MSSNY Passes Gun Safety Resolutions

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

 

The Medical Society of the State of New York Passes Gun Safety Resolutions
Resolutions Passed at Today’s Medical Society Annual House of Delegates Meeting

For Immediate Release

Westbury, NY, March 24, 2018—The Medical Society of the State of New York (MSSNY) today passed the following gun safety resolutions at its annual House of Delegates meeting:

  • MSSNY will support legislation that blocks the sale of any device or modification—including but not limited to bump stocks—that functionally convert a firearm into a weapon that mimics fully-automatic operation. In addition, MSSNY voted to support legislation that would ban the sale and/or ownership of high capacity magazines or clips and high speed high destruction rounds.
  • MSSNY will support legislation that requires a waiting period and background checks prior to the purchase of all firearms, including the person-to-person transfer, internet sales, and interstate transactions of all firearms.
  • MSSNY believes that gun violence in the United States is a public health crisis and will support legislation that would reverse the ban that prohibits the Center for Disease Control from researching gun related injuries, deaths and suicides related to this violence.
  • MSSNY will create a task force to study and make recommendations regarding how healthcare providers can play a role in safely sequestering a patient’s firearms to reduce the risk of suicide during a vulnerable time.

# # #

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

Press Contact:
Julie Vecchione
Medical Society of the State of New York
865 Merrick Avenue
Westbury, New York 11590
516-488-6100 x 302 / 631.697.3470 (cell)
jvecchione@mssny.org
 

March 30, 2018 – Happy Doctors’ Day

Thomas J. Madejski, MD MSSNY President

PRESIDENT’S MESSAGE
Thomas J. Madejski, MD
MSSNY President
March 30, 2018
Volume 18
Number 12


Dear Colleagues:

Happy Doctor’s Day! The day chosen is March 30th, in honor of the 91st anniversary of the first administration of ether during surgery in 1842 by Dr. Crawford Long of Georgia.  The NY Daily News is honoring our day with a pullout section today that features MSSNY articles. 

Who Am I?

For those who do not know me, I am an Internist who specializes in geriatric medicine and palliative care.  The practice of medicine has changed substantially over the last 25 years.  Many of my geriatric patients are living longer and healthier lives at the same time that a tsunami of obesity, diabetes, and disability arises in our younger population— disproportionately in people with social, economic and other challenges.

There was an article in the New York Post on Tuesday titled, “Beware: Hospitals think ‘do not resuscitate’ means you don’t want to live.  The author was concerned that a patient who chooses to forego some care, may suffer from their physicians and other caregivers not offering other useful interventions that could improve their quality of life.  While I am certain that there are some instances of a bias toward less treatment, the remedy proposed (don’t choose to limit care so that you get the care you should have) will lead to other patients receiving treatment that may cause increased discomfort, iatrogenic complications or actually hasten their demise. There are a number of factual mistakes in the article and much misinterpretation of data.  A couple of links below give some information on prognosis with CPR in patients with chronic disease. 2% or less of patients with advanced COPD, CHF, malignancy or cirrhosis who undergo CPR are discharged to home and live six months.

https://www.ncbi.nlm.nih.gov/pubmed/25086252

On the other hand, patients have a better chance of being resuscitated today.  Unfortunately, the survivors have more impairment, lower functional states and are less likely to return home.

https://www.ncbi.nlm.nih.gov/pubmed/23470471

The real world solution is listening to patients and adjusting care to their wishes after reviewing treatment options with them. We need to advocate for better implementation of advanced directives and encourage the use of MOLST Forms.

Patients celebrate Doctor’s Day because of the care and compassion you share with them during their time of greatest need.

Thanks to all of you for the difference you make one patient at a time.

I’ll Be Seeing You

We are expecting a busy legislative session this year. I hope to visit all of your districts to foster maintenance and growth in membership this year. We need more troops to enhance our voice both statewide and nationally.

Thomas J. Madejski, MD 
MSSNY President

Please send your comments to comments@mssny.org


HIT MLMIC Symposium



Northwell Physicians at 2018 House of Delegates

MSSNY - Northwell

(L-R) Dr. Carlos Zapata, Dr. Louis Auguste, Dr. Art Fougner, Dr. Marie Basile, Dr. Paul Hamlin, Dr. Penny Stern, Dr. Cara Kvilekval, Dr. Charles Rothberg, Dr. Ani Bodoutchian, Dr. Robert Schreiber, Dr. Bonnie Litvack, Dr. Michael Ziegelbaum, Dr. David Podwall, Dr. Inderpal Chhabra, Dr. Carol Moodhe



Happy National Doctors’ Day!
Today, in recognition of National Doctors’ Day, we celebrate our physician members who have dedicated their lives to taking care of all New Yorkers.  March 30th was established to recognize physicians, their work and their contributions to society and the community.

Today, we say “thank you” to our physician members for all they do to help their patients every day!

MSSNY has partnered with the NY Daily News to produce a supplement in today’s paper that celebrates the work of New York physicians. Click here to view National Doctors’ Day.

State Budget Still Not Final, But Likely to Reject Several Items Opposed by MSSNY
As of press time, it was uncertain whether the Legislature would be able to complete passage of the State Budget before the April 1 deadline.   However, they were getting close as several of the “agreed-to” Budget bills were being voted upon today.  Importantly, the Health Budget bill has rejected several Budget proposals of great concern that MSSNY together with specialty societies and other allies had been advocating against, including:

  • Independent practice authority for CRNAs
  • Authorization for corporate-owned retail clinics
  • Authorization for patient drug management protocols between Nurse Practitioners and pharmacists.  Moreover, there was a 2-year extension of the current Collaborative Drug Therapy pilot program (between physicians and pharmacists) that MSSNY supports
  • Steep Medicaid cuts to the Patient-Centered Medical Home program
  • Authorizations for EMTs to provide non-emergency care in patient homes without any express coordination requirement with that patient’s treating physician
  • Elimination of “Prescriber prevails” protections for Medicaid prescriptions
  • Provisions which would have reduced from 7 days to 3 days the length of an initial prescription for acute pain.
  • Significant expansion of the DOH’s Commissioner’s power to investigate physician misconduct, including provisions that would have a) greatly reduced the time to respond to document requests and b) expanded the power to search and seize records and equipment.  It should be noted that the final Health Budget bill did include a provision to permit the Commissioner to summarily suspend a physician who is both been charged with a felony crime and believed to be an imminent danger to the public as determined by the Commissioner.

At the same time, the Health Budget bill also included the following important items:

  • Continued funding for the Excess Medical Malpractice Insurance Program at the historical level.
  • A new $150,000 allocation for the MSSNY’s Veterans Mental Health Initiative
  • Reducing some of the insurance barriers to substance abuse treatment
  • Continued historical funding and a 5-year extension of the MSSNY Committee for Physicians Health until 2023.

Please remain alert for further updates.

NY AG, MSSNY AND AMA All Express Strong Concerns with Proposed OCR “Conscience” Rule
New York Attorney General Eric Schneiderman this week led a coalition of 19 state Attorneys General, to oppose a proposed rule of the US Department of Health and Human Services’ Office of Civil Rights (OCR) which would significantly expand the ability of businesses and individuals to refuse to provide necessary health care on the basis of businesses’ or employees’ “religious, moral, ethical, or other beliefs.”

The AG comments to OCR were submitted by the Attorneys General of New York, Connecticut, Delaware, Hawaii, Illinois, Iowa, Maine, Maryland, Massachusetts, Minnesota, New Jersey, New Mexico, Oregon, Pennsylvania, Rhode Island, Vermont, Virginia, Washington, and the District of Columbia.

At last weekend’s MSSNY House of Delegates, the physician delegates also expressed strong concern with this HHS “conscience” proposal, passing a resolution that called for MSSNY to a) speak against policies that are discriminatory and create even greater health disparities in medicine; and b) be a voice for New York’s most vulnerable populations, including sexual, gender, racial and ethnic minorities, who will suffer the most under such policies, further widening the gaps that exist in health and wellness in our nation.

The AMA also submitted a detailed letter to OCR expressing its strong concerns, noting that “the Proposed Rule would undermine patients’ access to medical care and information, impose barriers to physicians’ and health care institutions’ ability to provide treatment, impede advances in biomedical research, and create confusion and uncertainty among physicians, other health care professionals, and health care institutions about their legal and ethical obligations to treat patients. We are very concerned that the Proposed Rule would legitimize discrimination against vulnerable patients and in fact create a right to refuse to provide certain treatments or services.” (AUSTER, CLANCY)


2018 MSSNY HOD HIGHLIGHTS

Public Health and Education

  • MSSNY will support legislation to prohibit the sale of any device — such as a bump stock — that functionally converts a firearm to fully-automatic operation.
  • MSSNY will support legislation that would ban the sale and/or ownership of high capacity magazines or clips and high speed high destruction rounds.
  • MSSNY will support legislation that requires a waiting period and background checks prior to the purchase of all firearms.
  • As gun violence in the United States is a public health crisis, MSSNY will support legislation that would reverse the ban that prohibits the Center for Disease Control from researching gun related injuries, deaths and suicides related to this violence.
  • MSSNY will create a task force to study and make recommendations regarding how healthcare providers can play a role in safely sequestering a patient’s firearms to reduce the risk of suicide during a vulnerable time.

Governmental Affairs and Legal Matters A

  • MSSNY supports legislation to give discretion to the patient’s attending physician or the emergency physician to have such patient sent for skilled nursing care without having to first meet the current Medicare 3-day hospital stay pre-condition;
  • MSSNY will advocate to reduce the administrative burdens of complying with value-based payment programs and advocate to assure that these programs comply with evidence-based standards of care.
  • MSSNY will work to assure strong enforcement of the NY and federal laws that require health insurance companies to cover emergency room care when a patient reasonably believes they are in need of immediate medical attention, including the imposition of meaningful financial penalties on insurers who do not follow the law.
  • MSSNY will advocate that all pharmacies, prescription programs, and EHR vendors adopt technologies for physicians to easily cancel medications electronically.

Governmental Affairs and Legal Matters B

  • MSSNY will seek to have legislation introduced and signed into law in

New York State stipulating that a patient undergoing any medical treatment requiring anesthesia in a hospital or ambulatory surgical center, regardless of where the hospital or ambulatory surgical center is located and regardless of the type of health insurance coverage, be guaranteed that a physician-anesthesiologist will either personally administer or supervise a nurse anesthetist in the administration of anesthesia or the operative that a designated surgeon, who has agreed to medically supervise the nurse anesthetist.

  • MSSNY will advocate for patients to have a choice to receive maintenance prescriptions from either a mail order pharmacy or a brick-and-mortar pharmacy without any financial penalty, and advocate for legislation that prohibits pharmacies from charging higher prices (from pharmacy benefit managers or insurance plans) than the actual pharmacy price of the medication
  • MSSNY will support legislation to prohibit Medicare plans and HMO plans would not from changing covered drugs during the enrollment year
  • MSSNY will support the use of State funding to establish and to support addiction medicine fellowships in New York State. 

Socio-Medical Economics

  • MSSNY requests that the New York State Department of Financial Services mandate all insurance companies print current copays and deductibles and date of issue on all subscribers’ health insurance cards.
  • MSSNY will adopt the position that it is proper to remove the CLIA certification mandate requirement for physicians who only use CLIA-waived tests and physician-performed microscopy; and bring this proposal to the AMA.
  • MSSNY should call on the AMA to reimburse all AMA members for the fees they pay in relation to CPT coding; and the New York delegation to the AMA bring this resolution to the Annual Meeting of the AMA in 2018.
  • MSSNY will advocate that no providers may remit bills for services until they can document that all resources have been exhausted attaining third party reimbursement; and  when there is a balance for which the patient is responsible, that if paying the total amount due is a hardship for the patient that an installment plan be worked out; and recognizing that installment plans require extra staff time, charging a nominal fee is acceptable for such arrangements; and if it is ascertained that a beneficiary is responsible for a fee, reasonable payment options should be offered. 

Reports of Officers

  • Free county medical society and MSSNY membership for medical students (beginning in 2019)
  • Equity in Dues – HOD adopted policy that the long-term goal of MSSNY is to achieve equity in dues for all members through growth in membership.  The House of Delegates and the Council will monitor all programs created to achieve growth by enrolling members at special dues rates, to ensure that they are conducted in accordance with the MSSNY Bylaws.
  • Life Member Administration Fee – The House approved a pilot project whereby Life Members would be sent an annual statement requesting payment of a recommended voluntary administration fee of $100 to be shared equally by the county medical society and MSSNY.  


Aetna Follows United On Rebates to Customers for Medicines
Aetna announced Tuesday morning it will automatically provide pharmacy rebates to customers when they purchase their medicines. UnitedHealth Group said the same a few weeks ago. Both will provide discounts to people in fully insured commercial plans — which affects around 3 million people for Aetna.  

Antitrust Institute Calls for DOJ to Block CVS-Aetna Merger
Yesterday, the American Antitrust Institute (AAI), an antitrust research and advocacy organization whose mission is to advance the role of competition in the economy and to protect consumers, called upon the DOJ to block the merger of CVS-Aetna.

The AAI request was communicated in a persuasive and well-documented 10 page letter. It opens with a statement that “the letter adds to the concerns raised by other important voices, including the American Medical Association (AMA) and Consumers Union.” The letter concludes with the judgment that the merger would “trigger a fundamental restructuring of the US healthcare system” in ways that would “harm competition and consumers at all levels.” The AAI letter can be found here. 

SYMPOSIUM

Register Now For 2018 NY HIT Symposium on Sat. April 28 in Brooklyn

When: Saturday, April 28, 2018 8:30 a.m. – 3:00 p.m.
Where: Brooklyn Borough Hall
209 Joralemon St.
Brooklyn, NY 11201

Please join us as we examine potential risk management issues with EHR technology.

