MSSNY eNews: January 22, 2021


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Colleagues:

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

The Good

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

The Bad

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

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

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

The Ugly

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

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

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

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

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

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

Bonnie Litvack, MD
MSSNY President


 


Capital Update

MSSNY Weekly Podcast


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

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

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

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

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

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

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

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


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

Among the positive items in the proposed Budget include:

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

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

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

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


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

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

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

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


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

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

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

Educational Objectives:

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

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

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

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


 

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

Friday February 5, 2021 @ 7:30am

Click here to register 

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

Educational Objectives are:

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

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

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

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


Registration Now Open – Medical Matters: COVID Vaccine Update

Wednesday February 17, 2021 @ 7:30am

Click here to register

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

Educational Objectives:

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

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

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

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

 


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eNews

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

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


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

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

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

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


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See our flyer here. Learn about us here.

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

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

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

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

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

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

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


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

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

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

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

Speakers:

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

CLICK HERE TO REGISTER

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


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

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

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

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

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


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


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

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

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

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


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

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

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

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

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

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


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New York Physicians: From Healthcare Heroes to Healthcare Zeros 

For Immediate Release
January 20, 2021
 

New York Physicians: From Healthcare Heroes to Healthcare Zeros


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

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

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

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

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

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

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

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

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

# # #

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


Media Contact:
Roseann Raia

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

 

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

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

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

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


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

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

The Budget does include some positive items including:

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

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

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

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


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

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

Four survey findings:

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

 

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

Registration 

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

Agenda Topics to include:

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

James D. Bavoso
Provider Outreach & Education, Manager

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

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


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

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

Right now, our key messages for Medicare beneficiaries are:

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

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

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

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

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


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

CORONAVIRUS (COVID19)
VACCINE FAQ

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

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


 

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MSSNYeNews: January 15, 2021 – State of State


.MSSNY’s Partnership with Premier Group Purchasing

Colleagues:

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

Covid-19 Vaccine

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

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

Emergency Preparedness

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

Telehealth

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

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

Legalization of Adult Use Marijuana

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

OPMC Due Process

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

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

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

Bonnie Litvack, MD
MSSNY President


Capital Update

MSSNY Weekly Podcast


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

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

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

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


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

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

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

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

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

To Check Vaccine Eligibility, go here (CLANCY) 



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

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

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

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


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

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

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


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

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

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


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


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


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

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


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

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

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

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

Educational Objectives:

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

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

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

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


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

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

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

Dr. Craig Katz will serve as faculty for both webinars. Additional information or assistance with registration may be obtained by contacting Melissa Hoffman at mhoffman@mssny.org.

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

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


eNews

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

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

REGION

MONDAY

TUESDAY

WEDNESDAY

Capital Region

9.01%

8.67%

8.45%

Central New York

7.20%

6.77%

6.74%

Finger Lakes

9.01%

8.72%

8.28%

Long Island

9.07%

8.90%

8.69%

Mid-Hudson

7.86%

7.95%

7.81%

Mohawk Valley

9.51%

9.24%

9.18%

New York City

5.96%

5.92%

5.83%

North Country

7.62%

7.62%

7.69%

Southern Tier

4.67%

4.61%

4.33%

Western New York

7.67%

7.26%

7.43%

Statewide

7.21%

7.08%

6.95%

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

Council Notes-January 14
Council approved the following:

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

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

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


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

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

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

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

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


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


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

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

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

Costs :   Free (requires pre-registration)

Speakers:

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

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

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

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


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

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

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

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

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

Agenda Topics to include:

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

James D. Bavoso
Provider Outreach & Education, Manager

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

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



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

Minority Health Institute and UCLA BRITE Center


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

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

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

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

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

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

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

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

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

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

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

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


 

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


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

 

 

 

 

 

 

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MSSNY eNews: January 13, 2021

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


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

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

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

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


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

To accommodate the large number of participants, find our webinar streaming via YouTube Live (and available for viewing immediately thereafter) on the NYSDOH COVID website for providers:

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

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


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



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

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

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

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

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

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


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

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

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

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

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

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

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

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

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

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


MSSNY – Medicare Part B 2021 Important Update from Anthem

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

Agenda Topics to include:

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

James D. Bavoso
Provider Outreach & Education, Manager 

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

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


 

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

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

Speakers:

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

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

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

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

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

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

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


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

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

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


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

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

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

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


 

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Classified Ads Available for:

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

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


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


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


 

 

 

 

 

 

 

 

 

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

For Immediate Release
January 11, 2021 

 

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

 

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

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

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

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

# # #

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


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

 

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

or Immediate Release
January 11, 2021

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

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

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

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

# # #

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


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

 

