April 1, 2016 – Telemedicine v. Retail Clinics?

drmaldonado PRESIDENT’S  MESSAGE
 Dr. Joseph R.  Maldonado
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April 1,  2016
Volume 16, Number 13

Dear Colleagues:

This week, on a listserv for physicians elsewhere, I read of physician concerns regarding the expansion of urgent cares and retail clinics.  The sentiment was that we might be losing the battle in controlling cost when patients go to these clinics for their urgent medical needs.  The answer to the underlying question “do retail clinics and urgent care clinics raise the cost of healthcare?” is difficult to answer.  If you look at the issue from the perspective of patients who use their health insurance to cover the cost, clinics possibly may provide a lower cost service.  If however, you believe that the inclusion of payment for the services drives patients to over utilize these clinics, then you would say it drives up cost.

Others argue that the use of mid-level practitioners in these settings creates scenarios whereby providers are over-utilizing ancillary services such as imaging and labs as well as over-prescribing. This may increase the cost that might have been mitigated at a primary care physician’s office.  Of course, this overlooks the possibility that the patient might have gone to a hospital facility where the cost would have been greater than one at an urgent care clinic and a PCP’s office combined.  For patients who have high deductible plans (their numbers are increasing), the expenditure is not out of the pockets of the insurer.  Instead, the expenditures are made by the patient until they meet their deductible.

MSSNY Working on Options

MSSNY is working on at least one option that will help both primary and specialty physicians obviate the need for many of these patients to seek care in retail clinics.  If we can create momentum for such a telemedicine platform, many patients who currently seek care in retail clinics might be able to bring their care back into their physician’s care avoiding an unnecessary trip to a clinic.  In this manner, the cost of care is within the aegis of the patient’s doctor and the doctors are getting the reimbursement for the clinical service rather than a Wall Street for-profit retail clinic.  Furthermore, the cost to both the patient and the insurer would be lower than at these clinics.  A move to drive patients to a telemedicine platform with their physicians may render retail clinics an unsustainable model and a new physician- driven telemedicine model more meaningful and efficient.  If the possibility of participating in a telemedicine product that brings your patients back into your practice for care is of interest to you, let us know by sending a comment to this column.

Joseph Maldonado, M.D, MSc, MBA, DipEBHC
MSSNY President

Please send your comments to comments@mssny.org

MLMIC_011916_Enews_550x150


Capital_Update_Banner

State Budget for FY 2016-17 Finalized
Working through Thursday night into Friday, the Legislature was finalizing the passage of a $147 billion budget for the 2016-17 fiscal year. Importantly, it rejected several proposals that had been of great concern to physicians across New York State. Moreover, the final Budget also provides additional opportunities for certain physicians to receive e-prescribing waivers and leaves open the door to further action to address unpaid Health Republic claims.

The Governor’s crowning achievement was the enactment of an increase in the state’s minimum wage and paid family leave proposals. The latter proposal affords New Yorkers 12 weeks of paid family leave  (to be collected through an employee payroll deduction similar to disability benefits) allowing employees to be paid up to two-thirds of their weekly wage or two-thirds of the state average, whichever is lower.

The minimum wage increase differs depending upon the size and location of the business as follows: (1) For workers in New York City employed by large businesses (those with at least 11 employees), the minimum wage would rise to $11 at the end of 2016, then another $2 each year after, reaching $15 on 12/31/2018; (2) For workers in New York City employed by small businesses (those with 10 employees or fewer), the minimum wage would rise to $10.50 by the end of 2016, then another $1.50 each year after, reaching $15 on 12/31/2019; (3) For workers in Nassau, Suffolk and Westchester Counties, the minimum wage would increase to $10 at the end of 2016, then $1 each year after, reaching $15 on 12/31/2021; and (4) For workers in the rest of the state, the minimum wage would increase to $9.70 at the end of 2016, then another .70 each year after until reaching $12.50 on 12/31/2020 – after which it will continue to increase to $15 on an indexed schedule to be set by the Director of the Division of Budget in consultation with the Department of Labor.

The budget also included a significant investment of funding for a massive, multi-year infrastructure investment for airports, roads and bridge construction as well as a strengthening of mass transit systems in the New York City area. This includes over $55 billion of transportation investments statewide, including $27.14 billion for State Department of Transportation and Thruway programs and $27.98 billion for the Metropolitan Transportation Authority programs.

The final budget also included an increase of $1.5 billion in education aid, ­a 6.5% increase from last year.

Also included in the budget was an income tax cut for married couple earning up to $300,000.

Among issues on which MSSNY strongly advocated:

  1. Eligibility for Excess Coverage Preserved. The Legislature rejected the programmatic changes advanced by the Executive which would have resulted in over 13,000 physicians who currently have Excess coverage being dropped from the program. Moreover, the Legislature restored the $25M cut to the appropriation for the Excess program thereby continuing funding for the program at its historical level of $127.4M. Also continued was the authority for the Superintendent to set the rate for medical liability premiums.  MSSNY is thankful to leaders and members of both the Senate and Assembly for strongly supporting the restoration of funding for the Excess program and rejecting proposed programmatic changes that would have resulted in over 13,000 physicians losing Excess coverage.
  2. Retail Clinic proposal defeated; at least for now. The final budget does not include language to enable the establishment of ‘limited service’ clinics in retail stores owned by publicly traded corporations such as CVS, Walmart and Walgreens. MSSNY worked with other primary care and specialty medical societies in the defeat of this proposal. MSSNY will remain vigilant to oppose the proposal should it resurface toward the end of session.
  3. Changes to the Workers Compensation program rejected; role of County Medical Societies preserved! The Legislature rejected the Executive’s proposal to expand the list of providers eligible to deliver (and receive payment directly form the W/C program) to include acupuncturists, nurse practitioners, physician assistants, and social workers. Significantly, the Legislature also rejected the proposal to eliminate county medical society review and assistance for physicians looking to be authorized to deliver care. We thank the many county medical society leaders across New York State who took the time to contact their local Senators and Assembly members to express their concerns with this proposal.
  4. Health Republic. The budget expressly articulated the establishment of a fund to be known as the “health republic insurance of New York fund” which “shall consist  of transfers as authorized by the director of the budget, in his or her  sole  discretion,  between  April first,  two thousand sixteen and March thirty-first, two thousand nineteen, from amounts collected as a result of  a  judgement,  stipulation, decree, agreement to settle, assurance of discontinuance, or other legal instrument  resolving  any  claim  or  cause of action, whether filed or unfiled, actual or potential, and  whether  arising  under  common  law,  equity,  or  any  provision  of  law, and all other monies appropriated, credited, or transferred thereto from any other fund or source  pursuant to law”. Any payments to be made from this fund would be made after distribution of Health Republic’s remaining assets in a liquidation proceeding. We are seeking further clarification regarding which monies could be potentially assigned to this fund, and will continue to work with hospital associations to assure the deposit of sufficient monies to fully reimburse physicians and other providers for care provided to patients covered by the now defunct Health Republic. Despite being proposed in the Senate one-House Budget, the final Budget did not contain any provision to eliminate the DFS prior approval of health insurance rates.   We thank the many State Legislators who fought to assure that the State Budget articulate a dedicated funding stream to assure these claims are paid.
  5. No Regressive Tort Measures Included in Budget. Despite renewed attention on certain regressive tort bills including a date of discovery statute of limitations and repeal of the limitations on attorney contingency fees in medical liability cases, the measures were not included as part of the budget. MSSNY has been working collaboratively with GNYHA, HANYS and MLMIC to oppose these measures in the context of the budget. It is anticipated, however, that discussion on these issues will resume as MSSNY seeks to achieve meaningful tort reforms this legislative session.
  6. Elimination of prescriber prevails rejected. The Legislature rejected proposals that would have eliminated “prescriber prevails” protections for prescribing medications to all patients insured through fee for service Medicaid, as well as for several classes of medications for patients insured under Medicaid managed care. The Executive’s proposal would have eliminated these protections for medications for patients covered in the Medicaid program, except for atypical antipsychotic and anti-depressants.
  7. E-Prescribing Exception for Low Volume Prescribers approved. Eprescribing will not be required of prescribers who issue twenty five prescriptions or less each year provided that they submit a certification to that effect to the Department of Health. A certification may be submitted on or before July 1, 2016 and retroactively apply to March 27, 2016. A prescriber who has made a certification on or before the expiration of the current twelve month period may do so for a maximum of three twelve month certifications. While this is a very positive development for low-volume prescribers, the 3-year limit will require this issue to be revisited by MSSNY and the Legislature in 2019. At the same time, the Legislature considered but ultimately did not include language to address concerns raised by MSSNY regarding the onerous and burdensome requirements for physicians without waivers who issue paper prescriptions through the invocation of one of three statutory exceptions and who must submit their name, contact information, patient initials and the reason for which they issued the appear script to an email address  (erx@health.ny.gov) maintained by the bureau of narcotics enforcement. Many state legislators remain interested in addressing this issue, and MSSNY will continue to strongly advocate to reduce or eliminate altogether the requirement for submission of this information.
  8. Modifications to Doctors Across New York (DANY) Program Approved. Changes to the DANY (physician loan repayment and physician practice support) program were made to equalize awards to up to $40,000 per year, reduce the service commitment from five to three years and to allow recipients to receive one but not both awards. MSSNY has been working with other healthcare stakeholders including HANYS, GNYHA, Iroquois Hospital System and ACP to secure these legislative changes to this important program. Allocations to the program added $1M above the historical $8M to provide 25 new DANY slots at $40,000/year each.
  9. Restoration of Medicaid Benefits 30 days Prior to Release from Prison/Jail. The Legislature authorizes the provision of Medicaid benefits, for ‘high needs” inmates who were on Medicaid prior to incarceration in a state prison or local jail, for the 30 days prior to release to pay for transitional services including medical, prescription, and care  coordination services. This authority is contingent on NY applying for and getting CMS approval for offer federal share Medicaid for such services.
  10. Additional funding ($35M) to combat heroin and opioid epidemic. These funds will continue to support prevention, treatment and recovery programs targeted toward chemical dependency, residential service opportunities, and public awareness and education activities.
  11. Prior Authorization for Medicaid Opioid Prescriptions. The final Budget requires Medicaid managed care plans to impose prior authorization requirements for patients with more than 4 opioid analgesic prescriptions in a 30-day period.
  12. Joint Ownership of LLCs by Chiropractors and MDs defeated. The final budget did not incorporate language that had been advanced by the Senate to allow chiropractors and physicians to jointly own and share revenue from their joint partnerships and businesses.
  13.  New monies allocated to MSSNY programs. MSSNY’s Committee for Physicians’ Health (CPH) was  allocation $990,000 to continue its operations and MSSNY was allocated $150,000 under the Veterans Mental Health Training Initiative through which MSSNY, NYSPA and NASW have offered training initiatives for physicians on the diagnosis and treatment of PTSD and TBI in returning veterans and will offer additional training in the future on substance abuse, suicide prevention and appropriate opioid prescribing and pain management for returning veterans
    (DEARS,AUSTER, CLANCY, MCPARTLON)


Urge Your Legislators to Reduce Liability Insurance Costs, Not Raise Them!
Now that the State Budget for FY 2016-17 has been finalized, the focus of policymakers will be on unresolved issues including legislation that would create a date of discovery statute of limitations which threatens to increase your liability premiums by 15%. In light of the huge financial pressures threatening the viability of physician practices and our health care delivery system, it is essential that you weigh in with your elected representatives to urge that no further liability increases can be tolerated.  Please join your colleagues by contacting your legislators to urge that they oppose legislation (A.285-A, Weinstein/S.6596, DeFrancisco) that could drastically increase New York’s already exorbitantly high medical liability premiums by changing the medical liability Statute of limitations to a “Date of Discovery” rule.

MLMIC’s estimate is that this bill could increase physician liability premiums by nearly 15%!   New York physicians continue to pay liability premiums that are among the very highest in the country.  By way of example, a neurosurgeon practicing on Long Island must pay an astounding $338,252 for just one year of insurance coverage and an OB/GYN practicing in the Bronx or Staten Island must pay $186,639.   New York far surpasses all other states in terms of total medical liability payouts, per capita payments, and medical liability awards above $1 million.

MSSNY has joined the Greater New York Hospital Association (GNYHA) and Healthcare Association of New York State (HANYS) in an ad in the Albany Times-Union and City & State calling for reduction in these exorbitant costs.

To make matters even worse, trial lawyers are aggressively pushing the Legislature to consider additional liability expansion bills such as legislation that would eliminate the statutory limitation on contingency fees in medical liability actions, legislation that MLMIC has estimated could have the effect of raising your premiums by over 10%.   Please tell your legislators to enact comprehensive liability reform to bring down these costs, not legislation that increases them!                                                                                                             (AUSTER, DEARS)


New United Hospital Fund Report Discuss Potential Impacts of Health Insurance Consolidation
Last week, the United Hospital Fund released a report analyzing the impact of the proposed mergers of health insurance giants Anthem (parent of Empire) and Cigna, as well as Aetna and Humana.  To read the report, click here: http://www.uhfnyc.org/assets/1461.  The UHF report references a report issued by the American Medical Association that highlighted that New York was one of the states where the Anthem–Cigna market concentration “raises significant competitive concerns and often warrants scrutiny,” including that the Long Island MSA was one of the regions across the country where the merger would be “presumed likely to enhance market concentration.”  The UHF report also referenced a letter sent by consumer and labor groups to Acting DFS Superintendent Maria Vullo raising concern about these proposed mergers, noting that (1) they could result in higher costs; and (2) they could result in fewer choices of health care providers and services for consumers.  MSSNY has also written to DFS, and to the New York State Attorney General’s office, to express its opposition to these proposed mergers.
 (AUSTER)


Physicians Urged to Register for April 14th House of Delegates Live CME Seminar or For Statewide Remote Webinar on Ebola
The Medical Society will conduct a Medical Matters LIVE seminar and concurrent webinar titled Ebola: A Perspective from the Field on April 14th at 2:00pm.  The live seminar will take place at the Westchester Marriott in Tarrytown, NY and the webinar will also be broadcast statewide via Webex.  Register for this program here.  Click on the ‘Upcoming’ tab and select the ‘Programs’.

Dario Gonzalez, MD, F.A.C.E.P. – Associate Medical Director Fire Department City of New York/Office of Medical Affairs is the faculty.  Dr. Gonzalez was deployed for nine weeks by Americares to Liberia, West Africa as part of the US response to the Ebola epidemic.  He managed and directed an Ebola Treatment Unit in Buchanan, Liberia.  Dr. Gonzalez developed the treatment and management guidelines.  He cared for suspected and confirmed Ebola patients, and was subsequently involved in NYC hospital Ebola preparedness with the NYC Fire Department and Office of Emergency Management. The educational objective for the program is to: Offer perspective and lessons learned from an individual who treated Ebola patients firsthand.

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.

Further information or assistance in registering for this program may be obtained by contacting Melissa Hoffman at mhoffman@mssny.org.                                                                                                 (CLANCY, HOFFMAN)

Physicians Urged to Register For April 15th House of Delegates Quality Conference on MIPS, APMS And Value Based Payment; What Will the Future Bring for Physician Practice?
The Medical Society’s Quality Improvement and Patient Safety Committee will present its ninth Annual Quality Conference from 1-3PM on April 15th at the Westchester Marriott entitled MIPS, APMs and Value Based Payment; What Will The Future Bring For Physician Practice? Please register for the Conference by clicking onto the following this link.

Conference Presenters include the following:
Jason Helgerson, Medicaid Director, NYS Department of Health

Delivery System Reform Incentive Program (DSRIP) and Value Based Payment (VBP); how greater care collaboration and integration within the healthcare delivery system will be achieved?

Jean Moody Williams, Deputy Director for the Center for Clinical Standards & Quality

The Intricacies of the Merit-Based Incentive Payment System (MIPS) and Alternative Payment Models (APM).

John Rugge, MD, Chief Executive Officer, Hudson Headwaters Health Network (HHHN) and Deepak Kapoor, MD, Chairman and Chief Executive Officer, Integrated Medical Professionals (IMP)

Lessons Learned from the perspective of physicians who have already embraced the transition to PCMH/IPAs/ACOs; How to prepare for Value Based Payment.

Andrew Gettinger, MD, Chief Medical Information Officer, Acting Director, Office of Clinical Quality and Safety, Office of the National Coordinator for Health Information Technology

Update on the Work of ONC With Regard To EHR Functionality and Interoperability

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.

Accreditation Statement: The Medical Society of the State of New York (MSSNY) 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 2.5 AMA PRA Category 1 Credits™.

Further information or assistance in registering for this program may be obtained by contacting Miriam Hardin at mhardin@mssny.org.                                                                                                       (DEARS, HARDIN)

MSSNY Announces Zika Podcast With DOH; Physicians Can Listen Now
MSSNY’s Committee on Emergency Preparedness and Disaster/Terrorism Response conducted an audio podcast with Dr. William Valenti and Dr. Elizabeth Dufort to discuss the Zika Virus.  The podcast discusses the epidemiology of Zika virus.  It also provides information on disease transmittal, diagnosis and the measures that the New York State Department of Health has taken to guide and protect all New Yorkers.  Listen to this timely and important podcast here.

Panelists:
William Valenti, MD, Chair MSSNY Infectious Disease Committee,
Elizabeth Dufort, MD, F.A.A.C.P., Medical Director, Division of Epidemiology, New York State Department of Health.                                 (CLANCY, HOFFMAN)

View Zika Webinar; Program Archived On MSSNY’s CME Site
The Medical Matters program, entitled “Zika Virus—An Evolving Story” is now archived to the MSSNY CME website and physicians and other health care providers can view this program free of charge by logging into http://cme.mssny.org.

The webinar was conducted by MSSNY and the New York State Department of Health and featured Dr. William Valenti, chair of MSSNY’s Infectious Disease Committee and member of the MSSNY’s Emergency Preparedness and Disaster/Terrorism Response Committee and Dr. Elizabeth Dufort, medical director, Division of Epidemiology from the New York State Department of Health.

The MSSNY CME site requires new users to register, but once registered physicians and other health care providers will have a personalized training page to take them to this webinar and other course work located on the site.   New registrants to the site will create a username and password, which should be retained and be used for continued access to the site. Once registered and logged into the site, physicians will be taken to an instruction page.   Click on the tool bar menu located at the top of the page and click on “My training” to view and take the various courses.  MSSNY has over 50 programs at this site and physicians are able to earn continuing medical education credits for each course. 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 online program has various programs with the number of continuing medical education credits, but the majority of the programs are for 1.0 AMA/PRA Category 1 credit™.  Further information on all these programs may be obtained by contacting Melissa Hoffman at mhoffman@mssny.org.
(CLANCY, HOFFMAN)


MSSNY’s Opioid Webinars are Now Available on Its CME Online Site
The Medical Society has archived its opioid webinar series on its continuing medical education website at http://cme.mssny.org/  

The webinars are:  Webinar 1 Pain Management at the Crossroads:  A Tale of Two Public Health Problems; Webinar 2 Rational Opioid Prescribing:  Is this Possible for Chronic Pain?; Webinar 3 Treatment of Opioid Use Disorders ; and Webinar 4 Pain Patients w/Substance Use Disorders .  The webinars series was jointly sponsored by the NYS Office of Alcoholism and Substance Abuse Services and the New York State Department of Health’s Bureau of Narcotics Enforcement.

Physicians and other prescribers can earn up to one hour of continuing medical credits by viewing this webinar and completing the test.    The MSSNY CME site requires new users to register, but once registered physicians and other health care providers will have a personalized training page to take the webinars and other course work located on the site.   New registrants to the site will create a username and password, which should be retained and be used for continued access to the site. Once registered and logged into the site, physicians will be taken to an instruction page.   Click on the tool bar menu located at the top of the page and click on “My training” to view and take the various courses.     MSSNY has over 50 programs at this site and physicians are able to earn continuing medical education credits for each course.

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 online program has various programs with the number of continuing medical education credits, but the majority of the programs are for 1.0 AMA/PRA Category 1 credit™.  Further information on all these programs may be obtained by contacting Pat Clancy at pclancy@mssny.org.
(CLANCY)


PTSD And TBI in Returning Veterans:  April – June Webinars and Live Program
MSSNY will be holding a series of CME webinars on PTSD and TBI in returning veterans on sx dates listed below from March through June. As part of a joint program with NYSPA, MSSNY will also be hosting a live presentation of the program at the Upsky Hotel in Hauppauge, Long Island. The faculty presenters will be Frank Dowling, MD and Joshua Cohen, MD.

Course objectives:

            • Explore the two most prevalent mental disorders facing American veterans today, their causes, symptoms, and comorbidities
            • Outline treatment options including evidence-based psychotherapy and pharmacotherapy
            • Discuss barriers to treatment, including those unique to military culture, and how to overcome them
            • Outline the process of recovery and post-traumatic grow

To register for this program, click on a date below and fill out the registration form

Thursday, April 7, 6-7 PM
Tuesday, April 12, 7:30-8:30 AM
Friday, April 15, 8-9 AM live at the Upsky Hotel in Hauppauge, Long Island
Thursday, May 5, 6-7 PM
Thursday, May 19, 7:30-8:30 AM
Thursday, June 2, 6-7 PM
Thursday, June 9, 7:30-8:30 AM
(ELPERIN, DEARS)  

For more information relating to any of the above articles, please contact the appropriate contributing staff member at the following email addresses:       

pschuh@mssny.org ldears@mssny.org      mauster@mssny.org  
pclancy@mssny.org jmcpartlon@mssny.org    

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Dr. Maldonado Says Liability Insurance, E-Prescribing Mandate   Contribute To Poor Environment For NY Physicians
The LI Business News reported that finance website WalletHub.com has ranked New York as the worst state for physicians, due to a “wide range” of factors including “high malpractice payouts, wages adjusted for the cost of living and competition.”  Dr. Joseph Maldonado said that New York’s “exorbitant medical liability insurance costs, overwhelming government mandates, now including an e-prescribing mandate, and abusive health insurance tactics make it a very difficult state to remain in practice to deliver patient care.” 


Physicians Foundation’s 650,000 Fourth Annual Physician Survey
Physicians Foundation, of which MSSNY is a charter member, is a non-profit organization that seeks to empower physicians to lead in the delivery of high-quality, cost-efficient healthcare, is launching its fourth national Survey of America’s Physicians, one of the largest physician surveys ever undertaken in the United States.

The survey is being conducted by Merritt Hawkins, and will be emailed to more than 650,000 physicians across the country from March-May of 2016. The survey will take approximately 10-12 minutes to complete and will allow physicians to share their thoughts on health reform, electronic medical records, new methods of physician reimbursement, ICD-10, and a variety of other topics. A full copy of the final survey report will be emailed to all physicians who participate, and participants will also be entered to win one of five $500 Amazon gift cards and one $5,000 Amazon gift card.

Physicians can access the survey via this link.


Zika Virus Structure Revealed, New Maps Show Reach of Aedes Mosquitoes

Researchers have revealed a “near-atomic level map” of the Zika virus. Published in Science, the three-dimensional image shows that Zika’s structure is similar to that of other flaviviruses, with one key exception: a variation in the E glycoprotein surface protein. This variation, according to an NIH news release, “could explain the ability of the virus to attack nerve cells, as well as the associations of Zika virus infection with birth defects and … Guillain-Barré syndrome. “Elsewhere, the CDC has published maps showing the potential range of Aedes mosquitos in the U.S.

ZIKA HOTLINE:

The city Health Department set up a call center for health care providers requesting Zika virus testing for New York City residents: (866) 692-3641.  Additional Zika testing information is online here.
CDC mosquito mapsNEJM Zika website http://bit.ly/1SFMFaR


NYSHealth Funding Opportunity: 2016 Special Projects Fund
The New York State Health Foundation (NYSHealth) is currently accepting request for proposals (RFP) for its 2016 Special Projects Fund. Applicants must submit an online inquiry form to determine whether a proposed project fits the funding criteria. The deadline for the online inquiry is April 7, 2016. Selected organizations will be invited to submit full applications, which will be reviewed on a rolling basis with a deadline of May 25, 2016.

NYSHealth Special Projects Fund awards are one-time, nonrenewable funding opportunities consistent with the Foundation’s mission to improve the health of all New Yorkers but outside of its main priority areas. Read details on the 2016 Special Projects Fund RFP and frequently asked questions.


Physicians Called On To Do More to Combat Opioid Epidemic
In an editorial, (Bloomberg 3/31) writes, “A lasting solution to America’s opioid epidemic depends mostly on a meaningful change in physicians’ attitudes about treating addiction.” Bloomberg urges physicians to reduce the number of opioid prescriptions and increase the number of doctors who provide buprenorphine, the leading anti-addiction medication. Citing the American Medical Association’s recent acknowledgement “this week that physicians need to do more,” Bloomberg concludes that, for the opioid epidemic to end, more physicians must “put aside their unease or lack of interest in treating addicts.”


CDC Report: One in Every 68 US Kids Has Autism Spectrum Disorder
On April 31, the Centers for Disease Control and Prevention released a surveillance summary showing “no change in how common autism is among US children.” Currently, approximately one “in 68 school-aged children” appears to “have autism or related disorders,” the same figure “as it was when health officials checked two years earlier,” the report published April 1 in the Morbidity and Mortality Weekly Report reveals. It is “too soon,” however, to determine if “the number is stabilizing, said Daisy Christensen,” PhD, the report’s lead author.

Study: Long-Term Antibiotic Therapy Ineffective At Alleviating Chronic Symptoms of Lyme Disease
In a 280-patient study published March 31 in the New England Journal of Medicine. 12 weeks of therapy with antibiotics appeared to be ineffective at alleviating chronic symptoms of Lyme disease. The study’s primary researcher “said it’s still an open question why some patients are cured of Lyme disease and others experience symptoms for years.” Currently, he “is working on prospective studies of patients suffering from Lyme disease to try to answer this question.” 


MSSNY in the News



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Central Park South Medical Office Available to Share
Central Park South medical office, next to Plaza Hotel. Gorgeous Central Park view. Recent beautiful high–end renovation. Share part time with cosmetic dermatologist. Fully equipped for in–office surgery. Two exam rooms for you, shared waiting room and personal office. Free WiFi. Available part time, full or half days. Suits plastic/cosmetic surgeons/ENT/OBGYN etc. Contact Judith Hellman, MD, at jhderm@gmail.com or (212) 755–5482



Relieve Physician Burnout through Yoga Science (30 CMEs)
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perspective on yourself and every personal and professional responsibility you face. This comprehensive training in Yoga Science as Holistic Mind/Body Medicine will provide easy-to-use, practical tools to prevent and reverse the debilitating causes and effects of physician burnout. Topics include: mantra meditation, diaphragmatic breathing, easy-gentle yoga, Yoga psychology, neuroplasticity, PTSD, trauma, resilience, the chakra system as a diagnostic tool, epigenomics, mind function optimization, Ayurveda, nutrition, functional medicine, and lymph system detoxification. Through engaging lectures by an accomplished faculty, instructive practicums and ongoing Q&A, you’ll gain experiential knowledge that will integrate Yoga Science into a dynamic self-care program. As a result of attending this conference, you’ll return home with a set of practical tools that can empower you to make conscious, discriminating and reliable choices to enhance your creativity, well-being, happiness and success. Regardless of how
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Physician Opportunities



Family & Internal Medicine Opportunity Just 50 miles North of NYC

Top $$ AND potential partnership with large multi-specialty physicians’ group + the balance of work & personal life you have been seeking. Perfect suburban area just 50 miles north of NYC. This is a growth position with the right person moving into a partnership opportunity within two to three years. You will enjoy a salary of $175K+ as well as:
• A monthly bonus potential
• Health, Dental, Vision and prescription insurance
• 3 weeks’ paid vacation time off annually
• 6 federal Holidays off with pay
• A $2500 CME reimbursement
• A 401K plan with company match
• Company pays 75% of a single premium life insurance policy at twice your annual salary
• Paid malpractice insurance, plus paid DEA and license renewals
The ideal candidate will possess the following:
• BE/C in Family Medicine or Internal Medicine
• Active NYS license
• Current DEA #
• Experienced as well as New Grads welcome to apply
**Relocating physicians are welcome and relocation assistance will be offered to the right candidate!**
For immediate consideration and additional information on position details please contact Laura Rappleyea at 845-344-3434 or lrappleyea@hereshelp.com and send CV’s for review.

Neurologist & Pain Management Physician Needed
A growing multi-specialty group in Orange County is looking for both a Neurologist and Pain Management Physician to join their group. This position will work with the headache center Neurologist/Pain Management Specialist. All subspecialties are welcome.
The ideal candidate will possess the following:
• BE/C in Family Medicine or Internal Medicine
   • Active NYS license
   • Experienced as well as New Grads welcome to apply
   • Experience in procedures and utilizing an integrated comprehensive approach to pain management.
For immediate consideration and additional information on position details please contact Laura Rappleyea at 845-344-3434 or lrappleyea@hereshelp.com and send CV’s for review.


OB/GYN Opportunity in the Hudson Valley
Are you looking for a great work/life balance? We are looking for an OB/GYN to join the team. We are looking for a provider to provide comprehensive primary health care to a select population of essentially healthy women, participate in the care of women with complications & responsible for providing a full range of agency approved antepartum, intrapartum, postpartum, gynecological and family planning service.
The ideal candidate will possess the following:
• BE/C in Family Medicine or Internal Medicine
       • Active NYS license
       • Experienced as well as New Grads welcome to apply
For immediate consideration and additional information on position details please contact Laura Rappleyea at 845-344-3434 or lrappleyea@hereshelp.com and send CV’s for review
.


Pediatrician Opportunity in Orange County, New York
A prestigious multi-specialty physicians’ group seeks a family driven
Pediatrician to join their group.
The ideal candidate will possess the following:
• BE/C in Family Medicine or Internal Medicine
   • Active NYS license
   • Experienced as well as New Grads welcome to apply
For immediate consideration and additional information on position details please contact Laura Rappleyea at 845-344-3434 or lrappleyea@hereshelp.com and send CV’s for review. 
.


Psychiatry Opportunity in New York’s Beautiful Hudson Valley
Our client, a prestigious multi-specialty physicians’ group who has been recognized as a Patient-Centered Medical Home by the National Committee for Quality Assurance, seeks a Psychiatrist to join their group.
The ideal candidate will possess the following:
• BE/C in Psychiatry
   • Active NYS license preferred
   • Experienced as well as New Grads welcome to apply
For immediate consideration and additional information on position details please contact Laura Rappleyea at 845-344-3434 or lrappleyea@hereshelp.com and send CV’s for review.



