Charles Rothberg, MD
|June 23, 2017
On Thursday, a medical liability expansion bill, fast-tracked by a select group of New York State Republican Senators was delivered to their peers amid a totally unacceptable veil. While quite early to deconstruct this ‘failure’ for the house of medicine, some important lessons are evident.
Healthcare is such a vital issue to the people of our nation that any legislative endeavor regarding this complicated topic deserves to be thoroughly scrutinized to assure it provides the highest standards possible prior to its enactment.
In that spirit, I must question how it is that any bill be considered if it has not been made available for public review and comment prior to its presentation on the floor of the Senate, or worse—after it has been voted into law?
To operate in obscurity is wrong. The public wants to know what doctors think. With rare exception, the public still trusts us to protect their interests—especially their health.
In that spirit, the MSSNY Council considered the manner in which the United States Senate has been crafting its ACA replacement – behind closed doors! While the Senate did (finally) release the language of the bill just yesterday, it plans to vote as early as next week, an unreasonably short time for public—let alone expert comment. It was the consensus of the MSSNY Council to advise Congress and the public of our desire to review and comment on health legislation, and to recommend that a similar position be taken by the American Medical Association.
Political Not Medical
I should say that at certain times, such as deliberations regarding investigations or national security, “closed door” deliberation may be appropriate. But in health care deliberations, the motive of closed-door deliberation is purely political. The result will be a political rather than a medical solution—not likely the best service to our sector or to the public we serve.
Our objections to the closed door manner of the Senate proceedings on health care is being disseminated to our entire physician membership, our patient population, and all media to advise the population-at-large of our concerns for their health and welfare—today and in the future.
Expansion of Liability Issue
Our position on the statute of limitations expansion bill that was passed on Wednesday is that it is a poor solution. We still require comprehensive laws to serve all stakeholders in the long term.
Lavern Wilkinson (of Lavern’ Law) was treated at a public hospital, a venue that enjoys a shortened 15-month statute of limitations. The remedy for Laverne could have extended the statute for public hospitals to 30 months (like all non-public venues). But instead, the new law unnecessarily expands liability for all physicians and all hospitals. There is major dysfunction operating here
You may recall that in 2008-2009, the New York Medicaid Redesign Team delivered 79 recommendations, including medical liability reform. Originally, MRT was to be enacted as a package up or down. But ultimately only one provision was excluded, tort reform. The other 78 became law and the genesis of DSRIP!
Both the Senators in Washington and those in the New York legislature cross paths in their exclusion of input from the major healthcare stakeholders—physicians and hospitals.
1) We urge Governor Cuomo to veto this legislation and to then bring parties together to pass comprehensive, not one-sided medical liability reform.
2) We urge congress to solicit, not exclude input from the local health care experts – our physicians.
Charles Rothberg, MD
Please send your comments to email@example.com
As you may be aware, the State Legislature ended its formally scheduled 2017 Legislative Session late Wednesday (though it is possible for them to return to Albany on a limited basis). Despite being besieged with numerous adverse proposals in the final weeks of Session, we are happy to report that the Session ended with MSSNY, working together with many other allies, able to assure that the scores of the adverse legislative proposals were rejected, including legislation that would have:
- Enabled corporate-owned Retail Clinics staffed by physician extenders
- Significantly expanded the information required to be included in the Physician Profile
- Limited injured worker choice of physician in Workers Compensation, expanded the role of Non-Physicians under Workers Compensation, and eliminated the county medical society role in processing applications
- Imposed burdensome new requirements on the prescribing of pain medications to patients;
- Required urgent care office –based surgery centers to use electronic health records
- Expanded the scope of practice of numerous non-physicians, including podiatrists, Nurse-anesthetists, optometrists, psychologists, chiropractors, and naturopaths; and
- Formally permitted non-physicians to perform laser hair removal with virtually no physician oversight.
Moreover, working with many other public health groups, we scored an important public health victory by assuring that e-cigarettes are regulated similar to other tobacco products.
However, as you will note below, we are very disappointed that the Legislature chose to pass a one-sided liability expansion bill at a time when physicians and hospitals already face exorbitant liability costs, and potentially significant cuts from Washington. With Governor Cuomo waging on aggressive public campaign to warn the public about the threat to our health care system and New Yorkers generally if cuts arising from various proposals to repeal the ACA are enacted, please let him know that further increases in liability costs would make these health care access problems even worse.
We thank the many of you who responded to our call throughout the Session to contact your legislators when requested.