Docs Upset by Nixing Due Process When Patients Make Unproven Allegations

For Immediate Release
January 10, 2021

 

Docs Upset by Nixing Due Process When Patients
Make Unproven Allegations

 

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

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

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

# # #

 

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


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

 

Councl January 14, 2021

MSSNY COUNCIL AGENDA
Thursday, January 14, 2021 at 9:00 a.m. (Virtual)

                                                                       

A. Call to Order and Roll Call

B. APPROVAL of the November 5, 2020 Council Minutes 

C. New Business
1. President’s Report
 a. MSSNY CME Action Item (For Council Approval)
 MSSNY Policy 1999.2 – Procedure for Processing Complaints/Inquiries 
 Concerning MSSNY Accredited CME Providers

 b. Legislative & Physician Advocacy Committee Resolutions
 Paul Pipia, MD Chair
 Action Items (For Council Approval) 
 Resolution 63  – Recommendations for Lowering Health Care Costs
 Resolution 69 – Office of Professional Medical Conduct Reform
 Resolution 106 – Piloting Use of Financial Incentives to Reduce
Unnecessary Emergency Room Visits
 Resolution 111 – Physician Assistance Parity With Lawyers
.
.2 Board of Trustees Report – Dr. Andrew Kleinman will present the report
         (For Council Approval) Report will be posted prior to the Council meeting
.
 3. Secretary’s Report – Dr.  Frank Dowling will present the report
         (For Council Approval)
.
 4. MLMIC Update – Dr. John Lombardo will present a verbal report
.
 5. AMA Delegation Report – Dr. John Kennedy will present the report
.
 6. MSSNYPAC Report – Dr. Thomas Lee will present the report

7. County Federation Report Dr. Aaron Kumar will present the report

8. Telemedicine Presentation (10:00 am)
    Shahin John Korangy, MD, Founder & CEO of CareClix


ADJOURNMENT OF COUNCIL

Action Item- For Council Approval

Approval of the Empire State Medical, Scientific & Educational Foundation, Inc. Election of Directors

RECONVENE OF COUNCIL


D. Reports of Officers

  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 1/1/20 – 12/31/20 (For Council Approval
    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 – Daniel E. Choi, 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
  10. Seventh District Branch Report – Janine L. Fogarty, MD
    (no report submitted)
  11. Eighth District Branch Report – Mark R. Jajkowski. MD
  12. Ninth District Branch Report – Thomas T. Lee, MD
  13. Medical Student Section Report – Shireen Saxena (no report submitted)
  14. Organized Medical Staff Section Report – Stephen F. Coccaro, MD
    (no report submitted)
  15. Resident & Fellow Section Report – Raymond Lorenzoni, MD
    16. Young Physician Section Report – L. Carlos Zapata, MD
    (no report submitted)

F. Commissioners (Informational Items)
  1. Commissioner of Communications, Maria A. Basile, MD, MBA
     Report from the Division of Communications

  1. Commissioner of Continuing Medical Education, Mark J. Adams, MD
        Report from the Division of CME
  1. Commissioner of Governmental Relations, Gregory L. Pinto, MD
    Report from the Division of Governmental Affairs
  1. Commissioner of Membership, David M. Jakubowicz, MD
        Report from the Division of Membership
    .
  2. Commissioner of Science & Public Health, Joshua M. Cohen, MD
    a. Preventive Medicine and Family Health Committee- Action Item
        Final Climate Change Paper (For Council Approval)

    (To be presented by Dr. Emily Senay & Dr. Moshe Bressler)
    b. Preventive Medicine and Family Health Minutes, October 29, 2020
    c. Bioethics Minutes, October 23, 2020
  1. Commissioner of Socio Medical Economics, Brian P. Murray, MD
        (no report submitted)

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

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

H. Report of the General Counsel, Garfunkel Wild, Barry Cepelewicz, MD, Esq
    Approval of the Erie County Medical Society Bylaws

I. Report of the Alliance, Barbara Ellman
   (no report submitted)

J. Other Information/Announcements 
 1. A letter from the Big Four re 21st Century Cures Act: Interoperability, Information Blocking, and the ONC Health IT Certification Program Final Rule:  Request for Delay of Implementation
 2. Status of 2020 AMAF Excellence in Medicine Awards
 3. Sign On VA Letter – Authority of VA Professionals to Practice Health Care

K. Adjournment

       

 

 

 

 

MSSNYeNews: January 8, 2021 – 2021: Ready for a New Chapter


.MSSNY’s Partnership with Premier Group Purchasing

Colleagues:

Happy New Year to all.  I think we are all relieved that 2020 and all its bad karma is behind us.  The New Year is starting with some positive updates about expansion of vaccine eligibility and a new money-saving MSSNY benefit.