Join Well Established Solo Female OB/GYN Physician Practice in New York City
Quality oriented, looking for MD for long term career opportunity. New graduates welcome to apply. Affiliated with Lenox Hill Hospital. The current office has a AAAA certified operating room and an AIUM accredited ultrasound service. Looking to establish another location. Great opportunity to balance personalized practice with quality lifestyle. Please summit CV to obgynpractice130@gmail.com



L.I. PSYCHIATRIC PRACTICE FOR SALE
                    Huntington, NY
Currently 20 hrs./wk – no evenings or weekends.
$100K/yr. gross. Low overhead.
Office available for rent or move to your location.
Details on request: 631-784-7704


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

 

 

 

 

 

 

 

 

 

 

 

 

 

March 25, 2016 – E-Prescribing Has Gone Into Effect

drmaldonado PRESIDENT’S  MESSAGE
 Dr. Joseph R.  Maldonado
asset.find.us.on.facebook.lgTwitter_logo_blue1

March 25,  2016
Volume 16, Number 11

Dear Colleagues:

Instead of my usual introduction, today this space is being used for very important information regarding the E-prescribing mandate that goes into effect this Sunday, March 27. Please share it with your colleagues.

E-PRESCRIBING OF ALL SUBSTANCES TAKES EFFECT ON SUNDAY MARCH 27, 2016
New York State’s e-prescribing requirements for non-controlled and controlled substances will go into effect on Sunday, March 27, 2016.According to the NYS Department of Health’s Bureau of Narcotic Enforcement, more than 70,000 prescribers are already e-prescribing and other prescribers are continuing to register their certified software for controlled substances with the New State Department of Health.     Practitioners should continue their efforts to become compliant with the law, including working with their software vendors to implement the additional security requirements needed for e-prescribing of controlled substances (EPCS), and registering their certified software applications with the Bureau of Narcotic Enforcement.For physicians who prescribe controlled substances, there are additional steps to complete in order to electronically prescribe controlled substances.  These include the following:

  • First, the software you currently use must meet all the federal security requirements for EPCS, which can be found on the Drug Enforcement Agency’s (DEA) web page. http://www.deadiversion.usdoj.gov/ecomm/e_rx/

Note that federal security requirements include a third party audit or DEA certification of the software.

  • Second, you must complete the identity proofing process as defined in the federal requirements.
  • Third, you must obtain a two-factor authentication as defined in the federal requirements.
  • Fourth, you must register your DEA certified EPCS software with the Bureau of Narcotic Enforcement (BNE). Registration instructions are included in the FAQs.

A copy of the BNE’s Frequently Asked Questions (FAQs) can be found here.

E-prescribing of non-controlled substances is also required under the law; however, registering of this system with the state is not necessary. 

Exceptions to the E-Prescribing Requirement:
The law currently allows for a list of exceptions from the requirement to electronically prescribe and they are:

  • Prescriptions issued in circumstances where electronic prescribing is not available due to temporary technological or electrical failure
  • Prescriptions issued by a practitioner under circumstances where the practitioner reasonably determines that it would be impractical for the patient to obtain substances prescribed by electronic prescription in a timely manner, and such delay would adversely impact the patient’s medical condition. In addition to these circumstances, the quantity of controlled substances cannot exceed a five day supply if supply if the controlled substance were used in accordance with the directions for use.
  • Prescriptions issued by a practitioner to be dispensed by a pharmacy located outside the state.
  • Practitioners who have received a waiver or a renewal thereof for a specified period determined by the commissioner, from the requirement to use electronic prescribing.

However, each time a prescriber uses the power or electrical failure exception they must file information about the issuance of the paper prescription electronically to the Department of Health within 72 hours and 48 hours when a prescriber uses the exception where the practitioner reasonably determines that that it would be impractical for the patient to obtain substances prescribed by electronic prescription in a timely manner, and such delay would adversely impact the patient’s medical condition or when the prescription will be dispensed by a pharmacy located out of state. MSSNY was informed yesterday by the DOH Bureau of Narcotic Enforcement that the information about “the issuance of the paper prescription” pursuant to one of these exceptions must include

  • That this is the notification required by PHL Section 281 (4) or 5
  • Physician’s name
  • License number
  • Telephone number
  • Work email address
  • Work address
  • Patient’s initials
  • The reason for invoking the exception including the citation to PHL Section 281 (3) technological or power failure, (d) patient harm or (e) out of state dispensing 

Notably absent from this list is the number on the paper prescriptions written.

Notification to the Department of Health should be sent to:  erx@health.ny.us

Additionally, MSSNY strongly recommends that use of the exceptions be included in the patient’s medical record.

And, on March 16, 2016, NYS Health Commissioner Howard  Zucker, MD issued a statement providing for 12 additional exemptions to the e-prescribing mandate.     Those exceptions are as follows:

  1. Any practitioner prescribing a controlled or non-controlled substance, containing two (2) or more products, which is compounded by a pharmacist;
  2. Any practitioner prescribing a controlled or non-controlled substance to be compounded for the direct administration to a patient by parenteral, intravenous, intramuscular, subcutaneous or intraspinal infusion;
  3. Any practitioner prescribing a controlled or non-controlled substance that contains long or complicated directions;
  4. any practitioner prescribing a controlled or non-controlled substance that requires a prescription to contain certain elements required by the federal Food and Drug Administration (FDA) that are not able to be accomplished with electronic prescribing;
  5. any practitioner prescribing a controlled or non-controlled substance under approved protocols under expedited partner therapy, collaborative drug management or in response to a public health emergency that would allow a non-patient specific prescription;
  6. Any practitioner prescribing an opioid antagonist that would allow a non-patient specific prescription;
  7. Any practitioner prescribing a controlled or non-controlled substance under a research protocol;
  8. a practitioner prescribing a controlled or non-controlled substance either through an Official New York State Prescription form or an oral prescription communicated to a pharmacist serving as a vendor of pharmaceutical services, by an agent who is a health care practitioner, for patients in nursing homes and residential health care facilities as defined in section twenty-eight hundred one of the public health law.
  9. A pharmacist dispensing controlled and non-controlled substance compounded prescriptions, prescriptions containing long or complicated directions, and prescriptions containing certain elements required by the FDA or any other governmental agency that are not able to be accomplished with electronic prescribing;
  10. A pharmacist dispensing prescriptions issued under a research protocol, or under approved protocols for expedited partner therapy, or for collaborative drug management;
  11. A pharmacist dispensing non-patient specific prescriptions, including opioid antagonists, or prescriptions issued in response to a public health emergency issued; and
  12. A pharmacist serving as a vendor of pharmaceutical services dispensing a controlled or non-controlled substance through an Official New York State Prescription form or an oral prescription communicated by an agent who is a health care practitioner, for patients in nursing homes and residential health care facilities as defined in section twenty-eight hundred one of the public health law.

The above-listed exceptional circumstances will be effective until March 26, 2017. According to an email that MSSNY received on March 17, 2016 from the NYS Bureau of Narcotics Enforcement, use of these exceptions does not require physicians to notify the Department of Health that they are using the exception.  

A copy of the Commissioner’s letter can be found here.


Waivers from e-prescribing requirement
NYS Department of Health has issued over 2,600 one year waivers to prescribers.   The law provides that physicians may apply for a waiver of the e-prescribing requirement for a) economic hardship b) technological limitations that are not reasonably within the control of the physician, or c) other exceptional circumstances.

Once a physician has received a waiver, they may issue the prescription on a paper script.   According to the NYS Department of Health Bureau of Narcotic Enforcement, there is nothing in the law that says a physician must notify the pharmacy that they have received a waiver; however, physicians can place their waiver number on the script should they want to do so.  Pharmacies should dispense medication whether the script has been e-prescribed or presented on the official NYS Prescription paper form.

Information on obtaining a one year wavier is available here.

The ISTOP legislation enacted in 2012 required e-prescribing of ALL substances. Regulations pertaining to the E-prescribing requirements were adopted on March 27, 2013.   The Medical Society of the State of New York was successful in obtaining a one year delay in the implementation of the e-prescribing mandate due to the fact that the vendors were not in compliance with the DEA rules for EPCS.  A copy of the regulations can be found here.

Additional information regarding e-prescribing may be accessed at the following links:
http://www.health.ny.gov/professionals/narcotic/electronic_prescribing/
http://www.op.nysed.gov/prof/pharm/pharmelectrans.htm

 

Joseph Maldonado, M.D, MSc, MBA, DipEBHC
MSSNY President

Please send your comments to comments@mssny.org


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Budget Negotiations Will Continue Through the Weekend; No Resolution on Issues of Concern to Physicians; Physicians Must Contact Their Elected Senators and Assemblymembers
The Legislature may have adjourned and will not return until Monday, March 28th, but serious budget negotiations will continue throughout the weekend with a view toward completing the passage of the budget by April 1st.

This being said, there has been no resolution on the many issues of concern to physicians. We ask that you take time over the weekend to reach out to your elected representatives to urge them to take steps to meaningfully address our issues of concern.  

Excess

First and foremost, while each House added $25M in their one House budget bills to restore funding for the Excess program, the Governor continues to resist these efforts.  Physicians should thank their elected officials for proposing to restore this funding and continue to urge identification of monies needed to restore this cut so that all physicians can remain eligible for this needed coverage.  If the cuts were to go through, over 13,000 physicians would lose this coverage! Go to the this link for a letter you can send to your elected representatives:.

Health Republic

While we are pleased that both Houses articulated desire that “funding or settlement funds be identified in  addition  to  remaining  assets  to   reimburse   hospitals, physicians and producers pro-rata for losses associated with the demise of Health  Republic  upon  completion  of  the  formal liquidation process” (Senate language) and , several key legislators (Senators Hannon, Rivera,  and Valesky and Assemblymembers Cahill and Walter) articulated this goal in the first meeting of the Health Budget Conference Committee this issue has not been finalized.  However, many legislators have expressed concerns that there may not be sufficient public monies to pay for a fund.  ALL PHYSICIANS SHOULD IMMEDIATELY GO TO THE FOLLOWING LINK TO CONTACT THEIR ELECTED REPRESENTATIVES TO URGE THE INDENTIFICATION OF A POOL OF MONIES TO REIMBURSE HEALTHCARE PROVIDERS FOR THE SERVICES RENDERED TO PATIENTS PREVIOUSLY INSURED BY HEALTH REPUBLIC.
http://cqrcengage.com/mssny/app/onestep-write-a-letter?10&engagementId=151313

Workers Compensation

Also, we are pleased that neither House included any of the workers’ compensation language we opposed. While this is a very positive development, the Governor continues to push this proposal.  Therefore, we must keep the pressure on by reaching out to your elected representatives if you haven’t yet done so by sending letters found at the following links:

Workers Comp proposal to remove critical role played by county medical societies

Workers Comp proposal to expand use of non-physicians:.

E-Prescribing

We continue to be pleased that the Senate bill included legislation in their one House budget bill strongly supported by MSSNY which would exempt low volume providers from the eRx mandate and allow prescribers invoking an exception to the mandate to make a notation in the patient’s medical record instead of contacting DOH (currently required by law). And we know that the Assembly is also urging adoption of this language.  However, the Attorney General has strongly opposed these changes.

In response MSSNY issued a press statement highlighting the need for flexibility in the implementation of the e-Prescribing law.

We urge you to contact your elected representatives to urge that these changes be enacted into law. 

Dual Eligibles

While we are pleased that the Senate one House repeals action taken in last year’s budget to eliminate Medicaid reimbursement for services provided to patients dually eligible for Medicaid and Medicare thereby restoring the 20% of the co-insurance, there is little money in the budget to do so. Please take action now to encourage your elected representatives to work to restore this appropriation.  Please send a letter in support here. 

Retail Clinics

We remain extremely concerned that the Legislature will allow publicly traded corporations to own and operate limited service clinics in retail space they own without regard for public need. While the Senate incorporated the Governor’s proposal in their one House budget bill, the Assembly advanced language which would, importantly, not allow publicly traded corporations to own and operate retail clinics but which seeks to regulate practices that rent space in retail establishments by, among other things, requiring them to be accredited; limit the type of services which can be provided and prohibit them from delivering care to children under the age of two. The corporately owned retail clinic language remains in play. Go to the this link to send a letter of opposition to this proposal to your legislators.                                                                                        (DIVISION OF GOVERNMENTAL AFFAIRS)


MSSNY’S Adult Immunization Podcasts Now Available
MSSNY’s Preventive Medicine and Family Health and Infectious Disease Committees have recorded nine podcasts on adult immunizations.  Each of these brief podcasts offers insightful commentary from committee members (all experts in their fields) on the importance of continuing vaccinations into adulthood.

The topics discussed are:

  • Hepatitis B
  • Human Papillomavirus (HPV)
  • Influenza
  • Measles, Mumps and Rubella (MMR)
  • Meningococcal Disease
  • Pneumococcal
  • Tetanus, Diphtheria and Pertussis (TD & Tdap)
  • Young Adults
  • Zoster

Listen to all nine podcasts here.
Please share this link with your patients!
(Hoffman, Clancy)


View Zika Webinar; Program Archived on MSSNY’s CME Site
You can now view the Medical Matters program, entitled “Zika Virus—An Evolving Story”.  The webinar was conducted by MSSNY and the New York State Department of Health and featured Dr. William Valenti, chair of MSSNY’s Infectious Disease Committee and member of the MSSNY’s Emergency Preparedness and Disaster/Terrorism Response Committee and Dr. Elizabeth Dufort, medical director, Division of Epidemiology from the New York State Department of Health.   This program has been archived to the MSSNY CME website and physicians and other health care providers can view this program free of charge by logging into http://cme.mssny.org.

The MSSNY CME site requires new users to register, but once registered physicians and other health care providers will have a personalized training page to take them to this webinar and other course work located on the site.   New registrants to the site will create a username and password, which should be retained and be used for continued access to the site. Once registered and logged into the site, physicians will be taken to an instruction page.   Click on the tool bar menu located at the top of the page and click on “My training” to view and take the various courses.  MSSNY has over 50 programs at this site and physicians are able to earn continuing medical education credits for each course.

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 online program has various programs with the number of continuing medical education credits, but the majority of the programs are for 1.0 AMA/PRA Category 1 credit™.

Further information on all these programs may be obtained by contacting Melissa Hoffman at mhoffman@mssny.org                          (Clancy, Hoffman) 


PTSD and TBI in Returning Veterans:  April – June Webinars and Live Program
MSSNY will be holding a series of CME webinars on PTSD and TBI in returning veterans on sx dates listed below from March through June. As part of a joint program with NYSPA, MSSNY will also be hosting a live presentation of the program at the Upsky Hotel in Hauppauge, Long Island. The faculty presenters will be Frank Dowling, MD and Joshua Cohen, MD.

Course objectives:

  • Explore the two most prevalent mental disorders facing American veterans today, their causes, symptoms, and comorbidities
  • Outline treatment options including evidence-based psychotherapy and pharmacotherapy
  • Discuss barriers to treatment, including those unique to military culture, and how to overcome them
  • Outline the process of recovery and post-traumatic grow (ELPERIN, DEARS)

To register for this program, click on a date below and fill out the registration form

Thursday, April 7, 6-7 PM
Tuesday, April 12, 7:30-8:30 AM
Friday, April 15, 8-9 AM live at the Upsky Hotel in Hauppauge, Long Island
Thursday, May 5, 6-7 PM
Thursday, May 19, 7:30-8:30 AM
Thursday, June 2, 6-7 PM
Thursday, June 9, 7:30-8:30 AM

For more information relating to any of the above articles, please contact the appropriate contributing staff member at the following email addresses:       

pschuh@mssny.org ldears@mssny.org      mauster@mssny.org  
pclancy@mssny.org jmcpartlon@mssny.org    

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Socio-Med: Be Aware of the Law if You No Longer Want to Accept WC patients
As a reminder, a physician who is authorized to treat Workers’ Compensation (WC) patients in NYS is not at liberty to pick and choose who to treat under NYS WC Law.

Please read the following:

  • NEW YORK CODES, RULES AND REGULATIONS, NYCRR 325-1.21 provides in part that a physician, “shall accept and treat such injured employees in a manner corresponding to that accorded other patients in his or her practice, without discriminating against such injured employees because they are or may be covered by the provisions of the Workers’ Compensation Law”.  The full text of NYCRR 325.21 is included below.

Section 325-1.21 Failure to treat.

A physician, podiatrist, chiropractor, psychologist, operator of a medical bureau or laboratory authorized by the chair to render treatment and care to injured employees under the Workers’ Compensation Law:

(a) shall accept and treat such injured employees in a manner corresponding to that accorded other patients in his or her practice, without discriminating against such injured employees because they are or may be covered by the provisions of the Workers’ Compensation Law; and

(b) shall not refuse to provide treatment and care to such injured

employees on the basis of a fee request greater than that set forth in the applicable prescribed fee schedule, but shall submit to arbitration such fee dispute in accordance with the provisions of the Workers’ Compensation Law, nor shall such treatment and care be denied to such injured employees because the source or manner of payment for such treatment and care is pursuant to the provisions of the Workers’ Compensation Law.

Nothing contained in this section shall prevent a voluntary payment by the employer or carrier of an amount higher than the fees and charges found in the fee schedule where agreed to by the employer or carrier. An authorized physician, podiatrist, chiropractor, psychologist, operator of a medical bureau or laboratory whose actions violate or are inconsistent with the provisions of this section shall be charged with misconduct, and his or her authorization to treat workers’ compensation cases shall be subject to suspension or revocation by the chair in accordance with the procedures set forth in the Workers’ Compensation Law.

In addition, I am providing you with the following Q&A:

  1. What is the consequence of Failure to Treat? 
  2. A provider can be removed from the list of authorized providers.
  3. If a physician can’t take on any new WC claimants, would the WCB consider this reportable misconduct?
  4. If a provider is removed from the list of authorized providers, it is reportable to DOH/OPMC.
  5. QWhat if the practice cannot financially sustain any more WC claimants?
  6. As the regulation states, “shall accept and treat such injured employees in a manner corresponding to that accorded other patients in his or her practice, without discriminating against such injured employees because they are or may be covered by the provisions of the Workers’ Compensation Law.”
  7. As an example, under managed care, doctors may feel they need to close their panel since it is not economically sustainable to take on new plan patients.
  8. The only acceptable reason not to take on new WC patients is if the practice is not taking on ANY new patients.
  9. What is the alternative if a physician feels h/she cannot sustain the financial viability of the practice without limiting the number of WC claimants?
  10. The physician may have to turn in their authorization to treat WC patients and cease treating all WC patients.
  11. Are you saying that the physician has no discretion to limit the number of WC claimants?
  12. Their discretion is limited only to the extent that they may refuse a new WC patient if the practice is not accepting ANY new patients.

If a physician makes an independent business decision to no longer treat WC patients, the physician needs to notify the WCB of the intent to voluntarily resign from the WC Program.  If a physician chooses to resign from WC, he/she must send a letter to the WCB at the address below indicating that he/she is voluntarily surrendering his/her WCB authorization as a treating provider: New York State Workers’ Compensation Board, Medical Director’s Office, 100 Broadway-Menands, Albany, NY  12241

Physicians who resign from WC can tell patients to search the WCB website at www.wcb.ny.gov  to find a physician under the section for WORKERS.  Or, patients can call the WCB for help:  Advocate for Injured Workers at 1-800-580-6665 or by e-mail to: advinjwkr@wcb.ny.gov

If you have any additional questions, please call Socio-Med VP Regina McNally at 516-488-6100 ext. 332.


MSSNY in the News
Associated Press – 03/19/16
As NY Demands Paperless Prescribing, Doctors are Mixed
(MSSNY President, Dr. Joseph Maldonado  and New York County Medical Society President Dr. Michael T. Goldstein, quoted)

Also appeared in:

ABC News
ABC – 13WHAM
Auburn Pub
The Columbian
CBS News
Claims Journal
Fox News
Indiana Gazette
Kansas City Star
KBET 790 Talk Now
Lockport Journal
NBC New York
NBC News 2 South Carolina
Oneida Daily Dispatch
Pittsburgh Tribune Review
Rocket News
Rutland Herald
Salina Journal
The Sentinel (PA)
Troy Record
Tribtown.com (Seymour, IN)

LoHud.com  -03/20/16
Concerns as N.Y. switches to e-scripts
(MSSNY President, Dr. Joseph Maldonado quoted)

Modern Readers – 03/20/16
As New York Prepares for Paperless Prescriptions, Docs Still Want Answers
(MSSNY President, Dr. Joseph Maldonado quoted)

Tech Times – 03/20/16
New York Mandates Paperless Prescriptions – Why Are Doctors Wary Of E-scripts?
(MSSNY President, Dr. Joseph Maldonado quoted)

Democrat & Chronicle – 03/19/16
Paperless prescribing to start March 27 in NY
(MSSNY President, Dr. Joseph Maldonado quoted)
The Buffalo News -03/19/16
Dr. John Radford wants to treat you over the web
(MSSNY Vice President, Dr. Thomas Madejski quoted)
Also ran in Pharmacy Choice

Finger Lakes Daily News –  03/21/16
Opposition to New Prescription Regulations
(MSSNY President, Dr. Joseph Maldonado comments)

Maine News Online – 03/21/16
Days of doctors handwriting prescriptions that patients then take to pharmacy coming to end
(MSSNY President, Dr. Joseph Maldonado quoted)

Syracuse.com – 03/21/16
Company news: Samuel Saleeb joined St. Joseph’s Health
(MSSNY member Dr. Samuel Saleeb mentioned) 

Pharmacy Choice  – 03/23/16
AAAASF Appoints New Vice President of Standards and Enters 36th Year of Promoting Patient Safety
(MSSNY member Dr. William B. Rosenblatt mentioned)
Also ran in StamfordAdvocate.com 

Becker’s Review

Medscape – 03/24/16
New York e-Prescribing Law Goes Into Effect This Sunday
(MSSNY President, Dr. Joseph Maldonado quoted)

If You Or Your Staff Receive a Yellow Envelope From Medicare And It Says “Revalidation” Please Take Heed
|It is very important that physicians submit a complete revalidation application by your due date and respond to all development requests from your MAC to avoid a hold on your Medicare payments and possible deactivation of your Medicare billing privileges.  If your application is received after the due date, or if you provide additional requested information after the due date your provider enrollment record may be deactivated.  Providers/suppliers deactivated will be required to submit a new full and complete application in order to reestablish their provider enrollment record and related Medicare billing privileges.   The provider/supplier will maintain their original PTAN; however, an interruption in billing will occur during the period of deactivation.  This will result in a gap in coverage.

NOTE:  The reactivation date after a period of deactivation will be based on the receipt date of the new full and complete application. Retroactive billing privileges back to the period of deactivation will not be granted.  

In addition, Medicare has said that if deactivation occurs, patients cannot be billed.  Services provided to Medicare patients during the period between deactivation and reactivation are the provider’s liability.  So if your practice relies on Medicare payment, please do NOT let a deactivation happen to you.  PLEASE share this vital information with your colleagues who bill Medicare but might not use email!


U of Buffalo Med School 628,000 S.F. Facility to Be Completed in 2017
On March 22, Governor Andrew M. Cuomo celebrated the milestone “Topping Off” at the University at Buffalo’s Jacobs School of Medicine and Biomedical Sciences. The Governor signed a steel beam that was raised and placed atop the eight-story, 628,000-square-foot facility which is expected to be completed in 2017. The project marks the largest such medical education building currently under construction in the nation. Upon completion, the new medical campus will bring more than 2,000 students, faculty and staff to the heart of downtown Buffalo.

The new building will allow UB to expand its medical school class size from 140 to 180 students and add 100 new physician-scientists to the UB faculty.


New York City’s Public Hospital System Facing “Unprecedented Threat”
The New York Daily News (3/21, Durkin) reports that New York City’s “public hospital system faces ‘unprecedented threats to our survival,’ its president said” yesterday. Speaking before the City Council, NYC Health + Hospitals (formerly the Health and Hospitals Corp.) president Ram Raju “said Obamacare, despite ‘all its positive impact,’ has dealt a financial blow to the already cash-strapped system, which runs 11 hospitals.” Not only is Health and Hospitals “losing Medicaid funds,” but it also “faces a $1.2 billion budget gap next fiscal year.” Furthermore, Federal aid to hospitals caring for uninsured patients could be cut “$300 million next year, and grow to $460 million a year after that.”


Now Available: 2016 PQRS Educational Materials
CMS is pleased to announce the posting of several 2016 PQRS educational materials. Some highlights include:

  • The “2016 Implementation Guide,” available on the PQRS How To Get Started webpage, contains information for individual eligible professionals and PQRS group practices participating in 2016 PQRS.The 2016 PQRS measures documents, for those reporting via the claims and registry reporting mechanism, are located on the PQRS Measures Codes webpage.
  • The 2016 group practice reporting option (GPRO) Web Interface measures documentation is available on the PQRS GPRO Web Interface webpage.
  • The PQRS Spotlight webpage contains a list of all recent documents and resources. Please check this page regularly for updates.

Be sure to look at the reporting mechanism-specific pages for “Made Simple” documents as well as other 2016 PQRS information. 2015 PQRS resources will be transferred to a separate webpage following the 2015 submission period.

For questions regarding 2016 PQRS reporting, please contact the QualityNet Help Desk at 1-866-288-8912 (TTY 1-877-715-6222) from 7:00 a.m. to 7:00 p.m. Central Time Monday through Friday, or via e-mail at qnetsupport@hcqis.org.


We Need More Email Addresses to Reach More Physicians

There are over 70,000 licensed physicians in NYS.  If we had more emails on file, two thing could happen:

  • More physicians would be made aware of the vital information we publish such as the article about the potential of losing their Medicare cash flow by not heeding the revalidation request; and
  • More physicians might consider joining us since we are organized to help them with these medical practice business issues.

Please share this e-news with your colleagues and ask them to send us their email addresses. Send address to:jvecchione@mssny.org


ZIKA Update: Three-in-One Test Approved by FDA
A new three-in-one laboratory test for Zika and a pair of other dangerous viruses has received emergency approval from the Food and Drug Administration and will be distributed soon, according to the Centers for Disease Control and Prevention. The test, which could speed the diagnosis of Zika, will be shipped to qualified labs across the country over the next two weeks, the agency said on March 18.

The test will allow doctors to determine in a single test whether an individual is currently infected with Zika, chikungunya or dengue. Currently, three tests are required.

The CDC said it will distribute the test to facilities in the Laboratory Response Network, a network of domestic and international laboratories that respond to public health emergencies. The test, called the Trioplex Real-time RT-PCR Assay, will not be available in hospitals or other primary care settings.

According to the CDC’s latest tally, at least 258 Americans have contracted Zika while traveling abroad. Eighteen of those cases have been diagnosed in pregnant women. 


CLASSIFIED

Physician Opportunities

Family & Internal Medicine Opportunity Just 50 miles North of NYC
Top $$ AND potential partnership with large multi-specialty physicians’ group + the balance of work & personal life you have been seeking. Perfect suburban area just 50 miles north of NYC. This is a growth position with the right person moving into a partnership opportunity within two to three years. You will enjoy a salary of $175K+ as well as:
• A monthly bonus potential
• Health, Dental, Vision and prescription insurance
• 3 weeks’ paid vacation time off annually
• 6 federal Holidays off with pay
• A $2500 CME reimbursement
• A 401K plan with company match
• Company pays 75% of a single premium life insurance policy at twice your annual salary
• Paid malpractice insurance, plus paid DEA and license renewals
The ideal candidate will possess the following:
• BE/C in Family Medicine or Internal Medicine
• Active NYS license
• Current DEA #
• Experienced as well as New Grads welcome to apply
**Relocating physicians are welcome and relocation assistance will be offered to the right candidate!**
For immediate consideration and additional information on position details please contact Laura Rappleyea at 845-344-3434 or lrappleyea@hereshelp.com and send CV’s for review.

Neurologist & Pain Management Physician Needed
A growing multi-specialty group in Orange County is looking for both a Neurologist and Pain Management Physician to join their group. This position will work with the headache center Neurologist/Pain Management Specialist. All subspecialties are welcome.
The ideal candidate will possess the following:
• BE/C in Family Medicine or Internal Medicine
   • Active NYS license
   • Experienced as well as New Grads welcome to apply
   • Experience in procedures and utilizing an integrated comprehensive approach to pain management.
For immediate consideration and additional information on position details please contact Laura Rappleyea at 845-344-3434 or lrappleyea@hereshelp.com and send CV’s for review.


OB/GYN Opportunity in the Hudson Valley
Are you looking for a great work/life balance? We are looking for an OB/GYN to join the team. We are looking for a provider to provide comprehensive primary health care to a select population of essentially healthy women, participate in the care of women with complications & responsible for providing a full range of agency approved antepartum, intrapartum, postpartum, gynecological and family planning service.
The ideal candidate will possess the following:
• BE/C in Family Medicine or Internal Medicine
       • Active NYS license
       • Experienced as well as New Grads welcome to apply
For immediate consideration and additional information on position details please contact Laura Rappleyea at 845-344-3434 or lrappleyea@hereshelp.com and send CV’s for review
.


Pediatrician Opportunity in Orange County, New York
A prestigious multi-specialty physicians’ group seeks a family driven
Pediatrician to join their group.
The ideal candidate will possess the following:
• BE/C in Family Medicine or Internal Medicine
   • Active NYS license
   • Experienced as well as New Grads welcome to apply
For immediate consideration and additional information on position details please contact Laura Rappleyea at 845-344-3434 or lrappleyea@hereshelp.com and send CV’s for review. 
.


Psychiatry Opportunity in New York’s Beautiful Hudson Valley
Our client, a prestigious multi-specialty physicians’ group who has been recognized as a Patient-Centered Medical Home by the National Committee for Quality Assurance, seeks a Psychiatrist to join their group.
The ideal candidate will possess the following:
• BE/C in Psychiatry
   • Active NYS license preferred
   • Experienced as well as New Grads welcome to apply
For immediate consideration and additional information on position details please contact Laura Rappleyea at 845-344-3434 or lrappleyea@hereshelp.com and send CV’s for review.



