MSSNY eNews: August 16, 2019 – There They Go Again

Arthur Fougner MSSNY Presiident

PRESIDENT’S MESSAGE
Arthur Fougner, MD
MSSNY President

MSSNY eNews
August 16, 2019

Vol. 22  Number 31


MSSNYPAC Seal


Colleagues:

Divide et impera.” Julius Caesar

CMS has proposed a new fee schedule. True to form, some physicians will see an increase in Medicare payments. However, some will see a pay cut. Not unexpectedly, I received a call from an ophthalmologist about his 10% pay cut. He also noted that his colleagues in Endocrinology would receive a 10% increase and wondered if the Diabetologists would be splitting the difference for those patients with cataracts and retinal disease caused by their diabetes.

No matter where in this equation your particular practice is located, whether a “winner” or a “loser,” realize that in truth we are all losers. Echoing my comments from last week, when others are able to pit physician against physician, colleague against colleague, physicians lose. For many years now, this trend has made the practice of medicine less about profitability and more about viability. Rather than grumbling about whose slice of the pie is larger, we should be demanding (yes, demanding) a bigger pie.

For over a decade, Medicare payments have not kept up with inflation. It appears that Medicine has the dubious distinction of being an American endeavor which annually is treated to a cost of living decrease.

We need to stop being Only a Pawn In Their Game.

What say you? Please feel free to address your comments to: afougner@mssny.org.

And do follow me on Twitter: @sonodoc99

Arthur Fougner, MD
MSSNY President 



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eNews


New York Approves Increased Rate for Individual Insurance Market
Crain’s New York Business (8/9) reported that New York’s “state Department of Financial Services said Friday it would allow insurers selling health plans to individuals to raise their rates by 6.8% on average for 2020, a reduction of about one-quarter from the 9.2% insurers requested from the state in May.”

The proposed reduction “represented a less drastic cut than the state levied last year, when it cut insurers’ requests by about two-thirds and granted an average increase of 8.6% in the individual insurance market.” The article added, “The 6.8% increase for 2020 will be the lowest since 2015.”


Nursing Home Associations Call for State Payment Reforms
New York’s nonprofit nursing homes say action from state lawmakers is needed to slow the transfer of facilities to for-profit chains. An analysis Crain’s last week showed 48 nonprofit nursing homes were sold to for-profit operators between 2014 and 2018. It noted that the attorney general’s office was increasing its scrutiny of such sales in light of the trend.

Leaders of two of the largest nonprofit nursing home associations, the Continuing Care Leadership Coalition and LeadingAge New York, told Crain’s they believe the state must go further. “The attorney general’s laudable efforts must be part of a multipronged approach involving the highest levels of New York state leadership to prevent further sales and closures of mission-driven, not-for-profit nursing homes,” wrote Scott Amrhein, president of CCLC, and James Clyne Jr., president and CEO of LeadingAge.

Amrhein and Clyne recommended increasing Medicaid payments to nursing homes, noting that a study commissioned last year found payment rates resulted in a $64 per-patient shortfall.

They also said Medicaid nursing home payments should return to a fee-for-service model administered by the state rather than the managed-care approach that has been adopted. Similarly, the restoration of a $246 million cut in the state budget, which lowered Medicaid rate adjustments based on residents’ acuity, also could boost nonprofits. (Crain’s Health Pulse, Aug 8)


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USPSTF Proposes Screening All Adults for Illicit Drug Use
On  August 13, the U.S. Preventive Services Task Force (USPSTF) issued a draft recommendation that providers screen all adult patients for illicit drug use, marking the first time the task force has proposed such a recommendation. According to STAT News, the draft recommendation is intended to help combat the U.S. opioid epidemic. A federal survey in 2017 found one in 10 U.S. residents older than age 18 reported using drugs or prescription drugs illicitly, and other research has shown more than 70,000 U.S. residents in 2017 died from a drug overdose, STAT News reports. USPSTF in 2008 had concluded that there was insufficient evidence to recommend that providers screen all adult patients for illicit drug use.

However, based on new evidence, USPSTF on August 13 proposed that providers screen all patients ages 18 and older for illicit drug use if the providers can offer or refer patients to services to accurately diagnose and effectively treat substance use disorders. USPSTF in the draft recommendation defined illicit drug use as the use of illicit drugs or prescription drugs in amounts and for durations or frequencies other than prescribed.

Recommend Questions Not Drug Tests

According to the draft recommendation, USPSTF found new evidence showing screening tools can allow providers to detect whether a patient is using drugs illicitly and whether a patient might need to be assessed further. However, Karina Davidson, co-chair of USPSTF, noted that the task force is not recommending providers use drug tests to screen their patients. Instead, USPTF said providers could ask their patients a series of questions to determine whether they are using drugs illicitly.

Based on the evidence, USPSTF concluded “with moderate certainty” that screening adult patients for illicit drug use has a moderate net benefit when providers can offer or refer patients to services to diagnose and treat substance use disorders. USPSTF did not endorse a particular screening tool or treatment, which means providers who follow the recommendations can decide how they will screen and treat their patients.

USPSTF gave a “B” grade to the draft recommendation. Under the Affordable Care Act, insurers are required to cover preventive services that receive a “B” grade or higher from USPSTF without cost sharing.


USPSTF Draft Did Not Extend to Adolescent Patients between the of 12 and 17
The task force said there was insufficient evidence to determine whether screening tools and treatments are safe and effective for adolescents. According to STAT News, the long-term effects of certain treatments on the developing brains of adolescents are unknown, which is why treatments such as buprenorphine are approved only for use among patients 16 and older. USPSTF in the draft recommendation called for additional research on screening tools and treatments for adolescents who use drugs illicitly.



AMA Speaks Against Pres. Trump’s Proposal to End Sexual Orientation Protections
On Monday, August 12, the American Medical Association (AMA) spoke out against the Trump administration’s misguided proposal to remove anti-discrimination protections related to sexual orientation, gender identity, and the termination of pregnancy across a wide variety of health care programs and insurance plans.

The AMA noted that the proposal perverts the nondiscrimination provisions included in the Affordable Care Act by drastically limiting coverage protections despite decades of case law recognizing these protections. The letter said: “This proposal marks the rare occasion in which a federal agency seeks to remove civil rights protections. It legitimizes unequal treatment of patients by not only providers, health care organizations, and insurers, but also by the government itself—and it will harm patients. Such policy should not be permitted by the U.S. government, let alone proposed by it.” The letter concludes: “HHS should not finalize the proposed rule, but rather should redirect their efforts toward advancing health care access and equity for all. The AMA remains ready to assist with such efforts.”

The full text of the letter can be downloaded here.


Garfunkel Wild Offers Discount to MSSNY Members for Nov. Symposium in NYC
Garfunkel Wild is pleased to offer a discount to members of the Medical Society of the State of New York to attend Garfunkel Wild’s 6th Annual ASC and Healthcare Management Symposium on November 1, 2019 in NYC.  This has been a highly successful program and over the years it has grown in content, attendees and sponsors.  The agenda includes speakers from New York, Connecticut and New Jersey who will present timely and important topics that should be of great interest to your members.

Please see the attached flyer which we hope you can market to your members.  Please note this discount (off the normal $350 registration fee) is only effective until September 15, 2019.


Medical Groups Raise Outcry Over New Immigration Rule
The Trump Administration’s new “public charge” rule released Monday could keep noncitizen immigrants from seeking necessary medical care, according to healthcare experts.

Under the rule (clocking in at 837 pages), immigrants’ financial status and past use of public assistance programs will be taken into account in deciding whether to approve applications for permanent residency (“green cards”) and visa renewals. Those with low incomes or little education, and who have used benefits such as Medicaid, food stamps, and housing vouchers, may be turned down because they’d be seen as more likely to need future government assistance.

The rule quickly came under attack.

“Today’s changes to how ‘public charges’ are classified will discourage noncitizen immigrants from seeking the care and other services they need and to which they are legally entitled,” said David Skorton, MD, president and CEO of the Association of American Medical Colleges.

The administration’s actions could worsen health disparities, Skorton said: “The consequences of this action will be to potentially exacerbate illnesses and increase the costs of care when their condition becomes too severe to ignore.”

The final rule expands the definition of “public charge” to include the use of non-cash programs that previously had been excluded, according to Samantha Artiga, director of the Disparities Policy Project for the Kaiser Family Foundation. Even before the rule was finalized, Artiga said anecdotal reports came from providers that immigrant families were not enrolling in certain public programs, despite being eligible. Providers said they also noticed women dropping out from the Women Infants and Children (WIC) supplemental nutrition program, even though that program isn’t included under the rule, she noted.

According to Ken Cuccinelli, acting director of the U.S. Citizenship and Immigration Services (USCIS), during a press briefing Monday, Cuccinelli said “self-reliance” has been a “core principle” of America for decades. He said his family came to the U.S. from Italy and “worked together to ensure that they could provide for their own needs and they never expected the government to do it for them.”

Public benefits that are part of the rule would include “general assistance,” such as supplemental security income, Supplemental Nutrition Assistance Program (SNAP, a.k.a. food stamps), most forms of Medicaid, and certain subsidized housing programs…The rule will apply prospectively to applications and petitions received starting on Oct. 15, 2019 of this year, Cuccinelli noted.

“Make no mistake — this rule is a threat to the health of immigrant children and families,” said Mark Del Monte, JD, CEO and interim executive vice president for the American Academy of Pediatrics. “The rule considers the use of public programs like Medicaid, SNAP, and housing assistance in this definition, forcing immigrant families into an impossible choice: keep your family healthy but risk being separated, or forgo vital services so your family can remain together in this country. This is really not a choice at all,” Del Monte said.

“The public charge rule further intimidates these families and expands on the chilling effects pediatricians have seen across the country ever since the proposed rule was issued, with families disenrolling from or avoiding critical health programs and services they are eligible for,” Del Monte added. (Medpage, August 12)


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How Anthem, UnitedHealth + 4 Other Payers Fared in Q2
Anthem, Centene, Cigna, Humana and UnitedHealth Group all reported higher profits in the second quarter of fiscal year 2019, while Molina Healthcare saw profits decline.

Here’s how the six payers fared in the three-month period ended June 30:

  1. Anthem reported total revenues of $25.5 billion, up 11 percent from $22.9 billion recorded in the same period a year prior. Anthem ended the second quarter with a $1.1 billion profit, up 8.1 percent year over year.
  2. Centene posted total revenues of $18.4 billion in the second quarter of this year, up 29.4 percent from $14.2 billion reported in the same period last year. Centene ended the quarter with a $495 million profit, up 65 percent from $300 million reported in the same period in 2018.
  3. Cigna saw its total revenues climb 238 percent year over year to $38.8 billion, compared to $11.5 billion in the year prior. Cigna ended the second quarter with net income of $1.4 billion, compared to $808 million reported in the same period a year prior.
  4. Humana saw its total revenues climb to $16.2 billion, up 13.9 percent from $14.3 billion recorded in the same period a year prior. The payer boosted its net income 387 percent in the second quarter of this year to $940 million, up from $193 million in the same period a year prior.
  5. Molina Healthcare‘s total revenue fell 14.1 percent to $4.2 billion, compared to $4.9 billion in the same quarter a year prior. Molina ended the quarter with net income of $196 million, down 3 percent from $202 million reported in the same period a year prior.
    6. UnitedHealth Group recorded total revenues of $60.6 billion, up 8 percent from $56.1 billion in the same quarter a year prior. After accounting for expenses, UnitedHealth ended the second quarter with net income of $3.3 billion, up 12.7 percent from $2.9 billion recorded in the same quarter of 2018. (Becker’s Payer Issues, Aug. 13)

21 companies affected by AMCA breach
Three more health care companies have notified patients that their personal information might have been exposed in a data breach at the American Medical Collection Agency. The companies’ announcements bring the total number of health care companies known to have been affected by the data breach to 21, and the total number of patients potentially affected by the breach to at least 24.4 million. (HIPAA Journal, 8/8)


Physicians Invited to DoctHERS 4th Annual Symposium in Buffalo on 9/21
The Jacobs School of Medicine and Biomedical Sciences’ Medical Alumni Association is proud to present the 4th Annual DoctHERS Symposium.

When;             Saturday, September 21, 2019
What time?     8:00 a.m. – 12:00 p.m.

Where?           The Westin Buffalo, 250 Delaware Avenue, Buffalo, NY 14202
Cost:               $25 general admissions; students and residents are free

Join us for a morning of networking, information, enrichment and resources for pay, promotions and equity in the workplace and support for females in the healthcare profession.

Dr. Rose Berkun, Co-Chair of MSSNYPAC, is the Chair of DoctHERS and is a Clinical Assistant Professor of Anesthesiology Jacobs School of Medicine and Biomedical Sciences.

2019 Symposium Registration
Registration is now open or the 2019 DoctHERS Symposium!

Learn more about DoctHERS here.

Keynote Speaker
 Susan Bailey MD Keynote Speaker

Susan R. Bailey, MD
President-Elect, American Medical Association
Allergist in private practice, Fort Worth, TX
Distinguished Fellow of the American College of
Allergy, Asthma, and Immunology

 

 

 


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Two fully equipped exam, two certified operating, bathrooms and consultation room.  Shared secretarial and waiting rooms. Elegantly decorated, central a/c, hardwood floors. Next to Park Lane and Plaza hotels. $1250 for four days a month. Available full or part-time. 212.371.0468drdese@gmail.com.


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PHYSICIAN OPPORTUNITIES

Great Career Opportunities for Clinical Physicians
The NYS Department of Corrections and Community Supervision has great career opportunities for Clinical Physicians. You must have possession of a license and current registration to practice medicine in New York State, and have two years of post-licensure medical experience.

Starting salary is $143,381 – $171,631 *(Additional $10,000 or $20,000). Benefits include comprehensive health insurance, NYS retirement system, deferred compensation plan, flexible spending plan, and paid time off.

We have openings in the following counties offering a choice of urban, suburban or rural living:

Clinton*                  Clinton Correctional Facility (sporting and recreational outlets)
Dutchess                 Fishkill and Green Haven Correctional Facilities (Hudson River Valley Beauty)
Franklin*                 Franklin and Upstate Correctional Facility (North Country, 1 hour to Montreal)
Greene*                  Greene Correctional Facility (rural charm yet only 2 hours to New York City)
Oneida                    Mohawk Correctional Facility (Cooperstown, breweries)
Sullivan                   Woodbourne Correctional Facility (mountains, outlets, casinos and entertainment)
Seneca*                  Five Points Correctional Facility (heart of wine country)
St. Lawrence           Riverview Correctional Facility (hiking, boating and museums)
Washington             Great Meadow Correctional Facility (Between Vermont & the Green Mountains)
Westchester            Bedford Hills Correctional Facility (Less than 1 Hour to NYC)

Contact: www.doccs.ny.gov or DOCCS Personnel Office at (518) 457-8132 for more information and to apply.

View of a doctor's office waiting area View of a doctor's office lobby

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Nurse, RN Utilization Review Full-Time-Westbury, NY (In-office position only)
Excellent opportunity for a RN who is seeking a position performing utilization review.  We require 1-2 years recent experience in hospital and/or insurer utilization review and experience using Interqual criteria and/or MCG Guidelines. Data entry/PC skills a plus. Benefits include 401(k), paid vacation and holidays. Send resume and salary requirements to: Empire State Medical Scientific and Educational Foundation, Inc. Human Resource Department e-mail: chunt@mssny.org  Fax: (1-516) 833-4760 Equal Oppty Employer M/F


CALL FOR RATES & INFO. CHRISTINA SOUTHARD: 516-488-6100 ext. 355

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 


MSSNYeNews: August 9, 2019 – House of Medicine Divided Cannot Stand

Arthur Fougner MSSNY Presiident

PRESIDENT’S MESSAGE
Arthur Fougner, MD
MSSNY President

MSSNY eNews
August 9, 2019

Vol. 22  Number 30


MSSNYPAC Seal


Colleagues:

“We must indeed all hang together, or most assuredly, we shall all hang separately.”
Benjamin Franklin

This week, famed physician-author Dr. Eric Topol generated quite a buzz with a piece in The New Yorker entitled “Why Doctors Should Organize.” Beginning with the recent #ThisIsOurLane pushback against a snarky NRA piece, Dr. Topol outlines past history of successes achieved when doctors organized. He rightly notes the rise of physician burnout engendered in no small part by electronic medical records which reduce caring professionals to data-entry clerks. The severing of the patient-physician relationship is also noted, thanks to the efforts of Regulators and Managed Care. Physicians, if organized, could be a powerful force but “the profession is balkanized.”

Where Dr. Topol and I part company is his assertion that Medical Societies should not be concerned with “protecting the interests of doctors.” While he is correct in recommending that a medical organization should promote the interests of the public, he’s somehow missed the history of, for example, the AMA post-Sunbeam. Eric, Medical Societies can and should do both. I’ll simply say that if physicians don’t stand up for ourselves and represent, who will?

So Dr. Topol, I am happy to continue this dialogue because you have clearly diagnosed the illness and the cure IS organizing. We must tear down the silos. We agree more than we disagree and I feel we can all work together for the good of our noble profession. We must. Our patients are counting on it.

Or, as Billy Joel put it, we will all go down together.

Arthur Fougner, MD
MSSNY President 

Comments? comments@mssny.org; @mssnytweet; @sonodoc99



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eNews

Physicians Must Make Their Voices Heard on Surprise Billing Proposals
Discussions are still ongoing regarding a national solution to surprise bills and the current incarnation winding its way through Congress would use a disastrous benchmarking system that would leave all of the power in insurers’ hands. Legislation such as S1895 and HR3630 would allow insurers to create an artificial ceiling for payment, giving market dominant insurers new incentives to drop physicians from their networks (as they have in California) and potentially limiting patient access to needed specialty care in in hospital emergency departments.

Given these threats, please take the time to send a letter to your members of Congress by going here. The letter is pre-populated and allows you to get the message to the right individuals in just a few short minutes.  Please also work with your local county medical society to arrange to meet with your Representative of Congress, as legislators are now home in their districts until the end of September.  To find your representative, go here, where you can find their contact information including phone number and Twitter handle. Please speak with their staffs and if possible, request a meeting to discuss the issue in more detail.

For more information about why this legislation is worrisome, check out the following articles. Congress is About to Give Health Insurance Companies the Nuclear Weapon discusses how it would control surprise billing mediation for any patient in an ERISA-regulated health plan and why that would likely lead to a massive cut in physician compensation. Congress, Don’t Harm Patients With The Wrong Surprise Medical Bills Solution also provides a strong overview of the topic.

MSSNY supports an approach such as HR 3502 (Ruiz-Roe-Morelle) that is modeled after New York’s acclaimed law which has shown to be remarkably effective and fair.   It mandates use of an independent dispute resolution system similar to New York’s instead of utilizing an insurer-determined benchmark.

Please do not let Congress give insurers even more ability to implement abusive tactics that interfere with needed patient care.


Five Measles Cases Reported in Mennonite Community in Wyoming County
Health officials say they’ve confirmed five cases of measles in a Mennonite community in western New York. The DOH says Thursday the cases were recorded in Wyoming County. The department has issued an advisory to notify regional health care providers of the potential for exposure.

Amid the nation’s worst measles outbreak in decades, Gov. Cuomo in June signed a law ending all non-medical exemptions for vaccines required for children to attend school in the state. The CDC Control has counted nearly 1,200 cases of measles in 30 states so far this year. About three-quarters of the cases are linked to outbreaks in New York.



FDA Investigating 127 Cases of Seizures After Vaping
The Food and Drug Administration is investigating 127 cases of people suffering from seizures after vaping, the agency announced Wednesday.

The agency received about 92 new reports of people, especially kids and young adults, experiencing seizures after using e-cigarettes since it first announced its investigation into the issue in April. The FDA said it’s unclear whether e-cigarettes caused the seizures and cautioned these cases occurred over a 10-year period.

When the FDA announced its investigation in the spring, it asked for people to let the agency know if they had ever experienced this. The FDA on Wednesday again encouraged people to report if they had seizures after vaping.

“We appreciate the public response to our initial call for reports, and we strongly encourage the public to submit new or follow-up reports with as much detail as possible,” acting FDA Commissioner Ned Sharpless said in a statement.

“Additional reports or more detailed information about these incidents are vital to help inform our analysis and may help us identify common risk factors and determine whether any specific e-cigarette product attributes, such as nicotine content or formulation, may be more likely to contribute to seizures,” he added.