  • Liability pitfalls in EHR documentation
  • Fraud risks in documenting encounters
  • Privacy, security, and confidentiality in EHR technology


The HIT Symposium is designed for physicians in all specialties.

Supported by MLMIC and MSSNY

CME

Plague & Q Fever” CME Webinar on April 18, 2018; Registration Now Open

Upcoming in MSSNY’s Medical Matters continuing medical education (CME) webinar series is: Plague & Q Fever”.  This webinar will take place on Wednesday, April 18, 2018 at 7:30 a.m.   Faculty for this program is Kira Geraci-Ciardullo, MD, MPH.  Register for this webinar here.

Educational objectives are:

  • Describe the epidemiology of Plague and Q Fever
  • Describe the transmission of Plague and Q Fever
  • Describe the diagnosis and treatment of Plague and Q Fever
  • Explain the use of Yersinia pestis and Coxiella burnetii as a biologic weapons(s)
  • Identify infection control procedures
  • Identify resources for reporting

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

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

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

CMS

CMS Extends MIPS 2017 Data Submission Deadline
If you’re an eligible clinician participating in the Quality Payment Program, you now have until Tuesday, April to submit your 2017 MIPS performance data. You can submit your 2017 performance data using the new feature on the Quality Payment Program website.

Note: For groups that missed the March 16 CMS Web Interface data submission deadline, it’s not too late to submit your data through another mechanism.

How to Get Started

Go to qpp.cms.gov and click on “sign in” on the top right side of the web page.

  • You’ll be required to log into the Quality Payment Program data submission feature using your Enterprise Identity Management (EIDM) credentials user name and password. If you don’t have an EIDM account, you’ll need to obtain one. Review this EIDM user guide and get started with the process as soon as possible. Currently, you should allow at least 5 business days for EIDM requests to be processed.
  • After logging in, the feature will connect you to the Taxpayer Identification Number (TIN) associated with your National Provider Identifier (NPI).
  • You’ll be able to report data either as an individual or as a group. Be sure to login and get familiar with the feature before you submit your data.

Real-Time Score Projections

As you enter data into the feature, you’ll see real-time scoring projections for each of the Merit-based Incentive Payment System (MIPS) performance categories. This scoring may change if new data is reported or quality measures that have not yet been benchmarked are used.

Data can be updated at any time during the submission period. Once the submission period ends, CMS will calculate your payment adjustment based on your last submission or submission update.

Please note, your performance category score will not initially take into account your Alternative Payment Model (APM) status, Qualifying APM Participant (QP) status, or other special status—if applicable. To check your QP status, review the updated APM Lookup Tool.

Get Help and Learn More

Contact the Quality Payment Program by email at qpp@cms.hhs.gov or toll free at 1-866-288-8292, if you need help or have questions about using the data submission feature.

You can also view the data submission fact sheet and this video to learn more about the Quality Payment Program data submission feature.

Open Payments Program Year 2017 Review and Dispute Period Begins April 1st
Review and dispute for the Program Year 2017 Open Payments data begins on Sunday, April 1, 2018 and will last until May 15, 2018. During the review and dispute period physicians and teaching hospitals may review, affirm, and, if necessary, dispute their attributed records. Physicians and teaching hospitals must initiate their disputes during the 45-day review period in order for the disputes to be addressed before or reflected in the June data publication.

Note: Physicians and teaching hospitals must work directly with the reporting entity to reach a resolution. The Centers for Medicare & Medicaid Services (CMS) does not mediate or moderate disputes.

Physician and teaching hospital review of the data is voluntary, but strongly encouraged.
While the opportunity for physicians and teaching hospitals to dispute any data associated with them expires at the end of the calendar year in which the record is published, the disputes must be initiated during the 45-day review and dispute period, ending on May 15th, in order to be reflected in the June 30th publication.  CMS will publish the Open Payments Program Year 2017 data and updates to previous program year’s data in June 2018.

If You Have Never Registered In Open Payments Before:

Before you begin, make sure you have your National Provider Identifier (NPI) number and State License Number (SLN). Initial registration is a two-step process and should take approximately 30 minutes:

  1. Register in the CMS Enterprise Identity Management System (EIDM);
  2. Register in the Open Payments system

For Users That Registered Last Year and Have Used Their Accounts in the Last 60 Days:

Physicians and teaching hospitals who registered last year do not need to reregister in the EIDM or the Open Payments system. If the account has been accessed within the last 60 days, go to the CMS Enterprise Portal, log in using your user ID and password, and navigate to the Open Payments system home page.

For Users That Registered Last Year but Have Been Inactive for More than 60 Days:

The EIDM locks accounts if there is no activity for 60 days or more. To unlock an account, go to the CMS Enterprise Portal, enter your user ID and correctly answer all challenge questions; you’ll then be prompted to enter a new password.

For Users That Registered Last Year but Have Been Inactive for More than 180 Days:

The EIDM deactivates accounts if there is no activity for 180 days or more. To reinstate an account that has been deactivated, contact the Open Payments Help Desk at
1-855-326-8366.

Classified

RENTAL/LEASING SPACE

Beautiful NYC Medical Office — Long-term Share
Bright, big consultation room and one or two exam rooms in large,  tastefully furnished office in first-rate building. 58th Street between Park and Lexington. Near transportation.  Smaller, windowed consultation room and exam room also available. Rent by the day or week, beginning June 1 or sooner. $180 per day or $5500 per months. Perfect for internist, rheumatologist, physical medicine, ob-gyn and others. Superb front desk and office management available, along with many amenities including internet, ultrasound, EMG, kitchen, optional C-arm. Call Carol: 917-856-6402.


Medical Office to Sublet – Sheepshead Bay, Brooklyn
Sublet available 2-3 days per week. Features 3 exam rooms, consultation room, x-ray and waiting room. Reasonable rent. Call 917-971-1691


For Rent – Medical Office 715 W 170 Street New York
Ground floor just completed build out 4 exam rooms with sinks and wall cabinets
Waiting and reception areas, windows throughout.
Street and private entrances, two bathrooms and storage/lab/staff room.
One block to bus and two blocks to Presbyterian Medical Center and subway.
$1900-$7900/ month for one to 4 exam rooms.
Drdese@gmail.com or 917.8618273


For Share – Plastic Surgeon’s Office Facing Central Park Ground Floor Lobby Entrance/Private exit
One to three exam rooms, consult/private office and procedure room for full or part time use.
Elegant, modern and spacious secretarial, waiting and two exam rooms.
Accredited operating rooms and recovery rooms on site.
One block to bus and 20 feet to subways.
$1275-$3750/day monthly for one to three exam rooms.
Drdese@gmail.com or 917.861.8273


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


Magnificent medical suites for lease – 184 East 70th St . New York, NY.
The space has just undergone a complete STATE OF THE ART renovation.
Located in a luxury building with a separate elevator entrance on the prestigious upper east side of Manhattan, this recently renovated space is conveniently situated steps from Lenox Hill Hospital , Cornell /Columbia Presbyterian, HSS and Memorial Sloan Kettering. Includes exam rooms, new custom cabinetry, new exam beds, scale, waiting area – new furniture, new TV, water cooler etc. Space A : one consultation room plus 2 exam rooms . $6000 per month
Space B:One consultation room plus one exam room. $4500 per month
Space C: one consultation plus one exam $4500.
other combination may work as well. Available for sharing
For full details and photos see listing at http://bit.ly/2E3Zvh0 or contact Karen Tamir at 917-865-1006 or KarenTamir@Yahoo.com.  


PHYSICIAN OPPORTUNITIES

General or Vascular Surgeon Needed
Busy Vein Center in Brooklyn and Staten Island, NY is looking for a General or Vascular Surgeon,Previous experience in vein procedures is helpful but not necessary. Full-time or part-time  schedules available. For additional information please Call Muhammad Shoaib at 718-435-1777 or send resumes to shoaib@varicosecenter.com info@varicosecenter.com varicosecenter.com


Patient Navigation and Patient Advocacy Services for Your Patients
Barbara A. Brody & Associates, LTD., founded in 1992, is a private “Value–Added” resource for practices and patients. Barbara A. Brody, MPA analyses medical insurance policies, long–term care policies, and insurance billing (physicians, healthcare facilities and pharmaceutical plans). We provide an understanding of the details of Medicare, Group and Individual policies to your patients and, in return, to you and your staff.  We can help your patients with long–term claim filing and medical financial management too.  We help your patients figure out their insurance so you don’t have to.  Contact us at (212) 517–5100 or www.barbarabrody.com


Family Practice Physician – Schenectady/Amsterdam, NY
Hometown Health Centers is a Federally Qualified Community Health Center in the Upstate, Schenectady and Amsterdam, NY areas. Bi-lingual in English/Spanish is a plus.  Excellent total compensation package.  No hospital rounding. Flexible and part-time schedules available.  Sign-on bonus. For additional information please send inquiries or resumes to jobs@hhchc.org. www.hometownhealthcenters.org

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


 

New York Is 2018’s 3rd Worst State for Doctors

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

 

For Immediate Release
March 28, 2018

New York Is 2018’s 3rd Worst State for Doctors
New York Moves Up from 51st to 49th Worst State

Statement attributable to:
Thomas Madejski, MD
President, Medical Society of the State of New York

The latest report identifying New York as the 3rd worst state in the country to be a physician shows that we have a long way to go to improve New York’s practice climate.  Once again, New York’s exorbitant malpractice insurance costs  combined with low insurer payments creates an untenable squeeze that makes it exceedingly difficult to continue to be available to deliver patient care.  Make no mistake – physicians, residents and medical students make decisions about where to locate to deliver patient care based upon perception of the practice environment.  It is imperative that the Legislature and the Governor work together to advance initiatives to make  New York physician- friendly, by reducing hassles with insurance companies, controlling medical liability costs, and providing opportunities for meaningful loan repayments.  Patients who depend on physician availability deserve nothing less.”

# # #

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

Press Contact:
Julie Vecchione
Medical Society of the State of New York
865 Merrick Avenue
Westbury, New York 11590
516-488-6100 x 302 / 631.697.3470 (cell)  jvecchione@mssny.org

MSSNYeNews: Thumbs Up! Welcome Dr. Madejski

Charles Rothberg, MD - MSSNY President
PRESIDENT’S MESSAGE

Charles Rothberg, MD
March 16, 2018
Volume 18
Number 11

Dear Colleagues:

Next week is our Annual House of Delegates and I am leaving you in the capable hands of Dr. Tom Madejski. We came up the ranks together and we had brilliant mentors who taught us to follow— then lead. No one is better prepared to lead than Dr. Madejski.

My Three Pillars—Engagement, Disparity, Wellness

This year, membership was key to all of our pillars. The process was uncomfortable for some but it became apparent that we had to be more inclusive if we want to remain viable and true to our physician mission. We need the force of numbers behind our legislative platform if we want to succeed.   We must encourage big step-recruiting – group practices, employees, hospital-based specialties, private practitioners who are newly affiliated with a health care system (sometimes through no effort of their own).  We must engage physicians where and how they work.

 Every physician needs MSSNY!

As to my Three Pillar platform of Wellness, Engagement and Disparity, we made meaningful inroads that will continue as areas of concentration.

Engagement: In addition to revitalizing the way we look at membership, our communications are updated and our social media presence has expanded mightily. We have improved our relations with other medical associations such as the AMA – as evidenced by collaboration on such matters as the Anthem 25 modifier issue.  We have made an imprint on others, such as the coalition of state medical societies.

We have engaged the Health Department on education and disaster preparedness. We have fortified our relationships with MLMIC on so many physician programs. And we have collaborated with other provider stakeholders such as the hospital associations.

Big issues require partners. We continue to develop key relationships with New York and national media by delivering timely and decisive positions.  We no longer try to be conciliatory when we should be militant.

Wellness: We progressed in studying our Physician Burnout issue under Dr. Michael Privitera’s Committee.  Council approved a Peer Program and authorized us to seek the financial backing to start it. The Committee’s scientific papers will be presented at the House.

Disparity: We now have excellent representation on the AMA Committee for Disparity by Dr. Malcolm Reid and Dr. Erick Eiting.

Watch Out for the Big Players

I leave with one caveat! Adverse business practices by the mega-insurance companies is rearing its ugly head again. BCBS is instituting a policy of monitored anesthesia care by the surgeon (instead of the anesthesiologist) during common ophthalmological services (i.e. cataract extraction); Fidelis has instituted a policy requiring authorization for most of the common ultrasound procedures for OB/GYNS; another company is instituting a policy where they will not pay for a Level 4 or 5 ER visit unless the patient is admitted to the hospital. There are many other egregious activities by other plans. Anthem proposed to institute a 50% reimbursement reduction for an E & M visit performed on the same day as a procedure. With the help of the AMA and DFS, we were successful in having Anthem retreat on that proposal.

I don’t know if we have to initiate another class action lawsuit (as we did 18 years ago), but I do know as organized medicine we must speak loudly to the regulatory authorities and our legislature to curb the resurgence of these insurer directed adverse business practices that increase our burdens and decrease the quality of care.

We cannot do this alone. You need to speak to your colleagues, coworkers and any physician you know who is not a member and get them to JOIN US. The more voices, the more valid and powerful we become. If we fail, the insurers will WIN!

Not all stakeholders appreciate us.  If they were more  clever, they would leverage us as a resource. Good health and good healthcare is robust for us all – even business. Healthcare in NY would be a better system and a better product.

Credits

I thank our EVP Phil Schuh for his strong (amazing, actually) guidance and all MSSNY Division Vice-Presidents for their expertise. My predecessor Dr. Malcolm Reid “set the table for me” and I just had to “dig in.” Dr. Frank Dowling and Dr. Marie Basile are great friends, councilors AND counselors! Dr. Josh Cohen and Dr. Parag Mehta and the entire executive committee could not have been a more resourceful team. And this year’s MSSNY council was among the most thoughtful, deliberative and productive in memory. Thanks too to Past Board chair Drs. Scher and Ostuni, current chair Dr. Hamlin and the entire BOT for enabling and guiding our activities this year. And so many more on the MSSNY team.