Join Well Established Solo Female OB/GYN Physician Practice in New York City
Quality oriented, looking for MD for long term career opportunity. New graduates welcome to apply. Affiliated with Lenox Hill Hospital. The current office has a AAAA certified operating room and an AIUM accredited ultrasound service. Looking to establish another location. Great opportunity to balance personalized practice with quality lifestyle. Please summit CV to obgynpractice130@gmail.com



L.I. PSYCHIATRIC PRACTICE FOR SALE
                    Huntington, NY
Currently 20 hrs./wk – no evenings or weekends.
$100K/yr. gross. Low overhead.
Office available for rent or move to your location.
Details on request: 631-784-7704


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

 

 

 

 

 

 

 

 

 

 

 

 

 

March 18, 2016 – DOH’s Exceptions to E-Prescribing

drmaldonado PRESIDENT’S  MESSAGE
 Dr. Joseph R.  Maldonado
asset.find.us.on.facebook.lgTwitter_logo_blue1

March 18,  2016
Volume 16, Number 10

Dear Colleagues:

In lieu of my weekly introduction, New York State Commissioner of Health Dr. Howard Zucker issued a very important letter on March 15th outlining “12 Exceptions” to the E-Prescribing Law that is looming over us and goes into effect in 10 days.

“This letter is to inform you of a blanket waiver with respect to the electronic prescribing requirements, pursuant to Public Health Law (PHL) § 281 and Education Law § 6810, that goes into effect on March 27, 2016, for exceptional circumstances in which electronic prescribing… Read More

Joseph Maldonado, M.D, MSc, MBA, DipEBHC
MSSNY President

Please send your comments to comments@mssny.org


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Legislature Puts in One House Budget Bills; Negotiations to Begin in Earnest
The Senate and Assembly one house bills were posted over the weekend. While DGA staff continues to analyze the provisions of the bills, below are highlights of what we have read thus far.

  1. After strenuous advocacy by MSSNY and other advocacy groups, each House added $25M in their one House budget bills to restore funding for the Excess program. In addition they included language to continue the Excess program as is and to continue the Superintendent’s authority to set medical malpractice rates. Physicians should thank their elected officials for proposing to restore this funding and continue to urge restoration of this cut as the final Budget is being negotiated. Go to the this link for a letter you can send to your elected representatives.
  1. After proactive advocacy by MSSNY and other advocacy groups, both Houses articulated a desire that “funding or settlement funds be identified in  addition  to  remaining  assets  to   reimburse   hospitals, physicians and producers pro-rata for losses associated with the demise of Health  Republic  upon  completion  of  the  formal liquidation process” (Senate language). Importantly, several key legislators (Senators Hannon, Rivera, and Valesky and Assemblymembers Cahill and Walter) articulated this goal in the first meting of the Health Budget Conference Committee this week.  In addition, the Senate bill would eliminate the requirement for prior approval of health insurance premium rates and would establish a requirement that within thirty days deeming an insurer insolvent, the superintendent must apply for a liquidation order.

ALL PHYSICIANS SHOULD IMMEDIATELY GO TO THE FOLLOWING LINK TO CONTACT THEIR ELECTED REPRESENTATIVES TO URGE THE INDENTIFICATION OF A POOL OF MONIES TO REIMBURSE HEALTHCARE PROVIDERS FOR THE SERVICES RENDERED TO PATIENTS PREVIOUSLY INSURED BY HEALTH REPUBLIC.  http://cqrcengage.com/mssny/app/onestep-write-a-letter?5&engagementId=151313

  1. The Senate included the Governor’s retail clinic language which would allow publicly traded corporations to own and operate limited service clinics in retail space they own without regard for public need. The Assembly advanced language which would, importantly, not allow publicly traded corporations to own and operate retail clinics but which seeks to regulate practices that rent space in retail establishments by, among other things, requiring them to be accredited; limit the type of services which can be provided and prohibit them from delivering care to children under the age of two. The corporately owned retail clinic language remains in play.  Go to the this link to send a letter of opposition to this proposal to your legislators.
  1. After strenuous advocacy by MSSNY and other advocacy groups, neither House included any of the workers’ compensation language we opposed. While this is a very positive development, we must keep the pressure on by reaching out to your elected representatives if you haven’t yet done so by sending a letter found at this site.
  1. The Senate bill includes language to require the commissioner of health to develop an elder abuse screening tool. Physicians, PAs and NPs are permitted (not required) to use the tool to identify abuse or maltreatment of their patients. The language also calls for the establishment of an interagency clearinghouse for reported cases involving physical abuse, sexual abuse, emotional abuse, active, passive or self-neglect, financial exploitation or other hazardous situations which could jeopardize the health and wellbeing of an individual and calls for the creation of multidisciplinary teams for the purpose of investigating reports of suspected elder abuse. The proposal would also authorize a financial institution to disallow a transaction if it believes that financial exploitation of a vulnerable adult is occurring.
  1. The Senate bill included legislation strongly supported by MSSNY which would exempt low volume providers from the eRx mandate and allow prescribers invoking an exception to the mandate to make a notation in the patient’s medical record instead of calling DOH (currently required by law).  Please send in support letter here:
  1. Senate bill sets aside an additional $12M in new funding for 100 new loan forgiveness/practice support slots as part of the Doctors Across New York. The bill would reduce from five to three the number of years of service associated with the support and would allow for $40,000 in loan forgiveness/practice support each year up to $120,000 for each new recipient.
  1. Each House would restore existing ”prescriber prevails” protections in the Medicaid and Medicaid Managed Care program.
  1. Each House devotes a significant amount of new money ($26M (Senate) and $32M (Assembly)) to address substance abuse with significant money flowing for prevention and treatment services, recovery support services and recovery community centers. In addition, the Assembly would require OASAS to: develop educational materials for schools and require schools to make Substance Use Disorder (SUD) treatment referrals; develop materials for pharmacies to distribute regarding drug addiction, treatment and disposal of drugs; develop SBIRT materials; develop SUD materials for physicians for voluntary distribution to patients and require hospitals to establish policies regarding referral of individuals in need of SUD treatment.
  1. The Senate included language in its one House bill that MSSNY opposes that would allow chiropractors and physicians to partner in LLPs/LLCs.
  1. Importantly, the Senate one House repeals action taken in last year’s budget to eliminate Medicaid reimbursement for services provided to patients dually eligible for Medicaid and Medicare thereby restoring the 20% of the co-insurance. Please send a letter in support here.

The conference committees are expected to continue meeting next week.

We will keep you informed of discussions which ensue throughout the next couple of weeks.

Best Regards,
Liz. Moe, Pat and James

NYS DOH Commissioner Issues 12 Additional Exemptions to the E-Prescribing Requirment
NYS Health Commissioner Howard Zucker, MD issued a statement this week providing 12 exemptions to the e-Prescribing mandate going in effect March 27th.   In a March 16th letter, the Commissioner said that exceptional circumstances existed in which electronic prescribing cannot be performed due to limitations in software functionality.   In a letter to prescribers, the Commissioner listed the 12 additional exceptions to the e-prescribing requirement.   Those exceptions are as follows:

  • any practitioner prescribing a controlled or non-controlled substance, containing two (2) or more products, which is compounded by a pharmacist;
  • any practitioner prescribing a controlled or non-controlled substance to be compounded for the direct administration to a patient by parenteral, intravenous, intramuscular, subcutaneous or intraspinal infusion;
  • any practitioner prescribing a controlled or non-controlled substance that contains long or complicated directions;
  • any practitioner prescribing a controlled or non-controlled substance that requires a prescription to contain certain elements required by the federal Food and Drug Administration (FDA) that are not able to be accomplished with electronic prescribing;
  • any practitioner prescribing a controlled or non-controlled substance under approved protocols under expedited partner therapy, collaborative drug management or in response to a public health emergency that would allow a non-patient specific prescription;
  • any practitioner prescribing an opioid antagonist that would allow a non-patient specific prescription;
  • any practitioner prescribing a controlled or non-controlled substance under a research protocol;
  • a practitioner prescribing a controlled or non-controlled substance either through an Official New York State Prescription form or an oral prescription communicated to a pharmacist serving as a vendor of pharmaceutical services, by an agent who is a health care practitioner, for patients in nursing homes and residential health care facilities as defined in section twenty-eight hundred one of the public health law. The Assembly and Senate have passed similar legislation (A.9334/S6778)
  • a pharmacist dispensing controlled and non-controlled substance compounded prescriptions, prescriptions containing long or complicated directions, and prescriptions containing certain elements required by the FDA or any other governmental agency that are not able to be accomplished with electronic prescribing;
  • a pharmacist dispensing prescriptions issued under a research protocol, or under approved protocols for expedited partner therapy, or for collaborative drug management;
  • a pharmacist dispensing non-patient specific prescriptions, including opioid antagonists, or prescriptions issued in response to a public health emergency issued; and
  • a pharmacist serving as a vendor of pharmaceutical services dispensing a controlled or non-controlled substance through an Official New York State Prescription form or an oral prescription communicated by an agent who is a health care practitioner, for patients in nursing homes and residential health care facilities as defined in section twenty-eight hundred one of the public health law.

The the above-listed exceptional circumstances will be effective until March 26, 2017. According to an email that MSSNY received on March 17, 2016 from the NYS Bureau of Narcotics Enforcement, any use of these the exceptions does not require physicians to notify the Department of Health that they are using the exception.

Additionally, on March 17, 2016, Governor Cuomo issued a press statement about e-prescribing, noting that the “requirement is a key component of New York’s I-STOP initiative that is focused on helping curb the abuse of prescription medication throughout the state”.   He reminds prescribers that e-prescribing will become effective on March 27, 2016.   A copy of the Governor’s press release is here.

A copy of the Commissioner’s letter can be found here.                                (CLANCY, DEARS)

Continue to Urge your Legislators to Reduce Liability Insurance Costs, Not Raise Them!
Last week physicians and medical students from across New York State came to Albany to remind their legislators that, in light of the huge financial pressures threatening the viability of physician practices and our health care delivery system, no further liability increases can be tolerated.  Please continue to urge  your legislators (http://cqrcengage.com/mssny/app/write-a-letter?4&engagementId=105729) to oppose legislation (A.285-A, Weinstein/S.6596, DeFrancisco) that could drastically increase New York’s already exorbitantly high medical liability premiums by changing the medical liability Statute of limitations to a “Date of Discovery” rule.

MLMIC’s estimate is that this bill could increase physician liability premiums by nearly 15%!   New York physicians continue to pay liability premiums that are among the very highest in the country.  By way of example, a neurosurgeon practicing on Long Island must pay an astounding $338,252 for just one year of insurance coverage and an OB/GYN practicing in the Bronx or Staten Island must pay $186,639.   New York far surpasses all other states in terms of total medical liability payouts, per capita payments, and medical liability awards above $1 million.

MSSNY joined the Greater New York Hospital Association (GNYHA) and Healthcare Association of New York State (HANYS) in an ad in the Albany Times-Union and City & State calling for reduction in these exorbitant costs.

To make matters even worse, trial lawyers are aggressively pushing the Legislature to consider additional liability expansion bills such as legislation that would eliminate the statutory limitation on contingency fees in medical liability actions, legislation that MLMIC has estimated could have the effect of raising your premiums by over 10%.   Please tell your legislators to enact comprehensive liability reform to bring down these costs, not legislation that increases them!                                                                                                  (AUSTER, DEARS)

MSSNY Joins Many Other Group in Expressing Strong Concerns with Changes to Payment for Medicare Part B Drugs
MSSNY joined numerous patient advocacy groups, specialty societies and state medical societies in a letter to HHS, CMS and Congressional leaders expressing strong concerns with proposed changes to the methodology for paying for medications covered under Medicare Part B, such as chemotherapy and ophthalmological medications.   CMS is proposing to change the reimbursement methodology of Part B drugs from the current 6% add-on to the “Average Sales Price (ASP)” to 2.5% plus a flat fee.  CMS also proposed a second phase that would implement value-based purchasing tools similar to those employed by commercial health plans, pharmacy benefit managers, hospitals, and other entities that manage health benefits and drug utilization. 

Broad concerns with this proposal were expressed by several groups and members of Congress in a New York Times article last week.  The American Society of Clinical Oncology released a statement condemning the proposal noting that “it is inappropriate for CMS to manipulate choice of treatment for cancer patients using heavy-handed reimbursement techniques…..Physicians did not create the problem of drug pricing and its solution should not be on their backs.”  More here.

To read the CMS press release and other materials describing CMS’ proposal, click here.                                                                                                            (AUSTER)


Assembly Passes Stand-Alone Ethics Reform Bill
On Tuesday, March 15th, the Assembly passed a bill (A.9535) that was introduced by Speaker Heastie and includes over 85 assembly sponsors. The bill proposes to limit outside earned income, close the LLC loophole, place restrictions on legislator-lawyers, and prohibit ownership interests in any company with matters before the state. The bill would limit outside earned income of legislators to no greater than 40% of the annual salary of the state justices of the New York State Supreme Court. And it places restrictions on legislator-lawyers by prohibiting the sharing of legal fees between legislator-lawyers and other lawyers who are not a member of the same law firm, unless the legislator-lawyer actually performs legal work, and the fee is in proportion to the services performed.

Legislators, without a legislative ethics commission written opinion, would be prevented from earning income from ownership interests in any firm, corporation, LLC, or partnership engaged in any lobbying activity (directly or indirectly), representing litigants against the state, contracting with the state, or appearing to have matters before the state. Within 30 days of taking offices, legislators would also be required to submit records of all ownership interests in any company to the legislative ethics commission.                                              (MCPARTLON)


PTSD and TBI in Returning Veterans:  March – June Webinars
MSSNY will be holding a series of CME webinars on PTSD and TBI in returning veterans on seven dates listed below from March through June. The faculty presenters will be Frank Dowling, MD and Joshua Cohen, MD.

Course objectives:

  • Explore the two most prevalent mental disorders facing American veterans today, their causes, symptoms, and comorbidities
  • Outline treatment options including evidence-based psychotherapy and pharmacotherapy
  • Discuss barriers to treatment, including those unique to military culture, and how to overcome them
  • Outline the process of recovery and post-traumatic grow

To register for this webinar, click on a date below and fill out the registration form

Tuesday, March 22, 6-7 PM
Thursday, April 7, 6-7 PM
Tuesday, April 12, 7:30-8:30 AM
Thursday, May 5, 6-7 PM
Thursday, May 19, 7:30-8:30 AM
Thursday, June 2, 6-7 PM
Thursday, June 9, 7:30-8:30 AM                                                                                   (DEARS, ELPERIN)

298 Participants View Zika Webinar; Program Archived on MSSNY’s CME Site
Nearly 300 physicians and other healthcare providers participated in this month’s MSSNY Medical Matters program, entitled “Zika—An Evolving Story”.    The webinar was conducted by MSSNY and the New York State Department of Health and featured Dr. William Valenti, chair of MSSNY’s Infectious Disease Committee and member of the MSSNY’s Emergency Preparedness and Disaster/Terrorism Response Committee and Dr. Elizabeth Dufort,  medical director, Division of Epidemiology from the New York State Department of Health.   This program has been archived to the MSSNY CME website and physicians and other health care providers can view this program free of charge by logging into the MSSNY CME Website.

The MSSNY CME site requires new users to register, but once registered physicians and other health care providers will have a personalized training page to take them to this webinar and other course work located on the site.   New registrants to the site will create a username and password, which should be retained and be used for continued access to the site. Once registered and logged into the site, physicians will be taken to an instruction page.   Click on the tool bar menu located at the top of the page and click on “My training” to view and take the various courses.     MSSNY has over 50 programs at this site and physicians are able to earn continuing medical education credits for each course. 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 online programs have varying numbers of continuing medical education credits, but the majority of the programs are for 1.0 AMA/PRA Category 1 credit™.  Further information on all these programs may be obtained by contacting Pat Clancy at pclancy@mssny.org.
(CLANCY)

Live Seminar on Ebola at MSSNY House of Delegates; Physicians Can Also Participate by Web
The April session of Medical Matters will take place at the MSSNY House of Delegates and is entitled,

“Ebola: A Perspective from the Field”.  The program will be held on Thursday, April 14, 2016 at 2:00pm. Physicians may attend the session at the Westchester Marriott, 670 White Plains Road, Tarrytown, NY 10591 or by webinar.  Registration is limited at the Tarrytown, so physicians are encouraged to register for the live session as soon as possible.   Registration for the live session or by webinar is now open here. Click on the upcoming tab and select the program.

The program will be conducted by Dario Gonzalez, MD, FACEP, Associate Medical Director, Fire Department City of New York/Office of Medical Affairs.  Dr. Gonzalez was deployed for nine weeks by Americares to Liberia, West Africa as part of the US response to the Ebola epidemic.  The educational objective is: Offer perspective and lessons learned from an individual who treated Ebola patients firsthand.

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.

Further information or assistance in registering for any of these programs may be obtained by contacting Melissa Hoffman at mhoffman@mssny.org.
(CLANCY, HOFFMAN)

For more information relating to any of the above articles, please contact the appropriate contributing staff member at the following email addresses:       

pschuh@mssny.org ldears@mssny.org      mauster@mssny.org  
pclancy@mssny.org jmcpartlon@mssny.org    

 

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JAMA: Physicians’ EHR-Inboxes Are Overloaded
A research letter published online March 14 in JAMA Internal Medicine suggest “some physicians receive more than 100 notifications per day via electronic health record (EHR)-based inboxes, and dealing with this electronic burden requires more than an hour every day.” Researchers arrived at these conclusions after evaluating “the electronic logs of 276,207 notifications received from January 1 through June 30, 2015, by 92 physicians at three large practices (one multispecialty and two primary care practices) in Texas.

“Information overload is of emerging concern because new types of notifications and “FYI” (for your information) messages can be easily created in the EHR (vs in a paper-based system). Furthermore, the additional workload to read and process these messages remains uncompensated in an environment of reduced reimbursements for office-based care. Conversely, EHRs make it easier to measure the amount of information received. We quantified the notifications that physicians received via inboxes of commercial EHRs to estimate their burden.”


THIS WEEK: MSSNY in the News
New York Times – 03/14/16
The End of Prescriptions as We Know Them in New York
(MSSNY President Dr. Joseph Maldonado quoted)
Also picked up in:
Times Union – 03/14/16

State rewrites medical practice
(MSSNY President, Dr. Joseph Maldonado quoted)

The Buffalo News – 03/14/16
In New York, paper prescriptions out, computers in
(MSSNY President, Dr. Joseph Maldonado quoted

 

The Oneida Daily Dispatch (AP) – 3/13/16
NY mulls legalizing doctor-assisted suicide
(MSSNY mentioned)

The Daily Freeman(AP)  03/13/16
NY Legislature mulling doctor-assisted suicide bills
(MSSNY mentioned)

The Troy Record (AP) 03/13/16
New York lawmakers eye assisted suicide law
(MSSNY mentioned)

The Saratogian (AP) – 03/13/16
New York lawmakers eye assisted suicide law
(MSSNY mentioned)

Private Officer Breaking News – 03/14/16
New York to Discard Prescription Pads, and Doctors’ Handwriting, in Digital Shift
(MSSNY President Dr. Joseph Maldonado quoted)

Utica Observer – 03/15/16
E-scripts: Is everyone ready?
(MSSNY President Dr. Joseph Maldonado quoted)

New York State Osteopathetic Medical Society – 3/15/2016
NYSOMS joins MSSNY in Powerful Day of Advocacy
(MSSNY mentioned)

Thefix.com – – 03-17/16
New York State Is Doing Away With Paper Prescriptions
(MSSNY President Dr. Joseph Maldonado quoted)

Crain’s Health Pulse – 03/18/16
As e-prescribing deadline looms, DOH issues waivers
(Elizabeth Dears, MSSNY’s senior vice president for legislative and regulatory affairs quoted)


Are You a Pre-residency IMG looking for Experience?  Are You a Physician Who Can Help?
MSSNY’s IMG Committee, through its Clearinghouse of Opportunities Program, seeks to place IMG candidates seeking externship and internship opportunities.

Contact us if you are an IMG looking for a meaningful experience to help you become familiar with the US healthcare system and help prepare you for residency training. Past participants have worked as scribes, entering notes into electronic medical records; performed chart audits for preventive care as a quality improvement measure; educated patients; coordinated with insurance and healthcare providers; helped with research and special projects, etc.

If you are looking for a way to stay connected to medical practice as you pursue residency training, or if you have a position to offer an unlicensed medical graduate, please contact Ruzanna Arsenian (rarsenian@mssny.org). Graduates should include a CV, and those with previous experience in their home countries as faculty members, practicing physicians, or researchers, should be sure to mention that.  Let us know where you are located, how far you would be able to travel, and whether or not you require a paid position or if you could accept a role as a volunteer.

Physicians who are willing to help familiarize an unlicensed medical graduate with medical practice in the US are asked to describe the role they would ask the graduate to fill and include any specific requirements in terms of hours or duties.  Please indicate if the position will include observership experience with a formal evaluation leading to a possible letter of recommendation, or will offer payment for office work performed.


Commit to Pursuing Your Leadership Potential
Join the American Association for Physician Leadership from April 13-15 in Washington, D.C. for the 2016 Spring Institute and engage with health care’s influencers to find solutions to today’s toughest challenges. Register today for leadership courses from the American Association for Physician Leadership®, formerly ACPE, and earn up to 35 CME credits.

Recommended courses:

  • Physician in Management Series (35 CME/Credits)
    Gain a solid foundation to succeed in your new leadership role.
  • Managing Physician Performance (24 CME/Credits)
    Learn to effectively hire, engage and manage physicians within your organization.
  • Election 2016 and Health Policy for Physician Leaders (11 CME/Credits)
    Get insight from health policy experts and learn how to communicate with policymakers.

Register today for leadership courses from the American Association for Physician Leadership®, formerly ACPE, and earn up to 35 CME credits.
View All Courses
Hurry! Hotel group rate expires March 28. 


Zika Virus Update from NYSDOH
New York officials announced a new plan to combat Zika on Thursday. The state of New York plans to “monitor and target a type of mosquito that officials fear could spread the Zika virus,” in addition to distributing “prevention kits to pregnant women.” Thus far the state has reported 49 cases of Zika, all from people who have recently traveled to affected areas, the AP says. Gov. Andrew Cuomo said Thursday that officials “expect that number to go up” but are unsure “how high.”

Health Advisory: Expansion of Zika Virus Testing to Pregnant Women Who Had Unprotected Sex With A Partner Who Traveled to An Area With Active Mosquito-borne Transmission of Zika Virus – March 10, 2016


NYU Med Offerings: Dietary Strategies in Cardiovascular Risk Reduction
Thursday, May 19, 2016, 12:30 PM – 5:30 PM
To Register and for more information: http://www.med.nyu.edu/cme/diet_cardiovascular
The NYU Post-Graduate Medical School designates this live activity for a maximum of 4.25 AMA PRA Category 1 Credits™. Physicians should claim only the credit commensurate with the extent of their participation in the activity. ​

The course will cover topics such as the Mediterranean Diet, the Vascular Biology of Eating, Plant Based Nutrition and explore the evidence and controversies surrounding saturated fat, cholesterol, sugar and salt.  Attendees will also be instructed in dietary assessment and dietary counseling with the latest innovations in counseling—motivation/technology. The course will also offer a unique lecture on the link between the human microbiome and cardiovascular disease.

Advances in Cardiovascular Risk Reduction
Friday, May 20, 2016, 8:30 AM – 3:45 PM
To register and for more information: http://www.med.nyu.edu/cme/cardiovascular
The NYU Post-Graduate Medical School designates this live activity for a maximum of 7.00 AMA PRA Category 1 Credits™. Physicians should claim only the credit commensurate with the extent of their participation in the activity.

This one-day course will cover state-of-the-art management of patients with cardiovascular risk factors, with a focus on prevention. This year’s program focuses on recent clinical trial results with implications in the management of cardiovascular disease risk factors, such as diabetes, hypertension and ischemia. Additional topics include new developments in PCSK9 treatments for familial hypercholesterolemia, the use of aspirin in cardiac prevention and weight loss surgery insights.


CLASSIFIED

Physician Opportunities

Family & Internal Medicine Opportunity Just 50 miles North of NYC
Top $$ AND potential partnership with large multi-specialty physicians’ group + the balance of work & personal life you have been seeking. Perfect suburban area just 50 miles north of NYC. This is a growth position with the right person moving into a partnership opportunity within two to three years. You will enjoy a salary of $175K+ as well as:
• A monthly bonus potential
• Health, Dental, Vision and prescription insurance
• 3 weeks’ paid vacation time off annually
• 6 federal Holidays off with pay
• A $2500 CME reimbursement
• A 401K plan with company match
• Company pays 75% of a single premium life insurance policy at twice your annual salary
• Paid malpractice insurance, plus paid DEA and license renewals
The ideal candidate will possess the following:
• BE/C in Family Medicine or Internal Medicine
• Active NYS license
• Current DEA #
• Experienced as well as New Grads welcome to apply
**Relocating physicians are welcome and relocation assistance will be offered to the right candidate!**
For immediate consideration and additional information on position details please contact Laura Rappleyea at 845-344-3434 or lrappleyea@hereshelp.com and send CV’s for review.

Neurologist & Pain Management Physician Needed
A growing multi-specialty group in Orange County is looking for both a Neurologist and Pain Management Physician to join their group. This position will work with the headache center Neurologist/Pain Management Specialist. All subspecialties are welcome.
The ideal candidate will possess the following:
• BE/C in Family Medicine or Internal Medicine
   • Active NYS license
   • Experienced as well as New Grads welcome to apply
   • Experience in procedures and utilizing an integrated comprehensive approach to pain management.
For immediate consideration and additional information on position details please contact Laura Rappleyea at 845-344-3434 or lrappleyea@hereshelp.com and send CV’s for review.


OB/GYN Opportunity in the Hudson Valley
Are you looking for a great work/life balance? We are looking for an OB/GYN to join the team. We are looking for a provider to provide comprehensive primary health care to a select population of essentially healthy women, participate in the care of women with complications & responsible for providing a full range of agency approved antepartum, intrapartum, postpartum, gynecological and family planning service.
The ideal candidate will possess the following:
• BE/C in Family Medicine or Internal Medicine
       • Active NYS license
       • Experienced as well as New Grads welcome to apply
For immediate consideration and additional information on position details please contact Laura Rappleyea at 845-344-3434 or lrappleyea@hereshelp.com and send CV’s for review
.


Pediatrician Opportunity in Orange County, New York
A prestigious multi-specialty physicians’ group seeks a family driven
Pediatrician to join their group.
The ideal candidate will possess the following:
• BE/C in Family Medicine or Internal Medicine
   • Active NYS license
   • Experienced as well as New Grads welcome to apply
For immediate consideration and additional information on position details please contact Laura Rappleyea at 845-344-3434 or lrappleyea@hereshelp.com and send CV’s for review. 
.


Psychiatry Opportunity in New York’s Beautiful Hudson Valley
Our client, a prestigious multi-specialty physicians’ group who has been recognized as a Patient-Centered Medical Home by the National Committee for Quality Assurance, seeks a Psychiatrist to join their group.
The ideal candidate will possess the following:
• BE/C in Psychiatry
   • Active NYS license preferred
   • Experienced as well as New Grads welcome to apply
For immediate consideration and additional information on position details please contact Laura Rappleyea at 845-344-3434 or lrappleyea@hereshelp.com and send CV’s for review.



Join Well Established Solo Female OB/GYN Physician Practice in New York City
Quality oriented, looking for MD for long term career opportunity. New graduates welcome to apply. Affiliated with Lenox Hill Hospital. The current office has a AAAA certified operating room and an AIUM accredited ultrasound service. Looking to establish another location. Great opportunity to balance personalized practice with quality lifestyle. Please summit CV to obgynpractice130@gmail.com


Jerome I. Sager – Attorney at Law
The health care law experts representing medical professionals for more than 25 years.  See us for Professional Medical Conduct Defense, Medicaid and Medicare Fraud Cases, DEA and Controlled Substance Issues, Third party insurance issues. We can handle most legal matters. Call us for a free consultation. 212-685-2333 / 917-312-6631, jeromesager@cs.com

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

 

 

 

 

 

 

 

 

 

 

 

 

 

March 11, 2016 – Opting Out of What Is Being Sold to Us

drmaldonado PRESIDENT’S  MESSAGE
 Dr. Joseph R.  Maldonado
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March 11,  2016
Volume 16, Number 9

Dear Colleagues: 

Opting Out of the Pipe Dream Floated to Most Doctors

The latest mantra being floated by the purveyors of the next iteration to transform healthcare in America is Value Based Payments.  Doctors are told that they will have to adjust to a new reimbursement methodology that changes from fee for service to value based payments.  Those preaching the virtues of this new gospel aim to convince physicians that this new reimbursement methodology rewards them for what they do best.  They extol the virtues of it and label those aspects of the payment methodologies that carry the greatest financial risk, “premium” level engagement.  Surely, those touting such “premium” level methodologies cannot possibly be serious given the just published CMS outcomes for the Value Modifier Program for quality and cost effectiveness measures.  One has to ask whether the failure to attain meaningful positive improvements in physician compensation for value based services is a reflection of Bent Flyvbjerg’s notions of “optimism bias” or simply “strategic misrepresentation.”

Abysmal Misrepresentation

This year’s results indicate that only 1.5% of entities which participated in the CMS’ Value Modifier Program were able to attain a positive adjustment to their reimbursements for 2016.  The prior year’s review indicated that only 0.86% of entities were able to gain a positive adjustment for 2015.  I await the spin that there has been a 50% improvement in physician capability to garner upward adjustment in reimbursement for their stellar quality and cost effectiveness performance.  These numbers clearly show the abysmal misrepresentation that participation in these quality programs offer a real opportunity for physicians to improve their reimbursements.  Consider the investments in time, energy and monies of the 8,395 practices representing 98.5% of those eligible for the touted, but missed, upward adjustments.

The “Game” Is rigged

These dreadful results make it clear to me that participation in these value base payment schemes is a pipe dream for most physician practices.  It is the promise held out by the claw machines for prizes in game arcades.  The prizes are real.  The likelihood of grabbing the prize is low.  The game is rigged.  With no firm guaranty of physicians being made whole in the Health Republic debacle, it is perplexing to me why anyone would believe the promise of a value based payment scheme that offers anything better than the abysmal outcomes reported by the CMS Value Modifier Program in the past two years or the chances with the claw machines in the gaming arcade.

I’ve opted out of this game.  Stop the optimism bias.  Stop the strategic misrepresentation.

Joseph Maldonado, M.D, MSc, MBA, DipEBHC
MSSNY President

Please send your comments to comments@mssny.org


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By All Accounts MSSNY’s Lobby Day A Success – MSSNY Thanks All Who Participated
MSSNY’s “Physician Advocacy Day” was held in Albany earlier this week on March 8th. More than 300 physicians, medical students, residents, alliance members and friends of medicine participated in the event. By all accounts, the Lobby Day was a real success! 

The March 8th program has been archived and is available for viewing here.

