legislation becomes effective next week, September 30. The amount of sick leave an employer is required to provide depends on the size and net income of the employer:

  • Employers with 4 or fewer employees and a net income of $1 million or less in the prior tax year must provide employees with up to 40 hours of unpaid sick leave in each calendar year;
  • Employers with 4 or fewer employees and a net income of greater than $1 million in the prior tax year must provide employees with up to 40 hours of paid sick leave in each calendar year;
  • Employers with between 5 and 99 employees must provide up to 40 hours of paid sick leave in each calendar year; and
  • Employers with 100 or more employees must provide up to 56 hours of paid sick leave in each calendar year.

Employees begin to accrue paid sick leave when the law goes into effect (September 30) or upon the employee’s date of hire, whichever is later. Although employees may begin accruing leave prior to January 1, 2021, employers are not required to begin to allow employees to take sick leave until January 1, 2021.

For summaries of this new law, click here: NEW YORK ENACTS PAID SICK LEAVE REFORM 
Into Effect September 30 for 2021 Use


Bassett Healthcare Network Appoints MSSNY Members to New Positions
The Bassett Healthcare Network CEO has made the following three appointments:

Bassett Appointees Enlarged(Top-Left) Joseph Sellers, MD, will become the Physician Executive for the Bassett Medical Group (BMG). Dr. Sellers has been an attending physician at Bassett in Internal Medicine and Pediatrics since 1989. He became an area medical director for Primary Care in 1996, and in 2013 became the Eastern Region Medical Director with responsibility for 20 primary care sites and 90 practitioners.

In his role as physician executive for the BMG, Sellers will have oversight of all strategic and operational elements of the BMG and foster physician engagement while driving enhanced quality at all medical group practices. Dr. Sellers will also continue to see patients at Bassett’s Cobleskill primary care center. Dr. Sellers is the current President-Elect of MSSNY.


(Top-Right) Henry Weil, MD, will take on the added responsibilities of Chief Academic Officer for Bassett Healthcare Network. The newly created CAO position is essential to Bassett Healthcare Network’s strategic development and will enhance an existing, strong academic and research foundation.

Dr. Weil is a professor of clinical medicine and senior associate dean for the Bassett affiliation at Columbia’s College of Physicians and Surgeons. He has served in a variety of other capacities including director of the Internal Medicine Residency Program, assistant physician-in-chief, medical director for inpatient services, director of medical informatics, and director of the intensivist and hospitalist programs.

In addition to his role as CAO, Dr. Weil will retain his responsibilities within the Columbia-Bassett Medical School program and work collaboratively with other Bassett leaders and educational and research partners to develop and implement plans for innovation and growth of the education and research missions at Bassett.


(Bottom) Nicholas Hellenthal, MD, will take on the added responsibilities of Chief Medical Officer for the Bassett Medical Group in addition to continuing to serve as chief of surgery. Dr. Hellenthal has been with Bassett since 2010, has been chief of the Department of Surgery since 2015, and was interim chief since 2013.

In this part-time role as CMO, Dr. Hellenthal will work closely with the BMG physician executive to improve practitioner and patient experience and patient access. He will also be working with each of the medical chiefs to drive evidence-based protocols across all services and leveraging analytics to reduce clinical variation.


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

UES Park Avenue Medical Office Space for Rent – One or Two Days a Week
Elegant office space on UES, in Park Avenue doorman building.  Enormous furnished windowed consult room, large exam room and private secretarial area.  Private elevator to office, huge waiting room and all shared office space. One – two days available; ideal for low volume Practitioner of any specialty. Please contact office manager Theresa – 212-288-2171 or via email at drfox.903parkave@gmail.com.

Consult Room

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Dermatology Practice for Sale – Staten Island, NY
Building includes 3 exam rooms, waiting area. Please respond by calling 718-987-3300 or email enbmd@aol.com

MSSNY eNews: September 23, 2020 – DOH Commissioner: COVID-19 Medical Grand Rounds on Tuesday, Sept. 30


DOH Commissioner: COVID-19 Medical Grand Rounds on Tuesday, Sept. 30
We are excited to share the marketing materials for a special session of our 2020-2021 Commissioner’s Medical Grand Rounds series, which will take place on Wednesday, September 30th. This session, entitled NYSDOH Update on COVID-19: Current Knowledge and Best Practices for Primary Care During the COVID-19 Pandemic, we will bring together providers from various perspectives to discuss the unique and ongoing challenges in addressing primary care needs during a pandemic.
Two primary care physicians who responded to the COVID-19 crisis in some of the earliest and hardest-hit areas of New York will discuss their experiences, recommendations, and lessons learned. Our speakers will discuss the most up-to-date, evidence-based best practices for delivering care, addressing patient needs, and COVID-19 testing. A flyer is attached here—please feel free to share liberally among your networks.
This virtual session will take place on Wednesday, September 30th from 1:30 – 3:00 pm, and will be streamed via live webcast. The session will also be archived on the NYSDOH Website. The event is free-of-charge and open to all interested providers across New York State. The link to register can be found here.


DOH Issues Health Advisory on Reporting of COVID-19 and Influenza Test Results
The New York State Department of Health issued a health advisory regarding new data elements that need to be reported according to Executive Order 202.61.  The new order requires all health care providers who order or administer COVID 19 tests to collect and report where a patient attends or works in a school and the name and location of the school.

The order also requires listing of the patient’s local address if different from their permanent address.  This requirement applies to physicians’ office laboratories (POL) and to any point of care (POC) or rapid testing conducted by the healthcare provider.  All providers using POL and POC must report within 3 hours of receiving results of COVID 19 (testing through ECLRS, along with the required information.  Most importantly, clinical labs and POLCs or health care providers conducting POC influenza testing must report Influenza test results immediately through the ECLRS.  A copy of Commissioner Howard Zucker, MD letter and the health advisory can be found here.


US House Passes Measure to Continue Government Funding Through December; Expected to Pass Senate
Yesterday, the US House of Representatives passed legislation (H.R. 8337) by a bipartisan vote of 359-57 to fund federal government operations until December 11, 2020 and is intended to avert a potential government shutdown prior to the November elections.  It is expected to pass the US Senate later this week.  Among the notable health care provisions contained within the measure:

  • Extends the Medicare GPCI cost index floor, important for helping to prevent Medicare cuts to the upstate New York payment locality;
  • Holds the 2021 Medicare Part B monthly premium at the 2020 amount for the standard premium, plus an additional percentage, and establishes a “small surcharge” of approximately $3 for most seniors, on the monthly premium, until the Part B trust fund is repaid.
  • For physicians and other health providers receiving Medicare accelerated or advance payments between the date of enactment of the CARES Act, and through the end of the COVID-19 public health emergency, the continuing resolution extends the period “before repayment begins and the period before the balance must be repaid in full, reduces the recoupment percentage, and lowers the interest rate for payments” to 4%.

COVID Treatment Could Increase Cardiac Risk if Taken with Certain Drugs
Azithromycin, an antibiotic being studied as a potential COVID-19 treatment, could cause cardiac events if taken in combination with drugs that affect the heart’s electrical rhythm, according to research published Sept. 16 in JAMA Network Open.

The FDA issued a warning for azithromycin in 2012 saying it may be linked to cardiac events, but subsequent studies have not produced conclusive results. A new study conducted by researchers from the University of Illinois Chicago found that the drug itself does not increase the risk of cardiac events, but it could if taken in combination with a QT-prolonging drug, which refers to a drug that affects the interval in the heart’s electrical rhythm called the QT interval.

Common QT-prolonging medications include blood pressure drugs, opioids, certain antidepressants, antimalarial drugs, and some muscle relaxers.

“Our findings should give researchers and clinicians looking at azithromycin as a potential treatment for COVID-19 pause,” Haridarshan Patel, PharmD, one of the study’s authors, said in a news release. “We found that if taken together with drugs that affect the electrical impulses of the heart, the combination is linked with a 40 percent increase in cardiac events, including fainting, heart palpitations and even cardiac arrest.”

The study comes about three months after the FDA rescinded its emergency use authorization for hydroxychloroquine, the antimalarial treatment used by some physicians as a COVID-19 treatment. The FDA’s June 15 decision came after an impassioned debate in the medical community over hydroxychloroquine’s reputation for increasing the risk of cardiac events.


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US Dept. of Labor

Narrows Families First Coronavirus Response Act’s Definition of “Health Care Provider
On September 11, 2020, the United States Department of Labor (“DOL”) revised a definition of who is a “health care provider” for purposes of excluding those employees, i.e., not providing federal paid sick leave, from the Families First Coronavirus Response Act (“FFCRA”). The Revised Final Rule significantly narrows the prior definition, and employers in the health care industry should review and revisit their policies regarding eligible coverage (or exemption) under the FFCRA.

That revised Rule took effect on September 16, 2020. The FFCRA is a federal law that requires certain employers to provide employees with paid leave for certain COVID-19 related reasons. The FFCRA, however, allows employers to exclude “health care providers” from the paid leave requirement.