Your MSSNY Division of Government Affairs Team
Tell Governor Cuomo to Reject Medical Liability Expansion Bill and Call for Comprehensive Liability Reform
All physicians are urged to call Governor Cuomo at 518-474-8390 and send a letter here Click Here:
urging that he veto a purported “cancer only” medical liability statute of limitations expansion bill (S.6800/A.8516) that passed the Legislature over the strong objections of MSSNY, the specialty societies, the hospital industry and MLMIC. Please urge that instead he work towards enacting comprehensive medical liability reform.
The bill, introduced in the final days and passed in the final hours of the 2017 Legislative Session, would expand the medical liability statute of limitations for cases involving “alleged negligent failure to diagnose a malignant tumor or cancer”. The bill would permit lawsuits 2.5 years from the “date of discovery” of such alleged negligence, up to an outside limit of 7 years.
While it is likely that a more narrowly focused bill will reduce the premium increase needed for this legislation (if signed) from the 15% projected to be needed for an earlier version of this bill, there is great ambiguity in the language that could generate significant litigation as to which cases it would apply. Moreover, the bill does not just apply to cases that may arise in the future but has a retroactive impact. The ambiguities are likely the result of the bill being “rushed into print” late Sunday night to meet the constitutional “3-day aging” requirement before a bill can be considered by the Legislature, as the Legislature was planning to adjourn its 2017 Session Wednesday.
The bill passed the State Senate by a 56-6 vote (those voting no included Senators Hannon, Klein, Murphy, Ortt, O’Mara, and Valesky) and the Assembly by a 112-27 vote (to see how your Assembly member voted, Click Here:
In response to the passage, Dr. Rothberg issued the following statement (Click Here) expressing MSSNY’s great concerns with proposals to expand liability when are in desperate cost decreases:
“New York’s physicians are extremely concerned about the ultimate impact to New Yorkers’ access to care if the statute of limitations expansion bill (S.6800/S.8516) considered by the Legislature today is ultimately signed into law. Many New York hospitals and physicians are already struggling to keep their doors open.
New York State has already earned the dubious distinction as the absolute worst state in the country in which to practice medicine, in large part due to its overwhelming liability costs. The bill will add significantly to these costs that have already driven physician after physician out of private practice, and in many cases driving them out of New York altogether. It will also discourage countless others from coming here to practice. We urge Governor Cuomo to veto this legislation and bring parties together to pass comprehensive, not one-sided, medical liability reform. New Yorkers’ access to health care is at stake.”
- Rothberg’s concerns here noted in both the Daily News and Crains Health Pulse.
We thank all of you who took the time to contact their legislators over the last several days to oppose these and the myriad of other liability expansion bills that were also being aggressively pushed by the Trial Bar in the Session’s final days (for example, the attorney contingency fee limit removal was also under serious consideration but was defeated: Click Here.
Again, please urge the Governor to veto the bill and encourage your colleagues to do the same! Please let the Governor how patient access to care will be harmed if this bill were to be enacted. (DIVISION OF GOVERNMENTAL AFFAIRS)
New York State Legislature Approves Bill Banning E-Cigarettes From Bars, Restaurants
The New York State Legislature has approved A. 516A/S. 2543A expanding the state’s Clean Indoor Air Act so that it now bans e-cigarettes from bars and restaurants. Assembly member Linda Rosenthal and Senator Kemp Hannon were the sponsors of the measure. The Medical Society of the State of New York strongly supported this measure and worked with other health organizations on the bill’s passage. Governor Andrew Cuomo, who proposed the measure in his budget earlier this year, is expected to sign the bill. (CLANCY)
Legislature Does Not Take Up Retail Clinic Legislation
The Legislature ended its regularly scheduled session Wednesday night without taking action on legislation strongly opposed by MSSNY (A.958, Paulin) that would permit corporate-owned retail clinics, which would have veered New York away from its long history of opposition to corporately owned care delivery. Big box store interests were aggressively pursuing this legislation. The bill advanced from the Assembly Health Committee to the Assembly Codes Committee earlier this year, but moved no further. This legislation was also opposed by the New York State Nurses Association.
Your membership yields results and will continue to do so. When your 2017 invoice arrives, please renew. KEEP MSSNY STRONG!
Anti-Physician Workers Compensation “Reform” Proposals Not Taken Up
The Legislature left Albany without taking action on legislation (A.8387, Pretlow and S.6349, Alcantara) that could have significantly impaired injured workers access to care from WC-authorized physicians including giving greater discretion to the Board to penalize physicians, expanding the scope of numerous non-physicians to treat injured workers without requiring coordination with a physician, and limiting the ability of your county medical society to assist physicians in completing applications to become WC-authorized.