A full slate of legislators and top Administration officials participated including Donna Frescatore, Executive Director, NYS Health Benefit Exchange; Jason Helgerson, Medicaid Director, NYS Department of Health; Troy Oechsner, Executive Deputy Superintendent, Department of Financial Services; Senate Health Chair Kemp Hannon; Assembly Health Chair Richard Gottfried; Senate Insurance Chair James Seward; Assembly Insurance Chair Kevin Cahill.

In addition, Assembly Majority Leader Joe Morelle and Senate Majority Leader John Flanagan also addressed the physician advocates in  the morning proceedings. A brief informal luncheon in which members of each House also attended and spoke with their constituents followed the morning program.  In the afternoon participants met with their elected representatives and/or their staff to discuss the organized medicine’s priority issues.

MSSNY’s leadership including its President, Joseph Maldonado, MD, President-Elect, Malcolm Reid, MD, Vice-President, Charlie Rothberg, Immediate Past Presient, Andrew Kleinman, MD, HOD Speaker Kira Geraci-Ciardullo, MD and Legislative Committee Chair Paul Pipia, MD led discussion which ensued with the speakers on important issues including restoration of funding to the Excess program, a Guaranty Fund for failed health insurers like Health Republic, identification of funding to reimburse physicians for care provided to the now defunct Health Republic, and defeat of the retail clinic and workers compensation proposal.

MSSNY would like to thank all county medical society executive directors, the leadership of the NYS Osteopathic Medical Society, the leadership of several specialty medical societies including, in particular, ACOG and David Welch, MD for bringing more than 100 medical students, residents and aspiring High School students to participate in this event.

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Dr. Robert Goldberg with Touro medical students at MSSNY’s Lobby Day
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(left to right) Senator Kemp Hannon, Chair, Senate Health Committee; Assemblyman Kevin Cahill , Chair, Assembly Insurance Committee; Senator James Seward, Chair, Senate Insurance Committee
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Senate Majority Leader John Flanagan addresses physicians at MSSNY’s Lobby Day

(DIVISION OF GOVERNMENTAL AFFAIRS)


Physicians Urged to Oppose Huge Cuts To Excess Medical Liability Insurance Program
While many leaders and staff in the Assembly and Senate have indicated strong concerns with the proposal in the Executive Budget to cut funding for the Excess Medical Malpractice Insurance Program by $25 million, physicians must continue to contact their legislators to urge that they continue to fight to assure this funding is restored in the final State Budget.

The proposal would result in 55% of physicians who currently receive this additional coverage being dropped from the program.  Across much of upstate New York, only neurosurgeons, bariatric surgeons and OB-GYNs would keep this coverage.   And downstate, many primary care physicians, ophthalmologists, otolaryngologists, pathologists, dermatologists and allergists would be dropped.

The Excess Medical Liability Insurance Program provides an additional layer of $1M of coverage to physicians with hospital privileges who maintain primary coverage at the $1.3 million/$3.9 million level.  The program was created over 30 years ago as a result of the liability insurance crisis of the mid-1980’s to address concerns among physicians that their liability exposure far exceeded available coverage limitations.  Absent meaningful liability reform, with verdicts and physician liability premiums continuing to be far out of proportion compared to the rest of the country, full funding for the Excess program is absolutely essential in today’s very challenging practice environment.

At a time when the state is seeking to attract and retain physicians, this proposal deters physicians from wanting to practice in New York State for fear of putting themselves and their families in financial jeopardy for judgements and settlements exceeding the limits of their primary coverage.  Please urge your legislators to restore full funding for the program!                                                                 (AUSTER, DEARS)


Urge Your Legislators to Reduce Liability Insurance Costs, Not Raise Them!
This week, physicians and students from across New York State came to Albany to remind their legislators that, in light of the huge financial pressures threatening the viability of physician practices and our health care delivery system, no further liability increases can be tolerated.  Please join your colleagues by contacting your legislators (http://cqrcengage.com/mssny/app/write-a-letter?4&engagementId=105729) to urge that they oppose legislation (A.285-A, Weinstein/S.6596, DeFrancisco) that could drastically increase New York’s already exorbitantly high medical liability premiums by changing the medical liability Statute of limitations to a “Date of Discovery” rule.   

MLMIC’s estimate is that this bill could increase physician liability premiums by nearly 15%!   New York physicians continue to pay liability premiums that are among the very highest in the country.  By way of example, a neurosurgeon practicing on Long Island must pay an astounding $338,252 for just one year of insurance coverage and an OB/GYN practicing in the Bronx or Staten Island must pay $186,639.   New York far surpasses all other states in terms of total medical liability payouts, per capita payments, and medical liability awards above $1 million.

MSSNY has joined the Greater New York Hospital Association (GNYHA) and Healthcare Association of New York State (HANYS) in an ad in the Albany Times-Union and City & State calling for reduction in these exorbitant costs.

To make matters even worse, trial lawyers are aggressively pushing the Legislature to consider additional liability expansion bills such as legislation that would eliminate the statutory limitation on contingency fees in medical liability actions, legislation that MLMIC has estimated could have the effect of raising your premiums by over 10%.   Please tell your legislators to enact comprehensive liability reform to bring down these costs, not legislation that increases them!
(AUSTER, DEARS)
 


Physicians Urged to Contact Their Representatives to Urge Defeat of the Retail Clinic Proposal
Physicians are urged to contact their elected representatives to urge rejection of the retail clinic proposal included in the Governor’s budget which would  permit public corporations to own and operate retail clinics, or “limited service clinics”, throughout New York State. Go to the following link to send a letter to your legislators.

While various versions of this legislation exist, each seeks to allow publicly traded corporations to establish health clinics without need for certificate of need for review—for the first time in New York State. By permitting this practice, NYS will infringe upon the independence of medical decision-making and the integrity of the doctor-patient relationship. Furthermore, corporately owned and operated retail clinics will open the floodgates to conflicts of interest posed to exist as retail clinics directly profit from the very prescriptions they write, and treatments they recommend—all under the very same roof.

At a time when we in NYS are working hard to ensure and expand primary care and medical home capacity, retail clinics threaten the very viability of primary care physician’s practices. Contact your legislator today, and urge them to oppose the expansion of Retail Clinics in New York State.
(McPARTLON, DEARS)
 


Urge the Inclusion of Monies to Pay Health Republic Claims in the State Budget
This week numerous key legislative leaders articulated their awareness that failure to pay outstanding Health Republic claims will have a seriously destabilizing impact on regional health care delivery systems across the State.  Therefore, as the Assembly, Senate and Governor’s office begin in-depth negotiations on the State Budget, it is imperative that physicians continue to contact their legislators to urge that a Guarantee Fund or other allocation of monies be included in the State Budget to assure these claims are paid.  To send a letter, click here.

So far, 35 Assemblymembers have joined Assembly Health Committee Chair Richard Gottfried and Assemblyman Charles Lavine (D-Nassau County) in co-sponsoring legislation (A.9311) to establish a Guarantee Fund to help to assure the payment of the hundreds of millions that Health Republic owes physicians and hospitals across New York State, as well as to protect consumers and health care providers from future health plan insolvencies.  To view the list of co-sponsors, click here.

Identical legislation (S.6667, Valesky, also with several co-sponsors – see here) has been introduced in the State Senate.

You must remind your legislators that, with physicians facing so many other challenges in seeking to keep their doors open to deliver patient care, including high liability costs, expensive electronic medical record equipment, employee costs, insurance companies dropping physicians from their networks and declining payments from insurers, failure to assure payment for these claims would have serious negative consequences for patient care and employment in your community.
(AUSTER, DEARS)


Payment of Health Republic Claims, Restoring Excess Insurance Cuts, Listed as Priorties of Senate Democratic Conference
The New York State Senate Democratic Conference this week released a 17-page letter outlining its Budget priorities as the Assembly and Senate Majority conferences were planning to advance its own suggested modifications to the Governor’s proposed Budget.  Of note, Senate Democratic Leader Andrea Stewart-Cousins’ letter to Senate Majority Leader Flanagan included the following items consistent with MSSNY’s Budget advocacy:

  • Restoring the $25 million cut to the Excess Medical Malpractice Insurance Program, and extending the program for 3 years;
  • Establish a Health Care Guarantee Fund “to reimburse providers for uncompensated care as a result of the collapse of health insurance companies such as Health Republic”;
  • Rejecting the proposed Workers Compensation reforms;
  • Rejecting the proposal to permit the establishment of limited service (retail) clinics;
  • Rejecting the proposal to eliminate “prescriber prevails” in fee for service Medicaid and Medicaid managed care.
    (AUSTER, DEARS)


Physicians Must Continue to Let Their Legislators Know of Concerns With Adverse Workers’ Compensation Budget Proposal
While leaders and staff in both the Assembly and Senate have articulated significant concerns with the sweeping Workers Compensation reform proposals contained in the Executive Budget, all physicians must continue to contact their local legislators to urge that these proposals be rejected as in-depth negotiations towards a final Budget commence.

MSSNY staff continues to meet with key legislative leaders and staff to voice its very serious concerns with Budget proposals that would:

  • Expands the list of non-physicians who can treat and be paid directly for care to injured workers without any clarity as to how these non-physicians will coordinate care delivery when specialized care is needed;
  • Expand the circumstances when a physician or other health care provider can have their authorization removed and empowers the Board to impose significant fines on a physician or any other Board-authorized health care provider for violating a Workers Compensation rule;
  • Remove the authority of county medical societies to recommend physicians to serve as treating providers or independent medical examiners under Workers Compensation.
  • Reduce choice for injured workers by expanding the circumstances when an injured worker must seek care within a PPO network;
  • Remove the requirement for a referral by a physician for an injured worker as a pre-condition to receive psychological care; and
  • Remove the ability of professional associations, such as MSSNY, to recommend arbitrators to resolve medical fee disputes between health care providers and carriers.

Working closely with MSSNY, county medical society leaders from across the State have been writing to, and meeting with, their local Senators and Assemblymembers to request that these proposals be jettisoned from the Budget. Moreover, many of these proposals are being opposed by other stakeholders, including the NYS AFL-CIO, the NYS Trial Lawyers Association, the Injured Workers Bar Association and the New York Insurance Association.
(AUSTER, DEARS)                                                                             

Legislation to Make Changes to the ERx Law to Exempt Low Volume Prescribers Passes NYS Senate; Amendments Introduced in The Assembly
Legislation (S.6779, Hannon) which would completely exempt low volume prescribers from the e-prescribing mandate passed the Senate this week. Amendments were made to the Assembly counterpart (A.9335, Gottfried) to clarify that when a low volume prescriber terminates his/her low volume status because they intend to issue more than twenty five prescriptions in a year the validity of the first twenty five prescriptions remain intact.  The amendments also make clear that a provider who certifies to the Department that he/she is a low volume prescriber must make a notation in the patient’s medical record that the reason a paper script was issued is that the prescriber is certified as low volume. This will obviate the need to contact the Department each time he/she issues a paper script.

MSSNY is aware that physicians who are low volume prescribers (those who write less than 25 prescriptions a year) are receiving waivers from the mandate; but those waivers are only good for one year requiring low volume physicians to reapply each year. This measure would eliminate the need for them to re-apply for a waiver each year.

The bill would also amend the eRx law by eliminating existing provisions which require prescribers who invoke one or more of the exemptions to the eRx mandate to contact the department when they exercise an exemption. Instead, the bill would require a prescriber to make a notation in the patient’s record that the exercise of the exemption was utilized.

It is anticipated that the Senate will recall and amend S.6779 to incorporate the amendments thereby making it the same as the Assembly version and will re-pass it as soon as possible.                       (DEARS, AUSTER) 


Legislation to Enable Nurses in LTC Facilities to Act as Agent for the Physician Passes NYS Senate
Legislation (A.9334, Gottfried/S.6778, Hannon), supported by MSSNY, passed the Senate this week and was advanced to the floor of the Assembly. Specifically this proposal would allow prescriptions for non-controlled substances for nursing home residents to be made orally rather than electronically.  For decades, nurses, acting as the agent to the physician, have been authorized to take oral orders from the physician for non-controlled medications through the nursing home medication administration system to deliver medications to residents safely and without delay. In this long-standing system, the physician then routinely signs the oral orders within 48 hours.

Physicians are not physically present in nursing homes 24 hours a day. Nurses serve a vital role ensuring proper medication administration in nursing homes. This bill is necessary to assure that physicians’ orders are timely filled to protect the health and well-being for each resident in a safe and secure method.
(DEARS, AUSTER)


CMS Proposes Huge Changes to Payment for Medicare Part B Drugs; Prompts Negative Reaction From Physician Groups and Pharma
This week CMS proposed testing a new model for covering drugs under Medicare Part B, such as chemotherapy medications, which immediately prompted concerns from several groups and members of Congress, as was noted in the New York Times.  CMS is proposing to change the reimbursement methodology of Part B drugs from the current 6% add-on to the “Average Sales Price (ASP)” to 2.5% plus a flat fee.  CMS also proposed a second phase that would implement value-based purchasing tools similar to those employed by commercial health plans, pharmacy benefit managers, hospitals, and other entities that manage health benefits and drug utilization.

The American Society of Clinical Oncology released a statement condemning the proposal noting that “it is inappropriate for CMS to manipulate choice of treatment for cancer patients using heavy-handed reimbursement techniques…..Physicians did not create the problem of drug pricing and its solution should not be on their backs.”

To read the CMS press release and other materials describing CMS’ proposal, click here.                                                                                                             (AUSTER)

Clinical Update for Primary Care Providers on Pre-Exposure Prophylaxis (Prep)
The New York State (NYS) Department of Health AIDS Institute Clinical Education Initiative (CEI) and Mount Sinai Institute for Advanced Medicine will be offering an educational program on the Treatment for Hepatitis C: New Tests, New Drugs & New Recommendations on Thursday, March 31, 2016, 9:00am – 12:00pm at St. Mary’s Healthcare, Amsterdam – Carondelet Pavilion Auditorium, 380 Guy Park Ave, Amsterdam, New York 12010. 

RegistrationOn-line registration is required as space will be limited.

This free event will focus on the current epidemiological trends, updates on prevention and care best practices, and NYSDOH guidance on HIV & HCV, as well as therapeutic regimens and monitoring plans.

This event is open to New York State clinical providers, such as physicians, physician assistants, nurses, nurse practitioners, and pharmacists.  The New York State (NYS) Department of Health AIDS Institute Clinical Education Initiative (CEI) is designed to enhance the capacity of New York’s diverse health care workforce to deliver clinical services to improve health outcomes related to HIV, sexually transmitted diseases (STDs) and hepatitis C (HCV). The aims of the CEI are fourfold:

  • provide progressive HIV, HCV and STD education to clinicians;
  • disseminate AIDS Institute clinical practice guidelines;
  • expand the base of providers able to diagnose and care for HIV, HCV and STD patients; and
  • foster partnerships between community-based providers and HIV, HCV and STD specialists.

Mount Sinai serves as The HIV/HCV Center and provides free education and training for medical providers in NYS. Clinicians are updated on the latest NYS guidelines to enhance the capacity to deliver clinical services to improve health outcomes related to HIV/HCV.  Further information is available by contacting Robert Walsh at 212-636-1315 or at rwalsh@chpnet.org.
(CLANCY) 


Learn about MOLST  and eMOLST Dr. Pat Bomba VP and Medical Director, Geriatrics, Excellus BlueCross Blue Shield

When: Tuesday, March 15, 2016 @  12:30-1:30 PM

WHAT:

  • Learn about the MOLST and eMOLST form and how it should be used with patients.
  • Describe how the NYS eMOLST: Improves Quality & Patient Safety and Reduces Harm
  • Learn about the 8 step MOLST protocol and how it can be used effectively
  • Describe how eMOLST aligns with move toward Value Based Payment

Additional information can be found here.

To register for this CME webinar:  Click here and fill out registration form.

For additional information, contact Miriam Hardin at: mhardin@mssny.org or (518) 465-8085

Accreditation Statement: 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.

Disclosure Statement: The Medical Society of The State of New York relies upon planners and faculty participants in its CME activities to provide educational information that is objective and free of bias. In this spirit and in accordance with the guidelines of MSSNY and the ACCME, all speakers and planners for CME activities must disclose any relevant financial relationships with commercial interests whose products, devices or services may be discussed in the content of a CME activity, that might be perceived as a real or apparent conflict of interest.

Any discussion of investigational or unlabeled uses of a product will be identified.


MSSNY to Conduct Medical Matters Webinar on Zika Virus on March 16, April Session on Ebola
The Medical Society, in conjunction with the New York State Department of Health will conduct a Medical Matters webinar on the  “Zika Virus: An Evolving Story” on March 16th at 7:30 a.m.   Registration for this program is now open.  Click on the upcoming tab and select the programs.

The educational objectives for this program are: 1) Describe the epidemiology of Zika Virus infection;

2) Understand the modes of transmission; 3) Understand how to advise patients; and 4) Learn methods for prevention of infection.  William Valenti, MD, chair of MSSNY’s Infectious Disease Committee, and Elizabeth Dufort, MD,  Medical Director, Division of Epidemiology from the New York State Department of Health will conduct this presentation.

The April session of Medical Matters will take place at the MSSNY House of Delegates and is entitled, “Ebola: A Perspective from the Field”.  The program will be conducted by Dario Gonzalez, MD, FACEP. Associate Medical Director,  Fire Department City of New York/Office of Medical Affairs.  Dr. Gonzalez was deployed for nine weeks by Americares to Liberia, West Africa as part of the US response to the Ebola epidemic.  The program will be held on Thursday, April 14, 2016 at 2:00pm. Physicians may attend the session at the Westchester Marriott, 670 White Plains Road, Tarrytown, NY 10591 or by webinar.  Registration is now open. Click on the upcoming tab and select the program.

The educational objective is: Offer perspective and lessons learned from an individual who treated Ebola patients firsthand.

The May session will be “Radiological Emergencies”, this session will be held on May 18, 2016 at 7:30 AM. (Please note that this session was originally scheduled for March 16, 2016) Faculty for this session will be Cham Dallas, PhD.  Dr. Dallas is a professor in the Department of Health Policy and Management at the College of Public Health, University of Georgia.  He is also the Director of the Institute for Disaster Management at the University of Georgia and a Board Member of the National Disaster Life Support Foundation (NDLSF).  Dr. Dallas has a national/international reputation in toxicology and emergency preparedness and response, including over 30 years of experience.

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.

Further information or assistance in registering for any of these programs may be obtained by contacting Melissa Hoffman at mhoffman@mssny.org.
(CLANCY, HOFFMAN) 


MSSNY’s Opioid Webinars are Now Available Through Its CME Online Site
The Medical Society has archived its opioid webinar series on its continuing medical education website at http://cme.mssny.org/   The webinars that are currently on the site are:  Webinar 1 Pain Management at the Crossroads:  A Tale of Two Public Health Problems and Webinar 2   Rational Opioid Prescribing:  Is this Possible for Chronic Pain?  Physicians and other prescribers can earn up to one hour of continuing medical credits by viewing this webinar and completing the test.    The reminder of the webinars will be placed on line in the very near future. 

The MSSNY CME site requires new users to register, but once registered physicians and other health care providers will have a personalized training page to take the webinars and other course work located on the site.   New registrants to the site will create a username and password, which should be retained and be used for continued access to the site. Once registered and logged into the site, physicians will be taken to an instruction page.   Click on the tool bar menu located at the top of the page and click on “My training” to view and take the various courses.     MSSNY has over 50 programs at this site and physicians are able to earn continuing medical education credits for each course. 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 online program has various programs with the number of continuing medical education credits, but the majority of the programs are for 1.0 AMA/PRA Category 1 credit™.  Further information on all these programs may be obtained by contacting Pat Clancy at pclancy@mssny.org.                  (CLANCY) 


PTSD And TBI in Returning Veterans:  March – June Webinars
MSSNY will be holding a series of CME webinars on PTSD and TBI in returning veterans on seven dates listed below from March through June. The faculty presenters will be Frank Dowling, MD and Joshua Cohen, MD.

Course objectives:

  • Explore the two most prevalent mental disorders facing American veterans today, their causes, symptoms, and comorbidities
  • Outline treatment options including evidence-based psychotherapy and pharmacotherapy
  • Discuss barriers to treatment, including those unique to military culture, and how to overcome them
  • Outline the process of recovery and post-traumatic grow

To register for this webinar, click on a date below and fill out the registration form.

Tuesday, March 22, 6-7 PM
Thursday, April 7, 6-7 PM
Tuesday, April 12, 7:30-8:30 AM
Thursday, May 5, 6-7 PM
Thursday, May 19, 7:30-8:30 AM
Thursday, June 2, 6-7 PM
Thursday, June 9, 7:30-8:30 AM
(ELPERIN, DEARS)

For more information relating to any of the above articles, please contact the appropriate contributing staff member at the following email addresses:       

pschuh@mssny.org ldears@mssny.org      mauster@mssny.org  
pclancy@mssny.org jmcpartlon@mssny.org    

 

 


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Council Notes

At the March 8 meeting in Albany, Council approved the following items:

  • MSSNY should seek supplemental funding sources other than Medicare funding to increase the number of residency training positions in New York State, and should take the lead in bringing together the various parties to devise a supplemental funding source to meet the medical educational and workforce needs of New York State. This should involve State officials responsible for health and medical education, leaders of academic medical centers, and businesses that are thriving economically and that benefit from the work of the medical profession. Medicare should not bear major responsibility for GME funding. Strong arguments can be made that health insurers, pharmaceutical companies and device manufacturers should also contribute to the cost of graduate medical education.
  • The MSSNY president may decide if a non-MSSNY physician group (such as the Out-of-Network Preservation Work Group) warrants creation of its own special committee within MSSNY. Each President-Elect of MSSNY shall continue to analyze on an annual basis MSSNY’s committee structure with an intention to eliminate any committee not felt to be contributing directly to MSSNY’s mission, and combining committees wherever possible to reduce duplication, confusion and cost.  MSSNY may sign on to letters with non-MSSNY groups when consistent with existing MSSNY policy and at the discretion of the President.


State Awards $112.3 to Long Island Hospitals
The state has awarded $112.3 million to Long Island hospitals and clinics for projects ranging from repairs at Nassau University Medical Center to building an emergency department in East Hampton.

The 16 grants, part of $1.5 billion statewide announced March 4, are intended to help health care providers involved in New York’s Delivery System Reform Incentive Program, or DSRIP.

Under the program, up to $6.42 billion will go to safety-net or public hospitals and their community collaborators statewide if they cut avoidable hospital use among Medicaid recipients by 25 percent by the end of 2019. To do that, hospitals and community organizations must work together to improve access and coordination of patients’ care. These grants — an addition to the $6.42 billion — are meant to assist with that.

REMINDER:  All Prescriptions Must Be Sent Electronically Beginning March 27th
Tell your patients NOW that you will NOT be issuing papers scripts as of March 27. With the e-prescribing mandate quickly approaching, we at MSSNY are concerned about the lack of preparedness expressed by New York doctors.  Our recent survey showed that more than 40% of responding physicians are not yet prepared to meet the e-prescribing mandate.
We DO NOT expect an extension of the deadline, and urge you to ACT NOW to ensure you are compliant with the law.


From Socio-Med: 38,000 Doctors Will Have to Revalidate with CMS
I have been told that NGS Medicare is required by CMS to initiate the REVALIDATION process for 38,000 NYS practitioners. Please be on the LOOK OUT for a yellow envelope.  The official letter will be mailed from National Government Services in a yellow envelope: J6/JK Provider Enrollment Sample Yellow Envelope

If you rely on Medicare payments, you do not want your cash flow disrupted.  Please be sure that you and your staff are aware of the vital mailing.  In addition, please share this information with your colleagues, especially those who might not use email. The yellow envelope for NGS Medicare should not be overlooked.


Expansion to Include Pregnant Women with Sex Partner Who Traveled To a Country with Zika Virus Transmission
On March 9, the NYSDOH was directed by Gov. Cuomo to expand free Zika virus testing to pregnant women who engaged in unprotected sex with a partner who had recently traveled to a country where Zika is present.  Meanwhile, the city is ramping up its efforts in preparation for mosquito season to protect against transmission of the virus in New York. Health Commissioner Mary Bassett said the city is increasing the number of mosquito traps around the city by 20% to 50%.

To date, NYSDOH’s Wadsworth Center has conducted tests on samples from more than 1,400 patients and 40 have been found to be positive. With the exception of the one possible case of sexual transmission, all of the infected patients have been returning travelers from countries where Zika virus is ongoing.

NYSDOH also already offers testing to pregnant women who themselves have traveled to an area with ongoing Zika virus transmission during their pregnancy, as well as to non-pregnant women, men or children who developed symptoms of Zika virus within 4 weeks of travel to an area with active Zika virus transmission.


CDC: NYS has High Rate of Childhood Flu Vaccination
The New York State DOH is being honored, for the second year in a row, by the CDC for having high rates of childhood influenza vaccine coverage. During the 2014-15 flu season, 67 percent of New York children (outside of NYC) 6 months to 17 years of age received the flu vaccine, well above the national average of 59 percent. Childhood influenza vaccination coverage rates in other states ranged from 45.3 percent to 78.6 percent.


CMS Mulling New Payment Models For Some Medicare Part D Prescription Drugs
On March 8, Medicare proposed new models to determine the best “ways to pay for drugs administered in a doctor’s office, including many cancer treatments.” Dr. Patrick Conway, acting principal deputy administrator and chief medical officer of CMS, explained that the Federal government will not decide which drugs physicians can prescribe, but the objective “is to address financial incentives in the current payment system that can encourage the use of a more expensive drug, when a cheaper medication is just as effective.” According to Conway, “‘Perverse incentives’ in the current rules do not benefit patients or Medicare.”

The NY Times http://nyti.ms/1P46uDU reports CMS plans to “test new ways to pay for prescription drugs in an effort to slow the growth of Medicare spending on medicines while encouraging doctors to choose the most effective treatments for their patients.” Dr. Conway said the government was not infringing on the discretion or authority of doctors. “Physicians and clinicians will make the prescribing decisions,” he said. “Nothing limits the ability of physicians to prescribe the most appropriate medications.” Data indicate CMS “spent $20 billion last year under Part B of Medicare for prescription drugs administered in doctors’ offices and hospital outpatient departments.” 


The Age of Compliance and the Impact on Your Healthcare Revenue Cycle
The arrival of the Consumer Financial Protection Bureau (CFPB) and associated increased legislation in the area of Healthcare Debt Collection has made the job of Healthcare Revenue Cycle Professionals more challenging than ever before.

Listen as IC System’s Vice President of Healthcare discusses these issues in detail, and shares tips and tactics to help insure that your Healthcare Business Office stays efficient, effective and compliant.

Please click on this link  to register for the LIVE presentation.


Pediatrics Group Issues New Recommendations to Screen for Poverty
The American Academy of Pediatrics has issued a policy statement at  http://bit.ly/1p89Tfv recommending that “with nearly half of American children living in poverty or close to that line, pediatricians need to broach another health-related matter with mom or dad: Are you having trouble making ends meet?”

THE AAP announced the “new recommendations to screen for poverty in a bid to reduce its health effects.” In its policy statement, “the group highlights what it calls the ‘lifelong hardship’ faced by kids who grow up in poverty.”


Ithaca Mayor Wants to Create Heroin Injection Sites to Stop Overdoses
In a more than 1,450-word article, the Washington Post reports Svante Myrick, the mayor of Ithaca, New York, is pushing to create “supervised injection sites where addicts can use” heroin “under the watch of medical professionals” who are available to administer naloxone if overdoses occur. While Myrick will struggle to convince state and Federal officials, the Post states his “proposal nonetheless marks the latest departure from the zero-tolerance orthodoxy that has for years governed the drug war.” The article explains that success stories in Germany, Switzerland, the Netherlands, and Canada “sold Myrick on the idea.”


CLASSIFIED

Physician Opportunities

Family & Internal Medicine Opportunity Just 50 miles North of NYC
Top $$ AND potential partnership with large multi-specialty physicians’ group + the balance of work & personal life you have been seeking. Perfect suburban area just 50 miles north of NYC. This is a growth position with the right person moving into a partnership opportunity within two to three years. You will enjoy a salary of $175K+ as well as:
• A monthly bonus potential
• Health, Dental, Vision and prescription insurance
• 3 weeks’ paid vacation time off annually
• 6 federal Holidays off with pay
• A $2500 CME reimbursement
• A 401K plan with company match
• Company pays 75% of a single premium life insurance policy at twice your annual salary
• Paid malpractice insurance, plus paid DEA and license renewals
The ideal candidate will possess the following:
• BE/C in Family Medicine or Internal Medicine
• Active NYS license
• Current DEA #
• Experienced as well as New Grads welcome to apply
**Relocating physicians are welcome and relocation assistance will be offered to the right candidate!**
For immediate consideration and additional information on position details please contact Laura Rappleyea at 845-344-3434 or lrappleyea@hereshelp.com and send CV’s for review.

Neurologist & Pain Management Physician Needed
A growing multi-specialty group in Orange County is looking for both a Neurologist and Pain Management Physician to join their group. This position will work with the headache center Neurologist/Pain Management Specialist. All subspecialties are welcome.
The ideal candidate will possess the following:
• BE/C in Family Medicine or Internal Medicine
   • Active NYS license
   • Experienced as well as New Grads welcome to apply
   • Experience in procedures and utilizing an integrated comprehensive approach to pain management.
For immediate consideration and additional information on position details please contact Laura Rappleyea at 845-344-3434 or lrappleyea@hereshelp.com and send CV’s for review.


OB/GYN Opportunity in the Hudson Valley
Are you looking for a great work/life balance? We are looking for an OB/GYN to join the team. We are looking for a provider to provide comprehensive primary health care to a select population of essentially healthy women, participate in the care of women with complications & responsible for providing a full range of agency approved antepartum, intrapartum, postpartum, gynecological and family planning service.
The ideal candidate will possess the following:
• BE/C in Family Medicine or Internal Medicine
       • Active NYS license
       • Experienced as well as New Grads welcome to apply
For immediate consideration and additional information on position details please contact Laura Rappleyea at 845-344-3434 or lrappleyea@hereshelp.com and send CV’s for review
.


Pediatrician Opportunity in Orange County, New York
A prestigious multi-specialty physicians’ group seeks a family driven
Pediatrician to join their group.
The ideal candidate will possess the following:
• BE/C in Family Medicine or Internal Medicine
   • Active NYS license
   • Experienced as well as New Grads welcome to apply
For immediate consideration and additional information on position details please contact Laura Rappleyea at 845-344-3434 or lrappleyea@hereshelp.com and send CV’s for review. 
.