Veterans’ Care Claims Inappropriately Denied
Veteran Affairs (VA) claims processors inappropriately processed claims for emergency care received at non-VA hospitals, resulting in denied or rejected claims for tens of thousands of veterans, according to a VA Office of Inspector General (OIG) report released this week. VA’s OIG noted that denied or rejected claims can leave veterans on the hook for the total costs of their care.



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Play Ball! Baseball Players May Live Longer than Other Pros and American Men
Professional baseball players may live longer than other professional athletes or American men overall, study indicates the New York Times (8/7) reports on a study published in JAMA Internal Medicine, in which researchers found that professional baseball players may have greater life expectancy than other professional athletes “and American men in general.”

The researchers also found that professional baseball players with long careers are less likely to die from cardiovascular disease and certain other diseases, but more likely to die from cancer, especially lung and skin cancer.


New Apps Give Updates to Waiting Family Members During Surgery
The Wall Street Journal (8/6) reports that startups and large healthcare companies are developing tools designed to give family members updates on the status of their relatives during surgery or hospital stays.


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USPSTF Recommends Against Pancreatic Cancer Screening
Reaffirming its 2004 statement, the U.S. Preventive Services Task Force (USPSTF) has issued a ‘D’ recommendation against screening for pancreatic cancer in low-risk adults with no signs or symptoms of this lethal disease.” The USPSTF authors wrote in their recommendation statement  published online in JAMA that “the USPSTF found no new substantial evidence that would change its recommendation and therefore reaffirms its recommendation against screening for pancreatic cancer in asymptomatic adults.”

The task force “concluded that screening has the potential for significant harm owing to the low prevalence of pancreatic cancer (12.9 cases per 100,00 person-years), the poor outcomes of treatment (5-year survival rate of only 9.3%), the limited accuracy of screening tests, and the invasive nature of diagnostic tests.”


Review Suggests Chronic Hepatitis Can Be Eliminated Globally
MedPage Today reports that “chronic hepatitis is a major public health challenge that can be eliminated globally, according to an infectious disease expert” who conducted a review study. The review study found that “although progress has been made in the prevention and treatment of chronic hepatitis C virus (HCV) and hepatitis B virus (HBV) infections, challenges remain.”

The author suggests one step to achieving elimination of hepatitis is that, “all patients with risk factors should be tested for HCV and HBV and all persons born between 1945 and 1965 should be routinely tested for HCV to prevent liver disease and hepatitis transmission.” Moreover, the researcher “advised that ‘all who are positive for HBsAg or HCV should be evaluated for treatment and those susceptible to HBV or HAV should be vaccinated.’” The findings were published in the New England Journal of Medicine. https://bit.ly/2OMkY8h


CMS Releases Proposed 2020 Medicare Rule; Significant Up & Down Specialty Impacts
CMS recently released a 1700-page proposed rule for the 2020 Medicare physician fee schedule (PFS). CMS notes that “with the budget neutrality adjustment to account for changes in RVUs, as required by law, the proposed CY 2020 PFS conversion factor is $36.09, a slight increase above the CY 2019 PFS conversion factor of $36.04.

On a positive note, the 3-year review of Medicare GPCIs would produce a slight upward adjustment to the Geographic Adjustment Factors for the 5 New York Medicare payment localities.

However, it should be noted that the proposed changes to Medicare payment proposed in this rule could produce some significant upward and downward adjustments to Medicare physician payment, based upon specialty, if CMS finalizes the proposal without modification. Please see Table 111 on pp.1187-1188 of the proposed rule for a possible specialty by specialty impact.

For example, it predicts an overall +16% increase for Endocrinology, +15% for Rheumatology, +12% for Family Practice and Hematology/Oncology, +8% for Urology and Neurology, and +7% for Ob-GYN and Allergy/Immunology.  On the other hand, it predicts an overall -10% decrease for ophthalmology, -8% for Radiology and Cardiac Surgery, and -7% for Anesthesiology, Emergency Medicine and Thoracic Surgery.  The AMA notes that this impact table “should be viewed with caution” as they believe it may contain some errors.

For more information from CMS on the proposed rule, click here.  For a comprehensive AMA summary of the proposed rule, click here.

The AMA provided state medical societies with an overview of 2 of the key components of this rule:

Changes to E&M Coding and the MIPS Program

  • Office Visits – Evaluation and Management – While retaining the important modifications to reduce documentation burden, CMS will implement coding and payment modifications in 2021 that are based on the resources required to perform various levels of office visits. This will ensure that physicians treating the sickest patients are not unfairly penalized, while providing simpler solutions to coding and documentation.

Following CMS’ proposal last year to collapse payment for office visits, the AMA coordinated a response from 170 national medical specialty societies and state medical associations urging a different solution. The CPT Editorial Panel and AMA/Specialty Society RVS Update Committee (RUC) convened a Workgroup, that adopted changes in February 2019, to document office visits on either medical decision making or time spent on the date of the encounter.  According to AMA, CMS accepted most of the CPT framework and RUC recommendations.  Among the key aspects of the Office Visit Proposed Rule:

  • Effective January 1, 2021, CMS will adopt the CPT guidelines to report office visits based on either medical decision making or physician time.
  • CMS adopted the RUC work recommendations for the office visit codes. The work value increases represent $3 billion in redistributed spending, resulting in a 3% reduction in the conversion factor.
  • CMS adopted the RUC physician time recommendations. Coupled with the work value increases and some modifications in direct practice costs, these changes lead to an additional $2 billion in redistributed spending, resulting in an additional 2% across-the-board reduction.
  • Two departures from the CPT and RUC recommendations that we will need to be addressed:
    • CMS would implement an add-on payment for office visits for primary care and patients with serious or complex conditions. This proposal redistributes an additional $2 billion, resulting in an additional 2% reduction to the Medicare conversion factor.
    • Although the surgical specialties participated in the RUC survey and their data and vignettes were incorporated into the RUC recommendations, CMS proposes not to apply the office visit increases to the global surgery packages.
  • Merit-based Incentive Payment System (MIPS) – The AMA noted that it is encouraged by results showing 95% of eligible clinicians successfully participated in MIPS in 2017, increasing to 98% in 2018 based on initial results. However, many physicians report that the current program is too costly and requires reporting for reporting’s sake, diverting time from patient care.

The AMA noted that, in the 2020 proposed rule, CMS embraced the AMA’s proposed concept for streamlining MIPS. The agency outlined a high-level framework and seeks feedback on an episode-based approach to MIPS, which it is calling the MIPS Value Pathways (MVP). The attached MVP diagram is included in the rule.

In the AMA’s view, an MVP-type approach could be a turning point for the program because an option that ties MIPS to episodes of care has the potential to be more clinically relevant, less burdensome, and a stepping stone to alternative payment models.  The AMA does have concerns with several specific aspects of MVP that CMS has proposed, such as a return to the use of controversial population health administrative claims measures that the AMA successfully fought to eliminate from the initial MIPS program.  CMS does not plan initial implementation of an MVP approach until 2021.

 

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RENTAL/LEASING SPACE

Shared NYC Medical Space *Prime Flatiron Location* 17th Street and 5th Ave
Fantastic offering for shared sublease. Perfect for physician, physical therapist, psychotherapist, chiropractor, acupuncture, massage therapist, etcCentral HVAC system /High ceiling / Waiting area / Full-time use of the room /24/7 access and security. Up to 4 rooms for rent (for treatment or consultation) in shared medical office at prime NYC location. Telephone and Internet ready. Perfect for any medical professional. Included are: * Large reception area, fully equipped *Shared common areas *All utilities –electric, water, heat and A/C $ 4500 per month Part-time rates available Available September 1, 2019 Contact Information: jillian3335@gmail.com
Location: New York, NY, United States
17th Street and 5th Ave Main Lobby and Waiting Room


Ground Floor Office with Private Street Entrance in Luxury Park Avenue Building
Rental includes: two consultation rooms, private office, private bathroom.  Common waiting room, back office filing space and reception desks included.  Affordable rent.  Location East 60s between Park and Lexington.  Easy distance to Lenox Hill Hospital and New York Cornell.  Subway access within 1 block. Immediate 
occupancy available.  Call James: 917-710-7643

Fully Renovated Office Space for Part-Time Lease in Hauppauge
Available Tuesdays/Fridays, $450 half session, $750 full session. Elegant office space, beautiful waiting room with new stone and granite reception desk, custom molding, large windows, abundant natural light, TV, and refreshment counter.  Four new exam rooms and dictation room.  New stainless and granite kitchenette.  State-of-the-art network infrastructure meets HIPPA & PCI DSS compliance standards.  Digital X-ray room with PACS in each exam room available as an option.  Located in close proximity to LIE, Northern State Pkwy, and Vets Memorial Hwy. Contact us at (631) 486-8855;  Please see our listing
: https://www.loopnet.com/Listing/517-Route-111-Hauppauge-NY/15298633/



Office Rental 30 Central Park South
Two fully equipped exam, two certified operating, bathrooms and consultation room.  Shared secretarial and waiting rooms. Elegantly decorated, central a/c, hardwood floors. Next to Park Lane and Plaza hotels. $1250 for four days a month. Available full or part-time. 212.371.0468drdese@gmail.com.


Are You Trying to Lease Your Medical Office or Sell Your Medical Practice? Trying to Sell New or Used Medical Equipment?
Clineeds, the new online platform designed for medical providers. With Clineeds you can lease your medical officeshared your office spacebuy and sell used medical equipment, or post healthcare job opportunities. LISTING IS FREE! Why wait? Click here to sign-up: www.clineeds.com/sign-up


PHYSICIAN OPPORTUNITIES

Great Career Opportunities for Clinical Physicians
The NYS Department of Corrections and Community Supervision has great career opportunities for Clinical Physicians. You must have possession of a license and current registration to practice medicine in New York State, and have two years of post-licensure medical experience.

Starting salary is $143,381 – $171,631 *(Additional $10,000 or $20,000). Benefits include comprehensive health insurance, NYS retirement system, deferred compensation plan, flexible spending plan, and paid time off.

We have openings in the following counties offering a choice of urban, suburban or rural living:

Clinton*                  Clinton Correctional Facility (sporting and recreational outlets)
Dutchess                 Fishkill and Green Haven Correctional Facilities (Hudson River Valley Beauty)
Franklin*                 Franklin and Upstate Correctional Facility (North Country, 1 hour to Montreal)
Greene*                  Greene Correctional Facility (rural charm yet only 2 hours to New York City)
Oneida                    Mohawk Correctional Facility (Cooperstown, breweries)
Sullivan                   Woodbourne Correctional Facility (mountains, outlets, casinos and entertainment)
Seneca*                  Five Points Correctional Facility (heart of wine country)
St. Lawrence           Riverview Correctional Facility (hiking, boating and museums)
Washington             Great Meadow Correctional Facility (Between Vermont & the Green Mountains)
Westchester            Bedford Hills Correctional Facility (Less than 1 Hour to NYC)

Contact: www.doccs.ny.gov or DOCCS Personnel Office at (518) 457-8132 for more information and to apply.

View of a doctor's office waiting area View of a doctor's office lobby

View of a doctor's office


 


Nurse, RN Utilization Review Full-Time-Westbury, NY (In-office position only)
Excellent opportunity for a RN who is seeking a position performing utilization review.  We require 1-2 years recent experience in hospital and/or insurer utilization review and experience using Interqual criteria and/or MCG Guidelines. Data entry/PC skills a plus. Benefits include 401(k), paid vacation and holidays. Send resume and salary requirements to: Empire State Medical Scientific and Educational Foundation, Inc. Human Resource Department e-mail: chunt@mssny.org  Fax: (1-516) 833-4760 Equal Oppty Employer M/F


CALL FOR RATES & INFO. CHRISTINA SOUTHARD: 516-488-6100 ext. 355

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 


MSSNY eNews: August 2, 2019 – Yes! We Are Role Models!

Arthur Fougner MSSNY Presiident

PRESIDENT’S MESSAGE
Arthur Fougner, MD
MSSNY PresidentMSSNY eNews
August 2, 2019

Vol. 22  Number 29


MSSNYPAC Seal


Colleagues:

The Impossible Dream
To dream the impossible dream,
To fight the unbeatable foe,
To bear with unbearable sorrow,
To run where the brave dare not go.

Yesterday, I had the good fortune, thanks to Queens County’s own Dr. Allen Small, to attend a presentation on Cultural Competence – “When East Meets West” – presented under the auspices of the Chinese American Coalition for Compassionate Care. Familiarity with other backgrounds and perspectives is often the difference between success or failure of a doctor-patient relationship. That is one reason why one of our Past Presidents, Dr. Charles Rothberg, made diversity one of MSSNY’s pillars.

The thought occurred to me during a break that cultural perspectives often define future career choices. Such was the story of Carl Allamby of Cleveland. Carl’s family was of modest means and Carl got a job while in high school selling auto parts. He soon was working on cars after school and found he was really skilled at auto repair. Carl related that no one had ever spoken to him about college. The conversations were always about factory work or the military.

Carl kept at it and soon had his own garage, then another, while also selling used cars. His customers raved about him. Still something was missing, and Carl finally began taking college courses to get a business degree. He kept putting off one class – Biology. However, he finally relented when told it was mandatory for his degree. The class was pretty basic, taught by Dr. Micah Watts, resident in interventional radiology at Cleveland Clinic. The first class was a Eureka moment. Carl knew from that moment on that his true calling was medicine. He’d never really thought about it that much as a child – he had no role models. But now he did, as he befriended two African-American physicians at the gym. They told him to aim high, that he could do it.

Jaime Escalante, who taught advanced placement calculus in East Los Angeles, advised his students not to let anyone tell them what they would be. They alone determined their future. We should remember this when we interact with patients and their families. We should strive to be that role model.

Today, meet Carl Allamby, MD, Emergency Medicine Resident. As Paul Harvey would have put it, now you know the rest of the story.

“Don’t give up. Don’t ever give up.” Jim Valvano

Arthur Fougner, MD
MSSNY President 

Comments? comments@mssny.org; @mssnytweet; @sonodoc99


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eNews

MSSNY’s Statement re Creation of Maternal Mortality Review Board
“The Medical Society of the State of New York thanks Governor Andrew Cuomo and the Legislature for passing and signing into law the creation of a Maternal Mortality Review Board. The creation of a maternal mortality review board will assist the state in developing and creating new strategies to improve maternal health and lessen the impact of maternal mortality and morbidity. Under this law, the review board would allow multidisciplinary experts to conduct a review process of causes of maternal death, factors leading to death, preventability and opportunities for intervention.

It requires the board to report aggregate findings and recommendations in order to share best practices on the prevention of maternal deaths.  The law embraces national best practices on maternal health and ensures accountability and sustainability of a maternal review board.  It ensures that the board is diverse, multi-disciplinary and includes experts who serve and are representative of the diversity of women in medically underserved areas of the state. It also ensures confidentiality protections regarding the board’s proceeding and requires the board to report on its aggregate findings and recommendations,” stated Dr. Arthur Fougner, MSSNY President.


NY Physicians Still Have a Chance to Impact Surprise Billing Legislation
With federal legislators now on recess until the second week of September, it is prime time to contact them and set up meetings to discuss the surprise billing legislation that is making its way through Congress. If you are familiar with a member of Congress in your area, it is incumbent upon you to discuss this issue with them. And even if you’re not, as a constituent and a fellow New Yorker you have the right and duty to let them know how disastrous the policy in its current incarnation would be for doctors and their patients. To find your representative, click here. Please speak with their staffs and if possible, request a meeting to discuss the issue in more detail.

As stated in a highly informative article published recently, “Congress is About to Give Health Insurance Companies the Nuclear Weapon” as elected officials at the federal level continue to move legislation that would control surprise billing mediation for any patient in an ERISA-regulated health plan.

This bill is clearly slanted toward favoring insurance companies as it would utilize a benchmark of the “Median In-Network Price” to determine reimbursement for “surprise bills”. The reasons for which this would be disastrous to the physician community are outlined quite clearly in the above referenced article and it is estimated that this could cut physician compensation by greater than 60%.

There is hope however, that physician advocacy could move the needle as negotiations continue to occur. In addition to calling and meeting with them, please also take a moment to send a letter to your members of Congress by going to http://tiny.cc/SurpriseBIlling. The letter is pre-populated and allows you to get the message to the right individuals in just a few short minutes.



Be Sure to Listen to MSSNY’s Latest Podcast: Mental Health & Women in Military
MSSNY proudly announces our latest podcast entitled The Mental Health Needs of Women in the Military. Dr. Frank Dowling, MSSNY Secretary, discusses the history and challenges faced by women in the military with Dr. Malene Ingram, Colonel, US Army Reserves and Marcelle Leis, CMS (Ret.) USAF/ANG and Lance Allen Want, Lt. Col. (Ret.) USA.  Listen here.


Webinar for Measles and Repeal of Non-Medical Exemptions
New York State Health Commissioner, Dr. Howard Zucker, invites physicians to attend a webinar on the recent measles outbreak and information pertaining to the new law regarding non-medical exemptions for vaccinations and existing requirements for authorizing medical exemption.

During this presentation, New York State Department of Health staff will review the current status of New York’s measles outbreak, discuss current reporting requirements, the importance of case investigations and monitoring of exposed individuals and control strategies in healthcare facilities. This webinar is an opportunity to partner with the provider community to prepare for the upcoming school season and discuss activities underway to implement the new legislation.

Date: Tuesday, August 13th 3-4PM 

When we have more information, we will let you know.



 

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RFK Files Second Suit Challenging “Medical Exemptions Only” Vaccine Law
Robert F. Kennedy Jr. and other opponents of a law ending New York’s religious vaccination exemption have filed their second lawsuit challenging the repeal. The challenge, filed in the U.S. District Court for the Eastern District of New York on behalf of several unnamed children, contends that the legislation should be overturned because it violates the Individuals with Disabilities Education Act. (Politico July 29)


MSSNY Past President Dr. Robt. Goldberg Appointed to AMA Guides Editorial Panel
MSSNY is proud to report that Dr. Robert Goldberg has been selected by the American Medical Association (AMA) to serve on the AMA Guides Editorial Panel. Dr. Goldberg was nominated by MSSNY for the position, and was selected by the AMA from a large pool of candidates who submitted their resumes for the position.

Dr. Goldberg will work to modernize the AMA Guides to the Evaluation of Permanent Impairment.  The panel ‘s goal is to deliver the most current evidence-based medicine to the community in ways that address the most common challenges experienced by physicians, workers’ compensation organizations and the broad stakeholder community.

The Editorial Panel—which is comprised of physician experts in the field of impairment and disability and impairment experts from the legal and workers’ compensation community—will work based on published guidelines and acceptance criteria, and will utilize a stakeholder comment process similar to that used in CPT.

Dr. Goldberg has a strong background in the area of physician impairment and workers compensation policy. He currently serves as a consultant to the Workers’ Compensation Board of the State of New York. In addition to his private practice work in the area of Physical Medicine & Rehabilitation, Dr. Goldberg provides Rehabilitation Services at Beth Israel Hospital in New York City.


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United: “Average Price for Treating Primary Care Conditions in ED? $2,032”
Each time a patient enters the emergency department with a condition that can be treated in a primary care setting, it comes at an average cost of $2,032 to the healthcare system, according to an analysis published by UnitedHealth Group.

UnitedHealth said the average cost is 12 times higher than visiting a physician office, which costs an average of $167. It also said the $2,032 price tag is 10 times higher than an urgent care visit, which costs an average of $193. “In other words, visiting either a physician’s office or an urgent care facility instead of a hospital would save an average of more than $1,800 per visit — creating a $32 billion annual savings opportunity system wide,” according to UnitedHealth.

UnitedHealth said the 10 most common conditions treated in the ED that could be treated in a primary care setting are bronchitis, cough, dizziness, f­lu, headache, low back pain, nausea, sore throat, strep throat and upper respiratory infection. UnitedHealth projects 18 million of the 27 million ED visits made by privately insured Americans each year are avoidable.


Garfunkel Wild: PRE-SYMPOSIUM WEBINAR on Resolving Payer Obstacles

Date:         Thursday, August 8, 2019
Time:         12:00 PM – 1:00 PM EDT

Overview: Providers are finding it increasingly difficult to administer and maximize the reimbursement available through their payer contracts. This webinar will discuss practical tools and strategies that providers can adopt to best overcome these obstacles.

Speakers: Garfunkel Wild Partner-Directors

Debra A. Silverman and Roy W. Breitenbach,  Grassi Healthcare Advisors, and LLC Senior Manager Alicia Shickle

Registration: Click Here To Register

Limited space available additional information please visit our website at nymetroasc.com on November 1,2019 in Manhattan or call 516-393-2294


AAP Issues Policy Statement on Racism in Child and Adolescent Health
The American Academy of Pediatrics has issued a policy statement on the role of racism in developmental and health outcomes among children and adolescents.