The DOL had previously defined the term “health care provider” broadly as “anyone employed at any doctor’s office, hospital, health care center, clinic, post-secondary educational institution offering health care instruction, medical school, local health department or agency, nursing facility, retirement facility, nursing home, home health care provider, any facility that performs laboratory or medical testing, pharmacy.”

On September 11, 2020, the DOL revised its definition of “health care provider” to narrow its scope. The Revised Final Rule makes it clear that it is “not enough” that an employee merely works for an employer that provides health care services. Instead, the exemption will now only apply to and allow for exclusion of employees who would fall under the Family Medical Leave Act (“FMLA”)’s definition of “health care provider” or who are employed to provide diagnostic services, treatment services, or other services that are integrated with and necessary to the provision of patient care which, if not provided, would adversely impact patient care.” Under the FMLA, a “health care provider” includes physicians and physicians’ assistants, podiatrists, dentists, clinical psychologists, optometrists, chiropractors, nurse practitioners, nurse-midwives, clinical social workers, and Christian Science practitioners.

The DOL indicates that the revised definition may also include: (i) nurses, nurse assistants, and medical technicians; (ii) employees providing services under the supervision, order, or direction of, or providing direct assistance to, specifically identified health care providers; and (iii) employees that provide services that are “integrated with and necessary components to the provision of care,” such as laboratory and radiology technicians. Examples of employee positions that would not be covered by the health care provider exception include: information technology professionals, building maintenance staff, HR personnel, cooks and food service workers, record managers, consultants, and billers as employees that should not be exempted from coverage under the FFCRA.

To minimize the spread of COVID-19, DOL encourages employers to be judicious when using this exemption. For example, an employer may decide to exempt these employees from leave for caring for a family member, but choose to provide them paid sick leave in the case of their own COVID-19 illness.

Should you have any questions regarding the above, please contact the Garfunkel Wild attorney with whom you regularly work.


FDA to Announce Stricter Rules on Emergency Use Authorization for Vaccine
The FDA is expected to announce new standards for emergency use authorization of a COVID-19 vaccine as soon as this week, which would make it more difficult for any vaccine to be approved before Election Day, The Washington Post reported.

The new guidance would require manufacturers seeking emergency use authorization to monitor clinical trial participants in late-stage trials for at least two months after they receive a second dose of the vaccine. The agency will also likely look for at least five cases of severe COVID-19 in the placebo group as well as some in older people, according to the Post.

The new standards, in addition to the time it will take for drug makers to prepare their applications and the agency to review the data, make it highly unlikely any vaccine will be authorized before Election Day, the Post reported.

The FDA has said it is issuing the guidance to increase transparency and public trust, as public health experts have become increasingly worried that President Donald Trump’s prediction for a vaccine by Nov. 3 may cause Americans to reject the vaccine out of concern it was rushed.

The updated guidance is much more rigorous than what was used for hydroxychloroquine or convalescent plasma, the Post reported. The standards are being reviewed by the White House Office of Management and Budget.

Pfizer said Sept. 22 that it still plans to have data on the effectiveness of the vaccine by the end of October and that it plans to collect safety data for two years. Moderna has said it is unlikely to have data in October, according to the Post. AstraZeneca’s trial is still on halt in the U.S. while investigators try to figure out if a serious adverse reaction in a patient in Britain was caused by the vaccine.

Read the full article here.


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Is 6 Feet Enough? CDC Walks Back Its Walkback on Airborne Transmission of COVID-19
The Centers for Disease Control and Prevention, which quietly changed its guidance on coronavirus transmission through the air Friday, reversed field again Monday. On Friday, the CDC posted an update on its website saying 6 feet may not be sufficient to keep people safe and that ventilation was key to easing transmission indoors. That determination could be crucial for schools where desks are now set up 6 feet apart. Offices, restaurants and even church services also could be affected by the change. (KHN,9/21)


Employee Sick Leave Requirements Go into Effect September 30 for 2021
Earlier this year, the New York State Legislature enacted a new law that requires all New York employers to provide sick leave to employees. The legislation becomes effective next week, September 30. The amount of sick leave an employer is required to provide depends on the size and net income of the employer:

  • Employers with 4 or fewer employees and a net income of $1 million or less in the prior tax year must provide employees with up to 40 hours of unpaid sick leave in each calendar year;
  • Employers with 4 or fewer employees and a net income of greater than $1 million in the prior tax year must provide employees with up to 40 hours of paid sick leave in each calendar year.
  • Employers with between 5 and 99 employees must provide up to 40 hours of paid sick leave in each calendar year; and
  • Employers with 100 or more employees must provide up to 56 hours of paid sick leave in each calendar year.

Employees begin to accrue paid sick leave when the law goes into effect (September 30) or upon the employee’s date of hire, whichever is later. Although employees may begin accruing leave prior to January 1, 2021, employers are not required to begin to allow employees to take sick leave until January 1, 2021.

For summaries of this new law, click here.


 

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

UES Park Avenue Medical Office Space for Rent – One or Two Days a Week
Elegant office space on UES, in Park Avenue doorman building.  Enormous furnished windowed consult room, large exam room and private secretarial area.  Private elevator to office, huge waiting room and all shared office space. One – two days available; ideal for low volume Practitioner of any specialty. Please contact office manager Theresa – 212-288-2171 or via email at drfox.903parkave@gmail.com.

Consult Room

Consult Room

Exam Room

Exam Room

 

 

 

Waiting Room

Waiting Room


Dermatology Practice for Sale – Staten Island, NY
Building includes 3 exam rooms, waiting area. Please respond by calling 718-987-3300 or email enbmd@aol.com

MSSNY Supports Requirement that School Age Children Receive the Influenza Vaccine 

For Immediate Release  

MSSNY Supports Requirement that School Age Children
Receive the Influenza Vaccine 
 

American Academy of Pediatrics, NYS District II, Chapters 1, 2 & 3
 Joins MSSNY in Support of Requirement 

Westbury, New York, September 18, 2020—The Medical Society of the State of New York (MSSNY) and the American Academy of Pediatrics, NYS District II, Chapters 1, 2 & 3 today announced joint support of the requirement that all school-age children and teens who attend childcare, pre-kindergarten, K-12 and colleges and universities in New York State receive the flu vaccine, unless medically contraindicated.

“In light of the COVID-19 pandemic, immunizing school-age children with the influenza vaccine is vital to public health,” said Dr. Bonnie Litvack, president of the Medical Society of New York. “Studies show that children frequently introduce influenza to households and that schools act as a conduit for infection transmission in communities.

“Vaccination of children protects the elderly populations and those individuals, including the immune-comprised, who are already at high risk of serious complications of influenza,” continued Dr. Litvack.

“During this time of COVID-19, it is imperative that all infants, children and teens who are attending childcare, school or college be immunized against flu, said Dr. Warren Seigel, Chair of NY American Academy of Pediatrics, District II, NYS. “With the increased time spent indoors as fall and winter approach, school age children and young people in college settings are even more vulnerable to both COVID-19 and flu. We have an effective and safe flu vaccine. Let’s use it!”

# # #

About MSSNY
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. 

About American Academy of Pediatrics, NYS District II, Chapters 1, 2 & 3
The New York Chapter of the AAP was established in 1949 as an endorsed Chapter Affiliate of the national organization.  The AAP is a national organization composed of over 55,000 pediatricians.   

 

Media Contact:
Roseann Raia

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

 

 

 

 

MSSNY eNews: September 18, 2020 – MSSNY President, Bonnie Litvack MD, Inaugurated

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Colleagues:

Let me start by saying thank you to our entire House of Delegates, our physician members throughout the state and our county and state staff.  You are rock stars and heroes. Your ethics, courage, strength, ingenuity, and resilience pulled this state through a spring like we have never seen before, the roughest healthcare crisis in recent memory. You are role models for the state and the nation and are the reason that New York currently has among the lowest virus levels in the country.

While this year we had to forgo our ceremony of presidents, a moving and meaningful part of our House of Delegates, the spirit of that event lives on.  Our leadership is a continuum building from year to year incorporating the best of the past and welcoming the new, the present and the future.  I thank all the past presidents that came before me for their service, inspiration, and guidance.

Women in Medicine Month and Mentors

This month is “Women in Medicine” month and therefore a perfect time for our first ever virtual House of Delegates with a female society president. As most of you know, I am the third female president in the history of the Medical Society of the State of NY.  However, most of you do not know that the reason I got involved in the medical society was at the behest of Dr. Ann Cea our first female MSSNY president.  Watching Ann artfully and seamlessly navigate through multiple land mines and successfully build coalitions to benefit NY was mesmerizing. I am extremely grateful for her mentorship and all that she has given to our entire 9th district delegation. I treasure and admirer my 9th district delegation who are incredibly dedicated and thoughtful leaders. I am proud to call all of you my friends and colleagues. In particular, I must single out Dr. Andy Kleinman who continues to mentor me on the “art of the deal”, Dr. Mark Fox and Dr. Kira Geraci who regularly share their expertise on creating effective policy, Dr. Tom Lee for his abounding energy and sharing his financial and legislative prowess and Dr. Michael Rosenberg for always modeling calm, reasonable and approachable leadership and of course the phenomenal executive directors that I have been privileged to work with throughout the state but in particular, Stuart Hayman, Brian Foy and Janine Miller.