Psychiatry Opportunity in New York’s Beautiful Hudson Valley
Our client, a prestigious multi-specialty physicians’ group who has been recognized as a Patient-Centered Medical Home by the National Committee for Quality Assurance, seeks a Psychiatrist to join their group.
The ideal candidate will possess the following:
• BE/C in Psychiatry
   • Active NYS license preferred
   • Experienced as well as New Grads welcome to apply
For immediate consideration and additional information on position details please contact Laura Rappleyea at 845-344-3434 or lrappleyea@hereshelp.com and send CV’s for review.



Join Well Established Solo Female OB/GYN Physician Practice in New York City
Quality oriented, looking for MD for long term career opportunity. New graduates welcome to apply. Affiliated with Lenox Hill Hospital. The current office has a AAAA certified operating room and an AIUM accredited ultrasound service. Looking to establish another location. Great opportunity to balance personalized practice with quality lifestyle. Please summit CV to obgynpractice130@gmail.com


Want to Sublease Your Clinic Space or Rent Space to Expand Your Practice? List with Clineeds 
Clineeds is an online platform designed to help physicians find and sublease clinic space. Listing is completely FREE! Sign up today at http://clineeds.com/signup We take care of the rest!


Jerome I. Sager – Attorney at Law
The health care law experts representing medical professionals for more than 25 years.  See us for Professional Medical Conduct Defense, Medicaid and Medicare Fraud Cases, DEA and Controlled Substance Issues, Third party insurance issues. We can handle most legal matters. Call us for a free consultation. 212-685-2333 / 917-312-6631, jeromesager@cs.com

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

 

 

 

 

 

 

 

 

 

 

 

 

 

March 4, 2016 – Physicians Shaping the Discourse

drmaldonado PRESIDENT’S  MESSAGE
 Dr. Joseph R.  Maldonado
asset.find.us.on.facebook.lgTwitter_logo_blue1

March 4,  2016
Volume 16, Number 9

Dear Colleagues:

This is the key issue that you should drive home with your legislator on Tuesday: Click Here.

Joseph Maldonado, M.D, MSc, MBA, DipEBHC
MSSNY President

Please send your comments to comments@mssny.org


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MSSNY Lobby Day Scheduled For March 8th – Physicians Urged to Attend and Wear Your White Lab Coats
MSSNY’s “Physician Advocacy Day” will be held on March 8th in the Lewis Swyer Theatre in the Egg located at the Empire State Plaza in Albany, New York.  If you plan to attend, please register here.

A full slate of legislators and top Administration officials will attend and dialogue with Advocacy Day participants including:

  • Donna Frescatore, Executive Director, NYS Health Benefit Exchange;
  • Jason Helgerson, Medicaid Director, NYS Department of Health;
  • Troy Oechsner, Executive Deputy Superintendent, Department of Financial Services;
  • Legislative Panel: Senate Health Chair Kemp Hannon; Assembly Health Chair Richard Gottfried; Senate Insurance Chair James Seward; Assembly Insurance Chair Kevin Cahill.

In addition, Assembly Majority Leader Joe Morelle and Senate Majority Leader John Flanagan have also agreed to attend the morning proceedings. A brief informal luncheon to which members of each House are invited to speak with their constituents will follow the morning program.   County Medical Societies will be scheduling appointments for physicians to meet with their elected representatives.

For those unable to attend in person, this event will be webcast LIVE. You can access the webcast by going to the following link: http://totalwebcasting.com/live/mssny

PHYSICIANS ARE ENCOURAGED TO IMMEDIATELY REGISTER THROUGH THE LINK BELOW TO ATTEND THE MARCH 8TH LOBBY DAY IN ALBANY. http://goo.gl/forms/Mw7CX8JfzL
(DIVISION OF GOVERNMENTAL AFFAIRS)


Senate Health Committee Chair, Senator Kemp Hannon will be Guest for Fireside Chat With MSSNY President Dr. Joseph Maldonado.
On March 7th, the evening before MSSNY’s Lobby Day, Joseph Maldonado, Jr., MD, MSc, MBA, will conduct a “fireside chat” with Senator Kemp Hannon, Chairman of the Senate Health Committee.

This is a relaxed and fluid format in which Dr. Maldonado and Senator Hannon can discuss issues of concern to the medical community (network adequacy, action taken by Emblem Health to narrow its network,  the collapse of Health Republic, etc). Physicians are invited to be physically present at this event in the DGA offices located at Ste 408, One Commerce Building, in Albany or can engage in real time by submitting their questions during the LIVE webcast of the event through this link.

The program will run for one hour from 5:30-6:30PM on March 7th.  To register to attend the event, click onto the this link.  
(DIVISION OF GOVERNMENTAL AFFAIRS)
 


Physicians Urged To Oppose Huge Cuts to Excess Medical Liability Insurance Program
Physicians are urged to continue to contact their legislators to object to a provision in the Executive Budget that would cause more than half of physicians to lose their Excess Medical Malpractice Insurance coverage.     

Specifically, the proposal would cut funding for the Excess program by $25 million, which would result in 55% of physicians who currently receive this additional coverage being dropped from the program.  Across much of upstate New York, only neurosurgeons, bariatric surgeons and OB-GYNs would keep this coverage.  That means that in the Capital District, in Northern New York, in Central New York, in western New York and in the Southern Tier every family physician, internist, pediatrician, ophthalmologist, emergency room physician, vascular surgeon, cardiologist, radiologist, pathologist, otolaryngologist, dermatologist and allergist would be automatically dropped.  And downstate, many primary care physicians, ophthalmologists, otolaryngologists, pathologists, dermatologists and allergists would be dropped.

The Excess Medical Liability Insurance Program provides an additional layer of $1M of coverage to physicians with hospital privileges who maintain primary coverage at the $1.3 million/$3.9 million level.  The program was created over 30 years ago as a result of the liability insurance crisis of the mid-1980’s to address concerns among physicians that their liability exposure far exceeded available coverage limitations.  Absent meaningful liability reform, with verdicts and physician liability premiums continuing to be far out of proportion compared to the rest of the country, full funding for the Excess program is absolutely essential in today’s very challenging practice environment.

At a time when the state is seeking to attract and retain physicians, this proposal deters physicians from wanting to practice in New York State for fear of putting themselves and their families in financial jeopardy for judgments and settlements exceeding the limits of their primary coverage.  Please urge your legislators to restore full funding for the program!                                                                       (AUSTER, DEARS) 

Urge Your Legislators to Reduce Liability Insurance Costs, Not Raise Them!
All physicians must continue to contact their legislators to urge that they oppose legislation (A.285-A, Weinstein/S.6596, DeFrancisco) that could drastically increase New York’s already exorbitantly high medical liability premiums by changing the medical liability Statute of limitations to a “Date of Discovery” rule.

You need to tell your legislators that no liability increases can be tolerated.  MLMIC’s estimate is that this bill could increase physician liability premiums by nearly 15%!   New York physicians continue to pay liability premiums that are among the very highest in the country.  By way of example, a neurosurgeon practicing on Long Island must pay an astounding $338,252 for just one year of insurance coverage and an OB/GYN practicing in the Bronx or Staten Island must pay $186,639.   New York far surpasses all other states in terms of total medical liability payouts, per capita payments, and medical liability awards above $1 million.

Last week, MSSNY joined the Greater New York Hospital Association (GNYHA) and Healthcare Association of New York State (HANYS) in an ad in the Albany Times-Union calling for reduction in these exorbitant costs.

To make matters even worse, trial lawyers are aggressively pushing the Legislature to consider additional liability expansion bills such as legislation that would eliminate the statutory limitation on contingency fees in medical liability actions, legislation that MLMIC has estimated could have the effect of raising your premiums by over 10%.   Please tell your legislators to enact comprehensive liability reform to bring down these costs, not legislation that increases them!                                                                                                       (AUSTER, DEARS)


Nearly 30 Assemblymembers Affirm Support for Health Republic Guarantee Fund Legislation (S.6667/A.9311)
27 Assemblymembers have joined Assembly Health Committee Chair Richard Gottfried and Assemblyman Charles Lavine (D-Nassau County) in introducing legislation (A.9311) to establish a Guarantee Fund to help to assure the payment of the hundreds of millions that Health Republic owes physicians and hospitals across New York State, as well as to protect consumers and health care providers from future health plan insolvencies.  To view the list of co-sponsors, click here.

Identical legislation (S.6667, Valesky, also with several co-sponsors (see here) has been introduced in the State Senate.  Right now, New York is the only state in the country that does not have such a Guarantee Fund.

With the health insurance industry in strong opposition to this proposal, it is imperative that you urge your Senators and Assemblymembers to support this bill and include it as part of the State Budget currently under negotiation by sending a letter from here. The template letter urges support for the legislation or the use of other monies, such as the hundreds of millions in dollars accruing to the State as a result of settlements with financial institutions, to help pay these outstanding claims.

You must remind your legislators that, with physicians facing so many other challenges in seeking to keep their doors open to deliver patient care, including high liability costs, expensive electronic medical record equipment, employee costs, insurance companies dropping physicians from their networks and declining payments from insurers, failure to assure payment for these claims would have serious negative consequences for patient care and employment in your community.
(AUSTER, DEARS)


Physicians Must Continue to Let Their Legislators Know of Concerns with Adverse Workers’ Compensation Budget Proposal
All physicians must continue to contact their State Senators and Assemblymembers to express their strong opposition to sweeping Workers’ Compensation reform proposals contained in the Executive Budget.

MSSNY staff continues to meet with key legislative leaders and staff to voice its very serious concerns with Budget proposals that would:

  • Expand the list of non-physicians who can treat and be paid directly for care to injured workers without any clarity as to how these non-physicians will coordinate care delivery when specialized care is needed;
  • Expand the circumstances when a physician or other health care provider can have their authorization removed and empowers the Board to impose significant fines on a physician or any other Board-authorized health care provider for violating a Workers Compensation rule;
  • Remove the authority of county medical societies to recommend physicians to serve as treating providers or independent medical examiners under Workers Compensation.
  • Reduce choice for injured workers by expanding the circumstances when an injured worker must seek care within a PPO network; and
  • Remove the requirement for a referral by a physician for an injured worker as a pre-condition to receive psychological care;

In the 30-day Executive Budget amendments, the proposal was made even more adverse by a) requiring physicians and other currently authorized WC providers to execute an “authorization agreement” with the Board (as of now, it is unclear what would be contained within such “authorization agreement”) within 12 months of the effective date of the proposal, if it were to be enacted; and b) removing the ability of professional associations, such as MSSNY, to recommend arbitrators to resolve medical fee disputes between health care providers and carriers.

Working closely with MSSNY, county medical society leaders from across the State have been writing to, and meeting with, their local Senators and Assemblymembers to request that these proposals be jettisoned from the Budget. Moreover, many of these proposals are being opposed by other stakeholders, including the NYS AFL-CIO, the NYS Trial Lawyers Association, the Injured Workers Bar Association and the New York Insurance Association.
(AUSTER, DEARS)


Legislation To Make Changes to The Erx Law to Exempt Low Volume Prescribers and to Enable Nurses in Ltc Facilities to Act as Agent for the Physician Reported by Senate Health Committee
Legislation (A. 9335, Gottfried/ S.6779, Hannon) which would exempt low volume prescribers from the e-prescribing mandate entirely was reported from the Senate Health Committee to the floor of the Senate this week. MSSNY is aware that physicians who are low volume prescribers (those who write less than 25 prescriptions a year) are receiving waivers from the mandate; but those waivers are only good for one year requiring low volume physicians to reapply each year. This measure would eliminate the need for them to re-apply for a waiver each year.

The bill would also amend the eRx law by eliminating existing provisions which require prescribers who invoke one or more of the exemptions to the eRx mandate to contact the department when they exercise an exemption. Instead, the bill would require a prescriber to make a notation in the patient’s record that the exercise of the exemption was utilized.

A second proposal (A.9334, Gottfried/S.6778, Hannon), also supported by MSSNY, was also reported by the Senate Health Committee this week to the Senate floor. Specifically this proposal would allow prescriptions for non-controlled substances for nursing home residents to be made orally rather than electronically.  For decades, nurses, acting as the agent to the physician, have been authorized to take oral orders from the physician for non-controlled medications through the nursing home medication administration system to deliver medications to residents safely and without delay. In this long-standing system, the physician then routinely signs the oral orders within 48 hours.

Physicians are not physically present in nursing homes 24 hours a day. Nurses serve a vital role ensuring proper medication administration in nursing homes. This bill is necessary to assure that physicians’ orders are timely filled to protect the health and well-being for each resident in a safe and secure method.(DEARS,AUSTER)


Endo Enters Into Settlement With NY AG to Limit Marketing of Opana
Attorney General Eric T. Schneiderman announced an agreement with Endo Pharmaceuticals this week which requires Endo to cease all misrepresentations regarding the properties of Opana ER, to describe accurately the risk of addiction to Opana ER, and to summarize studies regarding Opana ER on its website.  To read the AG’s full press release, click here.

Specifically, the settlement requires Endo to:

  • Provide truthful and complete information regarding addiction risks associated with Opana ER;
  • Stop improperly marketing Opana ER as being crush resistant;
  • Create an Abuse and Diversion Detection Program that requires Endo’s sales representatives to report to the company health care providers it suspects of engaging in abuse and illegal diversion of opioids, and for Endo to cease marketing opioids to certain prescribers;
  • Post results of clinical studies on Endo’s website;
  • Encourage health care providers to seek training on appropriate opioid prescribing practices; and
  • Provide health care providers with information about addiction treatment resources for their patients.

Furthermore, the Attorney General also imposed a $200,000 penalty on Endo.
(AUSTER) 


NY AG Investigates Health Insurers Over Hep C Coverage
New York Attorney General Eric Schneiderman has asked 16 health insurance companies for information regarding their coverage rules for patients with hepatitis C, requesting documents explaining how they make decisions on who to cover or not, according to several media reports.  As is noted in these articles (see here), the companies being investigated include Anthem, Aetna and Emblem.  (AUSTER)


Physicians Now Have Until July 1 to Apply For 2015 EHR Meaningful Use Hardship Waiver
CMS announced late last week that physicians will now have until July 1to apply for a “hardship exemption” from the electronic health record (EHR) meaningful use financial penalties for the 2015 program year.   Without obtaining such “hardship exemption”, physicians could face up to a 3% cut in their Medicare payments in 2017.  In its statement announcing the delay, CMS noted that it “is extending the deadline so providers have sufficient time to submit their applications to avoid adjustments to their Medicare payments in 2017.”

The AMA has advised that all physicians should apply for the exemption since  CMS has said that submitting an application for a hardship exemption will not prevent those who qualify from receiving an incentive payment.

To obtain the application, click here. The AMA has developed step-by-step instructions to help simplify the submission process. Physicians do not need to include documentation of their circumstances with their application, but should hold onto it for their own records.

Moreover, new this year, individuals can apply on behalf of a group of physicians, an important change enacted by Congress at the end of 2015 as a result of the combined advocacy of MSSNY, the AMA and many medical and specialty societies from across the country.
(AUSTER)


PTSB and TBI in Returning Veterans:  March – June Webinars
MSSNY will be holding a series of CME webinars on PTSD and TBI in returning veterans on eight dates listed below from March through June. The faculty presenters will be Frank Dowling, MD and Joshua Cohen, MD.

Course objectives:

  • Explore the two most prevalent mental disorders facing American veterans today, their causes, symptoms, and comorbidities;
  • Outline treatment options including evidence-based psychotherapy and pharmacotherapy;
  • Discuss barriers to treatment, including those unique to military culture, and how to overcome them;
  • Outline the process of recovery and post-traumatic grow. 

To register for this webinar, click on a date below and fill out the registration form

Wednesday, March 9, 7:30-8:30 AM
Tuesday, Mach 22, 6-7 PM
Thursday, April 7, 6-7 PM
Tuesday, April 12, 7:30-8:30 AM
Thursday, May 5, 6-7 PM
Thursday, May 19, 7:30-8:30 AM
Thursday, June 2, 6-7 PM
Thursday, June 9, 7:30-8:30 AM
(ELPERIN)


Clinical Update for Primary Care Providers on Pre-Exposure Prophylaxis (Prep)
The New York State (NYS) Department of Health AIDS Institute Clinical Education Initiative (CEI) and Mount Sinai Institute for Advanced Medicine will be offering an educational program on the Treatment for Hepatitis C: New Tests, New Drugs & New Recommendations on Thursday, March 31, 2016, 9:00am – 12:00pm at St. Mary’s Healthcare, Amsterdam – Carondelet Pavilion Auditorium, 380 Guy Park Ave. Amsterdam, New York 12010. 

Registration:   On-line registration is required as space will be limited.

This free event will focus on the current epidemiological trends, updates on prevention and care best practices, and NYSDOH guidance on HIV & HCV, as well as therapeutic regimens and monitoring plans.

This event is open to New York State clinical providers, such as physicians, physician assistants, nurses, nurse practitioners, and pharmacists.  The New York State (NYS) Department of Health AIDS Institute Clinical Education Initiative (CEI) is designed to enhance the capacity of New York’s diverse health care workforce to deliver clinical services to improve health outcomes related to HIV, sexually transmitted diseases (STDs) and hepatitis C (HCV). The aims of the CEI are fourfold:

  • provide progressive HIV, HCV and STD education to clinicians
  • disseminate AIDS Institute clinical practice guidelines
  • expand the base of providers able to diagnose and care for HIV, HCV and STD patients
  • foster partnerships between community-based providers and HIV, HCV and STD specialists

Mount Sinai serves as The HIV/HCV Center and provides free education and training for medical providers in NYS. Clinicians are updated on the latest NYS guidelines to enhance the capacity to deliver clinical services to improve health outcomes related to HIV/HCV.  Further information is available by contacting Robert Walsh at 212-636-1315 or at rwalsh@chpnet.org.
(CLANCY) 


MSSNY Joins New York Kicks Butts Campaign
The Medical Society of the State of New York has joined the “New York Kicks Butts” campaign which is a week-long citywide effort to encourage all smokers in New York City to quit smoking.   Smoking Cessation Week will be held May 31-June 6, 2016 and will encourage smokers in the New York City area to seeking assistance from physicians and other health care professionals to learn about the tools and support available to assist them to quit smoking.  MSSNY has joined with American Cancer Society, Cancer Action Network, NYC Smoke-Free, the American Lung Association, the Campaign for Tobacco Free Kids and other health groups in this campaign.  Further information on this campaign will be available shortly from MSSNY and through the campaign’s website(CLANCY)


 MSSNY-HCA Collaborate on Legislation to Address Health Care Disparities
Following MSSNY’s most recent Health Care Disparities Committee meeting, the Home Care Association of New York State (HCA) and MSSNY have joined forces to address health care disparities. After circulating the idea among members of the Black, Puerto Rican, Hispanic and Asian Legislative Caucus and receiving positive feedback—next week, MSSNY and HCA will present legislation and a grant proposal to all 50 members of the Caucus. Our proposal will allow physicians, home care agencies and hospitals to collaborate, by applying individually or collectively to the DOH for grant funding for programs to address a wide array of health care disparities. MSSNY hopes that the legislation will not only allow for spirited, localized programs specific to community needs, but also provide funding for: continuing medical education programs on health care disparities issues and educational outreach initiatives to attract adolescent members of minority population to the profession of medicine.                                                                                 
(MCPARTLON)
 


President Obama Lauds Affordable Care Act Achievements
On Thursday, March 03, 2016, President Obama announced that since the passage of the Affordable Care Act, more than 20 million have gained health insurance and the country has the lowest uninsured rate ever recorded. The President also announced that as of January 16th more than 30 percent of Medicare Part A and B payments are tied to alternative payment models (nearly a year ahead of schedule.)  In a press release issued by the Center for Medicare & Medicaid Services (CMS), it stated it was proud to achieve such a timely result and shift to quality and value of care. More information and CMS’ press release can be found here.(MCPARTLON) 


Governor Cuomo Continues Push for 12 Week Paid Family Leave
With One-House Budget bills only days away, Governor Cuomo renewed his call for paid family leave in two Op-Ed pieces, one published by Newsday and the other by the Buffalo News. In Newsday, striving to appeal to small business owners worried about their bottom-line, the Governor reiterated its zero cost to business owners as an employee-funded benefit that will reduce turnover and strengthen the state-wide labor force.  In the Buffalo News, Governor Cuomo delivered an appeal for New Yorkers to spend time with their loved ones when they need it most. Both articles can be found here (Newsday / Buffalo News ).
(MCPARTLON) 


Final Opioid Prescribing Webinar on March 10th;  Registration is Now Open
The fourth and final webinar in the opioid series will be held on Thursday, March 10th at 7:30 a.m. Title of the program is “Treatment of Opioid Use Disorders”.   Physicians and other prescribers are encouraged to register this for this webinar  at the this link.

Click on the upcoming tab and select the programs.

Physicians and other prescribers are allowed to register up to ½ hour before the webinar.

The Medical Society of the State of New York, the New York State Office for Alcoholism and Substance Abuse Service and the NYS Department of Health’s Bureau of Narcotic Enforcement, are jointly providing this free, four part webinar series on opioid prescribing. 

Entitled,) “Revisiting the Role of Opioid Analgesics for Simple and Complex Patients with Chronic Pain”, faculty for the session will be Charles Argoff, MD and Charles Morgan, MD, FASAM, FAAFP, DABAM.   The educational objectives are:    Recommend tools to assist in the management of patients for whom opioids are indicated and prescribed; discuss strategies to reduce risk of treating pain in patients with substance use disorders.

Physicians and other prescribers can take one or all of the webinars. 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.

Please contact Pat Clancy at pclancy@mssny.org or Terri Holmes at tholmes@mssny.org for further information.                                        (CLANCY, DEARS) 


MSSNY’s Opioid Webinars are Now Available Through Its Cme Online Site
The Medical Society has archived its opioid webinar series on its continuing medical education website at http://cme.mssny.org/   The webinars that are currently on the site are:  Webinar 1 Pain Management at the Crossroads:  A Tale of Two Public Health Problems and Webinar 2   Rational Opioid Prescribing:  Is this Possible for Chronic Pain?  Physicians and other prescribers can earn up to one hour of continuing medical credits by viewing this webinar and completing the test.    The reminder of the webinars will be placed on line in the very near future. 

The MSSNY CME site requires new users to register, but once registered physicians and other health care providers will have a personalized training page to take the webinars and other course work located on the site.   New registrants to the site will create a username and password, which should be retained and be used for continued access to the site.

Once registered and logged into the site, physicians will be taken to an instruction page.   Click on the tool bar menu located at the top of the page and click on “My training” to view and take the various courses.     MSSNY has over 50 programs at this site and physicians are able to earn continuing medical education credits for each course. 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 online program has various programs with the number of continuing medical education credits, but the majority of the programs are for 1.0 AMA/PRA Category 1 credit™.  Further information on all these programs may be obtained by contacting Pat Clancy at pclancy@mssny.org.
(CLANCY) 


MSSNY to Conduct Medical Matters Webinar on Zika Virus on March 16, April Session on Ebola
The Medical Society, in conjunction with the New York State Department of Health will conduct a Medical Matters webinar on the  “Zika Virus: An Evolving Story” on March 16th at 7:30 a.m.   Registration for this program is now open. Click on the ‘Upcoming’ tab and select the ‘Programs’.

The educational objectives for this program are: 1) Describe the epidemiology of Zika Virus infection;

2) Understand the modes of transmission; 3) Understand how to advise patients; and 4) Learn methods for prevention of infection.  William Valenti, MD, chair of MSSNY’s Infectious Disease Committee, and Elizabeth Dufort, MD,  Medical Director, Division of Epidemiology from the New York State Department of Health will conduct this presentation.

The April session of Medical Matters will take place at the MSSNY House of Delegates and is entitled, “Ebola: A Perspective from the Field”.  The program will be conducted by Dario Gonzalez, MD, FACEP. Associate Medical Director,  Fire Department City of New York/Office of Medical Affairs.  Dr. Gonzalez was deployed for nine weeks by Americares to Liberia, West Africa as part of the US response to the Ebola epidemic.  The program will be held on Thursday, April 14, 2016 at 2:00pm. Physicians may attend the session at the Westchester Marriott, 670 White Plains Road, Tarrytown, NY 10591 or by webinar.  Registration is now open. Click on the ‘Upcoming’ tab and select the ‘Programs’.

The educational objective is: Offer perspective and lessons learned from an individual who treated Ebola patients firsthand.

The May session will be “Radiological Emergencies”, this session will be held on May 18, 2016 at 7:30 AM. (Please note that this session was originally scheduled for March 16, 2016) Faculty for this session will be Cham Dallas, PhD.  Dr. Dallas is a professor in the Department of Health Policy and Management at the College of Public Health, University of Georgia.  He is also the Director of the Institute for Disaster Management at the University of Georgia and a Board Member of the National Disaster Life Support Foundation (NDLSF).  Dr. Dallas has a national/international reputation in toxicology and emergency preparedness and response, including over 30 years of experience.

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.

Further information or assistance in registering for any of these programs may be obtained by contacting Melissa Hoffman at mhoffman@mssny.org.
(CLANCY, HOFFMAN)

For more information relating to any of the above articles, please contact the appropriate contributing staff member at the following email addresses:          

pschuh@mssny.org ldears@mssny.org            mauster@mssny.org  
pclancy@mssny.org jMcPartlon@mssny.org    

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Michael J. Schoppmann Joins MLMIC’s Service Company
MLMIC announces the appointment of Michael J. Schoppmann, Esq. as President of our service company subsidiary. In this role, Schoppmann will work closely with Edward J. Amsler, CEO of the service company, to serve the needs of MLMIC policyholders.

Schoppmann’s long history of protecting doctors in New York State will contribute to the superior protection, sound defense and active risk management we offer all of our insureds.

Michael J. Schoppmann’s legal career spans 30 years, and his tenure defending healthcare professionals has earned him national regard. Prior to joining MLMIC, Schoppmann was the managing principal partner in a private firm (Kern, Augustine, Conroy & Schoppmann) where he dedicated more than two decades of his career to providing counsel to physicians and other health care providers. His background, reputation and drive will be extremely valuable to MLMIC as we continue to serve policyholders in an increasingly competitive environment. 


Endoscope Maker Olympus to Pay Record $623 Million to Settle Kickback Allegations
The nation’s largest endoscope distributor will pay $623.2 million to resolve civil and criminal allegations that it paid kickbacks to hospitals and doctors in exchange for purchasing its devices, the Justice Department announced Tuesday.

Olympus Corporation of the Americas has agreed to pay a record-setting $310.8 million to settle civil claims that it violated the False Claims Act because its claims were tainted by illegal kickbacks. The sum is the largest ever paid by a medical-device company over violations related to the federal anti-kickback law, according to the government. Olympus will also pay a $312.4 million criminal penalty over the allegations. The company admitted to paying doctors and hospitals in the form of consulting payments, travel, meals, grants and free endoscopes in exchange for their business, according to the Justice Department.

The company admitted, for example, to paying for three doctors’ trips to Japan in 2007 in exchange for their hospital’s decision to use Olympus. The company gave another doctor who had a major role in his medical center’s buying decisions free of use of $400,000 in equipment.

Nacho Abia, CEO of Olympus Corporation of the Americas, said in a statement, said “Olympus is committed to complying with all laws and regulations and to adhering to our own rigorous code of conduct which guides our business processes, decisions and behavior.”Abia also noted that the company’s past actions didn’t affect patient health or care. He said the settlements will not affect the company’s ability to offer its products and services.

According to the Justice Department, the kickbacks helped the company make more than $600 million in sales and gross profits of more than $230 million. The company entered into a deferred prosecution agreement that will allow it to avoid conviction if it follows certain requirements.


The NYeC PQRS Registry is Open for Business and Ready to Support You
If you are a Medicare provider, but still haven’t selected a registry to submit your PQRS measurements and want to avoid payment penalties, NYeC as a CMS qualified Registry can help you control your reporting process. Remember this is a time sensitive program, and your data needs to be received by NYeC by March 17th to ensure your submission meets the CMS deadline of March 31, 2016.

Learn more about our full service PQRS Registry at http://bit.do/nyecpqrsportal. You can also email us at supportpqrs@nyehealth.org or call 646-619-6485.

Join them for a FREE informational webinar about their full service CMS qualified registry.

Webinar dates:

  • Monday, March 7, 2016, 10:00 am EST

REGISTER NOW

Topics to be covered:

  • Review of Eligible Professionals required to participate in the PQRS Program
  • How to avoid negative payment adjustments
  • Participation informs quality ratings that compare providers to their peers
  • Overview of New York eHealth Collaborative’s Registry Services
  • Review of reporting methodologies Registration, fees, support, and critical deadlines

The webinar should be for total of 45 minutes (30 min informational and 15 min Q&A).


The Medicare EHR Incentive Program Hardship Application Deadline for All Providers is Now July 1, 2016
This week, CMS is extending the application deadline for the Medicare EHR Incentive Program hardship exception process that reduces burden on clinicians, hospitals, and critical access hospitals (CAHs). The new deadline for Eligible Professionals, Eligible Hospitals and Critical Access Hospitals is July 1, 2016. CMS is extending the deadline so providers have sufficient time to submit their applications to avoid adjustments to their Medicare payments in 2017.

In January, CMS posted new, streamlined hardship exception application forms that reduce the amount of information that eligible professionals (EPs), eligible hospitals, and CAHs must submit to apply for an exception. The new applications and instructions for providers seeking a hardship exception are available here.


Reminder: Time for Physicians and Teaching Hospitals to Complete Open Payments System Registration
As a reminder, the Open Payments system is available for Physician and Teaching Hospital registration. The review and dispute period for physicians and teaching hospitals is targeted to start in April 2016. Just a reminder, only information that has been submitted in the current program year is eligible for review and dispute.

Registering in the Open Payments system is voluntary for physicians and teaching hospitals. However, registering is required if a physician or teaching hospital wants the opportunity to review and dispute data. The data is submitted by applicable manufacturers and applicable group purchasing organizations (GPOs) prior to public posting on June 30, 2016. If a physician or teaching hospital registered last year, they are not required to register again this year.

However, if it has been over 180 days since a physician or teaching hospital has logged onto the Enterprise Identity Management System (EIDM), the account has been deactivated for security purposes. If an account has been deactivated, contact the Help Desk. The Help Desk hours are from 8:30 a.m. – 7:30 p.m. (EST). For new users, the quick reference guide on the EIDM system can be found here. In addition, the quick reference guides on teaching hospital registration can be found here, and the guide for physician registration can be found here.

CMS plans to publish the 2015 payment data and make any applicable updates to the 2013 and 2014 data in June 2016. More information about Open Payments is available at www.cms.gov/openpayments.