What did I learn? We can always rely on the decency and humanity of doctors. We all seem to have innate curiosity; we are welcoming and we never seem to stop thinking and creating.

Thank you for letting me share the glory of being a physician!

Charles Rothberg, MD
MSSNY President

Please send your comments to comments@mssny.org


Capital Update


Assembly, Senate Advance Budget Proposals with April 1 Deadline In Sight
This week the Assembly and the Senate each advanced their respective “one-House” Budget proposals in reaction to the Governor’s proposed Budget.  These proposals will set the stage for intense negotiations as the Governor and the Legislature seek to finalize a State Budget by April 1.  In fact, the early arrival of Easter and Passover this year places additional incentive to reach Budget passage by Thursday, March 29.

Assembly One-House Budget

The Assembly Budget proposal deleted nearly all of the initiatives contained in the Governor’s Budget proposal that were opposed by MSSNY.  Among the proposals rejected by the Assembly:

  • Independent practice authority for CRNAs
  • Authorization for corporate-owned retail clinics
  • Authorization for patient drug management protocols between Nurse Practitioners and pharmacists
  • Steep Cuts to the Patient-Centered Medical Home program
  • Authorizations for EMTs to provide non-emergency care in patient homes without any express coordination requirement with that patient’s treating physician
  • Elimination of “Prescriber prevails” protections for Medicaid prescriptions
  • Significant expansion of the DOH’s Commissioner’s power to investigate physician misconduct, including provisions that would have a) greatly reduced the time to respond to document requests and b) expanded the power to search and seize records and equipment.  However, it included a provision to permit the Commissioner to summarily suspend a physician who is both been charged with a felony crime and believed to be an imminent danger to the public as determined by the Commissioner.

The Assembly Budget proposal also included aspects of the Governor’s proposal supported by MSSNY including maintaining the historical funding level for the Excess Medical Malpractice Insurance Program, and taxing e-cigarettes in the same manner as tobacco cigarettes. 

Click here to read MSSNY President Dr. Charles Rothberg’s comments on the Assembly Budget proposal. 

Senate One-House Budget

The Senate one-House Budget proposal also rejected a number of Executive Budget proposals opposed by MSSNY including:

  • Independent practice authority for CRNAs
  • Steep Cuts to the Patient-Centered Medical Home program
  • Elimination of “Prescriber prevails” protections for Medicaid prescriptions
  • Significant expansion of the DOH Commissioner’s power to investigate physician misconduct
  • Authorization for patient drug management protocols between Nurse Practitioners and pharmacists.

The Senate Budget proposal also contains important adds, including a new $150,000 appropriation for MSSNY’s Veterans Mental Health Initiative, and a continuation of MSSNY’s Committee for Physicians Health for an additional 5-year period, including an extension of the programs goals to address physician burnout.  The Senate Budget proposal also maintained the historical funding level for the Excess Medical Malpractice Insurance Program.

However, the Senate included language opposed by MSSNY to permit corporate-owned retail clinics, though its proposal has significant differences from the Governor’s proposal.

Moreover, the Senate Budget proposal contained a comprehensive proposal to address opioid abuse, which contains a number of important public health improvement initiatives but also several items of concern to place new restrictions on opioid prescribing (see attached article).

Click here to read MSSNY President Dr. Charles Rothberg’s comments on the Senate Budget proposal.                                                                                                                  (DIVISION OF GOVERNMENTAL AFFAIRS)

March Madness Also Begins in Albany
As both the New York State Assembly and Senate have released their “one-House” Budget proposals this week in reaction to the Governor’s proposed Budget, it sets the stage for round the clock negotiations as the Governor, Assembly and Senate seek to finalize a Budget by April 1, just two weeks away.

This is the time when physicians must be engaged in extensive grassroots communications with their legislators.   In this regard, physicians are urged to continue to contact their legislators, and make phone calls, Facebook and Twitter updates, e-mail blasts and other forms of activism on the following issues that will be on the table in the next 2 weeks: 

  • Oppose Expanding scope of practice for certified nurse anesthetists (CRNAs)

This provision would allow Certified Registered Nurse Anesthetists (CRNAs) to administer anesthesia without the supervision of a physician anesthesiologist or surgeon.  To urge your legislators to protect safe anesthesia care for patients please click here.

  • Oppose Authorizing Health Services Offered In Big Box Stores

This provision authorizes the delivery of health services in a retail setting such as a pharmacy, grocery store, or shopping mall.  Sponsors could include a business corporation.   With the recently announced proposal of drugstore chain giant and PBM operator CVS to purchase health insurance giant Aetna, this could result in an explosion of retail clinics at the expense of community physician practices. To urge your legislators to reject corporate owned retail clinics, please click here.

  • Oppose Overbroad Prescribing Restrictions (see related article)

While the Senate Budget proposal contains a number of important initiatives to respond to the heroin and opioid abuse epidemic, it also contains a number of proposals to place new restrictions on the clinical decision making authority of physicians to prescribe medications that may be needed by their patients to alleviate pain.  To urge your legislator to oppose overbroad prescribing restrictions, please click here.

  • Oppose Patient-Centered Medical Home cuts

This proposal would slash the Patient-Centered Medical Home (PCMH) add-on Medicaid payment that many primary care practices receive to help manage and coordinate needed patient care services.  Moreover, it would potentially require all PCMH primary care practices to have a Level 1 Value-Based payment contract on July 1, 2018, or face further steep cuts in PMPM payments. To send a letter click here.

  • Oppose Comprehensive Medication Management Protocols

This proposal allows nurse practitioners and pharmacists to provide comprehensive medication management to patients with a chronic disease or diseases who have not met clinical goals of therapy and are at risk for hospitalization.  Urge your legislators to reject this inappropriate scope of practice expansion.  Click here to send a letter to your legislator.

  • Oppose Repealing “Prescriber prevails” protections that currently exist in Medicaid and Medicaid Managed Care, forcing physicians to go through even more burdensome prior authorization requirements
  • Oppose Overbroad Authority to Investigate Alleged Physician Misconduct that would authorize the Commissioner of Health to obtain a warrant that would allow DOH to search and seize documents, computers and electronic devices where relevant, as well as shorten from 30 to 10 days the time allowed to respond to the Commissioner’s request for relevant information.

 (DIVISION OF GOVERNMENTAL AFFAIRS) 

Physicians Urged to Contact Legislators on the Senate’s Proposal to Further Limit Opioid Prescribing
There is a comprehensive proposal in the Senate one-House Budget to address the heroin and opioid abuse epidemic in New York.  While there are important initiatives contained within this proposal including removal of barriers to patients receiving needed treatment and an expanded drug “take back” program,  the Medical Society is concerned that this proposal may also have the effect of discouraging physicians from addressing their patients’ legitimate pain needs.

It would further limit the prescribing of an opioid medication from 7 to 3 days for an initial prescription for acute pain, require parental consent for the prescribing of an opioid to a minor and would also require a detailed written treatment plan for coverage by Medicaid and commercial payors when opioids are used for longer than 30 days.

The Medial Society is concerned that the “law of unintended consequences” could follow with further restricting what was already an arbitrary 7-day limitation on patients’ ability to receive necessary medications, such as a situation where a patient has surgery and is unable to easily return to the physician’s office or hospital if additional pain medications are necessary.  These concerns are even more magnified by reducing this 7-day limitation to three days, when many patients post-surgical pain will not have not yet abated.  Requiring parental consent for a minor to receive an opioid could also impact  on patients’ ability to receive necessary medications.  This could also set a precedent for requiring parental consent for minors for certain procedures where our laws do not require receiving such consent.  The provision to require a written treatment plan when use of opioids will be longer than 30 days significantly differs from the CDC Guidelines for the treatment of chronic pain which recommends a written treatment plan for use more than 90 days or past the time of normal tissue healing.  Physicians are encouraged to send a letter to their legislators. (CLANCY)



Register NOW for MSSNY House of Delegates Live CME Seminars on Thursday March 22nd and Friday March 23rd
The Medical Society of the State of New York will conduct three live seminars at its House of Delegates meeting on March 22nd and 23rd.  The programs are opened to all physicians in the western New York area and will be held at the Adam’s Mark Hotel, 120 Church Street, Buffalo, NY 14202.  Pre-registration is strongly suggested.  The following programs will be offered: 

Medical Matters: Disaster Medicine: Every Physician’s Second Specialty

Thursday, March 22nd, 1:00-2:00pm

Register HERE.

Faculty: Lorraine Giordano, MD, FACEP, FAADM

* Must attend in person at the House of Delegates.

Educational Objectives:

  • Identify core preparedness competencies every physician should know
  • Explore essential elements of preparedness plans for staff, patients, and family
  • Describe available courses, resources and organizations to obtain disaster preparedness education and training

Bending the Diabetes Curve

Thursday, March 22nd, 2:00-3:00pm

Register HERE.

Faculty: Geoffrey Moore, MD & Sarah Nosal, MD

* Must attend in person at the House of Delegates.

Educational Objectives:

  • Describe the trends in Type 2 diabetes and implications for clinical practice
  • Review evidence that supports referring patients with prediabetes to lifestyle change program
  • Outline the considerations for implementing a diabetes prevention initiative in a physician practice
  • Describe NYS specific incidents of prediabetes and diabetes in adult population
  • Understand the reimbursements mechanisms for DPP

Current Concepts in Concussion for Pediatric and Adult Patients

Friday, March 23rd, 1:00-2:00pm

Register HERE.

Faculty: Deborah Light, MD & John Pugh, MD, PhD

* Must attend in person at the House of Delegates.

Educational Objectives:

  • Identify signs and symptoms indicative of concussion as well as red flags that indicate alternate or more severe pathology;
  • Outline an appropriate management plan for a patient presenting with concussion including a return to “normal life” protocol;
  • Describe methods for the primary and secondary prevention of concussion;
  • Identify patients who would benefit from referral to a concussion specialist                                                                                                 (HOFFMAN)


Tickborne Diseases: An update on trends, diagnostics, and emerging infections to be presented at the MSSNY House of Delegates on March 22nd
The New York State’s Department of Health Commissioner’s Grand Rounds session titled “Tickborne Diseases” will be presented as a live seminar at the MSSNY House of Delegates on Thursday, March 22, 2018 from 3-4:30 p.m. at the Adam’s Mark Hotel, 120 Church Street, Buffalo, NY 14202.  The purpose of this presentation is to describe the epidemiology of tickborne diseases in NYS, review diagnostic approaches to tickborne diseases, and provide an update on emerging tickborne infections.

Host for the afternoon session will be NYS Health Commissioner Howard A Zucker, MD, JD.  Faculty will include C. Ben Beard, MS, PhD,  Deputy Director Division of Vector-Borne Diseases. Centers for Disease Control and Prevention; Philip Molloy, MD, Rheumatologist, Nantucket Cottage Hospital, Medical Director for Tickborne Diseases, Imugen Inc.; Michael Ryan, PhD, Director, Division of Laboratory Quality Certification, Wadsworth Center, New York State Department of Health; P. Bryon Backenson, MS, Deputy Director, Bureau of Communicable Disease Control, New York State Department of Health, Assistant Professor, Department of Epidemiology and Biostatistics, University at Albany School of Public Health.

The Grand Rounds session is offered free to all health care providers and advance registration is required.  For additional information and to register for this event please see the flyer here.

Continuing Medical Education Credits will be issued by The School of Public Health, University at Albany which is accredited by the Medical Society of the State of New York (MSSNY) to provide continuing medical education for physicians. The School of Public Health, University at Albany designates this live activity for a maximum of 1.5 AMA PRA Category 1 CreditsTM. Physicians should claim only the credit commensurate with the extent of their participation in the activity.                                                              (CLANCY)

DOH To Host Buprenorphine Training in Syracuse
The NYSDOH AIDS Institute and Onondaga County Health Department are hosting a Free Buprenorphine Waiver Eligibility Training for Clinical Providers on Saturday, April 21st, 2018 from 8:00AM to 1:00PM at the SUNY Upstate Medical University, 762 Irving Ave, Setnor Hall, Room 3509-3510, Syracuse, NY 13210.

Information is available by clicking on the following links:  location, online registration.   Further information will be sent out to confirmed attendees.  Registration closes on April 18th at 12pm.

Trainers for the event are:

Ross Sullivan, MD, SUNY Upstate Medical/Upstate University Hospital, Syracuse, NY 

Laura Martin, DO, ACR Health & MyCare Syracuse Family Practice, Syracuse, NY

Please Note: CME Credits will be made available.  This is the first half of the minimum required 8 hours of training, and the second half must be completed online after attendance to the live training.  Currently NPs & PAs are required to take an additional 16 hours of online training which is available on the PCSS-MAT website (Part 2).

Upcoming NYSDOH Spring/Summer Waiver Trainings (contact DOH for more info):
April 28th – Schenectady County
May 5th – Columbia County
June 2nd – Sullivan County
June 23rd – Dutchess County
Dates TBD – Westchester County, Broome County, Long Island

For more information about the Clinical Education Initiative and their opioid resources, please visit https://ceitraining.org/resources/opioid. For more information about NYSDOH buprenorphine related trainings, mentoring, coaching, technical assistance and more, please contact us at buprenorphine@health.ny.gov or 1-800-692-8528.            (CLANCY)


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   mauster@mssny.org  pclancy@mssny.org  

eNews

Physician Advocacy Institute Study: 42% of Physicians Are Employed by Hospitals
On March 14, the Physicians Advocacy Institute (PAI), of which MSSNY is a charter member and a member of the Board of Directors, released a report that updates a previously-released study conducted by Avalere Health that examined the continued growth in hospital acquisitions of physician practices and the trend toward physician employment. The new study adds an additional year of data to the earlier study, which reviewed the period from mid-2012 to mid-2015.