Moreover, MSSNY expressed concerns that the bill does nothing to address the myriad of administrative hassles that physicians have experienced with the Workers Compensation system that have forced many physicians to leave the program. Similar legislation was considered during negotiations of the State Budget, but was ultimately rejected. Discussions on this topic are likely to continue over into next year.
Legislature Does Not Take Up Bill to Empower Non-Physicians to Perform Laser Hair Removal
The Legislature left Albany without taking action on legislation (S.6088-A, Savino/A.7977-A, Paulin) to expressly permit estheticians and others to perform laser hair removal with only minimal physician oversight. The bill, strongly opposed by MSSNY and other specialty societies, had advanced from the Senate Consumer Protection to the Rules Committee, but moved no further.
MSSNY has adopted policy that vigorously opposes certification of non-physicians (including non-medical personnel) to perform laser and intense pulsed light source skin enhancement procedures. That is because lasers have the potential to cause painful burns and permanent scarring if not used properly. With laser hair removal largely unregulated in New York, legislation to provide strong physician oversight of this process would be appropriate. However, the only physician oversight this legislation would have required is a once per year audit of policies and procedures.
Legislature Rejects Scope of Practice Changes
Working together with the affected specialty societies MSSNY was successful in convincing the legislature to reject various bills that would have expanded the scope of practice for various professions. These bills include:
- Certification of Certified Registered Nurse Anesthetists (CRNAs)
A.442 (Paulin) / S.1385 (Gallivan) – This measure would provide for the certification by the education department of certified registered nurse anesthetists (CRNAs). Because this bill fails to define a scope of practice we had conserns that it could have given the Education Dept authority to enable independent practice for CRNA’s.
- Broadens scope of practice of dentistry
A.4543 (Morelle) / S.3551 (Golden) – This measure would permit dentists to perform a wide range of medical surgical procedures involving the oral and maxillofacial area. This bill would expand the current scope of practice for dentist which is currently limited to the oral and maxillofacial area relating to restoring and maintaining dental health.
- Podiatric Scope of Practice
A.1880 (Pretlow) – This bill would expand the scope of practice of podiatrists to allow podiatrists to “diagnose, treat, operate or prescribe for cutaneous conditions of the ankle to the level of the distal tibial tuberocity” (knee).
- Allows PA’s to Operate Fluoroscopy Imaging Technology
A.4716 (Gottfried) -This bill would allow physician assistants (PAs) who have completed a training program approved by the Department of Education to operate fluoroscopy imaging technology as part of a diagnostic or treatment procedure.
- Psychologists Prescribing
A.2851(Mcdonald) / S.4498 (Lanza) – would permit Psychologists to prescribe medications
Assembly and Senate Pass Legislation Designed to Regulate Biosimilar Substitutions
The Assembly and Senate passed legislation (S.4788-A/A.7509-A) this week that would establish rules regarding the substitution of interchangeable biological products. While New York State law regulates the substitution by pharmacists of generic drugs for their branded counterparts, the existing law has not been updated to set forth the circumstances under which a biologic products can be substituted with a FDA approved interchangeable biologic. Importantly, it would prohibit a pharmacist from substituting an interchangeable biological product (as defined by the FDA) prescribed by a physician if the physician affirmatively requests that the product be dispensed as written.
If the physician does not specify that the biological medication should be dispensed as written, then the pharmacist may substitute an interchangeable biological product but only if the pharmacist provides notice to the physician within 5 days of the substitution. It would also establish a 5-year sunset on these provisions.
New York State Legislature Approves Bill Allowing Medical Marijuana For Treatment Of PTSD
The New York State Senate approved legislation A.7006/S.5629, sponsored by Assembly member Richard Gottfried and Senator Diane J. Savino, that allows medical marijuana to be used to treat post-traumatic stress disorder [PTSD]. The Assembly had passed the bill in May. The measure now heads to Gov. Andrew M. Cuomo for signature. The Medical Society of the State of New York opposes the use of marijuana in treatment for PTSD. Furthermore, MSSNY has expressed concerns about the law due to possible federal prosecution of physicians.
Public Health Issues
Sepsis Awareness Program – The New York State Legislature has passed a bill which would establish a sepsis awareness, prevention and education program to educate students, parents and school personnel about sepsis awareness on sepsis has passed the state Assembly.
