MSSNYeNews: Raymond J. Donovan’s Good Name – January 17, 2019

Arthur Fougner MSSNY Presiident

PRESIDENT’S MESSAGE
Arthur Fougner, MD
MSSNY President

MSSNY eNews
January 17, 2020

Vol. 23  Number 3


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Colleagues:

In 1987, Reagan’s former Secretary of Labor Raymond J. Donovan was accused of corruption and mob connections in a case involving NY subway contracts. Needless to say, the press had a field day with a Reagan cabinet official linked to organized crime. After a brief trial, in which the defense called no witnesses, the jury quickly returned an acquittal on all counts. Following the verdict, Donovan famously asked, “Which office do I go to to get my reputation back?

In his State of the State, Governor Andrew Cuomo announced he was calling for streamlined physician discipline proceedings with transparency as well. While no details have been revealed as of yet, this seems at first blush, quite concerning. And sure enough, right on cue, the media is already jumping in. The Syracuse Post-Dispatch featured anecdotes of physicians’ criminal activity, damning with a broad brush. So, I call out the media here and now— “Balance, Reporters – You Need Balance.”

Let me assist in providing such balance. There are over 100,000 physicians in NY State. In 2016, about 10,000 reports were made to NY’s Office of Professional Medical Conduct. Out of those, about 300 resulted in serious actions. You read it right – 300 out of 10,000 or less than 3%. And the time it took was the result of painstaking investigation with full due process rights provided.

Again, without details, it is difficult to know just what cases would trigger this transparency or result in summary loss of license. A physician’s license can already be pulled if he/she is deemed an imminent threat to public safety. I am quite sure no one would argue. However, plastering a physician’s name on the front page of every newspaper in the state for any claim by a disgruntled patient is quite a different matter, especially before all the facts are known. The allegations against Donovan were serious, yet a jury quickly concluded after the prosecutors’ weak case that the indictments should never have been brought. Should all NY physicians be now treated as badly as Donovan? A claim of misconduct from the state is more than just a bad Yelp Review. It can be a career ending. Is this truly what the governor is asking for? Drop a dime and cover a doctor with slime?

In these days of record physician burnout, the last thing NY State needs is a Salem, Part Deux. Feel free to let me know how you feel. I urge everyone reading this to make plans to let all of Albany know how we feel on March 4.

We must all hang together for assuredly we will all hang separately.
Benjamin Franklin

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

Arthur Fougner, MD
MSSNY President


Capital Update

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The Week’s Legislative Podcast


SAVE THE DATE: MSSNY‘s Annual “Physician Advocacy Day” (3/4) Please Plan to be in Albany!
On January 8th the New York State Legislature returned to Albany for the 2020 session. As the New Year rings in and a new session begins, the need for physician advocacy and grassroots involvement is greater than ever. With the Governor’s State of the State Address teeing up items for potential concern such as Medicaid cuts, legalized marijuana and changes to the physician disciplinary process, but also supported reforms such as regulating PBMs and a flavored tobacco ban, it is imperative that physicians be in contact with their local legislators to ensure the physician community’s message is well-represented.

One opportunity is to participate in MSSNY’s “Physician Advocacy Day” that will be held on Wednesday, March 4th in the Lewis Swyer Theatre in the Egg located at the Empire State Plaza, Albany NY. Click here to register!

Join your colleagues from all around New York State and come to MSSNY’s Physician Advocacy Day to speak with your legislators and key policymakers to ensure they’re making the right choices for New York’s physicians and their patients.

A brief luncheon to which members of each House are invited to speak with their constituents will follow the morning program.  Please work with your County Medical Societies to schedule appointments for physicians to meet with their elected representatives.  If you have any questions/comments, please contact Raza Ali at rali@mssny.org.                  (ALI)


MSSNY Continues to Push Back Against Troubling Proposal to Bypass Disciplinary Due Process
With the Governor’s proposal to bypass important due process protections for physicians during disciplinary proceedings likely to be part of the 2020-21 Executive Budget, all physicians are urged to contact their legislators please click here to urge that the Legislature reject this proposal.

MSSNY President Dr. Art Fougner issued a statement (statement) and has been quoted in numerous media outlets across the State of New York (read here) that MSSNY is anxious to work to address gaps in the disciplinary process to protect the public, but also has strong objections to what has been publicly announced.

“Recognizing that there are enormous professional implications when disciplinary action is taken against a physician, or even when there has been an accusation, we must also ensure that fair due process is provided when a physician is accused of professional misconduct” Dr. Fougner stated. In fact, very few complaints made to the Office of Professional Medical Conduct ever result in any findings of misconduct.

More information about this proposal will be released next week.  (AUSTER)


Please Urge Your Legislators to Reject Unfair Medicaid Cuts
With the Governor’s soon to be released Executive Budget likely to include significant cuts to the State’s Medicaid program to address its estimated $4 billion Budget deficit, physicians are urged to contact their legislators (here) ask that they restore the recent 1% cut to Medicaid payments and to reject further cuts.

MSSNY recently joined on to a letter with several other physician and health care provider associations to protest the recent 1% across the Board Medicaid cuts announced New Years’ Eve.  MSSNY has publicly stated (MSSNY response) that these cuts are particularly offensive given the already grossly inadequate payments for physician care under Medicaid and Medicaid Managed Care in New York, and that New York physicians were not the beneficiaries of increases given last year to other health care sectors.  Indeed, New York Medicaid physician payment is a microscopic part of New York’s overall Medicaid Budget, with New York ranking 46th in the nation for reimbursement for Medicaid physician payment generally and 47th for primary care.   In short, the already tiny amount we currently spend for community based physician care helps to reduce costs in the Medicaid program, and should not be forced to share in the burden of addressing this deficit.

We must do more to assure patients have access to timely needed care.  However, this cut will do nothing to assure adequate care for New York’s neediest patients, and in fact, make this problem even worse.  Please urge your legislators to reverse the cuts, and to prevent future cuts (click here)                                                                                      (AUSTER)


MSSNY Joins Effort to Enact Comprehensive Law to Prohibit Flavored Nicotine and Tobacco Products
Gregory Threatte, MD, President of Albany County Medical Society and MSSNY President Arthur Fougner, MD participated in a press conference this week calling upon the NYS Legislature to enact bills that would ban all flavored e-cigarettes, including menthol. The groups also called for legislation that would also ban all flavored tobacco products, such as chewing tobacco and cigarillos. The press conference included Senator Brad Hoylman, Assemblymembers Linda Rosenthal, Rodneyse Bichotte and Tremaine Wright and other public health groups. MSSNY supports S. 428-B/A. 47-
A, sponsored by Senator Hoylman and Assemblywoman Rosenthal, which would prohibit the sale of flavored e-cigarettes, including menthol, and S.6809/A.8808, sponsored by Senator Hoylman and Assemblymember Bichotte, which would ban flavored tobacco products.  Passage of this legislation is now more critical since a state Supreme Court judge struck down New York State regulations called for by Governor Cuomo that would have banned flavored vaping products.  Physicians are encouraged to send a letter to their legislators and to the Governor about these bills through MSSNY Grassroots Action Center (GAC) here.
(CLANCY,CARY,ALI)  


NYS Senate Health Committee Moves Package of Bills on E-cigarettes
The Senate Health Committee this week moved several legislative e-cigarette proposals to the Senate Rules Committee.   S.428B, sponsored by Senator Brad Hoylman, would prohibit the sale and distribution of flavored e-cigarettes.  S.3905A, sponsored by Senator Gustavo Rivera, would regulate electronic cigarettes in the same way as tobacco products to prevent access to products by persons younger than 21 years. S.4249A, sponsored by the Senator Monica Martinez, would create restrictions for the locations of tobacco stores and electronic cigarette stores to be at least 200 feet away from a school or place of worship.              (CLANCY)


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Legislation to Expand Mandate For Pain Management For All DEA Prescribers on Senate Calendar
A measure that would expand the coursework under the current pain management requirement has moved to the Senate calendar.  S.7102, sponsored by Senator Brian Benjamin, would expand the topics within the three hour course to include techniques that would reduce the likelihood of overdose and spread of blood-borne diseases by those who use drugs; medications used for the treatment of addiction and information about becoming a buprenorphine prescriber.

The Medical Society of the State of New York is opposed to this measure.  MSSNY staff has been discussing the implications of this measure with Senators and Senate staff and its effect on prescribers who may have already taken course work to meet the requirement.   Physicians and other health care providers who have a DEA license were required to take a three hour course on pain management, palliative care, addiction that included the state and federal requirement for prescribing controlled substances, appropriate prescribing, managing acute pain, palliative medicine, prevention, screening and signs of addiction, responses to abuse and addiction and end of life care.

This requirement passed the Legislature in 2016 and physicians were required to have taken this program by July 1, 2017.  The law also requires that DEA prescribers take the course every three years—2020 is the start of a new cycle and physicians are again required to take this course.      (CLANCY)


MSSNY Opposes Legislation to Allow Estheticians & Others to Perform Laser Hair Removal
A bill (S.2834/A.821) that would allow estheticians, and others, to perform laser hair removal with only minimal physician oversight, was reported out of the Senate Committee on Consumer Protection at its first meeting of 2020, on Tuesday, January 14. MSSNY has long opposed this legislation as it would essentially legitimize a currently unregulated practice to perform a procedure that should only be done by an appropriately trained and educated individual, under physician supervision.

MSSNY indicated in its’ memo of opposition that it appreciates the intent of the legislation to increase safety and oversight and is working with the sponsors to make changes to the bill that establishes critical physician oversight and ensures patients’ safety.          (CARY)


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Partial Fill Prescribing Moves Forward in Senate
Legislation that would enable the dispensing of a partially filled controlled substances prescription, is moving forward quickly and is now on the Senate calendar for a vote.  The measure, S. 7115/A.9034, sponsored by Senator Gustav Rivera and Assemblymember John McDonald, would allow a prescriber to issue a partially filled prescription for a Controlled Substance II, III, IV, V to a patient.  The prescription would be recorded in the same manner as a refill and the remaining quantity of the prescription may be dispensed separately.

In 2016, Congress passed legislation that would enable partial fill prescription under the Comprehensive Addiction and Recover Act (CARA).  This state measure would allow New York State to conform to what is allowable under federal law.   A similar measure had passed during the 2019 legislative session, but was vetoed by Governor Andrew Cuomo.  This new bill addresses concerns expressed by the administration in its veto message. The Medical Society supports this measure and believes that it will help to reduce the amount of unused pain medication and will allow prescribers to help patients balance the need to relive pain with an adequate supply of medication.   (CLANCY)


Physicians Ordering Home Care for Your Patients – Are You Aware of the Impact of the New Medicare PDGM Methodology?
Physicians should be aware that Medicare has just implemented a new system for how it pays for patient home care services through a new methodology known as the Patient-Driven Groupings Model (PDGM).  The PDGM relies more heavily on clinical characteristics and other patient data to classify home health services into defined payment categories. While part of CMS’ effort to shift Medicare payment away from volume-based payment towards value-based payment, it could also produce new documentation responsibilities for physicians.

In particular, the PDGM will break up the standard 60-day episode of care into one of two 30-day periods. That means 30-day periods will be implemented as a basis for payment vs. the 60-day periods used now. Each 30-day period is grouped into one of 12 clinical categories based on the patient’s main diagnosis. Moreover, the PDGM will increase the number of payment groupings and unique case-mix potential from 153 to 432. The current system allowed for 153 combinations, but with PDGM each 30-day period can be categorized into one of 432 case-mix groups.

The Home Care Association of New York State has shared with MSSNY a suite of resources for physicians interested in learning more about the PDGM.  To read more about what physicians ordering home care services need to know about this program, please review: Brochure  and Physicians Toolkit Guide

At the November 7, 2019 meeting of the MSSNY Council, a resolution was adopted to monitor implementation of the PDGM “to determine whether this new program will impose additional administrative burdens on physicians certifying home care services for their patients, and/or whether it will impede patients from receiving needed home care services”.  To that end, please let us know if this system is causing new difficulties in ensuring your patients get the home care services they need.         (AUSTER)


Registration now open for Medical Matters: Virtual Drill: Incident Command System & Crisis Communications
MSSNY’s next Medical Matters will feature a Virtual Drill on the Incident Command System and Crisis Communications on February 19th from 6:00-8:00pm. Faculty for this program are: Arthur Cooper, MD; Pat Anders, MS, MEP; William Valenti, MD and Lorraine Giordano, MD.

Educational Objectives are:

  • Obtain information about local, state and national chain of command in a public health emergency and learn how to access resources
  • Understand the importance of planning for medical surge and triage of patients, as well as staff and family considerations, in the office-based practice setting during a health emergency
  • Develop an understanding that all public health emergencies can potentially have mental health implications for survivors and others connected with the event
  • Acquire skills for the management of patients in a public health emergency

Please note that there are recommended pre-course materials to be viewed prior to this virtual drill. You will be sent a link with your registration confirmation. We encourage all participants to examine these prior to the Virtual Drill.  Register by clicking   here Additional information or assistance with registration may be obtained by contacting Melissa Hoffman at mhoffman@mssny.org.

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

The Medical Society of the State of New York designates this live activity for a maximum of 2.0 AMA/PRA Category 1 credits™.  Physicians should claim only the credit commensurate with the extent of their participation in the activity.

 pschuh@mssny.org mauster@mssny.org  pclancy@mssny.org  zcary@mssny.org
rali@mssny.org

 

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Three US Airports (JFK Included) Screen for Novel Virus from China
Today, in response to an outbreak of novel coronavirus, public health screening will begin at three major U.S. airports that receive travelers from Wuhan, China, the CDC announced. Starting today, airports in San Francisco (SFO), New York (JFK), and Los Angeles (LAX) will screen for symptoms associated with this virus in travelers arriving from direct or connecting flights from Wuhan, where the outbreak originated, the agency said in a statement.

Officials said that they expect to see cases of this novel virus “around the world” as people start to look for it more and that it is highly plausible at least one case will occur in the U.S.

Screening will begin Friday night at JFK for a flight that arrives around 10 p.m., CDC officials said in a conference call on Friday. JFK is one of two airports, along with SFO in San Francisco, that receive travelers on flights directly from Wuhan. Officials said that LAX was included because of the large volume of passengers coming from indirect flights.

Passengers will be screened about symptoms and fever at the airport and people of concern will be triaged for evaluation, including a more detailed exam and questions about exposures. Then, they will be referred to a facility where, ultimately, diagnostic tests can be performed. CDC said its lab “already has the ability to identify the pathogen,” with the exact sequence of the virus, which is publicly available. They added that they are working on a test to identify the virus to distribute to state health departments.

In the statement, CDC said it is deploying about 100 additional staff at the three airports to supplement staff at CDC quarantine stations.


SIGN UP TO RECEIVE ALERTS FROM MSSNY’S GRASSROOTS ACTION CENTER 

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When you subscribe to the Medical Society of the State of New York Grassroots Action Center, the Division of Governmental Affairs will alert you when legislation and issues of importance to physicians and patients, either in the NYS legislature or in Congress, are at critical stages.

Accordingly, contact from constituents would be vital to influencing the path and future of that legislation or issue.

Alerts will be accompanied by recommended actions you or your designee can take to have maximum impact such as calling, tweeting and emailing a customizable letter to your legislators.

If you are concerned with health care policy formation in New York State, please subscribe today by texting MSSNY to 52886 and you will be prompted to enter your email address.  When you sign up, it is best to use your NY-based voting address or practice address (if you do not reside in NY) for your alerts.

Contact the Division of Governmental Affairs at 518-465-8085 or albany@mssny.org if you have questions or comments.  Thank you.
(WILKS)


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Survey: Gen-X physicians More Likely to Report Burnout
Physicians ages 40 to 54, grouped together as Generation X, were more likely to report feeling burned out than the millennial and baby boomer doctors surveyed by Medscape in its latest report on job-related stress and suicide risk among doctors.

The survey was completed by about 15,000 physicians in 29 specialties. Medscape defines burnout as “long-term, unresolved, job-related stress leading to exhaustion, cynicism, detachment from job responsibilities and lacking a sense of personal accomplishment.”