Avalere researchers found that by mid-2016, hospitals acquired an additional 5,000 medical practices, and physician employment grew 11% from a year prior.  By 2016, 42% of physicians were employed, as compared to just one in four in 2012.  In a regional analysis, researchers found growth in hospital acquisitions of medical practices in every region of the country, ranging from 83% to 205% over the four-year period.  PAI is studying these trends as part of an ongoing research collaboration with Avalere Health in order to better understand how physician employment and consolidation in the health care system affects the practice of medicine and impacts spending by payers and patients.

Invitation to MSSNYPAC Network Reception
Charles Rothberg, MD and the MSSNYPAC Executive Committee cordially invite you to attend the MSSNYPAC & Physician Advocacy Liasion Network Reception.

When:           Friday, March 23, 2018 at 3:30-5pm
Where:         Adam’s Mark Hotel Buffalo Grand Ballroom E
Admission:   FREE Open Bar * Lite Fare * Business Attire

We ask all attendees to bring a colleague to the reception (physician, resident or medical student).

Join us for a candid discussion with physicians from around the state about the PAL Network we are building, collective political action and state-wide grassroots activities.   We will explore the relationship of advocacy to patient care and how engaging with policymakers to assure patients continue to receive the care they expect and deserve is a vital aspect of the practice of medicine.

To learn more visit www.mssnypac.org/PAL

View the invitation here. RSVP to mssnypac@mssny.org or send a text to 914-933-7722 

Residency Match Is Largest Ever Per National Resident Matching Program (NRMP)
NRMP announced today that the 2018 Main Residency Match is the largest yet, with a record 37,103 US and international applicants listing program choices for 33,167 positions. The number of first-year (PGY-1) positions increased by 1383 from last year and now stands at 30,232.Of those 30,232 positions, nearly half (14,695) were in primary care: family medicine; internal medicine; internal medicine–pediatrics; internal medicine–primary; and pediatrics. Within the primary care slots, 14,333 (97.5%) were filled, and 7104 (48.3%) were filled by US allopathic seniors. Since 2014, the number of primary care positions has grown by 1713, or 13.2%. The following is the breakdown of primary care highlights from 2018.

NYT Prints Letter to Editor from MSSNY Past President Robert Goldberg

To the Editor:

The Price They Pay (Science Times, March 6) puts a face on “Why Your Pharmacist Can’t Tell You That $20 Prescription Could Cost Only $8 (news article, Feb. 25).

Anyone watching the effort by CVS to buy Aetna should be alarmed by the prospect of a future filled with medication denials and cost shifts to the sickest in our midst.

Imagine the power and conflict in having Aetna determine the tier of a drug and letting CVS bill at least a third of the list price to the patient to save Aetna money.

Worse, a person examined by a nurse in a CVS walk-in clinic may be prescribed a drug that might have a cheaper alternative. Unbeknown to the patient, the pharmacist is prohibited from revealing that.

New York State prevents doctors from owning a pharmacy, to avoid a scenario of having their patients exit through it as through a museum gift shop. The cost of drugs, the proposed merger and the gag orders translate to staggering human suffering.

ROBERT GOLDBERG
MORRISTOWN, N.J.

The writer is a past president of the Medical Society of New York State.

REGISTER NOW for MLMIC’s Free Risk Management Conference in Buffalo

When: March 22, 2018 at 9:30am
Where: Adams Mark Hotel – Buffalo, NY 

MLMIC is pleased to invite you to attend its Risk Management Conference on Thursday, March 22, 2018, at the Adams Mark Hotel in Buffalo, New York (The morning of the MSSNY House of Delegates). The program will run from 9:30 a.m. to 12:30 p.m. During this year’s event, which qualifies physicians for CME credit, experts will examine current risk management issues facing all specialties.

Topics will include:

  • Effective Coordination of Care: The Role of the Hospitalist
  • The Physician-Patient Relationship: A Closer Look
  • 2018 Healthcare Law Review

Attendance at this complimentary educational event will enable physicians to earn a maximum of 3.0 AMA PRA Category 1 Credits™
Click on the link below to register at www.mlmic.com/2018risk; or REGISTER BY E-MAIL
Forward this e-mail with your full name to pjorge@mlmic.com

To REGISTER BY FAX: Print and Fax this e-mail with your full name to 212-300-9406

MLMIC is accredited by the Medical Society of the State of New York to sponsor continuing medical education for physicians. MLMIC designates this live activity for a maximum of 3.0 AMA PRA Category 1 CME Credits™. Physicians should claim only the credit commensurate with the extent of their participation in the program.

AGENDA 

9:00-9:30 a.m.             Registration and Continental Breakfast 

9:30-10:30 a.m.           Effective Coordination of Care: The Role of the Hospitalist

                                      John Krisa, MD

                                      Hospitalist and Physician Advisor for Acute Care Troy

                                      St. Peter’s Health Partners 

10:30-11:30 a.m.        The Physician-Patient Relationship: A Closer Look

                                     Carol S. Doty, Esq. – Partner

                                     Jonathan D. Rubin, Esq. – Senior Partner

                                     Kaufman Borgeest & Ryan, LLP

 11:30-12:30 p.m        2018 Healthcare Law Review

                                     Nancy May-Skinner, Esq.

                                     Managing Attorney

                                     Fager Amsler Keller & Schoppmann, LLP 

The Legal Pitfalls of HIT Technology: Mitigating the Risks on Sat., April 28
Join the Medical Society of the County of Kings for an informative program entitled “The Legal Pitfalls of EHR Technology: Mitigating the Risks. The program is supported by both MSSNY and Medical Liability Insurance Company (MLMIC).

Topics will include the legal pitfalls of Cut and Paste, Copy Forward, Metadata, Burnout, Privacy and Security and will be presented by physicians and attorneys who are national experts in the field. There is no charge for NY physicians, NPs, PAs and invited guests. Breakfast and lunch will be provided.

When: Saturday, April 28, 2018, 8:30am-3pm
Where: Brooklyn Borough Hall, 209 Joralemon Street, Brooklyn, NY 11201

Click here for the flyer. Or contact Liz Harrison, Executive Director of the Medical Society of the County of Kings at liz@MSCK.org or 718.745.5800.

“Wave of Mergers” Leaves Long Island With Only One Independent Hospital Left
Newsday (NY) (3/15) reports there is only one independent hospital left on Long Island following “a wave of mergers.” Hospitals have merged “with larger health systems” for many reasons including access to services, funding, and increased negotiating power.

Higher Prices, Not Higher Use
The United States spends nearly twice as much on health care as 10 other wealthy nations, according to a study published on March 13 in JAMA. The study suggests that the United States does not spend more because U.S. residents use more services, but because U.S. residents pay more for procedures and treatments. 

Gun Violence: APHA Offers Free Access to Gun Violence and Public Health
The American Public Health Association is offering free access to its archive of peer-reviewed, published research on gun violence and public health. “With the Centers for Disease Control and Prevention functionally barred from conducting meaningful research on firearm violence by Congress, the public health community is stepping up to fill the knowledge gap,” said Dr. Alfredo Morabia, editor-in-chief of AJPH, in a statement. 

MIPS, NGS, CMS

MIPS Filing Deadline
By now, you should know that the deadline for filing MIPS claims data is MARCH 31. MSSNY has been working with The Physicians’ Advocacy Institute (PAI).  PAI’s MACRA resource center is here.

We have also been in contact with CMS and IPRO.  IPRO’s web page is here.  You can also contact IPRO by phone at 1-866-333-4702 or send IPRO an email.

For those of you who need help in submitting your 2017 MIPS data, we suggest that you call the MACRA Help Group at IPRO IPRO; 518-320-3508. Or complete details and the latest information, visit the CMS QPP website here. For questions, contact the QPP Service Center by phone at (866) 288-8292 or by email at QPP@cms.hhs.gov.

Revised: Important Notice Re Handwriting on Claims Submitted to Medicare
On Monday, 7/10/2017, NGS began returning paper claims submitted with handwriting on the face of the claim that is not a signature field, (i.e., Items 12, 13, or 31). A notice will be attached to the front of the returned claim and a new claim will need to be submitted.
NGS has been rolling out the return of handwritten paper claims on a state/locality basis and by June 2018, all handwritten paper claims with handwriting other than in the signature field will be returned to the provider.

NGS has published an informative article titled, “Revised: Important Notice Regarding Handwriting on Claims Submitted to Medicare.” Please click on the link to review the schedule of implementation dates and nonpaper claim submission alternatives we offer.

Classified

RENTAL/LEASING SPACE


Medical Office to Sublet – Sheepshead Bay, Brooklyn
Sublet available 2-3 days per week. Features 3 exam rooms, consultation room, x-ray and waiting room. Reasonable rent. Call 917-971-1691


 For Rent – Medical Office 715 W 170 Street New York
Ground floor just completed build out 4 exam rooms with sinks and wall cabinets
Waiting and reception areas, windows throughout.
Street and private entrances, two bathrooms and storage/lab/staff room.
One block to bus and two blocks to Presbyterian Medical Center and subway.
$1900-$7900/ month for one to 4 exam rooms.
Drdese@gmail.com or 917.8618273


For Share – Plastic Surgeon’s Office Facing Central Park Ground Floor Lobby Entrance/Private exit
One to three exam rooms, consult/private office and procedure room for full or part time use.
Elegant, modern and spacious secretarial, waiting and two exam rooms.
Accredited operating rooms and recovery rooms on site.
One block to bus and 20 feet to subways.
$1275-$3750/day monthly for one to three exam rooms.
Drdese@gmail.com or 917.861.8273


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


Magnificent medical suites for lease – 184 East 70th St . New York, NY.
The space has just undergone a complete STATE OF THE ART renovation.
Located in a luxury building with a separate elevator entrance on the prestigious upper east side of Manhattan, this recently renovated space is conveniently situated steps from Lenox Hill Hospital , Cornell /Columbia Presbyterian, HSS and Memorial Sloan Kettering. Includes exam rooms, new custom cabinetry, new exam beds, scale, waiting area – new furniture, new TV, water cooler etc. Space A : one consultation room plus 2 exam rooms . $6000 per month
Space B:One consultation room plus one exam room. $4500 per month
Space C: one consultation plus one exam $4500.
other combination may work as well. Available for sharing
For full details and photos see listing at http://bit.ly/2E3Zvh0 or contact Karen Tamir at 917-865-1006 or KarenTamir@Yahoo.com.  


PHYSICIAN OPPORTUNITIES

General or Vascular Surgeon Needed
Busy Vein Center in Brooklyn and Staten Island, NY is looking for a General or Vascular Surgeon,Previous experience in vein procedures is helpful but not necessary. Full-time or part-time  schedules available. For additional information please Call Muhammad Shoaib at 718-435-1777 or send resumes to shoaib@varicosecenter.com info@varicosecenter.com varicosecenter.com


Patient Navigation and Patient Advocacy Services for Your Patients
Barbara A. Brody & Associates, LTD., founded in 1992, is a private “Value–Added” resource for practices and patients. Barbara A. Brody, MPA analyses medical insurance policies, long–term care policies, and insurance billing (physicians, healthcare facilities and pharmaceutical plans). We provide an understanding of the details of Medicare, Group and Individual policies to your patients and, in return, to you and your staff.  We can help your patients with long–term claim filing and medical financial management too.  We help your patients figure out their insurance so you don’t have to.  Contact us at (212) 517–5100 or www.barbarabrody.com


Family Practice Physician – Schenectady/Amsterdam, NY
Hometown Health Centers is a Federally Qualified Community Health Center in the Upstate, Schenectady and Amsterdam, NY areas. Bi-lingual in English/Spanish is a plus.  Excellent total compensation package.  No hospital rounding. Flexible and part-time schedules available.  Sign-on bonus. For additional information please send inquiries or resumes to jobs@hhchc.org. www.hometownhealthcenters.org

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


 

Council March 25, 2018

 

 AGENDA
 MSSNY Council Meeting
Tuesday, March 25, 2018
Adam’s Mark Hotel
Buffalo, NY      

A. Call to Order and Roll Call

B. Approval of the Council Minutes of March 6, 2018 (pgs. 1-9)

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

1.  President’s Report
Please welcome our MSSNY Officers, Councilors, Trustees, County Execs, Guests and MSSNY Staff and the following:

Bonnie L. Litvack, MD – New Vice-President
Gregory Pinto, MD – New Fourth District Councilor
Stephen F. Coccaro, MD – New OMSS Councilor
Breyen Coffin – New Medical Student Section Councilor

 a. APPROVAL of the 2018/2019 Meeting Schedule (pg. 10)
 b. APPROVAL of the 2018/2019 Committee Appointments (pgs. 11-17)

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

  1. Membership Dues Revenue Schedule (pg. 18)
  2. Group Institutional Dues Schedule (pg. 19)

E. Reports of Councilors

1.  Nassau County Report – Paul A. Pipia, MD  (pg. 20)
2.  Suffolk County Report – Maria A. Basile, MD, MBA (pg. 21)
3.  Kings and Richmond Report – Parag H. Mehta, MD (pg. 22)

F. MESF Report  – To be presented by Dr. Malcolm Reid  (pg. 23-25)

 

Statement of MSSNY President Dr. Charles Rothberg in response to NYS Senate Budget Proposal


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

 

For Immediate Release
March 14, 2018

Statement of MSSNY President Dr. Charles Rothberg in response to
NYS Senate Budget Proposal

“We thank Senators Flanagan and Klein and the Senate Republican and Independent Democratic conferences for their support of a number of important measures in their one-House Budget proposal.  These include continued support for the Excess Medical Malpractice Insurance Program, additional support for Veterans’ Health care needs, and support for the continuation of the critically important services being provided through the Committee for Physician’s Health program.  We also thank them for opposing several problematic proposals in the Executive Budget that would reduce the ability of patients to continue to receive needed care from their physicians, including provisions that would expand burdensome  pre-authorization requirements for medications needed by patients covered by Medicaid, impose steep cuts for physicians participating in the Patient Centered Medical Home program, and inappropriately expand independent practice authority for nurse anesthetists.