COVID-19 Vaccine Updates

The New Year started off with the right sentiment in this regard when on 1/4/2021 all community physicians and their patient facing office staff were added to the 1a list of those authorized to receive the COVID-19 vaccine. View information on how to get the COVID-19 vaccine.

We share the goal of the Governor and the DOH of getting as many vaccines into arms as quickly as possible. We need to reach herd immunity to get back to some semblance of normal—and that requires 70-90% of the population to be vaccinated. Time wasted = lives lost.  Hospitalization rates are increasing, the UK strain that spreads more quickly is in NY, staff shortages are appearing, and we want to avoid another shutdown of elective surgery and a shutdown of our economy. Time is of the essence!

We are aware that implementation of the vaccine roll-out has been bumpy, and we have been in constant communication and partnership with DOH to right the ship.   MSSNY has made DOH aware of the IT website issues, communication problems concerning pop-up sites and issues identifying locations with availability—and DOH has responded.  Please make sure you are checking your MSSNY communications frequently as MSSNY is sharing all communications concerning vaccine and availability with our county societies, sending direct email communication to our physicians, and is posting the information on our website and on social media in an effort to get the information to physicians in real time.

Currently we are still in the 1a phase of vaccination and after 3 weeks of vaccinations, 1 million New Yorkers in the 1a category have yet to be offered their first dose.  The speed of vaccination must increase.  The next category 1b (Those >75yo and essential workers) includes 3 million New Yorkers.  To speed up vaccination we need to add significant additional capacity – our Community Physician Practice Distributors who are ready, willing, and able experienced vaccinators!

Volunteers Needed 

We will also need all hands-on deck and to that end MSSNY is encouraging all physicians, residents, students, and retired physicians to volunteer to provide COVID-19 immunizations through ServNY.  ServNY is a volunteer management system, administered by the department’s Office of Health Emergency Preparedness (OHEP) that was established after 9/11.  It is a web-based registry of individuals willing to assist on behalf of New York State during an emergency. When volunteers are needed, they are automatically notified via phone or e-mail with the information necessary for a volunteer to determine if they are ready and available for the assignment.  Physicians would most likely be contacted by their local Department of Health, the regional hospital hub, or by the county’s Medical Reserve Corp.  Sign–up through ServNY provides liability protections for physicians and other health care providers during their service to the NYS.  The sign-up is through the NYS health Commerce site.

NYS Department of Health has two numbers for assistance:

  • 1-866-529-1890, option 1 to assist with the Heath Commerce System
  • ServNY at 1-518-408-5163

Savings for Your Practice And/Or Yourself: Group Purchasing

MSSNY is now offering a GPO benefit for MSSNY members through Premier Inc., one of the largest group purchasing companies. There are no fees and no minimums, just savings for you and your practice, which in most cases will more than cover the cost of MSSNY membership. Premier offers a portfolio featuring over 900 suppliers and 2,000 products and services, including numerous PPE products! See our website www.mssny.org, contact MSSNY-Premier@premierinc.com or call (888) 258-3273.

I am hopeful that the challenges of 2020 will give way to a stronger, more cohesive profession and a new chapter of engagement in organized medicine leading to a healthier New York and a stronger profession.

Bonnie Litvack, MD
MSSNY President


Capital Update

MSSNY Weekly Podcast


Notes from Governor Cuomo’s Briefing:
COVID:
– Day 314
– Statewide positivity rate without micro-clusters: 7.49%
– Statewide rate with micro-clusters: 7.7%
– Micro-cluster rate: 8.3%
– 243,0000 tests conducted
– 161 deaths
– 8,561 hospitalizations, up 13
– 1,475 ICU patients, up 51
– 912 intubations, up 53

Hospitalizations by Region:
– Finger Lakes: 905 (0.08%)
– Western NY: 530 (0.04%)
– Southern Tier: 212 (0.03%)
– Mid Hudson: 980 (0.04%)
– NYC: 3,066 (0.04%)
– Long Island: 1,552 (0.05%)
– Central NY: 374 (0.05%)
– Mohawk Valley: 321 (0.07%)
– Capital Region: 515 (0.05%)
– North Country: 106 (0.03%)

Positivity by Region:
– Finger Lakes: 10.22%
– Western NY: 8.61%
– Southern Tier: 5.30%
– Mid Hudson: 8.12%
– NYC: 6.42%
– Long Island: 9.68%
– Central NY: 8.57%
– Mohawk Valley: 10.80%
– Capital Region: 10.16%
– North Country: 8.45%
– Manhattan: 4.45%
– Staten Island: 7.84%
– Brooklyn: 6.70%
– Queens: 7.49%
– Bronx: 8.21%