This measure, A. 6053/S.4971, sponsored by Assemblywoman Catherine Nolan and Senator Carl Marcellino, also amends New York State’s amends Public Health Law to require that information on sepsis be part of course work in infection control practices already taken by all healthcare providers and would require that this coursework be completed on or before July 1, 2022.
Raise the Age for Tobacco Purchase—S.3978/A.273, which would increase the purchasing age for tobacco products from eighteen to 21 years of age remained in the Assembly Codes Committee and the Senate Finance Committee. MSSNY continues to support this measure.
Three Day Limitation on Pain Medication— There was no action taken on A. 7741/S.6246, sponsored by Assemblyman John McDonald and Senator Kemp Hannon, which would have limited the initial prescription of a Schedule II or III for the alleviation of acute pain from a seven-day supply to a three-day supply for someone suffering from acute pain. Most importantly, patients throughout New York State who are suffering acute pain, such as acute postoperative pain; acute back or chest pain; acute pain related to an injury, post-herpetic neuralgia, or acute pain related to disease or condition, could be significantly impacted. The Medical Society of the State of New York continues to strongly oppose this measure.
Conversion Therapy—A.3977/S.263, sponsored by Assemblywoman Deborah Glick and Senator Brad Hoylman, would prohibit mental health professionals from engaging in sexual orientation change efforts with a patient under the age of eighteen years and expands the definition of professional misconduct with respect to mental health professionals. The measure had passed the New York State Assembly, but remained in the in the Senate’s Mental Health and Development Disabilities Committee. (CLANCY)
Bill Passes to Prohibit Medical Record Charges When Needed to Support a Patient’s Government Benefit Application
The Senate and Assembly passed legislation (S.6078, Valesky/A.7842, Gottfried) that would prohibit health care providers and entities from charging patients for copies of medical records when such records are needed “for the purpose of supporting an application, claim or appeal for any government benefit or program”.
The purpose of the legislation is to respond to numerous complaints lodged by patients where they were charged for medical records necessary to assist applications and appeals for government programs assisting lower income patients such as Social Security Disability Insurance (SSDI) and the Supplemental Nutritional Assistance Program (SNAP), despite provisions in existing law that prohibit charging a fee for medical records where a patient is unable to pay.
MSSNY had expressed concerns that the terminology “any government benefit or program” was too broad, and suggested that the bill be amended to identify specifically those low-income government benefit programs to which this fee prohibition should apply. However, that change was not made. (AUSTER)
US Senate Releases Its Own Health Care Reform Proposal
The US Senate this week released its own proposal to repeal substantial portions of the Affordable Care Act, entitled the “Better Care Reconciliation Act of 2017”, with a vote possibly before the July 4 recess.
While the framework of the legislation mirrors the American Health Care Act (AHCA) passed in May by the US House of Representatives, there are some important differences, including with respect to the length of time for the existing Medicaid expansion to be phased out, as well as the distribution of the tax credits to be provided to subsidize the cost of health insurance coverage.
The bill would continue the current tax credit structure provided under the ACA through 2019. Beginning in 2020, advanceable refundable tax credits would be available for those with incomes up to 350% FPL, down from the existing 400% FPL. It would not base the size of the tax credit on a person’s age, as was proposed in the House’s AHCA bill. The benchmark for determining the subsidy would be based on 58% of a health insurance plan’s actuarial value.
Similar to the House’s AHCA legislation, it would contain provisions supported by MSSNY to eliminate the current limitations on a person’s contribution to their HSA, as well as delaying until 2026 enforcement of the “Cadillac Tax” on comprehensive health insurance coverage.
However, of significant concern, it would repeal existing cost-sharing subsidies similar to the AHCA. That would have the effect of repealing funding for New York’s Essential Plan, which provides low out -of-pocket cost coverage for over 600,000 New Yorkers who make between 138-200% FPL. It would also phase out from 2021-2024 the existing option to have Medicaid cover individuals who make unto 138% FPL.
Moreover, the bill also contains the “Faso-Collins amendment” contained in the AHCA that would shift $2.3 billion in county Medicaid costs to New York State, which could result in additional cuts or an expansion of risk-based payments in Medicaid to make up the difference.
Next week, Governor Cuomo will host a series of regional forums across New York State to discuss the potential impact of these proposals on New York’s health care system and its citizens. MSSNY Treasurer and Cobleskill Internist/Pediatrician Dr. Joseph Sellers will participate at the forum on Monday, June 26 in Hudson. The Governor issued a statement on Thursday expressing great concerns with the US Senate’s proposal. MSSNY working together with the AMA and state medical societies across the country are continuing their review of this proposal and will follow up with more detailed information about this proposal and whether the Senate will be able to pass it.