FLU View

The most recent FluView report shows increasing flu activity in the United States. Ongoing flu activity is expected for several weeks. (NY is Region 2)

CDC reports this season’s flu vaccine is nearly 60 percent effective against all circulating viruses. It is not too late to get your flu vaccine this season.


CDC Interim Recommendations re Olympics and Zika Virus in Pregnancy
Because Zika virus infection in a pregnant woman is linked to a serious birth defect of the brain called microcephaly and miscarriage, CDC recommends special precautions for the following groups:

  • Women who are pregnant (in any trimester): Consider not going to the Olympics; if you have a male partner who goes to the Olympics, either use condoms or abstain from sex for the duration of your pregnancy. If you must go, talk to your doctor or other health care provider first; you and your partner should strictly follow steps to prevent mosquito bites and use condoms or abstain from sex.
  • Women who are trying to become pregnant: Before you travel, talk to your doctor or other health care provider about your plans to become pregnant and the risk of Zika virus infection. You and your male partner should strictly follow steps.
  • Men with pregnant partners should use condoms or abstain from vaginal, anal, or oral sex for the duration of the pregnancy.

Specific areas where Zika virus transmission is ongoing are often difficult to determine and are likely to change over time. As more information becomes available, this travel notice will be updated. Please check back frequently for the most up-to-date recommendations.


Onondaga County Holds Annual Legislative Roundtable
Onondaga County Legislative Roundtable
The Onondaga County Medical Society held its annual Legislative Breakfast and Roundtable discussion with area federal and state legislators on February 27. The following elected representatives were in attendance:  Congressman John Katko, Sen. John DeFrancisco, Sen. David Valesky, Assemblywoman Pamela Hunter, and Assemblyman Albert Stirpe.  Director Jennifer Cook represented Assemblyman Will Barclay, Special Assistant Pamela Kirkwood represented Assemblyman Gary Finch and Craig Swyecki represented Assemblyman William Magnarelli.

This annual event gives interested physician members and our governing body the opportunity to talk with local federal and state representatives about issues of concern. Physicians in attendance were: Drs. Beers, Abdulky, Nave, Halleran, Semeran, Sneider, Hart, Huang, Walsh, and Practice Manager Anne Zecchio of Nephrology Associates.


 


CLASSIFIED

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

 

 

 

 

 

 

 

 

 

 

 

 

 

Council – March 7, 2015

AGENDA
Council Meeting
March 7, 2016, 1:00 pm
Renaissance Hotel, 144 State Street
Albany, NY 12207

A.Call to Order and Roll Call

B. Approval of the Council Minutes of January 21, 2016

C. New Business (All New Action & Informational Items)

1. President’s Report

a. Presentation to the Albion Bernstein Award Recipient, William M. Valenti, MD
Dr. Valenti is an internist/infectious diseases specialist and a native of Rochester, NY. He is a co-founder of Community Health Network, a not-for-profit medical clinic caring for 700 people with HIV/AIDS in Rochester, NY, now Trillium Health. Dr. Valenti is a graduate of the Medical College of Wisconsin, did his infectious diseases training at the University of Rochester and is Clinical Associate Professor of Medicine at the University Of Rochester School Of Medicine. He has been involved in HIV treatment, research and policy in the United States since the early 1980’s and is chair of the Medical Society’s Infectious Diseases Committee. He is also a member of the Medical Society’s Committee on Emergency Preparedness and Disaster/Terrorism Response. Dr. Valenti serves as faculty for the Medical Society’s various educational programs and has authored several programs.

b. ACTION ITEM – A Resolution submitted by Kira Geraci-Ciardullo, MD, MPH
Nominations from the Floor

c. ACTION ITEMS – Submitted by the Council Work Group to develop Guidelines for Collaborating With Non-MSSNY Physician Groups Seeking MSSNY Engagement

d. ACTION ITEMSRecommendations from the Task Force on the Shortage of Residency Positions

e. ACTION ITEM – Recommendation from the Task Force on Independent Practice

2. Secretary’s Report – Nominations for Life Membership & Dues Remissions

3. Board of Trustees Report – Dr. Latreille will present the report (handout at Council)

4. MSSNYPAC Report – Dr. Sellers will present the report (handout at Council)

5. MLMIC Update – Mr. Ed Amsler will present a verbal report

6. AMA Delegation Update – Dr. Kennedy will present a verbal update

7. MESF Update – Dr. Kleinman or Tom Donoghue will present a verbal report

8. Commissioners (All Action Items)
No reports submitted

9. Councilors & Presidents (All Action Items from County Medical Societies)
No reports submitted

D. Reports of Officers (Informational)
1. Office of the President – Joseph R. Maldonado, MD
2. Office of the President-Elect – Malcolm D. Reid, MD
3. Office of the Vice President – Charles Rothberg, MD
4. Office of the Treasurer – Thomas J. Madejski, MD Financial                     statement for the for the period 1/1/15 to 12/31/15
5. Office of the Speaker – Kira A. Geraci-Ciradullo, MD

E. Reports of Councilors (Informational)
1. Kings & Richmond Report – Parag H. Mehta, MD
2. Manhattan/Bronx Report – Joshua M. Cohen, MD, MPH
3. Nassau County Report – Paul A. Pipia, MD
4. Queens County Report – Saulius J. Skeivys, MD
5. Suffolk County Report – Frank G. Dowling, MD
6. Third District Branch Report – Harold M. Sokol, MD
7. Fourth District Branch Report – John J. Kennedy, MD
8. Fifth District Branch Report –Howard H. Huang, MD
9. Sixth District Branch Report – Robert A. Hesson, MD
10. Seventh District Branch Report – Mark J. Adams, MD
11. Eighth District Branch Report – Edward Kelly Bartels, MD
12. Ninth District Branch Report – Thomas T. Lee, MD
13. Medical Student Section Report – Charles A. Kenworthy –                        no written report submitted
14. Resident & Fellow Section Report – Robert A. Viviano, DO
15. Young Physician Section Report – L. Carlos Zapata, MD –                          no written report submitted

F. Commissioners (All Committee & Sub-Committee Informational      Reports/Minutes) No reports submitted

G. Report of the Executive Vice President
Membership Dues Revenue Schedule

H. Report of the General Counsel
Proposal to Amend Bylaws

I. Report of the Alliance
Alliance Report

J. Other Information/Announcements
1. Prescription Drug Monitoring Programs (PDMP)
Sign-On Letter
to Congress
2. Minutes from the Physician Foundation Meeting
3. AMA Foundation –
Dr. Duane & Joyce Cady Honor Fund  Update

4. Physicians Advocacy Institute Site of Service Study

K. Adjournment

L. Executive Session – Discussion re Membership Survey

February 26, 2016 – Physicians Shaping the Discourse

drmaldonado PRESIDENT’S  MESSAGE
 Dr. Joseph R.  Maldonado
asset.find.us.on.facebook.lgTwitter_logo_blue1

February 26,  2016
Volume 16, Number 8

Dear Colleagues:

This week, I attended the AMA National Advocacy Conference in Washington, DC.   New York had a very prominent number of physicians in attendance, many of whom went on their own dime.  It made me proud of their dedication and passion to take time from their busy schedules to go down to Washington and meet with our Federal legislators.  I was most impressed by Senator Schumer’s open style and graciousness in meeting with us.  He listened and made very insightful suggestions for our efforts.  Honestly I had not expected this level of engagement and I was glad to have seen it firsthand.

The sessions in Washington with the staff members of many of our legislators were refreshing.  They are a young group of individuals with a broad range of knowledge of the subject.  All of them have a keen aptitude and intellect in capturing the important concepts and engaging with them.  There was a seemingly genuine interest in listening to our perspective, which as a cynic of the Washington process, I had not expected.

While I tend to relate best to the seasoned staff of legislators in Albany, the group in Washington seemed to have a freshness about them that gave me hope that perhaps they were not jaded by years of work in the Washington arena.  They did a lot of listening, and didn’t seem to have established opinions.  They asked reasonable and smart questions.  They seemed interested in our views as physicians about how the problems could be addressed.  They offered options on how we might best tackle challenges facing us.

Most importantly, it was a pleasure not getting the sense that we were dealing with a group of young individuals who had an agenda to carry out and would indulge us on only those issues that complemented their agendas.  I’m not certain if there is a “Washington Staff Etiquette” course new staff members take before starting to work for Federal legislators, but the receptive style of engagement gave me hope that perhaps if we could not convince our legislators on key issues, engagement with their staff might provide them with the data needed for them to more effectively carry out the task on our behalf.

All in all, the advocacy experience was very positive.  Join us in Albany next week and see what your experience as a physician in the trenches can do for changing policymakers’ perspectives on healthcare.

Joseph Maldonado, M.D, MSc, MBA, DipEBHC
MSSNY President

Please send your comments to comments@mssny.org


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MSSNY Lobby Day Scheduled for March 8th – Physicians Urged to Attend and Wear Your White Lab Coats
MSSNY’s “Physician Advocacy Day” will be held on March 8th in the Lewis Swyer Theatre in the Egg located at the Empire State Plaza in Albany, New York.  If you plan to attend, please register here.

A full slate of legislators and top Administration officials will attend and dialogue with Advocacy Day participants including:

  • Donna Frescatore, Executive Director, NYS Health Benefit Exchange;
  • Troy Oechsner, Executive Deputy Superintendent, Department of Financial Services;
  • Legislative Panel: Senate Health Chair Kemp Hannon; Assembly Health Chair Richard Gottfried; Senate Insurance Chair James Seward; Assembly Insurance Chair Kevin Cahill.

In addition, Assembly Majority Leader Joe Morelle and Senate Majority Leader John Flanagan have also agreed to attend the morning proceedings.  Speaker Heastie has also been invited.  A brief informal luncheon to which members of each House are invited to speak with their constituents will follow the morning program.   County Medical Societies will be scheduling appointments for physicians to meet with their elected representatives.

PHYSICIANS ARE ENCOURAGED TO IMMEDIATELY REGISTER THROUGH THE LINK BELOW TO ATTEND THE MARCH 8TH LOBBY DAY IN ALBANY.  http://goo.gl/forms/Mw7CX8JfzL                (DIVISION OF GOVERNMENTAL AFFAIRS)


Physicians Invited to Attend Fireside Chat with MSSNY President Dr. Joseph Maldonado and Troy Oechsner, Deputy Superintendent of Insurance
On March 7th, the evening before MSSNY’s Lobby Day, Joseph Maldonado, Jr., MD, MSc, MBA, will conduct a “fireside chat” with Troy Oechsner, Deputy Superintendent at DFS.

This is a relaxed and fluid format in which Dr. Maldonado and Mr. Oechsner can discuss issues of concern to the medical community (network adequacy, action taken by Emblem Health to narrow its network,  the collapse of Health Republic, etc). Physicians are invited to be physically present at this event in the DGA offices located at Ste 408, One Commerce Building, in Albany or can engage in real time by submitting their questions during the LIVE webcast of the event through the this link.

The program will run for one hour from 5:30-6:30PM on March 7th.  To register to attend the event, click here.
(DIVISION OF GOVERNMENTAL AFFAIRS)


Why Physicians Need to Take a Day Away From Your Practice to Lobby Albany on March 8, 2016

  • Think you pay too much in malpractice insurance costs?  The Trial Bar doesn’t care. They have introduced legislation that will certainly increase your premium costs.
  • If you practice in the Capital District, Southern Tier, Central NY, or Western NY, New York State wants to take away your Excess Liability Insurance Coverage.
  • New York State wants to enable NPs to deliver care to injured workers and take away County Medical Society review of authorized physicians rather than fixing what ails the Workers’ Compensation system.
  • The Proposed NYS Budget does nothing to compensate physicians for the unpaid care they have provided to Health Republic insureds.
  • New York State wants to enable Walmart and Target to hire NPs to deliver care to the public to compete directly against you.
  • Patient health could be threatened by inappropriately expanding the scope of practice of countless non-physicians, including dentists, optometrists and psychologists.
  • We need to prevent insurers from offering patients narrow networks for Exchange plans and denying patient access to out of network physicians.

These are very real issues that are currently being discussed and will be resolved either in the State Budget which will be enacted by April 1st or before the end of Session on June 16th. You need to come to Albany, and speak with your elected officials so that they can hear your concerns. Otherwise, all they will hear are the perspectives of trial lawyers and insurance companies.

PLEASE  JOIN YOUR COLLEAGUES FROM ACROSS THE STATE TO LOBBY YOUR ELECTED LEADERS IN PERSON IN ALBANY MARCH 8TH. REGISTER HERE.
(DIVISION OF GOVERNMENTAL AFFAIRS)


Legislation to Make Changes to the ERx Law to Exempt Low Volume Prescribers and to Enable Nurses in LTC Facilities to Act as Agent for the Physician Introduced and Reported by Assembly Health Committee
Just this week, legislation (A. 9335, Gottfried/ S.6779, Hannon) was introduced at MSSNY’s request which would exempt low volume prescribers from the e-prescribing mandate entirely. MSSNY is aware that physicians who are low volume prescribers (those who write less than 25 prescriptions a year) are receiving waivers from the mandate; but those waivers are only good for one year requiring low volume physicians to reapply each year. This measure would eliminate the need for them to re-apply for a waiver each year.

The bill would also amend the eRx law by eliminating existing provisions which require prescribers who invoke one or more of the exemptions to the eRx mandate to contact the department when they exercise an exemption. Instead, the bill would require a prescriber to make a notation in the patient’s record that the exercise of the exemption was utilized.

The Assembly bill was reported unanimously from the Assembly Health Committee to the Assembly Codes Committee. The Senate counterpart is on next week’s Senate Health Committee.

A second proposal (A.9334, Gottfried/S.6778, Hannon), also supported by MSSNY, was unanimously reported by the Assembly Health Committee this week to the Assembly floor. Specifically this proposal would allow prescirptions for non-controlled substances for nursing home residents to be made orally rather than electronically.  For decades, nurses, acting as the agent to the physician, have been authorized to take oral orders from the physician for non-controlled medications through the nursing home medication administration system to deliver medications to residents safely and without delay. In this long-standing system, the physician then routinely signs the oral orders within 48 hours.

Physicians are not physically present in nursing homes 24 hours a day. Nurses serve a vital role ensuring proper medication administration in nursing homes. This bill is necessary to assure that physician’s orders are timely filled to protect the health and well-being for each resident in a safe and secure method. The Senate counterpart to the Assembly bill is also on next week’s Senate Health Committee agenda.
(DEARS, AUSTER)


Senate Advances Legislation to Limit Opioid Prescribing to 3-10 Days for Patients in Acute Pain
Senate Bill 6091A, sponsored by Senator Kemp Hannon, has moved to the Senate floor for a vote.  This bill would limit the initial prescription by a physician or other prescriber of Controlled Substance, Schedule II or III, to a three to 10 day supply for patients suffering acute pain.   Its companion measure, A. 8601, sponsored by Assemblymember John McDonald, is in the Assembly Health Committee.  

The bill, if enacted, would establish a limitation on a physician’s license by prohibiting the physician from practicing to the fullest extent of his/her education and training when they seek to prescribe Schedule II or III controlled substance.  Senate Bill 6091A/A.8601 would effectively prevent a physician from exercising his/her clinical judgement on behalf of the patient.   Moreover, this action would set a dangerous precedent in New York State and represents an enormous encroachment of the New York State Legislature into the practice of medicine.  The Medical Society of the State of New York is strongly opposed to this measure.  Physicians are urged to contact their legislator and urge them not to enact this measure.   Physicians may call the NY Senate at 518-455-2800 or the Assembly at 518-455-4100.
(CLANCY, DEARS)


Health Republic Guarantee Fund Legislation (S.6667/A.9311) Picks Up Several New Assembly Co-Sponsors
13 Assemblymembers  have joined Assembly Health Committee Chair Richard Gottfried  and Assemblyman Charles Lavine (D-Nassau County) in introducing legislation (A.9311) to establish a Guarantee Fund to help to assure the payment of the hundreds of millions that Health Republic owes physicians and hospitals across New York State, as well as to protect consumers and health care providers from future health plan insolvencies.  To view the list of co-sponsors, click here.

Identical legislation (S.6667, Valesky, also with several co-sponsors) has been introduced in the State Senate.  Right now, New York is the only state in the country that does not have such a Guarantee Fund.  With the health insurance industry in strong opposition to this proposal, it is imperative that you urge your Senators and Assemblymembers to support this bill and include it as part of the State Budget currently under negotiation by sending a letter from here.

You must remind your legislators that, with physicians facing so many other challenges in seeking to keep their doors open to deliver patient care, including high liability costs, expensive electronic medical record equipment, employee costs, insurance companies dropping physicians from their networks and declining payments from insurers, failure to assure payment for these claims would have serious negative consequences for patient care and employment in your community.
(AUSTER, DEARS)


Please Complete Survey to Let Us Know What You are Owed as a Result of Health Republic Debacle
MSSNY’s updated survey of outstanding Health Republic claims shows that, based upon results received, physicians are owed nearly $25,000,000.  However, we believe that far more physicians who have been adversely impacted have yet to respond.  As we continue our advocacy in support of legislation (A.9311, Gottfried/S.6667, Valesky) to create a Guarantee fund and/or the allocation of other monies to pay for the unpaid claims as a result of the Health Republic demise, we need those of you who have not completed the survey to provide us with updated information regarding the amounts you are due from Health Republic.  To complete the survey, click hereThis data is critical to our advocacy efforts!   We need to obtain updated and more precise numbers from as many impacted physicians as possible since many legislators have asked us for this data.
(AUSTER, DEARS)


Physicians Must Continue to Let Their Legislators Know of Concerns with Adverse Workers’ Compensation Budget Proposal
All physicians must continue to contact their State Senators and Assemblymembers to express their strong opposition to sweeping Workers’ Compensation reform proposals contained in the Executive Budget.

MSSNY staff continues to meet with key legislative leaders and staff to voice its very serious concerns with Budget proposals that would:

  • Expand the list of non-physicians who can treat and be paid directly for care to injured workers without any clarity as to how these non-physicians will coordinate care delivery when specialized care is needed;
  • Expand the circumstances when a physician or other health care provider can have their authorization removed and empowers the Board to impose significant fines on a physician or any other Board-authorized health care provider for violating a Workers Compensation rule;
  • Remove the authority of county medical societies to recommend physicians to serve as treating providers or independent medical examiners under Workers Compensation.
  • Reduce choice for injured workers by expanding the circumstances when an injured worker must seek care within a PPO network; and
  • Remove the requirement for a referral by a physician for an injured worker as a pre-condition to receive psychological care;

In the 30-day Executive Budget amendments, the proposal was made even more adverse by a) requiring physicians and other currently authorized WC providers to execute an “authorization agreement” with the Board (as of now, it is unclear what would be contained within such “authorization agreement”) within 12 months of the effective date of the proposal, if it were to be enacted; and b) removing the ability of professional associations, such as MSSNY, to recommend arbitrators to resolve medical fee disputes between health care providers and carriers.

MSSNY has also reached out to labor organizations and associations representing attorneys for injured workers to coordinate its advocacy in opposition.  We are pleased to learn that the New York Insurance Association has released a memo in opposition to the provisions that would expand the role of non-physicians in Workers Compensation.  MSSNY has also been working closely with county medical society leadership from across the State to encourage their outreach to their local Senators and Assemblymembers to request that these proposals be jettisoned from the Budget.
(AUSTER, DEARS)


Please Advocate for Due Process Rights When Physicians are Non-Renewed by a Health Insurer
Physicians are urged to contact their legislators to support a bill (A.1212, Lavine/S.4751, Hannon) that would assure physicians are accorded a fair peer review appeals mechanism before their participation contract with a health insurance company can be non-renewed.  To send a letter in support of this legislation here:.  The bill is currently on the Assembly calendar and in the Senate Insurance Committee.  The legislation is in response to situations such as the recent example of Emblem dropping 750 of its network physicians in October based upon specious allegation of failure to transition to value-based payments, severing patient treatment relationships for countless patients.  MSSNY has strenuously urged to the Department of Financial Services, Department of Health, and Attorney General that these physicians be given a fair opportunity to be reinstated, and have shared this information with the entire New York State Legislature. (See MSSNY letter to DFS here.

The Attorney General’s office continues to investigate specific complaints raised by individual physicians whether they were given a fair chance to appeal these non-renewals.
(AUSTER, DEARS)


Tell Your Legislators to Reduce Your Liability Costs, Not Expand Them!
All physicians must continue to contact their legislators to urge that they oppose legislation (A.285-A, Weinstein/S.6596, DeFrancisco) that could drastically increase New York’s already exorbitantly high medical liability premiums by changing the medical liability Statute of limitations to a “Date of Discovery” rule.

You need to tell your legislators that no liability increases can be tolerated.  MLMIC’s estimate is that this bill could increase physician liability premiums by nearly 15%!   New York physicians continue to pay liability premiums that are among the very highest in the country.  By way of example, a neurosurgeon practicing on Long Island must pay an astounding $338,252 for just one year of insurance coverage and an OB/GYN practicing in the Bronx or Staten Island must pay $186,639.   New York far surpasses all other states in terms of total medical liability payouts, per capita payments, and medical liability awards above $1 million.

This week, MSSNY joined the Greater New York Hospital Association (GNYHA) and Healthcare Association of New York State (HANYS) in an ad in the Albany Times-Union with the headline “NEW YORK’S HOSPITALS AND DOCTORS HAVE THE HIGHEST MEDICAL MALPRACTICE COSTS – AND THAT MAKES NO SENSE”.

To make matters even worse, trial lawyers are aggressively pushing the Legislature to consider additional liability expansion bills such as legislation that would eliminate the statutory limitation on contingency fees in medical liability actions, legislation that MLMIC has estimated could have the effect of raising your premiums by over 10%.   Please tell your legislators to enact comprehensive liability reform to bring down these costs, not legislation that increases them!                                                                                                       (AUSTER, DEARS)


Physicians Advocate for Their Colleagues and Patients in Nation’s Capitol
Several New York leader physicians and MSSNY staff traveled to Washington DC this week to meet with key members of New York’s Congressional delegation.  The meetings were in conjunction with the AMA’s National Advocacy Conference.  The physicians participating in these Hill visits included:

  • Rome urologist and MSSNY President Dr. Joseph Maldonado;
  • Manhattan physiatrist and MSSNY President-elect Dr. Malcolm Reid;
  • Saratoga Springs ENT and MSSNY Board of Trustees member Dr. Robert Hughes;
  • Touro College of Osteopathic Medicine Dean and past MSSNY President Dr. Robert Goldberg;
  • Schenectady ophthalmologist and MSSNY Councilor Dr. John Kennedy;
  • Harrison allergist and MSSNY House of Delegates Speaker Dr. Kira Geraci-Ciardullo;
  • Rochester Psychiatrist Dr. John McIntyre; and
  • Buffalo Urologist Dr. Willie Underwood

The physicians urged members of Congress to address a number of issues that are adversely affecting the delivery of patient care in New York State, including: assuring the claims of failed co-op insurer Health Republic are paid; simplifying the enormously cumbersome Meaningful Use program; assuring fairness in Medicare Recovery Audits; supporting comprehensive multipronged efforts to reduce the nation’s opioid abuse crisis in a way that does not inadvertently limit treatment options for patients; and pushing CMS to investigate Medicare Advantage plans (such as Emblem) interfering with existing treatment relationships by dropping scores of physicians from their networks.

In addition to meetings with many New York Congressional delegation members and staff, in conjunction with physician leaders of several other state medical societies, meetings were held with US House Ways & Means Chair Kevin Brady (R-TX); Rep. Dr. Michael Burgess, a key leader of the House Doctors Caucus; and with key health policy “central” staff for both the US House and US Senate.
(AUSTER)

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AMA National Advocacy Conference. L-R: Former MSSNY President  Dr. Robert Hughes, Representative .Dr. Michael Burgess (R-TX), Phil Schuh, MSSNY Executive VP

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Dr. Robert Goldberg, Dr. John Kennedy, Representative Eliot Engel, Dr. Malcolm Reid, Dr. Kira Geraci, and MSSNY VP Moe Auster

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MSSNY leadership with Ways and Means Chair Kevin Brady (R-TX)) & representatives of the  TX, CA, NJ, OK and NC state medical societies


Bill to Require  Physicians to Prescribe Medications in Accordance to Guidelines Moves Forward in Assembly; Would Create a New Element of Professional Misconduct
Assembly Bill 2230, sponsored by Assemblyman Richard Gottfried, has moved to the Assembly floor for a vote.  This legislation requires health care professionals to order, prescribe, administer and dispense pain-relieving medications in accordance with professional standards and guidelines. The bill would provide limited protections for physicians from professional discipline and criminal liability for ordering, prescribing, and administering pain relieving medications in accordance with reasonable standards of care including an “accepted guideline”.  The definition of “accepted guideline”, under the proposed legislation, means a peer reviewed clinical practice guideline for pain management developed, as applicable, by a nationally-recognized health care professional or specialty association, or a nationally-recognized pain management association.  However, Assembly Bill  2230 establishes  a new element of professional misconduct for failure to adequately order, prescribe, administer or dispense pain-reliving medications or other treatments for the relief of pain in accordance with the reasonable standard of care of the health care practitioner’s profession, including an accepted guideline. This legislation would apply to all patients with pain.   The Medical Society of the State of New York is opposed to this measure.                                                                            (CLANCY, DEARS)


Final Opioid Prescribing Webinar on March 10th;  Registration is Now Open
The final webinar in the opioid series will be held on Thursday, March 10th at 7:30 a.m. Title of the program is “Treatment of Opioid Use Disorders”.   Physicians and other prescribers are encouraged to register for the remaining webinars  at this link.  Click on the upcoming tab and select the programs.

Physicians will need to register for each webinar; each webinar has different topics described below. Physicians and other prescribers are allowed to register up to ½ hour before the webinar.

The Medical Society of the State of New York, the New York State Office for Alcoholism and Substance Abuse Service and the NYS Department of Health’s Bureau of Narcotic Enforcement, are jointly providing this free, four part webinar series on opioid prescribing. 

Entitled “Revisiting the Role of Opioid Analgesics for Simple and Complex Patients with Chronic Pain”, faculty for the session will be Charles Argoff, MD and Charles Morgan, MD, FASAM, FAAFP, DABAM.   The educational objectives are:    Recommend tools to assist in the management of patients for whom opioids are indicated and prescribed; and discuss strategies to reduce risk of treating pain in patients with substance use disordershysicians and other prescribers can take one or all of the webinars. 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.

Please contact Pat Clancy at pclancy@mssny.org or Terri Holmes at tholmes@mssny.org for further information.                                       (CLANCY, DEARS)


MSSNY’s Opioid Webinars are Now Available Through its CME Online Site
The Medical Society has archived its opioid webinar series on its continuing medical education website at http://cme.mssny.org.  The webinars that are currently on the site are:  Webinar 1 Pain Management at the Crossroads:  A Tale of Two Public Health Problems and Webinar 2   Rational Opioid Prescribing:  Is this Possible for Chronic Pain?  Physicians and other prescribers can earn up to one hour of continuing medical credits by viewing this webinar and completing the test.    The reminder of the webinars will be placed on line in the very near future. 

The MSSNY CME site requires new users to register, but once registered physicians and other health care providers will have a personalized training page to take the webinars and other course work located on the site.   New registrants to the site will create a username and password, which should be retained and be used for continued access to the site. Once registered and logged into the site, physicians will be taken to an instruction page.   Click on the tool bar menu located at the top of the page and click on “My training” to view and take the various courses.    

MSSNY has over 50 programs at this site and physicians are able to earn continuing medical education credits for each course.  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 number of continuing medical education credits for these online programs vary, but the majority of the programs are for 1.0 AMA/PRA Category 1 credit.  Further information on all these programs may be obtained by contacting Pat Clancy at pclancy@mssny.org.            (CLANCY)


PTSD and TBI in Returning Veterans:  March – June Webinars
MSSNY will be holding a series of CME webinars on PTSD and TBI in returning veterans on eight dates listed below from March through June. The faculty presenters will be Frank Dowling, MD and Joshua Cohen, MD.

Course objectives:

  • Explore the two most prevalent mental disorders facing American veterans today, their causes, symptoms, and comorbidities
  • Outline treatment options including evidence-based psychotherapy and pharmacotherapy
  • Discuss barriers to treatment, including those unique to military culture, and how to overcome them
  • Outline the process of recovery and post-traumatic grow

To register for this webinar, click on a date below and fill out the registration form

Wednesday, March 9, 7:30-8:30 AM

Tuesday, Mach 22, 6-7 PM

Thursday, April 7, 6-7 PM

Tuesday, April 12, 7:30-8:30 AM

Thursday, May 5, 6-7 PM

Thursday, May 19, 7:30-8:30 AM

Thursday, June 2, 6-7 PM

Thursday, June 9, 7:30-8:30 AM


MSSNY to Conduct Medical Matters Webinar on Zika Virus on March 16, April Session on Ebola
The Medical Society, in conjunction with the New York State Department of Health will conduct a Medical Matters webinar on the  “Zika Virus: An Evolving Story” on March 16th at 7:30 a.m.   Registration for this program is now open at. Click hereClick on the upcoming tab and select the programs.

The educational objectives for this program are: 1) Describe the epidemiology of Zika Virus infection;

2) Understand the modes of transmission; 3) Understand how to advise patients; and 4) Learn methods for prevention of infection.  William Valenti, MD, chair of MSSNY’s Infectious Disease Committee, and Elizabeth Dufort, MD,  Medical Director, Division of Epidemiology from the New York State Department of Health will conduct this presentation.

The April session of Medical Matters will take place at the MSSNY House of Delegates and is entitled,

“Ebola: A Perspective from the Field”.  The program will be conducted by Dario Gonzalez, MD, FACEP, Associate Medical Director,  Fire Department City of New York/Office of Medical Affairs.  Dr. Gonzalez was deployed for nine weeks by Americares to Liberia, West Africa as part of the US response to the Ebola epidemic.  The program will be held on Thursday, April 14, 2016 at 2:00pm. Physicians may attend the session at the Westchester Marriott, 670 White Plains Road, Tarrytown, NY 10591 or by webinar.  Registration is now. Click here.  Click on the upcoming tab and select the program.

The educational objective is: Offer perspective and lessons learned from an individual who treated Ebola patients firsthand.

The May session will be “Radiological Emergencies”, this session will be held on May 18, 2016 at 7:30 AM. (Please note that this session was originally scheduled for March 16, 2016) Faculty for this session will be Cham Dallas, PhD.  Dr. Dallas is a professor in the Department of Health Policy and Management at the College of Public Health, University of Georgia.  He is also the Director of the Institute for Disaster Management at the University of Georgia and a Board Member of the National Disaster Life Support Foundation (NDLSF).  Dr. Dallas has a national/international reputation in toxicology and emergency preparedness and response, including over 30 years of experience.