Vaccine:
– Gov. cautioned “frightening infection rate” of new strain, combined with
low supply of the vaccine can still cause stress on the hospital system
– State is concerned about low vaccination rate for healthcare workers,
particularly in New York City, which is currently at 13%
Private providers, ambulatory centers, pharmacies, county health departments
will begin being utilized next week

– On Monday, reservations for vaccinations will be accepted, the state will have a
website to sign up
– Healthcare workers must continue to be prioritized, but the next tier (1b)
will be eligible as well
– NYSDOH will hold a webinar on Monday for new providers, county DOHs
– State will allocate to distribution network proportionately by population
of each group and region
– State will be mandating social equity distribution by local health departments
Gov. signing an EO making additional staff eligible to administer vaccinations
DOH is setting up 20 “mass distribution sites” in the coming weeks: Javits Center
will be open next Wednesday

– Gov. noted at the current rate, the first two tiers (1a) and (1b) will not be
completed until mid-April

Federal:
– Gov. further condemned the events at the U.S. Capitol, and
President Trump’s actions; Gov. questioned the lack of security at the Capitol

State of the State:
– Will be on Monday, will be focused on specific initiatives, post-COVID issues
– Gov. proposing legislation to process absentee ballots as soon as they’re received
and begin being counted on election day
– Also to extend early voting hours, and extend timeframe to request absentee ballot
to 45 days before an election
– Gov. will propose legislation to create an Office to End Domestic and Gender-Based
Violence, and to authorize courts to force abusers to pay damages, including housing
and moving costs
– Legislation will also create new misdemeanor for those convicted of domestic violence
attempting to purchase guns, closing a loophole in existing law
– Also proposing legislation for a statewide eviction moratorium on commercial evictions
to be extended until May 1
– Also, penalties for late residential rent payments will be prohibited through May 1
– Gov. also announced the creation of a new public space at Pier 76 on the west side of
Manhattan, where a tow pound currently exists
– By law, NYPD had to vacate this space by January 1, it will be transferred to
Hudson River Park Trust, which will be accepting proposals for design this month

On when vaccinations will start for second (1b) tier:
– Appointments can be scheduled on Monday, some pharmacies will begin
administering Monday, others will take longer
– Gov. said website will be available Monday, listing available sites and accepting
reservations
– Gov. added the Biden administration is currently working on increasing the
supply available to states

On any updates on reallocation of vaccine from low-performing hospitals:
– Gov. responded that performance from hospitals has increased over the
last week, but low-performing hospitals will not receive additional allocations
– Gov. said this issue is expected to be solved by the new distribution
network being introduced next week

On current vaccination number:
– 479,000 vaccines done so far in the state
– Nursing home residents, staff will be completed by the end of next week

On how the state will ensure healthcare workers will continue to be prioritized:
– Providers must continue to give priority to healthcare workers when
scheduling appointments
– New providers in the distribution network are required to vaccinate their
own workers prior to administering the vaccine


Vaccine Availability by Counties That Have Submitted Schedules

View a list of Counties that have submitted vaccine schedules.

  • Saratoga County
  • Westchester County
  • Nassau County
  • Suffolk County
  • Essex, Warren, Wash, Clinton, Franklin Counties

Governor’s State of the State Message This Monday
With the State Legislature initiating the 2021 Legislative Session earlier week, this upcoming Monday the Governor will unveil his State of State message, followed by his release of the proposed State Budget for the 2021-22 Fiscal Year the following week (likely 1/19).

With the State looking to close a historic $65 billion multi-year deficit, there is likely to be many concerning provisions impacting the state’s health care system, even as physicians and other care providers struggle to manage historic drops in patient visits and revenue.  Please remain alert for comprehensive summaries and follow up action steps as these documents are released next week and the following week.                                     (AUSTER)


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

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

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

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


MSSNY Prioritizes Key Telehealth Policies Department of Financial Services (DFS) Extends COVID19 Telehealth Policy
One of the key items MSSNY will be working on for the 2021 legislative session, is to advocate for policies to help maintain expanded health insurance coverage for telemedicine services and to advocate for parity in payment for health care services delivered via video, as well as required insurer coverage for delivering care for audio-only visits with patients. A central part of this work will include advocating for passage of legislation to require health insurers to provide “payment parity” between telemedicine visits and in-office visits. MSSNY is teaming up in this effort with a range of provider organizations including many specialty societies, the Healthcare Association of New York State (HANYS), communication centers, among others. To read the letter: click here.

Prior to the onset of the COVID19 crisis, some physicians across the state had integrated Telemedicine into their practices, but the pandemic forced physicians, and other health care providers, to quickly increase their capacity to provide care remotely. A May 2020 MSSNY survey showed that 83% of the physician respondents indicated they had incorporated telemedicine into their practice, with nearly half the respondents noting that they were treating at least 25% of their patients remotely. Moreover, a spring 2020 Fair Health study showed that, for the northeastern part of the country, use of Telehealth went from 0.08% of claim submissions in May 2019, to 12.5% in the span of a month. (report.