Dr. Carol Bernstein, vice chair of faculty development and well-being at Montefiore Medical Center and the Albert Einstein College of Medicine, said in the report that the midcareer period, which Gen Xers are in, can be particularly stressful.

“In addition, I suspect that group is juggling multiple roles outside of work, including caring for children as well as elderly parents, and working as well as planning for retirement,” Bernstein said in the report.

Overall, the rate of physician burnout, at 42%, has fallen slightly from a rate of 46% five years ago. Forty-eight percent of women said they felt burned out, compared with 37% of men. About half of physicians said they would take a pay cut if it meant more free time.

Doctors said bureaucratic tasks such as charting and long hours were leading drivers of stress.

Specialists in urology, neurology and nephrology reported the highest rates of burnout, with about half of those respondents saying they have experienced it. (Crain’s Health Plus Jan. 15) Public health and preventive medicine doctors, ophthalmologists and orthopedists reported the lowest rates, approximately 3 in 10.


First Study by CDC: Evidence of Links Between Lung Injury with Use of E-Cigarettes
The Centers for Disease Control and Prevention said Tuesday that a new study, along with state-based evidence, strengthens the link between lung injury associated with the use of e-cigarettes or vaping products and the use of THC-containing products obtained from informal sources, including family and friends as well as online sellers.


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Statistics Indicate Alcohol Use Been Rising for Two Decades
The AP (1/14) reports a new federal health statistic indicates “Americans are drinking more now than when Prohibition was enacted;” moreover, “it’s been rising for two decades, and it’s not clear when it will fall again.” The stats “show a rise in per-person consumption and increases in emergency room visits, hospitalizations and deaths tied to drinking,” but teen drinking is down. The article details history of alcohol use in the U.S., and cultural attitudes surrounding drinking.

The Hill (1/14) reports “Americans drink, on average, 2.3 gallons of alcohol per year in the form of beer, wine and mixed beverages, according to a new analysis of federal health statistics.” This “news comes just a day after it was announced by beverage industry trackers that U.S. wine consumption dropped in 2019 for the first time since 1994.”



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As of December 5, 2019, Influenza is Prevalent in NYS
At this time, Section 2.59 of the New York State Sanitary Code (10 NYCRR § 2.59) requires all health care and residential facilities and agencies regulated pursuant to Article 28, 36, or 40 of the Public Health Law to ensure that all personnel, as defined in the regulation, not vaccinated against influenza for the current influenza season wear a surgical or procedure mask while in areas where patients or residents are typically present. https://www.health.ny.gov/diseases/communicable/influenza/seasonal/providers/prevention_of_influenza_transmission/ See Influenza Activity, Surveillance and Reports for to access the full weekly report. For information about the “flu mask regulation” and the current status of the Commissioner’s declaration, please visit www.health.ny.gov/FluMaskReg. Download the data used in this dashboard at Health Data NY.


Pan-Resistant Candida auris in New York Detailed
Three cases of pan-resistant Candida auris in New York highlight the need for continued C. auris surveillance, researchers write in MMWR.

From August 2016 through June 2019, some 800 cases of C. auris were identified in the state. Of isolates that underwent susceptibility testing, nearly all were resistant to fluconazole, two-thirds to amphotericin B, and 4% to echinocandins. For three patients, isolates were resistant to all three antifungal classes:

  • The three patients were 50 or older with multiple comorbidities; none had traveled recently.
  • Pan resistance appeared to develop after treatment with echinocandins, the first-line treatment for C. auris.
  • There was no epidemiologic link among the three.
  • These patients did not appear to transmit pan-resistant C. auris to others or to the environment.

The authors advise, “Patients on antifungal treatment for C. auris should be monitored closely for clinical improvement, and follow-up cultures should be obtained. Repeat susceptibility testing should also be conducted, especially in patients previously treated with echinocandins.”

MMWR article (Free)
Background: HIV and ID Observations post on C. auris and antimicrobial resistance (Free)


DEA Data: More Than 100 Billion Pain Pills Saturated the Nation Over Nine Years
The Washington Post (1/14) reports that data from the Drug Enforcement Administration “shows that more than 100 billion doses of oxycodone and hydrocodone were shipped nationwide from 2006 through 2014 – 24 billion more doses of the highly addictive pain pills than previously known to the public.” In July, The Post “reported that the data revealed that the nation’s drug companies had manufactured and distributed more than 76 billion pain pills.” The “two additional years of information – 2013 and 2014 – was recently posted by a data analytics company managed by lawyers for the plaintiffs in a massive lawsuit against the opioid industry.”



press conference on January 13
Dr. Gregory Threatte, president of the Albany County Medical Society and Dr. Art Fougner, MSSNY President, participated in a press conference on January 13 calling for the elimination of all flavored e-cigarettes and tobacco products, including menthol flavors.   Dr. Hazel Dukes, President of the NAACP New York State conference, Senator Brad Hoylman, Assemblymembers Linda Rosenthal, Rodneyses Bichotte and Tremaine Wright, joined with more than 40 organizations from across the state to call for a full and immediate end to the sale of flavored tobacco products in NYS.

Doctors and NAACP President: Ban All Forms of Flavored Tobacco
Public health officials, leaders of the state NAACP and other advocates urged Albany lawmakers on Monday to target all forms of flavored tobacco — including menthol combustible cigarettes — in their expected crackdown on vaping.

With the Senate and Assembly set to advance a package of e-cigarette bills as early as next week, advocates said that menthol cigarettes, smokeless tobacco, hookah and other products should be included in any statewide flavor ban.

“Don’t confuse the delivery device with the underlying toxin,” Gregory Threatte, president of the Medical Society of the County of Albany, told lawmakers during an afternoon news conference at the Legislative Office Building.

Hazel Dukes, president of the NAACP New York State Conference, argued that a ban on all flavored tobacco products “is long overdue” given the industry’s history of using these products to target children and minorities.

“This is nothing new,” she said at the news conference. “The device may have evolved but the deceptions have not. For generations the tobacco industry has been targeting our youth, and particularly African American kids, with flavor products, especially menthols.”

Dukes urged lawmakers to “immediately end this immoral, discriminatory practice of targeting kids” by ending sales of all flavored tobacco products in New York.


CMS

Upcoming QPP Service Center Hold Times
Due to the opening of the 2019 MIPS data submission period, the Quality Payment Program (QPP) Service Center is projecting an increase in volume of calls and emails between January and March 2020, resulting in longer wait times.

CMS recommends the following to minimize wait times and ensure successful 2019 submission:

  • Use One Method to Report Issues— Due to the increase in volume at the QPP Service Center, to minimize backlog, please use only one method of reporting for the same issue (email or phone). Note: Cases are processed in the order in that they are received regardless of the manner in which the Service Center was contacted. Please allow time for processing.
  • Submit Your Data Early— We encourage you to submit your 2019 MIPS performance period data early during the submission period. Early submission will allow you plenty of time for Service Center assistance if needed.
  • Call the Service Center at Off-Peak Hours— We strongly recommend calling the Service Center during off-peak hours (8:00 AM-10:00 AM ET OR 2:00 PM-8:00 PM ET).

For More Information

  • Visit the QPP Resource Library to review new and existing QPP resources.
  • Contact the Quality Payment Program at 1-866-288-8292, Monday through Friday, 8:00 AM-8:00 PM ET or by e-mail at: QPP@cms.hhs.gov. Reminder: to receive assistance more quickly, consider calling during non-peak hours—before 10:00 AM and after 2:00 PM ET.
  • Customers who are hearing impaired can dial 711 to be connected to a TRS Communications Assistant.

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Great Career Opportunities for Clinical Physicians
Physicians, are you looking for a change?  Tired of working long shifts with an overwhelming patient load?  Come work at a well-equipped and staffed correctional facility where you can MAKE a difference, working with a smaller number of patients for reasonable hours.

Starting salary is $143,381 – $171,631 *Additional $20,000 geographical differential for Clinton & Franklin CF, and $10,000 for Five Points, Greene and Groveland CFs. We offer full-time, part-time & hourly/per-diem positions.

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

Clinton*                 Clinton Correctional Facility (sporting and recreational outlets)
Chemung               Elmira and Southport Corrl Facilities (Gateway to the Finger Lakes)
Columbia*             Hudson Correctional Facility (antiquing, arts & collectables)
Dutchess                Green Haven Correctional Facility (Hudson River Valley Beauty)
Franklin*                Franklin & Upstate Corrl Facilities (North Country, 1 hour to Montreal)
Greene*                 Greene Correctional Facility (rural charm yet only 2 hours to NY City)
Livingston*            Groveland Correctional Facility (State Parks, hiking, fishing)
Oneida                   Mohawk Correctional Facility (Cooperstown, breweries)
Orleans                  Albion Correctional Facility (Greater Niagara Region & Canal Town Culture)
Sullivan                  Woodbourne Correctional Facility (mountains, outlets, entertainment)
Seneca*                 Five Points Correctional Facility (heart of wine country)
St. Lawrence          Riverview Correctional Facility (hiking, boating and museums)
Ulster                     Shawangunk and Wallkill Corrl Facility (Catskill Mountains, Casinos)
Washington           Great Meadow Corrl Facility (Between Vermont & Green Mountains)
Westchester           Bedford Hills Correctional Facility (Less than 1 Hour to NYC)
Wyoming               Wyoming Correctional Facility (waterfalls, family farms, natural beauty)

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Inquire with the Facility Personnel Office regarding benefits and anticipated opportunities: http://www.doccs.ny.gov/faclist.html. Contact: www.doccs.ny.gov or DOCCS Personnel Office at (518) 457-8132 for more information and to apply.



 

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

 

MSSNY Responds to Governor’s Statement on Physician Discipline Proposal


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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
January 10, 2020 

MSSNY RESPONDS TO GOVERNOR’S STATEMENT ON PHYSICIAN DISCIPLINE PROPOSAL 

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

“New York’s Physicians have a great interest in working with the State Health Department to ensure that New York’s disciplinary process moves swiftly when necessary to remove those from practice that present a threat to the public.  To that end, we have worked proactively with the Administration and Legislature on laws to enhance the ability of OPMC to “summarily suspend” physicians in certain instances where it would be imprudent to wait for a final action.  And it is imperative that we work for improvements to this system as issues arise that interfere with its mission to protect the public.

At the same time, an appropriate balance is needed.  Recognizing that there are enormous professional implications when disciplinary action is taken against a physician, or even when there has been an accusation, we must also ensure that fair due process is provided when a physician is accused of professional misconduct.  Indeed, most complaints of alleged misconduct do not become actual findings of misconduct. Yet with Google and Yahoo search functions, an unproven allegation could linger forever in cyberspace, and permanently and unfairly scar a reputation.  We look forward to reviewing the text of this proposal as it becomes available and working with the Legislature and Governor to ensure we maintain the critical balance of protecting the Public while also protecting against the consequences of unfounded allegations.”

# # #

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
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MSSNYeNews: A Hard Rain’s A ‘Gonna Fall – January 10, 2020

Arthur Fougner MSSNY Presiident

PRESIDENT’S MESSAGE
Arthur Fougner, MD
MSSNY President

MSSNY eNews
January 10, 2020

Vol. 23  Number 2


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Colleagues:

As I wing my way toward the AMA’s State Legislation Advocacy Meeting in Florida, I keep thinking about Governor Cuomo’s State of the State speech. While there are things we most certainly can support, when he got to healthcare, the tone shifted. As I wrote previously, Medicaid is the largest item responsible for NY’s $6B budget deficit. The Governor had already cut payments 1%, but he went further. He blamed local spending for much of the problem and offered that his initial Medicaid Redesign would need Redesign.

We also learned that he would propose legislation to boost OPMC and physician discipline. As it so happens, on Monday, MSSNY will be meeting with DOH and OPMC and will learn more about specifics.

All too often, we hear about physician burnout, physician suicide and how physician wellness is on the DOH agenda. It appears ironic to talk about burnout and wellness when the state is cutting payments and talking about streamlining physician discipline. If physicians feel that someone has stuck a “Kick Me” sign on their backs, it is understandable. Medicine has become a profession of Rodney Dangerfields. I can hear him now – “When I see patients, I get no respect. After Press Ganey gets me, the Insurers, Trial Lawyers and Government get their licks in, too.”

Getting physicians to join together has been likened to herding cats. However, in the coming weeks and days, we all really do need to band together. Stay tuned to MSSNY updates as many devilish details remain to be hashed out. Trust me, this is serious. If we don’t work collegially and collectively, we are sunk. The 1% Medicaid Cut was but a test of our resolve. Far worse may be coming down I-87.  Please consider this year’s March 4th Lobby Day in Albany, our day to make them hear all of us. I call on all NY’s physicians, Medical Staff Societies, Specialty Societies, Ethnic Societies to text MSSNY to 52886 to get our Grassroots alerts and updates. Also, please contribute to our MSSNY-PAC as well. No contribution is too small. We need all the help we can get. Quoting David Byrne as I have previously: “This ain’t no party. This ain’t no disco. This ain’t no foolin’ around.”

And it’s a hard, it’s a hard
It’s a hard, it’s a hard
It’s a hard rain’s a gonna fall.
Bob Dylan, A Hard Rain’s A Gonna Fall

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

Arthur Fougner, MD
MSSNY President


Capital Update

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Governor Cuomo Proposes Changes to OPMC Processes; MSSNY Expresses Strong Objections
Governor Cuomo released his 36th proposal as part of a package of policy changes in 2020. The plan calls for changes in the way that DOH investigates, disciplines and monitor physicians, physician assistants and specialist assistants licensed in New York. Details of the proposed changes include:

  • Making investigations public “when the Commissioner of Health deems it warranted”, as well as, making administrative warning actions public.
  • Eliminating lifetime licensure to ensure out of state physicians with a NY license periodically renew.
  • Amend the Public Health law to allow the State Health Commissioner to suspend a physician’s license, at the start of an investigation, if the commissioner deems that physician to be a risk to the public. This would be a lessened standard from the current “imminent danger” standard currently required for a summary suspension.

In response, MSSNY released the following statement:  “New York’s Physicians have a great interest in working with the State Health Department to ensure that New York’s disciplinary process moves swiftly when necessary to remove those from practice that present a threat to the public. To that end, we have worked proactively with the administration and legislature on laws to enhance the ability of OPMC to “summarily suspend” physicians in certain instances where it would be imprudent to wait for a final action. And it is imperative that we work for improvements to this system as issues arise that interfere with its mission to protect the public.

At the same time, an appropriate balance is needed. Recognizing that there are enormous professional implications when disciplinary action is taken against a physician, or even when there has been an accusation, we must also ensure that fair due process is provided when a physician is accused of professional misconduct. Indeed, most complaints of alleged misconduct do not become actual findings of misconduct. Yet with Google and Yahoo search functions, an unproven allegation could linger forever in cyberspace, and permanently and unfairly scar a reputation. We look forward to reviewing the text of this proposal as it becomes available and working with the Legislature and Governor to ensure we maintain the critical balance of protecting the Public while also protecting against the consequences of unfounded allegations.”