Here are some of the many recommendations for clinicians, published in Pediatrics:

  • Establish a “culturally safe medical home” for patients in which “providers acknowledge and are sensitive to the racism that children and families experience.” This should include screening patients for perceived and experienced racism.
  • Evaluate patients reporting racism for mental health sequelae, including post-traumatic stress, anxiety, depression and grief. Make referrals for mental health care as appropriate.
  • Educate clinicians and office staff about providing culturally and linguistically appropriate care (see second link below for Health and Human Services guidance).

The AAP’s policy statement, linked below, offers numerous resources for clinicians.

Separately in Pediatrics, researchers report evidence that infants of color generally receive worse neonatal intensive care — in particular, neonatal mortality rates are higher at minority-serving hospitals.

LINK(S):
AAP policy statement in Pediatrics; HHS guidance on providing culturally appropriate healthcarePediatrics article on racial/ethnic disparities in the NICU


HHS Unveils Drug-Importation Plan
The Trump Administration announced yesterday that it will “create a way for Americans to legally and safely import lower-cost prescription drugs from Canada for the first time, reversing years of refusals by health authorities amid a public outcry over high prices for life-sustaining medications.”

In addition, HHS “also said it would allow drugmakers to bring drugs that they sell more cheaply in foreign countries into the United States for sale here.” The New York Times (7/31) reports, “The proposed rule would not apply to high-priced drugs like insulin or other biologic drugs…because of exceptions included in earlier legislation.” Moreover, “the separate F.D.A. guidance would permit importation of drugs, including insulin, only if the drug makers agreed to take part in the plan.”


CMS’ 2020 Proposed Rule Released that Will Reduce Paperwork
On July 29, CMS proposed major policy changes to ensure clinicians spend more time providing high-value care for patients instead of filing cumbersome paperwork. As part of CMS’s annual changes to the Medicare Physician Fee Schedule and Quality Payment Program, the agency’s proposals are aimed at reducing burden, recognizing clinicians for the time they spend with patients, removing unnecessary measures and making it easier for them to be on the path towards value-based care. This proposed rule builds on the Trump Administration’s efforts to establish a patient-driven healthcare system that focuses on better health outcomes, and is projected to save 2.3 million hours per year in burden reduction.

For the full press release describing this announcement, please visit here.

For a fact sheet on the CY 2020 Physician Fee Schedule proposed rule, please visit here.

To view the CY 2020 Physician Fee Schedule and Quality Payment Program proposed rule, please visit here.



MSSNYPAC’s Day at the Saratoga Races
Photo of doctors who attended A Day at the Races in SaratogaDr. Tom Madejski and Sandra Madejski; Paul and Patricia Hartigan; Don Young and Grace Young; Dr. Greg Pinto; Natalie Adler; Dominique Oliveria Adamec Michael Adamec; and MSSNY’s Alliance Co-Chair Barbara Ellman


Classified

RENTAL/LEASING SPACE

Photo of Park Ave building facadePrestigious Park Ave Office Near Lenox Hill Hospital for Sale
2,400 sq/ft on two levels with a separate 6×12 ft. storage closet. Fireplace in waiting room and consult room. Perfect for plastic surgeons, cosmetic dermatologists or other. $2,950,000 Call for details and appoint to view. 212-570-6060


 

 


Ground Floor Office with Private Street Entrance in Luxury Park Avenue Building
Rental includes: two consultation rooms, private office, private bathroom.  Common waiting room, back office filing space and reception desks included.  Affordable rent.  Location East 60s between Park and Lexington.  Easy distance to Lenox Hill Hospital and New York Cornell.  Subway access within 1 block. Immediate 
occupancy available.  Call James: 917-710-7643


Upper East Side Medical Office Space for Rent Part–Time
Beautiful, newly renovated medical office on the Upper East Side between Lexington and Park Ave. Full service building with 2 entrances, conveniently located near all public transportation. Office includes 2 consult rooms, 3 exam rooms, treatment area, 2 bathrooms, kitchenette and reception area with waiting room. The office is available on a part-time basis. Please call 212-288-2278 or e-mail eastsidemedical@usa.net for further information.
Upper East Side Office lobby and receptions area


Park Avenue Office Share-3 Days Per Week
Tasteful, bright, well-maintained medical office in prestigious building on Park Avenue at 94th Street.  Large waiting room and reception area, consultation room and 2 exam rooms available 3 days per week. Room for an
assistant or clerical help 5 days per week. 


Please email abgmdpc@gmail.com or call 987-5000


Medical Office Space for Rent!
Beautiful Newly Renovated Medical Office on the Upper East Side between Madison and Park Avenue! Conveniently located near all public transportation and Mount Sinai Hospital. Consult and Exam room available for rent part time or full time (see pictures). Please call 212-860-0300 or email
carnegiehill0062@gmail.com <for further information.
Pictures of office space for rent on Madison Ave




Fully Renovated Office Space for Part-Time Lease in Hauppauge
Available Tuesdays/Fridays, $450 half session, $750 full session. Elegant office space, beautiful waiting room with new stone and granite reception desk, custom molding, large windows, abundant natural light, TV, and refreshment counter.  Four new exam rooms and dictation room.  New stainless and granite kitchenette.  State-of-the-art network infrastructure meets HIPPA & PCI DSS compliance standards.  Digital X-ray room with PACS in each exam room available as an option.  Located in close proximity to LIE, Northern State Pkwy, and Vets Memorial Hwy. Contact us at (631) 486-8855;  Please see our listing
: https://www.loopnet.com/Listing/517-Route-111-Hauppauge-NY/15298633/



Office Rental 30 Central Park South
Two fully equipped exam, two certified operating, bathrooms and consultation room.  Shared secretarial and waiting rooms. Elegantly decorated, central a/c, hardwood floors. Next to Park Lane and Plaza hotels. $1250 for four days a month. Available full or part-time. 212.371.0468drdese@gmail.com.


Are You Trying to Lease Your Medical Office or Sell Your Medical Practice? Trying to Sell New or Used Medical Equipment?
Clineeds, the new online platform designed for medical providers. With Clineeds you can lease your medical officeshared your office spacebuy and sell used medical equipment, or post healthcare job opportunities. LISTING IS FREE! Why wait? Click here to sign-up: www.clineeds.com/sign-up


PHYSICIAN OPPORTUNITIES

Great Career Opportunities for Clinical Physicians
The NYS Department of Corrections and Community Supervision has great career opportunities for Clinical Physicians. You must have possession of a license and current registration to practice medicine in New York State, and have two years of post-licensure medical experience.

Starting salary is $143,381 – $171,631 *(Additional $10,000 or $20,000). Benefits include comprehensive health insurance, NYS retirement system, deferred compensation plan, flexible spending plan, and paid time off.

We have openings in the following counties offering a choice of urban, suburban or rural living:

Clinton*                  Clinton Correctional Facility (sporting and recreational outlets)
Dutchess                 Fishkill and Green Haven Correctional Facilities (Hudson River Valley Beauty)
Franklin*                 Franklin and Upstate Correctional Facility (North Country, 1 hour to Montreal)
Greene*                  Greene Correctional Facility (rural charm yet only 2 hours to New York City)
Oneida                    Mohawk Correctional Facility (Cooperstown, breweries)
Sullivan                   Woodbourne Correctional Facility (mountains, outlets, casinos and entertainment)
Seneca*                  Five Points Correctional Facility (heart of wine country)
St. Lawrence           Riverview Correctional Facility (hiking, boating and museums)
Washington             Great Meadow Correctional Facility (Between Vermont & the Green Mountains)
Westchester            Bedford Hills Correctional Facility (Less than 1 Hour to NYC)

Contact: www.doccs.ny.gov or DOCCS Personnel Office at (518) 457-8132 for more information and to apply.

View of a doctor's office waiting area View of a doctor's office lobby

View of a doctor's office


 


Nurse, RN Utilization Review Full-Time-Westbury, NY (In-office position only)
Excellent opportunity for a RN who is seeking a position performing utilization review.  We require 1-2 years recent experience in hospital and/or insurer utilization review and experience using Interqual criteria and/or MCG Guidelines. Data entry/PC skills a plus. Benefits include 401(k), paid vacation and holidays. Send resume and salary requirements to: Empire State Medical Scientific and Educational Foundation, Inc. Human Resource Department e-mail: chunt@mssny.org  Fax: (1-516) 833-4760 Equal Oppty Employer M/F


CALL FOR RATES & INFO. CHRISTINA SOUTHARD: 516-488-6100 ext. 355

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 


Medical Society Supports Creation of Maternal Mortality Review Board 


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

 

For Immediate Release
August 2, 2019

Medical Society Supports Creation of Maternal Mortality Review Board 

Statement attributable to:
Arthur Fougner, MD
President, Medical Society of the State of New York

“The Medical Society of the State of New York thanks Governor Andrew Cuomo and the Legislature for passing and signing into law the creation of a Maternal Mortality Review Board. The creation of a maternal mortality review board will assist the state in developing and creating new strategies to improve maternal health and lessen the impact of maternal mortality and morbidity.  The law embraces national best practices on maternal health and ensures accountability and sustainability of a maternal review board.  Maternal mortality is an important public health issue that must be addressed and the creation of this board is the first step.” Arthur Fougner, MD, MSSNY President.

# # #

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

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

 

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MSSNY eNews: July 26, 2019 – Turn Complaints into Action

Arthur Fougner MSSNY Presiident

PRESIDENT’S MESSAGE
Arthur Fougner, MD
MSSNY President

MSSNY eNews
July 26, 2019

Vol. 22  Number 28


MSSNYPAC Seal


Colleagues:

One of the most, if not THE most, aggravating issues plaguing physicians is the process of obtaining prior authorization for medically necessary drugs, procedures or tests. In fact, Medical Economics has cited the all too often arduous process of obtaining authorizations as one major factor associated with physician burnout. In 2016, this video, illustrating the absurdity of the process, went viral. Yet, like a stubborn cold, the problem remains.

Finally, it appears someone with sufficient juice may be paying attention. Yesterday, your Medical Society’s Regina McNally received an email from CMS’ NY Division of Financial Management and Fee for Service Operations, urging comments on this process as part of the “Patients over Paperwork Initiative designed to find opportunities to modernize or eliminate rules and requirements that are outdated, duplicative, or getting in the way of quality patient care.”

Simply register here and fire away. Here’s our chance to turn complaints into action. But we need to move on this one as there is an August 12th deadline.

Although personally, I find the Murphy-Reinhold Maneuver attractive, I’d make our comments more substantive. So as Larry the Cable Guy would put it, let’s “Git ‘Er Done.” (See further info below).

Arthur Fougner, MD
MSSNY President 

CMS Regional Offices are contacting provider organizations to make a special request for comments on prior authorization procedures under Medicare FFS, as well as those of Medicare Advantage, Medicaid Advantage and Health Insurance Marketplace Plans. Physicians are invited to send their experiences and comments concerning preauthorization to PatientsoverPaperwork@cms.hhs.gov. CMS anonymizes the comments, stories, experiences, and recommendations you share, with the exception of your ‘role’ e.g., clinician, ‘location’ e.g., state, or ‘facility type’ e.g., hospital.

The team uses the information to inform policy and operational staff, as well as for internal presentations. The early goal of this Prior Authorization Engagement is to create a strategy that will become the foundation for improving the prior authorization process. This is part of CMS’ ongoing “Patients over Paperwork” initiative designed to find opportunities to modernize or eliminate rules and requirements that are outdated, duplicative, or getting in the way of quality patient care.  In that regard, I should remind you that CMS recently published a Request for Information (RFI) in the Federal Register: “Reducing Administrative Burden to Put Patients over Paperwork”, a broad request for public comments on ways to improve CMS programs. You can submit formal comments on the RFI by August 12, 2019, and we hope that you do.  

Comments? comments@mssny.org; @mssnytweet; @sonodoc99


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eNews

With Congressmembers Back in Districts, Now is the Time to Meet with Them to Raise Concerns with Surprise Billing Proposals
A recently published article, “Congress is About to Give Health Insurance Companies the Nuclear Weapon” noted that elected officials at the federal level continue to move well-intended, but seriously misguided legislation that would address surprise bills for out of network care delivered to a patient covered by an ERISA-regulated health plan. 

Specifically, they are referring to legislation that has advanced from the Senate HELP (S.1895) and House Energy & Commerce Committees (HR 3630) that would limit payments to out of network physicians for “surprise” hospital bills to an insurer determined “median contracted” rate.

These bills are clearly slanted toward benefiting insurance company interests.  MSSNY and many other physician groups agree with the goal to assure patients are protected from surprise bills, but disagree with the approach of these bills.  These bills are far different than New York’s balanced approach to this issue, which includes regionally adjusted charges (as reported by Fair Health) for services as a major consideration for determining fair reimbursement by an independent dispute resolution entity.  As has happened in California, permitting insurers to pay an in-network rate in these instances would give already fat-cat insurance companies the incentive to further narrow their networks, and impact the ability of ALL physicians to fairly negotiate with these corporate behemoths.

However, physicians still have the opportunity to shape the outcome as negotiations continue to occur.  We still have a chance to impact the ongoing dialogue as the bill continues to move through the legislative process.  MSSNY and many other physician organizations have noted their support for HR 3502 (Ruiz/Roe/Morelle), which largely mirrors New York’s approach to surprise medical bills.

As members of Congress are back in New York for the “August recess,” please seek to call and meet with them to let them know that HR 3630 and S.1895 would be an unmitigated disaster, resulting in narrower networks and potentially making it much harder for hospitals to have needed on-call specialty care in their emergency departments.  Instead, urge them to support the Ruiz-Roe HR 3502 approach to this issue.

Notably, an AMA press release this week raised strong concerns with the “clear mischaracterization” of the impact of an independent arbitration process by America’s Health Insurance Plans (AHIP). 

Please also take a moment to send a letter to your members of Congress by going to http://tiny.cc/SurpriseBIlling. The letter is pre-populated and allows you to get the message to the right individuals in just a few short minutes.


Gov.: New Action Ensuring Insurers Give Expanded Coverage for HIV-Prevention
This week, Gov. Cuomo issued a statement that requires additional co-pay assistance for coverage of HIV prevention drug PrEP in a proposed regulation to require more information on patients’ health insurance ID cards. 



Responders Continue to Suffer from World Trade Center-Related Illnesses
The Centers of Disease Control and Prevention “notes that thousands of responders and survivors of the 9/11 attack continue to suffer adverse health effects from toxic contaminants, risks of traumatic injury, and physically and emotionally stressful conditions.” New York City Fire Commissioner Daniel Nigro said, “It is almost incomprehensible that after losing 343 members on September 11, we have now had 200 more FDNY members die due to World Trade Center illness.” The recent deaths “come as legislation remains stalled in Congress to extend the 9/11 Victim Compensation Fund that provides financial help to victims of the attack in exchange for their agreement not to sue the airline corporations involved.”


Study Finds Google Search More Accurate Than Medicare Advantage Directories
Compared to Google, Medicare Advantage provider directories contained less accurate information, according to a study published in the American Journal of Managed Care. Austin Frakt, PhD, director of the Partnered Evidence-Based Policy Resource Center at the V.A. Boston Healthcare System and a co-author of the study, wrote in a column for The New York Times that even for researchers, “figuring out which doctors are available (and where) can be exceedingly difficult, if not impossible” for Medicare Advantage plans.

While Medicare Advantage has been promoted by the Trump administration as an alternative to Medicare that offers more coverage for a lower price tag, Dr. Frakt writes that often a limitation of the plans — that physician networks may be narrower — is omitted from this discourse. In addition, directories for the plans are often riddled with errors. CMS found nearly half of provider entries had either address errors, incorrect phone numbers or physicians who weren’t accepting new patients, according to Dr. Frakt, who cited government audits of Medicare Advantage plans.

“Still, because there is no way for Medicare beneficiaries to compare plan networks, people could easily stumble into a narrow network plan without knowing it,” Dr. Frakt wrote. “As with many things in healthcare, it’s hard to make an informed decision.”


 

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Anthem’s New App Can Schedule and Pay for Care Via Smartphone
Anthem will roll out a new app this month that will give members and nonmembers the ability to schedule and pay for medical care through their smartphones. The app, right now called CareSpree, will be tested in Indiana during the last week of July. Anthem plans to expand the app to people across its 14 main states. The app will include an artificial intelligence-powered chat function to predict diagnoses for consumers after they enter their symptoms and other health information. The app then allows users to connect with a physician through text for follow-up.

Video physician visits will also be a feature of the app. The app will allow Anthem and non-Anthem users to schedule in-person physician visits, MRIs and X-rays, and pay a pre-negotiated rate through their smartphones. Anthem has made deals with 10 healthcare providers for the app, according to The Wall Street Journal.

Users not covered by Anthem will be charged to text and video message with physicians. Anthem members will be able to tie the app with their health history and health plan, allowing them to pay any out-of-pocket charges with their smartphone. Additionally, Anthem will offer a new digital personal health record for its members later this year.
(Becker’s Hospital July 22)


Death Rates Rising for Young and Middle-Aged Adults
Death rates are on the rise for young and middle-aged American adults, according to a study published July 23 by the CDC.  Among younger adults ages 25-44, the death rate rose 21 percent for whites and blacks and 13 percent for Hispanics between 2012 and 2017. Most died of injuries such as drug overdoses, suicides, homicides and heavy use of alcohol.

Among middle-aged adults ages 45-64, death rates rose by 6.9 percent for whites and 4.2 percent for blacks. The Hispanic death rate in this cohort did not change significantly.

The analysis further examines negative health trends across the U.S., where the opioid epidemic and heart disease are decreasing life expectancy.

Death rates have declined overall for the general population, but the decline is slowing. Hispanics have typically had lower death rates than blacks and whites in the U.S., but the opioid epidemic is curbing that trend among younger Hispanics. In contrast, older Hispanics, many of whom are foreign-born, have remained healthier.


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More Than 25% of Early-Middle-Aged Adults Have Osteopenia in Their Neck
Healio (7/19) reported, “More than 25% of early-middle-aged adults had osteopenia in their neck,” researchers concluded after “173 questionnaires from men and women aged 35 to 50 years that determined calcium intake, weekly exercise and other risk factors associated with osteoporosis and osteopenia.” The findings were published in the Journal of the American Osteopathic Association.


Study: Colorectal Cancer Rates Among Adults Under 50 Are Increasing
An observational study indicates “more adults below the age of 50 are being diagnosed with colorectal cancer compared with five decades ago.” The study, published in the journal Cancer, showed “under 50s made up 12 percent of colorectal patients, spiking to 13.9 percent among African Americans and 18.9 percent among Hispanic populations.”

Furthermore, “when younger patients are diagnosed, the disease is more likely to be picked up in the advanced three or four stages, at 51.6 percent versus 40 percent of those above 50.” HemOnc Today (7/22)reports that “overall incidence of colorectal cancer incidence has decreased in the United States over the past several decades,” but “the percentage of colorectal cancer cases diagnosed among adults aged younger than 50 years increased from 10% in 2004 to 12.2% in 2015.”


USPSTF Reaffirms Recommendation to Screen All Pregnant Women for Hepatitis B
The U.S. Preventive Services Task Force is again recommending that all pregnant women be screened for hepatitis B infection. The grade A recommendation, published in JAMA, reaffirms the group’s 2009 guidance and aligns with recommendations from the CDC and American College of Obstetricians and Gynecologists.

The task force specifies that a hepatitis B surface antigen test should be ordered at the first prenatal visit. Women who continue to have hepatitis B risk factors during pregnancy (for example, use of injection drugs) should be screened again at admission for delivery.

All women should be screened in each pregnancy, even if they have tested negative in a prior pregnancy or have been vaccinated against hepatitis B.

The USPSTF notes that since 1998, rates of maternal hepatitis B infection have increased 5.5% per year. Screening accurately identifies such infection, and treatment can prevent perinatal transmission.