In the wisdom our forefathers, the “Office of the President” construct was erected helping to provide a seamless transition from one year to the next.  Our office of the president meets weekly to discuss, strategize and plan our agenda.  This group lives the motto: “Together we are Stronger.”   It is and has been a true honor to work with and learn from Sam Unterricht, Bob Hughes, Andy Kleinman, Charlie Rothberg, Tom Madejski, Art Fougner, Joe Sellers, Parag Mehta, Bill Latreille and Maria Basile as well as Phil Schuh and our MSSNY Senior Vice Presidents, Moe, Pat, Eunice, Christina, Laurie and Regina. I thank all of you for your friendship and for sharing your time, thoughts, worries and advice.  A special thank you to our Executive Director, Phil Schuh who will be retiring in December but who will remain at the forefront of our thoughts after spending 30 years at MSSNY advancing the agenda of the house of medicine and helping to steer us in the right direction.  Phil, we owe you debt of gratitude and we salute you.

Victories

Even in the midst of a pandemic the work of medicine and medical advocacy continued. Over the course of the past year we have made great strides forward repealing the religious vaccine exemption, establishing the maternal mortality review board with confidentiality protections, obtaining reforms for insurance parity for mental health conditions, substance use disorders, and autism spectrum disorders, obtaining a 20% tax on the sale of “vapor products”, a defeat of the trial lawyers’ “Wrongful Death” bill, maintaining the excess layer of malpractice coverage and defeating the proposal to bypass existing OPMC due process protections for physicians.

Our success has, in no small part been due to the strong leadership of my dear friend and our immediate past president, Dr. Arthur Fougner.  This year we continue to build on those successes and to deal with the new and challenging current practice environment.

Helping Practices During Covid-19

With the pandemic, we have focused on emergency preparedness with our emergency preparedness committee and our infectious disease committee working tirelessly and in tandem to create useful webinars to share information about Covid as well as to provide feedback to our NYS DOH about testing, tracing and vaccine distribution.  We have met with legislators, the governor’s office, DOH and testified before our NYS legislature, coordinated with the AMA and sent letters to federal legislators highlighting the need for more funds to NYS physician practices, the woefully inadequate PPE supply chain, the high cost of PPE and the need for faster testing turn-around times and community physician access to point of service tests and supplies.  We continue to look for ways for our NYS physicians to procure vetted PPE at a reasonable cost and continue to work with DFS, the Health Plan Association and the legislature on solutions to defray the cost of PPE to physician practices.  We have procured and distributed 40,000 N95 masks at cost and on Monday will be offering members access to 6,000 face shields donated by the Ford Company.  Our Member Benefits committee expects to shortly announce the opportunity for MSSNY members to participate in a Group Purchasing Organization that will give our members access to numerous discounts, including PPE.

During the pandemic, MSSNY has focused not only on our community physicians but has also spoken out on the plight of our employed physician members.  We raised concern and objections with the Governor’s office, DOH, our NYS legislature and in the press about unacceptable working conditions and protections that put the health and safety of physicians and their families in jeopardy and the despicable practice of imposing gag orders and sanctions. We also objected to enforcement of non-competes on furloughed physicians as well as salary reductions and withheld productivity bonuses. This year a new committee will be formed chaired by Dr. Arthur Fougner which is charged with empowering our employed members.

Physician Wellness

Physician Wellness has been and remains a priority for our society.  This year thanks to the hard work of Dr. Charlie Rothberg, Frank Dowling, Pat Clancy and Cayla Lauder and the entire Physician Wellness and Resilience Committee we have made considerable progress.  The MSSNY Peer to Peer Program is now up and running and any physician, resident, fellow or medical student can access the confidential helpline by calling 1-844-P2P-PEER or by emailing p2p@mssny.org to be connected with a trained, empathetic peer supporter who will offer support, provide positive coping skills, or connect physicians to professionals for more focused assistance.  In addition, four NYS institutions have now agreed to partner with MSSNY and the AMA in the Practice transformation Initiative in order to enact system level change in a continuous learning collaborative format.

Advocacy

Advocacy is always a MSSNY priority and progressive malpractice reform and collective negotiation remain at the top of the list this year as well as advocating for telehealth payment parity and opposing national surprise medical bill legislation that does not adhere to the tried and true NY model. However, front and center over the past few months has been Scope of Practice.  MSSNY has met with the Governor’s Office and our legislators and testified at a joint hearing of the Senate and Assembly to express our concern with Executive Orders 202.55 that continues the waiver of otherwise statutorily required physician supervision requirements for various non-physician health care practitioners, including nurse anesthetists, nurse practitioners and physician assistants. We have urged that given our relatively low virus infection rate that statutory supervision and/or oversight requirements be restored as soon as possible.  Our MSSNY Scope of Practice committee has been monitoring the legislative scope of practice initiatives of nurse midwives, nurse practitioners, nurse anesthetics and others and is hard at work on strategy for fighting scope of practice creep in our state.

Health Equity

Achieving health equity and gender equity have long been MSSNY goals. Our committee to eliminate healthcare disparities was instrumental in the creation of the AMA’s Center for Health Equity that is working to embed health equity as a part of practice, process, action, innovation, and organizational performance and outcomes and AMA president, Dr. Patrice Harris personally expressed her thanks to MSSNY at our June council meeting. Our MSSNY committee will play a critical role this year in helping our state to work toward greater health equity by identifying and eliminating inequities through advocacy, community leadership and education. Our Women Physicians committee will also continue to play an important role this year in righting gender equity in our organization and our profession.

My Family

This MSSNY house provides shelter, support, and stability for all in the medical profession.  It is welcoming and dynamic and I am proud to be a part of it and honored and humbled to be able to serve as your president.  I am grateful that my children grew up in the house of medicine as they have learned much from our passion, dedication, ability to share information and even our ability to “argue” respectfully.  My girls Sydney, Haley and Carly may not ultimately choose medicine as a career but from us they have learned the importance of leadership and advocacy and they will be better people and citizens for having been exposed to our House of Medicine.  I thank them and my husband Craig for allowing me to take time away from our family to be with and lead my medical family.

We as a medical society have learned much and will use our knowledge and leadership skills to guide our state and our country forward, out of the worst global pandemic in a century and into a future that includes a healthy and unified state and nation.  We will do this by this by adhering to our core values as physicians and Americans and by honoring our pledge of allegiance to one nation under god, indivisible with liberty, justice, and health for all.

Thank you, Mr. Speaker and Madam Vice Speaker for your hard work in developing an online format for our 2020 HOD and for the privilege of addressing this house.

Bonnie Litvack, MD
President


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MSSNY’s Weekly Podcast


Federal Stimulus Funds for Physicians
Survey of New York Physicians 

TAKE IT TODAY!

In March and April, Congress passed multiple pieces of legislation to create the Paycheck Protection forgivable loan Program (PPP) to assist small businesses including physician practices. To date, the program has approved assistance to nearly 250,000 New York businesses in two different rounds of application periods, including many physician practices.

These Congressional packages have also allocated $175 billion for the CARES Act Health Provider Relief Pool to assist physicians, hospitals, and other health providers. The funds from this pool have been allocated in various distribution segments over the past several months.

We understand that many physicians have received distributions from one or both of these funding pools. However, we have also frequently heard that these funding pools have only modestly offset the enormous drop in patient revenue for this year. That is why MSSNY continues to advocate with many organizations in support of urging Congress to enact another “stimulus” bill to supplement these previous efforts.

As with our two previous surveys, MSSNY wants to gather data to determine how much New York physicians are benefiting from these new resources to better guide our advocacy.

Please help us evaluate this by taking a few minutes to fill out and submit the
Surveymonkey questionnaire TODAY!


Press Release

MSSNY Supports Requirement that School Age Children Receive the Influenza Vaccine

Westbury, New York, September 17, 2020—The Medical Society of the State of New York (MSSNY) and the American Academy of Pediatrics, NYS District II, Chapters 1, 2 & 3 today announced support of requiring the administration of the influenza vaccine for all school-age children and teens, unless medically contraindicated, who attend childcare, pre-kindergarten, K-12 and college and universities in New York State.

“In light of the COVID-19 pandemic, immunizing school-age children with the influenza vaccine is vital to public health,” said Dr. Bonnie Litvack, president of the Medical Society of New York. “Studies show that children frequently introduce influenza to households and that schools act as a conduit for infection transmission in communities.

“Vaccination of children protects the elderly populations and those individuals, including the immune-comprised, who are already at high risk of serious complications of influenza,” continued Dr. Litvack.