Additionally, the New York Department of Financial Services (DFS) extended for additional 60 days (until March 5) its emergency rules supported by MSSNY requiring New York State health insurance plans to cover Telehealth services without patient cost-sharing.

In early 2020, the DFS issued a circular letter detailing its requirements for insurers to a) waive cost-sharing requirements for services delivered via telemedicine b) permit coverage for health care services delivered via audio-only mechanisms and c) enabling delivery of telemedicine services through basic smartphone and video technologies. To read the letter: (circular letter)

Even though states have started administering Covid vaccines, public health experts anticipate that COVID-19 will remain a public health threat for the foreseeable future, making it reasonably likely that this expanded Telehealth coverage policy will need to be extended well beyond March. (CARY, AUSTER)


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Governor Announces Proposal to Legalize Adult Use Recreational Marijuana
Governor Andrew Cuomo this week announced a proposal to create an Office of Cannabis Management to regulate both the medical and adult-use of marijuana.   The governor’s proposal will be part of his State of State and his 2021-22 New York State budget.  The governor estimated that this proposal would generate more than $300 million in tax revenue—however, that revenue is not anticipated to be generated for several years.

The Medical Society of the State of New York is opposed to the legalization of recreational marijuana and continues to oppose this measure along with the New York State Association of County Health Officials (NYSACHO), the Mental Health Association of New York State, the NYS PTA, and Smart Approaches to Marijuana (SAM).  MSSNY believes that with the COVID-19 pandemic, this measure, if enacted would create an even greater stress on New York State’s public health system.  The National Institute of Drug Abuse (NIDA) reports that COVID-19 is a respiratory illness that attacks the lungs, and is a serious threat to anyone who smokes or vapes tobacco or marijuana products.

MSSNY has also been working with various states in expressing opposition to the legalization of recreational marijuana. MSSNY also joined with the state medical societies of Delaware, New Jersey, New York, Ohio, and Pennsylvania to express mutually shared concerns about state governments’ efforts to legalize marijuana for recreational use. Legalization continues to present serious public health concerns.  A copy of the press release can be found here.                                 (CLANCY, AUSTER)


 

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MSSNY Partners With “Let’s Get Immunized NY”
The Medical Society of the State of New York has partnered with “Let’s Get Immunized NY”  a campaign that strives to provide all New Yorkers reliable and trustworthy information on immunization and encourage New Yorkers to get recommended vaccines.  The campaign will also support policies that protect and improve access to immunization, increase awareness of the public health benefits of vaccination, and address health disparities with vaccine access, especially in medically underserved areas and communities with low immunization rates.

MSSNY is also on the steering committee for Let’s Get Immunized NY.   Some of the organizations that are part of this campaign are:  The NYS Chapter of the Academy of Family Physicians; the NYS American Academy of Pediatrics, NYS Chapters 1, 2, & 3; the NYS Association of County Health Officials (NYSACHO); the March of Dimes; the NYS Public Health Association; The Business Council and the NYS Farm Bureau.  Further information may be obtained at the website: http://www.letsgetimmunizedny.org (CLANCY)           


Assemblyman Gottfried Reintroduces Physician-Friendly Legislation
Assemblyman Richard N, Gottfried (D-Manhattan), Chair of the New York State Assembly Committee on Health, has reintroduced three pieces of legislation that MSSNY has supported for several past legislative cycles. They are:

1. A.832, which would prohibit or restrict a number of practices between HMOs and health care providers that negatively impact physicians’ ability to provide the highest quality of care. 2. A.951, which would permit some collective negotiations between physicians and health insurance plans under close supervision by the state. 3. A.879, which ensures that health plans can only deny payment for covered benefits after review by a physician, or other health care professional, licensed in New York State and when the provider is board certified in the same, or similar, specialty as the treatment under review.

MSSNY thanks Chairman Gottfried for his continued leadership on these important bills and will update its membership as they advance this session.   (CARY)


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

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

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

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

Educational Objectives:

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

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

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

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


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

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

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

Dr. Craig Katz will serve as faculty for both webinars. Additional information or assistance with registration may be obtained by contacting Melissa Hoffman at mhoffman@mssny.org.

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

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


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Vaccine Availability by Counties That Have Submitted Schedules
View a list of Counties that have submitted vaccine schedules.