We agree about the continuing need for aggressive efforts to address our heroin and opioid abuse epidemic.  New York physician leaders have been extensively involved in efforts to respond to this public health crisis.  At the same time, it is essential that as measures are developed there is a proper balance struck between efforts to address and prevent opioid abuse and assuring that prescribers do not face undue barriers so that their patients can receive the medications they need.  We look forward to continued discussions on all these issues as the Senate, Assembly and Governor seek to finalize a State Budget over the next 2 weeks.”

# # #

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

 

Media Contact:
Roseann Raia
Communications / Marketing
Medical Society of the State of New York
516.488.6100
rraia@mssny.org

 

Statement of MSSNY President Dr. Charles Rothberg in response to Assembly Budget Proposal


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

 

For Immediate Release
March 13, 2018

Statement of MSSNY President Dr. Charles Rothberg in response to Assembly Budget Proposal

“We thank Assembly Speaker Carl Heastie and the Assembly Democratic Conference for their continued support of the Excess Medical Malpractice Insurance Program in their one-House Budget proposal, as well as for opposing several problematic proposals in the Executive Budget that would reduce the ability of patients to continue to receive needed care from their physicians.  These problematic provisions would have expanded burdensome  pre-authorization requirements for medications needed by patients covered by Medicaid, imposed steep cuts for physicians participating in the Patient Centered Medical Home program, authorized corporate/insurance company owned ‘retail clinics’ that will harm patient access to physician-led medical homes, and inappropriately expanded independent practice authority for nurse anesthetists.  We look forward to working with the Legislature to assure these provisions are not included in the final State Budget being negotiated between the Assembly, Senate and the Governor”

# # #

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

 

Media Contact:
Julie Vecchione
Medical Society of the State of New York
865 Merrick Avenue
Westbury, NY 11590
516.488.6100 x 340 (o)
631.697.3470 (cell)
jvecchione@mssny.org

 

 

March 9, 2018 – Making Lemonade Out of Snow

Charles Rothberg, MD - MSSNY President
PRESIDENT’S MESSAGE

Charles Rothberg, MD
March 9, 2018
Volume 18
Number 10

Dear Colleagues:

Making Lemonade Out of Snow

The 2018 Lobby Day scheduled for Wednesday, March 7, promised to be best attended showing in a decade. Top legislative leaders were all teed up to speak at the Egg for an informative program, and almost all Council members came for the Annual Albany Council Meeting. All hands were on deck.

Then, Mother Nature had an alternate plan— which was to dump at least a foot of snow on Albany and all points south on Tuesday night and Wednesday.  Governor Cuomo put a Travel Ban in place and the Legislative Session for Wednesday was canceled— an extremely rare occurrence. Since the legislators left town to beat the storm, the Executive Committee agreed that there was no point in going ahead with the schedule and risking people’s safety.

The 2018 MSSNY Lobby Day was canceled. We definitely made the right decision. It snowed in Albany, beginning at 11:21PM on Tuesday and continued for 23 hours!

However, with many physician leaders already in Albany, there was still advocacy to be done!

On Wednesday morning, a contingent of physicians and staff consisting of Drs. Frank Dowling, President Elect Tom Madejski, Councilor Marie Basile, Suffolk County Executive Aaron Kumar and myself had the opportunity to have a lengthy meeting with Senate Majority Leader John J. Flanagan (2nd District Suffolk County) and his top staff that may have been cut short had we not had the “snow day.” It was a great opportunity to discuss the litany of concerns we have in the proposed State Budget (see below), as well as push for the collective negotiation bill.

MSSNY Councilors meet with NYS Senate Majority Leader John J. Flanagan (center). Dr. Frank Dowling;President Elect Dr. Tom Madejski; MSSNY President Charles Rothberg; Dr. Marie Basile; and Suffolk County Executive Aaron Kumar.

We also had a very good meeting with Senate Democratic Conference Leader Andrea Stewart Cousins (35th District Westchester), who was well versed in the issues that face New York’s physicians’ and their patients. And we had the opportunity to meet with one of the top advisors to Senate Independent Conference leader Jeff Klein.

I thank our hard working staff for all their work in pulling this day together. However, sometimes the best laid plans do not come to fruition.

Don’t worry, legislators, we will be back in full force for the 2019 Lobby Day!  We also hope to identify a Tuesday in May when we may have another contingent of physicians come to Albany to press for our top priority bills as the Legislature makes its final push towards the end of the Legislative Session.  We hope there will be no snow then! 

In the meantime, please continue to contact your legislators on our key priority issues as the State will finalize its State Budget in three weeks.  While our Albany staff will be meeting with all of our legislators regularly to keep them apprised of our positions and agendas for this session, legislators need to continue to hear directly from you – their constituents.

Charles Rothberg, MD
MSSNY President

Please send your comments to comments@mssny.org



Capital Update

Budget Negotiations Starting to Heat Up
Both houses of the legislature are expected to release their one-house budget proposals next week.  This should give Physicians insight on where the Senate and Assembly stand on a number of Governor Cuomo’s budget proposals.

Budget negotiations will then begin to heat up and we must continue to apply pressure on the legislature to ensure that our voices are heard.  It is important for physicians to continue to be engaged in the budget process all the way until the end.  While the one house budget proposals are very important, the Governor  has a significant amount of influence and power in the budget process.

The budget will be negotiated at all hours of the day and night.  Additionally, MSSNY staff will usually be updated on various developments in negotiations.  The final budget agreement is due by April 1.

MSSNY members are also urged to continue to contact their legislators, and make phone calls, Facebook and Twitter updates, e-mail blasts and other forms of activism. Among the many issue’s.

  • Oppose Expanding scope of practice for certified nurse anesthetists (CRNAs)

This provision would allow Certified Registered Nurse Anesthetists (CRNAs) to administer anesthesia without the supervision of a physician anesthesiologist.  To urge your legislators to protect safe anesthesia care for patients please click here.

  • Oppose Authorizing Health Services Offered In Big Box Stores

This provision authorizes the delivery of health services in a retail setting such as a pharmacy, grocery store, or shopping malls.  Sponsors could include a business corporation.

With the recently announced proposal of drugstore chain giant and PBM operator CVS to purchase health insurance giant Aetna, this could result in an explosion of retail clinics at the expense of community physician practices. To urge your legislators to reject corporate owned retail clinics, please click here.

  • Oppose Patient-Centered Medical Home cuts

This proposal would slash the Patient-Centered Medical Home (PCMH) add-on Medicaid payment that many primary care practices receive to help manage and coordinate needed patient care services.  Moreover, it would potentially require all PCMH primary care practices to have a Level 1 Value-Based payment contract on July 1, 2018, or face further steep cuts in PMPM payments. Please send a letter here click here.

Additional budget items of great concern include:

  • Repealing “Prescriber prevails” protections that currently exist in Medicaid and Medicaid Managed Care,  forcing physicians to go through even more burdensome prior authorization requirements.
  • Eliminating the Empire Clinical Research Investigator Program (ECRIP).
  • Consolidating 30 public health appropriations into four pools, and reduce overall spending by 20 percent.
  • Comprehensive Medication Management Protocols

This proposal allows nurse practitioners and pharmacists to provide comprehensive medication management to patients with a chronic disease or diseases who have not met clinical goals of therapy and are at risk for hospitalization.  Urge your legislators to reject this inappropriate scope of practice expansion. Click here to send a letter to your legislator.

  • Community Paramedicine

This proposal would allow emergency medical personnel to provide non-emergency care in residential settings.  While a laudable goal, the bill language only includes general references to collaboration with the patient’s treating providers, rather than specific requirements to communicate with actively treating physicians and other care providers.  To protect proper continuity and coordination of patient care with treating providers, please click here to send a letter to your legislator. 

Additionally please click below to see the various joint letters with other organizations that MSSNY has been closely working with: 

Sign-On letter to reject Governor’s Budget Bill regarding a nurse anesthetist to independently administer anesthesia

Sign-On letter rejecting the proposal to authorize retail clinics

Final Version of PCMH Letter

Sign On Letter Comprehensive Medical Management (CMM)  

Sign On Letter Community Paramedicine Program (CPP)                                

Sign On Letter Prescriber Prevails click here                                                           (DIVISION OF GOVERNMENTAL AFFAIRS)

Legislation Introduced by Senate Health Committee Chair to Reduce Prior Authorization Hassles Based on AMA Prior Authorization Principles
As physicians and patients continue to raise concerns regarding the increasing burden of health insurer imposed pre-authorization requirements, legislation (S.7872/A.9588) has been introduced by Senate Health Committee Chair Kemp Hannon and Assembly Health Committee Chair Richard Gottfried to help reduce some of these administrative hassles.  The legislation is consistent with elements of a recently released document entitled Prior Authorization and Utilization Management Reform Principles, developed by the American Medical Association, American Hospital Association, Medical Group Management Association, American Pharmacists Association, and Arthritis Foundation along with several other health and patient advocacy associations including MSSNY. Among the elements include:

  • Requiring health plan utilization review criteria to be evidence-based and peer reviewed ;
  • Reducing the time frame for reviewing prior authorization requests from 3 business days to 48 hours (and to 24 hours for urgent situations);
  • Assuring that a prior authorization, once given, is enduring for the duration of the medication or treatment.
  • Prohibiting mid-year prescription formulary changes; and
  • Assuring that once a prior authorization is given, it cannot be withdrawn if eligibility is confirmed on the day of the service.

MSSNY together with NY Academy of Family Physicians & the NY Chapter of The American College of Physicians advocated for the introduction of this legislation. Legislation to reduce prior authorization hassles is more important than ever.

For example, a recent study by Milliman noted that insurers’ use of burdensome prior authorization and step therapy requirements for many prescription medications nearly doubled between 2010 and 2015. And a recent Annals of Internal Medicine study reported that physicians spend two hours on administrative work for every hour with a patient.

While legislation is one route to address these hassles, another route is direct discussion among representative organizations. For example, recently the AMA and the American Hospital Association joined with organizations representing health insurers (AHIP and the Blue Cross Blue Shield Association) in a consensus statement click here to work for “improvement in prior authorization programs”.  And last week, the AMA and Anthem jointly announced collaborative efforts on a number of fronts, including working to “streamline and/or eliminate low-value prior authorization requirements” click here      (AUSTER)

Join MSSNY’s Physician Advocacy Liaison Network
One of the most frequent comments raised at MSSNY DGA staff’s various meetings with Legislatures and their staff is the importance of hearing their physician constituents’ experiences, stories, knowledge and expertise.  This is why participating in MSSNY’s PAL program is so important.  Please see the information below on how to sign up to become a PAL.

With so many changes occurring in our health care system, and other opposing interests seeking to marginalize the physician’s role as leader of the health care team, we must make up for it with an overwhelming presence in grassroots activity that will make it impossible for legislators to ignore.

Physicians must mobilize and become more active in the legislative and budget process to better ensure the enactment of favorable legislation and the defeat of proposals that will adversely impact the care that you provide to your patients. Click click here to sign up to be a PALNext week on March 15 there will be a special briefing for PAL members on the State Budget negotiations.                                                                       (BELMONT)



Legislature Passes Bill to Restrict PBM Gag Clauses
Legislation (S.6940, Hannon) passed the Senate this week to prohibit Pharmaceutical Benefit Managers (PBMs) from prohibiting or penalizing pharmacists from disclosing to individuals the cost of a prescription medication and the availability of therapeutically equivalent alternatives or alternative payment methods, such as paying cash, that may be less expensive.  The legislation would also prohibit the imposition of a copayment that exceeds the total submitted charge by the pharmacy and prohibits a PBM from redacting or recouping the adjudicated cost from the pharmacy.

Identical legislation (A.8781,Rosenthal) passed the Assembly earlier this Session.  Earlier this week, the MSSNY Council passed a resolution calling for an end to such gag clauses in response to multiple media reports highlighting PBM practices that prohibited pharmacists from telling patients that they could save money by paying cash for prescription drugs rather than using their health insurance.                                                                        (AUSTER)

AG Fines Emblem for Inappropriate Disclosures in Mailing
New York Attorney General Eric Schneiderman this week announced a settlement with EmblemHealth after the health insurance company admitted a mailing error that resulted in 81,122 social security numbers being disclosed on a mailing. In addition to paying a $575,000 penalty, EmblemHealth agreed to implement a Corrective Action Plan and conduct a comprehensive risk assessment.

The AG’s press release please click here notes that, in October 2016, Emblem discovered that it had mailed over 80,000 policyholders a paper copy of their Medicare Prescription Drug Plan Evidence of Coverage (“EOC Mailing”) that included a mailing label with the policyholder’s social security number on it.  In addition to the financial penalty, Emblem is also required to implement a Corrective Action Plan that includes a thorough risk analysis of security risks associated with the mailing of policy documents to policyholders, and submit a report of those findings to the Attorney General’s office within 180 days of the settlement.
(AUSTER)

Tickborne Diseases: An update on trends, diagnostics, and emerging infections to be presented at the MSSNY House of Delegates on March 22nd
The New York State’s Department of Health Commissioner’s Grand Rounds session title Tickborne Diseases will be presented as a live seminar at the MSSNY House of Delegates on Thursday, March 22, 2018 from 3-4:30 p.m. at the Adam’s Mark Hotel, 120 Church Street, Buffalo, NY 14202.  The purpose of this presentation is to describe the epidemiology of tickborne diseases in NYS, review diagnostic approaches to tickborne diseases, and provide an update on emerging tickborne infections.