MSSNY Division of Governmental Affairs Staff will keep our members updated as discussions move forward, in the coming months, in Albany.                               (DIVISION OF GOVERNMENTAL AFFAIRS)             


Governor Cuomo Outlines 2020 Health Priorities at State-of-the-State
On Wednesday, January 8th, members of the New York State Senate, Assembly, and other governmental dignitaries, gathered in the Convention Center for Governor Cuomo’s State-of-the-State speech, where he outlined his 2020 agenda, including his health priorities. MSSNY will likely support many of these initiatives, while other items raise serious concerns, at first glance, and require close monitoring, this session. The following is the full list of issues MSSNY Staff will closely follow, and potentially take action if necessary, in the coming months:

  • Proposal for legislation to address the OPMC disciplinary process that would enact periodic renewal requirements for New York physicians, physician assistants and specialist assistants to maintain their licenses and ability to practice in the state if they practice out of state. He will also seek to update the public health law to strengthen disciplinary oversight and allow for quick removal of providers who present a risk to patients; ensure the public can access up-to-date information about physicians and any professional conduct concerns; and give the Office of Professional Medical Conduct authority to increase patient safety and physician accountability.
  • Reducing the small business tax from 6.5% to 4%.
  • Expands Access to Buprenorphine, an important advance in Medication Assisted Treatment, which, like methadone and injectable naltrexone, is used in combination with counseling, to help people reach and sustain recovery from Opioid Use Disorder.
  • Governor Cuomo will direct the Department of Health (DOH), to require all hospitals statewide to develop protocols for their emergency departments to address Opioid Use Disorder based on the standard of care for treatment or referral for treatment. The Enacted Budget also prohibits health plans from requiring prior authorization for Medication Assisted Treatment.
  • Legalizing Gestational Surrogacy Current state law creates legal uncertainty for parents of children conceived by reproductive technology. The governor’s proposal establishes criteria for surrogacy contracts, providing for the nation’s strongest protections for parents and surrogates. His proposal will also streamline the “second parent” adoption process, removing outdated barriers and extending common-sense protections for New York families.
  • A proposal to legalize recreational marijuana.
  • Proposal to ban all flavored nicotine vaping product, including menthol flavors. The governor has also proposed banning vaping advertisements aimed and youth and to authorize the NYS Department of Health to regulate the sale of chemicals used in vaping-related products and ban the sale of vaping product carrier oils deemed a hazard to public health. His proposal also includes legislation that would prohibit the online, phone and mail order sale of e-cigarettes and would require that only registered retailers be allowed to purchase e-cigarettes using these methods.
  • Legislation to crack down on retailers that illegally sell untaxed cigarettes and other tobacco products in New York State. Under the Governor’s proposal, retailers who acquire untaxed cigarettes from other states or other sources and sell them illegally in New York would face possible closure. The Governor is also proposing strengthening penalties and fines for retailers that sell tobacco products to people under 21 years of age.
  • A proposal for the Department of Health, the Department of Financial Services, and the New York State Digital and Media Services Center- a joint enterprise of the Office of Information Technology Services and Office of General Services – to create a consumer-friendly website, called NYHealthcareCompare, where New Yorkers can easily compare the cost and quality of healthcare procedures at hospitals around the state. The platform will also provide consumers with educational resources designed to help consumers know their rights including financial assistance options, what to do about a surprise bill and more.
  • Require the registration of all PBMs and oversight by DFS.
  • Proposal to develop a three part plan to lower prescription drug costs for all New Yorkers. The Governor’s proposal would cap insulin co-payments at $100 per month for insured patients to help address the rising cost of insulin that has resulted in diabetes patients rationing, skipping doses and not filling prescriptions.
  • A call for legislation banning fentanyl analogs — a deadly synthetic opioid that is 50 to 100 times more potent than morphine — by making them subject to the same criminal sale or possession penalties as other controlled substances. The legislation will also empower the New York State Health Commissioner to ban any new fentanyl analogs that have been added to the federal schedule of controlled substances, allowing the State to deal with these deadly substances in real time rather than play catch up.
  • A proposal calling for legislation to prevent individuals from receiving New York State gun licenses if they commit a crime in another state that is similar to a crime that would disqualify them from owning a gun in New York State. New York law currently prohibits individuals from obtaining a gun license if they commit certain New York misdemeanors that are deemed “serious offenses.” However, the law does not prohibit individuals from obtaining a New York gun license after committing comparable misdemeanors in another state.
  • Expanding the surprise bill law to: prohibit billing of patients by out of network physicians and hospitals for emergency care for amounts above the applicable cost-sharing amounts; and to require disclosure of facility fees to patients in Article 28 and Office-Based surgery settings.

Proposed Cuts to Medicaid
On January 1, 2020, Governor Cuomo implemented a 1% across-the-board cut to the state’s Medicaid program & we anticipate additional proposed reductions to the program when his budget is released. The Governor did not provide more details about his plans to address the $6 Billion Budget deficit, except for his goal to convene a new Medicaid Redesign Team (MRT). More details will come when Governor Cuomo releases in his New York State Budget on this cut and the other proposals contained in his State of the State. MSSNY Division of Governmental Affairs staff will follow with more information as it becomes available. At this time, it is unclear whether each of these initiatives will be pursued in the State Budget or through stand alone “program” legislation.
(DIVISION OF GOVERNMENTAL AFFAIRS)        


MSSNY Calls for a Reversal of Medicaid Cut; Please Join Our Efforts
MSSNY joined several other specialty societies and health care provider associations in a letter to Governor Cuomo this week urging that the recently enacted 1% cut to Medicaid physician payments be reversed.  The letter noted that “The State’s Medicaid program has not adequately reimbursed for increased costs and critical policy initiatives since the Medicaid Redesign Team (MRT) changes began to take effect” and that “In spite of these cost increases in the past decade, providers have not had a trend factor to recognize the basic expenses of providing care to the poor, elderly and disabled in our State.”

In MSSNY’s own statement on this cut (click here for MSSNY statement), MSSNY President Dr. Art Fougner noted that physicians are “confounded by the announced cuts”, given that “Medicaid physician payment remains a very small part of New York’s overall Medicaid Budget” and that “New York has one of the lowest Medicaid to Medicare physician payment ratios in the country”. With New York State facing a $6 Billion Budget deficit for the 2020-21 fiscal year, further steep cuts could be proposed in the soon-to-be released Governor’s Executive Budget.  Physicians are urged to contact their legislators to act to reverse these cuts, and prevent further cuts. click here.                                                                        (AUSTER)


Senate Health Committee To Act on Package of Bills Regarding E-Cigarettes
On Monday, January 13th, the Senate Health Committee will take action on several legislative e-cigarette proposals.  S. 428B, sponsored by Senator Brad Hoylman, which would prohibit the sale and distribution for use in e-cigarettes.  S. 3905A, sponsored by Senator Gustav Rivera, which would regulate electronic cigarettes in the same way as tobacco products to prevent access to products by persons younger than 21 years.  S. 4249A, sponsored by the Senator Monica Martinez, which would create restrictions for the locations of tobacco stores and electronic cigarette stores to be at least 200 feet away from a school or place of worship.

The Medical Society of the State of New York supports banning all flavored e-cigarettes, including menthol and supports legislation that would also ban all flavored tobacco products, such as chewing tobacco and cigarillos.  On January 13th, MSSNY President Arthur Fougner, MD, and Gregory Threatte, MD, President of the Albany County Medical Society will participate in an Albany press conference on e-cigarettes with members of the Legislature and will join with other public health groups, in advocating for measures that would prohibit the sale of flavored tobacco products and e-cigarettes, including menthol.   

In December,  MSSNY has joined with other public health organizations that called upon the Governor, the Senate and Assembly leaders, and members to pass legislation that would prohibiting the sale of flavored nicotine and tobacco products which will protect our young people from the scourge of the myriad health problems and addictions caused by flavored tobacco products and e-cigarettes. Physicians are encouraged to send a letter through MSSNY Grassroots Action Center (GAC)  here.>
(CLANCY)


Legislation to Expand Mandate For Pain Management for All DEA Prescribers
A measure that would expand the coursework under the pain management requirement will be acted upon by the Senate Health Committee next week.  S. 7102, sponsored by Senator Brian Benjamin, would include requirements that would reduce the likelihood of overdose and spread of blood-borne diseases by those who use drugs; medications used for the treatment of addiction and information about becoming a buprenorphine prescriber.  Additionally, the bill requires prescribers to update standards and approvals as necessary according to best practices for providing patient centered care with the consideration of social determinants of health and co-occurring disorders.

The Medical Society of the State of New York is opposed to this measure.  Physicians and other health care providers who have a DEA license were required to take a three hour course on pain management, palliative care, addiction that included the state and federal requirement for prescribing controlled substances, appropriate prescribing, managing acute pain, palliative medicine, prevention, screening and signs of addiction, responses to abuse and addiction and end of life care.

This requirement passed the Legislature in 2016 and physicians were required to have taken this program by July 1, 2017.  The law also requires that DEA prescribers take the course every three years—2020 is the start of a new cycle and physicians are again required to take this course.  MSSNY is in the process of updating its current pain management program and it will be available by spring. (CLANCY)


MSSNY Opposes Legislation to Allow Estheticians & Others to Perform Laser Hair Removal
A bill that would allow estheticians, and others, to perform laser hair removal with only minimal physician oversight, was reintroduced in 2019 and is on the agenda for next week’s Senate Committee on Consumer Protection. MSSNY has long opposed this legislation as it legitimizes in statute a currently unregulated practice to perform a procedure that should only be done by an appropriately trained and educated individual, under physician supervision. Procedures involving lasers have the potential to cause painful burns and permanent scarring if not used properly.

A 2013 article in the Journal of the American Medical Association (JAMA) reported on a study that showed that, despite the fact that approximately only 1/3 of laser hair removal procedures are performed by non-physicians, 75.5% of hair removal lawsuits from 2004 to 2012 were performed by non-physicians, and that from 2008 to 2012, this percentage increased to 85.7%. MSSNY appreciates the efforts of the sponsors to provide greater regulation of a currently unregulated practice, but in its current form, MSSNY opposes this legislation. We will continue to work with the sponsors to ensure the bill is amended to establish necessary oversight of this practice and to ensure patients’ safety.                      (CARY)


Barclay Elected as New Assembly Minority Leader
Assemblymember Will Barclay (R-Pulaski) has been elected by the Assembly Republican Conference as the new Minority Leader of the New York State Assembly.  Assemblyman Barclay previously served as Ranking Member of Assembly Ways & Means Committee and, prior to that, as Ranking Member of the Assembly Insurance Committee.  He replaces Assemblymember Brian Kolb in this post.  MSSNY congratulates Assemblymember Barclay on this new position, and looks forward to working with him.                                          (AUSTER)


AG James Stops Public Charge Rule From Taking Effect
The United States Court of Appeals for the Second Circuit denied the Trump Administration’s efforts to immediately reverse preliminary injunction on the president’s Public Charge Rule. In September 2019, Attorney General James filed a motion to seek a preliminary injunction to stop the Trump Administration’s public charge rule from going into effect. In August 2019, Attorney General James and a coalition that included the attorney general of Connecticut and Vermont, as well as the City of New York filed a lawsuit challenging the Trump Administration’s Public Charge rule which aimed to deny green cards and visas to immigrants who use government assistance programs.

The preliminary injunction seeks to stop the public charge rule from taking effect arguing that it would harm millions of non-citizens and their family members by deterring them from accessing public benefits that they are lawfully entitled to receive. As New York braces to confront the $6 billion dollar budget gap with DOH’s decision to cut Medicaid payments by 1% in 2020 as well as overall Medicaid enrollment decline, individuals who would have otherwise had access to healthcare are at risk of living with undiagnosed and untreated conditions.                                                                              (ALI)


SAVE THE DATE: MSSNY‘s Annual “Physician Advocacy Day” (3/4)
On January 8th the New York State Legislature welcomed back returning members to Albany! As the new session begins, the need for physician advocacy and grassroots involvement is greater than ever.  Physicians can sign up to participate in MSSNY’s “Physician Advocacy Day” which will be held on Wednesday, March 4th in the Lewis Swyer Theatre in the Egg, Empire State Plaza, Albany NY. Click here to register!

Join your colleagues from all around New York State and come to MSSNY’s Physician Advocacy Day to speak with your legislators and key policymakers to ensure they’re making the right choices for New York’s physicians and their patients.

A brief luncheon to which members of the NYS Legislature are invited to speak with their constituents will follow the morning program. County medical societies will also be scheduling appointments for physicians to meet with their elected representatives.

If you have any questions/comments, please contact Raza Ali at rali@mssny.org.                                                               (ALI)


“Doctor Are You Ready?” CME Webinar on January 15; Registration Now Open
Disasters big and small happen every day.  Be sure to find out how best to be prepared at MSSNY’s next Medical Matters webinar: Doctor Are You Ready? on January 15th at 7:30am.  Kira Geraci-Ciardullo, MD, MPH immediate past speaker of the house and a member of the Emergency Preparedness and Disaster/Terrorism Response Committee will serve as faculty for this program. Registration is now open for this webinar here

Educational objectives are:

  • Explore core preparedness competencies every physician should possess
  • Describe emergency situations that arise on a regular basis
  • Identify resources to acquire preparedness training

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

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

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


MSSNY & St. Peter’s Health Partners to Host Four Grand Rounds Seminars
The Medical Society of the State of New York and St. Peter’s Health Partners are providing four CME live seminars for the Veterans Matters programs. The following seminars will take place at St. Peter’s Hospital in Mercy Conference Rooms 1 – 4, 315 S Manning Blvd, Albany, NY 12208.

  • The Special Mental Health Needs of Women Veterans
        When: January 15, 2020 at 7:00 am
    Faculty: Malene Ingram, MD (Col., US Army Reserves)
  • Substance Use Disorders (SUDs) in Veterans
        When: January 22, 2020 at 7:00 am
    Faculty: Thomas Madejski, MD
  • PTSD in Returning Veterans
        When: January 29, 2020 at 7:00 am
    Faculty: Adolph Meyer, MD
  • Military Culture: Everything Physicians Need to Know about Veterans as Patients
        When: February 5, 2020 at 7:00 am
    Faculty: Lt. Cl. Lance Allen Wang

Reservations can be made by contacting Lori Weaver at Lori.Weaver@sphp.com or (518) 874-6914. Please click here to view the flyer.

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

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


eNews

TODAY!
MSSNY Responds To Gov.’s Statement on Physician Discipline Proposal
“New York’s Physicians have a great interest in working with the State Health Department to ensure that New York’s disciplinary process moves swiftly when necessary to remove those from practice that present a threat to the public.  To that end, we have worked proactively with the Administration and Legislature on laws to enhance the ability of OPMC to “summarily suspend” physicians in certain instances where it would be imprudent to wait for a final action. And it is imperative that we work for improvements to this system as issues arise that interfere with its mission to protect the public.

At the same time, an appropriate balance is needed. Recognizing that there are enormous professional implications when disciplinary action is taken against a physician, or even when there has been an accusation, we must also ensure that fair due process is provided when a physician is accused of professional misconduct.  Indeed, most complaints of alleged misconduct do not become actual findings of misconduct. Yet with Google and Yahoo search functions, an unproven allegation could linger forever in cyberspace, and permanently and unfairly scar a reputation.  We look forward to reviewing the text of this proposal as it becomes available and working with the Legislature and Governor to ensure we maintain the critical balance of protecting the Public while also protecting against the consequences of unfounded allegations.”


MSSNY President Criticizes Governor Cuomo’s Medicaid Cuts
Politico Pro (1/6) reports that healthcare providers, insurers, and others are pushing back against “the state’s new 1 percent across-the-board reduction in Medicaid spending” calling for Gov. Cuomo “to take a more targeted approach as it looks to close a $4 billion budget gap in the coming months.”

Dr. Art Fougner, the president of the Medical Society of the State of New York (MSSNY), said,Physicians are confounded by the announced cuts to their payments for care delivered to Medicaid beneficiaries… This is particularly difficult to accept given that they were not the beneficiaries of increases to Medicaid payments recently granted to other parts of the health care system. In fact, Medicaid physician payment remains a very small part of New York’s overall Medicaid Budget.”


WSJ: Former MSSNY President Warns Risks of Expanding Marijuana Industry
In a letter for the Wall Street Journal (1/6) former President of the Medical Society of the State of New York Dr. Thomas J. Madejski, wrote:

Regarding your editorial “The Vaping-Marijuana Nexus” (Dec. 26): Tobacco, marijuana and vaping companies mislead the public on the clear harms associated with wider use of today’s higher-THC-content marijuana and inhaling substances other than clean air. Opponents of expansion of marijuana availability acknowledge concerns about disparate enforcement of drug laws. But the costs to society from legitimizing the addiction industry far outweigh the benefits. Meanwhile, proponents of recreational marijuana push the false narrative of a tax windfall for governments and improved safety for users while ignoring the harms: mental-health issues, addiction, acute and chronic lung disease, domestic violence and more.”

Thomas J. Madejski, M.D.
Albion, N.Y.
Jan. 7, 2020
Dr. Madejski Is the Immediate Past President of MSSNY.