USPSTF recommendation statement in JAMA;JAMA editorial


 

Classified

RENTAL/LEASING SPACE

Photo of Park Ave building facade
Prestigious Park Ave Office Near Lenox Hill Hospital for Sale
2,400 sq/ft on two levels with a separate 6×12 ft. storage closet. Fireplace in waiting room and consult room. Perfect for plastic surgeons, cosmetic dermatologists or other. $2,950,000 Call for details and appoint to view. 212-570-6060



 

Ground Floor Office with Private Street Entrance in Luxury Park Avenue Building
Rental includes: two consultation rooms, private office, private bathroom.  Common waiting room, back office filing space and reception desks included.  Affordable rent.  Location East 60s between Park and Lexington.  Easy distance to Lenox Hill Hospital and New York Cornell.  Subway access within 1 block. Immediate occupancy available.  Call James: 917-710-7643


For Lease – Buffalo Area Urgent Care / Primary Care Clinic
Next door to only grocery store in town: Sav-a-Lot 4+ exam rooms, X-Ray room, Lab, Offices, etc. 3300 Sq Ft. – Fully built-out facility  ADA compliant Dunkirk New York
View full listing https://reporting.loopnet.com/report/3008dc65-60b8-4476-ab01-df4ffa2bc628.Contact geoff_jenkins@hotmail.com / (917) 825-4542


Upper East Side Medical Office Space for Rent Part–Time
Beautiful, newly renovated medical office on the Upper East Side between Lexington and Park Ave. Full service building with 2 entrances, conveniently located near all public transportation. Office includes 2 consult rooms, 3 exam rooms, treatment area, 2 bathrooms, kitchenette and reception area with waiting room. The office is available on a part-time basis. Please call 212-288-2278 or e-mail eastsidemedical@usa.net for further information.
Upper East Side Office lobby and receptions area


Park Avenue Office Share-3 Days Per Week
Tasteful, bright, well-maintained medical office in prestigious building on Park Avenue at 94th Street.  Large waiting room and reception area, consultation room and 2 exam rooms available 3 days per week. Room for an
assistant or clerical help 5 days per week. Please emailabgmdpc@gmail.com or call 987-5000


Medical Office Space for Rent!
Beautiful Newly Renovated Medical Office on the Upper East Side between Madison and Park Avenue! Conveniently located near all public transportation and Mount Sinai Hospital. Consult and Exam room available for rent part time or full time (see pictures). Please call 212-860-0300 or email
carnegiehill0062@gmail.com <for further information.
Pictures of office space for rent on Madison Ave




Fully Renovated Office Space for Part-Time Lease in Hauppauge
Available Tuesdays/Fridays, $450 half session, $750 full session. Elegant office space, beautiful waiting room with new stone and granite reception desk, custom molding, large windows, abundant natural light, TV, and refreshment counter.  Four new exam rooms and dictation room.  New stainless and granite kitchenette.  State-of-the-art network infrastructure meets HIPPA & PCI DSS compliance standards.  Digital X-ray room with PACS in each exam room available as an option.  Located in close proximity to LIE, Northern State Pkwy, and Vets Memorial Hwy. Contact us at (631) 486-8855;  Please see our listing
: https://www.loopnet.com/Listing/517-Route-111-Hauppauge-NY/15298633/



Office Rental 30 Central Park South
Two fully equipped exam, two certified operating, bathrooms and consultation room.  Shared secretarial and waiting rooms. Elegantly decorated, central a/c, hardwood floors. Next to Park Lane and Plaza hotels. $1250 for four days a month. Available full or part-time. 212.371.0468drdese@gmail.com.


Rare Find — Great Office Share
Wonderful office share in terrific location at great price. Available Monday, Wednesday, Friday and weekends. Choice of smaller windowed consultation room with adjoining exam room or big windowed consultation room with one or two exam rooms. Beautiful bright rooms, lovely reception area and front . First-rate building on 58th Street between Park and Lexington. Rent by day (about $180). Front desk and office management available if needed, along with many other amenities, including internet, ultrasound, EMG Kitchen, optional C Arm. Willing to make changes for new tenant. Call 646-642-0700.


  

 


Are You Trying to Lease Your Medical Office or Sell Your Medical Practice? Trying to Sell New or Used Medical Equipment?
Clineeds, the new online platform designed for medical providers. With Clineeds you can lease your medical officeshared your office spacebuy and sell used medical equipment, or post healthcare job opportunities. LISTING IS FREE! Why wait? Click here to sign-up: 
www.clineeds.com/sign-up

PHYSICIAN OPPORTUNITIES

Great Career Opportunities for Clinical Physicians
The NYS Department of Corrections and Community Supervision has great career opportunities for Clinical Physicians. You must have possession of a license and current registration to practice medicine in New York State, and have two years of post-licensure medical experience.

Starting salary is $143,381 – $171,631 *(Additional $10,000 or $20,000). Benefits include comprehensive health insurance, NYS retirement system, deferred compensation plan, flexible spending plan, and paid time off.

We have openings in the following counties offering a choice of urban, suburban or rural living:

Clinton*                  Clinton Correctional Facility (sporting and recreational outlets)
Dutchess                 Fishkill and Green Haven Correctional Facilities (Hudson River Valley Beauty)
Franklin*                 Franklin and Upstate Correctional Facility (North Country, 1 hour to Montreal)
Greene*                  Greene Correctional Facility (rural charm yet only 2 hours to New York City)
Oneida                    Mohawk Correctional Facility (Cooperstown, breweries)
Sullivan                   Woodbourne Correctional Facility (mountains, outlets, casinos and entertainment)
Seneca*                  Five Points Correctional Facility (heart of wine country)
St. Lawrence           Riverview Correctional Facility (hiking, boating and museums)
Washington             Great Meadow Correctional Facility (Between Vermont & the Green Mountains)
Westchester            Bedford Hills Correctional Facility (Less than 1 Hour to NYC)

Contact: www.doccs.ny.gov or DOCCS Personnel Office at (518) 457-8132 for more information and to apply.

View of a doctor's office waiting area View of a doctor's office lobby

View of a doctor's office


 


Nurse, RN Utilization Review Full-Time-Westbury, NY (In-office position only)
Excellent opportunity for a RN who is seeking a position performing utilization review.  We require 1-2 years recent experience in hospital and/or insurer utilization review and experience using Interqual criteria and/or MCG Guidelines. Data entry/PC skills a plus. Benefits include 401(k), paid vacation and holidays. Send resume and salary requirements to: Empire State Medical Scientific and Educational Foundation, Inc. Human Resource Department e-mail: chunt@mssny.org  Fax: (1-516) 833-4760 Equal Oppty Employer M/F


CALL FOR RATES & INFO. CHRISTINA SOUTHARD: 516-488-6100 ext. 355

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 


MSSNYeNews: July 19, 2019 – The Final Frontier

Arthur Fougner MSSNY Presiident

PRESIDENT’S MESSAGE
Arthur Fougner, MD
MSSNY President

MSSNY eNews
July 19, 2019

Vol. 22  Number 27


MSSNYPAC Seal


Colleagues:

Congress is continuing to work on legislation that aims to deal with “surprise bills.” Keep your eyes peeled to your email inbox for updates. I realize this may seem tiresome but if the wrong legislation is passed, the Uniteds and Aetnas of the world may get handed the ability to set benchmark payments for everyone. Believe me, it won’t be pretty. Attention is soon moving to the House Ways and Means, where we have a shot. NY Reps Tom Suozzi (downstate) and Brian Higgins (western NY) are on Ways and Means and are also cosponsors of HR 3502 which would set up an independent arbitration system similar to NY’s to resolve disputes. Please take a moment and Call Rep Suozzi 202-225-3335 and Rep Higgins 202-226-0347, asking them to oppose HR 3630 and support the bill they co-sponsor— HR3502.

Perhaps contemplating the alternative should Congress get it wrong will get you to dial that much faster.

Now, please allow me to digress.

This weekend marks the 50th anniversary of that “one small step for man, one giant leap for mankind” as the first humans walked on another galactic body. Just three years before in 2016 was another 50th anniversary – that of arguably the most famous split infinitive of all time – as the voyages of the Starship Enterprise embarked on its five-year mission. This now celebrated Science Fiction series made the Science Fact of the moon mission all the more incredible. July 20, 1969 was the day the Impossible became Possible.

Space has been the dream of all humanity from the day the first sentient primate climbed down out of that tree, looked up, saw the night sky and wondered what was out there. Now, folks from all over the world are preparing to return to space. There will no doubt be missteps as there have been in the past – Apollo One and Challenger come to mind – but in the not too distant future, we will once again see explorers, as Ronald Reagan put it in another, more somber context, slip “the surly bonds of earth to touch the face of God.”

Oh, when I look back now
That summer seemed to last forever
And if I had the choice
Yeah, I’d always wanna be there
Those were the best days of my life

Oh, yeah
Back in the summer of sixty-nine

–Bryan Adams, Summer of Sixty-Nine

Arthur Fougner, MD
MSSNY President 

Comments? comments@mssny.org; @mssnytweet; @sonodoc99


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eNews

US House Committee Advances Surprise Billing Legislation Opposed by Physician Community
This week the US House Energy and Commerce Committee reported out by voice vote surprise billing legislation (HR 3630) strongly opposed by MSSNY and other medical associations. The legislation would limit out of network payment for surprise hospital bills to a median in-network rate, for which MSSNY and the medical community has raised strong concerns that it would give enormous new powers to already market dominant health insurers.  An amendment to HR 3630 offered by Rep. Dr. Raul Ruiz MD (D-CA) and Rep. Dr. Larry Bucshon MD (R-IN) was adopted to add an appeals provision.  Appeals would be restricted to complex cases with a payment above $1,250 (indexed to inflation).

Arbitrators would be permitted to consider median contracted in-network rate, provider’s level of training, experience, quality and outcomes measurements and acuity of care/services rendered.  In order to hold down the budget score of the amendment, the arbitrator would be prohibited from considering billed charges.

The AMA has reported that the addition of an appeals process, while imperfect, represents progress on this issue, noting that there will be opportunities with two other House committees (Ways &Means/Education& Labor) to make further improvements on this and other elements in the legislation both before and during floor action in the House and Senate. While this legislation would protect New York’s law for state regulated health insurance products, it would establish this insurer determined default rate for plans governed by ERISA.

Amendments were also adopted by the E&C Committee for HHS and the GAO to conduct studies to assess impact of the legislation on access to providers, network adequacy, premiums and patient out of pocket costs. In addition, a requirement to conduct an audit of at least 25 health plans to assure that in-network median rates are being properly calculated was also adopted.

MSSNY will continue to work with the federation of medicine to fight for a law that is consistent with New York’s acclaimed approach, rather than bills such as HR 3630, which is essentially a gift to the health insurance industry wrapped in a consumer protection package. We thank the many physicians have who have contacted their respective members of Congress, and urge physicians to continue doing so by clicking here.


Physician Action Needed on Bills Awaiting Governor’s Signature
Bills that passed during the 2019 session must now be sent to the governor in order to be enacted into law. There are still a few outstanding pieces of legislation that passed both houses this year that MSSNY has taken strong positions on, and as such it is incumbent upon MSSNY members to take a moment to let the governor know where we stand on these issues. There is power in numbers; the more physicians that reach out to the governor, the louder our message will be heard.

Physicians can quickly and easily send a letter to the Governor here on these issues:

  • Malpractice expansion – two bills passed the legislature that will further tip the scales in lawsuits against physicians and others, adding costs and potentially increasing your liability premiums while doing nothing to reform the current broken system. One would force physician defendants into making a “blind gamble” in cases involving multiple defendants where one defendant settles prior to trial and would enable in many cases the total payout to a plaintiff to actually exceed a jury’s award. The other would allow plaintiffs to collect a judgment from a third party that is not a direct party to the lawsuit in question. The bill would permit this to occur even though the plaintiff had not sued or perhaps could not have sued the third-party defendant in the first instance. Please let the governor know how destructive these bills would be by clicking here.
  • Mid-year formulary changes – would prohibit a health insurer from removing a prescription drug from a formulary during the patient’s policy year. Moreover, if the plan’s drug formulary has two or more tiers of drug benefits with different deductibles, copayments or coinsurance, the plan may not move a drug to a tier with higher patient cost sharing during the policy year. It also prohibits the plan from adding new or additional formulary restrictions during the policy year. Please reach out to the governor and let him know how helpful this bill would be by clicking here.
  • Partial prescription fills – would allow prescribers, in consultation with their patients, to prescribe up to a 30-day supply of a controlled substance with a notation to the pharmacist that they should only dispense the amount agreed to by patient and prescriber. Each partial fill would be dispensed and recorded in the same manner as a normal refill and the aggregate quantity dispensed across partial fillings may not exceed the overall total quantity prescribed. This measure should help to address patients’ pain while reducing the amount of leftover medication in households. Please encourage the governor to sign this legislation by clicking here.



Gov. Signs Law Raising Tobacco Sales from Age 18 to 21
This week Governor Cuomo signed into law legislation (A.558/S.2833) that would raise the statewide tobacco purchase age from 18 to 21, legislation long supported by MSSNY.  The new law will take effect on November 13, 2019.  MSSNY President Dr. Art Fougner offered the following statement praising the Governor and legislators for taking this action:

“This major public health advancement will help to prevent a generation of New Yorkers from becoming addicted to smoking by delaying children and young adults’ access to tobacco products.  Data shows the earlier a child begins to smoke the more severe the addiction is likely to be and 90% of all smokers begin before age 20.   This new law will reduce the likelihood they ever start smoking and therefore create a healthier state. We thank Governor Cuomo for signing this legislation into law, and Assemblywoman Rosenthal and Senator Savion for advancing this important legislation”


New York Insurer Opens Office in Hospital
CDPHP, a New York health insurer, opened a branch inside Ellis Medicine in Schenectady, N.Y., to connect patients directly with insurance staff if they have questions during treatment and post-discharge, according to the Albany Business Review.

The idea came to CDPHP’s CEO, John Bennett, MD, after a recent hospitalization revealed some of the difficulties patients face when navigating the healthcare system. CDPHP opened its office July 16, which is staffed with representatives tasked with answering questions about what insurance will pay for at Ellis Medicine, among other discussions.

Ellis Medicine CEO Paul Milton told the Albany Business Review he expects to see improved patient satisfaction and readmission rates among CDPHP members because of the partnership. In addition, since Ellis Medicine houses CDPHP’s first hospital office, CDPHP members may seek out the hospital for care. Read the full article here.


 

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Private Equity Investing Heavily in Physician Practices
Private equity is a big mover in the long-term care continuum, especially in the home care and hospice spaces where the platforms are looking to build growth through acquisition-heavy strategies, Providing’s Kyle Daly told Bloomberg Law  (June 17).

Involvement by BDT Capital Partners and Gryphon Investors in deals in the physical therapy space demonstrated private equity’s continued interest in expanding its presence in key markets through add-on acquisitions, Daly said.

Private equity also is investing heavily in physician practices, Hirschman said. Radiology remains a hot practice area for consolidation, he said.

Private investors have shown the most interest in ophthalmology, gastroenterology, ear-nose-and-throat, obstetrics-gynecology, and orthopedics practices, Hirschman said. This is because those specialties have the greatest potential to increase revenues and profits through additional investments in new and expanded ancillary services, like ambulatory surgical centers, he said.


40% of Physicians Refuse New Patients Who Use Opioids for Chronic Pain
Researchers found that more than 40% of physicians refuse “to take on new patients who need opioids to control pain.” The study surveyed 194 primary care clinics in Michigan. The findings were published in JAMA.


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Our State Fair is a Great State Fair…Don’t Miss it from August 21 to September 5!
Once again the Onondaga County Medical Society will staff the Medical Society of the State of New York/New York State Society of Anesthesiologists booth at the state fair. Medical Society physician members are encouraged to volunteer to work the booth during a time slot. This is a great opportunity to perform public health outreach, and to promote your practice or organization at the NYS Fair, free of charge. Those who work at the booth will receive free admission tickets and free parking (on a limited basis). Feel free to bring handouts about your practice or other timely medical information to share with fair goers. Please let us know if you have any ideas for exhibits, testing, etc., that you feel will be informative and help advance a positive image of the medical profession.

Contact us for available time slots remaining for the 13-day fair, which runs from Wednesday, August 21 – Monday, September 2, 2019 (Labor Day). You can work as little as two hours or the entire day if you’d like. We need only one physician-member group per time slot. This is being updated daily. Time availability is on a first-come, first-served basis.  Contact Patty Corasaniti at (315) 424-8118, or send email to corasaniti@oncms.org for more information.


American Medical Women’s Association Hosts Congress July 25 in Brooklyn
The American Medical Women’s Association will be hosting the Centennial Congress of the Medical Women’s International Association MEDICAL WOMEN: AMBASSADORS OF CHANGE IN A CHALLENGING GLOBAL WORLD from July 25-28, 2019 at the Brooklyn Bridge Marriott Hotel (333 Adams Street, Brooklyn). Keynote speaker Gloria Steinem, author/co-founder of MS. Magazine and New York Magazine will address the audience of more than 1000 female physicians on Friday, July 26, 2019 at 11AM.

The hashtag for the 3-day conference is #MWIA100.  The Centennial Congress will feature discussions on Digital Health, Innovation & Genomics, Gender Specific Medicine, Gender Equity, Global Health, Work-Life Balance, Violence Against Women, Obesity: A Global Health Crisis, Sex & Gender Specific Medicine, and Sexual Harassment, among other professional tracks and topics.To register for the Conference, please follow this link. For more information, please contact: Charlotte Tomic, 917-882-5243; charlotte@tomiccommunications.com.


Frances Foy, Wife of Ret’d MSSNY EVP, Don Foy, Mother of Former Westchester EVP Brian Foy, Died on July 7; Services in St. Augustine FL on Friday, August 2
Frances M. Foy, age 82, of St. Augustine, FL, passed away on July 7, 2019 at her home with family at her side. She was the mother of four children; grandmother of nine; and great grandmother of two. Frances met her husband, Donald, in California where she was a former TWA flight attendant. They were married for nearly 59 years.  A memorial mass will be held at 9:00 am on Friday, August 2, 2019 at St. Anastasia Catholic Church in St. Augustine, FL.


 

 

Classified

RENTAL/LEASING SPACE

Photo of Park Ave building facade
Prestigious Park Ave Office Near Lenox Hill Hospital for Sale
2,400 sq/ft on two levels with a separate 6×12 ft. storage closet. Fireplace in waiting room and consult room. Perfect for plastic surgeons, cosmetic dermatologists or other. $2,950,000 Call for details and appoint to view. 212-570-6060



 

Ground Floor Office with Private Street Entrance in Luxury Park Avenue Building
Rental includes: two consultation rooms, private office, private bathroom.  Common waiting room, back office filing space and reception desks included.  Affordable rent.  Location East 60s between Park and Lexington.  Easy distance to Lenox Hill Hospital and New York Cornell.  Subway access within 1 block. Immediate occupancy available.  Call James: 917-710-7643


For Lease – Buffalo Area Urgent Care / Primary Care Clinic
Next door to only grocery store in town: Sav-a-Lot 4+ exam rooms, X-Ray room, Lab, Offices, etc. 3300 Sq Ft. – Fully built-out facility  ADA compliant Dunkirk New York
View full listing https://reporting.loopnet.com/report/3008dc65-60b8-4476-ab01-df4ffa2bc628.Contact geoff_jenkins@hotmail.com / (917) 825-4542


Upper East Side Medical Office Space for Rent Part–Time
Beautiful, newly renovated medical office on the Upper East Side between Lexington and Park Ave. Full service building with 2 entrances, conveniently located near all public transportation. Office includes 2 consult rooms, 3 exam rooms, treatment area, 2 bathrooms, kitchenette and reception area with waiting room. The office is available on a part-time basis. Please call 212-288-2278 or e-mail eastsidemedical@usa.net for further information.
Upper East Side Office lobby and receptions area


Park Avenue Office Share-3 Days Per Week
Tasteful, bright, well-maintained medical office in prestigious building on Park Avenue at 94th Street.  Large waiting room and reception area, consultation room and 2 exam rooms available 3 days per week. Room for an
assistant or clerical help 5 days per week. Please emailabgmdpc@gmail.com or call 987-5000


Medical Office Space for Rent!
Beautiful Newly Renovated Medical Office on the Upper East Side between Madison and Park Avenue! Conveniently located near all public transportation and Mount Sinai Hospital. Consult and Exam room available for rent part time or full time (see pictures). Please call 212-860-0300 or email
carnegiehill0062@gmail.com <for further information.
Pictures of office space for rent on Madison Ave




Fully Renovated Office Space for Part-Time Lease in Hauppauge
Available Tuesdays/Fridays, $450 half session, $750 full session. Elegant office space, beautiful waiting room with new stone and granite reception desk, custom molding, large windows, abundant natural light, TV, and refreshment counter.  Four new exam rooms and dictation room.  New stainless and granite kitchenette.  State-of-the-art network infrastructure meets HIPPA & PCI DSS compliance standards.  Digital X-ray room with PACS in each exam room available as an option.  Located in close proximity to LIE, Northern State Pkwy, and Vets Memorial Hwy. Contact us at (631) 486-8855;  Please see our listing
: https://www.loopnet.com/Listing/517-Route-111-Hauppauge-NY/15298633/



Office Rental 30 Central Park South
Two fully equipped exam, two certified operating, bathrooms and consultation room.  Shared secretarial and waiting rooms. Elegantly decorated, central a/c, hardwood floors. Next to Park Lane and Plaza hotels. $1250 for four days a month. Available full or part-time. 212.371.0468drdese@gmail.com.