Host for the afternoon session will be NYS Health Commissioner Howard A Zucker, MD, JD.  Faculty will include C. Ben Beard, MS, PhD,  Deputy Director Division of Vector-Borne Diseases. Centers for Disease Control and Prevention; Philip Molloy, MD, Rheumatologist, Nantucket Cottage Hospital, Medical Director for Tickborne Diseases, Imugen Inc.; Michael Ryan, PhD, Director, Division of Laboratory Quality Certification, Wadsworth Center, New York State Department of Health; P. Bryon Backenson, MS, Deputy Director, Bureau of Communicable Disease Control, New York State Department of Health, Assistant Professor, Department of Epidemiology and Biostatistics, University at Albany School of Public Health.

The Grand Rounds session is offered free to all health care providers and advance registration is required.  For additional information and to register for this event please see the flyer here.

Continuing Medical Education Credits will be issued by The School of Public Health, University at Albany which is accredited by the Medical Society of the State of New York (MSSNY) to provide continuing medical education for physicians. The School of Public Health, University at Albany designates this live activity for a maximum of 1.5 AMA PRA Category 1 CreditsTM. Physicians should claim only the credit commensurate with the extent of their participation in the activity.                                                              (CLANCY)

Register NOW for MSSNY House of Delegates Live CME Seminars on Thursday March 22nd and Friday March 23rd
The Medical Society of the State of New York will conduct three live seminars at its House of Delegates meeting on March 22nd and 23rd .  The programs are opened to all physicians in the western New York area and will be held at the Adam’s Mark Hotel, 120 Church Street, Buffalo, NY 14202.  Pre-registration is strongly suggested.  The following programs will be offered: 

Medical Matters: Disaster Medicine: Every Physician’s Second Specialty
Thursday, March 22nd, 1:00-2:00pm
Register HERE.

Faculty: Lorraine Giordano, MD, FACEP, FAADM

* Must attend in person at the House of Delegates.

Educational Objectives:

  • Identify core preparedness competencies every physician should know
  • Explore essential elements of preparedness plans for staff, patients, and family
  • Describe available courses, resources and organizations to obtain disaster preparedness education and training

Bending the Diabetes Curve
Thursday, March 22nd, 2:00-3:00pm
Register HERE.

Faculty: Geoffrey Moore, MD & Sarah Nosal, MD

* Must attend in person at the House of Delegates.

Educational Objectives:

  • Describe the trends in Type 2 diabetes and implications for clinical practice
  • Review evidence that supports referring patients with prediabetes to lifestyle change program
  • Outline the considerations for implementing a diabetes prevention initiative in a physician practice
  • Describe NYS specific incidents of prediabetes and diabetes in adult population
  • Understand the reimbursements mechanisms for DPP

Current Concepts in Concussion for Pediatric and Adult Patients
Friday, March 23rd, 1:00-2:00pm
Register HERE.

Faculty: Deborah Light, MD & John Pugh, MD, PhD

* Must attend in person at the House of Delegates.

Educational Objectives:

  • Identify signs and symptoms indicative of concussion as well as red flags that indicate alternate or more severe pathology;
  • Outline an appropriate management plan for a patient presenting with concussion including a return to “normal life” protocol;
  • Describe methods for the primary and secondary prevention of concussion;
  • Identify patients who would benefit from referral to a concussion specialist        (HOFFMAN)


Dr. Kenneth Offit Makes Presentation to MSSNY Council on the BRCA Founder Outreach Study
Dr. Kenneth Offit, Chief of the Clinical Genetics Service at Memorial Sloan Kettering Cancer Center, presented information on the BRCA Founder Outreach (BFOR) Study at this week’s MSSNY Council meeting. The study is an innovative research initiative that will use an online platform and other novel approaches to health care delivery to address a longstanding, unmet need: access to screening for BRCA mutations. It has significant potential to save lives and advance progress in the emerging field of precision medicine. The BFOR study offers individuals no-cost BRCA testing for three mutations found in those of Ashkenazi ancestry. BRCA Mutations increase risk for breast, ovarian and prostate cancer.

Men and women at least 25 years old with at least 1 Ashkenazi Jewish grandparent are eligible. Participants register online and supply a DNA sample at a nearby lab.  The study seeks to learn how many participants will choose to receive their BRCA results through their primary care provider (PCP) or from the study staff.  If they choose their own provider, the PCP will have the option to disclose the genetic test results.  If a PCP prefers not to disclose the results, the study staff will take this role.  If a PCP chooses to disclose results, study staff will provide educational material to inform patient counseling and recommend additional testing if needed. Physicians and patients can learn more about eligibility for the study through the attached information sheet please click here or at www.bforstudy.com or by calling 1-833-600-BFOR.                                                  (CLANCY)

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   mauster@mssny.org  pclancy@mssny.org  

eNews

Council Notes—March 6, 2018

  • Kenneth Offit, MD, MPH presented an update on a NY cancer screening effort focused on physician involvement. The BRCA Founder Outreach Study (BFOR) is a research initiative that will use an online platform to address a longstanding, unmet need: access to screening for BRCA mutations. Dr. Offit is Chief of the Clinical Genetics Service and Vice Chairman, Academic Affairs, Department of Medicine at Memorial Sloan Kettering Cancer Center. Learn more at bforstudy.com
  • Donald Moore, MD, MPH, Chair, MSSNY’s HIT Committee, presented a proposal regarding a program that will focus on the legal pitfalls of EHR Technology and how to mitigate the liability risks to physicians. MSSNY pledged support, along with the Medical Society of the County of Kings, to sponsor, promote and implement a statewide, 5 credit CME/HIT Symposium and Expo at the Brooklyn Borough Hall on Saturday, April 28, 2018.
  • Council approved a new pilot project to facilitate recruitment of new members and former members who return after an absence of at least two years. The program will include a low introductory dues rate in participating counties and a schedule of gradually increasing dues over the course of four years.
  • Council passed the following resolutions:
  1. MSSNY will support the creation of a state-wide clinical preceptorship tax credit for community based and hospital based health care practitioners and that any necessary documentation for the tax credit be contained in a simplified form to encourage participation in the program. The resolution will be sent to the AMA for consideration.
  2. MSSNY and the AMA and the American Osteopathic Association will communicate with US medical schools to study the inclusion of clinician-performed, point-of-care ultrasound instruction and training. The resolution will be sent to the AMA for consideration.


UHC’s Physician Advisory Council; Tell Us Now if You have Issues with United!
As part of the last legal settlement with United that was concluded in 2015, United agreed to the formation of a Committee referred to as the PAC – Physician’s Advisory Council.  The Medical Society of the State of New York has four physician members who are on the UHC PAC.  The Committee meets four times a year with similarly named physicians from United.  One criteria for being on this group is that the physician must be participating with United.

The Committee is charged with addressing any issue of contention, either operational or administrative, that might be encountered in dealing with United. While issues are discussed at length, the agreement stipulates that UHC is there to listen and report back to the UHC leadership on items discussed.  United does not present new policy matters to the PAC.  However, the group could discuss United policy issues that cause concern and these concerns would then be taken back the leadership for their thoughts and/or action.

The spirit of the settlement agreement is that MSSNY could share subject matters at a high level to garner a better relationship with UHC.  Our next meeting is Tuesday night, March 13th.  In this spirit, MSSNY is asking members if they have specific issues with United that we can address and advocate for your behalf.  If you have a concern, please send an email to Regina McNally, VP, Socio-Medical Economics.  Please state the subject as UHC PAC Item and send your email to rmcnally@mssny.org  MSSNY email is not HIPAA-secure, so please do NOT include any PHI!

RAND: Many NY Healthcare Providers Not Prepared to Care for Veterans
Fierce Healthcare (3/5) reports researchers concluded that New York healthcare providers are “almost manifestly incapable of caring for veterans, according to a new study by RAND Corp.

Researchers “surveyed 746 providers across the state of New York,” and found that “only 2% of civilian physicians and other medical providers are capable of providing quality care in a timely manner.”

UnitedHealth Tightens Reins on Emergency Department Reimbursement
The nation’s largest health insurer, UnitedHealth Group, is following rival Anthem’s footsteps with a new payment policy aimed at reducing its emergency department claims costs. (Modern Healthcare 03/07).

Under the policy, rolled out nationwide March 1, UnitedHealth is reviewing and adjusting facility claims for the most severe and costly ED visits for patients enrolled in the company’s commercial and Medicare Advantage plans. Hospitals that submit facility claims for ED visits with Level 4 or Level 5 evaluation and management codes—codes used for patients with complex, resource-intensive conditions—could see their claims adjusted downward or denied, depending on a hospital’s contract with the insurer, if UnitedHealth determines the claim didn’t justify a high-level code.

Minnetonka, Minn.-based UnitedHealth said the policy is meant to ensure accurate coding among providers. But hospitals fear the policy could squeeze reimbursement even further and lead to lower revenue.

UnitedHealth’s policy is different from Indianapolis-based Anthem’s, which has been denying coverage for ED visits that it decides were not emergencies after the fact. But both policies are aimed at lowering the insurers’ spending on ED claims.

Cigna Nears Deal to Buy Express Scripts
Health insurer Cigna is nearing a deal to buy Express Scripts, according to people familiar with the matter. A deal could be announced as soon as today, the people said. As of Wednesday, Express Scripts, a pharmacy-benefits manager, had a market value of $41 billion, meaning that with a typical premium the transaction could be worth $50 billion or more.

The combination would be the latest in a flurry of proposed tie-ups in the rapidly changing healthcare-services business. (WSJ, 3/8)

JAMA: Opioids No Better than Nonopioids for Easing Common Chronic Pain
Edited by David G. Fairchild, MD, MPH, and Lorenzo Di Francesco, MD, FACP, FHM

Opioids are not better than nonopioid drugs for relieving back pain or pain related to hip or knee osteoarthritis, a JAMA study finds.

Nearly 250 patients with moderate-to-severe chronic back pain or hip or knee osteoarthritis pain were randomized to receive either opioids or nonopioids. In the opioid group, patients began taking immediate-release opioids and could be stepped all the way up to fentanyl patches (maximum daily dosage, 100 morphine-equivalent mg). For nonopioids, patients began with acetaminophen or nonsteroidal anti-inflammatory drugs and could be stepped up to drugs requiring authorization from the clinic, including pregabalin.

The primary outcome — pain-related function — was similar between the groups over 12 months. Pain intensity, a secondary outcome, was significantly better with nonopioids (improvement of 0.5 on a 10-point scale). Opioid recipients had more medication-related symptoms.

The authors conclude that their findings do not support starting opioids in such patients.
JAMA article (Free abstract)

Trump Initiative: Provide Consumers with Greater Access to Their Medical Data
Bloomberg News (3/6) reports that the Trump Administration intends to provide consumers with “greater access to their medical data,” CMS Administrator Seema Verma said on Tuesday at a Las Vegas conference for health IT professionals. Verma is quoted as saying, “At a time when health-care data is being generated from so many sources, too often that data runs into the hard walls of closed systems that hold patients, and their information, hostage.” AP (3/6) reports that the Administration plans to launch a new initiative called MyHealthEData, which will “make electronic medical records easier for patients to use.” The effort “will be overseen by the White House Office of American Innovation, headed by presidential son-in-law Jared Kushner.”

The goal “is to reduce the time and costs associated with compliance, Verma said, but CMS will also be ‘laser focused’ on giving patients better access to their medical data.” Verma criticized the practice of “data blocking” which prevents “patients from sharing records outside of a particular hospital.”

FDA, MIPS, Coding Tips

FDA’s Gottlieb Criticizes Drug Supply Chain for Higher Costs
FDA administrator Scott Gottlieb criticized pharmaceutical companies, pharmacy benefit managers, and insurers for “Kabuki drug-pricing constructs” that he says unnecessarily raise drug costs. “Patients shouldn’t face exorbitant out-of-pocket costs, and pay money where the primary purpose is to help subsidize rebates paid to a long list of supply chain intermediaries,” Gottlieb told a conference attended by health insurers. “Sick people aren’t supposed to be subsidizing the healthy.”

Bloomberg News reported that Gottlieb placed most of the blame on the high levels of market consolidation among PBMs, distributors, and drug stores that stifle competition. He was particularly critical of how that system treats generic and biosimilar medication.

PAI’s QPP Tip of the Month
Physicians Have Until March 31, 2018 to Submit 2017 MIPS Performance Data and Avoid a -4% Payment Adjustment in 2019
Physicians have until March 31 to submit their 2017 MIPS performance data to avoid a negative payment adjustment in 2019. These data can be submitted through the CMS QPP submission portal. With the 2017 Merit-based Incentive Payment System (MIPS) reporting deadline fast approaching, you may be unsure of or need additional information on what steps you need to take to submit your 2017 MIPS participation data. PAI has gathered the most helpful CMS resources that provide you with step-by-step instructions on submitting your 2017 MIPS data:

Additional resources on the QPP, MIPS, and Advanced APMs are also available on PAI’s MACRA QPP Resource Center. Please note that resources for the 2017 performance year are still available to help you with your 2017 MIPS submission; updated materials for 2018 MIPS participation will be made available by PAI on March 15, 2018.

Coding Tip of the Week

Why Is Medicare Denying My Claims for Mammography and Breast Biopsies?
By Jacqueline Thelian, CPC, CPC-I, CHCA, CPMA Medco Consultants, Inc.

When Medicare updated their systems with the updates to mammography and breast biopsy policies some ICD-10-CM codes were inadvertently left out.

The omitted new codes are N63.11-N63.14, N63.21-N63.24, N63.31, N63.32, N63.41, and N63.42, which will replace the truncated ICD-10 diagnosis N63.

The Centers for Medicare & Medicaid Services (CMS) will correct the policies with its next update, which is scheduled for April 1. But CMS did not require its Medicare contractors to reprocess the denied claims.

CMS has instructed MACs to adjust any claims brought to their attention that were processed in error for any of the NCDs included in CR 10318. These adjustments will not take place until after April 2, 2018 unless otherwise noted.