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Staten Island Hospital Opens Opioid Treatment Center for Teens, Young Adults
Richmond University Medical Center in Staten Island has opened a medication-assisted treatment center for people ages 16 to 24 who are struggling with opioid-use disorder.

The center, funded by a Statewide Health Care Facility Transformation Program grant, is in the Center for Integrative Behavioral Medicine, also known as the Silberstein Clinic, at 1130 South Ave.

The opening comes about a year after the Staten Island Mental Health Society became a division of the medical center in a merger.

A substance-use program has existed for adolescents ages 11 and older and their families, said Dr. Joel Idowu, chairman of psychiatry and behavioral health sciences at the medical center. However, he said, older people with opioid-use disorder also can benefit from medication-assisted treatment.

The treatment “offers something that frees you to be able to go to work and live your life like any other person,” Idowu said. “The medication is effective and helps people to stay sober, and it reduces the risk of overdose.”

An injectable form of one such medication, buprenorphine, is available through the new program, he said, adding that it comes in convenient monthly doses.

For most patients, insurance covers the treatment.

The medical center noted in a filing with the state that opioid misuse, including heroin misuse, among adolescents and young adults has “risen dramatically in the past two decades.” However, it said, treatment capacity for the population remains “extremely low,” and Staten Island has the highest incidence of opioid use and related deaths in the city.

The new program is aimed at addressing those gaps in care and aligning with the state’s Medicaid reform priority of integrating medication-assisted treatment into primary-care settings. (Crains’ Health Plus) Jan 6


NYS Flu Statistics for Week of January 4
During the week ending January 4, 2020

• Influenza activity level was categorized as geographically widespread. This is the sixth consecutive week that widespread activity has been reported.
• There were 10,085 laboratory-confirmed influenza reports, a 9% increase over last week.
• The number of patients hospitalized with laboratory-confirmed influenza was 1,964, a 34% increase over last week.
• There were no influenza-associated pediatric deaths reported this week. There has been one influenza-associated pediatric death reported this season.
https://www.health.ny.gov/diseases/communicable/influenza/surveillance/2019-2020/flu_report_current_week.pdf

Widespread Flu Activity Reported in 46 States

As of the last week of December, “widespread” flu activity was reported by health departments in 46 states. More ominously, a second measure — the percentage of patients with flu symptoms visiting medical clinics — shot up almost to the peak reached at the height of the 2017-18 flu season, which was the most severe in a decade. About 61,000 Americans died of flu that season, the CDC said. (The original estimate of 79,000 was revised downward last year; the agency said the number changed as more death certificate information became available.)

This year’s flu vaccine may not be particularly effective against the strain of the virus now widespread in the United States, experts said. According to the CDC, it is worth getting the shot because people who are vaccinated fare better if struck by the flu than those who are not.


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CDC Updates Guidelines for Discharging Vaping Patients
After a new study found at least one quarter of vaping-related rehospitalizations and deaths occurred within two days of discharge, the CDC now recommends outpatient follow-up within 48 hours, according to the CDC’s Morbidity and Mortality Weekly Report published Jan. 2.

A recent analysis of previously hospitalized EVALI patients found common comorbidities among patients who were readmitted or died after discharge. The findings prompted the CDC, in consultation with the Lung Injury Response Clinical Working Group, to revise EVALI patient guidelines, which previously recommended outpatient visits within two weeks of discharge.

Guideline updates for providers include:

  1. Confirming that vital signs have not significantly changed for at least 24 to 48 hours before discharge.
  2. Ensuring outpatient primary care or pulmonary specialist follow-up, ideally within 48 hours of discharge.
  3. Planning discharge care, early follow-up and management of any comorbidities.
  4. Following best practices for medication adherence.
  5. Ensuring access to mental health and substance use disorder services.

US Cancer Death Rates See Largest Single-Year Drop on Record
Overall cancer death rates in the U.S. fell by 2.2 percent from 2016 to 2017, the largest single‐year drop ever recorded, according to a report from the American Cancer Society. The annual report estimates the numbers of new cancer cases and deaths expected this year. It also compiles the most recent data on cancer occurrence from the Surveillance, Epidemiology, and End Results Program; the National Program of Cancer Registries and the North American Association of Central Cancer Registries.


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CMS

CMS Releases MIPS Results for 2018: 5 Things to Know
CMS published 2018 results for the Merit-Based Incentive Payments System program Jan. 6.

Five things to know about the results:
1. CMS Administrator Seema Verma said 2018 participation in MIPS, created under the 2015 Medicare Access and CHIP Reauthorization Act, exceeded participation rates in 2017.
2. More clinicians will receive a positive payment adjustment compared to the 2017 performance year, with nearly all eligible clinicians participating in MIPS getting a payment boost in 2020.
3. In total, 889,995 clinicians saw a MIPS payment adjustment, whether negative, neutral or positive. Ninety-eight percent of those clinicians will receive a neutral or positive payment adjustment.
4. Additionally, more rural and small practices will see positive payment adjustments compared to the 2017 performance year.
5. More clinicians are earning Qualifying Alternative Payment Model Participant status under the Advanced APM path than in the previous reporting year.

“Positive payment adjustment will remain modest in part because, under the MACRA law, the positive and negative payment adjustments must be budget neutral,” Ms. Verma said. “This means that the funds available for positive payment adjustments are limited to the estimated decrease in payments resulting from the negative payment adjustments. However, because the thresholds have been lower, many providers have qualified. As the program matures, we expect that the increases in the performance thresholds in future program years will create a smaller distribution of positive payment adjustments for high performing clinicians who continue to invest in improving quality and outcomes for beneficiaries and positive adjustments will increase.”

To view the full results, click here.


MSSNY Benefit – Protect your hearing with American Hearing Benefits


Deadline to Submit 2019 Registration and Attestation Info for MIPS Is March 2
The deadline to submit 2019 data for (CMS) Medicare Promoting Interoperability Program is March 2, 2020. 

As a reminder, in 2018, CMS transitioned to the QualityNet System (also known as CMS’s Hospital Quality Reporting [HQR] system) for hospitals that attest to CMS for the Medicare Promoting Interoperability Program. By transitioning to one system, CMS continues in their effort to streamline data submission methods.

Specific submission details for each program are listed below.

  • Medicare Eligible Hospitals and Critical Access Hospitals (CAHs) – These participants must attest to CMS through the QualityNet Secure Portal.
  • Medicaid Eligible Professionals (EPs), Eligible Hospitals, CAHs – These participants should follow the requirements of their State Medicaid agencies to submit their meaningful use attestation.
  • Dual-Eligible Hospitals and CAHs – Those who qualify for both the Medicare and Medicaid Promoting Interoperability Programs are required to demonstrate meaningful use to CMS through the QualityNet Secure Portal (not their State Medicaid agency).

Registering on Behalf of a Medicaid EP?
An EP can designate a third party to register and attest on his or her behalf. To do so, users working on behalf of an EP must have an Identity and Access Management System (I&A) web user account (User ID/Password) and be associated with the EP’s National Provider Identifier (NPI). If you are working on behalf of one or more EPs and do not have an I&A web user account, please visit I&A Security Check to create one.

Note: States and territories will not necessarily offer the same functionality for registration and attestation in the Medicaid Promoting Interoperability Program. Check with your state or territory’s Promoting Interoperability Program to see what functionality is offered.

Additional Resources

For More Information

Visit the Registration and Attestation page on the CMS Promoting Interoperability Programs website.

Medicare & dual-eligible hospitals participating in the Medicare & Medicaid Promoting Interoperability Programs may contact the QualityNet help desk for assistance at 1 (866) 288-8912 or qnetsupport@hcqis.org.


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PAI Comments on Stark Law and Anti-Kickback Proposed Rules
On December 31, PAI submitted comment letters in response to two proposed rules proposing modifications to the Anti-Kickback (AKS) Statute and the Physician Self-Referral (Stark) Law. The letters are attached and summarized below. Please share widely with your medical association staff and physician members.

PAI was generally supportive of both the Centers for Medicare and Medicaid Services’ (CMS’s) and the HHS Office of the Inspector General’s (OIG’s) efforts to remove regulatory barriers and create alignment between the Stark Law and AKS exceptions and safe harbors to encourage participation in APMs and innovative payment arrangements. We were also supportive of the new definitions related to value-based arrangements, including Value-Based Enterprise (VBE), VBE Participant, Value-Based Activity, Value-Based Purpose, etc., bought sought additional clarification on what would/would not satisfy these definitions and whether existing arrangements could be used to satisfy these definitions for the safe harbors and exclusions. PAI’s specific comments in response to each proposed rule are summarized below.

Anti-Kickback Statute Proposed Rule
PAI was supportive of the following proposed new safe harbors and updates to existing safe harbors, and made additional recommendations in response to each:

  • Care Coordination Arrangements (CCAs) – PAI sought additional clarification on the “commercially reasonable” standard under AKS
  • VBAs with Substantial Downside Risk – PAI recommended a more flexible definition for “risk-sharing”
  • VBAs with Full Financial Risk – PAI expressed concerns that the VBAs with Full Financial Risk safe harbor would only be made available to larger, more integrated systems, and that smaller and rural practices may not be able to enter traditionally defined “full risk” models even though they are embracing downside risk
  • Patient Engagement and Support Arrangements – PAI strongly supported focusing on improving access to items, services, and supports that address social determinants of health (SDOH)
  • Blanket Safe Harbor for CMMI Model Participants
  • Donation of Certain Cybersecurity Technology and Related Services – PAI urged the OIG to ensure that the donors must donate the technology with “no strings attached” tied to future upgrades, maintenance costs, etc.
  • Outcomes-Based Payment Arrangements – PAI encouraged the OIG to also include full and partial capitation payments
  • Updates to the EHR Safe Harbor – PAI opposed proposals that would allow the safe harbor exception to apply if the items or services were “deemed” to be interoperable, and urged how important it is for the OIG to continue focusing on how the data and systems are actually being used and information is being shared to ensure that information blocking is not occurring.
  • Updates to the Warranties Safe Harbor
  • Updates to the Local Transportation Safe Harbor – PAI supported expansion of this safe harbor to include ride-sharing services and urged the OIG to further expand the safe harbor to be inclusive of urban areas as well as “provide a ride” and telephonic-related programs and services
  • Updates to the ACO Beneficiary Incentive Program – PAI codifying protections for beneficiaries but requested additional guidance on what is required for such protected beneficiary remunerations
  • Exceptions for Telehealth Technology Definitions for In-Home Dialysis – PAI did not support the requirement that donations of such technology must be made available to all eligible Part B beneficiaries, as this may restrict small and rural providers from offering such donations entirely 

Stark Law Proposed Rule
PAI was supportive of the following proposed exceptions and made additional recommendations in response to each:

  • Exceptions for Full-Risk Models – PAI commented that full-risk should be more inclusive of other types of arrangements in addition to capitated payments, including bundled and episodic payments, and that additional flexibility should be considered for demonstrating “full-risk” arrangements
  • Exceptions for VBAs with Meaningful Downside Financial Risk to the Physician – PAI expressed concerns with defining “meaningful downside risk” and believed that the 25% threshold is too high and should be decreased to 5%
  • Exceptions for General VBAs – PAI supported general exceptions for VBAs, regardless of risk, as we believe this exception will be most applicable for independent, small, and rural practices. However, PAI did support the contribution requirement of 15% for VBAs under such exceptions as it could adversely impact the same group of physicians and practices.
  • Price Transparency – PAI believes that any information to be made public should first be shared with physicians and others to ensure that it is accurate, and that physicians have appropriate time to review and correct the information.

In addition to the above, PAI also provided comments on additional technical changes proposed in the rule.

http://www.mssnyenews.org/wp-content/uploads/2020/01/PAI-2019-AKS-Proposed-Rule-Comment-Letter.pdf

http://www.mssnyenews.org/wp-content/uploads/2020/01/PAI-2019-AKS-Proposed-Rule-Comment-Letter.pdf


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We improve the employee and patient experience to help you achieve your goals and grow your practice. How? With strategic processes that support you, your staff, and your patients! We integrate your values into all areas of your practice including hiring, training, communication and operational strategies. Whether you’re independent or part of a group, we have an approach that will work for you. If you’re ready to strengthen your practice, we can help. smays@thepractice.coach https://www.thepractice.coach/  https://www.instagram.com/practicecoach/ https://twitter.com/coach_practice


RENTAL/LEASING SPACE


Furnished Luxury Park Avenue East 70’s Medical Office Rental Available.
Voted most beautiful block on UES. Private Entrance. Central A/C.
Dedicated consultation room, exam room, procedure room, reception and nurse areas in a multispecialty office setting. Suitable for all subspecialties.Walk to Lenox Hill Hospital and NY Cornell. Proximate to Mt Sinai Hospital. Subway 2 blocks away. Full Time/Part Time. No fee.
START SEEING PATIENTS IMMEDIATELY!!!
Please call or text 929 316-1032


PHYSICIAN OPPORTUNITIES

Pediatric Board Tutor
Looking for a tutor for Initial Pediatric Board Exam
Flexible hours, Negotiable rate. If interested please email at: pedboardhelp@gmail.com


 

NYS Corrections Logo

Great Career Opportunities for Clinical Physicians
Physicians, are you looking for a change?  Tired of working long shifts with an overwhelming patient load?  Come work at a well-equipped and staffed correctional facility where you can MAKE a difference, working with a smaller number of patients for reasonable hours.

Starting salary is $143,381 – $171,631 *Additional $20,000 geographical differential for Clinton & Franklin CF, and $10,000 for Five Points, Greene and Groveland CFs. We offer full-time, part-time & hourly/per-diem positions.

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

Clinton*                 Clinton Correctional Facility (sporting and recreational outlets)
Chemung               Elmira and Southport Corrl Facilities (Gateway to the Finger Lakes)
Columbia*             Hudson Correctional Facility (antiquing, arts & collectables)
Dutchess                Green Haven Correctional Facility (Hudson River Valley Beauty)
Franklin*                Franklin & Upstate Corrl Facilities (North Country, 1 hour to Montreal)
Greene*                 Greene Correctional Facility (rural charm yet only 2 hours to NY City)
Livingston*            Groveland Correctional Facility (State Parks, hiking, fishing)
Oneida                   Mohawk Correctional Facility (Cooperstown, breweries)
Orleans                  Albion Correctional Facility (Greater Niagara Region & Canal Town Culture)
Sullivan                  Woodbourne Correctional Facility (mountains, outlets, entertainment)
Seneca*                 Five Points Correctional Facility (heart of wine country)
St. Lawrence          Riverview Correctional Facility (hiking, boating and museums)
Ulster                     Shawangunk and Wallkill Corrl Facility (Catskill Mountains, Casinos)
Washington           Great Meadow Corrl Facility (Between Vermont & Green Mountains)
Westchester           Bedford Hills Correctional Facility (Less than 1 Hour to NYC)
Wyoming               Wyoming Correctional Facility (waterfalls, family farms, natural beauty)

NYS Corrections Personnel Ad

Inquire with the Facility Personnel Office regarding benefits and anticipated opportunities: http://www.doccs.ny.gov/faclist.html. Contact: www.doccs.ny.gov or DOCCS Personnel Office at (518) 457-8132 for more information and to apply.



 

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

 

MSSNYeNews: Iceberg Right Ahead – January 3, 2020

Arthur Fougner MSSNY Presiident

PRESIDENT’S MESSAGE
Arthur Fougner, MD
MSSNY President

MSSNY eNews
January 3, 2020

Vol. 23  Number 1


MSSNYPAC Seal


Colleagues:

We all remember the scene from Jim Cameron’s Titanic when the lookouts first notice the looming iceberg. Well, that is how I felt when I opened my email before getting ready to celebrate the coming of the New Year. Then, I saw this on my twitter feed:

Doctor's Tweet

That is right— once again, the government’s first solution to a healthcare budget deficit is to cut doctors’ payments. We clearly are regarded as low-hanging fruit here. Imagine the response of say the TWU if the solution to MTA fiscal problems were to first cut the workers’ pay? Right. Well, it’s 2020 and our issue clearly comes into 20-20 focus.