Rare Find — Great Office Share
Wonderful office share in terrific location at great price. Available Monday, Wednesday, Friday and weekends. Choice of smaller windowed consultation room with adjoining exam room or big windowed consultation room with one or two exam rooms. Beautiful bright rooms, lovely reception area and front . First-rate building on 58th Street between Park and Lexington. Rent by day (about $180). Front desk and office management available if needed, along with many other amenities, including internet, ultrasound, EMG Kitchen, optional C Arm. Willing to make changes for new tenant. Call 646-642-0700.


  

 


Are You Trying to Lease Your Medical Office or Sell Your Medical Practice? Trying to Sell New or Used Medical Equipment?
Clineeds, the new online platform designed for medical providers. With Clineeds you can lease your medical officeshared your office spacebuy and sell used medical equipment, or post healthcare job opportunities. LISTING IS FREE! Why wait? Click here to sign-up: 
www.clineeds.com/sign-up

PHYSICIAN OPPORTUNITIES

Great Career Opportunities for Clinical Physicians
The NYS Department of Corrections and Community Supervision has great career opportunities for Clinical Physicians. You must have possession of a license and current registration to practice medicine in New York State, and have two years of post-licensure medical experience.

Starting salary is $143,381 – $171,631 *(Additional $10,000 or $20,000). Benefits include comprehensive health insurance, NYS retirement system, deferred compensation plan, flexible spending plan, and paid time off.

We have openings in the following counties offering a choice of urban, suburban or rural living:

Clinton*                  Clinton Correctional Facility (sporting and recreational outlets)
Dutchess                 Fishkill and Green Haven Correctional Facilities (Hudson River Valley Beauty)
Franklin*                 Franklin and Upstate Correctional Facility (North Country, 1 hour to Montreal)
Greene*                  Greene Correctional Facility (rural charm yet only 2 hours to New York City)
Oneida                    Mohawk Correctional Facility (Cooperstown, breweries)
Sullivan                   Woodbourne Correctional Facility (mountains, outlets, casinos and entertainment)
Seneca*                  Five Points Correctional Facility (heart of wine country)
St. Lawrence           Riverview Correctional Facility (hiking, boating and museums)
Washington             Great Meadow Correctional Facility (Between Vermont & the Green Mountains)
Westchester            Bedford Hills Correctional Facility (Less than 1 Hour to NYC)

Contact: www.doccs.ny.gov or DOCCS Personnel Office at (518) 457-8132 for more information and to apply.

 


Nurse, RN Utilization Review Full-Time-Westbury, NY (In-office position only)
Excellent opportunity for a RN who is seeking a position performing utilization review.  We require 1-2 years recent experience in hospital and/or insurer utilization review and experience using Interqual criteria and/or MCG Guidelines. Data entry/PC skills a plus. Benefits include 401(k), paid vacation and holidays. Send resume and salary requirements to: Empire State Medical Scientific and Educational Foundation, Inc. Human Resource Department e-mail: chunt@mssny.org  Fax: (1-516) 833-4760 Equal Oppty Employer M/F


CALL FOR RATES & INFO. CHRISTINA SOUTHARD: 516-488-6100 ext. 355

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 


MSSNY eNews: July 12, 2019 – Oppose Disastrous Surprise Med Bill Now

Arthur Fougner MSSNY Presiident

PRESIDENT’S MESSAGE
Arthur Fougner, MD
MSSNY President

MSSNY eNews
July 12, 2019

Vol. 22  Number 26


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Colleagues:

Congress, Don’t Harm Patients With The Wrong Surprise Medical Bills Solution
by Dustin Corcoran and Phil Schuh

Dustin Corcoran is chief executive officer of the California Medical Association, and Phil Schuh, CPA, is executive vice president and chief financial officer of the Medical Society of the State of New York.

Former Supreme Court Justice Louis Brandeis said in the early 1930s that states are laboratories of democracy that can experiment with various policies without harming the rest of the country. Now that more than 10 states have enacted laws to end surprise medical bills, Congress is discussing various policies that work toward the same goal.

Everyone agrees patients need to be held harmless from surprise medical bills to prevent financial hardship. What hasn’t been resolved is how the anticipated federal law will direct insurers and physicians to resolve billing disputes and enter into fair contracts. As Congress continues to consider this question, the experiences of California and New York offer important lessons that can ensure patients don’t inadvertently lose access to essential medical services in an emergency as they gain important new financial protections from surprise bills.

California’s law instituted a government-mandated benchmark to resolve disputes, championed by the health insurance industry. Instead of promoting fairness, the benchmark has become an artificial ceiling.

It fails to consider the actual cost of medical services and has emboldened insurers to avoid entering into contracts with doctors, meaning even more physicians will remain outside of insurers’ networks. Experience has shown this creates a huge hardship for patients and is precisely what surprise medical bills legislation is supposed to solve.

With more doctors forced out of network, patients will encounter more difficulty finding an in-network doctor. When they seek care out of network, it will substantially increase their deductibles and out-of-pocket costs.

Importantly, fewer hospital-based physicians, such as surgeons, obstetricians and anesthesiologists, will be able to serve patients in emergencies, a direct result of empowering insurance companies to decide how disputes should be settled. It’s not an exaggeration to assume that California’s approach will eventually destroy access to emergency and “on-call” safety net physicians.

The difference between life and death in some emergencies is a matter of minutes. Patients need to know that the right physician specialist will be there to treat them.

Contrast this cautionary tale with the overwhelmingly positive results attributed to New York’s surprise medical bills law. It should be the basis for federal legislation because consumers are no longer financially responsible for payment; complaints have plummeted; premiums have grown more slowly in New York than the rest of the country; physicians’ out-of-network charges are down 13 percent; and out-of-network billing is down 34 percent, according to a recent Georgetown University analysis. In other words, New York has prevented the serious problems that arise in a marketplace, like California’s, that’s unduly dominated by insurers.

Most importantly, the New York law ensures patients can continue to see the doctors they need in an emergency because arbitration is deterring disputes from ever reaching that point. When they do, outcomes are grounded in fair, transparent and independent data, in stark contrast to California’s arbitrary, insurer-championed approach that’s adding to the ranks of out-of-network doctors and diminishing access to essential emergency physicians.

As Congress continues to debate federal legislation to end surprise medical bills, the approach it ultimately adopts to resolve insurer-physician disputes could be the difference between a health care system where insurance coverage includes an adequate number of in-network physicians to protect patients and a system that empowers even bigger, more powerful insurance companies to encourage health care consolidation that decreases access to doctors and raises prices.

As leaders of two of the nation’s largest medical societies, we know from experience that federal surprise medical bills legislation needs to look like New York’s law, which is why Congress should support the House of Representatives’ bipartisan Protecting Patients from Surprise Medical Bills Act introduced by Reps. Raul Ruiz, MD (D-Calif.), and Phil Roe, M.D. (R-Tenn.). The Senate Health, Education, Labor and Pensions Committee’s legislation, which uses the so-called “median in-network” rate, another government-mandated benchmark, is far too much like California’s law, which experience shows has been devastating for patients and physicians.

Arthur Fougner, MD
MSSNY President 

Comments? comments@mssny.org; @mssnytweet; @sonodoc99


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Physicians Urged to Contact Schumer, Gillibrand and Members of Congress to Oppose Disastrous Surprise Medical Bill Legislation
Please do not let the US Congress make it even harder for physicians to be able to negotiate fairly with market dominant health insurers, and force even more physicians into employment arrangements.   Physicians are urged to continue to contact Senators Schumer and Gillibrand, as well as their respective US Representative, to oppose disastrous legislation that would mandate out of network payment at insurer determined in-network levels, and in support of legislation to align with New York’s approach to surprise medical bills.  A letter can be sent from here.

While these bills would protect New York’s law for state regulated health insurance products, it would establish this insurer determined default rate for plans governed by ERISA.

This week, the US Energy& Commerce Health Subcommittee reported to the full Committee legislation (HR 3630) that would tie out-of-network payments for surprise medical bills to an insurer determined in-network payment level.  Legislation (S.1895) with a similar “default rate” remedy for these surprise bills was also recently advanced from the US Senate Health, Education, Labor and Pensions (HELP) Committee.  Both bills ignore New York’s successful approach that resolves these disputes through a simplified independent dispute resolution system based upon “baseball arbitration” that includes consideration of regional charges for health care services.

MSSNY President Dr. Art Fougner issued a statement noting that “New York’s physicians are extremely concerned about the impact to patient care of a bill before the US House Energy& Commerce Health Subcommittee…that would further enable abusive health insurer practices by establishing an insurer determined “default rate” for surprise medical bills (HR 3630). New York’s physicians very much agree with the goal of the legislation to protect patients from facing these bills, but disagree strongly with the solution being offered by Rep. Frank Pallone and Rep. Greg Walden, Chair and Ranking Member of the E&C Committee…”

Instead, MSSNY has supported legislation (HR 3502) that had been introduced by Representative Raul Ruiz, MD (D-CA) and Representative Phil Roe, MD (R-TN) based on New York’s model that has the support of a number of New Yorkers, including Representatives Clarke (D-Brooklyn), Higgins (D-Buffalo), Lowey (D-Westchester), Maloney (D-Westchester), Morelle (D-Rochester), Rice (D-Long Island), Stefanik (R-North Country), Suozzi (D-Long Island) and Velasquez (D-NYC).  While this legislation has some drafting errors that need to be fixed, it most closely follows New York’s approach.

MSSNY has been working closely with other state medical associations, national specialty associations, the Physicians Advocacy Institute and the AMA to oppose the health insurance industry gift that is S.1895 and HR 3630, and to instead support legislation that aligns with New York’s approach.  MSSNY’s letter to Senators Alexander and Murray expressing strong concerns with S.1895 can be found here.


Physician Action Needed on Bills Awaiting Governor’s Signature
While the legislative session may be over, there is still ample opportunity to influence the policy-making process. Many bills that passed both houses of the legislature have yet to be sent to the Governor for his signature or veto. Please take just a few minutes to send letters to the Governor from MSSNY’s Grassroots Action Center in support or opposition of the following issues:

  • Mid-year formulary changes (MSSNY supports)– would prohibit a health insurer from removing a prescription drug from a formulary during the patient’s policy year. Moreover, if the plan’s drug formulary has two or more tiers of drug benefits with different deductibles, copayments or coinsurance, the plan may not move a drug to a tier with higher patient cost sharing during the policy year. It also prohibits the plan from adding new or additional formulary restrictions during the policy year. Please reach out to the governor and let him know how helpful this bill would be by clicking here. 
  • Partial prescription fills (MSSNY supports) – would allow prescribers, in consultation with their patients, to prescribe up to a 30-day supply of a controlled substance with a notation to the pharmacist that they should only dispense the amount agreed to by patient and prescriber. Each partial fill would be dispensed and recorded in the same manner as a normal refill and the aggregate quantity dispensed across partial fillings may not exceed the overall total quantity prescribed. This measure would help to address patients’ pain control needs while also reducing the amount of leftover medication in households. Please encourage the governor to sign this legislation by clicking here. 
  • Malpractice expansion (MSSNY opposes) – two bills passed the legislature that will further tip the scales in liability actions against physicians and others, adding costs and potentially increasing liability premiums while doing nothing to help reform our current broken system.

The first would require a non-settling co-defendant in a tort action, where another co-defendant has settled, to make a “blind gamble” prior to trial (instead of after) whether to reduce the overall jury determined amount by the settlement amount or the settling defendant’s equitable share, instead of after a jury verdict has been reached.

The other would allow plaintiffs to collect a judgment from a third party that is not a direct party to the lawsuit in question. The bill would permit this to occur even though the plaintiff had not sued or perhaps could not have sued the third-party defendant in the first instance.

Please let the Governor know that these bills would unnecessary costs to an already broken system by clicking here.


Hospital Association Urges Support for Bill to Repeal Medicaid DSH Cuts
Ahead of an important congressional hearing, the Greater New York Hospital Association is urging its members to express support for a bill that repeals impending Medicaid disproportionate share hospital cuts. The House Energy and Commerce Health Subcommittee will consider the bill. If approved, House leaders have said they would like the full chamber to vote on the bill before the end of the month.

MSSNY weighed in on surprise billing ahead of Thursday’s hearing.

“New York’s physicians very much agree with the goal of the legislation to protect patients from facing these bills but disagree strongly with the solution being offered by Rep. Frank Pallone and Rep. Greg Walden, chair and ranking member of the [Energy and Commerce Health Subcommittee],” said Dr. Art Fougner, president of the medical society, in a statement.

“Their proposal would greatly limit the ability of physicians to negotiate patient-care terms fairly with already market-dominant insurance companies. It would also make it much harder for hospitals to ensure needed on-call specialty care in their emergency departments. Moreover, it could have a particularly significant adverse impact on rural and smaller hospitals.

Kenneth Raske, president of the association, wrote in a letter to members Wednesday stating, “Eliminating Medicaid DSH cuts is GNYHA’s top federal priority, and we worked closely with Rep. Engel on getting this amendment included,” Raske wrote.

Safety-net hospitals that serve high numbers of low-income and uninsured patients operate on tight margins, Engel recently said of his efforts to repeal Medicaid DSH cuts. “If Medicaid DSH cuts were implemented, it would have a devastating impact on these critical facilities, potentially leading many to close their doors.” (Crains July 11)


RFK Jr. and NY Families Sue State for Ending Religious Exemptions to Vaccines
Attorneys Michael Sussman and Robert F. Kennedy Jr. filed a lawsuit Wednesday in the New York State Supreme Court that questions the constitutionality of the vaccination exemption changes, which took effect on June 13. The challenge, filed on behalf of 55 New York families who had lawful religious exemptions, requests that the court “enjoin the enactment of the repeal temporarily, preliminarily and permanently.” Kennedy, chief legal counsel for Children’s Health Defense, argued that it’s “unconstitutional for the state to deprive people of such important rights when religious animus has played a key role.”

Sussman, an attorney with Goshen-based Sussman & Associates, further argued that “to deprive families of the rights to freedom of religious expression, parental rights and the right to either a public or private education, the state must demonstrate a ‘compelling state interest’ that the state has failed to prove here.” Under New York Department of Health guidance issued in response to the new law, children attending daycare or public, private or parochial school who had a religious exemption were required to receive the first age appropriate dose in each immunization series by June 28. Parents and guardians must show that they have scheduled appointments for all required follow-up doses by July 14 for their children to remain in school or daycare. (Politico, July 10)



Female Physicians Paid Less Than Males
Female primary care providers are paid an average of 25% less than their male counterparts in the United States, according to Medscape‘s Female Physician Compensation Report released last week. The report noted that, overall, male physicians were more likely than female physicians to say they felt fairly compensated.


FCC Approves New Telehealth Pilot Program, Issues Proposed Rulemaking
The Federal Communications Commission voted unanimously to approve a notice of proposed rulemaking to establish a new $100 million “Connected Care Pilot Program” to support telehealth for low-income Americans, including veterans and those living in rural areas. “The future of health care is connected care, and this is the future that I want the FCC to support,” said FCC Chairman Ajit Pai.

The AHA has said the program is a critical next step toward delivering affordable telehealth services to those Americans who need it the most, and in September shared comments and recommendations with the FCC on its notice of inquiry about the program. Among other areas, FCC’s proposed rule seeks comments on who should participate in the pilot, including eligible health care providers and broadband service providers; the goals of the pilot; and the project application submission and evaluation. FCC will accept comments for 30 days after the rule is published in the Federal Register.


Federal Judge Blocks Rule Mandating Drug Prices in TV Ads
A federal judge on Monday blocked a rule that would have required pharmaceutical companies to disclose the prices of their drugs in television ads, according to media reports.

The rule, set to go into effect on Jul. 9, would have mandated cost disclosure for any drug covered by Medicare or Medicaid that has a list price above $35 for a month’s supply or the usual course of treatment. In June, three drug companies filed a lawsuit against the regulation, and on Monday, Judge Amit P. Mehta ruled that the Department of Health and Human Services had “exceeded its regulatory authority” in requiring such disclosure, the New York Times reports.

For now, TV ads will stay as they are. An HHS spokesperson said that “the administration … was consulting with the Justice Department on what to do next,” according to the Times.  Physician’s First Watch coverage of lawsuit


Doctors Without Borders Information Session in Queens
Every day, Doctors Without Borders/ Médecins Sans Frontières aid workers from around the world to provide assistance to people whose survival is threatened by violence, neglect, or catastrophe—treating those most in need regardless of political, religious, or economic interest. Whether an emergency involves armed conflicts or epidemics, malnutrition or natural disasters, Doctors Without Borders is committed to bringing quality medical care to people caught in crisis.

On Wednesday, July 31st, medical and non-medical professionals are invited to an evening presentation in Queens to learn more about joining Doctors Without Borders’ pool of dedicated aid workers. This is your opportunity to meet the recruitment team and learn about how you can join the pool of dedicated aid workers. The organization is currently recruiting for a variety of medical and non-medical positions.

Where:
Sunnyside Community Services
Seminar Room
43-31 39th St.
Sunnyside, Queens 11104

When:
July 31st, 2019, 7-8:30 pm

Register here.


Primary Care First Seriously Ill Population Webinar: Scheduling Update
In an effort to share model details and to include Center for Medicare and Medicaid Innovation leadership, the upcoming webinar on the Primary Care First Seriously Ill Population (SIP) payment option will now be held at the following date and time:

Wednesday, July 24th at 12:00 PM EDT

We apologize for any inconvenience and appreciate your continued interest in Primary Care First. Webinar slides will be available for download on the Primary Care First webpage shortly after the event.

Please forward the registration link below to colleagues who may be interested in learning more about the Seriously Ill Population payment model option of Primary Care First.

Register to attend here.

If you registered for the event on July 10th, then you do not need to re-register for the event as the link you received is still valid.

For additional information about Primary Care First, please visit the model webpage here.

Questions or Feedback?

If you have questions or feedback, please email PrimaryCareApply@telligen.com.


Thanks from Anti-Recreational Marijuana Group
The following letter of gratitude from Kevin Sabot, PhD, President of Smart Approaches to Marijuana (SAM), was sent to MSSNY’s Moe Auster thanking him for MSSNY’s support regarding our opposition to the legalization of recreational marijuana and convincing the legislature from legalizing recreational marijuana during this year’s legislative session.


 

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Classified

RENTAL/LEASING SPACE

Photo of Park Ave building facade
Prestigious Park Ave Office Near Lenox Hill Hospital for Sale
2,400 sq/ft on two levels with a separate 6×12 ft. storage closet. Fireplace in waiting room and consult room. Perfect for plastic surgeons, cosmetic dermatologists or other. $2,950,000 Call for details and appoint to view. 212-570-6060

 


 

Ground Floor Office with Private Street Entrance in Luxury Park Avenue Building
Rental includes: two consultation rooms, private office, private bathroom.  Common waiting room, back office filing space and reception desks included.  Affordable rent.  Location East 60s between Park and Lexington.  Easy distance to Lenox Hill Hospital and New York Cornell.  Subway access within 1 block.  Immediate occupancy available.  Call James: 917-710-7643


For Lease – Buffalo Area Urgent Care / Primary Care Clinic
Next door to only grocery store in town: Sav-a-Lot 4+ exam rooms, X-Ray room, Lab, Offices, etc. 3300 Sq Ft. – Fully built-out facility  ADA compliant Dunkirk New York
View full listing https://reporting.loopnet.com/report/3008dc65-60b8-4476-ab01-df4ffa2bc628.Contact geoff_jenkins@hotmail.com / (917) 825-4542


Upper East Side Medical Office Space for Rent Part–Time
Beautiful, newly renovated medical office on the Upper East Side between Lexington and Park Ave. Full service building with 2 entrances, conveniently located near all public transportation. Office includes 2 consult rooms, 3 exam rooms, treatment area, 2 bathrooms, kitchenette and reception area with waiting room. The office is available on a part-time basis. Please call 212-288-2278 or e-mail eastsidemedical@usa.net for further information.
Upper East Side Office lobby and receptions area


Park Avenue Office Share-3 Days Per Week
Tasteful, bright, well-maintained medical office in prestigious building on Park Avenue at 94th Street.  Large waiting room and reception area, consultation room and 2 exam rooms available 3 days per week. Room for an
assistant or clerical help 5 days per week. Please emailabgmdpc@gmail.com or call 987-5000


Medical Office Space for Rent!
Beautiful Newly Renovated Medical Office on the Upper East Side between Madison and Park Avenue! Conveniently located near all public transportation and Mount Sinai Hospital. Consult and Exam room available for rent part time or full time (see pictures). Please call 212-860-0300 or email
carnegiehill0062@gmail.com <for further information.
Pictures of office space for rent on Madison Ave




Fully Renovated Office Space for Part-Time Lease in Hauppauge
Available Tuesdays/Fridays, $450 half session, $750 full session. Elegant office space, beautiful waiting room with new stone and granite reception desk, custom molding, large windows, abundant natural light, TV, and refreshment counter.  Four new exam rooms and dictation room.  New stainless and granite kitchenette.  State-of-the-art network infrastructure meets HIPPA & PCI DSS compliance standards.  Digital X-ray room with PACS in each exam room available as an option.  Located in close proximity to LIE, Northern State Pkwy, and Vets Memorial Hwy. Contact us at (631) 486-8855;  Please see our listing
: https://www.loopnet.com/Listing/517-Route-111-Hauppauge-NY/15298633/



Office Rental 30 Central Park South
Two fully equipped exam, two certified operating, bathrooms and consultation room.  Shared secretarial and waiting rooms. Elegantly decorated, central a/c, hardwood floors. Next to Park Lane and Plaza hotels. $1250 for four days a month. Available full or part-time. 212.371.0468drdese@gmail.com.