National Government Services (NGS) has already updated their system and will reprocess claims upon the provider’s request.

Source: CMS Transmittal 2005 ICD-10-CM and other Coding Revisions to National Coverage Determinations (NCDs)

If you have a coding or compliance question you would like to have answered please send your question to MSSNY at eskelly@mssny.org, and complete the subject line with Tip of the Week.

Classified

RENTAL/LEASING SPACE


Medical Office to Sublet – Sheepshead Bay, Brooklyn
Sublet available 2-3 days per week. Features 3 exam rooms, consultation room, x-ray and waiting room. Reasonable rent. Call 917-971-1691


 For Rent – Medical Office 715 W 170 Street New York
Ground floor just completed build out 4 exam rooms with sinks and wall cabinets
Waiting and reception areas, windows throughout.
Street and private entrances, two bathrooms and storage/lab/staff room.
One block to bus and two blocks to Presbyterian Medical Center and subway.
$1900-$7900/ month for one to 4 exam rooms.
Drdese@gmail.com or 917.8618273


For Share – Plastic Surgeon’s Office Facing Central Park Ground Floor Lobby Entrance/Private exit
One to three exam rooms, consult/private office and procedure room for full or part time use.
Elegant, modern and spacious secretarial, waiting and two exam rooms.
Accredited operating rooms and recovery rooms on site.
One block to bus and 20 feet to subways.
$1275-$3750/day monthly for one to three exam rooms.
Drdese@gmail.com or 917.861.8273


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


Magnificent medical suites for lease – 184 East 70th St . New York, NY.
The space has just undergone a complete STATE OF THE ART renovation.
Located in a luxury building with a separate elevator entrance on the prestigious upper east side of Manhattan, this recently renovated space is conveniently situated steps from Lenox Hill Hospital , Cornell /Columbia Presbyterian, HSS and Memorial Sloan Kettering. Includes exam rooms, new custom cabinetry, new exam beds, scale, waiting area – new furniture, new TV, water cooler etc. Space A : one consultation room plus 2 exam rooms . $6000 per month
Space B:One consultation room plus one exam room. $4500 per month
Space C: one consultation plus one exam $4500.
other combination may work as well. Available for sharing
For full details and photos see listing at http://bit.ly/2E3Zvh0 or contact Karen Tamir at 917-865-1006 or KarenTamir@Yahoo.com.  


PHYSICIAN OPPORTUNITIES

General or Vascular Surgeon Needed
Busy Vein Center in Brooklyn and Staten Island, NY is looking for a General or Vascular Surgeon,Previous experience in vein procedures is helpful but not necessary. Full-time or part-time  schedules available. For additional information please Call Muhammad Shoaib at 718-435-1777 or send resumes to shoaib@varicosecenter.com info@varicosecenter.com varicosecenter.com


Patient Navigation and Patient Advocacy Services for Your Patients
Barbara A. Brody & Associates, LTD., founded in 1992, is a private “Value–Added” resource for practices and patients. Barbara A. Brody, MPA analyses medical insurance policies, long–term care policies, and insurance billing (physicians, healthcare facilities and pharmaceutical plans). We provide an understanding of the details of Medicare, Group and Individual policies to your patients and, in return, to you and your staff.  We can help your patients with long–term claim filing and medical financial management too.  We help your patients figure out their insurance so you don’t have to.  Contact us at (212) 517–5100 or www.barbarabrody.com


Family Practice Physician – Schenectady/Amsterdam, NY
Hometown Health Centers is a Federally Qualified Community Health Center in the Upstate, Schenectady and Amsterdam, NY areas. Bi-lingual in English/Spanish is a plus.  Excellent total compensation package.  No hospital rounding. Flexible and part-time schedules available.  Sign-on bonus. For additional information please send inquiries or resumes to jobs@hhchc.org. www.hometownhealthcenters.org


Pediatric Medical Director , NY State Office of Health Insurance Programs
The position of Medical Director of Pediatric Policy in the Office of Health Insurance Programs will focus on 4 primary initiatives over the next year, to include the First 1000 Days on Medicaid initiative, Value-Based Payment (VBP) Clinical Advisory Groups on Children’s Health and Maternity Care,  Children’s Health Homes and the Behavioral Health Transition into Managed Care, and Performance Measurement in the various quality programs. The Medical Director will collaborate with colleagues in the Department’s Office of Public Health and serve as a resource for Division staff who are seeking expert advice concerning medical and behavioral health issues involving children. For more information on how to apply, please go to this link: https://www.facebook.com/FuscoPersonnel/?sk=app_127890887255323&app_data=job-3059994


NYC Office of School Health PT and FT Positions for MDs and DOs
The New York City Office of School Health has both part-time and full-time job openings in the five boroughs for board certified/board eligible Physicians (MD, DO) specializing in Pediatrics, Adolescent Medicine, and Family Medicine with an emphasis on the school-aged population (K through 12) and/or Reproductive Health.

New York City School Health Physicians have flexible schedules (Minimum 20hrs/week to Maximum 35hrs/week).  Physicians working 20 or more hours per week receive comprehensive health insurance and other employment benefits.  Duties involve a balance of clinical work in New York City schools, administrative tasks, and public health assignments.  Work days are generally 9am to 5pm with no evening or weekend calls.  Physicians have the option to work or be furloughed during holidays and summers when schools are not in session. For more information, please send email inquiries to osh@health.nyc.govTo apply directly online and for job descriptions, please upload your resume and cover letter to https://a127-jobs.nyc.gov. For the Field Doctor positions, School Health Physician (K – 8), enter Job ID 319959

For the CATCH Reproductive School Health Physician (High School) positions, enter Job ID 297081
For the Supervising School Health Physician Positions, enter Job ID 307390


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


 

Council March 6, 2018

 AGENDA
 MSSNY Council Meeting
Tuesday, March 6, 2018, 1:00 p.m.
Renaissance Hotel
144 State Street
       Albany, NY  12207         

A. Call to Order and Roll Call

B. Approval of the Council Minutes of January 18, 2018

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

1.  President’s Report

a. Committee on Education (Resolutions referred to Council)
Resolution 2017-112Providing Income Tax Credit to Healthcare Professionals for Clinical Preceptorships (FOR COUNCIL APPROVAL) 

Resolution 2017-156 – Promoting 4-year, Vertical Ultrasound Curricula in Undergraduate Medical Education (FOR COUNCIL APPROVAL)
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 b. Committee on Long Range Planning
     Resolution 2017-211Relocation of the Annual MSSNY HOD meeting to Albany           (FOR COUNCIL APPROVAL)

          c. The Health Information Technology (HIT) Committee of MSSNY Symposium

HIT seeks authorization and support, along with the Medical Society of the County of Kings, to sponsor, promote and implement a state wide, five credit CME / HIT Symposium and Expo at the Brooklyn Borough Hall on Saturday, April 28, 2018. Submitted by Donald Moore, MD, Chair, HIT Committee.

2. Presentation – “Update on a NY Cancer Genetic Screening Effort Focused on Physician Involvement” presented by Kenneth Offit, MD, MPH, Chief, Clinical Genetics Service, Vice-Chairman, Academic Affairs, Department of Medicine, Memorial Sloan   Kettering Cancer Center.

3. Board of Trustees Report – Dr. Paul Hamlin will present the report (handout)

4. Secretary’s Report – Frank Dowling will present the report for Nominations for Life Membership, Dues Remissions.

5. MLMIC Report – Mr. Donald Fager will present a verbal report (via teleconference)

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

7. MSSNYPAC Report –  Dr. Joseph Sellers will present the report (handout)

8. CME Update – Dr. Mark Adams will present the report  

9. Councilors (All Action Items from County Societies and District Branches)
(No Action Items Submitted)       

D. Reports of Officers (Verbal Reports)

  1. Office of the President – Charles Rothberg, MD (Verbal)
  2. Office of the President Elect – Thomas J. Madejski, MD – MOC Letters
     
          MSSNY’s members’ concerns regarding the ABMS Program for MOC
  3.   Office of the Vice President –  Arthur C. Fougner, MD (Verbal)
  4.   Office of the Treasurer – Joseph R. Sellers, MD
    Financial Statement for the period 01/01/17 to 12/31/17
    5. Office of the Speaker  –  Kira A. Geraci-Ciradullo, MD, MPH (Verbal)

E. Reports of Councilors (Informational)

1.      Kings and 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 – Maria A. Basile, MD, MBA
6.      Third District Branch Report – Brian P. Murray, 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 – Janine L. Forgarty, MD
11.    Eighth District Branch Report – Edward Kelly Bartels, MD
12.    Ninth District Branch Report  –  Thomas T. Lee, MD
13.    Medical Student Section Report – Pratistha Koirala
14.    Organized Medical Staff Section Report – Bonnie L. Litvack, MD
15.    Resident & Fellow Section Report – Justin Fuehrer, DO
16.    Young Physician Section Report – L. Carlos Zapata, MD

F. Commissioners (Committee Action and Informational Items)

1. Commissioner of Communications, Maria A. Basile, MD, MBA
    Division of Communications Report
2. Commissioner of Governmental Relations, Gregory Pinto, MD
    a. Long Term Care Subcommittee Minutes, January 24, 2018
    b. Quality Improvement and Patient Safety Committee Minutes,
January 24, 2018
3. Commissioner of Science & Public Health, Frank G. Dowling, MD
    a  Addiction and Psychiatric Medicine Committee Minutes,
February 9, 2018
    b. Bio Ethics Committee Minutes, February 2, 2018
    c. Eliminate Health Disparities Committee Minutes, January 26, 2018
    d. Heart, Lung and Cancer Committee Minutes, January 24, 2018
    e. Infectious Diseases Committee Minutes, January 25, 2018
    f.  Medical Education Committee Minutes, January 10, 2018
    g. Preventive Medicine and Family Health Committee Minutes,
October 26, 2017
4. Commissioner of Membership, Parag H. Mehta, MD (Dr. Litvack will present the report)
Membership Committee Action and Discussion Items

Introductory Dues Rate for All New Members
The Membership Committee recommends approval of the pilot project as outlined for new and eligible former individual members in participating county medical societies.
(FOR COUNCIL APPROVAL)
Affiliation Agreements Offering Support Outside of Membership
The Membership Committee requests Council feedback on a proposal to offer groups that currently have no relationship with medical societies a way to demonstrate their support.
      (FOR COUNCIL DISCUSSION)

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

H. Report of the General Counsel, Garfunkel Wild

   1.  Amendments to the Bylaws of the First District Branch 
The proposed amendments to the Bylaws of the First District Branch of MSSNY were reviewed.  Article XVII, section 2 of the Bylaws of MSSNY provides that each district branch may adopt a constitution and bylaws for its government and may amend them.  The constitution, bylaws, and amendments may not be in conflict with the Bylaws of MSSNY and, before becoming effective, must be approved by the Council. A review of the amendments confirms that the amendments relate solely to the internal governance of the First District Branch, and do not conflict with the Bylaws of MSSNY. Accordingly, it is recommended that the Council approve the proposed amendments to the Bylaws of the First District Branch.
(FOR COUNCIL APPROVAL)
2. Amendments to the Bylaws of the Medical Society of the County of Queens
The proposed amendments to the Bylaws of the Medical Society of the County of Queens were reviewed.  Article XVIII, section 6 of the Bylaws of MSSNY provides that each component county medical society shall adopt a constitution and/or bylaws for regulation of its affairs and may amend them.  The constitution, bylaws, and amendments shall not be in conflict with the Bylaws of the Medical Society of the State of New York and, before becoming effective, they shall be approved by the Council.A review of the amendments confirms that they relate solely to the internal operations of the Medical Society of the County of Queens, and do not conflict with the Bylaws of MSSNY.  Accordingly, it is recommended that the Council approve the proposed amendments to the Bylaws of the Medical Society of the County of Queens.
(FOR COUNCIL APPROVAL)

IReport of the Alliance, Barbara Ellman, Co-President
   No written report submitted

J. Other Information/Announcements

1. PAI Letter to US House of Representatives – Impact of Consolidation Trends in the Healthcare Sector on Physician Practices
2. Sign-On letter to reject Governor’s Budget Bill regarding a nurse anesthetist to independently administer anesthesia
3. Sign-On letter rejecting the proposal to authorize retail clinics
4. Office of the National Coordinator for Health IT (ONC) release of the Draft Trusted Exchange Framework 
5. Final Version of PCMH Letter
6. Sign On Letter Comprehensive Medical Management (CMM)
7. Sign On Letter A Community Paramedicine Program (CPP)

K. Adjournment

 

March 2, 2018 – ABMS Listened to US!

Charles Rothberg, MD - MSSNY President
PRESIDENT’S MESSAGE

Charles Rothberg, MD
March 2, 2018
Volume 18
Number 9

Dear Colleagues:

The good news can’t wait— the American Board of Medical Specialties (ABMS) has put a survey online!

For several years, MOC issues have caused physicians measurable stress that has led to anger. Our membership has been very vocal in their criticism of the cost, the time and the weight given to the continuing process of maintaining MOC. Our incoming president, Dr. Tom Madejski, after attending an ABMS Meeting in Chicago, followed up with a letter to ABMS outlining our concerns:

  • MSSNY would like to see ongoing efforts in reducing direct and indirect costs related to the process (travel, time away from practice, etc.)
  • Non-punitive pathways for remediation. (Lack of certification should not result in loss of privileges.)
  • Education to external stakeholders with regards to non-maintenance of certification. (Certification should not be a sole criteria for privileges or participation with insurers)
  • Alternatives to the high stakes examination e.g. physicians should be able to complete a secure exam at a time and place of their choosing.
  • Enhance the life-work balance of physicians. (Burdens to physicians regarding certifications should be minimal.)