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.

Further information or assistance in registering for any of these programs may be obtained by contacting Melissa Hoffman at mhoffman@mssny.org.
(CLANCY, HOFFMAN)

For more information relating to any of the above articles, please contact the appropriate contributing staff member at the following email addresses:          

pschuh@mssny.org ldears@mssny.org            mauster@mssny.org  
pclancy@mssny.org jMcPartlon@mssny.org    

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MSSNY President Dr. Joseph Maldonado Quoted in Wall Street Journal Article on Looming E-Prescribing Deadline
In a Wall Street Journal article on Tuesday, Corinne Ramey reports that some medical institutions in New York are asking for more time to comply with a state law that will take effect on March 27th, requiring that all medications be prescribed electronically in order to cut down on drug abuse, errors, and fraud. Commenting on how the new policy will limit patients’ ability to shop for lower drug costs or take the prescription to another pharmacy, Medical Society of the State of New York President Joseph Maldonado stated, “The physician now has to deal with an angry patient, a belligerent patient or a patient that insists they want this in writing.” 


This Year’s Flu Vaccine Is 59% Effective, Preliminary Data Show
The CDC reported this week preliminary overall influenza effectiveness of 59 percent this year. Unlike last year, this year’s vaccine is a good match to the strains that make people sick. These data were presented at a meeting of the agency’s Advisory Committee for Immunization Practices (ACIP) in Atlanta. This finding is comparable to past estimates for seasons when most circulating flu viruses and vaccine viruses have been similar.

“This means that getting a flu vaccine this season reduced the risk of having to go to the doctor because of flu by nearly 60 percent,” said Joseph Bresee, M.D., chief of CDC’s Epidemiology and Prevention Branch. “It’s good news and underscores the importance and the benefit of both annual and ongoing vaccination efforts this season.”


CDC Study: HPV Infections Decline Among Teenage Girls
A CDC study published in the March issue of Pediatrics suggests that fewer US women are entering adulthood infected with HPV thanks to a vaccination program that began a decade ago. The study is the first to show falling levels of dangerous strains of the virus among American women in their early 20s. Girls between 14 and 19 years old saw infection rates on the four types of HPV covered by the Gardasil vaccine fall 64 percent from the rate prior to the vaccine’s introduction — from 11.5 percent in 2003-2006 to 4.3 percent between 2009 and 2012.


MSSNY Member Richard Lockwood, MD Named Vice President and Chief Medical Officer of Excellus BlueCross BlueShield Central New York Region
Excellus BlueCross BlueShield has named Richard Lockwood, M.D., vice president and chief medical officer of the company’s Central New York region. He replaces Marybeth McCall, M.D., who is now serving as vice president and chief medical officer of Excellus BlueCross BlueShield’s Utica region.

Lockwood has been vice president and chief medical officer of utilization management for Excellus BlueCross BlueShield since July 2015. He joined the company as a part-time associate medical director in 1999 and was named medical director for the company’s Central New York region in 2011.

In his professional career, Lockwood has been in private practice with Onondaga Hill Internists, Family Care Medical Group, Van Duyn Home and Hospital, Loretto, and Hill Haven Nursing Home, all in Syracuse. He has held the position of medical director at Iroquois Nursing Home, Jamesville, since 2005.

After graduating cum laude from Syracuse University and SUNY Downstate College of Medicine, Brooklyn, Lockwood completed his internship and residency in internal medicine at the Medical College of Pennsylvania in Philadelphia. He is a clinical instructor at SUNY Upstate Medical Center, Syracuse, and has hospital privileges at Upstate Medical University and Upstate University Hospital Community Campus, where he served as president of the medical staff prior to the hospital’s merger with Upstate Medical University.

A member of MSSNY since 1982, Dr. Lockwood is also a member of the Onondaga County Medical Society and American College of Physicians,  and is a Fellow of the American Board of Internal Medicine.


CMS Webinar on TCPI and CJR Programs
The New York City Regional Office of the Centers for Medicare & Medicaid Services will be hosting a webinar entitled “New Program Initiatives – Goals and Operations” on Tuesday, March 8, 2016, from 11:30 AM – 1:00 PM EST.  The programs that will be discussed along with a Q & A segment include:

  • Transforming Clinical Practice Initiative (TCPI) &
  • Comprehensive Joint Replacement Program (CJR)

The target audience is State Health and Trade Associations, Hospitals, Group, Specialty and Individual Physician Practices, and Ancillary providers (all provider types).

There is no charge to attend, but registration is required.  To register, click here 


Do You Have Expertise in Physician Stress and Burnout? We Need You!
At the 2015 House of Delegates of the Medical Society of the State of New York, a resolution was passed calling for action to address the prevalence of physician burnout.

We need your help!

We are looking to assemble the MSSNY team to tackle this work. This calls for physicians who have experience or expertise in designing or implementing physician health programs or stress/burnout programs for physicians. Please contact eskelly@mssny.org with a short bio and letter expressing your interest, expertise and what you intend to bring to the taskforce to advance the mission of the project.


Physician Entrepreneurship: Transform the Future of Health Care
Interested in opportunities to impact medicine beyond your clinical practice? Join the AMA for an exclusive event to discuss how physicians are getting involved in and, indeed, helping to lead health care innovation.

A dynamic panel of physicians will share their perspectives, accomplishments and insights gleaned as they’ve developed new products, formed companies, advised start-ups and invested in innovative health care ventures.

WHEN: 7 p.m., Tuesday, March 1. Cocktails and hors d’oeuvres will be provided.

WHERE: Impact Hub NYC, 394 Broadway, New York, NY

Register today! Free for AMA members. Limited seating available. $500 for non-AMA members.


Poster Symposium Seeks Judges on April 15 in Tarrytown
If you’re coming to the House of Delegates in Tarrytown – or just live in the neighborhood – and are free on Friday afternoon, April 15, from 2 – 4 pm, please consider participating as a judge at the MSSNY Resident and Fellow Section Poster Symposium. It’s always an exciting, lively event! Please contact sbennett@mssny.org or 516-488-6100 extension 383 if you’re interested. Thank you.


CLASSIFIED

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February 19, 2016 – We Are NOT Burned Out or Stressed! We Are Fed Up!

drmaldonado PRESIDENT’S MESSAGE
 Dr. Joseph R.  Maldonado
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February 19, 2016
Volume 16, Number 7

Dear Colleagues:

We Are NOT Burned Out or Stressed!  We Are Fed Up!

Over the past year, we have all read headlines highlighting physician burnout and stress.

I have to admit that I have been advocating for greater physician awareness and attention to physician burnout and stress.  I have established a taskforce that seeks to address physician stress and burnout.  I have done so by trying to look at the stressors placed on our lives from an observer perspective.

From that perspective, one frames physician stress as a common phenomenon.  The observer perspective allows us to distance ourselves from the overwhelming stresses, identify them for others while framing those affecting us differently.  From an observer perspective, our stresses are manageable and we are always capable of effectively dealing with stresses.  We are, of course, different than those other doctors who have a difficult time effectively coping with their stresses.  For those physicians, we clearly need solutions for managing stress and burnout – or so we frame it to distance ourselves from “those” colleagues.

This week, I came to realize the fallacy of this framework.  Yes, there are physicians who are coping ineffectively with stress.  Some physicians do burn out. HOWEVER, there is something ABSOLUTELY WRONG about framing the stresses facing physicians in context of our coping abilities.  Such framing seems to make it perfectly acceptable and normal to pile stressor upon stressor upon stressor onto physicians.  Any failure of a physician to respond like Superman or Wonder Woman is viewed as weakness.

The failing is NOT the inability of physicians to merrily face the assaults on the profession.  The failing is in our buying into these assaults and stresses as part of what we bought into when we entered our profession.  We must stop accepting these assaults and must fight back!  We are not stressed!  We are not burnt out.  WE ARE FED UP AND HAVE HAD ENOUGH!

This is NOT what I bought into when I became a doctor.  It’s time we reframed this demoralization within our profession.  We must stand up and say, “The problem is not with my abilities to cope with stress or burnout.  The problem lies in the assaults on us and our profession!  Enough is Enough!  We will not continue to accept these assaults.  We will walk away before burning out.”

I’m MAD AS HELL AND I’M NOT GONNA TAKE THIS ANYMORE!

I’M GONNA GIVE SOME LEGISLATORS A PIECE OF MY MIND NEXT MONTH!

Joseph Maldonado, M.D, MSc, MBA, DipEBHC
MSSNY President

Please send your comments to comments@mssny.org


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MSSNY Lobby Day Scheduled for March 8th – Physicians Urged to Attend and Wear  Your White Lab Coats
MSSNY’s “Physician Advocacy Day” will be held on March 8th in the Lewis Swyer Theatre in the Egg located at the Empire State Plaza in Albany, New York.  If you plan to attend, please register here.

A full slate of legislators and top Administration officials will attend and dialogue with Advocacy Day participants including:

  • Donna Frescatore, Executive Director, NYS Health Benefit Exchange;
  • Troy Oechsner, Executive Deputy Superintendent, Department of Financial Services;
  • Legislative Panel: Senate Health Chair Kemp Hannon; Assembly Health Chair Richard Gottfried; Senate Insurance Chair James Seward; Assembly Insurance Chair Kevin Cahill.

In addition, Assembly Majority Leader Joe Morelle and Senate Majority Leader John Flanagan have also agreed to attend the morning proceedings and Speaker Heastie has been invited to the event but has not yet confirmed his participation. A brief informal luncheon to which members of each House are invited to speak with their constituents will follow the morning program.   County Medical Societies will be scheduling appointments for physicians to meet with their elected representatives.

PHYSICIANS ARE ENCOURAGED TO IMMEDIATELY REGISTER THROUGH THE LINK BELOW TO ATTEND THE MARCH 8TH LOBBY DAY IN ALBANY. http://goo.gl/forms/Mw7CX8JfzL (DIVISION OF GOVERNMENTAL AFFAIRS) 


MSSNY Lobby Team to Conduct one more Pre-Lobby Day Webinar on Issues to be Discussed on March 8th
In advance of the Lobby Day, MSSNY DGA staff will offer one more morning briefing program so that you can hit the ground running on March 8th. The next briefing program will be held on Wednesday, February 24 from 7:30-8:30AM. If you and/or your colleagues wish to participate on this briefing session, please register by clicking onto the link below.

February 24 briefing session 7:30-8:30AM:
(DIVISION OF GOVERNMENTAL AFFAIRS)


Physicians Invited to Attend Fireside Chat With MSSNY President Dr. Joseph Maldonado and Troy Oechsner, Deputy Superintendent of Insurance and Donna Frescatore, Executive Director of the NY State of Health
On March 7th, the evening before MSSNY’s Lobby Day, Joseph Maldonado, Jr., MD, MSc, MBA, will conduct a “fireside chat” with Troy Oechsner, Deputy Superintendent at DFS and Donna Frescatore, Executive Director for the NY State of Health in the MSSNY office. This is a relaxed and fluid format in which Dr. Maldonado, Mr. Oechsner and Ms. Frascatore can discuss issues of concern to the medical community (network adequacy, action taken by Emblem Health to narrow its network,  the collapse of Health Republic, etc). Physicians are invited to be physically present at this event in the DGA offices located at Ste 408, One Commerce Building, in Albany or can engage in real time by emailing their questions during the LIVE webcast of the event. The program will run for one hour from 5:30-6:30PM on March 7th.  To register to attend the event, click onto this link:
(DIVISION OF GOVERNMENTAL AFFAIRS)


Why Physicians Need to Take a Day Away from Your Practice To Lobby Albany on March 8, 2016

  • Think you pay too much in malpractice insurance costs?  The Trial Bar doesn’t care. They have introduced legislation that will certainly increase your premium costs.
  • If you practice in the Capital District, Southern Tier, Central NY, or Western NY, New York State wants to take away your Excess Liability Insurance Coverage.
  • New York State wants to enable NPs to deliver care to injured workers and take away County Medical Society review of authorized physicians rather than fixing what ails the Workers’ Compensation system.
  • The Proposed NYS Budget does nothing to compensate physicians for the unpaid care they have provided to Health Republic insureds.
  • New York State wants to enable Walmart and Target to hire NPs to deliver care to the public to compete directly against you.
  • Patient health could be threatened by inappropriately expanding the scope of practice of countless non-physicians, including dentists, optometrists and psychologists.
  • We need to prevent insurers from offering patients narrow networks for Exchange plans and denying patient access to out of network physicians.

These are very real issues that are currently being discussed and will be resolved either in the State Budget which will be enacted by April 1st or before the end of Session on June 16th. You need to come to Albany, and speak with your elected officials so that they can hear your concerns. Otherwise, all they will hear are the perspectives of trial lawyers and insurance companies.

PLEASE JOIN YOUR COLLEAGUES FROM ACROSS THE STATE TO LOBBY YOUR ELECTED LEADERS IN PERSON IN ALBANY MARCH 8TH.
REGISTER HERE.
(DIVISION OF GOVERNMENTAL AFFAIRS)


Urge Your Legislators to Support Health Republic Guarantee Fund Legislation (S.6667/A.9311)
Assembly Health Committee Chair Richard Gottfried together with Assemblyman Charles Lavine (D-Nassau County) introduced legislation (A.9311) this week to establish a Guaranty Fund to help to assure the payment of the hundreds of millions that Health Republic owes physicians and hospitals across New York State, as well as to protect consumers and health care providers from future health plan insolvencies.  Identical legislation (S.6667, Valesky, with several co-sponsors) has been introduced in the State Senate.  Right now, New York is the only state in the country that does not have such a Guarantee Fund.  With the health insurance industry in strong opposition to this proposal, it is imperative that you urge your Senators and Assemblymembers to support this bill and include it as part of the State Budget currently under negotiation by sending a letter from 
here .

You must remind your legislators that, with physicians facing so many other challenges in seeking to keep their doors open to deliver patient care, including high liability costs, expensive electronic medical record equipment, employee costs, insurance companies dropping physicians from their networks and declining payments from insurers, failure to assure payment for these claims would have serious negative consequences for patient care and employment in your community.
(AUSTER, DEARS)


Please Complete Survey to Let Us Know What You Are Owed as a Result of Health Republic Debacle
MSSNY’s updated survey of outstanding Health Republic claims shows that, based upon results received, physicians are owed nearly $25,000,000.  However, we believe that far more physicians who have been adversely impacted have yet to respond.  As we continue our advocacy in support of a Guarantee or other special fund to pay for the unpaid claims as a result of the Health Republic demise, we need those of you who have not completed the survey to provide us with updated information regarding the amounts you are due from Health Republic.  To complete the survey, click hereThis data is critical to our advocacy efforts!   We need to obtain updated and more precise numbers from as many impacted physicians as possible since many legislators have asked us for this data.
 (AUSTER, DEARS)


Physicians Urged to Oppose Huge Cuts to Excess Medical Liability Insurance Program
Physicians are urged to continue to contact their legislators to object to a provision in the Executive Budget that would cause more than half of physicians to lose their Excess Medical Malpractice Insurance coverage.

Specifically, the proposal would cut funding by $25 million, with the effect that 55% of physicians who currently receive this essential coverage being dropped from the program.  Across much of upstate New York, only neurosurgeons, bariatric surgeons and OB-GYNs would keep this coverage.  That means that in the Capital District, in Northern New York, in Central New York, in western New York and in the Southern Tier every family physician, internist, pediatrician, ophthalmologist, emergency room physician, vascular surgeon, cardiologist, radiologist, pathologist, otolaryngologist, dermatologist and allergist would be automatically dropped.  And downstate, many primary care physicians, ophthalmologists, otolaryngologists, pathologists, dermatologists and allergists would be dropped.

The Excess Medical Liability Insurance Program provides an additional layer of $1M of coverage to physicians with hospital privileges who maintain primary coverage at the $1.3 million/$3.9 million level.  The program was created over 30 years ago as a result of the liability insurance crisis of the mid-1980’s to address concerns among physicians that their liability exposure far exceeded available coverage limitations.  Absent meaningful liability reform, with verdicts and physician liability premiums continuing to be far out of proportion compared to the rest of the country, full funding for the Excess program is absolutely essential in today’s very challenging practice environment.

At a time when the state is seeking to attract and retain physicians, this proposal deters physicians from wanting to practice in New York State for fear of putting themselves and their families in financial jeopardy for judgements and settlements exceeding the limits of their primary coverage.  Please urge your legislators to reject these cuts and restore full funding for the program!  (AUSTER, DEARS)


Physicians Urged to Oppose Adverse Workers’ Compensation Budget Proposal; 30-Day Amendments Bring Additional Concerns
All physicians must continue to contact their State Senators and Assemblymembers to express their strong opposition to sweeping Workers’ Compensation reform proposals contained in the Executive Budget.

MSSNY staff continues to meet with key legislative leaders and staff to voice its very serious concerns with Budget proposals that would:

  • Enable treatment of injured workers and direct payment for care by various non-physicians without clarity as to: how non-physicians treating patients with serious health conditions will coordinate patient care delivery when specialized care is needed; whether existing fees will need to be cut to cover this expanded list of care providers; and whether a non-physician can perform an IME of an injured worker to review the care provided by a physician to an injured worker;
  • Expand the circumstances when a physician or other health care provider can have their authorization removed and empowers the Board to impose significant fines on a physician or any other Board-authorized health care provider for violating a Workers Compensation rule;
  • Remove the authority of county medical societies to recommend physicians to serve as treating providers or independent medical examiners under Workers Compensation, which is currently an important peer review function provided by county medical societies to assure physician applications are complete and physician applicants are appropriately qualified to deliver this needed care to injured workers.
  • Reduce choice for injured workers by prohibiting in many instances an injured worker from seeking medical treatment from outside a Workers Compensation PPO before 120 days after his or her first visit to a PPO provider;
  • Remove the requirement for a referral by a physician for an injured worker as a pre-condition to receive psychological care;

In the 30-day Executive Budget amendments released last weekend, the proposal was made even more adverse by a) requiring all physicians and other currently authorized WC providers to execute an “authorization agreement” with the Board (as of now, it is unclear what would be contained within such “authorization agreement”) within 12 months of the effective date of the proposal, if it were to be enacted; and b) removing the ability of professional associations, such as MSSNY, to recommend arbitrators to resolve medical fee disputes between health care providers and carriers.

Exacerbating these concerns is that the proposal also does not meaningfully address the many excessive administrative hassles and payment delays that have caused many physicians to be unable to participate in the Workers Compensation program.   While there have been some modestly positive actions taken by the WCB in recent years to encourage physician participation in the WC program through removal of arbitration fees and development of an electronic portal for facilitating authorizations from carriers, the Budget proposals if enacted could further chase physicians away from the program.

MSSNY has also reached out to labor organizations and associations representing attorneys for injured workers to coordinate its advocacy in opposition.  MSSNY has also been working closely with county medical society leadership from across the State to encourage their outreach to their local Senators and Assemblymembers to request that these proposals be jettisoned from the Budget.
(AUSTER, DEARS)


MSSNY President Appears on News Program to Urge Passage of Legislation to Enable Override of Insurer “Fail First” Medication Policies
Concerned about health insurer policies that require your patients to “fail first” on certain prescription medications before they are able to take the medication that you believe is most medically appropriate to improve their health?  MSSNY is working together with a number of patient advocacy groups in support of legislation (A.2834-A, Titone/S.3419-A, Young) to provide physicians with an expeditious manner to override an insurer “fail first” policy when it is in the best interest of their patients’ health.  To send a letter in support of this legislation click here.   This week, MSSNY President Dr. Joseph Maldonado appeared on the YNN Statewide news program Capital Tonight along with Matthew Shapiro of the National Alliance on Mental Illness’ Matthew Shapiro to discuss the importance of the legislation.  To watch the broadcast, click here.(AUSTER, DEARS)


Please Advocate for Due Process Rights When Physicians are Non-Renewed by a Health Insurer
Physicians are urged to contact their legislators to support a bill (A.1212, Lavine/S.4751, Hannon) that would assure physicians are accorded a fair peer review appeals mechanism before their participation contract with a health insurance company can be non-renewed.  To send a letter in support of this legislation here.  The legislation is in response to situations such as the disrespectful way by which Emblem treated 750 of its network physicians who were unceremoniously dropped from the network in October based upon specious allegations of failure to transition to value-based payments, severing patient treatment relationships for countless patients.  MSSNY has strenuously urged to the Department of Financial Services, Department of Health, and Attorney General that these physicians be given a fair opportunity to be reinstated, and have shared this information with the entire New York State Legislature. (See MSSNY letter to DFS here.   The Attorney General’s office continues to investigate specific complaints raised by individual physicians whether they were given a fair chance to appeal these non-renewals.
 (AUSTER, DEARS)


To Physicians in Long Island, NYC, Hudson Valley, and Capital District:  Please Complete this Survey
State and federal regulators are very interested in knowing the prospective effects of these possible mergers on your practice and patient care.   In this regard, MSSNY working together with the American Medical Association Advocacy Resource Center have developed a survey seeking physician input on the potential impact on these proposed mergers.

Last fall, the AMA released a report articulating the significant potential anticompetitive effects that would occur in numerous regions all across the country as a result of this merger.  Among the identified regions of concern in New York State were Long Island, New York City, the Hudson Valley, the Capital District and the Glens Falls area.  Therefore, physicians practicing in these regions are asked to complete the Survey! 


Opioid Prescribing Webinar on Feb 23rd; Registration is Now Open
Registration is on-going for the third webinar in the opioid series which will be held Tuesday, February 23rd at 7:30 a.m. Title of the program is “Treatment of Opioid Use Disorders”.   Physicians and other prescribers are encouraged to register for the remaining webinars  at the this link.

Click on the upcoming tab and select the programs.

Physicians will need to register for each webinar; each webinar has different topics described below. Physicians and other prescribers are allowed to register up to ½ hour before the webinar.

The Medical Society of the State of New York, the New York State Office for Alcoholism and Substance Abuse Service and the NYS Department of Health’s Bureau of Narcotic Enforcement, are jointly providing this free, four part webinar series on opioid prescribing. 

Entitled,) “Revisiting the Role of Opioid Analgesics for Simple and Complex Patients with Chronic Pain”.  Faculty for the session will be Jeffrey Selzer, MD and the educational objective:  Describe potential for patient addiction, screening, diagnosis and subsequent treatment or referral.

The fourth webinar will be held on Thursday, March 10, 2016, 7:30 a.m. Faculty: Charles E. Argoff, MD and Charles Morgan, MD, FASAM, FAAFP, DABAM and the educational objectives:  Recommend tools to assist in the management of patients for whom opioids are indicated and prescribed; discuss strategies to reduce risk of treating pain in patients with substance use disorders.

Physicians and other prescribers can take one or all of the webinars. 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.

Please contact Pat Clancy at pclancy@mssny.org or Terri Holmes at tholmes@mssny.org for further information.                                        (CLANCY, DEARS)


MSSNY Continues Work to Address Disparities in Health Care
MSSNY’s Committee to Eliminate Health Care Disparities met this Friday, February 19th, and hosted Kyle Ishmael, the Executive Director of the Black, Puerto Rican, Hispanic and Asian Legislative Caucus. Mr. Ishmael spoke at length on the background of the Caucus and its legislative priorities outlined in the Caucus’ 2016-17 People’s Budget.

As budget season progresses, MSSNY hopes to collaborate with the Caucus and develop synergies to address health care disparities among minority populations. With a wide variety of illnesses and ailments disproportionately affecting minority populations, MSSNY remains diligent in its efforts to address these disparities and committed to attracting members of minority populations to the practice of medicine. A special thanks to Kyle Ishmael and the Black, Puerto Rican, Hispanic and Asian Legislative Caucus.
(MCPARTLON)


MSSNY to Conduct Medical Matters Webinar on Zika Virus on March 16, April Session on Ebola
The Medical Society, in conjunction with the New York State Department of Health will conduct a Medical Matters webinar on the  “Zika Virus: An Evolving Story” on March 16th at 7:30 a.m.  
Registration for this program is now open.

Click on the upcoming tab and select the programs.

The educational objectives for this program are: 1) Describe the epidemiology of Zika Virus infection;

2) Understand the modes of transmission; 3) Understand how to advise patients; and 4) Learn methods for prevention of infection.  William Valenti, MD, chair of MSSNY’s Infectious Disease Committee, and physicians from the New York State Department of Health will conduct this presentation.  Further information will be available shortly.

The April session of Medical Matters will take place at the MSSNY House of Delegates and is entitled,

“Ebola: A Perspective from the Field”.  The program will be conducted by Dario Gonzalez, MD, FACEP. Associate Medical Director,  Fire Department City of New York/Office of Medical Affairs.  Dr. Gonzalez was deployed for nine weeks by Americares to Liberia, West Africa as part of the US response to the Ebola epidemic.  The program will be held on Thursday, April 14, 2016 at 2:00pm. Physicians may attend the session at the Westchester Marriott, 670 White Plains Road, Tarrytown, NY 10591 or by webinar.  Registration is now open.

Click on the upcoming tab and select the program.

The educational objective is: Offer perspective and lessons learned from an individual who treated Ebola patients firsthand.

The May session will be “Radiological Emergencies”, this session will be held on May 18, 2016 at 7:30 AM. (Please note that this session was originally scheduled for March 16, 2016) Faculty for this session will be Cham Dallas, PhD.  Dr. Dallas is a professor in the Department of Health Policy and Management at the College of Public Health, University of Georgia.  He is also the Director of the Institute for Disaster Management at the University of Georgia and a Board Member of the National Disaster Life Support Foundation (NDLSF).  Dr. Dallas has a national/international reputation in toxicology and emergency preparedness and response, including over 30 years of experience.

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.

Further information or assistance in registering for any of these programs may be obtained by contacting  Melissa Hoffman at mhoffman@mssny.org.                                                      
(CLANCY, HOFFMAN)
 


PTSD and TBI in Returning Veterans: March – June Webinars
MSSNY will be holding a series of CME webinars on PTSD and TBI in returning veterans on eight dates listed below from March through June. The faculty presenters will be Frank Dowling, MD and Joshua Cohen, MD.

Course objectives:

  • Explore the two most prevalent mental disorders facing American veterans today, their causes, symptoms, and comorbidities;
  • Outline treatment options including evidence-based psychotherapy and pharmacotherapy;
  • Discuss barriers to treatment, including those unique to military culture, and how to overcome them;Outline the process of recovery and post-traumatic grow. 

To register for this webinar, click on a date below and fill out the registration form

Wednesday, March 9, 7:30-8:30 AM

Tuesday, Mach 22, 6-7 PM

Thursday, April 7, 6-7 PM

Tuesday, April 12, 7:30-8:30 AM

Thursday, May 5, 6-7 PM

Thursday, May 19, 7:30-8:30 AM

Thursday, June 2, 6-7 PM

Thursday, June 9, 7:30-8:30 AM

(ELPERIN, DEARS)

For more information relating to any of the above articles, please contact the appropriate contributing staff member at the following email addresses:          

pschuh@mssny.org ldears@mssny.org            mauster@mssny.org  
pclancy@mssny.org jMcPartlon@mssny.org    


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Do You Have Expertise in Physician Stress and Burnout? We Need You!
At the 2015 House of Delegates of the Medical Society of the State of New York, a resolution was passed calling for action to address the prevalence of physician burnout.

We need your help!

We are looking to assemble the MSSNY team to tackle this work. This calls for physicians who have experience or expertise in designing or implementing physician health programs or stress/burnout programs for physicians. Please contact eskelly@mssny.org with a short bio and letter expressing your interest, expertise and what you intend to bring to the taskforce to advance the mission of the project.


CDC Report: New Yorkers and Others Not Getting Enough Sleep
The CDC released a report revealing that about one-third of adults in the US appear to be getting insufficient sleep. Prevalence of healthy sleep duration varied among states and ranged from 56.1% in Hawaii to 71.6% in South Dakota (Table 2). Most of the Great Plains states were in the upper quintile for healthy sleep duration; states in the southeastern United States and along the Appalachian Mountains tended to be in the lower quintiles (Figure). After surveying some 444,000 US adults in 2014, the CDC “also found that while two-thirds of white people nationally got enough sleep, only about half of blacks, Native Hawaiians and Pacific Islanders did.”

In New York, 61.6-63.2 % of age-adjusted percentage of adults reported ≥7 hours sleep per 24-hour period.


Humana Fined $500,000 for Discriminating Against AIDS /HIV Patients
The Florida Office of Insurance Regulation (FOIR) announced this week that it had concluded its market examination of Humana and fined the health insurer $500,000 for failing to cooperate with investigators. In a consent order dated February 16, 2016, Humana agreed to “maintain procedures to ensure that it does not by effect or design treat people living with HIV/AIDS less favorably than any other condition.”

In 2014, The AIDS Institute and NHeLP filed a complaint with the U.S. Department of Health and Human Services’ Office for Civil Rights (OCR) charging four Florida health plans, including Humana, with unlawful discrimination against people living with HIV and AIDS by placing all HIV medications, including generics, on the highest cost sharing tier, thus requiring enrollees to pay as much as 50 percent co-insurance for every HIV drug. In the complaint, the groups contend that such practices discourage people with HIV/AIDS from enrolling in the plans and violate the Affordable Care Act’s (ACA) non-discrimination provisions. The ACA bans plans from discriminating against individuals based upon disability and prohibits them from discouraging enrollment by people with significant health needs.

Last year, HHS issued guidance to all plans nationwide informing them that such practices are discriminatory; and in proposed regulations implementing the ACA’s non-discrimination provision, Section 1557, HHS made clear that plan benefits cannot be designed to discriminate. However, OCR has yet to issue a ruling on the complaint.

The AIDS Institute’s analysis of Florida’s 2016 qualified health plans found that coverage for nearly all Hepatitis B and C drugs by several insurers remains subject to high co-insurance levels. Humana places almost all Hepatitis C drugs on Tier 5, which translates into coinsurance of either a 40 or 50 percent of drug cost, after the patient pays a $3,800 deductible. Aetna and CoventryOne place all Hepatitis C drugs and almost all hepatitis B drugs on Tiers 4 and 5, which carry coinsurance of 40 percent and 50 percent of drug cost, after a $2,750 deductible.


Young Adults on Adderall: Dramatic Increase in Emergency Room Visits
A study published online Feb. 16 in the Journal of Clinical Psychiatry indicates that “incidences of misuse and emergency room visits related to Adderall increased dramatically for young adults between 2006 and 2011.” Researchers arrived at this conclusion after examining data from the “National Disease and Therapeutic Index, a survey of office-based practices; National Survey on Drug Use and Health, a population survey of substance use; and Drug Abuse Warning Network, a survey of hospital emergency department visits.”