CMS Proposes Simplifications to the MIPS Program to Ease Physician Compliance
This week CMS proposed a revised rule implementing the Medicare Quality Payment Program (QPP) as required under MACRA. According to a summary provided by the AMA, CMS is proposing a number of policies to help small practices, including a significant expansion of the “low-volume” exemption threshold to $90,000 (up from $30,000) or less in Medicare Part B allowed charges OR 200 or fewer Medicare Part B patients (up from 100 patients).
CMS estimates that, under this proposed rule, more than 94% of eligible clinicians would earn either a positive or neutral payment adjustment.
In addition to increasing the low volume exemptions, other highlights articulated by the AMA include:
Additional accommodations for small practices
- Creates virtual groups to assist small practices;
- Adds 5 bonus points to the final MIPS scores for practices of 15 or fewer clinicians; and
- Adds a hardship exception from the Advancing Care Information (previously Meaningful Use) category for practices of 15 or fewer clinicians.
Advancing Care Information Category
- Allows the use of 2014 edition certified electronic health records technology (CEHRT) past 2017 – CMS will not mandate that physicians update their EHRs in 2018;
- Permits physicians to continue to report on Modified Stage 2 measures in 2018 instead of new Stage 3 measures.
- Increases the quality performance category weight to 60% in 2018 (due to the Cost category weight remaining at zero in 2018);
- No additional cross-cutting measure requirements added in 2018;
- CMS proposes a zero weight for costs again in the 2018 performance/2020 payment year, which would rise to 30% for 2019/2021.
- Physicians will receive information on how they would have scored under the two current value-based modifier measures (total costs per beneficiary and spending from 3 days before to 30 days after hospital admission)
Improvement Activities (IAs)
- CMS continues to allow physicians to report on IAs through simple attestation;
- The proposed rule creates stability in program requirements by not changing the number of IAs physicians must report; and
- It also develops additional IAs, including adding two activities related to diabetes prevention programs, and clarifies existing IAs to be inclusive of additional activities.
For more information, Click Here.
DOH Attestation Process for Pain Management CME Must Be Completed by July 1, 2017! One WEEK LEFT!
The New York State Department of Health has announced the attestation process for prescribers required to complete Pain Management CME. Prescribers must attest to the completion of the pain management, palliative care and addiction course work or training by July 1, 2017, and again every three years thereafter. The prescriber should only attest after completion of at least three hours of course work or training covering all eight topics.
A prescriber with a Health Commerce System (HCS) account will attest online using the Narcotic Education Attestation Tracker (NEAT) application. Complete the steps to access the NEAT (Narcotic Education Attestation Tracker) application in the NYS Health Commerce System (HCS):
- Log into the HCS
- Under “My Content” click on “All Applications”
- Click on “N”
- Scroll down to NEAT (Narcotic Education Attestation Tracker) and double click to open the application. You may also click on the “+” sign to add this application under “My Applications” on the left side of the Home screen.
Complete the steps to ATTEST to the completion of the education requirement. A full set of instructions can be found here.
Prescribers that do not have access to a computer can request a paper attestation form by calling the Bureau of Narcotic Enforcement (BNE) toll-free at 1-866-811-7957. They may then complete the form and return it by mail to the address provided in the form. The Bureau of Narcotic Enforcement has also released a Frequently Asked Questions (FAQs) on the prescriber mandate. A copy of the FAQs can be found here.
In certain limited circumstances, the New York State Department of Health may grant an exemption to the required course work or training to an individual prescriber who clearly demonstrates to the department that there is no need to complete such training. Exemptions will be granted only in very limited circumstances, and not solely on the basis of
Economic hardship, technological limitations, prescribing volume, practice area, specialty, or board certification.
Prescribers may apply for an exemption through the Health Commerce System. Further information may be obtained by contacting BNE at 1-866-811-7957 or firstname.lastname@example.org. (CLANCY)
Physicians Have One Week To Meet the Pain Management Mandatory Education By July 1, 2017
The Medical Society of the State of New York Pain Management, Palliative Care and Addiction modules are now available on-line here. These modules are being offered free of charge to all MSSNY members. Physicians who are new users to the MSSNY CME site will be required to register as a new user.