“During this time of COVID-19, it is imperative that all infants, children and teens who are attending childcare, school or college be immunized against flu, said Dr. Warren Seigel, Chair of NY American Academy of Pediatrics, District II, NYS. “With the increased time spent indoors as fall and winter approach, school age children and young people in college settings are even more vulnerable to both COVID-19 and flu. We have an effective and safe flu vaccine. Let’s use it!”


MLMIC Banner


MSSNYPAC Makes Candidate Endorsements
At this week’s MSSNY Council meeting, the following bi-partisan list of legislators (10 Assembly, 6 Senate; and 8 Congress) were endorsed for re-election by the Medical Society of the State of New York Political Action Committee (PAC) for the upcoming November 3 election. Each candidate on this list has demonstrated themselves to be champions of issues to preserve the ability of patients to continue to receive needed and timely physician care.


Council Approved the Following at the September 17 Council Meeting:

  • MSSNY Supports Requirement that School Age Children Receive the Influenza Vaccine
    The Medical Society of the State of New York supports a requirement for administration of the influenza vaccine for all school-age children, unless medically contraindicated, who attend childcare, prekindergarten, K-12 and colleges and universities in New York State.
  • MSSNY Approval of any Amicus Brief
    Any proposed MSSNY amicus, or proposed participation in any amicus brief by MSSNY, will require the approval of the President when MSSNY has related policy; approval of Council or Executive Committee when there is no relevant MSSNY policy; and approval of MSSNY Board of Trustees when expenditures are required in relation to the amicus brief. Any amicus approved by the President needs to be reported to the Council.
  • Access to Medication
    MSSNY will seek regulations that prohibit pharmacy benefit plans from limiting patient access to medications based on an initial prescription placed for mail-order and will seek regulations that require pharmacies to offer patients access to their prescribed medications without undue delay. MSSNY will seek support from the AMA to form regulations on a national level that prohibit pharmacy benefit plans from limiting patient access to medications based on an initial prescription placed for mail-order.
  • Resolutions Referred to Council
  • MSSNYPAC Report, including the list of recommendations for state and federal candidate endorsements.

MSSNY CME Provider Virtual Conference 2020 9/25/2020
The MSSNY CME Provider Conference will be virtual this year.  The conference is for CME professionals, including CME Directors, as well as physician leaders involved in the CME programs at their organizations.

The conference will be held on Friday, September 25, 2020, from 8:30 AM to 12:15 PM, Eastern Time.

More information is available on the flyer here. Registration is required; registration link here.

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

The Medical Society of the State of New York designates this live activity for a maximum of 3.0 AMA PRA Category 1 Credits™.  Physicians should only claim credit commensurate with the extent of their participation in the activity.


Registration Now Open
September 23, 2020 @ 7:30am Medical Matters CME Webinar
The Importance of Herd Immunity: 2020 Update with a COVID-19 Twist

Learn more about the role herd immunity plays in eliminating vaccine-preventable diseases (including SARS CoV-2) by registering for: “The Importance of Herd Immunity: 2020 Update with a COVID-19 Twist” on Wednesday, September 23, 2020 at 7:30 a.m.  William Valenti, MD, chair of MSSNY Infectious Disease Committee and a member of the Emergency Preparedness and Disaster/Terrorism Response Committee will serve as faculty for this program. Registration is now open for this webinar here

Educational objectives are:

  • Review the epidemiology vaccine-preventable infectious diseases and the role of herd immunity.
  • Describe how herd immunity protects vulnerable populations such as newborns, the elderly and those who are too sick to be vaccinated.
  • Discuss the percentage(s) of a population who need to be vaccinated for herd immunity to be effective.
  • Examine the role of herd immunity in relation to the COVID-19 pandemic

Additional information or assistance with registration may be obtained by contacting Melissa Hoffman at mhoffman@mssny.org.

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

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


MSSNY Podcasts and CME Keep You Informed and Current
In addition to MSSNY’s weekly Update podcasts, there are numerous informative podcasts available on topics ranging from COVID-19 to emergency preparedness to vaccines.  Each podcast offers insight from medical experts on topics they are extensively well versed on.  Go here and choose one or many to listen to.

MSSNY also has more than 30 modules on our CME website. (Note: new users to the site will need to create an account).  Time is running out to complete the required three hours of Pain Management, Palliative Care & Addiction (Free to MSSNY members, and $50.00 per CME credit for non-members) training which must be attested to by October 1st.  You can also earn free CME credits on emergency preparedness topics that range from Anthrax to Zika Virus.  Additional topics include Medical Matters and Veterans Matters as well as Steps to Physician Wellness and Resiliency.


Trump Poised to Approve Drug Imports from Canada
Over the objections of drugmakers, the Trump administration is expected within weeks to finalize its plan that would allow states to import some prescription medicines from Canada. Six states — Colorado, Florida, Maine, New Hampshire, New Mexico, and Vermont — have passed laws allowing them to seek federal approval to buy drugs from Canada to give their residents access to lower-cost medicines. (9/18 Kaiser Health News)


NEJM Publishes Free Articles for Physicians on COVID-19
NEJM published a collection of articles and other resources on the Coronavirus (Covid-19) outbreak, including clinical reports, management guidelines, and commentary. All NEJM content related to the Covid-19 pandemic is freely available. NEJM COVID-19 page


Check Out MSSNY’s Veterans Matters Podcast Series on Veterans’ Healthcare

Topics include:

PTSD in Returning Veterans, TBI in Returning Veterans, Substance Use in Veterans, Suicide in Veterans, The Special Mental Health Needs of Women Veterans and Military Culture: Everything Physicians Need to Know about Veterans as Patients.

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

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

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

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

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

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

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

Registration Now Open



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Be Sure to Check Out MSSNY’s Medical Matters & Emergency Preparedness
FREE CME Programs

It was recently announced that a leak at a biopharmaceutical company in China has caused a large outbreak of brucellosis.  You can learn more about brucellosis at the MSSNY CME site by viewing the Emergency Preparedness CME program entitled: Brucellosis, Glanders, Melioidosis and Tularemia.

You can also view all of MSSNY’s timely and relevant CME programs at https://cme.mssny.org.  Please note that you will need to create an account there if you haven’t already.

Additional information or assistance with the website may be obtained by contacting Melissa Hoffman at mhoffman@mssny.org.


MSSNY’s First Virtual HOD Zoom MeetingHOD Photo Collage

(Top Left) Phil Schuh, EVP, CFO; Assistant Speaker Maria Basile, MD;
Speaker of the House William R. Latreille, MD, FACP, AME

(Top Right) William R. Latreille, MD, FACP, AME; Michael Reyes, coordinating the Zoom meeting
(Center Left) Speaker William R. Latreille, Md, FACP, AME; Assistant Maria A. Basile, MD
(Center Right) Bonnie Litvack, MD, FACR, MSSNY President
(Bottom Left) Immediate Past President Arthur C. Fougner, MD
(Bottom Right) Phil Schuh, MSSNY EVP, CFO

 

 

Classifieds

Dermatology Practice for Sale – Staten Island, NY
Building includes 3 exam rooms, waiting area. Please respond by calling 718-987-3300 or email enbmd@aol.com

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


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

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


Office Space and Quad-A Certified O.R. for Rent
Plastic surgery office and/or quad A – certified operating room available for rent. We welcome you to tour our facility, where safety and luxury are combined in the most prime location on the upper east side. We assure you will be delighted by what you discover. We take pride in our facility, where your patients’ safety and satisfaction are our number one priority.
    • Fully equipped operating room perfect for a board-certified plastic surgeon
  • Pre-op and recovery areas
  • A bright and modern waiting area
  • 3 consultation rooms, administrative room, kitchenette, and 2 bathrooms
  • Full day office rental per week / O.R. rental per case

For inquiries please call 212.737.8700, email polina@specialtyaestheticsurgery.com

Office Space and Quad-A Certified O.R. for Rent


 

 

 

 

 

 

MSSNY eNews: September 16, 2020 – Top 10 Physician Specialties Using Telemedicine

Gov. Cuomo’s Press Briefing

COVID:

– Day 200
– 75,000 tests conducted yesterday
– 0.87% infection rate
– 4 lives lost yesterday
– 483 hospitalizations
– 138 ICU patients
– LI infection rate at 1.3%

REOPENING:

– Gov. stressed importance of continuing measured reopening
– Important that infection rate is not over 1% for extended period of time
– Gov. discussed federal response, “dangerous” denial of virus
– Gov. stated state is “doing as much as we can” to reopen businesses and keeping infection rate down
– Gov. discussed “trauma” from COVID, said cases of PTSD will likely increase as a result


Top 10 Physician Specialties Using Telemedicine
Endocrinology is the physician specialty with the highest rate of telemedicine adoption, according to Doximity’s 2020 State of Telemedicine report.

For the report, Doximity analyzed data on telemedicine adoption among U.S. physicians who use its virtual care network. The number of physicians reporting telemedicine as a skill increased by 38 percent from 2019-20, nearly doubling the 20 percent annual growth rate recorded over the past five years.