It is as obvious today as it has ever been. Medicine is the only US enterprise that regularly gets to enjoy a Cost of Living DECREASE. While we await further budget details to be hashed out, this is time for real New Year’s resolutions.

Let me be clear – we all need to come together. A House of Medicine divided cannot stand. And so, I call for a gathering – a Summit— if you will. We will put out an invite for our many groups – our ethnic societies, our specialty societies, employed physicians, independent physicians – everyone should be present.

As the Doors put it: “The time to hesitate is through. No time to wallow in the mire.”

Let’s Do It!

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

Arthur Fougner, MD
MSSNY President


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FLU ADVISORY
Due to elevated influenza activity in New York State (NYS), this advisory provides updated influenza prevention, surveillance and control guidance along with links and references to influenza resources.


MSSNY’s Weekly Legislative Podcasts


Governor Vetoes Liability Expansion Bills Opposed by MSSNY
Governor Cuomo has vetoed two bills passed by the State Legislature that had been opposed by MSSNY and MLMIC that, if enacted, could have produced further increases to New York’s already exorbitant medical liability insurance costs.  The bills had also been opposed by many other groups who could have been adversely impacted.

The first bill (S.6081/A.2373) would have forced physician defendants into making a “blind gamble” regarding the selection of how a particular court award should be reduced in cases involving multiple defendants where one of the defendants settles prior to trial.

MSSNY raised concerns that this legislation could create the possibility of a plaintiff being unjustly enriched by collecting more than the jury ultimately determined the award to be.  The second bill (S.6552/A.2373) would have allowed plaintiffs to collect a judgment from a third party that is not a direct party to the lawsuit in question but had been sued by the original defendant.  MSSNY raised concerns that it could encourage those parties who are unable to satisfy their apportioned share of liability to dodge their responsibility, while allowing a plaintiff to target deep-pocketed third parties.

MSSNY thanks Governor Cuomo for vetoing these problematic bills, given the enormous liability exposure physicians already face.


Governor Vetoes Patient Protection Bills
At the end of 2019, Governor Cuomo vetoed two pieces of legislation strongly supported by MSSNY, and other patient advocacy groups, that would have protected patients from harmful business practices by Pharmacy Benefit Manager (PBMS), and health insurers, in New York.

  • Cracking Down on PBMs

The first bill, S.6531, would have increased the oversight, transparency and accountability of Pharmacy Benefit Managers (PBMS).

Although, similar protections in the 2019 budget were agreed to for Medicaid beneficiaries, and Governor Cuomo had proposed additional requirements for PBMs used by commercial plans, he vetoed the bill because of concerns that provisions could be pre-empted by ERISA, and invite scrutiny from the FTC and DOJ and “sweep in plans that are not true PBMs, but rather health benefit funds only.”

  • Ending Plans’ Ability to Make Mid-Year Changes to Drug Formularies

A second bill, S.2849, would have created a list of safeguards designed to protect patients with private, commercial health insurance plans seeking to remove drugs from their pharmacy benefit formularies, in the middle of a contract year. New York’s current law puts thousands of patients at risk of losing access to therapies for such chronic and life-threatening diseases as epilepsy, rheumatoid arthritis, multiple sclerosis, among many others. It also usurps decisions by physicians as to what the most effective therapy is to treat a patient’s condition.

The Governor vetoed the bill because of concerns that “Insurers would have to anticipate and set rates for hypothetical future drug price increases, causing higher premiums for everyone, while pharmaceutical companies would be able to raise their prices with impunity”.

MSSNY pushed hard for passage of both these bills and will continue to advocate for these patient protections in the new legislative session.


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Governor Signs MAT Access Bill for Commercial Insurers and Vetoes MAT Access Bill for Medicaid
As the year came to an end Governor Cuomo signed and vetoed bills that would expand access for patients to Medication Assisted Treatment (MAT), both bills that had been strongly supported by MSSNY and the American Medical Association.

The first bill (A.2904/S.4808) that was signed into law requires commercial health insurance companies to eliminate prior authorization requirements for all MAT.  A provision enacted earlier in the year removed prior auth requirements for formulary approved MAT, but not all forms of MAT.  This gap was particularly problematic if a patient was stabilized on a particular form of MAT, but switched insurance company coverage.  Medical evidence shows that MAT promotes recovery from opioid use disorders, saves the health care system money. Prior authorization requirements for MAT delay access to evidence-based care.

However, the Governor vetoed similar legislation (A.7246/S.5935) that would have required Medicaid and Medicaid Managed Care plans to cover all MAT without prior authorization requirements. The lengthy veto message noted concerns that  the bill would “provide  a  statutorily-authorized  unfair  competitive advantage to one pharmaceutical manufacturer” which failed to “offer  sufficient  competitive  pricing  to be included on the preferred drug list or on many  managed  care  organization  formularies,  and  in lobbying  for this legislation to eliminate prior authorization requirements, requires Medicaid plans and the State to pay whatever price  this manufacturer charges.”


MSSNY’s Lobby Day – Wednesday, March 4th, 2020
Please plan to join your colleagues in Albany for MSSNY’s ‘Physician Advocacy Day’, which will take place at the Lewis Swyer Theater at The Egg in Albany on Wednesday, March 4, 2020.

Physician participation in this event is critical.  With a $6 billion Budget deficit likely to produce a swath of adverse proposals in the name of achieving “savings”, it is imperative that physicians let their legislators know of the potential adverse consequences to patient care in their communities. As with past years, the morning program will provide 3.0 Continuing Medical Education hours for physicians. To learn more about MSSNY’s Lobby Day click here and to sign up for the event click here.


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Gov. Cuomo Proposes to Ban Flavored Nicotine Vaping Products in State of State
Governor Andrew Cuomo has proposed in his State of the State agenda to ban all flavored nicotine vaping product, including menthol flavors.  The governor has also proposed banning vaping advertisements aimed and youth and authorized the NYS Department of Health to regulate the sale of chemicals used in vaping-related products and ban the sale of vaping product carrier oils deemed a hazard to public health. His proposal also includes legislation that would prohibit the online, phone and mail order sale of e-cigarettes and would require that only registered retailers be allowed to purchase e-cigarettes using these methods.

On the federal level, the Trump Administration and the FDA announced a limited ban of flavored e-cigarettes and the sale of all sweet and fruity flavored vape pods and cartridges, but allows gas stations and convenience stores to continue to sells menthol cartridges and vapes.

MSSNY supports banning all flavored e-cigarettes, including menthol and supports legislation that would also ban all flavored tobacco products, such as chewing tobacco and cigarillos. In December, MSSNY has joined with other public health organizations that called upon the Governor, the Senate and Assembly leaders, and members to pass legislation that would prohibiting the sale of flavored nicotine and tobacco products which will protect our young people from the scourge of the myriad health problems and addictions caused by flavored tobacco products and e-cigarettes. Physicians are encouraged to send a letter through MSSNY Grassroots Action Center (GAC) at: https://p2a.co/hn9SSVu

Additionally, MSSNY supported legislative efforts to increase the legal purchase age for tobacco and e-cigarette products and in November 2019, Governor Cuomo signed into law legislation that accomplished this goal.  In December, Congress passed the Federal Food, Drug and Cosmetic Act that raised the federal minimum age to purchase tobacco products from 18-19; President Trump signed the measure on December 20, 2019.  According to a statement on the FDA’s website, “it is now illegal for a retailor to sell any tobacco product—including cigarettes, cigars and e-cigarettes—to anyone under 21”.


Albany Memorial and Samaritan Hospitals Merge Albany Memorial Hospital and Samaritan Hospital in Troy, N.Y., merged Jan. 1.
Albany Memorial is now a third campus of Samaritan Hospital and has been renamed Samaritan Hospital-Albany Memorial Campus. The hospitals are part of Albany-based St. Peter’s Health Partners, which is a member of Livonia, Mich.-based Trinity Health. “The long-planned and previously announced merger of Samaritan and Albany Memorial represents the fulfillment of our always top-of-mind goal, which is to provide the highest quality, most compassionate, and most accessible care, to all who need it, in Albany, Troy and across the Capital Region,” Michael Finegan, president of acute care at SPHP, said in a news release.


Female Surgeons Face Fertility Issues; Radiation, Surgical Smoke, Exposures
The Telegraph (UK) (1/2) reports research suggests “female surgeons are more than twice as likely to suffer fertility problems due to radiation and the other hazards of operating theatres.”

The study published in JAMA Surgery indicates “there are direct medical risks from working as a surgeon, including from radiation, surgical smoke, anaesthetic gases and other toxic substances.” The researchers point “to a survey of 1,021 US females surgeons across different specialisms that found 32 per cent of respondents reporting difficulty with fertility, compared to 10.9 per cent in the general population,” and “the same study saw a pregnancy complication rate of 35.3 per cent, compared to 14.5 per cent generally.”


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Mysterious Pneumonia Cases in China Prompt International Concern
Infectious disease experts are keeping a close eye on a mysterious outbreak of pneumonia in central China that has sickened more than three dozen people, reports Bloomberg.

As of Jan. 3, 44 pneumonia cases have been confirmed in Wuhan, China, according to a statement from the city’s health agency cited by the publication.

The World Health Organization is working with the Chinese government to investigate the outbreak. Health officials have ruled out common respiratory illnesses like the flu, but the exact cause of the illness is still unknown.

Several of the sickened individuals worked at a local market that sold animals like birds and pheasants. This detail is prompting concerns that an unknown animal virus may have spread to humans, reminiscent of the 2003 SARS outbreak, which killed nearly 800 people.


WEBINAR

“Doctor Are You Ready?” CME Webinar on January 15; Registration Now Open
Disasters big and small happen every day.  Be sure to find out how best to be prepared at MSSNY’s next Medical Matters webinar: Doctor Are You Ready? on January 15th at 7:30am.  Kira Geraci-Ciardullo, MD, MPH immediate past speaker of the house and a member of the Emergency Preparedness and Disaster/Terrorism Response Committee will serve as faculty for this program. Registration is now open for this webinar here.  Please click here to view the flyer for this program.

Educational objectives are:

  • Explore core preparedness competencies every physician should possess
  • Describe emergency situations that arise on a regular basis
  • Identify resources to acquire preparedness training

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

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

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


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We improve the employee and patient experience to help you achieve your goals and grow your practice. How? With strategic processes that support you, your staff, and your patients! We integrate your values into all areas of your practice including hiring, training, communication and operational strategies. Whether you’re independent or part of a group, we have an approach that will work for you. If you’re ready to strengthen your practice, we can help. smays@thepractice.coach https://www.thepractice.coach/  https://www.instagram.com/practicecoach/ https://twitter.com/coach_practice


RENTAL/LEASING SPACE


Furnished Luxury Park Avenue East 70’s Medical Office Rental Available.
Voted most beautiful block on UES. Private Entrance. Central A/C.
Dedicated consultation room, exam room, procedure room, reception and nurse areas in a multispecialty office setting. Suitable for all subspecialties.Walk to Lenox Hill Hospital and NY Cornell. Proximate to Mt Sinai Hospital. Subway 2 blocks away. Full Time/Part Time. No fee.
START SEEING PATIENTS IMMEDIATELY!!!
Please call or text 929 316-1032


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PHYSICIAN OPPORTUNITIES

Pediatric Board Tutor
Looking for a tutor for Initial Pediatric Board Exam
Flexible hours, Negotiable rate. If interested please email at: pedboardhelp@gmail.com


 

NYS Corrections Logo

Great Career Opportunities for Clinical Physicians
Physicians, are you looking for a change?  Tired of working long shifts with an overwhelming patient load?  Come work at a well-equipped and staffed correctional facility where you can MAKE a difference, working with a smaller number of patients for reasonable hours.

Starting salary is $143,381 – $171,631 *Additional $20,000 geographical differential for Clinton & Franklin CF, and $10,000 for Five Points, Greene and Groveland CFs. We offer full-time, part-time & hourly/per-diem positions.

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

Clinton*                 Clinton Correctional Facility (sporting and recreational outlets)
Chemung               Elmira and Southport Corrl Facilities (Gateway to the Finger Lakes)
Columbia*             Hudson Correctional Facility (antiquing, arts & collectables)
Dutchess                Green Haven Correctional Facility (Hudson River Valley Beauty)
Franklin*                Franklin & Upstate Corrl Facilities (North Country, 1 hour to Montreal)
Greene*                 Greene Correctional Facility (rural charm yet only 2 hours to NY City)
Livingston*            Groveland Correctional Facility (State Parks, hiking, fishing)
Oneida                   Mohawk Correctional Facility (Cooperstown, breweries)
Orleans                  Albion Correctional Facility (Greater Niagara Region & Canal Town Culture)
Sullivan                  Woodbourne Correctional Facility (mountains, outlets, entertainment)
Seneca*                 Five Points Correctional Facility (heart of wine country)
St. Lawrence          Riverview Correctional Facility (hiking, boating and museums)
Ulster                     Shawangunk and Wallkill Corrl Facility (Catskill Mountains, Casinos)
Washington           Great Meadow Corrl Facility (Between Vermont & Green Mountains)
Westchester           Bedford Hills Correctional Facility (Less than 1 Hour to NYC)
Wyoming               Wyoming Correctional Facility (waterfalls, family farms, natural beauty)

NYS Corrections Personnel Ad

Inquire with the Facility Personnel Office regarding benefits and anticipated opportunities: http://www.doccs.ny.gov/faclist.html. Contact: www.doccs.ny.gov or DOCCS Personnel Office at (518) 457-8132 for more information and to apply.


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

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 


MSSNY Responds to Announcement of New York’s Medicaid Cuts


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
January 2, 2020

MSSNY RESPONDS TO ANNOUNCEMENT OF NEW YORK’S MEDICAID CUTS 

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

“While we understand the need to address significant Budget deficits, physicians across New York are confounded by the announced cuts to their payments for care delivered to their patients insured by Medicaid.  This is particularly difficult to accept given that they were not the beneficiaries of increases to Medicaid payments recently granted to other parts of the health care system.  In fact, Medicaid physician payment remains a very small part of New York’s overall Medicaid Budget.  No wonder, given that New York has one of the lowest Medicaid to Medicare physician payment ratios in the country.

As we try to address system health costs, and assure patients get the right care at the right time in the right setting, we should be taking steps to expand the availability of community primary and specialty care physicians in Medicaid Managed Care and traditional Medicaid. Further reductions in inadequate compensation will not accomplish that objective.”

# # #

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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Doctors Are Against Unjustified High Cost of Prescriptions


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
December 18, 2019 

DOCTORS ARE AGAINST UNJUSTIFIED HIGH COST OF PRESCRIPTIONS

Statement attributable to:
Art Fougner, MD

President, Medical Society of the State of New York

“We welcome Governor Cuomo’s announcement of a proposal to help to reduce the cost of some prescription medications for our patients, and look forward to reviewing further details regarding this proposal.  Patients in need of life-saving and health-maintaining medications, including insulin, must be able to receive them in a timely manner.  Furthermore, the Medical Society of the State of New York has long-standing policy supporting the investigation of sudden unjustified increases in the cost of prescription medications. We must continue to examine ways to ensure our patients are truly able to obtain the medications they need to lead a healthy life, including preventing inappropriate PBM or health insurer interference with patients receiving these needed medications.”

# # #

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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MSSNYeNews: December 20, 2019 – Merry Grinchmas – Stupid Insurance Tricks

Arthur Fougner MSSNY Presiident

PRESIDENT’S MESSAGE
Arthur Fougner, MD
MSSNY President

MSSNY eNews
December 20, 2019

Vol. 22  Number 47


MSSNYPAC Seal


Colleagues:

This is the last MSSNY Enews of the year. I was thinking of a holiday theme. Unfortunately, the Grinches of United Healthgroup have managed to drop a ton of coal in my stocking. So what has set me off? Well, this afternoon, I received a disturbing email about the Minnesota Miscreants. It seems that all claims are being systematically denied and requests for audits of medical records issued for each claim.