Medical School Deans Promote Three-Year Medical Degree
In an opinion piece in the Wall Street Journal (2/18, A11), dean and CEO Robert I. Grossman, MD, and vice dean for education, faculty, and academic affairs Steven B. Abramson, MD, of New York University’s Langone Medical Center and the NYU School of Medicine, write in favor of the three-year medical degree instead of the traditional four-year path as a way to save students money and help medical education adapt to the needs of the current century.


CA Hospital Pays “Ransomware”
Hollywood Presbyterian Medical Center paid a ransom in bitcoins equivalent to about $17,000 to hackers who infiltrated and disabled its computer network, the hospital’s chief executive said Wednesday. It was in the hospital’s best interest to pay the ransom of 40 bitcoins after the hacking that began Feb. 5, the C.E.O., Allen Stefanek said. The F.B.I. is investigating the attack, often called “ransomware,” in which hackers encrypt a computer network’s data to hold it hostage, providing a digital decryption key to unlock it for a price. “The quickest and most efficient way to restore our systems and administrative functions was to pay the ransom and obtain the decryption key,” Mr. Stefanek said. Bitcoins, an online currency, are hard to trace. The Los Angeles hospital network was operating fully again Monday, and patient care was not affected by the hacking, Mr. Stefanek said. 


CMS Plans to Correct Attestation System to Allow EPs to Claim an Exclusion for Measure 1 of the Patient Electronic Access Objective
The Centers for Medicare & Medicaid Services (CMS) will shut down the Medicare & Medicaid EHR Incentive Program Registration and Attestation System on Sunday, February 21, 2016, between 6:00 a.m. and 10:00 a.m. EST, to correct an error that is preventing eligible professionals (EPs) from claiming an exclusion for Measure 1 of the Patient Electronic Access Objective (referred to as 8A in the attestation system).

  • Patient Electronic Access, Measure 1 Exclusion: Any EP who neither orders nor creates any of the information listed for inclusion as part of the measures except for ‘Patient Name’ and ‘Provider’s name and office contact information.

EPs whose attestation was rejected as a result of not meeting objective 8 may modify and resubmit their attestation information after February 21, 2016. EPs who have successfully attested to the EHR Incentive Programs 2015 requirements do not need to take any action.

Batch attestation users who have not yet submitted their files will also need to wait to submit their data until after February 21. To successfully upload a batch attestation with this exclusion, please ensure the batch files include a Y/N indicator for each provider record on the file. Users who have already submitted a batch attestation file for the 2015 program year do not need to resubmit.

For More Information

Visit the CMS website or contact the EHR Information Center Help Desk at (888) 734-6433/ TTY: (888) 734-6563. The hours of operation are Monday through Friday between 7:30 a.m. and 6:30 p.m. EST.


CLASSIFIED

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

February 12, 2016 – NY Doctors Are Under Attack

drmaldonado PRESIDENT’S MESSAGE
 Dr. Joseph R.  Maldonado
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February 12, 2016
Volume 16, Number 6

Dear Colleagues:

THE DOCTORS OF NEW YORK ARE UNDER ATTACK—the likes of which we have not seen since the malpractice crisis of 1975. AT that time, we joined together and did the impossible—we created our own malpractice insurance company!

This time, the assault comes in the form of the change to the date of discovery and extension of the statute of limitations as well as the cut in the excess liability program.

The net effect of passage of these efforts will be a 30% increase in malpractice premiums. Is there any doctor in New York who can stay in practice with such an increase?

It is imperative that you be in Albany on March 8— if we stand any chance to stop this assault on our profession.

If that is not enough, consider the loss of millions of dollars to doctors from the Health Republic debacle, the radical changes in methodology through the DSRIP and SCHIP initiatives and the mounting efforts to kick doctors off insurance networks.

The events in this legislative session are going to radically change the practice of medicine in New York.

This year’s issues are of critical importance to YOU.

The outcome will change the ability of many physicians to remain in practice.

Last year, 15,000 teachers marched on Albany to demand their rights. Do teachers care more about their profession than we care about ours?

A lot of doctors feel it is someone else’s responsibility. This year, it is YOUR responsibility.

We will NOT have a second opportunity to turn this situation around.

Every physician in NY who is not engaged in emergency care must be in Albany on March 8 to lobby their legislators.

BE there –it’s YOUR FUTURE!

We cannot afford to allow the trial lawyers to expand the statute of limitations to 10 years.

We cannot afford physicians to lose millions of dollars in the Health Republic fiasco.

We cannot afford to lose the excess layer of coverage.

We cannot afford to have physicians excluded from insurance plans.

YOU MAY THINK YOU CANNOT AFFORD TO TAKE A DAY OFF TO COME TO ALBANY ON LOBBY DAY! But I can assure you that you will NOT be able to afford to stay in practice if you stay home.

NEXT YEAR MAY BE TOO LATE!

REGISTER NOW!

Joseph Maldonado, M.D, MSc, MBA, DipEBHC
MSSNY President

Please send your comments to comments@mssny.org


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MSSNY Lobby Day Scheduled for March 8th – Physicians Urged to Attend and Wear Your White Lab Coats
MSSNY’s “Physician Advocacy Day” will be held on March 8th in the Lewis Swyer Theatre in the Egg located at the Empire State Plaza in Albany, New York.  If you plan to attend, please register here.

A full slate of legislators and top Administration officials will attend and dialogue with Advocacy Day participants including:

  • Donna Frescatore, Executive Director, NYS Health Benefit Exchange;
  • Troy Oechsner, Executive Deputy Superintendent, Department of Financial Services;
  • Legislative Panel: Senate Health Chair Kemp Hannon; Assembly Health Chair, Richard Gottfried; Senate Insurance Chair, James Seward; Assembly Insurance Chair Kevin Cahill.

In addition, Assembly Majority Leader Joe Morelle and Senate Majority Leader John Flanagan have also agreed to attend the morning proceedings and Speaker Heastie has been invited to the event but has not yet confirmed his participation. A brief informal luncheon to which members of each House are invited to speak with their constituents will follow the morning program.   County Medical Societies will be scheduling appointments for physicians to meet with their elected representatives.

It is imperative for physicians to attend given the wide range of threats physicians face including legislation that would expand the statute of limitations with a broad date of discovery exception potentially increasing physician premiums by 14.5%; legislation to repeal the Trial Lawyers contingency fee limits, potentially increasing premiums by over 10%; significant reductions in eligibility of the Excess Program; legislation that will mandate physicians to take a 4-hour Pain Management CME course every two years; and a move to effectuate statutory and regulatory changes to implement a value-based payment structure under Medicaid and potentially to Medicare and commercial products as well. 

PHYSICIANS ARE ENCOURAGED TO IMMEDIATELY REGISTER THROUGH THE LINK BELOW TO ATTEND THE MARCH 8TH LOBBY DAY IN ALBANY.   http://goo.gl/forms/Mw7CX8JfzL      
(DIVISION OF GOVERNMENTAL AFFAIRS)
 


MSSNY Lobby Team to Conduct Pre-Lobby Day Webinars on Issues to be Discussed on March 8th
In advance of the Lobby Day, MSSNY DGA staff will offer two morning briefing programs so that you can hit the ground running on March 8th. Those briefing programs will be held on Tuesday, February 16 from 8:00-9:00AM and on Wednesday, February 24 from 7:30-8:30AM.

If you and/or your colleagues wish to participate on either of these briefing sessions, please register by clicking onto the appropriate link below.

February 16 briefing session: 8:00-9:00AM:

https://mssny.webex.com/mssny/k2/j.php?MTID=t20bd638fa04191a6a1ef419b97ccf6ec 

February 24 briefing session 7:30-8:30AM:

https://mssny.webex.com/mssny/k2/j.php?MTID=t93c8681382ad535070e436984c4e19ce
(DIVISION OF GOVERNMENTAL AFFAIRS) 


Physicians Invited to Attend Fireside Chat with MSSNY President Dr. Joseph Maldonado and Troy Oechsner, Deputy Superintendent of Insurance and Donna Frescatore, Executive Director of the NY State of Health
On March 7th, the evening before MSSNY’s Lobby Day, Joseph Maldonado, Jr., MD, MSc, MBA, will conduct a “fireside chat” with Troy Oechsner, Deputy Superintendent at DFS and Donna Frescatore, Executive Director for the NY State of Health in the MSSNY office. This is a relaxed and fluid format in which Dr. Maldonado, Mr. Oechsner and Ms. Frascatore can discuss issues of concern to the medical community (network adequacy, action taken by Emblem Health to narrow its network,  the collapse of Health Republic, etc). Physicians are invited to be physically present at this event in the DGA offices located at Ste 408, One Commerce Building, in Albany or can engage in real time by emailing their questions during the LIVE webcast of the event.  To View this event CLICK HERE.  The program will run for one hour from 5:30-6:30PM on March 7th.
(DIVISION OF GOVERNMENTAL AFFAIRS) 

Why Physicians Need to Take a Day Away from Your Practice To Lobby Albany on March 8, 2016
Think you pay too much in malpractice insurance costs?  The Trial Bar doesn’t care. They have introduced legislation that will certainly increase your premium costs.

  • If you practice in the Capital District, Southern Tier, Central NY, or Western NY, New York State wants to take away your Excess Liability Insurance Coverage.
  • New York State wants to enable NPs to deliver care to injured workers and take away County Medical Society review of authorized physicians rather than fixing the broken Workers Compensation system.
  • The Proposed NYS Budget does nothing to compensate physicians for the unpaid care they have provided to Health Republic insureds.
  • New York State wants to enable Walmart and Target to hire NPs to deliver care to the public to compete directly against you.
  • Patient health could be threatened by inappropriately expanding the scope of practice of countless non-physicians, including dentists, optometrists and psychologists.
  • We need to prevent insurers from offering patients narrow networks for Exchange plans and denying patient access to out of network physicians.

These are very real issues that are currently being discussed and will be resolved either in the State Budget which will be enacted by April 1st or before the end of Session on June 16th. You need to come to Albany, and speak with your elected officials so that they can hear your concerns. Otherwise, all they will hear are the perspectives of trial lawyers and insurance companies.


PLEASE JOIN YOUR COLLEAGUES FROM ACROSS THE STATE TO LOBBY YOUR ELECTED LEADERS IN PERSON IN ALBANY MARCH 8THREGISTER HERE.
 (DIVISION OF GOVERNMENTAL AFFAIRS)


Contact Your Legislators to Support a Health Republic Guarantee Fund (S.6667)
With the failure of the Executive Budget to include a Guarantee or other fund to cover the likely   hundreds of millions in payments due to Health Republic contracted providers, all physicians are urged to continue to contact their legislators and demand that the State Legislature take action to create such Guarantee or other fund to cover these costs as part of the State Budget process.

Senator David Valesky (D-Onondaga County) has introduced legislation (S.6667) to create such a Guarantee Fund.  The bill is co-sponsored by Senators Tony Avella (D-Queens), David Carlucci (D-Rockland County), Marc Panepinto (D-Erie County) and Diane Savino (D-Richmond County).  It is anticipated that similar legislation will be introduced in the Assembly shortly.

To read MSSNY’s memo in support of a Guarantee Fund, click here.

You must remind your legislators that, with physicians facing so many other challenges in seeking to keep their doors open to deliver patient care, including high liability costs, expensive electronic medical record equipment, employee costs, insurance companies dropping physicians from their networks and declining payments from insurers, failure to assure payment for these claims would have serious negative consequences for patient care and employment in your community.
(AUSTER, DEARS)


Please Complete Survey to Let Us Know What You Are Owed as a Result of Health Republic Debacle
As MSSNY continues its advocacy in support of a special fund to pay for the unpaid claims as a result of the Health Republic demise, we need you to take the time to complete a MSSNY survey to provide us with updated information regarding the amounts you are due from Health Republic.  To complete the survey, click here: https://www.surveymonkey.com/r/HRepublic2This data is critical to our advocacy efforts!  We thank the many of you who provided data in November detailing the amounts you are owed, but we need to obtain updated and more precise numbers since many legislators have asked us for this data.
(AUSTER, DEARS)

Physicians Urged to Oppose Huge Cuts to Excess Medical Liability Insurance Program
Physicians are urged to continue to contact their legislators (http://cqrcengage.com/mssny/app/onestep-write-a-letter?0&engagementId=161374) to object to a provision in the Executive Budget that would cause more than half of physicians currenty enrolled to lose their Excess Medical Malpractice Insurance coverage.     

MSSNY has expressed its strong opposition to these cuts in numerous meetings with Senators and Assemblymembers and in testimony to the Assembly Ways & Means and Senate Finance Committees.   To read MSSNY’s memo in opposition, click here.

Specifically, the proposal would cut funding by $25 million, with the effect that 55% of physicians who currently receive this essential coverage being dropped from the program.  Across much of upstate New York, only neurosurgeons, bariatric surgeons and OB-GYNs would keep this coverage.  That means that in the Capital District, in Northern New York, in Central New York, in western New York and in the Southern Tier every family physician, internist, pediatrician, ophthalmologist, emergency room physician, vascular surgeon, cardiologist, radiologist, pathologist, otolaryngologist, dermatologist and allergist would be automatically dropped.  And downstate, many primary care physicians, ophthalmologists, otolaryngologists, pathologists, dermatologists and allergists would be dropped.

The Excess Medical Liability Insurance Program provides an additional layer of $1M of coverage to physicians with hospital privileges who maintain primary coverage at the $1.3 million/$3.9 million level.  The program was created over 30 years ago as a result of the liability insurance crisis of the mid-1980’s to address concerns among physicians that their liability exposure far exceeded available coverage limitations.  Absent meaningful liability reform, with verdicts and physician liability premiums continuing to be far out of proportion compared to the rest of the country, full funding for the Excess program is absolutely essential in today’s very challenging practice environment.

At a time when the state is seeking to attract and retain physicians, this proposal deters physicians from wanting to practice in New York State for fear of putting themselves and their families in financial jeopardy for judgements and settlements exceeding the limits of their primary coverage.  Please urge your legislators to reject these cuts and restore full funding for the program!                         (AUSTER, DEARS)


Tell Your Legislators to Reduce Your Liability Costs, Not Expand Them!
All physicians must continue to contact their legislators to urge that they oppose legislation (A.285-A, Weinstein/S.6596, DeFrancisco) that could drastically increase New York’s already exorbitantly high medical liability premiums by changing the medical liability Statute of limitations to a “Date of Discovery” rule.   

You need to tell your legislators that no liability increases can be tolerated.  MLMIC’s estimate is that this bill could increase physician liability premiums by nearly 15%!   New York physicians continue to pay liability premiums that are among the very highest in the country.  By way of example, a neurosurgeon practicing on Long Island must pay an astounding $338,252 for just one year of insurance coverage and an OB/GYN practicing in the Bronx or Staten Island must pay $186,639.   New York far surpasses all other states in terms of total medical liability payouts, per capita payments, and medical liability awards above $1 million.

They also face rapidly increasing overhead costs to remain in practice such as the huge costs associated with implementing expensive and cumbersome electronic medical record systems.  At the same time, they face reduced payments from Medicare and commercial insurers, and many practices face losses of tens of thousands, hundreds of thousands and in some cases millions of dollars in losses due to the collapse of Health Republic.

And to make matters even worse, trial lawyers are aggressively pushing the Legislature to consider additional liability expansion bills such as legislation that would eliminate the statutory limitation on contingency fees in medical liability actions, legislation that MLMIC has estimated could have the effect of raising your premiums by over 10%.   Please tell your legislators to enact comprehensive liability reform to bring down these costs, not legislation that increases them!                                                                                  (AUSTER, DEARS) 


Physicians Urged to Continue to Oppose Adverse Workers Compensation Budget Proposal
All physicians should continue to contact their State Senators and Assemblymembers to express their strong opposition to sweeping Workers’ Compensation reform proposals contained in the Executive Budget.

MSSNY staff continues to meet with key legislative leaders and staff to voice its very serious concerns with Budget proposals that would:

  • Enable treatment of injured workers and direct payment for care by various non-physicians without clarity as to: how non-physicians treating patients with serious health conditions will coordinate patient care delivery when specialized care is needed; whether existing fees will need to be cut to cover this expanded list of care providers; and whether a non-physician can perform an IME of an injured worker to review the care provided by a physician to an injured worker;
  • Expand the circumstances when a physician or other health care provider can have their authorization removed and empowers the Board to impose significant fines on a physician or any other Board-authorized health care provider for violating a Workers Compensation rule;
  • Remove the authority of county medical societies to recommend physicians to serve as treating providers or independent medical examiners under Workers Compensation, which is currently an important peer review function provided by county medical societies to assure physician applications are complete and physician applicants are appropriately qualified to deliver this needed care to injured workers.
  • Reduce choice for injured workers by prohibiting an injured worker not subject to a collective bargaining agreement from seeking medical treatment from outside a Workers Compensation PPO before 120 days after his or her first visit to a PPO provider;
  • Remove the requirement for a referral by a physician for an injured worker as a pre-condition to receive psychological care;

Exacerbating these concerns is that the proposal also does not meaningfully address the many excessive administrative hassles and payment delays that have caused many physicians to be unable to participate in the Workers Compensation program.   While there have been some modestly positive actions taken by the WCB in recent years to encourage physician participation in the WC program through removal of arbitration fees and development of an electronic portal for facilitating authorizations from carriers, the Budget proposals if enacted could further chase physicians away from the program.

MSSNY has also reached out to labor organizations and associations representing attorneys for injured workers to coordinate its advocacy in opposition.  MSSNY has also been working closely with county medical society leadership from across the State to encourage their outreach to their local Senators and Assemblymembers to request that these proposals be jettisoned from the Budget.
(AUSTER, DEARS) 


Please Urge Support for Legislation to Accord Due Process Rights When Physicians Are Non-Renewed by a Health Insurer
Legislation (A.1212, Lavine/S.4751, Hannon) is back before the full Assembly that would assure physicians are accorded a fair peer review appeals mechanism before their participation contract with a health insurance company can be non-renewed.  The legislation is in response to situations such as the disrespectful way by which Emblem treated 750 of its network physicians who were unceremoniously dropped from the network in October based upon specious allegation of failure to transition to value-based payments, severing patient treatments relationships for countless patients.  MSSNY has strenuously urged to the Department of Financial Services, Department of Health, and Attorney General that these physicians be given a fair opportunity to be reinstated, and have shared this information with the entire New York State Legislature. (See MSSNY letter to DFS here.

A.1212 passed the Assembly overwhelmingly in 2015, but not the Senate.  Physicians can send a letter in support of this legislation here.  A customizable template is provided.                                                                                                           (AUSTER, DEARS)


Urge Your Legislators to Pass Legislation to Override Insurer “Fail First” Medication Policies
Concerned about insurer policies that require your patients to “fail first” on certain prescription medications before they are able to take the medication that you believe is most medically appropriate to improve their health?  MSSNY is working together with a number of patient advocacy groups in support of legislation (A.2834-A, Titone/S.3419-B, Young) to provide physicians with an expeditious manner to override an insurer “fail first” policy when it is in the best interest of their patients’ health.  To send a letter in support of this legislation click here.  To read an op-ed in the Albany Times-Union from earlier this week from Mental Health Association CEO Glenn Liebman articulating the need for this legislation, click here. (TU password required).
(AUSTER, DEARS) 


Third Webinar on Opioid Prescribing to be Held Feb 23rd; Registration Is Now Open
The third webinar in the opioid series will be held Tuesday, February 23rd at 7:30 a.m. Physicians and other prescribers are encouraged to register for the entire webinar series at this link.

Click on the upcoming tab and select the programs.

Physicians will need to register for each webinar; each webinar has different topics described below. Physicians and other prescribers are allowed to register up to ½ hour before the webinar.

The Medical Society of the State of New York, the New York State Office for Alcoholism and Substance Abuse Service and the NYS Department of Health’s Bureau of Narcotic Enforcement, are jointly providing this free, four part webinar series on opioid prescribing.  

Entitled, “Revisiting the Role of Opioid Analgesics for Simple and Complex Patients with Chronic Pain”.  Faculty for the session will be Jeffrey Selzer, MD and the educational objective:  Describe potential for patient addiction, screening, diagnosis and subsequent treatment or referral.

The fourth webinar will be held on Thursday, March 10, 2016, 7:30 a.m. Faculty: Charles E. Argoff, MD and Charles Morgan, MD, FASAM, FAAFP, DABAM and the educational objectives:  Recommend tools to assist in the management of patients for whom opioids are indicated and prescribed; discuss strategies to reduce risk of treating pain in patients with substance use disorders.

Physicians and other prescribers can take one or all of the webinars; each webinar has been accredited for one hour of continuing medical education credits.
(CLANCY, DEARS) 


To Physicians In Long Island, NYC, Hudson Valley, and Capital District: Please Complete This Survey Regarding Impact of Proposed Cigna-Anthem Merger
As many physicians know, Anthem, the parent of Empire Blue Cross/Blue Shield, has filed paperwork to acquire CIGNA.   MSSNY has written to the New York State Department of Financial Services and Attorney General’s office to express its concerns about the impact to patient care as a result of further health insurer consolidation.

State and federal regulators are very interested in knowing the prospective effects of these possible mergers on your practice and patient care.   In this regard, MSSNY working together with the American Medical Association Advocacy Research Center have developed a survey seeking physician input on the potential impact on these proposed mergers.

Last fall, the AMA released a report articulating the significant potential anticompetitive effects that would occur in numerous regions all across the country as a result of this merger.  Among the identified regions of concern in New York State were Long Island, New York City, the Hudson Valley, the Capital District and the Glens Falls area.  Therefore, physicians practicing in these regions are asked to complete the Survey!
(AUSTER) 


Influenza Declared Prevalent in New York State Requiring Unvaccinated Health Care Workers to Wear Masks
On Thursday, New York State Health Commissioner Dr. Howard Zucker declared influenza prevalent in New York State, subsequently requiring health care workers who are not vaccinated against influenza to wear surgical or procedure masks in areas where patients are typically present.

In a statement Dr. Zucker reasoned, “Health care workers play a vital role in containing the spread of the flu…Although flu shots are a safe and effective way to reduce the risk for flu, not all health care workers choose to get vaccinated. By requiring those who are unvaccinated to wear masks when they’re around patients, we’re doing what we can to protect the most vulnerable.”

So far this year the flu has been confirmed in 44 counties and all five boroughs of New York City, along with 817 flu-related hospitalizations.

More information about influenza and NYS’ monitoring techniques can be found here.
(MCPARTLON) 

NYS DOH to Conduct Webinar Update on Zika Virus
New York State Department of Health will be offering a session of the ‘Zika Virus Webinar: an Update for Healthcare Providers’ on Wednesday February 17th, 2016 at noon. This webinar will provide updated guidance on Zika virus and review Zika virus testing eligibility, processes, and interpretation of results The webinar is being offered again to provide clinicians with another opportunity to join. Additionally, the webinar will be posted on the NYSDOH website.

Zika Virus Webinar: An Update on New Guidance and Testing for New York State Healthcare Providers

Time: 12-1pm; Presenter: Elizabeth Dufort, MD, FAAP, Medical Director, Division of Epidemiology, New York State Department of Health.
Registration
(CLANCY)


MSSNY to Sponsor Free CME Webinar On Public Health Preparedness on Feb. 17th
Public Health Preparedness 101 will be the topic of MSSNY’s Medical Matters webinar on Wednesday, February 17, 2016 with. Kira Geraci-Ciardullo, MD, MPH and Arthur Cooper, MD, MS serving as faculty.  This program is designed to help physicians and staff on how to prepare professionally and personally for a public health emergency.  The program will begin at 7:30 a.m.   Registration is now open to physicians and other public health officials:.

Go to training session and click on the upcoming sessions tab.

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.

Further information or assistance in registering for any of these programs,  may be obtained by contact Melissa Hoffman at mhoffman@mssny.org.       
(
CLANCY, HOFFMAN)

For more information relating to any of the above articles, please contact the appropriate contributing staff member at the following email addresses:          

pschuh@mssny.org ldears@mssny.org            mauster@mssny.org  
pclancy@mssny.org jMcPartlon@mssny.org    

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DOH Commissioner Zucker: Flu Prevalent in New York
On February 11, State health commissioner Dr. Howard Zucker declared flu prevalent in New York State, meaning all health care workers who are not vaccinated must wear surgical masks when dealing with patients. The flu virus has been found in 44 counties and all five boroughs of New York City, according to the state health department. There have been no flu-related deaths so far this season.   “Health care workers play a vital role in containing the spread of the flu,” Dr. Zucker said. “Although flu shots are a safe and effective way to reduce the risk for flu, not all health care workers choose to get vaccinated. By requiring those who are unvaccinated to wear masks when they’re around patients, we’re doing what we can to protect the most vulnerable, which includes the sick and the elderly.”

So far this season in New York, 817 flu-related hospitalizations have been reported, and no reports of pediatric deaths from flu. Over the last three seasons, there have been 26 pediatric flu deaths in New York and an average of 9,966 flu-related hospitalizations each season.


New Cases of Hepatitis C  Increasing In NYC
The number of New York City residents newly diagnosed with chronic hepatitis C increased to 7,691 in 2014, a 13 percent jump from 2013 and the most new cases the city has seen since 2011.” According to a new report from the city’s health department “an estimated 146,000 New Yorkers over the age of 20 – 2.4 percent of that population – have hepatitis C.” According to the report, “an estimated 146,000 New Yorkers over the age of 20 – 2.4 percent of that population – have hepatitis C.  Bedford-Stuyvesant and Crown Heights lead the city in new HIV infections, according to data.


Travel Alerts on Zika Virus
The CDC has issued a Health Advisory on Zika Virus infections for returning travelers from Central America, South America, the Caribbean, and Mexico. The CDC has also issued a Level 2 Travel Advisory for those same areas. For maps of the latest affected areas, visit the websites for the Center for Disease Control and Prevention (CDC) and the Pan American Health Organization (PAHO).
·       Health Advisory: Zika Virus Testing Process – February 9, 2016 (PDF, 112KB)
Two additional cases of Zika virus infections have been identified in Suffolk County, bringing the statewide total to 12 cases. On February 11, the CDC reported that two women who contracted the Zika virus while traveling out of the country miscarried after returning home. The virus was later found in the placentas.


Gov. Cuomo Proposes Extending Confidentiality for Minors with HIV
The New York Times (2/11) reports, “A new proposal from Gov. Andrew M. Cuomo’s office seeks” to extend “to minors the confidentiality that is already given to them for the treatment of other sexually transmitted infections.” Currently, minors in New York “generally cannot be treated or get medication to prevent its transmission without parental consent,” which physicians “say can deter minors from seeking help.” In 2013, “only 48 percent of HIV-positive people aged 13 to 24 in New York took medications that reduced their virus levels to very low levels, compared with the overall statewide rate of 63 percent, the governor’s office said.”


Do You Want to Be on IPA Task Force? Looking for Leaders Successful Models
Do You Have Expertise in Physician Stress and Burnout? We Need You!

At the 2015 House of Delegates of the Medical Society of the State of New York, a resolution was passed calling for action to address the prevalence of physician burnout.

We need your help!

We are looking to assemble the MSSNY team to tackle this work. This calls for physicians who have experience or expertise in designing or implementing physician health programs or stress/burnout programs for physicians. Please contact eskelly@mssny.org with a short bio and letter expressing your interest, expertise and what you intend to bring to the taskforce to advance the mission of the project.



Physician Entrepreneurship: Transform the Future of Health Care.

Interested in opportunities to impact medicine beyond your clinical practice? Join the AMA for an exclusive event to discuss how physicians are getting involved in and, indeed, helping to lead health care innovation.

A dynamic panel of physicians will share their perspectives, accomplishments and insights gleaned as they’ve developed new products, formed companies, advised start-ups and invested in innovative health care ventures.

WHEN: 7 p.m., Tuesday, March 1. Cocktails and hors d’oeuvres will be provided.

WHERE: Impact Hub NYC, 394 Broadway, New York, NY
Register today! Free for AMA members. Limited seating available. $500 for non-AMA members.


Opinion: Repealing Certificate-Of-Need Laws Will Improve Healthcare in NY
Nathan Nascimento, director of state initiatives at Freedom Partners Chamber of Commerce, wrote an opinion piece for the Buffalo (NY) News (2/6) arguing that the states outdated laws and regulations, “including New York’s decades old certificate-of-need laws,” are contributing to the “troubling trend” of “rising costs and fewer choices in health care.” Nascimento concluded that “for the sake of New Yorkers, all of whom deserve access to the best and most affordable health care, state legislators in Albany should start 2016 by cutting the red tape blocking the door to the doctor’s office.” Adopted in 1966, it requires New York health care providers to obtain permission from the Department of Health before adding new medical equipment, opening a new facility, expanding a current practice or even relocating.

“In practice, certificate-of-need laws drive up costs and deprive people of more health care choices. It requires reams of paperwork – forcing health care providers to satisfy bureaucrats over their patients. This is all in addition to other licenses and training requirements physicians face. Although 14 states have repealed their own versions of these laws, New Yorkers continue to deal with the negative impact of this red tape.

When health care providers submit their applications for a certificate, competitors are often invited to weigh in, and frequently succeed in blocking the certificate from being granted. In fact, practicing physicians and hospital representatives even sit on many state certificate-of-need boards, regulating the very industry in which they work.


NY Presbyterian and Northwell Run Super Bowl Ads
Crain’s New York Business (2/5) reports that “rivals New York-Presbyterian and Northwell Health” launched new television advertisements during the Super Bowl on Sunday in order “to attract new patients.” New York-Presbyterian is running a Super Bowl ad “to highlight innovation and scientific discovery at the health system and its medical schools.” Northwell Health ran three ads to “highlight the 42,000 babies delivered at Northwell hospitals each year, which was also the theme of its commercial introducing its new moniker on Jan. 1.”

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OFFICE SPACE – Sutton Place
Newly renovated medical office. Windows in every room looks out to a park like setting on the plaza level. 2-4 exam rooms/offices available, possible procedure room or gym. Separate reception and waiting area, use of 3 bathrooms and a shower. Central air and wireless. All specialties welcome. Public transportation nearby. Please call 212-772-6011 or e-mail: advocate@medicalpassport.org

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


Jerome I. Sager – Attorney at Law
The health care law experts representing medical professionals for more than 25 years.  See us for Professional Medical Conduct Defense, Medicaid and Medicare Fraud Cases, DEA and Controlled Substance Issues, Third party insurance issues. 212-685-2333 / 917-312-6631, jeromesager@cs.com.



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

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