Here are the top 10 specialties using telemedicine:

  1. Endocrinology
  2. Rheumatology
  3. Gastroenterology
  4. Nephrology
  5. Cardiology
  6. Urology
  7. Neurology
  8. Geriatrics
  9. Hematology/oncology
  10. Pulmonology

Click here to view the report. (Sept. 16, Beckers Hospital Report)


Urge Congress to Waive “Budget Neutrality” to Prevent Steep 2021 Medicare Cuts
The 2021 Medicare Physician payment rule advanced by CMS contains a number of important changes, including reduced documentation for E&M codes and long overdue increases for office visits.

However, of great concern it also sets forth an 11% cut to the Medicare conversion factor, greatly limiting the benefit of these other increases and potentially causing great harm to many practices.  The conversion factor cut is required due to statutory “budget neutrality” requirements that prohibit increases without corresponding decreases.  MSSNY and many other groups are urging Congress to pass legislation to waive these “budget neutrality” requirements to prevent devasting cuts and permit needed changes to go forward.

You can send a letter to supplement these efforts here.

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

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

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Please Urge Governor Cuomo to Veto Mandatory OPMC Signage Legislation
All physicians are urged to contact Governor Cuomo to request that he veto legislation (S.6678-A/A.7991-A) requiring every physician’s office to post a sign regarding how a patient can file a misconduct complaint with the OPMC.  Let the Governor know that this proposal would create unnecessary distrust in the physician-patient relationship and unfairly singles out physicians.

This legislation is also unnecessary because this information is already easily available through a simple internet search.  With nearly 10,000 complaints already made each year to OPMC (resulting in only a few hundred actual disciplinary actions), it is clear there is already strong public awareness of this oversight body. You can send a letter and tweet to the Governor opposing this baffling legislation here.


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

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

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

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

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

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


CDC Study: COVID-19 Patients Twice as Likely to Report Dining in Restaurant
U.S. adults who test positive for COVID-19 are more likely to have dined at a restaurant in the past two weeks, a new CDC study suggests.

Researchers analyzed data on 314 U.S. adults who received a COVID-19 test at an outpatient testing site or healthcare center in 10 states from July 1-29. They also polled study participants on what community-based activities they participated in two weeks prior to the test.

Of the 154 who tested positive, 42 percent reported having close contact with someone diagnosed with COVID-19 in the past two weeks. Only 14 percent of respondents who tested negative reported the same.

Researchers found no significant differences in reported participation in the following activities among patients who tested positive for COVID-19:

  • Shopping
  • Going to an office, gym, or hair salon
  • Gathering with fewer than 10 people in a home
  • Using public transportation
  • Attending a religious gathering

However, people who tested positive were about two times more likely to have dined at a restaurant in the past 14 days compared to people who tested negative.

The research does not differentiate between indoor and outdoor dining, which is one limitation of the study, researchers said.

To view the full study, click here.


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12% of Physicians Are Considering Leaving Medicine and 7 Other Findings About the US Physician COVID-19 Experience
About 54 percent of U.S. physicians said they have treated COVID-19 patients in person, and another 26 percent report treating coronavirus patients over the phone or via video, according to a new Medscape report.

The survey polled 7,414 physicians from eight countries, including 5,005 physicians from the U.S. The survey was conducted between June 9 and July 20.

Eight findings from U.S. physicians’ survey responses:

  1. Emergency medicine physicians (94 percent) and nephrologists (89 percent) are the top two specialists treating COVID-19 patients in person.
  2. Twenty-three percent of physicians report lacking appropriate personal protective equipment when treating COVID-19 patients.
  3. Around 5 percent of physicians said they have been diagnosed with COVID-19.
  4. Sixty-two percent of physicians said their income decreased since the beginning of the pandemic, with 33 percent reporting their income decreased by 11 percent to 25 percent.
  5. Approximately 64 percent of physicians report higher burnout since the pandemic started.
  6. Forty-six percent said they are lonelier due to stay-at-home and social distancing guidelines.
  7. About 25 percent of physicians are planning to retire earlier than planned as a result of their experiences treating COVID-19, and 12 percent are considering leaving medicine.
  8. Forty-three percent of physicians said their workplace offers activities to help clinicians with stress and grief. (Sept.11 Becker’s Hospital Review)


UK Testing Vaccine May be More Effective When Inhaled Rather than Injected
The AP (9/14) reports scientists at Oxford University and Imperial College London “are beginning a small study comparing how two experimental coronavirus vaccines might work when they are inhaled by people instead of being injected.” The scientists “said a trial involving 30 people would test vaccines developed by both institutions when participants inhale the droplets in their mouths, which would directly target their respiratory systems.”

Reuters (9/14) reports both vaccine candidates are “being tested in trials through intramuscular injection, but scientists from Imperial said that vaccines delivered via inhalation could potentially deliver a more specialized response.” Chris Chiu of Imperial’s Department of Infectious Disease said there is evidence influenza vaccines can be more effective when inhaled, “We are keen to explore if this may also be the case for SARS-CoV-2 and whether delivering COVID-19 vaccines to the respiratory tract is safe and produces an effective immune response.”


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Classifieds

Dermatology Practice for Sale – Staten Island, NY
Building includes 3 exam rooms, waiting area. Please respond by calling 718-987-3300 or email enbmd@aol.com

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


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

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


Office Space and Quad-A Certified O.R. for Rent
Plastic surgery office and/or quad A – certified operating room available for rent. We welcome you to tour our facility, where safety and luxury are combined in the most prime location on the upper east side. We assure you will be delighted by what you discover. We take pride in our facility, where your patients’ safety and satisfaction are our number one priority.
    • Fully equipped operating room perfect for a board-certified plastic surgeon
  • Pre-op and recovery areas
  • A bright and modern waiting area
  • 3 consultation rooms, administrative room, kitchenette, and 2 bathrooms
  • Full day office rental per week / O.R. rental per case

For inquiries please call 212.737.8700, email polina@specialtyaestheticsurgery.com

Office Space and Quad-A Certified O.R. for Rent


 

 

 

 

 

 

MSSNY eNews: September 11, 2020 – Join MSSNY HOD Live on Sunday at 1 pm


MSSNY Grassroots Action Center (GAC): Getting the Work of Medicine Accomplished

* The link for Virtual HOD will be provided at 12:00 Noon on Sunday, Sept. 13 at www.mssny.org *

We hope you will join us this Sunday for our first ever Virtual MSSNY House of Delegates (HOD). Many new and important MSSNY policies will be adopted by our HOD and will be added to our MSSNY agenda. However, in order for these to be enacted by New York State, the overwhelming majority will require state legislation, regulation, budgetary inclusion and/or grant availability.

Overcoming these hurdles is not an easy task particularly given so many factions in New York State that are seeking to control health care and to diminish the clinical autonomy of physicians. Success depends upon an integrated approach, consisting of lobbying and grassroots efforts and political action. Numbers and dollars are critical!

So here is your TO DO LIST:

•  Sign up for the GAC (GRASSROOTS ACTION CENTER) by texting MSSNY to 52886

•  This is an easy way to be alerted to legislative issues and a quick way to send a letter or a tweet to your elected officials on a matter of importance

•  Your can also easily forward the information to any colleagues (member or not)

•  Volunteer for the Physician Advocacy Liaison (PAL) network:  

• The PAL network makes grassroots contacts with legislators defined and personal, exceedingly important with the enormous number of new legislators that have arrived and will be arriving next year in Albany.

• At least two or three MSSNY members are assigned as a liaison to each state legislator and meet personally with their assigned legislator at least twice a year.

• Visit www.mssnypac.org or text MSSNY PAC to 52866 to donate to MSSNYPAC 

•  MSSNYPAC is a separate fund administered by the State Medical Society that collects voluntary contributions from physicians and distributes donations to pro-medicine candidates for state office.

• MSSNYPAC is the physician’s voice in the political process. (Attending events, fundraising for candidates, endorsements, campaign work)

•  A strong physician PAC helps to counter the political influence of trial lawyers, insurers and others seeking to diminish the physician’s primary role in the health care delivery system.

We all want to see healthcare change in New York — more funding for physicians, a stop to scope creep, an end to administrative hassles, progressive malpractice reform, collective negotiation, important public health initiatives and fair treatment of physicians. MSSNY has tremendous clout in and access to the corridors of power and that combined with our collective willingness to invest time and finances in the future of medicine is our path to success.


Poll: Most Americans Worry Political Pressure Will Lead to Premature Approval of a COVID-19 Vaccine; Half Say They Would Not Get a Free Vaccine Approved Before Election Day

Democrat Voters Graph

Most Americans (62%) worry that the political pressure from the Trump administration will lead the Food and Drug Administration to rush to approve a coronavirus vaccine without making sure that it is safe and effective, the latest KFF Health Tracking Poll finds. This includes majorities of Democrats (85%) and independents (61%), as well as a third of Republicans (35%).

In addition, about four in ten say that the FDA (39%) and the CDC (42%) are paying “too much attention” to politics when it comes to reviewing and approving treatments for coronavirus or issuing guidelines and recommendations.