As a new user, physicians and non-physicians will be required to enter fields that include: position; name (the name should be what you want to appear on the CME certificate); email address; and then create a password. MSSNY members who encounter a payment page or have difficulty registering, please email email@example.com for technical support. Directions for creating a new account/or logging in can be found here. Non-MSSNY physicians will be charged $50 per module.
The MSSNY CME is a new site and while many MSSNY members have an account with mssny.org a MSSNY member may not necessary have an account with cme.mssny.org If in doubt, try to create an account and if it tells you that the email address is unavailable or in use, an account exists. Passwords can be reset if you don’t know it.
Physicians who have previously had an account at the MSSNY CME site will need to log into the site using their email and password. The MSSNY CME site provides the ability for physicians and other prescribers to view the archived webinar at their leisure, take the required test, and download their certificate. The online program covers all eight topics required in the New York State statute. MSSNY developed the program with the NYS Office of Alcoholism and Substance Abuse Services (OASAS). MSSNY is listed as an accrediting organization by the NYS DOH Bureau of Narcotic Enforcement. Information on the three CME modules is available here. Additional information or technical support may be obtained by contacting firstname.lastname@example.org.
Council Notes from June 22, 2017
- Discussion of the effects in the near future of hospitals and physicians regarding the expansion of liability law
- MSSNY Council Don Moy advised physicians that they should keep medical records dating back 10 years
- MLMIC reported that the Berkshire Hathaway deal was moving forward without problems
- MSSNY won two contested elections at the AMA –Dr. Robert Goldberg , DO, AMA Council on Medical Education; Jerry Cohen MD was reelected to the AMA Council on Constitution and Bylaws;and Meena Davaluri, MD was elected to the Resident slot on the Council on Medical Service. MSSNY now has seats on all AMA Councils that provide guidance on the policies being adopted. AMA Delegation Chair Dr. John Kennedy thanked the 38 delegates and alternates who came to the AMA Annual Meeting in Chicago.
- Joe Sellers, MD, PAC Chairman said “too many doctors remain on the sidelines with fewer giving even more support” to the PAC. He said that “Doctor to Doctor” solicitation is the most effective was to recruit new PAC members and that the PAC would be happy to meet with small groups throughout the state in an effort to increase PAC membership.
- Donald Moy, Lawrence Kobak and Thomas Gallo from Kern Augustine will be serving as MSSNY General Counsel.
- MSSNY Task Force on Physician Stress and Burnout Chair Michael Privitera, MD, made recommendations on the Task Force’s findings for further research collaboration for data analysis
- Parag Mehta, MD, Commissioner of Membership, presented a resolution about alternate types of memberships for Nonaffiliated Groups of Physicians
Anthem: Minor Conditions No Longer Covered in ED as of July 1
Anthem recently announced that as of July 1, it will no longer cover emergency department visits for most instances of minor conditions that could “safely [be] treated in less acute facilities.” Jay Moore, CMO for Anthem Blue Cross Blue Shield (BCBS) Missouri, said the policy has long been part of coverage contracts, but it has not always been enforced.
A spokeswoman for the insurer, Said its goal was to control costs by steering patients away from expensive ER services and toward doctor offices or urgent care clinics when those are more appropriate settings for treatment. She said the policy wouldn’t apply when the patient is 14 or younger, an urgent care clinic isn’t located within 15 miles, or the visit occurs on a Sunday or holiday. She said it’s aimed at manifestly minor ailments — “If you had cold symptoms; if you have a sore throat. Symptoms of potentially more serious conditions, such as chest pains, could be seen at the ER even if they turn out to be indigestion.” (CBS News & LA Times)
Buffalo Health Centers: ACA Will “Strip People of Their Health Insurance”
The Buffalo (NY) News (6/21) reports that “leaders of Kaleida Health, Erie County Medical Center and the University at Buffalo issued a joint statement this week warning that the bill, known as the American Health Care Act, ‘will ultimately make health care more expensive for patients, doctors and hospitals’” or “strip people of their health insurance, ‘either through prohibitively high premiums for people with pre-existing conditions, elimination of the Medicaid safety net or forcing patients into severely underfunded high-risk pools.’”
The group also said that two key areas of western New York’s economic recovery are medical education and biomedical research, to which “potential cutbacks that stem from the legislation will pose a challenge.”
MSSNY Members Only: Unpaid Claims
We Can Help!
In 2016, MSSNY’s Ombudsman Program was successful in recovering $89,815.79 for physicians who had reached a stalemate regarding unpaid claims. From January to June of 2017, the program recovered $121,441.68 for our members who availed them of the Ombudsman service.If you are a member in good standing, this service is available to you for FREE!For further information, call 516-4886100 ext. 334 or 332.