Rare Find — Great Office Share
Wonderful office share in terrific location at great price. Available Monday, Wednesday, Friday and weekends. Choice of smaller windowed consultation room with adjoining exam room or big windowed consultation room with one or two exam rooms. Beautiful bright rooms, lovely reception area and front . First-rate building on 58th Street between Park and Lexington. Rent by day (about $180). Front desk and office management available if needed, along with many other amenities, including internet, ultrasound, EMG Kitchen, optional C Arm. Willing to make changes for new tenant. Call 646-642-0700.


  

 


Are You Trying to Lease Your Medical Office or Sell Your Medical Practice? Trying to Sell New or Used Medical Equipment?
Clineeds, the new online platform designed for medical providers. With Clineeds you can lease your medical officeshared your office spacebuy and sell used medical equipment, or post healthcare job opportunities. LISTING IS FREE! Why wait? Click here to sign-up: 
www.clineeds.com/sign-up

PHYSICIAN OPPORTUNITIES

Great Career Opportunities for Clinical Physicians
The NYS Department of Corrections and Community Supervision has great career opportunities for Clinical Physicians. You must have possession of a license and current registration to practice medicine in New York State, and have two years of post-licensure medical experience.

Starting salary is $143,381 – $171,631 *(Additional $10,000 or $20,000). Benefits include comprehensive health insurance, NYS retirement system, deferred compensation plan, flexible spending plan, and paid time off.

We have openings in the following counties offering a choice of urban, suburban or rural living:

Clinton*                  Clinton Correctional Facility (sporting and recreational outlets)
Dutchess                 Fishkill and Green Haven Correctional Facilities (Hudson River Valley Beauty)
Franklin*                 Franklin and Upstate Correctional Facility (North Country, 1 hour to Montreal)
Greene*                  Greene Correctional Facility (rural charm yet only 2 hours to New York City)
Oneida                    Mohawk Correctional Facility (Cooperstown, breweries)
Sullivan                   Woodbourne Correctional Facility (mountains, outlets, casinos and entertainment)
Seneca*                  Five Points Correctional Facility (heart of wine country)
St. Lawrence           Riverview Correctional Facility (hiking, boating and museums)
Washington             Great Meadow Correctional Facility (Between Vermont & the Green Mountains)
Westchester            Bedford Hills Correctional Facility (Less than 1 Hour to NYC)

Contact: www.doccs.ny.gov or DOCCS Personnel Office at (518) 457-8132 for more information and to apply.


Nurse, RN Utilization Review Full-Time-Westbury, NY (In-office position only)
Excellent opportunity for a RN who is seeking a position performing utilization review.  We require 1-2 years recent experience in hospital and/or insurer utilization review and experience using Interqual criteria and/or MCG Guidelines. Data entry/PC skills a plus. Benefits include 401(k), paid vacation and holidays. Send resume and salary requirements to: Empire State Medical Scientific and Educational Foundation, Inc. Human Resource Department e-mail: chunt@mssny.org  Fax: (1-516) 833-4760 Equal Oppty Employer M/F


CALL FOR RATES & INFO. CHRISTINA SOUTHARD: 516-488-6100 ext. 355

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 


Statement of MSSNY President Dr. Art Fougner Urging US House Committee to Fix Unfair Surprise Bill Proposal


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

 

For Immediate Release
July 10, 2019 

Statement of MSSNY President Dr. Art Fougner Urging US House Committee to Fix Unfair Surprise Bill Proposal

“New York’s physicians are extremely concerned about the impact to patient care of a bill before the US House Energy& Commerce Committee Health Subcommittee, tomorrow July 11, that would further enable abusive health insurer practices by establishing an insurer determined “default rate” for surprise medical bills (HR 3630).  New York’s physicians very much agree with the goal of the legislation to protect patients from facing these bills, but disagree strongly with the solution being offered by Rep. Frank Pallone and Rep. Greg Walden, Chair and Ranking Member of the E&C Committee.  Their proposal would greatly limit the ability of physicians to negotiate patient care terms fairly with already market dominant insurance companies.  It would also make it much harder for hospitals to ensure needed on-call specialty care in their emergency departments. Moreover, it could have a particularly significant adverse impact on rural and smaller hospitals.  We strongly urge Representative Eliot Engel (a member of the Health Subcommittee) to urge that this harmful legislation be replaced with HR 3502 (Ruiz/Roe/Morelle) that would protect patients from surprise medical bills based on the nationally acclaimed model adopted in New York which has proven to be an effective and balanced approach”

# # #

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

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

 

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MSSNY eNews: June 28, 2019 – Surprise Bills Go National

Arthur Fougner MSSNY Presiident

PRESIDENT’S MESSAGE
Arthur Fougner, MD
MSSNY President

MSSNY eNews
June 28, 2019

Vol. 22  Number 25


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Colleagues:

We’ve all seen Geico’s humorous “Surprising” ad campaign. Unanticipated or “Surprise Bills” are not so funny. This situation most often occurs when a patient seeks services from a participating physician or hospital but then requires services not covered by the patient’s insurance plan. Consequently, the patient receives a surprise bill, often a significant amount. Everyone agrees this issue is problematic. The real issue becomes how to deal with it. Caution: this may get wonky.

New York State took the lead on this issue with the nation’s first surprise bill law, Article 6 of Financial Services Law: Emergency Medical Services and Surprise Bills. Most importantly, this law removed the patient from this troubling billing situation, leaving the dispute now between payer and provider. The out of network provider bills the plan for the services. If the claim cannot be resolved, the plan pays “an amount the health care plan determines is reasonable for the health care services rendered, except for the insured’s copayment, coinsurance or deductible” and the dispute may now go for independent resolution much like baseball arbitration – the arbitrator decides which number – the physician’s charge or the plan’s proposed payment is more appropriate.  One of the factors utilized by independent resolution is the usual and customary charge for that service.

History

Let’s back up for some history. In 2009, a settlement was reached between then NY State Attorney General Andrew Cuomo and UnitedHealth Group over using Ingenix, a wholly-owned subsidiary of United, as the resource for “usual, customary, and reasonable” pay rates. This settlement established FAIR Health. For NY, FAIR Health is now the resource for UCR.

NY’s law works. No, make that NY’s law works well. Arbitration decisions have gone 50 – 50. Surprise Bill complaints have dwindled down to a trickle. So NY’s law should be the model for the nation, right? Well … not so fast. Congress is now dealing with this issue as well other vexing pricing problems. Because of this, the insurers are now getting another bite at this apple. Proposed legislation would similarly remove the patient from any dispute but would establish the In Network payment as the standard. This is troubling for several reasons not the least of which is that that rate most commonly is felt to be a “low ball” payment. For this reason, many specialty care physicians had chosen not to participate with the plan in the first place.  Perhaps even more often, health insurers chose to not contract with these physicians because they were trying to limit their networks.  Heck, if this were going to be the case, why do the plans fight so bitterly against “any willing provider” clauses and insist on narrowing networks?

Why would Congress choose to reward the health insurance industry for this abusive behavior?

Proposed Solution

Another proposed solution is an All Payer Database. (I warned you this would get wonky.) Turns out the APD often excludes information about many employer-provided ERISA plans which tend to be the highest payers and are therefore more heavily weighted toward lower payers such as Medicaid. Perhaps we should call them Some Payer Databases. NY uses FAIR Health. The nation should do the same.

This issue is important because it involves all physicians – employed and independent, in-network and out-of-network. Employed physicians depend on the success of independent doctors the same as in network doctors depend on the success of their out of network colleagues.  What is being debated ultimately becomes a ceiling and the insurers know this. They are mobilizing all resources for this issue. We need to do the same. The wrong national law may undo much of what NY has successfully accomplished. You have received and will continue to receive MSSNY alerts on this issue. Please answer the call. We need all hands on deck. Please send a letter to your Representative, and Senators Schumer and Gillibrand here.

 

Arthur Fougner, MD
MSSNY President 

Comments? comments@mssny.org; @mssnytweet; @sonodoc99


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eNews

Physicians Urged to Contact Schumer, Gillibrand and Members of Congress to Oppose Disastrous Surprise Medical Bill Legislation

All physicians are urged to contact Senators Schumer and Gillibrand, as well as their respective US Representative, to oppose disastrous legislation that would mandate out of network payment at insurer determined in-network levels, and in support of legislation to align with New York’s approach to surprise medical bills.  A letter can be sent from here.

This week the Senate Health, Education, Labor and Pensions (HELP) Committee advanced by a 20-3 vote S. 1895, the Lower Health Care Costs Act.  The surprise billing provisions of the bill are problematic because they would tie out-of-network payments to average in-network rates in situations where a patient did not have the opportunity to choose an in-network provision.  It also omits the independent payment arbitration process that has been supported by the AMA and state medical associations, and has been a successful model for New York.  Senator Dr. William Cassidy (R-LA) made strong comments against the surprise billing section in S.1895, noting that is it skewed heavily in favor of insurance companies.  He warned that letting insurance companies set rates will have dire consequence for rural and critical access hospitals that are already closing due to inadequate payments and it will exacerbate health care market consolidation problems.  Senators Hassan, Romney and Murkowski were also outspoken, expressing concerns with the contracted in-network rate benchmark and speaking in favor of including of an independent dispute resolution mechanism.

Separately, Congressman Ruiz, MD (D-CA) and a significant number of cosponsors from both sides of the aisle, including Representatives Morelle (D-Rochester), Stefanik (R-North Country) and Clarke (D-Brooklyn) from New York, introduced surprise billing legislation in the House that is based on New York model’s.

MSSNY has been working closely with other state medical associations, national specialty association, the Physicians Advocacy Institute and the AMA to oppose the health insurance industry gift that is S.1895, and to instead support legislation that aligns with New York’s approach.  MSSNY’s letter to Senators Alexander and Murray expressing strong concerns with S.1895 can be found here.


Physician Action Needed – Urge Governor Cuomo to Veto Liability Expansion Bills
Physicians are urged to contact the Governor to urge that he veto 2 bills passed at the end of the Legislative Session over the objections of many groups that could have the effect of driving up liability costs and creating an even more toxic malpractice adjudication system. Please take a minute to go to http://tiny.cc/VetoLiabilityBills and send a letter to Governor Cuomo urging him to veto these two bills and instead act to help bring down these costs through comprehensive reform.

S.6081/A.2372 will add costs to the system by requiring non-settling co-defendants in a tort action to choose whether to reduce their liability exposure by the stated settlement amount of a co-defendant or the settling co-defendant’s allocated percentage of fault prior to the first opening statement of the trial.  It would force these defendants into making a “blind gamble” and would enable in many cases the total payout to a plaintiff to actual exceed a jury’s award. There is little justification to this proposal other than increasing lawyer fees.

S.6552/A.2373 will also add new costs to the system, again with little justification. The bill would allow plaintiffs to collect a judgment from a third party that is not a direct party to the lawsuit in question. The bill would permit this to occur even though the plaintiff had not sued or perhaps could not have sued the third-party defendant in the first instance.

These bills have also been opposed by hospital associations and the insurance industry.

These bills would exacerbate an already onerous system. New York was recently granted the dubious distinction of having by far and away the highest cumulative medical liability payouts in the country. Of course, this is not the first time that our state has been “honored” with this distinction. In New York we pay out nearly two times as much as in the state with the next highest amount. We also pay out the highest amount per capita.

Yet instead of trying to address this problem, these two bills would make this problem even worse.

It is imperative that the Governor and legislators take action to ensure that physicians and hospitals remain available to deliver the quality and timely care our patients expect and deserve to receive. A critical element to this is acting to reduce the choking costs of medical liability insurance and stopping one-sided proposals that will undoubtedly raise these costs. We urge the Governor to work towards comprehensive reform to enable a comprehensive supply of physicians across New York, rather than enabling cynical attempts to increase lawyer fees at the expense of patient care.

URGE A VETO OF ONEROUS LIABILITY EXPANSION BILLS! CLICK HERE

 



Two NY Healthcare Groups Lose EHR Access Following Ransomware Attacks
Both Olean (N.Y.) Medical Group and Seneca Nation Health System in Salamanca, N.Y., have lost access to their computer and EHR systems following recent cyberattacks on the organizations, Olean Times Herald reports.

OMG, which serves around 40,000 patients, said that no patient records or information were compromised as a result of the ransomware attack, according to the publication. The medical group has been completing patient charting by paper since the organization’s computer systems and EHR were infected with the ransomware June 11, OMG CEO Christine Strade told Becker’s Hospital Review.

The hacker demanded “a significant amount of money,” in exchange for access to the systems’ files, which OMG did pay, Ms. Strade confirmed. The group is working to restore all the encrypted files.

Seneca, which is not affiliated with OMG, also maintained security of patients’ protected health information following the attack on its health system, according to a statement from Mark Halftown, acting CEO, published to the health system’s website. He added that while access to patients’ electronic charts and the hospital’s scheduling system is currently down, Seneca is still seeing patients.

“We are working feverishly to rebuild our system and we apologize for any inconvenience,” Mr. Halftown wrote.

OMG hired Kivu, a cybersecurity forensic group, to investigate the attack, according to the report. After its review, the forensic group determined numerous attacks, which mostly came from Eastern Europe and Africa, against OMG had been stopped by the medical group’s security system prior to the breach.

It is not clear whether the ransomware attacks on both organizations originated from the same hacker. (Becker’s Hospital Review June 20)


Opioid Prescriptions Tied to Higher Overdose Risk among Family Members
People whose family members have opioid prescriptions face increased risk for opioid overdose themselves, according to a case-control study in JAMA Internal Medicine.

Using claims data from 2004 to 2015, researchers matched roughly 2300 people with opioid overdose to 9200 controls without overdose. Having a family member with a prior opioid prescription was associated with nearly triple the odds of overdose. Additionally, the overdose odds increased when more opioids were prescribed. Children aged 0 to 12 years had a fourfold increase in overdose risk when a family member had a prescription, but risk was increased across most age groups.

The authors conclude: “Interventions may focus on opioid dispensing limits, encouraging patients to properly dispose of prescription opioids after use, enhancing patient and public education, and using secure medication storage boxes to limit the risk of opioid overdose among other household family members. Treating and preventing opioid overdose events at the family level, as well as expanding access to opioid antagonists, should also be considered.”

JAMA Internal Medicine article; Background: Physician’s First Watch coverage of parental opioid use and suicide attempts among offspring

 


 

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Lawsuit Filed in North Dakota Claims State Law Forces Physicians to Lie
The AP (6/25) reports a federal lawsuit filed by the only abortion clinic in North Dakota claims state law “forces doctors to lie, including one measure passed this year requiring physicians to tell women that they may reverse a so-called medication abortion if they have second thoughts.” The suit was filed by “the Center for Reproductive Rights on behalf of the Red River Women’s Clinic and the American Medical Association” and “also targets an existing law requiring doctors to tell patients that abortion terminates ‘the life of a whole, separate, unique, living human being.’” The suit “asks a judge to block enforcement.” AMA President Patrice A. Harris, M.D., told the AP, “The AMA will step in when there is any interference with our ability to talk to our patients about legal, evidence-based medical procedures.” Dr. Harris also “said AMA lawyers are monitoring abortion laws in all states and decided North Dakota’s was the next case to be ‘actively involved in.’”

For more information on this lawsuit, see the AMA’s press release

Vaccine Panel Downgrades Pneumonia Shot Recommendation for Seniors
The AP (6/26) reports the Advisory Committee on Immunization Practices “said routine vaccination with Pfizer’s Prevnar 13 [pneumococcal vaccine] shot was no longer necessary for all healthy people 65 and older.” The panel’s recommendation will likely be adopted by the Centers for Disease Control and Prevention. Vaccine injury claims are rare, federal data show

Research Offers Clue to Lyme Arthritis Found in Patients’ Inflamed Joints
“A small but significant number of people with Lyme disease continue to suffer from symptoms long after finishing an antibiotic treatment,” and “the mystery of why may have come closer to being solved with a study…that found that bits of the Lyme bacteria can persist in patients’ inflamed joints even after taking antibiotics.” Investigators “examining synovial fluid from those inflamed joints also found antibodies to the persisting molecules, called peptidoglycans, that come from the outer covering of the Lyme bacteria, according to the study.” The findings were published in the Proceedings of the National Academy of Sciences. https://www.pnas.org/content/early/2019/06/11/1904170116

 


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Ground Floor Office with Private Street Entrance in Luxury Park Avenue Building
Rental includes: two consultation rooms, private office, private bathroom.  Common waiting room, back office filing space and reception desks included.  Affordable rent.  Location East 60s between Park and Lexington.  Easy distance to Lenox Hill Hospital and New York Cornell.  Subway access within 1 block.  Immediate occupancy available.  Call James: 917-710-7643


For Lease – Buffalo Area Urgent Care / Primary Care Clinic
Next door to only grocery store in town: Sav-a-Lot 4+ exam rooms, X-Ray room, Lab, Offices, etc. 3300 Sq Ft. – Fully built-out facility  ADA compliant Dunkirk New York

View full listing https://reporting.loopnet.com/report/3008dc65-60b8-4476-ab01-df4ffa2bc628.

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Upper East Side Medical Office Space for Rent Part–Time
Beautiful, newly renovated medical office on the Upper East Side between Lexington and Park Ave. Full service building with 2 entrances, conveniently located near all public transportation. Office includes 2 consult rooms, 3 exam rooms, treatment area, 2 bathrooms, kitchenette and reception area with waiting room. The office is available on a part-time basis. Please call 212-288-2278 or e-mail eastsidemedical@usa.net for further information.
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Park Avenue Office Share-3 Days Per Week
Tasteful, bright, well-maintained medical office in prestigious building on Park Avenue at 94th Street.  Large waiting room and reception area, consultation room and 2 exam rooms available 3 days per week. Room for an
assistant or clerical help 5 days per week. Please email abgmdpc@gmail.com or call 987-5000


Medical Office Space for Rent!
Beautiful Newly Renovated Medical Office on the Upper East Side between Madison and Park Avenue! Conveniently located near all public transportation and Mount Sinai Hospital. Consult and Exam room available for rent part time or full time (see pictures). Please call 212-860-0300 or email
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Fully Renovated Office Space for Part-Time Lease in Hauppauge
Available Tuesdays/Fridays, $450 half session, $750 full session. Elegant office space, beautiful waiting room with new stone and granite reception desk, custom molding, large windows, abundant natural light, TV, and refreshment counter.  Four new exam rooms and dictation room.  New stainless and granite kitchenette.  State-of-the-art network infrastructure meets HIPPA & PCI DSS compliance standards.  Digital X-ray room with PACS in each exam room available as an option.  Located in close proximity to LIE, Northern State Pkwy, and Vets Memorial Hwy. Contact us at (631) 486-8855;  Please see our listing
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Office Rental 30 Central Park South
Two fully equipped exam, two certified operating, bathrooms and consultation room.  Shared secretarial and waiting rooms. Elegantly decorated, central a/c, hardwood floors. Next to Park Lane and Plaza hotels. $1250 for four days a month.Available full or part-time. 212.371.0468drdese@gmail.com.