The poll comes as President Trump and others working in his administration and for his reelection campaign have suggested a vaccine could be ready in the coming months. The Centers for Disease Control and Prevention recently asked states to be ready to distribute a vaccine by November 1, just two days before the 2020 elections.



MSSNY’s Weekly Podcast


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Two CME Webinars September 15TH @ 7:30AM and September 23rd @ 7:30am Registration Now Open

“THE SPECIAL MENTAL HEALTH NEEDS OF WOMEN VETERANS” WEBINAR SEPTEMBER 15th @ 7:30 am

The Medical Society of the State of New York is hosting a CME live webinar entitled Veterans Matters: The Special Mental Health Needs of Women Veterans on Tuesday, September 15, 2020 at 7:30 am.

Click HERE to view the flyer and register for the program!

When:            September 15, 2020 at 7:30 am

Faculty:           Malene Ingram, MD and Colonel, U.S. Army Reserves

Educational Objectives:

  • Review how the increased role of women in the military has impacted their mental health
  • Describe mental health concerns unique to women veterans and how to identify them
  • Identify the barriers that women veterans face in getting the specific care they need

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

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

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


“THE IMPORTANCE OF HERD IMMUNITY – 2020 UPDATE WITH A COVID-19 TWIST” WEBINAR SEPTEMBER 23RD 

“Medical Matters” will begin its 2021 webinar series with “The Importance of Herd Immunity – 2020 Update with a COVID-19 Twist” on Wednesday, September 23, 2020 at 7:30 a.m. 

Click HERE to view the flyer and register for the program! 

William Valenti, MD, chair of MSSNY Infectious Disease Committee and a member of the Emergency Preparedness and Disaster/Terrorism Response Committee will serve as faculty for this program. The educational objectives are 1) Review the epidemiology of vaccine-preventable infectious disease and role of herd immunity.  2) Describe how herd immunity protects vulnerable populations such as newborns, the elderly and those who are too sick to be vaccinated.  3) Discuss the percentage(s) of a population who need to be vaccinated to allow herd immunity to be effective. 4) Examine the role of herd immunity in relation to the COVID-19 pandemic. 

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 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. 

Additional information or assistance with registration may be obtained by contacting Milissa Hoffman at mhoffman@mssny.org.


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Manager of New York Clinics Gets 13 Years in Prison for Kickback Scheme
The manager of medical clinics in New York City was sentenced Aug. 31 to 13 years in prison for his role in a healthcare kickback and money laundering scheme, according to the Department of Justice.

Aleksandr Pikus was sentenced about nine months after he was convicted by a federal jury of two counts of money laundering and one count each of conspiracy to commit money laundering, conspiracy to pay and receive healthcare kickbacks and conspiracy to defraud the US by obstructing the IRS.

According to evidence presented at trial, Mr. Pikus managed medical clinics that employed physicians, physical and occupational therapists and other medical professionals. Mr. Pikus referred patients to these providers in exchange for illegal kickbacks. He and his co-conspirators then laundered a portion of the proceeds through companies he controlled, according to the Justice Department.

Mr. Pikus is one of more than 25 individuals that have pleaded guilty or been convicted for participating in the scheme. In addition to the prison term, Mr. Pikus was ordered to pay $39.4 million in restitution to the federal government and forfeit an additional $2.6 million.


FDA Establishes Vaccine Approval Guidelines to Counter Political Influence
The FDA is using vaccine approval guidelines it created in June to protect reviewers from political pressures, Bloomberg reported.

The guidelines stipulate that a COVID-19 vaccine must be at least 50 percent effective to be eligible for both traditional and emergency use FDA approval.

The framework also leaves it up to drugmakers to submit vaccines for approval, making it difficult for a third party to pursue an emergency use approval using trial data. This strengthens the sentiment behind nine major drugmakers’ Sept. 8 pledge to uphold their commitment to the scientific process during the vaccine race.

FDA Commissioner Stephen Hahn, MD, emailed all 17,000 employees earlier in September to affirm the agency’s adherence to the scientific process during vaccine review, according to Bloomberg. He also said the agency has “not lost sight of [its] responsibility to ensure [its] decisions related to all medical products, including COVID-19 vaccines, are based on science and data,” in a Sept. 8 tweet.

The FDA and pharmaceutical industry’s recent attempts to assure the public about their adherence to the scientific process address the public’s growing concern that the vaccine approval process is too politics-driven.

During a Sept. 7 news conference, President Donald Trump repeated his declaration that a vaccine will be ready by Election Day, saying, “The faster the better.” However, Moderna, considered by most to be one of the drugmaker’s furthest along with its vaccine development, told Bloomberg that gaining approval by Thanksgiving is its best-case scenario. Becker’s Hospital Review, Sept. 9)


Classifieds

Dermatology Practice for Sale – Staten Island, NY
Building includes 3 exam rooms, waiting area. Please respond by calling 718-987-3300 or email enbmd@aol.com

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


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

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


Office Space and Quad-A Certified O.R. for Rent
Plastic surgery office and/or quad A – certified operating room available for rent. We welcome you to tour our facility, where safety and luxury are combined in the most prime location on the upper east side. We assure you will be delighted by what you discover. We take pride in our facility, where your patients’ safety and satisfaction are our number one priority.
    • Fully equipped operating room perfect for a board-certified plastic surgeon
  • Pre-op and recovery areas
  • A bright and modern waiting area
  • 3 consultation rooms, administrative room, kitchenette, and 2 bathrooms
  • Full day office rental per week / O.R. rental per case

For inquiries please call 212.737.8700, email polina@specialtyaestheticsurgery.com

Office Space and Quad-A Certified O.R. for Rent


 

 

 

 

 

 

Council (Virtual) September 17, 2020

MSSNY COUNCIL AGENDA
Thursday, September 17, 2020, 9:00 a.m. (Virtual)

A. Call to Order and Roll Call

B. APPROVAL of the June 4, 2020 Council Minutes

C. New Business

  1. President’s Report:
a. Executive Committee Minutes – July 23, 2020
(For Council Information)
b. Executive Committee Minutes – August 6, 2020
(For Council Information)

c. Reference Committee on Governmental Affairs A
(For Council Approval)

    • Resolution 2020-54 End Restrictive Covenants
    • Resolution 2020-55 Restrictive Covenants
    • Report of the Reference Committee on Governmental Affairs A Speaker Extraction

d. Reference Committee on Governmental Affairs B
(For Council Approval)

    • Resolution 2020-108 Access to Medication
    • Report of the Reference Committee on Governmental Affairs B Speaker Extraction

    e. Resolution Introduced by Dr. Frank Dowling (For Council Approval)
             Clarification of MSSNY Policy for Approval of any Amicus Brief

f. Public Health & Education Resolution (For Council Approval)
MSSNY Emergency Preparedness and Disaster/Terrorism Response Planning Committee – “Influenza Vaccination for School-Aged Children

g. 2020 HOD Resolutions Referred to Council (For Council Approval)

         h. Doctors Council Presentation – Doctors Unions
Why now? How does this benefit both patients and doctors?
Presented by:
Frank Proscia MD, President, Doctors Council
Mr. Kevin Collins, Executive Director, Doctors Council

   2. Board of Trustees ReportDr. Kleinman will present the report

  1.  Secretary’s ReportDr. Frank Dowling will present the report
    .
  2.  MLMIC UpdateDr. John Lombardo will present a verbal report
    .
  3.  AMA Delegation ReportDr. John Kennedy will present the report
    .
  4.  MSSNYPAC ReportDr. Thomas Lee will present the report
    a. List of recommendations for state/federal candidate endorsement
    (FOR COUNCIL APPROVAL
           b. MSSNYPAC Report
    .
  5.  County Federation Report Dr. Aaron Kumar will present the report

D. Reports of Officers (Verbal)

  1. Office of the President – Bonnie L. Litvack, MD
  2. Office of the President-Elect – Joseph R. Sellers, MD
  3. Office of the Vice-President – Parag H. Mehta, MD
  4. Office of the Immediate Past President – Arthur C. Fougner, MD
  5. Office of the Treasurer – Mark J. Adams, MD, Financial Statement
    ….for the period 01/01/2020 – 08/31/2020
  6. Office of the Speaker – William R. Latreille, Jr., MD

E. Reports of Councilors (Informational)

  1. Kings & Richmond Report – Adolph B. Meyer, MD
  2. Manhattan & Bronx Report – David M. Jakubowicz, MD
  3. Nassau County Report – Paul A. Pipia, MD
  4. Queens County Report – Saulius J. Skeivys, MD
  5. Suffolk County Report – Linda S. Efferen, MD
  6. Third District Branch Report – Brian P. Murray, MD
  7. Fourth District Branch Report – Gregory L. Pinto, MD
  8. Fifth District Branch Report – Barry Rabin, MD
  9. Sixth District Branch Report – Robert A. Hesson, MD
    (No written report submitted)
  1. Seventh District Branch Report – Janine L. Fogarty, MD
  2. Eighth District Branch Report – Mark R. Jajkowski. MD
  3. Ninth District Branch Report – Thomas T. Lee, MD
  4. Medical Student Section Report – Shireen Saxena
    (No written report submitted)
  5. Organized Medical Staff Section Report – Stephen F. Coccaro, MD
    (No written report submitted)
  6. Resident Fellow Section Report – Raymond Lorenzoni, MD
    (No written report submitted)
  1. Young Physician Section Report – L. Carlos Zapata, MD
    (No written report submitted)