AMA: New Video Shows Physicians How to Avoid Medicare Payment Penalties
The AMA and the M are looking to help physicians avoid a negative Medicare payment adjustment in 2019—an effort that may be particularly relevant to physicians who have not previously participated in Medicare reporting programs, and/or physicians in smaller practices. The AMA has designated the week starting June 26, 2017 as Pick Your Pace Week, and will broadly disseminate simple instructions on how to report “one patient, one measure, no penalty.” The new materials, available on the AMA website, include:
- A short video: One patient, one measure, no penalty: How to avoid a Medicare payment penalty with basic reporting.
- A sample CMS-1500 claim form
- Links to quality measures on the CMS website
A link to the CMS MIPS eligibility tool
Important Notice Regarding Handwriting on Claims Submitted to Medicare
Beginning 7/1/2017, NGS will return to the provider any paper claim submitted with handwriting on the face of the claim that is not a signature field, (i.e., Items 12, 13, or 31). A notice will be attached to the front of the returned claim and you will need to submit a new claim.
The Centers for Medicare & Medicaid Services (CMS) Internet-Only Manual (IOM) Publication 100-04, Medicare Claims Processing Manual, Chapter 26, Section 30, “Printing Standards and Print File Specifications Form CMS-1500” (700 KB) contains the printing specifications for the CMS-1500 claim form. These printing specifications do not provide instructions to submit handwritten claims. Please use this CMS IOM reference to ensure you are completing paper claims correctly.
We understand this may require some substantial changes to your office practices and we at NGS have two alternatives to handwritten paper claims that would be of little cost to your practice:
NGSConnex is our web-based self-service portal, free of charge, and available through Internet access. You can login to NGSConnex and submit claims to us. In addition to claims submission, NGSConnex has other useful functions like verifying Medicare entitlement, submitting appeals on claims, and viewing and downloading your remittance advice. Take this opportunity to get started on NGSConnex today!
Electronic claim submission and other transactions submitted electronically process considerably faster than paper submission. The Electronic Data Interchange (EDI) page on our website, explains how to enroll and what capabilities your office needs to be able to submit electronic claims.
$7M in Overpayments on Electronic Submissions; Recovery Attempt Expected
In the attachment please find the latest report from the Dept. of Health and Human Services, Office of the Inspector General, regarding their recently completed analysis of the Electronic Health Record Incentive Program. The report basically outlines their approach in reviewing the program through which participants received billions in incentive payments for adoption of electronic health records.
They are now asserting that upwards of $729,424,395 (amount reached through extrapolation) of those payments could have been made in situations that did not actually meet the necessary requirements of the program. Therefore, you should be aware that a recovery attempt might be undertaken to get back some of those funds previously paid out to early adopters. More information here.
Only 25% of Youth with Opioid Use Disorder Receive Buprenorphine or Naltrexone
According to a JAMA Pediatrics study, only 25% of youth with opioid use disorder receive buprenorphine or naltrexone. Guidelines from the American Academy of Pediatrics recommend that clinicians consider offering pharmacotherapy to adolescents with opioid use disorder. Using a health insurance database, researchers tracked the treatment of youth aged 13 to 25 who were diagnosed with opioid use disorder between 2001 and 2014.
The proportion of patients with opioid use disorder who received buprenorphine or naltrexone increased from 3% in 2002 to 32% in 2009, but by 2014 it had fallen to 28%. Meanwhile, prevalence of opioid use disorder in this age group rose more than fivefold.
The authors and editorialists both note that few pediatricians have the necessary waiver to prescribe buprenorphine. “These findings suggest that provision of [buprenorphine and naltrexone] is not keeping up with the growing need for these treatments among youth.”
Physicians Invited to Meaningful Use MIPS Webinar
Physicians are invited to CAPG Educational Series 2017 webinar with CMS, Advancing Care Information: How to Implement the New Meaningful Use Component of MIPS, on July 7. Space is filling quickly, so please make sure to reserve your place – register now! CMS will provide an overview of the substantive changes to the program from meaningful use to ACI. Additionally, CMS will answer audience questions on the specific ACI component of the Quality Payment Program.
CAPG will have its members cover key implementation steps for physicians and physician organizations starting on this important transition. Our members will tell the audience about the rationale behind their strategy and any implications this will have on their organization.
Please visit our Educational Series web page to learn more and register here for July’s webinar.