  • Saratoga County
  • Westchester County
  • Nassau County
  • Suffolk County
  • Essex, Warren, Wash, Clinton, Franklin Counties

MSSNY Information for Physicians: How to Get the COVID-19 Vaccine
Community-based physicians and their  staff are now eligible to receive the COVID-19 vaccine.  Below is information on how physicians and staff, including NY City based physicians, can make an appointment to receive the vaccine.

To better ensure expeditious distribution of the COVID-19 vaccine, this week the Governor announced additional possible enforcement actions against hospitals that do not distribute their supply within the week they receive it.

COVID-19 Vaccine Process for NY State Physicians and Staff
The web page will ask for information for your name, where you live, and what you do for a living.  If you are in a priority group currently getting the vaccine, the site will show you the location of health care providers who can give you the vaccine near you.  Just choose the one you prefer, and schedule the appointment.

COVID-19 Vaccine Process for NYC Physicians and Staff
The New York City Department of Health and Mental Hygiene updated their COVID-19 vaccination page with information for non-hospital providers, including vaccination locations and related scheduling.

The NYC Department of Health and Mental Hygiene indicated that vaccine locations and supply are limited, and they are working very hard to ensure that providers and their staff across New York City are vaccinated as quickly as possible. The City plans to ramp up capacity at these sites and add sites over the coming weeks. MSSNY encourages physicians to check the NYC vaccination page regularly, as this is where the most up-to-date information will be posted.

Community-based physicians and staff eligibility information can be found here.

Physicians, Residents, Students and Retired Physicians Who Would Like to Volunteer to Provide COVID-19 Immunizations
The Medical Society of the State of New York encourages the physician community to volunteer to provide COVID-19 Immunizations to residents of New York State. The first step in this process is by signing up for ServNY. .


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Congressional Package Includes Expansion of Paycheck Protection Program (PPP)
As was recently reported, the Congressional year end package included an additional $284 billion for the Paycheck Protection Program (PPP).  Importantly, it would enable a second PPP forgivable loan for the hardest-hit small businesses (including physician practices) with 300 or fewer employees which can demonstrate a loss of 25% of gross receipts in any quarter during 2020 when compared to the same quarter in 2019.

Moreover, it would also provide that loans will not be included in taxable income, and clarifies that deductions are allowed for expenses paid with proceeds of a forgiven PPP loan, effective as of the date of enactment of the CARES Act and applicable to subsequent PPP loans.  MSSNY had heard from several physicians concerned that receipt of a PPP loan/grant was going to cause them to not be able to deduct business expenses due to a recent IRS interpretation.

Please read here for a comprehensive AMA summary of this and many other provisions in the Congressional Covid relief package.


Congress Passes Measure to Address Surprise Medical Bills
As was widely reported, among the provisions contained in the year-end Congressional Covid relief package was a comprehensive measure to establish a federal standard for addressing surprise out-of-network medical bills.

The new federal surprise bill provisions will apply to patients insured by ERISA plans, and New York’s approach would continue to be followed for out of network claims from patients insured in state-regulated plans.  There are similarities in this federal standard to New York’s well-regarded approach, but also significant differences for which MSSNY expressed serious concerns.

Here is a comprehensive summary of these provisions from the AMA: http://www.mssnyenews.org/wp-content/uploads/2020/12/Summary-of-Surprise-Billing-Language-12-21-20.pdf

The measure, to take effect January 1, 2022, would ensure that patients are “held harmless” from surprise out-of-network medical bills. Like New York’s law, patients would only be required to pay the in-network cost-sharing, (i.e., copayment, coinsurance, and deductibles) amount for out-of-network emergency care, for certain ancillary services provided by out-of-network providers at in-network facilities, and for out-of-network care provided at in-network facilities without the patient’s informed consent.

However, unlike New York’s law, the federal provision calls for a 30-day open negotiation period for out of network physicians and payers to settle out-of-network claims, and if the 30 day negotiation period is unsuccessful, requires either the physician or the health plan to initiate an independent dispute resolution (IDR) process within 4 days of the end of the 30-day period.

The federal IDR process is similar to New York’s mechanism in that the IDR entity would select which side – the physician’s or the insurer’s suggested payment – will prevail.  Physicians may batch similar services in one proceeding when claims are from the same payer, but the bill permits only 30 days of batching.  The IDR entity would consider numerous sources of information brought by either party, such as the provider’s training and experience, patient acuity, and the complexity of furnishing the item or service.   However, in a significant departure from New York, neither provider charges nor usual and customary charges may be considered by the IDR entity, and the IDR entity is required to consider the market-based median in-network rate.  This a major deficiency that MSSNY has highlighted in its advocacy efforts over the last year on this issue, and was noted by MSSNY President Dr. Bonnie Litvack in MSSNY’s press release.