F. Commissioners (Informational Items)

  1. Commissioner of Communications, Maria A. Basile, MD, MBA
    Report from the Division of Communications

 2. Commissioner of Continuing Medical Education, Mark J. Adams, MD
Report from the Office of CME (including Action Items) 

 3. Commissioner of Governmental Relations, Gregory L. Pinto, MD
 Report from the Division of Governmental Affairs
.

 4. Commissioner of Membership, David M. Jakubowicz, MD
                Report from the Division of Membership

5. Commissioner of Science & Public Health, Joshua M. Cohen, MD
 a. Addiction & Psychiatric Medicine Minutes, May 1, 2020
 b. Emergency Preparedness & Disaster/Terrorism Response Minutes,
      May 7, 2020
 c. Health Disparities Minutes, May 29, 2020
 d. Heart, Lung Cancer Minutes, May 6, 2020
 e. Infectious Disease Minutes, April 29, 2020
 f.  Preventive Medicine & Family Health Minutes, May 14, 2020
 g. Public Health & Education Report
     Peer to Peer Interview, Dr. Frank Dowling & Dr. Charles Rothberg

6. Commissioner of Socio Medical Economics, Brian P. Murray, MD
(No written report submitted)

G. Report of the Executive Vice President, Philip Schuh, CPA, MS

  1. Group Institutional Dues Report
  2. Membership Dues Revenue Schedule

H. Report of the General Counsel, Garfunkel Wild, Barry Cepelewicz, MD, Esq
Medical Society of the County of St. Lawrence Bylaws  (For Council Approval)

This will confirm that in or about February/March 2019 Eunice Skelly and I reviewed a proposed “Constitution and Bylaws of the Medical Society of the County of St. Lawrence, Inc.” (“Bylaws”).  We recommended revisions to ensure that the Bylaws of the Medical Society of the County of St. Lawrence are not in conflict with the Bylaws of MSSNY.   We were informed that on or about May 22, 2019, our recommendations were accepted and the Bylaws were revised pursuant to such recommendations.  Accordingly, it is recommended that the St. Lawrence Bylaws be approved.

I. Other Information/Announcements

 1. AMA Letter re PPE shortages
 2. Dr. Litvack’s Letter to the AMA re PPE shortages  
 3. Sign-On Letter re Non-Profit Organizations provided access to
 PPE Loan Programs
 4. AMA Letter re Provider Relief Fund / CARES Act
 5. AMA Sign-On Letter re HHS Budget Neutrality
 6. Sign-On Letter re Veterans Affairs
 7. AMA Letter re Police Reform
 8. Letter to NYS Dept. of Financial Services re Electronic Billing by Health  
Care Providers for No-Fault Coverage Claims

 J. Adjournment

MSSNY COVID-19 Update – September 27, 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;


Coronavirus Magnified

Alerts and Notifications


DOH Issues Health Advisory on Reporting of COVID-19 and Influenza Test Results


Revised Protocols for Personnel in Healthcare and Other Direct Care 

Settings to Return to Work Following COVID-19 Exposure or Infection


SBA and Treasury Announce New EZ and Revised Full Forgiveness Applications for the Paycheck Protection Program


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

COVID-19 update for healthcare providers (Recorded)

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

Protocol for COVID-19 Testing Applicable to All Health Care Providers and Local Health Departments

Guidance for Private Physician Practices Operating Specimen Collection Sites

Should ibuprofen be Used to Treat COVID-19?


Telehealth

Medicaid Update on Telehealth

Telehealth Services 

MSSNY Telehealth Video Series

HHS Telemedicine Hack on Telemedicine (One Hour per Week) Begins on July 22
This course is a free 10-week learning community to accelerate telemedicine implementation for ambulatory providers. It is a learning collaborative from the US Department of Health and Human Services and others addressing telemedicine. Questions should be directed to: c19ECHO@salud.unm.edu

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


September 27 Statistics

New York State: 454,760 confirmed; 25,450 deaths.
New York City: 237,628 confirmed cases; 19,167 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

Join MSSNY’s preferred wealth manager Altfest on Wednesday, August 12, 11:00-11:45 am for a free interactive webinar on Retirement Planning for Physicians Amid COVID-19


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


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

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

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

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

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

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

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

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


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

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


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

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

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

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

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

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


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

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

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

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

MLMIC Banner


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


Gov. Cuomo’s COVID-19 Press Briefing Today

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

RESTAURANTS:

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

GENERAL:

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

FEDERAL:

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


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

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

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

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


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

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


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

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

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

  • New York State and federal requirements for prescribing controlled substances
  • Pain management
  • Appropriate prescribing
  • Managing acute pain
  • Palliative medicine
  • Prevention, screening, and signs of addiction
  • Responses to abuse and addiction
  • End of life care

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

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

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


Garfunkel Wild Ad


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

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

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


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

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

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

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

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

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

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


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

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

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

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


Classifieds

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


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

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


Office Space and Quad-A Certified O.R. for Rent
Plastic surgery office and/or quad A – certified operating room available for rent. We welcome you to tour our facility, where safety and luxury are combined in the most prime location on the upper east side. We assure you will be delighted by what you discover. We take pride in our facility, where your patients’ safety and satisfaction are our number one priority.
    • Fully equipped operating room perfect for a board-certified plastic surgeon
  • Pre-op and recovery areas
  • A bright and modern waiting area
  • 3 consultation rooms, administrative room, kitchenette, and 2 bathrooms
  • Full day office rental per week / O.R. rental per case

For inquiries please call 212.737.8700, email polina@specialtyaestheticsurgery.com

Office Space and Quad-A Certified O.R. for Rent


 

 

 

 

 

 

MSSNY eNews: September 4, 2020 – Laboring on Your Behalf: Telehealth and PPE Advocacy Updates; New PPE Offering


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Colleagues:

The COVID crisis has ushered in big changes in how we see and treat patients. Telehealth has emerged as a new safe and effective tool in our box. Many appointments have been shifted from in-office visits to telehealth appointments, a fact that I shared with our NYS legislature on August 12th during testimony at a joint hearing of the NYS Assembly and Senate on COVID-19 and hospitals. I discussed the importance of payment parity for telehealth visits, both audio and video.

Telehealth Issues

On August 26, I was invited by the Home Care Association (HCA) to participate in a panel discussion with HANYS, HPA, LANY, MSSNY and HCA on “Collaborating Across the Continuum.” Telehealth was an issue that emerged as a common theme and we will build on that discussion. Assemblywoman Carrie Woerner (D- Saratoga) has introduced A.9667, which would require insurance companies to provide payment parity for primary care services delivered via telehealth, equal to payment for in-office visits. We have conveyed that this bill should be expanded to include parity for all specialties. We will continue to build a coalition and work with the NYS legislature, to pass payment parity legislation this year.

PPE Still an Issue

Thankfully, COVID-19 positivity rates have remained at low levels throughout the summer in NYS.  However, the PPE crisis continues with cost and acquisition remaining as significant problems for New York State physicians. I discussed this in my testimony to the NYS legislature in August and this was another item of common concern on the HCA panel discussion.  MSSNY this month has met with the Governor’s office and the members of the NYS legislature to discuss the problem and solutions.

Last week, we met with the Health Plan Association (HPA) and we discussed this as a safety issue for plan members, panel physicians and physicians’ staff.  We were told that some plans are providing their members with free PPE.  In addition, NY HPA President, Eric Linzer agreed to work with us on additional solutions. In the meantime, MSSNY has been informed that some physician practices are billing CPT 99070 – Supplies and materials provided by the physician or other qualified health care professional over and above those usually included with the office visit or other services rendered to represent charges for PPE; and, that some companies are intermittently allowing these charges. We will be following up with the HPA as well as the legislature and the Governor’s office to resolve the PPE supply and cost issues.

Face Shields Available Soon

As you know, from time to time MSSNY has been able to secure quality PPE for our members. Another such opportunity has arisen. MSSNY reached out the Ford Motor Company who has been working on providing PPE to healthcare companies in need. Ford responded to our request by donating 6,000 face shields to MSSNY. We will be distributing these face shields on a first-come, first-served basis in quantities of 25 per member (while supplies last) for the cost of shipping and handling. Keep checking your email for details concerning this offer.

At MSSNY, we have your back, advocating relentlessly on your behalf and listening to and providing for your needs.

I wish all a happy and healthy Labor Day Weekend.