Procedures and visits are routinely downcoded. Remember, United just reported earnings for the third quarter of over 60 Billion Dollars. That’s roughly forty times the largest Powerball jackpot ever. In 2018, United CEO David Wichmann received total compensation of over $21 million. Let that all sink in for a moment. A man received a sum that would make even Midas jealous for denying claims for the care of folks whose only mistake was in paying premiums to his company.

We have been fighting this War on Doctors for many years. This year, much of my time has been occupied by the issue of unexpected Out of Network bills, dubbed Surprise Bills. Physicians are being portrayed by Health Policy wonks as “Greedy Doctors.” Yet the late Uwe Reinhardt offered that if you compared doctors to the talent pool from which they are recruited, physicians are woefully underpaid.

Moreover, about half of their revenue is absorbed by practice overhead. In addition, this doesn’t take into account college and medical school debt. Medicare payments for over twenty years have been essentially flat compared with the rising cost of living. But the doctors are greedy. Physicians account for, at most, 7.5% of total US healthcare spending. The doctors are greedy— really? Physicians contribute to local, state and federal economies both directly and indirectly by providing jobs, being consumers, and, oh yes, paying taxes. But hey, let’s pillory those greedy doctors.

I have spoken to Albany and NY’s Department of Financial Services has been alerted. However, they need data. So here’s my ask – send me as much information as possible about the insurer, the numbers of claims, what’s being denied, what info is being demanded, etc. The more specificity the better. Send it to me directly. I promise that I will collate the information and dispatch it to Albany if I have to walk it up myself.

We have fought these adversaries before – taking on Oxford and winning a class action suit, working with then Attorney General Cuomo to take down Ingenix. We have called them on their Stupid Insurance Tricks and won. To quote the late President George HW Bush, “This aggression will not stand.”

And to quote his son, President George W. Bush, “We will not waver; we will not tire; we will not falter; and we will not fail.”

And to you and yours, I, along with everyone at MSSNY, wish for you a Happy and a Merry. May the blessings of this holiday season last the whole year long.

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

Arthur Fougner, MD
MSSNY President


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MSSNY Together with Physicians Nationwide Raise Concerns with One-Sided Surprise Billing Proposal
With the passage of a 6-month federal Budget resolution this week by the US Congress that did not contain provisions to address “surprise” out of network medical bills, consideration of this issue will continue into 2020.  As consideration continues, physicians should continue to contact Senators Schumer and Gillibrand, as well as their US Representative, to urge for a balanced solution to protect patients from “surprise” out of network medical bills.  Physicians can send a letter here.

Last week, competing legislative proposals were advanced.  MSSNY, together with organized medicine, raised huge concerns with the insurance industry-friendly proposal advanced by Senator Alexander (R-TN) and Rep. Frank Pallone (D-NJ) that would provide health insurers with new incentives to drop physicians from their networks by enabling them to make payment for such surprise bills at the insurer-determined median in-network rate.  While an appeal arbitration mechanism would be available, it appears it would practically offer little recourse for a physician to be paid above benchmark payment.

MSSNY President Dr. Art Fougner issued a statement urging Congress to “go back to the drawing board”, noting that “the just announced Alexander-Pallone proposal Congress would hand market dominant health insurers a shiny new club to enable it to drop more physicians from their networks.”  The statement also praised “the many members of the NY delegation, including Rep. Morelle and Senator Schumer, for their efforts to assure the passage of a far more balanced approach that protects patients’ access to timely needed care.”

This week, Dr. Fougner also responded to an adverse article in Crains that cited statistics from New York union 32 BJ that had paid $10 million in out of network claims over the last 3 years.  Dr. Fougner’s response noted that: “Employer and union plans, such as 32BJ, should not be able to both have their cake and eat it too. They should not be able to both severely limit their physician/hospital networks and then complain about having to pay out of network claims when their insureds—our patients—inevitably need to be treated by an out of network physician due to an inadequate network.”

Separately, House Ways & Means Committee Chair Richard Neal (D-MA) and W&M Ranker Kevin Brady (R-TX) announced their own proposal to address surprise medical bills that, according to a press release “respects the private market dynamics between insurance plans and providers and first allows them to work out differences without interference. If the parties cannot come to agreement on their own, the agreement provides for a robust, impartial, and structured process to settle payment”.  However, no other information has been made available beyond this general description.


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Physician Action on Key Health Care Legislation Needed
As we approach the end of the year, several bills of strong interest to physicians and patients that passed the Legislature have been sent to the Governor for his consideration.  As noted below, please urge the Governor to sign TWO bills that would limit the power of health insurers and PBMs to limit patients’ access to needed prescription medications.   At the same time, please urge opposition to TWO bills that would expand already outrageously high liability costs facing physicians.

  • Protect against Insurer 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 urge the Governor to sign this bill into law.
  • Support Regulation of PBMs– This legislation would enable the State Department of Financial Services for the first time to oversee the practices of the PBM industry, and help to provide greater assurance that PBMs develop their prescription formularies fairly.  Please urge the Governor to sign this legislation into law.
  • Oppose Liability expansion– two bills passed the Legislature that will further tip the scales in lawsuits against physicians and the business community generally, 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 urge the Governor to veto these bills.

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Physicians Ordering Home Care for Your Patients – Are You Aware of the Impact of the New Medicare PDGM Methodology?
Starting in 2020, Medicare is significant revising how it will pay for patient home care services through a new methodology known as the Patient-Driven Groupings Model (PDGM).

The PDGM is a new payment methodology for home care that relies more heavily on clinical characteristics and other patient data to classify home health services into more meaningful payment categories. It is part of CMS’ effort to shift Medicare payment away from volume-based payment towards value-based payment.   However, the new model could produce significant new documentation responsibilities for physicians.

In particular, the PDGM will break up the standard 60-day episode of care into one of two 30-day periods. That means 30-day periods will be implemented as a basis for payment vs. the 60-day periods used now. Each 30-day period is grouped into one of 12 clinical categories based on the patient’s main diagnosis. Moreover, the PDGM will increase the number of payment groupings and unique case-mix potential from 153 to 432. The current system allowed for 153 combinations, but with PDGM each 30-day period can be categorized into one of 432 case-mix groups.

The National Association for Home Care & Hospice (NAHC) has developed a suite of resources for physicians interested in learning more about the PDGM.  To read more about what physicians ordering home care services need to know about this program, please review here.

At the November 7, 2019 meeting of the MSSNY Council, a resolution was adopted to monitor implementation of the PDGM “to determine whether this new program will impose additional administrative burdens on physicians certifying home care services for their patients, and/or whether it will impede patients from receiving needed home care services”.


First Long-Term Study of Health Impact of Vaping Points Way to Regulation of All Tobacco Products
On December 16, 2019, the first long-term study of e-cigarette use was published in the American Journal of Preventive Medicine. The results show conclusively that the use of e-cigarettes dramatically increases the risk of lung disease. It also found that dual use of combustible and electronic cigarettes increases risk beyond using either product alone. This information should be used immediately to inform tobacco regulation at the national, state and local levels. Unfettered access to these products is a public health threat.

The study did not conclude whether vaping is as dangerous as smoking combustible cigarettes, nor did it set out to do so. This question is largely irrelevant. Traditional cigarettes are the most dangerous consumer product in history, killing nearly half a million Americans each year. E-cigarettes need not be as dangerous to warrant strict regulations or sales bans.

A number of cities and states have already taken decisive action to curtail youth e-cigarette use by banning flavors or even overall sales. ASH believes that a flavor ban is a reasonable approach, provided it covers all flavors, including mint and menthol. Other studies have shown that the vast majority of youth e-cigarette users use flavored products. ASH also urges the Food and Drug Administration to re-open its efforts to reduce nicotine in all tobacco products to non-addictive levels.

As legislators consider how to address the e-cigarette epidemic, they should take a broad view of tobacco product sales. Addressing only e-cigarette sales can lead to inconsistent public health policy, for example: eliminating menthol e-cigarettes but leaving menthol cigarettes – which have killed millions – on the shelf.

The most comprehensive and defensible approach is to phase out the sale of all commercial tobacco products, as Beverly Hills, CA has done.


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Study: Adding Genetic Testing to Management of Patients with IBD May Help Determine Which Patients May Be At Greater Risk for Loss of Response
Healio (12/18) reports, “Adding genetic testing to the management of patients with inflammatory bowel disease [IBD] may present an opportunity to determine which patients are at greater risk for loss of response and help select the best therapies for each individual patient,” research indicated. In a presentation given at the Advances in Inflammatory Bowel Disease annual meeting, researchers discussed “the HLA-DQA15 allele and its ability to help predict loss of response.”

In a “study comprising more than 1,600 patients in Europe,” investigators “found that the presence of the allele was associated with a significant likelihood of loss of response due to antibody formation to both Remicade (infliximab, Janssen) and Humira (adalimumab, AbbVie),” with the “highest rate for loss of response…found among patients on infliximab monotherapy without an immunomodulator.”


Cold and Flu Rarely Strike at Same Time, Study Finds
People may be less likely to get the flu if they already have a common cold, according to a study published in Proceedings of the National Academy of Sciences.

For the study, researchers analyzed data on 44,230 respiratory illness samples from 36,157 patients in Glasgow, Scotland, between 2005 and 2013. Researchers tested each patient for 11 different virus groups.

Thirty-five percent of samples tested positive for a virus, and 8 percent were infected with more than one type of virus at the same time. Researchers also discovered an inhibitory interaction between flu and rhinoviruses, which are responsible for the common cold, at both an individual and population level.

“When there is a lot of flu in the population, there is little rhinovirus, and vice versa,” said study author Dr. Pablo Murcia, a researcher at the University of Glasgow Centre for Virus Research.

This trend may explain why cold and flu seasons peak at different times of the year on a cyclical basis. It also highlights the need for researchers to study viruses together like an ecosystem, rather than studying one at a time, Dr. Murcia said in a press release.


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Trump Administration Proposes New Rules to Increase Organ Transplants
The AP (12/17) reports the Trump Administration “proposed new rules Tuesday to increase organ transplants – steps to make it easier for the living to donate and to make sure that organs from the deceased don’t go to waste.” The article outlines the proposed rules that would increase potential reimbursement for donors and hold “organ procurement organizations” to higher standards.

The Hill (12/17, Sullivan) reports HHS “said that 20 people die each day while on the waitlist for a life-saving organ transplant, and that the new rules are intended to reduce that number and save lives.”

Health Exec (12/17, Baxter) also covers the story.


VA Discontinues Star Ratings System for Hospitals
The U.S. Department of Veteran Affairs has discontinued its star ratings system in an effort to improve transparency and allow veterans seeking healthcare to more easily compare VA and non-VA facilities.

The star ratings system, developed as an internal tool, enabled veterans to compare quality and performance at VA facilities.

However, the ratings did not “provide insight as to how our hospitals stack up against nearby non-VA facilities and are therefore of little value in helping veterans make informed healthcare decisions,” VA Secretary Robert Wilkie said in a news release.

Instead, each VA hospital’s website now features links to tools that will allow users to compare wait times, quality of medical care and patient experience ratings at facilities in their local area.

The VA will, however, continue to publicly release its Strategic Analytics for Improvement and Learning data that is used to internally manage hospital performance within the VA’s health system. Strategic Analytics for Improvement and Learning data assesses 60 quality metrics, overall efficiency and physician capacity.


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Study Suggests Eliminating H. Pylori Tied To 75 Percent Reduction In Gastric Carcinoma Risk
A recent research study indicates, “eliminating Helicobacter (H) pylori from a patient’s gastrointestinal tract could lead to a 75% reduction in risk of gastric carcinoma.” The retrospective study  https://www.gastrojournal.org/article/S0016-5085(19)41464-9/fulltextof over 370,000 veterans published in Gastroenterology “also found that racial and ethnic minorities, as well as smokers, were at significantly higher risk of gastric cancer after detection of H pylori.”


Hospitals Sue HHS to Block 2020 Medicare Drug-Rate Rule
Bloomberg Law (12/17) reports behind a paywall that hospitals across the US “are suing the Health and Human Services secretary in federal court in the District of Columbia to stop implementation of a 2020 rule governing the rate the agency will reimburse them for certain medications.” The challenged rule “reduces by nearly 30% Medicare reimbursements to certain public and not-for-profit hospitals for prescription drugs they purchase at a discounted price under the 340B program.” It “takes effect Jan. 1, 2020, and expands the facilities subject to the reduction to include off-campus provider-based departments.”


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WORKERS COMP

Information Re WC Deposition Fees for Depos Given on or/after October 2018
When a depo is ordered, the standard direction provides “A medical witness is entitled to a witness fee pursuant to Part 301 of Title 12 of the Official Compilation of Codes, Rules and Regulations of the State of New York. Within ten days of the completion of a witness’s deposition, the party responsible for such witness’s fee, if any, pursuant to the Workers’ Compensation Law and regulations, shall remit payment of the fee to the witness.  The fee is to be awarded in like manner as a witness fee, awarded for attendance at a hearing, irrespective of the location where the deposition takes place (including telephone and video testimony).  If the witness believes that the fee in excess of that set in Part 301 is warranted, such witness must submit a request to the Board within ten days of the deposition.  The Board will review such request and issue a subsequent decision concerning whether an additional fee is warranted.”

This standard language has been used by the WCB for many years.  When a claimant’s physician testifies, the fee must be paid within ten days.  If the doctor is not timely paid, the doctor should send a letter to the carrier, saying “I was deposed on X date, directing that I be paid within 10 days of my testimony. I have not been paid to date.  Please pay me within 10 days of this letter.”

If the carrier still does not pay within the demanded time frame, the doctor should send a letter to the Board, laying out the dates, saying “ I still have not been paid”, and attach the letter that was sent to the carrier.  The WC Board can issue an Administrative Determination directing payment of the standard fee under Regulation 301 (the Administrative Determination cannot provide for any requested extra fee— as the standard language above says, that has to be ordered by the WCLJ in the decision regarding the disputed issue for which testimony was taken).

If this process is followed, the WCB can then identify recalcitrant carriers, and penalize them.  It is expected that this process could very quickly put an end to this practice, and more importantly, will get doctors paid timely.

For your ease in complying with the process, MSSNY has created these templates for your use.


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FDA Clears First Interoperable, Automated Insulin Dosing Controller
The FDA on Friday authorized the first interoperable, automated glycemic controller device. The Tandem Diabetes Care Control-IQ Technology adjusts insulin delivery to a patient with diabetes by connecting an insulin pump to a continuous glucose monitor.

Previous software to automate insulin delivery was approved as part of a single system. The Tandem Control-IQ technology, meanwhile, is designed to communicate with numerous compatible devices.

In a news release, an FDA official said that the authorization “help[s] ensure the safety and efficacy of innovative and customizable diabetes management systems that may help patients better tailor their treatments to their individual needs.” FDA news release


US Deaths from Alcohol-Related Liver Disease at Highest Levels since 1999
CDC data revealed that “U.S. deaths from alcohol-related liver disease (ALD) are at their highest levels since 1999 and have risen every year since 2006 in nearly every racial, ethnic and age group.” After analyzing “causes of death for people aged 25 and older in the two decades since 1997,” investigators “found that 2017 had the highest rates of death from ALD, at 13.1 per 100,000 deaths in men and 5.6 per 100,000 in women,” which “compares to 1999 ALD mortality rates of 10.6 per 100,000 in men and 3.3 per 100,000 in women.”

In particular, “mortality rates and recent increases in ALD diagnoses were…pronounced among middle-aged adults, Native Americans and non-Hispanic whites,” the study found. The findings were published online in the American Journal of Gastroenterology


Decline in US Life Expectancy
The decline in US life expectancy U.S. residents for decades had seen improvements in average life expectancy, but the trend reversed in 2014, according to a study published in JAMA. Researchers found that, since 2014, more U.S. residents have been dying at middle age from drug overdoses, diseases, obesity, suicide, and dozens of other causes.


New Drug Formulary FAQs
Now that the NY WC Formulary for new prescriptions has been in effect for almost two weeks, the Board has received some frequently asked questions and would like to make all stakeholders aware of them.