The Congressional provisions also address “voluntary” out of network services by providing that non-participating providers at participating facilities may not bill a patient more than the cost-sharing requirements or balance bill the patient unless the notice and consent requirements are met. These consent requirements include providing the patient with written notice and consent 72 hours in advance of appointment; providing a good faith estimate of the costs of the services; and providing the patient with a list of in-network providers at the facility and information regarding medical care management, such as prior authorization.

At participating facilities, the notice and consent exception does not apply to out-of-network providers of radiology, pathology, emergency, anesthesiology, diagnostic, and neonatal services; assistant surgeons, hospitalists, intensivists, and providers offering services when no other in-network provider is available.

Further analysis of this far-reaching legislation is ongoing, so please remain alert for further updates.


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Congressional Package Helps to Prevent or Reduce Medicare Cuts
As a result of an advocacy effort across medicine including from the AMA and MSSNY, the year-end Congressional package included a number of steps that helped to prevent and/or reduce what would have been enormous cuts to Medicare payments to many physician specialties.  Specifically, the bill:

  • Provides for a one-time, one-year increase in the Medicare physician fee schedule of 3.75%, to support physicians and other professionals in adjusting to changes in the Medicare physician fee schedule during 2021, and to provide relief during the COVID-19 public health emergency.
  • Delays for 3 years the Secretary’s implementation of Code G2211 which reportedly will increase the MPFS by approximately 3%.
  • Delays the -2% sequestration cuts for 3 months.

As noted in this chart developed by the AMA analyzing the specialty by specialty impact of these Congressional actions, an example of the impact:

  • Under the original CMS Medicare 2021 payment rule, ophthalmologists were expected to see a 6% cut, but now will face likely no cut.
  • Under the original CMS Medicare 2021 payment rule, general surgeons were expected to see a 6% cut, but now will face likely no cut.
  • Under the original CMS Medicare 2021 payment rule, neurosurgeons were expected to see a 6% cut, but now likely will face no cut.
  • Under the original CMS Medicare 2021 payment rule, interventional radiologists were expected to see an 8% cut, but now it will be a likely 2% cut.
  • Under the original CMS Medicare 2021 payment rule, internal medicine was expected to see a 4% increase, but now likely a 6% increase.
  • Under the original CMS Medicare 2021 payment rule, anesthesiology was expected to see an 8% cut, but now likely a 2% cut.
  • Under the original CMS Medicare 2021 payment rule, PM&R was expected to see a 3% cut, but now likely will have a 3% increase.

Importantly, as well, the long overdue E&M increases set forth in the CMS 2021 Medicare payment rule will go forward.

We thank all the physicians who took the time to respond to our call for grassroots action on this and the litany of other “year-end” issues before Congress.  We anticipate that CMS will soon issue an update announcing these changes arising from Congressional action.


2021 E & M Coding Changes Webinar on Friday, Jan. 22 from 12-2 PM
On January 22 from 12 noon to 2PM,  MSSNY will be hosting a webinar for our Members regarding the 2021 E & M coding changes.  NGS Medicare staff will be making the presentation. NGS will be sending a registration URL to MSSNY shortly that we will then send on to the membership.


Five States with Highest Confirmed Cases
The 5 states with the highest total confirmed cases are:

  1. California: 2.536,832
  2. Texas: 1,885, 609
    3. Florida:1,409, 906
    4. New York: 1,064, 297
    5. Illinois: 999, 288

Deaths: New York has the most deaths due to COVID-19 with 38,912 reported fatalities, followed by Texas with 29,123 deaths, and California with 28,081.

Tests administered: California leads in number of persons tested with 34,548,621 people tested, followed by New York with 26,333,682 people tested, and Florida with 16,310,438 people tested.


How NY Hospitals Are Using Their Allocated Their Allocated Vaccine
Gov. Andrew Cuomo in his Jan.6 briefing provided an updated list of the top and bottom 10 hospitals that have used their allocated vaccines. The previous list was of health systems. In the city, NYU Langone’s Tisch Hospital in Kips Bay (100%), Richmond University Medical Center on Staten Island (100%), SUNY Downstate in East Flatbush (100%), New York-Presbyterian on the Upper East Side (99%) and Northwell Health’s Lenox Hill Hospital (87%) were top performers. Montefiore Mount Vernon (11%) and Montefiore New Rochelle (23%) in Westchester County, Brookdale Hospital Medical Center in Brownsville (24%), NYC Health + Hospitals—Queens in Jamaica (29%) and NYC Health + wHospitals—Coney Island (34%) were the lowest performing.


FDA Warns Against Changes to Authorized Dosing Schedules of COVID-19 Vaccines
FDA officials recommend all health care professionals should continue to administer 2 full doses of the 2 COVID-19 vaccines currently available.