Bonnie Litvack, MD
MSSNY President


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

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

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

  • New York State and federal requirements for prescribing controlled substances
  • Pain management
  • Appropriate prescribing
  • Managing acute pain
  • Palliative medicine
  • Prevention, screening and signs of addiction
  • Responses to abuse and addiction
  • End of life care

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

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

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

Attestation Process for Mandatory Prescribers

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

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


CDC: Over 50% of COVID-19 Medications in March and April Were Prescribed by Primary Doctors
The CDC stated that “primary care prescribers were responsible for more than half of hydroxychloroquine and chloroquine prescriptions dispensed at outpatient retail pharmacies between March and April in the” U.S. After analyzing “outpatient retail pharmacy transaction data to identify potential differences in prescriptions by provider type between January and June,” researchers found that “new prescriptions of hydroxychloroquine and chloroquine by specialists who did not typically prescribe those medications increased from 1,143 prescriptions in February 2020 to 75,569 in March 2020 – an 80-fold increase compared with March 2019,” with “primary care prescribers…responsible for writing 10,350 dispensed prescriptions for hydroxychloroquine and chloroquine in March 2019 and 108,705 in March 2020.” The findings were published in the CDC’s Morbidity and Mortality Weekly Report.


CDC Sends Plans to States for COVID-19 Vaccine Distribution by Early November
The CDC has sent three documents to all 50 states telling them how to prepare to distribute a COVID-19 vaccine as soon as late October or early November, The New York Times reported. The documents outline technical scenarios to state public health officials for the distribution of two potential COVID-19 vaccines, referred to as Vaccine A and Vaccine B. The descriptions of the vaccine seem to match the vaccines being developed by Pfizer and Moderna, according to the Times. They are the two vaccines furthest along in late-stage clinical trials.

The accelerated timeline has raised concern that the government is trying to rush distribution of a vaccine before election day on Nov. 3, according to the Times. The three documents were sent to states Aug. 27, the same day President Donald Trump said in his speech at the Republican National Convention that a COVID-19 vaccine may be available before the end of the year.

The CDC acknowledged that the plans are hypothetical, saying, “The Covid-19 vaccine landscape is evolving and uncertain, and these scenarios may evolve as more information is available.” Approving a vaccine before late-stage clinical trial data is available could lead to rare but dangerous side effects surfacing over a period of time, the Times reported.

The plans detail requirements for shipping, mixing, administration and storage of a potential vaccine. They say that healthcare professionals would be among the first to receive a vaccine, along with other essential workers and national security employees. People over 65, people from racial and ethnic minority populations, and incarcerated people are also prioritized in the documents. The documents predict that Vaccine A will have about 2 million doses ready by early November and Vaccine B will have about 1 million doses ready.


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Sept. 13 Deadline: CMS How to Apply for PRF Funding are Shown Below
CMS has announced that Sunday, September 13th, is the new deadline for Medicaid and Child Health Plus (CHP) providers to apply for the Provider Relief Fund (PRF) under the Coronavirus Aid, Relief, and Economic Security (CARES) Act and the Paycheck Protection Program and Health Care Enhancement Act.

To Apply:

All eligible medical, dental, and long-term services and supports (LTSS) providers may begin the application process at: hhs.gov/providerrelief. Also available here are Medicaid and CHIP Provider Distribution Instructions and the Medicaid and CHIP Provider Distribution Application Form. It is recommended that you use these documents to help you complete the process through the Enhanced Provider Relief Fund Payment Portal.

Visit the CMS website here.


CME

Veterans Matters: The Special Mental Health Needs of Women Veterans Webinar
The Medical Society of the State of New York is hosting a CME live webinar entitled Veterans Matters: The Special Mental Health Needs of Women Veterans on Tuesday, September 15, 2020 at 7:30 am.

Click HERE to view the flyer and register for the program!

When:   September 15, 2020 at 7:30 am
Faculty: Malene Ingram, MD and Colonel, U.S. Army Reserves 

Educational Objectives:

  • Review how the increased role of women in the military has impacted their mental health
  • Describe mental health concerns unique to women veterans and how to identify them
  • Identify the barriers that women veterans face in getting the specific care they need

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

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

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

Fauci says COVID vaccine trials could end early if results are overwhelming.


Sept. 23, 2020 @ 7:30am Medical Matters CME Webinar Registration Now Open
The Importance of Herd Immunity: 2020 Update with a COVID-19 Twist
The first of MSSNY’s 2020 Medical Matters continuing medical education (CME) webinar series is: “The Importance of Herd Immunity: 2020 Update with a COVID-19 Twist” on Wednesday, September 23, 2020 at 7:30 a.m.  William Valenti, MD, chair of MSSNY Infectious Disease Committee and a member of the Emergency Preparedness and Disaster/Terrorism Response Committee will serve as faculty for this program. Registration is now open for this webinar here.  To view the flyer for this program, please click here

Educational objectives are:

  • Review the epidemiology vaccine-preventable infectious diseases and the role of
    herd immunity.
  • Describe how herd immunity protects vulnerable populations such as newborns,
    the elderly and those who are too sick to be vaccinated.
  • Discuss the percentage(s) of a population who need to be vaccinated for herd
    immunity to be effective.
  • Examine the role of herd immunity in relation to the COVID-19 pandemic

Additional information or assistance with registration may be obtained by contacting Melissa Hoffman at mhoffman@mssny.org.

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

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


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AMA’s First Major Overhaul of CPT Codes in 25 Years
The first major overhaul in more than 25 years to the codes and guidelines for office and other outpatient evaluation and management (E/M) services was included in today’s release of the 2021 Current Procedural Terminology (CPT®) code set AMA.

These foundational modifications were designed to make E/M office visit coding and documentation simpler and more flexible, freeing physicians and care teams from clinically irrelevant administrative burdens that led to time-wasting note bloat and box-checking. The changes to CPT codes ranging from 99201-99215 are proposed for adoption by the Centers for Medicare and Medicaid Services on Jan. 1, 2021.

The E/M office visit modifications include:

  • Eliminating history and physical exam as elements for code selection.
  • Allowing physicians to choose the best patient care by permitting code level selection based on medical decision-making (MDM) or total time.
  • Promoting payer consistency with more detail added to CPT code descriptors and guidelines.

Among this year’s important additions to the CPT code set are new medical testing services sparked by the public health response to the COVID-19 pandemic. The 2021 CPT codes and descriptors can be imported straight into existing claims and billing software using the downloadable CPT 2021 Data File. The file contains the updated code set’s complete descriptor package, including official descriptors for consumers and physicians, and the complete official CPT coding guidelines.


Classifieds

Elegant, Custom Built Home with Unparalleled Craftsmanship – Rhinebeck, NY
Set on 10.6 acres in one of the most sought-after neighborhoods in Rhinebeck, this stunning home borders Drayton Grant Park at Burger Hill (a conservation land and the highest point in Rhinebeck). Features beautifully landscaped gardens with sweeping hilltop views and a well established vegetable garden and barn. This handsome home is generously proportioned throughout, with an inviting foyer entry with tastefully designed staircase, millwork, high ceilings, cherry wood floors and custom windows.Rhinebeck Estate for SaleA world class kitchen with a marble counter-topped island, enjoys both a cozy fireside seating area perfect for winter evenings, and glass doors in the hexagonal eat-in-kitchen opening onto the expansive stone terrace for three season enjoyment and entertaining.A luxurious Master suite, with high vaulted ceiling design, his and hers walk-in closets and a gorgeous master bath with cast iron clawfoot tub. The second floor also includes two spacious bedrooms with generous closets and 2 full bathrooms, An additional large sitting room/office could easily make a lovely fourth bedroom. Lower level features a media room, exercise room, bar, wine cellar and full bathroom. Additionally there is a two story barn equipped with water and electricity.

The house is located 7 minutes to the charming center of Rhinebeck village with its many superb restaurants, boutiques & shops. The highly rated Northern Dutchess Hospital, the excellent Rhinebeck schools and the County Fairgrounds, a most desirable venue destination throughout the year, are all nearby. Rhinecliff train station is a mile beyond with Amtrak service south to NYC(1hour 40 minutes) and north to Hudson, Albany, Niagara Falls and Montreal. View full listing Contact Nader Kayal, MD, 845-518-7780 / entdoc53@aol.com or Joshua M. Briggs at Heather Croner RE-Sotheby’s 917 213-9042 / jmb@jmbfineart.com.


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

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


Office Space and Quad-A Certified O.R. for Rent
Plastic surgery office and/or quad A – certified operating room available for rent. We welcome you to tour our facility, where safety and luxury are combined in the most prime location on the upper east side. We assure you will be delighted by what you discover. We take pride in our facility, where your patients’ safety and satisfaction are our number one priority.
    • Fully equipped operating room perfect for a board-certified plastic surgeon
  • Pre-op and recovery areas
  • A bright and modern waiting area
  • 3 consultation rooms, administrative room, kitchenette, and 2 bathrooms
  • Full day office rental per week / O.R. rental per case

For inquiries please call 212.737.8700, email polina@specialtyaestheticsurgery.com

Office Space and Quad-A Certified O.R. for Rent


 

 

 

 

 

 

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