Please visit the Board’s Drug Formulary Overview webpage for:

  • An overview of the NY WC Formulary and the prior authorization process
  • The latest version of the NY WC Formulary: A Quick Guide and Video            overviews
  • A NY WC Formulary Dashboard Guide for Payers/TPAs
  1. Can a provider submit a prior authorization request via the Medical Portal for a non-formulary medication that is a continuation/refill of an existing prescription? 

Yes. The Board required that carriers provide prescribers with a list of their patients currently taking non-formulary medications by December 5, 2019. This requirement was put in place so that prescribers can immediately start either (a) switching their patients to formulary medications, or (b) submitting prior authorization requests in advance of the June 5, 2020, date.

  1. Should carriers process prior authorization requests for continuation/refill of medications submitted prior to June 5, 2020?

Yes. All prior authorization requests submitted via the Medical Portal (whether for new or continuation/refills) should be processed and reviewed.

Although refills/renewals of medications are not required to comply with the New York Workers’ Compensation Drug Formulary (NY WC Formulary) until June 5, 2020, if a prescriber submits a request via the Medical Portal, the carrier must process and review the request.

  1. What documentation is required from the prescriber to support a prior authorization request for the renewal/refill of a non-formulary medication?

The prescriber must provide the clinical rationale/justification for the use of the non-formulary medication.

  1. How should a prior authorization request for a refill/renewal of a non-formulary medication be processed by the carrier that is submitted prior to June 5, 2020?

If the prior authorization request provides appropriate clinical rationale/justification that would justify the use of the non-formulary medication, it may be approved for up to a one-year supply.  Said differently, if you were reviewing this on June 5, 2020, and would approve it, then approve it now for up to one year.

If the prior authorization request does not provide appropriate clinical rationale/justification for use of the non-formulary medication, then an approval (for up to a 30-day supply of the medication) should be granted. The reviewer should indicate that it is being approved as a refill/renewal for no more than a 30-day supply in anticipation that a subsequent request will be submitted with appropriate documentation to fully support the use of the non-formulary medication.

While a variance is not necessary for a refill/continuation of a medication, if an Attending Doctor’s Request for Approval of Variance and Carrier’s Response (Form MG-2) for a refill/continuation is submitted, the carrier should process the request using the current procedures until June 5, 2020, at which time all requests must go through the Medical Portal Prior Authorization process. Please be reminded that all requests for new medications must go through the Medical Portal Prior Authorization System effective December 5, 2019.

  1. I received a denial for a non-formulary request stating that the request was denied because the drug is not on the NY WC Formulary. Isn’t that what the non-formulary prior authorization requests are for, drugs not on the NY WC Formulary?

Yes, that is correct. If a drug is not on the NY WC Formulary, and the provider wishes to prescribe it, a non-formulary prior authorization request should be submitted using the electronic Prior Authorization System located on the Board’s Medical Portal.

If for any reason, the prescriber does not agree with the Level I or Level II denial or partial approval of their request, they should request the next level review.

  1. I requested oxycodone/acetaminophen 5mg/325mg for a patient that has been on it for five years. The patient is back to work, doing well, fully functional, but needs ongoing opioid medication for breakthrough pain. I requested prior authorization for a 365-day supply but received partial approval for a 30-day supply with the instruction that I need to wean the patient.  Is this an appropriate use of the prior authorization process?

The prior authorization request initiated by the provider was correct. The carrier’s advisory comment regarding weaning is not a direction to wean. A weaning direction can only come through the RFA-2OP process, which can only be ordered by a Workers’ Compensation Law Judge.

  1. If a medication (e.g., an opioid) is recommended per the Medical Treatment Guidelines, is it still necessary to get a prior authorization?

Opioids are considered formulary during Phase A only, and for a one-time seven-day supply only. Use of opioids outside of the Phase A one-time seven-day supply needs prior authorization. Documentation must support that the injured worker who requires long-term opioids demonstrates objective gains/maintenance of function with improved pain control consistent with the Non-Acute Pain Medical Treatment Guidelines recommendations.

  1. How many days’ supply of a formulary or non-formulary drug can I prescribe?

Phase A formulary drugs may be prescribed for up to a 30-day supply. Phase B formulary drugs may be prescribed for up to a 90-day supply.

When a prescriber submits a prior authorization request for a non-formulary medication, the request can be submitted and approved for up to a 365-day supply; however, the prescription can only be written for a maximum of a 90-day supply. If a prior authorization request for a 365-day supply is approved, the clinician can write the prescription for a 90-day supply with three refills.

Prior authorization requests for controlled substances (NYS CII – CV) can also be approved for up to a 365-day supply.  Prescribers would need to follow NYS Controlled Substances laws (e.g., NYS CIII – CV; 30-day supply with up to five refills, CIIs and benzodiazepines 30-day supply with zero refills). The 365-day supply prior authorization request could be approved, but multiple prescriptions would need to be written to encompass the 365 days.

For more information, visit the Drug Formulary Overview Page; General NY WC Formulary questions: WCBFormularyQuestions@wcb.ny.gov;

Technical support questions:

WCBCustomerSupport@wcb.ny.gov

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Program Year 2018 Open Payments Data Available for Review/Dispute through December 31, 2019
On June 28, 2019 the Centers for Medicare & Medicaid Services (CMS) published Program Year 2018 Open Payments data along with updated and newly submitted data from previous program years (2013-2017). Program Year 2018 data and newly submitted payment records are actively available for review and dispute through December 31, 2019. Learn more about reviewing and disputing public data.

Review Now

Physician and teaching hospital review of the data is voluntary, but strongly encouraged. If you have not previously reviewed the Program Year 2018 data visit https://openpaymentsdata.cms.gov/ to review the publically available data. If you believe any records attributed to you are inaccurate or incorrect in any way you may initiate a dispute and work with the reporting entity to reach a resolution. CMS does not mediate disputes.

For more information on the review, dispute and correction process visit the Open Payments resource page at: https://www.cms.gov/OpenPayments/About/Resources.html.

·       Questions – Contact Live Help Desk

Submit questions to the Help Desk via email at openpayments@cms.hhs.gov or by calling  1-855-326-8366 (TTY Line: 1-844-649-2766), Monday through Friday, from 9:00 a.m. to 5:00 p.m. (ET), excluding Federal holidays. Visit the Resources page on the Open Payments website for many of the above resources.


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RENTAL/LEASING SPACE


Park Avenue Medical Office for Sale
1100 square foot office for sale on Park Avenue in Carnegie Hill in an elegant pre-war, coop building. High ceilings complement two large consulting offices, spacious waiting room, administrative room/kitchenette and full bathroom. Enter through private, accessible street entrance or attended lobby. Currently configured for two psychiatrists, easily adaptable to any specialty with multiple exam room possibilities. Extraordinary location convenient to transportation and medical centers. Full listing available at http://ow.ly/IdA130pN5Ua. Call Robin J. Roy, Licensed Real Estate Salesperson, at 212-360-2292 or email robin.roy@corcoran.com for information and showings.

Furnished Luxury Park Avenue East 70’s Medical Office Rental Available.
Voted most beautiful block on UES. Private Entrance. Central A/C.
Dedicated consultation room, exam room, procedure room, reception and nurse areas in a multispecialty office setting. Suitable for all subspecialties.Walk to Lenox Hill Hospital and NY Cornell. Proximate to Mt Sinai Hospital. Subway 2 blocks away. Full Time/Part Time. No fee.
START SEEING PATIENTS IMMEDIATELY!!!
Please call or text 929 316-1032
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Park Avenue – Private Street Entrance, Same Block as Subway
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

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

Part-Time Pediatrician / Family Practicitioner Wanted for Private Rochester Area Office
Looking to fill a part time position in a private pediatric office serving Rural and Urban diverse population. Pediatrician and Family Practitioner if interested please send CV to : syedmasood@frontiernet.net


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Great Career Opportunities for Clinical Physicians
Physicians, are you looking for a change?  Tired of working long shifts with an overwhelming patient load?  Come work at a well-equipped and staffed correctional facility where you can MAKE a difference, working with a smaller number of patients for reasonable hours.

Starting salary is $143,381 – $171,631 *Additional $20,000 geographical differential for Clinton & Franklin CF, and $10,000 for Five Points, Greene and Groveland CFs. We offer full-time, part-time & hourly/per-diem positions.

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

Clinton*                 Clinton Correctional Facility (sporting and recreational outlets)
Chemung               Elmira and Southport Corrl Facilities (Gateway to the Finger Lakes)
Columbia*             Hudson Correctional Facility (antiquing, arts & collectables)
Dutchess                Green Haven Correctional Facility (Hudson River Valley Beauty)
Franklin*                Franklin & Upstate Corrl Facilities (North Country, 1 hour to Montreal)
Greene*                 Greene Correctional Facility (rural charm yet only 2 hours to NY City)
Livingston*            Groveland Correctional Facility (State Parks, hiking, fishing)
Oneida                   Mohawk Correctional Facility (Cooperstown, breweries)
Orleans                  Albion Correctional Facility (Greater Niagara Region & Canal Town Culture)
Sullivan                  Woodbourne Correctional Facility (mountains, outlets, entertainment)
Seneca*                 Five Points Correctional Facility (heart of wine country)
St. Lawrence          Riverview Correctional Facility (hiking, boating and museums)
Ulster                     Shawangunk and Wallkill Corrl Facility (Catskill Mountains, Casinos)
Washington           Great Meadow Corrl Facility (Between Vermont & Green Mountains)
Westchester           Bedford Hills Correctional Facility (Less than 1 Hour to NYC)
Wyoming               Wyoming Correctional Facility (waterfalls, family farms, natural beauty)

NYS Corrections Personnel Ad

Inquire with the Facility Personnel Office regarding benefits and anticipated opportunities: http://www.doccs.ny.gov/faclist.html. Contact: www.doccs.ny.gov or DOCCS Personnel Office at (518) 457-8132 for more information and to apply.


Physician Insights Wanted to Help Shape the Future of Primary Care
98point6 is a healthcare technology company committed to delivering more affordable, accessible, high-quality primary care. To support our mission, we need the insights of forward-thinking physicians that have opinions about the current state of primary care and are interested in the role technology can play in healthcare. Members of our exclusive Primary Care Council have no clinical responsibilities and are generally compensated for participation, which requires only a few hours per year. Interested? Learn more and apply today at: 98point6.com/pcc/


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

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 


It’s Time! Put Patients Over Paperwork


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
December 16, 2019

It’s Time! Put Patients Over Paperwork

December 16, 2019, Westbury, NY—A physician’s time should be spent delivering care to their patients—not on the phone with insurance companies.

“The excessive time spent attempting to achieve prior authorizations has been well-documented as a significant factor in the increasing problem of physician ‘burnout,’ said Art Fougner, MD, president of the Medical Society of the State of New York. “ We must find ways to reduce the excessive hassles that keep physicians from spending time with their patients.”

The amount of time physicians need to manage bureaucratic hassles imposed by health insurers to ensure their patients obtain needed care and medications have become intolerable.  A recent Annals Of Internal Medicine study found that a physician spent two hours on administrative tasks for every hour spent with a patient.  A just conducted study by the Medical Society of the State of New York (MSSNY) found that 43% of responding physicians and their staffs spent more than 10 hours per week managing insurer prior authorization requests alone.

Remarkably, 22% of responding physicians indicated that they and their staff spent greater than 20 hours per week on these tasks!

These administrative roadblocks don’t just take time away from delivering care; they can adversely impact patients, as well.  The survey reported that 92% of physicians indicated that prior authorization requirements at least sometimes adversely impacted their patients’ health, and 48% indicated that they frequently did.

One particular time-waster is repeating prior authorization requests that were previously approved.  94% of responding physicians, and their staff, indicated that they had to repeat a prior authorization request for care or medication that was previously approved. 48% indicated that they often had to repeat previously obtained prior authorization requests.

Even where the Legislature takes action to remediate these problems and protect patients’ access to care, there is no guarantee that these problems will be fixed. For example, the New York State Legislature and Governor Cuomo worked together to enact a law in 2016 that established criteria to allow physicians to override a health insurer’s decision to subject patients to step therapy protocols when warranted by the patient’s individual circumstances.  However, the survey reported that half the respondents to the MSSNY survey said that health plans’ override process was, at the very least, “challenging”, while 28% found the override process to be “extremely difficult”.

Remarkably, over 30% were unable to ever override a health insurer step therapy medication protocol.

“We are hopeful the insurance industry can work with their network physicians and the medical associations who represent them towards addressing these hassles,” said Dr. Fougner.  “Moreover, legislation has been advanced by Assemblyman Richard Gottfried and Senator Neil Breslin (Assembly Bill 3038/Senate bill S.2847) that would reduce the frustrations associated with prior authorization requests, including ensuring they are clinically appropriate and preventing the need to repeat what has already been authorized.  This legislation sets forth a number of important steps to reduce these obstacles that get in the way of patients getting the care they need.”

Let’s truly put patients over paperwork!

# # #

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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MSSNYeNews – Surprise Bills – Deal or No Deal: December 13, 2019

Arthur Fougner MSSNY Presiident

PRESIDENT’S MESSAGE
Arthur Fougner, MD
MSSNY President

MSSNY eNews
December 13, 2019

Vol. 22  Number 46


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Colleagues:

As the year slowly draws to a close, Congress is still wrestling with a fix for Surprise Medical Bills. Despite your pressure and persistence, some of the Committee Chairs still favor setting benchmark rates for out of network care based on insurers’ data for in network payments. Can you say WHAT? I knew you could.

This weekend, the story broke that there was a bipartisan deal in the works to resolve the issue. However, there was just one small problem – the purported deal was an early holiday gift to the insurance companies by setting the payment at the median in-network rate. Oh, they were throwing in a form of arbitration should doctor and insurer not agree, but this would be nothing close to NY’s. Moreover, physicians could only submit one claim every ninety days. Such a deal.

As often in DC, when rumors abound, others arise to take their place.  At this juncture, there is no deal. It is committee against committee and leader against leader. Your advocacy is working, folks. In June, insurers’ benchmarking was a done deal. Apparently, thanks to you, the deal has been slow cooking for so long that it’s not well done, it’s burnt to a crisp. But that’s today. There’s still some time before we can truly say benchmarking is dead for this session. While the bill we favor, based on elements of NY’s law, is also stalled, it’s clear that no bill is better than a bad bill. The backers of benchmarking want to get this done by Friday 13th (irony?) .Many in Congress would agree that it’s better to slow down and get it right. Therefore, it’s imperative that we keep the pressure on.

One easy way you can advocate on this issue is to go here. Just enter your information and send a note to your Representative and also to Senators Schumer and Gillibrand. Many of us have been active on social media as well, advocating for our patients and colleagues, so let’s keep it up.

Make no mistake; it could still be Merry Grinchmas.

For this session, it’s The Final Countdown.

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

Arthur Fougner, MD
MSSNY President


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MSSNY Together with Physicians Nationwide Raise Concerns with One-Sided Surprise Billing Proposal
Physicians are urged to continue to contact Senators Schumer and Gillibrand, as well as their US Representative, to urge that they continue to fight for a balanced solution to help protect patients from “surprise” out of network medical bills.  Physicians can send a letter here.

Competing legislative proposals were advanced this week. MSSNY, as well as the AMA, numerous state medical associations and national specialty societies raised huge concerns with the insurance industry-friendly proposal advanced by Senator Alexander (R-TN) and Rep. Frank Pallone (D-NJ) that would provide health insurers with new incentives to drop physicians from their networks by enabling them to make payment for such surprise bills at the insurer-determined median in-network rate.  While an appeal arbitration mechanism would be available, it would practically offer little recourse for a physician to be paid above the median in-network payment because it would not permit the consideration of regional charges for these services.

MSSNY President Dr. Art Fougner issued a statement urging Congress to “go back to the drawing board”, noting that “the just announced Alexander-Pallone proposal Congress would hand market dominant health insurers a shiny new club to enable it to drop more physicians from their networks, and make it even harder for physicians to negotiate fairly with these insurers”, it would also “make it harder for hospitals to have needed on/call specialty care in their emergency departments for patients in need of this critical care.”