Register: CMS Webinar on Proposed Rule for Year 2 of the Quality Payment
Join CMS Webinar on Proposed Rule for Year 2 of the Quality Payment Program
On Monday, June 26 at 1:00 p.m. ET, the Centers for Medicare & Medicaid Services (CMS) will host an overview webinar on the Medicare Quality Payment Program Year 2 proposed rule.
Join the webinar to hear CMS policy experts provide an overview of proposed participation requirements for the second year of the Quality Payment Program.
- Title: Medicare Quality Payment Program Year 2 Proposed Rule Overview
- Date: Monday, June 26
- Time: 1:00 – 2:30 p.m. ET
- Registration page, click here.
- Space for this webinar is limited. Register now to secure your spot. After you register, you will receive a follow-up e-mail with step-by-step instructions about how to log-in to the webinar.
- The audio portion of this webinar will be broadcast through the web. You can listen to the presentation through your computer speakers. If you cannot hear audio through your computer speakers, please contact CMSQualityTeam@ketchum.com.
- There will be a Q&A session if time allows. However, CMS must protect the rulemaking process and comply with the Administrative Procedure Act. Participants are invited to share initial comments or questions, but only comments formally submitted through the process outlined by the Federal Register will be taken into consideration by CMS. See the proposed rule for information on how to submit a comment.
Office Space Available within Beautiful Medical Spa in Woodbury NY
Seeking an MD that is looking to rent space in Woodbury, NY within a beautiful, state-of-the-art Medical Spa. Located in the Woodbury Common with high profile brands such as Soul Cycle, Athleta, Chop’t and more, this area is exclusive, elite and high-traffic. Rental space can include from 1 – 4 rooms with office space, shared reception and retail area. Size of area and price are negotiable. Great opportunity to share like-minded patients. email@example.com.
Medical Suite to share- located at 1201 Northern Blvd, Manhasset. The medical space includes 4 exam rooms and consultation rooms. Direct access to office- NO STEPS. Conveniently located between St.Francis Hospital and NS/LIJ Hospitals. For more information, please call 516-365-4616 or email RSwe777@aol.com
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Position Available for Critical Care Physician to Join Established Practice in Nassau County, Long Island, NY.
The Physician will join our existing team of Board-Eligible/Board-Certified Intensivists. This is a PT/FT position including both nocturnal and daytime responsibilities. The Physician will work with a dedicated group of highly trained mid-level practitioners, respiratory therapists and nurses to provide Critical Care at St. Francis Hospital in Roslyn, NY. St. Francis was ranked one of the top 10 hospitals in the nation for Cardiac Care and is top rated nationally in seven other adult specialties.
We are expanding our Intensivist Program and are expecting to add an Intensivist to our group.
Nassau Chest Physicians, P.C. was established in 1978 to provide state-of-the-art care to patients with pulmonary diseases on Long Island. We have expanded our practice to include 8 Intensivist/Pulmonologists and 5 pure Intensivists. Since 2006, we have assumed management of Critical Care services at St. Francis Hospital-The Heart Center in Roslyn, NY.
St. Francis Hospital is New York State’s only specialty designated cardiac center and is a nationally recognized leader in cardiology and heart surgery, ear-nose-throat, gastroenterology and GI surgery, geriatrics, neurology and neurosurgery. More cardiac procedures are performed at St. Francis than at any other hospital in New York State. The hospital is located on the North Shore of Long Island; approximately 30 minutes from Manhattan. The hospital combines unrivaled expertise in cardiovascular medicine with top-ranged nursing (AACN Magnet Award) to provide the very best in patient care.
In addition, St. Francis offers excellent Thoracic, Vascular, Oncologic, Neurosurgical, and Orthopedic Surgical Programs. We have a very active Emergency Department. The hospital offers the latest in technologies such as Therapeutic Temperature Modification, Impella, ECMO and LVAD. Our excellent and experienced medical staff supports strong medical and surgical subspecialty programs.
Aside from Certified Critical Care Nurses, many who have more than 20 years of experience and are expert at caring for this complex patient population, we have a growing pool of Intensivist mid-level practitioners who work hand in hand with our Intensivist physicians to coordinate the care of the critically ill patient, minister to them and perform procedures.
Of course, a New York License is required. J1 or H1 VISAS accepted.
Additional Salary Information: Salary and benefits are competitive and commensurate with experience. Interested applicants, send resume to: firstname.lastname@example.org
CALL FOR RATES & INFO. CHRISTINA SOUTHARD: 516-488-6100 ext. 355