In a new statement, the US Food and Drug Administration (FDA) recommended all health care professionals should continue to administer 2 full doses of the 2 vaccines currently available against the coronavirus disease 2019 (COVID-19).

The statement comes after discussions, including reports in the media, about altering the dosing schedule in order to immunize more individuals against COVID-19. Proposed alternatives include reducing the number of doses, extending the length of time between doses, changing the dose, or mixing and matching vaccines, according to the FDA.

The FDA has granted emergency use authorization for vaccines produced by Pfizer-BioNTech and Moderna. “At this time, suggesting changes to the FDA-authorized dosing or schedules of these vaccines is premature and not rooted solidly in the available evidence. Without appropriate data supporting such changes in vaccine administration, we run a significant risk of placing public health at risk, undermining the historic vaccination efforts to protect the population from COVID-19,” said FDA Commissioner Stephen M. Hahn, MD, and Peter Marks, MD, PhD, director, Center for Biologics Evaluation and Research, FDA, in the statement.

Hahn and Marks noted that administering rating a single-dose regimen and/or administering less than the dose studied in clinical trials is concerning, “as there is some indication that the depth of the immune response is associated with the duration of protection provided.”

Although data from the phase 3 trials of both the Pfizer-BioNTech and Moderna COVID-19 vaccine suggested some protection following the first dose, the FDA cautioned that the participants who did not receive 2 vaccine doses at either a 3- or 4-week intervals were only followed for a short period of time.

“We cannot conclude anything definitive about the depth or duration of protection after a single dose of vaccine from the single dose percentages reported by the companies,” said Hahn and Marks.

The current available data continues to support the use of the 2 vaccines. For the Pfizer-BioNTech COVID-19 vaccine, the interval is 21 days between the first and second dose and 28 days between doses for the Moderna vaccine.

“We know that some of these discussions about changing the dosing schedule or dose are based on a belief that changing the dose or dosing schedule can help get more vaccine to the public faster,” concluded Hahn and Marks. “However, making such changes that are not supported by adequate scientific evidence may ultimately be counterproductive to public whealth.” (Patient Care. Jan 7).


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COVID-19 ‘Long Haulers’ Identify 205 Virus Symptoms
Researchers have identified more than 200 long-term symptoms that can affect COVID-19 “long haulers,” or people who experience prolonged effects from the virus, according to a survey published Dec. 24 in the medical preprint server medRxiv.

Researchers polled 3,762 adults from 56 countries with confirmed or suspected COVID-19 cases. Respondents developed symptoms before June 2020 and experienced them for a minimum of 28 days.

Four survey findings:

  1. In total, respondents identified 205 symptoms in 10 organs linked to the virus, including 66 symptoms traced over seven months.
  2. The most commonly reported symptoms after six months were fatigue (77.7 percent), post-exertional malaise (72.2 percent) and cognitive dysfunction (55.4 percent).
  3. Respondents who were sick six months after symptom onset experienced an average of 13.8 symptoms.
  4. Most respondents had not returned to full-time work due to their health issues.

The survey has not been peer-reviewed. (Jan. 4 Becker’s Hospital)


States Ranked by Percentage of COVID-19 Vaccines Administered: Jan. 7
The CDC’s data tracker compiles data from healthcare facilities and public health authorities. It updates daily to report the total number of COVID-19 vaccines that have been distributed to each state and thew total number each state has administered.


Shortened Quarantine May Pose Transmission Risk, CDC Finds
About 19 percent of people who were exposed to COVID-19 and remained negative or asymptomatic through the first week developed an infection by the end of the 14-day quarantine period, according to the CDC’s Jan. 1 Morbidity and Mortality Weekly Report. 

Using interim data from an ongoing study, CDC researchers identified 185 household contacts who were exposed to COVID-19. A total of 109 household contacts had detectable SARS-CoV-2 at any point during the 14-day quarantine period after exposure. Among the close contacts infected, 76 percent (83) of test results were positive within seven days after the index patient’s illness onset, while 86 percent (94) of infections were detected within 10 days.

About 81 percent of household contacts who remained negative or asymptomatic through the first week after exposure did not develop COVID-19 through day 14. This increased to 93 percent for those who remained asymptomatic or negative through day 10.

In an effort to get more people to comply, the CDC trimmed its quarantine recommendations in December to 10 days without symptoms or seven days without symptoms and a negative test result.

In this latest report, researchers concluded the original 14-day quarantine period is the most effective way to minimize the spread of COVID-19.

“Although persons might be more adherent to a shorter quarantine period, such a policy is not without risk for further spread,” the report said. “Persons released from quarantine before 14 days should continue to avoid close contact and wear masks when around others until 14 days after their last exposure.”


 

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

 

 

 

 

 

 

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