 

Rare Find — Great Office Share
Wonderful office share in terrific location at great price. Available Monday, Wednesday, Friday and weekends. Choice of smaller windowed consultation room with adjoining exam room or big windowed consultation room with one or two exam rooms. Beautiful bright rooms, lovely reception area and front . First-rate building on 58th Street between Park and Lexington. Rent by day (about $180). Front desk and office management available if needed, along with many other amenities, including internet, ultrasound, EMG Kitchen, optional C Arm. Willing to make changes for new tenant. Call 646-642-0700.

  

 


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PHYSICIAN OPPORTUNITIES

Great Career Opportunities for Clinical Physicians
The NYS Department of Corrections and Community Supervision has great career opportunities for Clinical Physicians. You must have possession of a license and current registration to practice medicine in New York State, and have two years of post-licensure medical experience.

Starting salary is $143,381 – $171,631 *(Additional $10,000 or $20,000). Benefits include comprehensive health insurance, NYS retirement system, deferred compensation plan, flexible spending plan, and paid time off.

We have openings in the following counties offering a choice of urban, suburban or rural living:

Clinton*                  Clinton Correctional Facility (sporting and recreational outlets)
Dutchess                 Fishkill and Green Haven Correctional Facilities (Hudson River Valley Beauty)
Franklin*                 Franklin and Upstate Correctional Facility (North Country, 1 hour to Montreal)
Greene*                  Greene Correctional Facility (rural charm yet only 2 hours to New York City)
Oneida                    Mohawk Correctional Facility (Cooperstown, breweries)
Sullivan                   Woodbourne Correctional Facility (mountains, outlets, casinos and entertainment)
Seneca*                  Five Points Correctional Facility (heart of wine country)
St. Lawrence           Riverview Correctional Facility (hiking, boating and museums)
Washington             Great Meadow Correctional Facility (Between Vermont & the Green Mountains)
Westchester            Bedford Hills Correctional Facility (Less than 1 Hour to NYC)

Contact: www.doccs.ny.gov or DOCCS Personnel Office at (518) 457-8132 for more information and to apply.


Nurse, RN Utilization Review Full-Time-Westbury, NY (In-office position only)
Excellent opportunity for a RN who is seeking a position performing utilization review.  We require 1-2 years recent experience in hospital and/or insurer utilization review and experience using Interqual criteria and/or MCG Guidelines. Data entry/PC skills a plus. Benefits include 401(k), paid vacation and holidays. Send resume and salary requirements to: Empire State Medical Scientific and Educational Foundation, Inc. Human Resource Department e-mail: chunt@mssny.org  Fax: (1-516) 833-4760 Equal Oppty Employer M/F


CALL FOR RATES & INFO. CHRISTINA SOUTHARD: 516-488-6100 ext. 355

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 


MSSNY eNews: June 21, 2019 – A Funny Thing Happened on the Way to Legalization

Arthur Fougner MSSNY Presiident

PRESIDENT’S MESSAGE<
Arthur Fougner, MD
MSSNY President

MSSNY eNews
June 21, 2019

Vol. 22  Number 24


MSSNYPAC Seal

 


Colleagues:

As the NY State Budget was being prepared, revenue generated from the legalization of “adult use” marijuana figured prominently in Albany’s calculus.

The State Department of Health released a 96 page report which concluded that the benefits outweighed any risks of legalization. “Listening tours,” usually the sign of a done deal, were held all over NY State. While these meetings were being scheduled, then MSSNY President, Dr. Thomas Madejski of Orleans County didn’t just say no. Dr. Madejski said: “Hell, No” as he recruited physicians all over the state to testify at these meetings.

Slowly, the tide began to turn as not only MSSNY but law enforcement, substance use specialists and county health departments weighed in. Then, enter the PTAs. That did it. Marijuana was no longer a part of the budget. The legislators now worked on stand-alone bills for legalization. However, at this point, articles began to appear in the press which countered many of the arguments in favor of legalization. Visits to Emergency Departments had increased. Revenues were less than advertised. Legalization had not eliminated the black market. Big Pot was poised to supplant Big Tobacco.

Dr. Madejski’s “Just Say Know” campaign on social media soon attracted allies from other states as NJ and CT also threw up roadblocks to legalization. While the dust has not quite settled in Albany, it’s now clear that Albany’s “done deal” is indeed done.  Legal recreational pot in NY State is not happening in 2019.

Willie Nelson won’t be celebrating in Albany this year.

Horatius at the Bridge
When the goodman mends his armor,
And trims his helmet’s plume;
When the goodwife’s shuttle merrily
Goes flashing through the loom;
With weeping and with laughter
Still is the story told,
How well Horatius kept the bridge
In the brave days of old.
By Thomas Babington, Lord Macaulay

Arthur Fougner, MD
MSSNY President 

Comments? comments@mssny.org; @mssnytweet; @sonodoc99


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Podcast SymbolThis Week’s Podcast of MSSNY’s Legislative Priorities


Capital Update

Legislative Session Wrap Up; Brings Several Positive Outcomes for Physicians
The State Legislature worked through the night to wrap up its 2019 Legislative Session, one of the most memorable in recent years given the breadth of issues the Legislature decided to address following the power-shifting election which occurred last November.  Despite the many threats we faced, the Session produced several “wins” for physicians and their patients, though some adverse bills were also passed that will require MSSNY and others to request vetoes from the Governor.

Your DGA staff thanks the many physicians and county society staff who took the time to make phone calls, write letters, send tweets and personally meet with their local legislators on the myriad of issues which we prioritized our advocacy.  Moreover, we thank the numerous specialty societies we regularly partnered with to help achieve these outcomes.  Among the highlights of the last few weeks of Session:

  • Enactment of legislation supported by MSSNY which ensures that medical contraindications are the only acceptable exception to vaccine requirements;
  • Passage of legislation supported by MSSNY which significantly curtails health insurers making mid-year changes to their prescription formularies; or increasing patient cost sharing;
  • Passage of legislation supported by MSSNY which will provide extensive new regulation of Pharmaceutical Benefit Managers (PBM);
  • Passage of legislation supported by MSSNY that permits a prescriber to arrange with a pharmacist to “partially fill” a patient prescription for opioid medication;
  • Passage of legislation supported by MSSNY to reduce insurer prior authorization (PA) requirements when a PA for a related procedure has already been received;
  • Defeat of legislation opposed by MSSNY that would have legalized adult use marijuana, as well as proposals that would have significantly expanded the medical marijuana program.  Instead legislation was enacted supported by MSSNY that provides further “decriminalization” of small amounts of marijuana;
  • Defeat of every major scope of practice expansion bill opposed by MSSNY, including pushing back against aggressive efforts by podiatrists and optometrists;
  • Defeat of numerous trial lawyer backed bills opposed by MSSNY which could have greatly expanded lawsuits or damage awards against physicians, or made it much more difficult to defend a lawsuit.  It should be noted that the Legislature did pass a couple of smaller measures opposed by MSSNY and many other groups that will affect certain cases involving multiple defendants and where an adverse judgment has been reached;
  • Defeat of several bills opposed by MSSNY that would have overridden physician clinical judgment and added even more requirements on physicians prior to prescribing opioid medications to patients.

See below for a more detailed summary of these issues.                                   (DIVISION OF GOVERNMENTAL AFFAIRS) 


Physician Advocacy Urged to Prevent Congressional Attempts to Undermine New York “Surprise Bill” Law
Physicians are urged to send a letter Please click Here: to Senators Schumer and Gillibrand, as well as your local US Representative, urging your member of Congress to fight for a “surprise medical billing” law that is consistent with New York’s approach.  This week, US Senators Lamar Alexander (R-TN) and Patty Murray (D-WA) released a bill that would seriously undermine New York’s proven model and greatly diminish the ability of physicians to fairly negotiate patient care terms with market dominant health insurers.

Instead of the disastrous Alexander-Murray bill, MSSNY and many other physician advocacy organizations have praised a proposal advanced by Representative Joe Morelle (D-Rocheseter) together with Representative Dr. Phil Roe (R-TN) and Dr. Raul Ruiz (D-CA), that seeks to mirror New York’s law, which uses a “baseball arbitration” Independent Dispute Resolution (IDR) system to determine payment for out of network medical care, and uses charge data collected by an independent database as a leading benchmark to guide the IDR.

Specifically, the Alexander-Murray bill would require an insurer determined in-network based default rate for out of network surprise medical bills.  This would give enormous new powers to already market dominant insurers, and fails to recognize the insurance industry’s fault in creating this problem due to their narrow networks.  MSSNY has written to New York’s Congressional delegation praising the approach set forth by Representatives Morelle, Roe and Ruiz, and raising strong concerns with other proposals.  Specifically, New York’s letter raised concerns with the insurance industry’s own notorious history in establishing benchmarks for out of network payment, and the history of then-Attorney General Cuomo’s investigation which found that by using a flawed and conflicted database to determine reimbursement rates for out-of-network care, insurers were increasing profits at the expense of patients and physicians.

Moreover, it was noted that New York’s law struck a tenuous balance among various health care stakeholders that protected patients from surprise medical bills and assured that hospital emergency departments had access to needed on-call specialty care.

MSSNY has been working with several other state medical associations and national specialty societies in its advocacy to Congress.  Please see here for a short “Fact Sheet” developed by the Physicians Advocacy Institute that sets forth key principles for Congress to consider in this debate Please click here:  (AUSTER)



NYS Legislature Moves to Decriminalize Marijuana; Does Not Permit Legalization of Marijuana
Legislation to permit the legalization and commercial sales of recreational use marijuana did not happen this year. However, a measure to decriminalize possession of small amounts of marijuana was successful.  A.8420A/S.6579A, sponsored by Assembly Majority Leader Crystal Peoples-Stokes and Senator Jamaal T. Bailey, provides for further decriminalization of certain low level marijuana possession offenses and for expungement of the records.  Governor Cuomo has indicated that he will sign this measure.  The Medical Society had also indicated for support of the measure as it was consistent with MSSNY policy.

The legislature also did not act on legislation to expand the medical marijuana program, through a bill opposed by MSSNY that would eliminate the “serious condition” threshold for certifying a patient for medical marijuana, enable smoked versions of medical marijuana, and allow any “practitioner” who is authorized to prescribe controlled substances with the state to certify a patient for medical marijuana use.

MSSNY worked with the New York State Association of County Health Officials (NYSCHO), the PTA, the NYS Sherriff’s Association and Smart Approaches to Marijuana (SAM) in getting a unified message to the legislature about the potential impact of marijuana on young people as well as the adverse public health impacts in other states.  MSSNY also credits several members of the Legislature with bringing those concerns back to the members of their respective houses. (CLANCY, AUSTER)


Legislature Passes Bill to Curtail Mid-Year Formulary Changes by Health Plans
The Senate and Assembly gave final passage to legislation this week that would substantially limit the ability of health insurers to make changes to their prescription medication formularies during a policy year.

The legislation (A.2969, People-Stokes/S.2849, Breslin) would prohibit a health insurer from removing a prescription drug from a formulary during the patient’s policy year.  Moreover, if the plan’s drug formulary has two or more tiers of drug benefits with different deductibles, copayments or coinsurance, the plan may not move a drug to a tier with higher patient cost sharing during the policy year. It also prohibits the plan from adding new or additional formulary restrictions during the policy year.

The legislation does permit an insurer to move a prescription drug to a tier with a larger copayment, coinsurance and different deductible only if an AB-rated generic equivalent drug or interchangeable biological product is added to the formulary at the same time.  MSSNY supported this legislation and worked with several patient advocacy organizations to advocate for its passage.         (AUSTER, AVELLA)


 

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Pharmacy Benefit Manager Licensure and Regulation Passes Both Houses
Legislation that will require licensure for pharmacy benefit managers (PBMs) and outline their duties and responsibilities has passed both houses and awaits the governor’s signature. Senator Breslin and Assemblymember Gottfried’s bill (S.6531/A.2836A) passed the final week of session and will implement measures to provide clarity and oversight of PBMs and requires PBMs to act in the best interest of covered individuals, health plans and providers.

PBMs will be required to register with the Superintendent of Insurance and will require renewal of their license every three years. Licensure will be contingent upon meeting minimum standards established by DFS and the Commissioner of Health. PBMs will be required to address any conflicts of interest, deceptive practices, anti-competitive practices, and unfair claims practices. They will also be required to disclose plans with whom they contract and terms and conditions placed on their pharmacy networks. Per Trish Riley, the Executive Director of the National Academy for State Health Policy, New York’s policy will go the furthest in the nation toward regulating PBMs.                               (AVELLA)


Legislature Passes Bill to Reduce Certain Prior Auth Requirements to Prevent Interruption of Patient Care Services
The Assembly and Senate gave final passage this week to a measure to reduce insurer prior authorization (PA) requirements when a PA for a related procedure has already been received.  The bill, A.2880-B, Hunter/S.5328-B, Breslin, would ensure that if a physician providing a treatment to a patient for which a PA has been received determines that providing  an  additional  or related  service or procedure  is “immediately necessary as part of  such  treatment”  and  would  not  be  “medically  advisable  to  interrupt  the  provision of care to the patient” in order to obtain a PA, then the insurer shall not deny the claim, except under limited circumstances.

Specific patient scenarios this legislation is seeking to address include when a patient receiving chemotherapy needs to quickly receive treatment for related health issues, such as nausea, low platelet count or allergic reactions, without the need for the physician to ask and receive an additional PA from the insurance company.  MSSNY supported this legislation.                                (AUSTER) 


Partial-Fill Legislation Passes New York State Legislature; Bill Goes to Governor
Assembly Bill 3918 and Senate Bill 1813, Which was sponsored by Assemblymember John McDonald and Senator Gustavo Rivera would allow physicians to prescribe a controlled substance, on a partially filled basis and has passed the New York State Legislature. The measure will now go before Governor Cuomo for his consideration. Passage of this measure allows New York State to align itself with the federal law; partial fills were authorized on a federal level under the Comprehensive Addiction and Recovery Act (CARA).

This measure would allow physicians/prescribers, in consultation with their patient, to prescribe up to a 30 – day supply of a controlled substance with a notation to the pharmacist that he/she should only dispense the agreed – to amount.   Each partial filling would be dispensed and recorded in the same manner as a refilling (i.e., date refilled, amount dispensed, initials of dispensing pharmacist, etc.), and the total quantity dispensed in all partial fillings may not exceed the total quantity prescribed.

The Medical Society of the State of New York believes that this measure will now allow prescribers to help patients balance the need to relieve pain with an adequate supply of medication by only filling part of the prescription. Should they need additional pain relief; patients will be able to return to the pharmacy to fill the remaining portion of their prescription.  (CLANCY)


Maternal Mortality Board Fine-Tuned on Last Day of Session
Senator Rivera and Assemblymember Joyner passed legislation (S.6529/A.8338) to make technical changes to the maternal mortality legislation board that was passed earlier this year, & supported by MSSNY & ACOG. This bill will ensure that the board’s makeup is representative of the racial, ethnic and socioeconomic diversity of women and mothers in the state and to the extent possible, representative of areas that are medically underserved and areas with high occurrences of maternal mortality and morbidity. It also clarifies how committee members will be appointed and what information the commissioner may request from health departments and other public authorities.            (AVELLA)


Cesarean Section Mandate Fails to Pass in 2019
Legislation that would have required physicians and other health care providers to provide maternity patients with written information regarding the risks associated with Cesarean section passed the Assembly, but not the Senate. This bill, S.2888/A.318, which is sponsored by Senator Salazar and Assemblymember Paulin is opposed by MSSNY and the American College of Obstetricians and Gynecologists (ACOG).

This bill was opposed by MSSNY and ACOG for a variety of reasons, including the fact that the bill’s terminology is not consistent with accepted medical practice. Additionally, physicians already seek informed consent – this bill would interfere with the physician-patient relationship by requiring boilerplate, pre-determined written communication. This goes against the concept of patient-centered, custom provision of care that differs from patient to patient.

Further troubling to MSSNY is the recent trend in New York and across the nation to mandate discussions and/or certain actions by physicians. While these measures are well-intended, they do patients a disservice by interfering with their relationship with their doctor and often may prove to be more harmful than helpful. (AVELLA)


Legislature Rejects Liability Expansion Legislation with Huge Premium Impacts; Passes Others Affecting Cases with Multiple Defendants
Despite trial lawyers aggressively pushing the State Legislature on a litany of adverse bills in the Session’s final days, the Legislature left Albany without taking action on many of their priority bills that would have significantly driven up already excessive liability costs for physicians, hospitals and other business entities, and made it far more difficult for a physician to defend themselves in a medical liability action.  These bills included legislation that would have: exponentially expanded awardable damages in wrongful death lawsuit (S.4006/A.5612); prohibited a defendant physician’s defense counsel from interviewing a medical malpractice plaintiff’s treating physician (S.6194/A.2370); and permitted the admissibility of certain “hearsay” statements of employees in civil actions (A.7599/S.6335).

With significant objections from MSSNY, numerous specialty societies, HANYS and GNYHA, the Legislature did pass 2 bills affecting certain cases involving multiple defendants where the jury has awarded a judgment for the plaintiff, including:

  • A.2372/S.6081 – would permit a plaintiff to collect on a court judgment directly against a third party defendant that had been sued by the original defendant for contribution and indemnification.  The concern is that this type of practice could encourage those parties unable to satisfy their apportioned share of liability to dodge their responsibility, while allowing a plaintiff to target a deep-pocketed third party.
  • A.2373/S.6552 – would require a non-settling co-defendant in a tort action, where another co-defendant has settled, to choose whether to reduce his/her liability exposure by the stated settlement amount or the settling tortfeasor’s equitable share prior to a trial, instead of after a jury verdict has been reached.  The concern is that it forces the non-settling defendants to make a blind choice without knowing the ultimate outcome of the trial, with the risk that if the co-defendant makes the “wrong choice”, a plaintiff could receive a recovery above what the jury awarded.

MSSNY will be working with other groups to request that the Governor vetos these 2 bills given their likely inflationary impact on overall medical liability costs, which already are by far and away the highest in the country.                       (AUSTER)


Legislature Passes Bill to Provide Greater Clarity to Medical Record Disbursement When Physician Retires
The Senate and Assembly gave final passage this week to legislation setting forth procedures to follow when a physician or other health care practitioner decides to cease to stop providing patient care in New York State.  The goal of the legislation (A.2349/S.5367) is to address the often-asked question of where patient records should be sent when a physician or other care provider retires from medical practice or moves to another state.   Specifically, the legislation requires the practitioner, at least 30 days prior to ending their practice, to make a good faith effort to notify the practice’s “current patients” of the impending closure and of the patient’s right to request their patient information or medical records be sent to the health care provider, facility, or practitioner of their choice or returned to the patient.

The bill does not define what is considered to be a “current patient”.  The bill does, however, clarify that the provisions of the bill do not apply to situations where a physician’s practice is acquired or merged with another entity, and the physician continues to deliver care to patients.  MSSNY is continuing to review the legislation with its General Counsel and will submit comments to the Governor’s office when the bill is delivered to the Governor.                              (AUSTER)  


Opioid Measures Not Acted on By Legislature
There were several measures that related to opioid prescribing that would have imposed even more requirements on physicians prior to prescribing opioids that failed to win passage.  The bills are:

  • 8256/S.5867A, moved to the Assembly calendar but was not voted on by the full Assembly. This legislation would have amended the public health law to require health practitioners, before prescribing an opioid medication, to consider discussing with the patient and refer or prescribe alternative services such as chiropractic, massage therapy or behavioral therapy.
  • 5603/S.5150, moved to the Assembly Ways and Means Committee and to the Senate calendar but was not acted on by either house. This legislation would have amended the public health law to require that prescribers, who prescribe opioids for the first time must also co-prescribe an opioid antagonist with the prescription.
  • 7285A/S.4277A, passed the Senate but was not acted upon in the Assembly. The legislation would have amended the public health law to require health practitioners who prescribe an opioid or other Schedule II Controlled Substance to discuss with the patient the risks of being prescribed a CSII drug, other co-prescribe an opioid antagonist.