The statement also praised “the many members of the NY delegation, including Rep. Morelle and Senator Schumer, for their efforts to assure the passage of a far more balanced approach that protects patients’ access to timely needed care.”

On Wednesday, House Ways & Means Committee Chair Richard Neal (D-MA) and W&M Ranker Kevin Brady (R-TX) announced their own proposal to address surprise medical bills that, according to a press release “respects the private market dynamics between insurance plans and providers and first allows them to work out differences without interference. If the parties cannot come to agreement on their own, the agreement provides for a robust, impartial, and structured process to settle payment”.  However, no other information has been made available beyond this general description.

While some have speculated that this issue could be punted into January, with Congress looking for revenue for a December 20 Budget extender bill, physicians must continue to advocate for a fair solution to this issue that will not adversely impact patient access to needed care.


Governor Signs Bill Into Law to Reduce Some Prior Authorization Hassles
This week Governor Cuomo signed into law legislation (S.5328, Breslin/A.2880, Hunter) that would reduce the need to obtain prior authorization from a health insurer when a prior authorization for a related procedure has already been obtained from that insurer.  MSSNY supported this legislation and sent a letter to the Governor’s Counsel urging that this measure be signed into law.

This legislation would help to provide additional needed clarity to existing law to prevent patient inconvenience and unnecessary administrative hassles.  It would ensure that if a physician providing a treatment to a patient for which a prior authorization (PA) has already 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 seeks 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 request an additional PA from the insurance company.   We were also been made aware of several instances from the New York State Society of Orthopedic Surgeons where additional necessary health care services performed for a patient in the context of providing previously authorized arthroscopic surgery have been denied for lack of prior authorization and/or submission of different CPT codes.

The law takes effect in March.


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MSSNY Participates in Efforts to Assure Enforcement of NY’s “Step Therapy”
MSSNY Governmental Affairs staff this week participated in a roundtable discussion of patient and provider advocacy organizations to discuss issues related to the implementation of New York’s groundbreaking Step Therapy Reform law.  Adopted by the State Legislature and Governor Cuomo in 2016, it was fully implemented in January 2018.

The goal of the law is to ensure that patients have timely access to the most effective medications to treat or manage their particular condition, by assuring physicians have clearly defined criteria to quickly override a health insurer’s step therapy protocol with a minimum of hassle.  The law also requires health insurers to use evidence-based and peer reviewed clinical criteria in establishing a step therapy protocol.

A recent MSSNY survey reported that many physicians were unaware of the law’s protections.  Moreover, many other physicians reported that health plans’ step therapy override process was “challenging” or “extremely difficult”.

MSSNY has a dedicated webpage to help physicians better understand this important law and how they can effectively override these step therapy protocols when warranted by patient circumstances.  It is noteworthy that, according to DFS data, in 2018 there were only 13 attempted external appeals of a health insurer’s denial of a step therapy override request.

The group also discussed potential next steps to ensure that the law is working as intended, including arranging meetings with state regulators. MSSNY Governmental Affairs staff will continue to actively participate in efforts to ensure the law is being implemented as it was intended when it was enacted.


MSSNY Calls Upon Legislature and Governor to Prohibit the Sale of Flavored Nicotine and Tobacco Products
The Medical Society of the State of New York, working with close to 50 medical and public health organizations, called upon leadership in the New York State Legislature and the Governor to enact policies that would prohibit the sale of flavored nicotine products in e-cigarettes and tobacco products, such as cigarillos and chewing tobacco.

In December, MSSNY began meeting with members of the Governor’s staff and with key Assembly and Senator staff asking for enactment of policy either within the 2020 New York State Budget or early 2020 passage of two bills that would accomplish these important public health goals.  Assembly Bill 47A/Senate Bill 428A, sponsored by Assemblywoman Linda Rosenthal and Senator Brad Hoylman, would prohibit the sale and distributions of all flavored e-liquid, including menthol, for use in e-cigarettes.

Equally important, is Assembly Bill 8808/Senate Bill 6809, sponsored by Assemblywoman Rodneyse Bichotte and Senator Brad Hoylman, which would prohibit the sale and distribution of flavored tobacco products and accessories.  The Medical Society is urging physicians to send letters of support on these two bills to their legislators and to the Governor by going to MSSNY Grassroots Action Center (GAC) here.


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NYS Public Health and Planning Council Approve Continuation of Emergency Regulations on E-cigarettes
The Public Health and Health Planning Council’s Committee on Codes, Regulations and Legislation met on Thursday to continue emergency regulations that included requiring signage warning against the dangers of illegal products and the prohibition on the sale of electronic liquids with characterizing flavors.  The first proposal would require entities to post signage about the dangers of vaping illegal e-cigarettes liquid products. The second proposal would prohibit any individual or entity to possess, manufacture, distribute sell or offer to sell any e-liquid flavor product.

New York State Department of Health Deputy Commissioner Brad Hutton explained that the department was seeking approval from the committee to adopt the proposal to make the signage permanent. It would require retailers to post warning signs on their products.  Mr. Hutton noted that the committee had previously approved the emergency regulation prohibiting flavoring in September. Due to the court recently issuing a restraining order in preventing the department and local health departments from enforcing the ban the emergency regulation will expire December 15. Thus, the department seeks the committee’s approval to have the emergency regulation renewed for another 90 days in the same form as previously approved.


MSSNY Raises Concern to SED with Overbroad Practice Affidavit Form
MSSNY has reached out to top staff to the New York State Education Department (SED) to raise concerns with a problematic new affidavit form required to be completed when a physician practice notifies SED of its proposed formation or a practice name change.  For more information about this development, please see this “alert” prepared by MSSNY’s General Counsel, Garfunkel Wild.

Specifically, SED is requiring that new professional practice entities submit an affidavit when applying for Certificates of Authority to operate in New York State, or for professional practice entity name changes. The affidavit requires that a licensed professional who is either an owner or an authorized shareholder attest to whether the professional practice entity has any “relationship, ownership interest, affiliation or association with any other business and/or professional practice entity.” If there is such a connection, the licensed professional must name the affiliated/associated entity, state the nature of relationship, and attest that the relationship is fully compliant with all applicable rules and regulations of the New York Education Law and Business Corporation Law.

In addition to the confusion this generates, and the breadth of information being requested, there are concerns with the risk of significant penalties because of a component of the affidavit that states, “I understand that any misrepresentation or any false or misleading information in, or connection with, my application may be cause for denial, professional discipline or criminal prosecution.”

SED staff has indicated that revisions to the affidavit form are likely to be made.


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DFS Advises NY Insurers to Provide Vaping Cessation Coverage
The Department of Financial Services has issued a circular letter advising New York insurers to provide coverage for vaping cessation treatment that uses methods recommended for smoking cessation, including screening, behavioral interventions and federally approved pharmacotherapy for adults, as well as behavioral interventions for children and adolescents. Go here.


Transgender New Yorkers Less Likely to Receive HIV Treatment, PrEP
The city health department attributed the lack of HIV-negative transgender New Yorkers receiving care to misinformation circulating online, an official said at a joint hearing of City Council committees today.

Pre-exposure prophylaxis, or PrEP, is a medicine that reduces the risk of getting HIV through sex by 90 percent. It is often a free or low-cost medicine for insured people, while the uninsured will qualify for a new federal program; uninsured New Yorkers can receive PrEP through the city health department and other city services like NYC Health + Hospitals, Dr. Demetre Daskalakis, the city’s deputy health commissioner for disease control, told lawmakers on the health and hospitals committees.

“I’ve heard from a lot of our PrEP programs [that] we don’t have a lot of trans people,” Daskalakis said. “We think there is some misinformation about how PrEP interacts with hormones.”

He said he has seen advertisements falsely state the drugs interact with each other, as well as inaccurate information circulating online. Transgender individuals, regardless of status, are still less likely to receive HIV-related care.

HIV diagnoses in most groups declined in 2018, though transgender people and New Yorkers with a history of injection drug use are receiving care at lower rates, the city health department announced last month. (Politico 12/9)


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Flu is Prevalent in New York State, Health Officials Say
New York officials have declared that the flu is ‘prevalent’ in the state.” The state Department of Health said that as of Nov. 30, “there have been 3,158 laboratory-confirmed cases, 691 hospitalizations and one child death.” New York officials have declared that the flu is “prevalent” in the state.

This declaration initiates a state regulation that will require healthcare professionals who are not vaccinated for influenza to wear masks in areas where patients are present.

“Getting vaccinated remains the best way for all New Yorkers to protect against the flu, and it is vital for caregivers who come in contact with patients to get vaccinated to help prevent the spread of flu,” State Health Commissioner Howard Zucker said.

As of Nov. 30 there have been 3,158 laboratory-confirmed cases, 691 hospitalizations and one child death, according to the state Department of Health.

NYS FLU TRACKER
https://nyshc.health.ny.gov/web/nyapd/new-york-state-flu-tracker


First Time: More Women than Men Enrolled in Medical School
Women comprise the majority of enrolled U.S. medical students for the first time, according to 2019 data released December 11 by the AAMC (Association of American Medical Colleges). This progress builds on the milestone reached in 2017, when, for the first time, women comprised the majority of first-year medical students.

The proportion of women students has been rising over recent years, from 46.9% in 2015 to 49.5% in 2018. In 2019, women comprise 50.5% of all medical school students.

The number of applicants to medical schools rose by 1.1% from 2018 to 2019, to a record 53,371, and the number of matriculants (new enrollees) grew by 1.1%, to 21,869. Across applicants and matriculants, the number of women increased while the number of men declined.

The 2019 data also show that the nation’s medical schools continue to make modest gains in attracting and enrolling more racially and ethnically diverse classes, although these groups remain underrepresented in the overall physician workforce.

  • Applicants who are Hispanic, Latino, or of Spanish origin increased 5.1%, to 5,858, and matriculants from this group grew 6.3%, to 2,466.
  • The number of black or African American applicants rose 0.6%, to 5,193, and matriculants increased by 3.2%, to 1,916. Among black or African American men, applicants and matriculants increased 0.5%, and the total enrollment of black or African American men rose 3.7%, to 3,189.
  • American Indian or Alaska Native applicants grew by 4.8%, to 586, and matriculants rose 5.5%, to 230. Data tables are available here* (Dec. 11 American Assocation of Medical Colleges)

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First Time: More Americans Dying at Home Rather than in Hospitals
In 2017, 29.8 % of deaths by natural causes occurred in compared to 30.7 percent at home, according to research reported on Wednesday in the New England Journal of Medicine. That marks the first time in 50 years that a plurality of Americans were dying at home according to The New York Times.


Low-Dose Aspirin May Fail To Lower Dementia Risk Among Adults with T2D
HELIO reported, “Japanese adults with [T2D] assigned a long-term low-dose aspirin regimen did not lower their risk for dementia vs. similar adults who did not routinely take aspirin,” investigators concluded in a “post hoc analysis of the Japanese Primary Prevention of Atherosclerosis with Aspirin for Diabetes trial.” The findings of the 2,536-participant study were published online in Diabetes Care.


MEDICARE/MEDICAID

The New Medicare Beneficiary Identifier (MBI)
Effective 1/1/2020, the new Medicare Number, commonly referred to as the MBI, will be required for all Medicare inquiries and transactions. If you would like to learn more about the MBI, we have a section of our website with all the information you need to comply with the CMS initiative.
1. Select “Claims & Appeals” then select “Medicare Beneficiary Identifier (MBI).” Or
2. Click on the MBI scrolling banner on our home page. OR
3. Select “Learn About MBI” on our home page.
Avoid your claims being rejected. Use the MBI today.


Members Only: Year-End Car Deals You Won’t Want to Miss


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Most HICN Claims Reject – Regardless of Date Service
Use Medicare Beneficiary Identifiers (MBIs) now to avoid claim and eligibility transaction rejects. Starting January 1, 2020, regardless of the date of service on the Medicare transaction, most Social Security Number – based Health Insurance Claim Number (HICN) Medicare transactions will reject with a few exceptions.

If you do not use MBIs on claims after January 1, you will get:

  • Electronic claims reject codes: Claims Status Category Code of A7 (acknowledgment rejected for invalid information), a Claims Status Code of 164 (entity’s contract/member number), and an Entity Code of IL (subscriber)
  • Paper claims notices: Claim Adjustment Reason Code (CARC) 16 “Claim/service lacks information or has submission/billing error(s)” and Remittance Advice Remark Code (RARC) N382 “Missing/incomplete/invalid patient identifier”

Thank you for transitioning to MBIs during the 21-month transition period, protecting your patients from identity theft.

  • You are currently submitting 87% of claims with MBIs.
  • If your patient doesn’t have their new card, give them the Get Your New Medicare Card flyer in English or Spanish.
  • Get MBIs through the MAC portals (sign up (PDF) now and after the transition period. You can also find the MBI on the remittance advice.

See the MLN Matters Article (PDF) for more information on getting and using MBIs.

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Great Career Opportunities for Clinical Physicians
Physicians, are you looking for a change?  Tired of working long shifts with an overwhelming patient load?  Come work at a well-equipped and staffed correctional facility where you can MAKE a difference, working with a smaller number of patients for reasonable hours.

Starting salary is $143,381 – $171,631 *Additional $20,000 geographical differential for Clinton & Franklin CF, and $10,000 for Five Points, Greene and Groveland CFs. We offer full-time, part-time & hourly/per-diem positions.

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

Clinton*                 Clinton Correctional Facility (sporting and recreational outlets)
Chemung               Elmira and Southport Corrl Facilities (Gateway to the Finger Lakes)
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Dutchess                Green Haven Correctional Facility (Hudson River Valley Beauty)
Franklin*                Franklin & Upstate Corrl Facilities (North Country, 1 hour to Montreal)
Greene*                 Greene Correctional Facility (rural charm yet only 2 hours to NY City)
Livingston*            Groveland Correctional Facility (State Parks, hiking, fishing)
Oneida                   Mohawk Correctional Facility (Cooperstown, breweries)
Orleans                  Albion Correctional Facility (Greater Niagara Region & Canal Town Culture)
Sullivan                  Woodbourne Correctional Facility (mountains, outlets, entertainment)
Seneca*                 Five Points Correctional Facility (heart of wine country)
St. Lawrence          Riverview Correctional Facility (hiking, boating and museums)
Ulster                     Shawangunk and Wallkill Corrl Facility (Catskill Mountains, Casinos)
Washington           Great Meadow Corrl Facility (Between Vermont & Green Mountains)
Westchester           Bedford Hills Correctional Facility (Less than 1 Hour to NYC)
Wyoming               Wyoming Correctional Facility (waterfalls, family farms, natural beauty)

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Inquire with the Facility Personnel Office regarding benefits and anticipated opportunities: http://www.doccs.ny.gov/faclist.html. Contact: www.doccs.ny.gov or DOCCS Personnel Office at (518) 457-8132 for more information and to apply.


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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

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 


MSSNY Urges Congress to Go Back to Drawing Board on Surprise Bill Legislation


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
December 10, 2019

 

MSSNY URGES CONGRESS TO GO BACK TO DRAWING BOARD ON
SURPRISE BILL LEGISLATION

 

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

“The billion dollar health insurance industry must have been really good this year to have been given this holiday gift from Representative Pallone and Senator Alexander.

Physicians across New York and across the country agree with the goals of legislation to protect patients from surprise out of network medical bills. However, with the just announced Alexander-Pallone proposal Congress would hand market dominant health insurers a shiny new club to enable it to drop more physicians from their networks, and make it even harder for physicians to negotiate fairly with these insurers. It would also make it harder for hospitals to have needed on/call specialty care in their emergency departments for patients in need of this critical care.

The proposal fails to provide the balance that New York’s acclaimed surprise billing law achieved, which protected patients from these bills while fairly balancing the interests of insurers and physicians. New York’s law has saved consumers hundreds of millions of dollars and has not had any adverse impact on the NY health insurance premiums.

We thank the many members of the NY delegation, including Rep. Morelle and Senator Schumer, for their efforts to assure the passage of a far more balanced approach that protects patient’s access to timely needed care.

Bottom line – Congress needs to go back to the drawing board.”

# # #

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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