(CLANCY, AUSTER)


Efforts to Expand Scope of Practice Legislation Pending on Senate Calendar for a Vote
There are several bills that would have expanded the scope of practice of various professions that moved forward in the New York State Senate but failed to win approval in the Assembly. MSSNY worked together with several specialty societies to advocate on these issues.  The Medical Society had opposed the following measures:

  • 5395/A.6185, would have inappropriately expanded the scope of practice of podiatrists the following ways: by reducing certification requirements for podiatrists seeking to have advanced surgical privileges; removing the requirement that a podiatrist seeking either standard ankle surgery or advanced ankle surgery privileges be directly supervised by a podiatrist with an advanced license from the NYSED or a physician; and enabling podiatrists to treat wounds that are not contiguous with structures of the foot or ankle. This measure was approved by the Senate, but failed in the Assembly.
  • 1193, would have permitted Optometrists to prescribe oral antibiotic and other medications. The bill failed to advance out of the Higher Assembly Ed committee.
  • 5092/A.3867, would have added pharmacists to the list of licensed health care professionals authorized under public health law to perform non-invasive laboratory tests as an adjunct to their professional services, without an order from a physician. The measure advanced in the Senate, but failed to move in the Assembly.
  • 5227/A.6511A, would have allowed pharmacists to provide ALL immunizations on the Advisory Committee on Immunizations Practices (ACIP) list recommended for adults.This would more than double the number of immunizations pharmacists would be permitted to provide. The measure advanced in the Senate, but failed to move in the Assembly.
  • 4975/A.6486, would have authorized a pharmacist to administer vaccines for hepatitis A, hepatitis B, and human papillomavirus to adults via a patient or non-patient specific script. The measure advanced in the Senate, but failed to move in the Assembly.                                                                                                   (CLANCY, AUSTER)

Joint Statement Issued by DOH, Office of Children and Family Services, SED on Non-Medical Exemptions—Measles Outbreak Continues
The New York State Department of Health, the Office of Children and Family Services, and the State Education Department has issued a joint statement on the law that removed non-medical exemption from school vaccination requirements.  According to the statement, as of June 13, 2019, “there is no longer a religious exemption to the requirement that children be vaccinated against measles and other diseases to attend either a public, private or parochial school (for students in pre-kindergarten through 12th grade or child day care settings.”

For those children that have had a religious exemption to required immunizations, they must receive their first age appropriate dose in each immunization series by June 28, 2019 to attend or remain in school or child care.  A copy of the joint statement and Frequently Asked Questions about the legislation can be found at: Please click Here.

Physicians and other providers who provide immunizations to children are advised to be prepared to see an increase in children who need these vaccines and to try their best to accommodate them into their practice.  As summer and travel begins, there will be an increased demand for immunizations for both children and adults. The measles outbreak continues to grow in New York State.  There is continued ongoing transmission of measles in communities in NYS with the majority of cases in those who are unvaccinated or under- vaccinated. The New York State Department of Health has issued a June 14, 2019 health advisory that says:  Please click Here

  • Since October 1, 2018, there have been 932 cases reported in NYS: including 267 in Rockland County, 49 in Orange County, 18 in Westchester County, 8 in Sullivan County, and 588 in New York City (NYC).
  • Providers should NOT rely upon self-report of vaccination as evidence of immunity. If there is no record of vaccination or evidence of immunity (and no contraindication), the patient should be vaccinated.
  • For adults in outbreak areas, the NYSDOH recommends administration of a second dose of a measles-containing vaccine (MMR) for adults with one documented dose of a measles-containing vaccine.
  • For adults in non-outbreak areas, recommendations have not changed. One dose of a measles containing vaccine (or other presumptive evidence of immunity) is sufficient for most adults.
  • Healthcare providers need to maintain vigilance for measles and immediately report any suspect cases by telephone to the local health department (LHD) where the patient resides.                                                       (CLANCY)

A Big Thank You for Physician Advocacy Efforts!
MSSNY’s Physician Advocacy Liaison (PAL) network was instrumental in helping to achieve our numerous legislative victories, by helping us quickly respond to legislators who needed to hear the physician perspective on a number of issues. As always, thank you for the work all of you do on a daily basis, and for taking the additional time to be active in the legislative and budgetary process. There is no doubt that your efforts were a major contributor to our successes.

While another legislative session has wrapped up in Albany, MSSNY is still actively looking to expand the PAL network.  The PAL network is a vital way for elected officials to hear directly from their physicians and a way to make certain that our leaders remain committed to championing the issues that matter most to MSSNY members and their patients.

For more information on the PAL network or to sign-up, click Please click Here: (HARRING)


Measles Outbreak in New York State Continues to Spread Webinars Available at MSSNY CME Website
Did you know that 90% of the 1,044 measles cases in the United States are right here in New York?  The number of measles cases in New York State in 2019 has again seen an uptick over the past week.  943 of the 1,044 confirmed cases nationwide are in New York State. In 2019 there have been 596 confirmed cases in New York City and 323 outside of New York City (268 in Rockland; 51 in Orange; 18 in Westchester; 8 in Sullivan; 1 in Suffolk and 1 in Greene counties) confirmed cases as of June 17th.  MSSNY conducted a just-in-time Medical Matters webinar entitled “The Continued Public Health Threat of Measles 2018” in December, 2018.

This webinar has now been posted to the MSSNY CME website. You can also view MSSNY’s latest Medical Matters webinar entitled “What’s Your Diagnosis? Infectious Diseases” which involves a patient with a fever and a rash. Please check these out and keep yourself informed about the growing measles outbreak throughout New York State.  You can also listen to MSSNY’s newest podcasts on the current measles outbreak for both physicians and patients At as well as a brief podcast on the Measles, Mumps and Rubella vaccine at the same site.         (HOFFMAN, CLANCY)


Please Join Us for MSSNY’s Physicians’ Day at the Races
MSSNY’s 2nd Physicians’ Day at the Races will take place on Saturday, July 27, 2019 at the Saratoga Race Course “The Rail at the 1863 Club” in Saratoga Springs, NY.

Please join your friends and colleagues for a great event to benefit your profession.  MSSNY uses its resources and mobilizes support from elected officials who will stand and fight for us, regardless of what party they are from.  MSSNYPAC allows us to pool our resources and together, make a difference against other special interest that continues to try to undermine the delivery of quality health care.  MSSNY continues to develop new fundraising opportunities for our physicians to become more active.

Tickets:
$500/Physician
$300/Guest

Ticket price includes clubhouse admission, post parade programs, a gourmet buffet lunch at your own trackside table (11:30am-2:30pm), open bar, private viewing of the horses as they bring them from the paddock and private betting windows with a 1:00pm post time.

For more information, click Please click Here. Contact Jennifer Wilks at 518-465-8085 or jwilks@mssny.org to secure tickets.              (HARRING)                                                             


   

                                              


pschuh@mssny.org mauster@mssny.org  pclancy@mssny.org  mavella@mssny.org
charring@mssny.org
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NYS Workers’ Comp Board to Provide Training at Regional Conferences
The New York State Workers’ Compensation Board (Board) has announced a series of three regional conferences to take place this summer in Albany, Rochester, and New York City. The half-day, afternoon sessions are open to anyone with an interest in the New York State workers’ compensation system, and will highlight important advances in workers’ comp, as well as provide Continuing Legal Education (CLE) and Continuing Medical Education (CME) courses.

The conferences come on the heels of several significant Board initiatives, including New York’s first drug formulary and revised medical fee schedules that provide higher reimbursements to health care providers who treat injured workers. Additionally, the Board is gearing up to implement a new law that takes effect on January 1, 2020, that enables more types of health care providers to be authorized to treat workers’ compensation patients. In addition to a general overview highlighting recent accomplishments, attendees can also choose other sessions to attend for a deeper dive into key topics, such as:

  • Legal update: significant case law, developments in adjudication and legislation (CLE)
  • Ethical considerations in appearing before the Board (CLE)
  • Medical marijuana in NYS workers’ compensation (CLE/CME)
  • Impairment guidelines for determining schedule loss of use (CME)
  • Understanding variances and the drug formulary (CME)
  • Combatting fraud
  • Best practices in workers’ compensation
  • Intro to workers’ compensation for new providers

The regional schedule is below:

  • Albany
    Monday, July 1
    Empire State Plaza Convention Center
    Concourse Level Albany, NY 12242
  • Rochester
    Wednesday July 31
    Hyatt Regency Rochester
    125 East Main Street
    Rochester, NY 14604
  • New York City
    Monday, August 5
    New York Marriott Downtown
    85 West Street at Albany Street
    New York, NY 10006

The cost is $50 to attend, with hardship scholarships available to those who qualify. Registration is limited and will be granted mainly on a first-come, first-served basis. However, special consideration will be given to those seeking CME/CLE credits.

For complete details and to register, visit bit.ly/WCBconference19.

More information is also available at the Board’s website at wcb.ny.gov or by emailing outreach@wcb.ny.gov.


Attention: All Physicians
Do You Know about Having to Research Exclusionary Databases of Your Managing Employees?
MSSNY has heard from several physicians and specialty societies regarding the significant burdens associated with a requirement that managed care companies are imposing on its participating physicians to check numerous databases on a monthly basis.   The Office of the Medicaid Inspector General (OMIG) checked with their Office of Counsel (OOC) and it’s their interpretation of the contract that MCOs must require their participating providers to check exclusion lists for their managing employees, not all their employees.

Network physicians are being instructed by managed care organizations to conduct routine checks of Federal and State databases. These include the Social Security Administration’s Death Master file, and the National Plan and Provider Enumeration System (NPPES), and the Excluded Parties List System (EPLS), and either the List of Excluded Individuals and Entities (LEIE) or the Medicare Excluded Database (MED), the NYS OMIG Exclusion List, and any such other databases as the Secretary may prescribe; and check the LEIE (or MED), the EPLS and NYS OMIG Exclusions List no less frequently than monthly.

The NYS DOH has stated that this is a requirement for providers seeing Medicaid patients (and receiving public dollars), whether they are in FFS or managed care. Plans are enforcing the requirement.

Are you aware of this?  Please provide your feedback to MSSNY at csouthard@mssny.org or rmcnally@mssny.org


NYS Buprenorphine Waiver Eligibility Trainings for Clinical Providers

Summer 2019

The NYSDOH AIDS Institute in partnership with various local health departments are sponsoring free Buprenorphine Waiver Eligibility Trainings for Clinical Providers. In response to opioid overdose deaths in New York State, increased access to buprenorphine treatment for Opioid Use Disorder (OUD) is urgently needed. Physicians, Nurse Practitioners, Physician Assistants and Medical Residents are highly encouraged to attend.
Under current regulations, authorized practitioners (MDs, DOs, NPs & PAs) are required to obtain a ‘waiver’ to prescribe buprenorphine. To acquire this waiver, physicians are required to complete a standardized 8-hour buprenorphine waiver training.

Nurse Practitioners (NPs) and Physician Assistants (PAs) are required to complete the 8-hour buprenorphine waiver training as well as an additional 16 hours of online training as established by the Comprehensive Addiction and Recovery Act (CARA). Residents may also take the course and apply for their waiver once they receive their DEA license. The 8-hour buprenorphine waiver training is offered in a ‘half and-half’ format [4.5 hours of in-person training followed by 3.5 hours of online training]. Upon completion of the required training, providers will meet the requirement of the DATA 2000 to apply for a waiver to prescribe buprenorphine for opioid-dependent patients. Visit PCSS for more info including how to complete of all required training online:

*For more information about waiver trainings held in NYC, email buprenorphine@health.nyc.gov


Coalition Wants Johns Hopkins to Drop Medical Debt Suits v. Low-Income Patients
A coalition of Baltimore citizens, backed by two unions, presented a letter and petition June 17 to Baltimore-based Johns Hopkins Hospital President Redonda Miller, MD, calling on the hospital to drop medical debt lawsuits against patients.

The group, called the Coalition for A Humane Hopkins, published a joint report with National Nurses United and AFL-CIO last month that found the hospital won wage garnishments or seized funds from patient bank accounts in more than 400 cases. The groups claim the hospital seized the last $100 in a patient’s bank account in at least two instances. The report also alleges this issue disproportionately affects a primarily African American and low-income zip code in Baltimore.

The coalition wants the hospital to stop filing medical debt lawsuits, drop all current medical debt lawsuits and reimburse patients billed more than allowed under charity care rules. It also wants the hospital to be more transparent about its charity care rules by increasing signage and screening patients at admission to see if they are eligible for charity care. Lastly, it wants the hospital to offer charity care to patients who are not citizens of the U.S.

However, Johns Hopkins spokesperson Kim Hoppe said the hospital does provide financial assistance and charity care information to every patient.

Ms. Hoppe provided Becker’s the following statement:

“It is always our priority to provide the best possible care to every patient who comes to us. We have an extraordinary community benefits program, and it is our policy to inform our patients about our programs for free and discounted services. For patients who choose not to pursue those options or who have a demonstrated ability to pay, we will still make every effort to reach out to them and to accommodate their schedule and needs. In those rare occasions when a patient who has the ability to pay chooses not to, we then honor our obligation as a hospital in the state of Maryland, with its unique payer model, to pursue reimbursement.” (Beckers Hospital Review June 18)


Under Financial Pressure, US Citizens Travel to Canada to Buy Insulin
Between 2012 and 2016, the cost of insulin for treating Type 1 diabetes nearly doubled, according to the nonprofit Health Care Cost Institute,” and insulin can cost hundreds of dollars per vial in the US. Now, some people are traveling to Canada to buy the treatment, where insulin can be purchased “without a prescription for a tenth of” the price. Similarly, “Republicans and Democrats have produced federal and state proposals to import drugs from Canada.” Department of Health and Human Services spokeswoman Caitlin B. Oakley wrote in an email, “President Trump and [HHS] Secretary Azar are firmly committed to getting drug prices down.” Meanwhile, many Canadians “worry that bulk [insulin] buys from the United States could cause shortages or higher prices.” Washington Post (6/16)


Drug Cos. Sue HHS over Rule Requiring Them to Include List Prices in TV Ads
An effort “by the Trump administration to shine light on the high costs of prescription drugs prompted legal resistance by three major pharmaceutical companies.” The article said, “Amgen, Eli Lilly, and Merck sued the Department of Health and Human Services in a bid to block new rules requiring that companies disclose the ‘list price’ of their drugs in television advertising.” The companies “called the rules ‘entirely unnecessary, bad for patients, and detrimental to health care,’ as well as a violation of” their “free speech rights.” The lawsuit names HHS Secretary Alex Azar as a defendant.

Azar said last month when he announced the rule, “Claiming list prices don’t matter is almost the same as claiming there is no problem with high drug costs at all – and I don’t think many American seniors or patients with serious illnesses would say that’s the case.” Azar also stated at the time, “Requiring the inclusion of drugs’ list prices in TV ads is the single most significant step any administration has taken toward a simple commitment: American patients deserve to know the prices of the health care they receive.” Washington Post (6/14)


Join CMS for a Public Webinar on Quality Measurement
CMS is pleased to invite the public to attend its upcoming webinar titled Measuring Quality to Improve Quality: Strengths and Challenges of Clinical Quality Measurement. The webinar will provide an engaging and informative overview of key concepts that go into its quality measures. Additionally, the presentation will review current CMS quality measures, explain how they are used, and how they fit into CMS’s quality goals, including the Meaningful Measures initiative.

The webinar will be offered twice in June, on Tuesday, June 25th, from 2:00-3:00pm EST (Register here) and Thursday, June 27th, from 2:00-3:00pm EST (Register here). Please register in advance if you can attend as space will be limited. We request that you please only register for events you plan to attend. We hope you can join us and look forward to your questions! For questions, please contact MMSSupport@battelle.org.


Classified

RENTAL/LEASING SPACE


Ground Floor Office with Private Street Entrance in Luxury Park Avenue Building
Rental includes: two consultation rooms, private office, private bathroom.  Common waiting room, back office filing space and reception desks included.  Affordable rent.  Location East 60s between Park and Lexington.  Easy distance to Lenox Hill Hospital and New York Cornell.  Subway access within 1 block.  Immediate occupancy available.  Call James: 917-710-7643


For Lease – Buffalo Area  Urgent Care / Primary Care Clinic
Next door to only grocery store in town: Sav-a-Lot 4+ exam rooms, X-Ray room, Lab, Offices, etc. 3300 Sq Ft. – Fully built-out facility  ADA compliant Dunkirk New York

View full listing https://reporting.loopnet.com/report/3008dc65-60b8-4476-ab01-df4ffa2bc628.

Contact geoff_jenkins@hotmail.com / (917) 825-4542


Upper East Side Medical Office Space for Rent Part–Time
Beautiful, newly renovated medical office on the Upper East Side between Lexington and Park Ave. Full service building with 2 entrances, conveniently located near all public transportation. Office includes 2 consult rooms, 3 exam rooms, treatment area, 2 bathrooms, kitchenette and reception area with waiting room. The office is available on a part-time basis. Please call 212-288-2278 or e-mail eastsidemedical@usa.net for further information.
Upper East Side Office lobby and receptions area



Park Avenue Office Share-3 Days Per Week
Tasteful, bright, well-maintained medical office in prestigious building on Park Avenue at 94th Street.  Large waiting room and reception area, consultation room and 2 exam rooms available 3 days per week. Room for an assistant or clerical help 5 days per week. Please email abgmdpc@gmail.com or call 987-5000


Medical Office Space for Rent!
Beautiful Newly Renovated Medical Office on the Upper East Side between Madison and Park Avenue! Conveniently located near all public transportation and Mount Sinai Hospital. Consult and Exam room available for rent part time or full time (see pictures). Please call 212-860-0300 or email carnegiehill0062@gmail.com for further information.
Pictures of office space for rent on Madison Ave

 


Fully Renovated Office Space for Part-Time Lease in Hauppauge
Available Tuesdays/Fridays, $450 half session, $750 full session. Elegant office space, beautiful waiting room with new stone and granite reception desk, custom molding, large windows, abundant natural light, TV, and refreshment counter.  Four new exam rooms and dictation room.  New stainless and granite kitchenette.  State-of-the-art network infrastructure meets HIPPA & PCI DSS compliance standards.  Digital X-ray room with PACS in each exam room available as an option.  Located in close proximity to LIE, Northern State Pkwy, and Vets Memorial Hwy. Contact us at (631) 486-8855;  Please see our listing: https://www.loopnet.com/Listing/517-Route-111-Hauppauge-NY/15298633/



Office Rental 30 Central Park South.
Two fully equipped exam, two certified operating, bathrooms and consultation room.  Shared secretarial and waiting rooms. Elegantly decorated, central a/c, hardwood floors. Next to Park Lane and Plaza hotels. $1250 for four days a month.Available full or part-time. 212.371.0468drdese@gmail.com.


 

Rare Find — Great Office Share
Wonderful office share in terrific location at great price. Available Monday, Wednesday, Friday and weekends. Choice of smaller windowed consultation room with adjoining exam room or big windowed consultation room with one or two exam rooms. Beautiful bright rooms, lovely reception area and front . First-rate building on 58th Street between Park and Lexington. Rent by day (about $180). Front desk and office management available if needed, along with many other amenities, including internet, ultrasound, EMG Kitchen, optional C Arm. Willing to make changes for new tenant. Call 646-642-0700.


Are You Trying to Lease Your Medical Office or Sell Your Medical Practice? Trying to Sell New or Used Medical Equipment?
Clineeds, the new online platform designed for medical providers. With Clineeds you can lease your medical officeshared your office spacebuy and sell used medical equipment, or post healthcare job opportunities. LISTING IS FREE! Why wait? Click here to sign-up: www.clineeds.com/sign-up

PHYSICIAN OPPORTUNITIES

Multi-Specialty Medical Office Looking To Bring On More Doctors
New York Medicine Doctors Center is a multi-specialty Medical Agency networking some of the best medical professionals and specialists in the New York Tri-State area. Our offices currently serve both Manhattan and Queens, providing a variety of advanced technological on site testing, imaging, and services for the most rapid results.

We are actively looking to bring on board an array of Doctors specializing in Primary Care, Gynecology, Gastroenterology, ENT, Urology, Podiatry, and Dermatology.

As we continue to broaden our medical services in both locations, we also provide individualized on-boarding contracts with health benefits, tailored in-house marketing and advertising, practice management assistance, and in house team of administration dedicated in serving any and all concerns whether it be credentialing or equipment related tasks.

If you are interested in joining our growing network, please do not hesitate to contact us

at 718-360-9550 or 212-931-8533. Our direct email is drshusterman@gmail.com

Primary Contact: Oksana


 

 


Nurse, RN Utilization Review Full-Time-Westbury, NY (In-office position only)
Excellent opportunity for a RN who is seeking a position performing utilization review.  We require 1-2 years recent experience in hospital and/or insurer utilization review and experience using Interqual criteria and/or MCG Guidelines. Data entry/PC skills a plus. Benefits include 401(k), paid vacation and holidays. Send resume and salary requirements to: Empire State Medical Scientific and Educational Foundation, Inc. Human Resource Department e-mail: chunt@mssny.org  Fax: (1-516) 833-4760 Equal Oppty Employer M/F


CALL FOR RATES & INFO. CHRISTINA SOUTHARD: 516-488-6100 ext. 355

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 


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