Apparently, the ABMS was listening. On February 5, they announced a new Commission of 25 that will be responsible for assessing the continuing of board certification as well as a “Vision Initiative.” The newly selected Commission members will also be responsible for making recommendations and “establish a relevant and valuable program that meets the highest standard of quality patient care.”

ABMS’ “Vision Initiative” also allows stakeholders to actively engage in the process through a dedicated section for feedback and input. Stakeholders interested in sharing their feedback, ideas and suggestions are also encouraged to submit comments. The Commission’s final recommendations will be submitted to the American Board of Medical Specialties (ABMS) and its Member Boards on February 1, 2019.

It’s up to us now that we have an open line of communication.

Please take a few minutes to take the survey.

Charles Rothberg, MD
MSSNY President

Please send your comments to comments@mssny.org

Come to State Legislation Day in Albany on March 6th!
Let your voice be heard!




Capital Update
Please Join Us in Albany Next Wednesday March 7!
MSSNY’s “Physician Advocacy Day” will be held next Wednesday, March 7th in the Lewis Swyer Theatre in the Egg located at the Empire State Plaza, Albany NY. Click Here to Register!Join your colleagues from all around New York State and come to MSSNY’s Physician Advocacy Day to speak with your legislators to ensure they’re making the right choices for New York’s physicians and their patients. Please wear your white coats!We thank the New York State Osteopathic Medical Society for coordinating their advocacy day with MSSNY.Join us to urge your legislators to:

  • Reject the Inappropriate scope of practice expansions proposed in the Executive Budget
  • Prevent big-box store owned medical clinics that will hurt community primary care delivery
  • Reduce excessive health insurer prior authorization hassles that needlessly delay patient care
  • Reduce the high cost of medical liability insurance
  • Reject harmful Patient Centered Medical Home Cuts under Medicaid
  • Preserve opportunities for our medical students and residents to become New York’s future health care leaders

A brief luncheon to which members of each House are invited to speak with their constituents will follow the morning program. Physicians should contact their County Medical Societies which will be scheduling afternoon appointments for physicians to meet with their elected representatives. If you have any questions/comments, please contact Carrie Harring at charring@mssny.org.                                                                        (HARRING)

March Madness Kicks Off – Get Involved and Contact your Legislators
As part of our efforts to educate legislators on a number of complex and controversial budget proposals included in the budget, MSSNY has urged physicians to continue become actively engaged in the legislative and political process.

Governor Cuomo’s budget includes thousands of pages of legislative and budgetary proposals that impact the delivery of health care.  The continued challenges we face as a profession are evident once again.  There are budget proposals that would cut reimbursement rates, expand the scope of practice for various professions, increase unworkable mandates on physicians and change the delivery of patient care.  MSSNY has also partnered with specialty societies in communicating its concerns to the Legislature on many of these troublesome Budget issues. MSSNY Governmental Affairs staff has also had countless meetings with legislators and staff in Albany.  However what is most important is for legislators is to hear directly from their constituents. It is only with this dual approach that we can impact the decisions that will be made. Please call your legislator’s offices, write letters and meet with your elected officials.

Urge your legislators to:

  • Oppose Expanding scope of practice for certified nurse anesthetists (CRNAs)

This provision would allow Certified Registered Nurse Anesthetists (CRNAs) to administer anesthesia without the supervision of a physician anesthesiologist.  To urge your legislators to protect safe anesthesia care for patients please click here.

  • Oppose Authorizing Health Services Offered In Big Box Stores

This provision authorizes the delivery of health services in a retail setting such as a pharmacy, grocery store, or shopping malls.  Sponsors could include a business corporation.  Services to be offered would include treatment of minor episodic illnesses, episodic preventive and wellness services such as immunizations, administration of opioid antagonists, lab tests, and limited screening and referral for behavioral health conditions.

With the recently announced proposal of drugstore chain giant and PBM operator CVS to purchase health insurance giant Aetna (which is itself under investigation in several states for medical necessity denials), this could result in an explosion of retail clinics at the expense of community physician practices. To urge your legislators to reject corporate owned retail clinics, please click here.

  • Oppose Patient-Centered Medical Home cuts

This proposal would slash the Patient-Centered Medical Home (PCMH) add-on Medicaid payment that many primary care practices receive to help manage and coordinate needed patient care services.  Moreover, it would potentially require all PCMH primary care practices to have a Level 1 Value-Based payment contract by July 1, 2018, or face further steep cuts in PMPM payments. MSSNY has joined with several other Primary Care Societies to oppose this proposal (see related article) To send a letter click here.

Additional budget items of great concern include:

  • Expanding the investigatory powers of OPMC
  • Repealing “Prescriber prevails” protections that currently exist in Medicaid and Medicaid Managed Care, forcing physicians to go through even more burdensome prior authorization requirements.
  • Eliminating the Empire Clinical Research Investigator Program (ECRIP).
  • Consolidating 30 public health appropriations into four pools, and reduce overall spending by 20 percent.
  • Comprehensive Medication Management Protocols

This proposal allows nurse practitioners and pharmacists to provide comprehensive medication management to patients with a chronic disease or diseases who have not met clinical goals of therapy and are at risk for hospitalization.  Urge your legislators to reject this inappropriate scope of practice expansion. Click here to send a letter to your legislator.

  • Community Paramedicine

This proposal would allow emergency medical personnel to provide non-emergency care in residential settings.  While a laudable goal, the bill language only includes general references to collaboration with the patient’s treating providers, rather than specific requirements to communicate with actively treating physicians and other care providers.     To protect proper continuity and coordination of patient care with treating >providers, please click a href=”https://cqrcengage.com/mssny/app/write-a-letter?0&engagementId=430438″>here to send a letter to your legislator.                              (DIVISION OF GOVERNMENTAL AFFAIRS)

MSSNY, AMA Express Strong Concerns with Aetna-CVS Merger in Response to Congressional Hearing
In response to a United States House of Representatives Judiciary Committee hearing this weekexamining the proposed CVS takeover of Aetna, MSSNY President Dr. Charles Rothberg issued a statement (click here) noting the great importance of federal and state policymakers taking a thorough review of a proposed consolidation “that will

Specifically, Dr. Rothberg noted his concerns for patients and their physicians with this proposed market consolidation on a number of fronts, including:

  • Reduced choice of pharmacy for patients, as it may become harder for non-CVS pharmacies to be iincluded into the CVS-Aetna pharmaceutical network;
  • Even more burdensome prior authorization hassles for physicians and their staff as a pre-condition for patients receiving needed prescription medications;
  • An explosion of so-called “Minute Clinics”, to be owned by an insurance company that would likely have great incentive to steer patients to these sites through cost-sharing and network development instead of a community based primary care practice that typically serves as a patient’s medical home; and
  • the recent investigation by several states, as reported by CNN, into whether Aetna may be inappropriately denying coverage for patient care.

Dr. Rothberg’s comments were the focus of an article in the February 28 Crains Health Pulse. Importantly, the American Medical Association also submitted a lengthy statement (click here) to the House Judiciary Committee that articulated concerns that the proposed merger may harm competition in markets that are already highly concentrated.

Specifically, the testimony noted that the AMA is “concerned that the proposed merger has the potential to worsen competition (or reduce hopes for amelioration) in three poorly performing markets: PBM services; local health insurance markets; and many local retail pharmacy markets.  Moreover it was noted that “the adverse ramifications in the health insurance market of a combined CVS-Aetna…are likely to swamp any expected cost benefit”.   Among the concerns included:

  • The proposed transaction raises anticompetitive concerns that are unique to vertical mergers
  • Health insurance markets are highly concentrated and in numerous markets Aetna is the first or second largest health insurer
  • The PBM market is highly concentrated and CVS is one of the two largest PBMs
  • The retail pharmacy market is highly concentrated and CVS likely has market power in local markets
  • The merger may be anticompetitive because it would allow CVS-Aetna, the third largest health insurer, to control the PBM services of Anthem, the second largest insurer
  • The merger may be anticompetitive in the market for part D Medicare         (AUSTER)



MSSNY Joins Primary Care Societies and Associations to Urge Legislature to Reject Steep PCMH Cuts
This week MSSNY joined several other primary care advocacy associations in a collaborative letter to the NYS Assembly and Senate Health Committee Chairs urging that the State Legislature reject the proposed $20 million cut to Medicaid Patient Centered Medical Home (PCMH) incentive payments as proposed in the Executive Budget.

As outlined in the January 2018 Medicaid Update, beginning in May 2018, incentive payments for PCMH 2014 level 2 would be permanently eliminated and PCMH 2014 level 3 payments would be temporarily reduced from $7.50 per patient per month (PMPM) to $2 PMPM, a 75% reduction. Starting in July 2018, payments for PCMH 2014 level 3 would be reduced to $5-$6 PMPM on a permanent basis and tied to whether a provider has VBP contract.

The group letter notes that “one of the key components of the State’s transformation efforts is expanding access to high quality primary care. In furtherance of this, NYS made increasing the number of PCMH certified practices a DSRIP project goal. Primary care providers across the state have responded to the Department’s efforts by becoming PCMH certified at unprecedented rates- New York State currently has the highest percentage of PCMH certified providers in the country.

Moreover, sharing the concerns that we have heard from physicians, the letter notes that “If these cuts go into effect, PCMH certified providers stand to lose millions of dollars beginning in May- just two months from now. We have heard from some providers that they may not continue to participate in the program or seek higher levels of certification, as lower payments would not justify the amount of work necessary to achieve and maintain certification.”

In addition to MSSNY, the group letter requesting the restoration of this cut was signed by the Community Health Care Association of New York State (CHCANYS), the NYS Academy of Family Physicians, the NY Chapter of the American College of Physicians, the NYS American Academy of Pediatrics, and the Primary Care Development Corporation.

Physicians can send a letter to their legislators in opposition to these cuts here: (DIVISION OF GOVERNMENTAL AFFAIRS)

MSSNY To Conduct Veterans Matters Webinar: Suicide In Veterans On March 26th at 7:30am: Registration Now Open. Did you know that approximately 20 veterans commit suicide every day?  And that veterans account for 20-25% of suicides in the US?
The Medical Society has created free CME Veterans Matters programs to assist New York State physicians in recognizing the unique health problems faced by veterans and the best way to provide care to veterans.

Register here for Veterans Matters: Suicide in Veterans on March 26th at 7:30am.
Faculty: Jack McIntyre, MD

Educational Objectives:

  • Address the causes and warning signs of suicide and suicidal behavior among veterans
  • Explore evidence-based diagnostic, intervention and treatment options
  • Identify barriers to identification and treatment in military culture and methods to overcome them

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

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

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

Register NOW for MSSNY House of Delegates Live CME Seminars on Thursday March 22nd and Friday March 23rd
The Medical Society of the State of New York will conduct three live seminars at its House of Delegates meeting on March 22nd and 23rd .The programs are opened to all physicians in the western New York area and will be held at the Adam’s Mark Hotel, 120 Church Street, Buffalo, NY 14202.  Pre-registration is strongly suggested.  The following programs will be offered: 

Medical Matters: Disaster Medicine: Every Physician’s Second Specialty
Thursday, March 22nd, 1:00-2:00pm
Register here.

Faculty: Lorraine Giordano, MD, FACEP, FAADM

* Must attend in person at the House of Delegates.

Educational Objectives:

  • Identify core preparedness competencies every physician should know
  • Explore essential elements of preparedness plans for staff, patients, and family
  • Describe available courses, resources and organizations to obtain disaster preparedness education and training

Bending the Diabetes Curve
Thursday, March 22nd, 2:00-3:00pm
Register here.

Faculty: Geoffrey Moore, MD & Sarah Nosal, MD

* Must attend in person at the House of Delegates.

Educational Objectives:

  • Describe the trends in Type 2 diabetes and implications for clinical practice
  • Review evidence that supports referring patients with prediabetes to lifestyle change program
  • Outline the considerations for implementing a diabetes prevention initiative in a physician practice
  • Describe NYS specific incidents of prediabetes and diabetes in adult population
  • Understand the reimbursements mechanisms for DPP

Current Concepts in Concussion for Pediatric and Adult Patients
Friday, March 23rd, 1:00-2:00pm
Register here.

Faculty: Deborah Light, MD & John Pugh, MD, PhD

* Must attend in person at the House of Delegates.

Educational Objectives:

  • Identify signs and symptoms indicative of concussion as well as red flags that indicate alternate or more severe pathology;
  • Outline an appropriate management plan for a patient presenting with concussion including a return to “normal life” protocol;
  • Describe methods for the primary and secondary prevention of concussion;
  • Identify patients who would benefit from referral to a concussion specialist     (HOFFMAN)

Tickborne Diseases: An update on trends, diagnostics, and emerging infections to be presented at the MSSNY House of Delegates on March 22nd
The New York State’s Department of Health Commissioner’s Grand Rounds session title Tickborne Diseases will be presented as a live seminar at the MSSNY House of Delegates on Thursday, March 22, 2018 from 3-4:30 p.m. at the Adam’s Mark Hotel, 120 Church Street, Buffalo, NY 14202.  The purpose of this presentation is to describe the epidemiology of tickborne diseases in NYS, review diagnostic approaches to tickborne diseases, and provide an update on emerging tickborne infections.  Host for the afternoon session will be NYS Health Commissioner Howard A Zucker, MD, JD.

Faculty will include C. Ben Beard, MS, PhD,  Deputy Director Division of Vector-Borne Diseases. Centers for Disease Control and Prevention; Philip Molloy, MD, Rheumatologist, Nantucket Cottage Hospital, Medical Director for Tickborne Diseases, Imugen Inc.; Michael Ryan, PhD, Director, Division of Laboratory Quality Certification, Wadsworth Center, New York State Department of Health; P. Bryon Backenson, MS, Deputy Director, Bureau of Communicable Disease Control, New York State Department of Health, Assistant Professor, Department of Epidemiology and Biostatistics, University at Albany School of Public Health.

The Grand Rounds session is offered free to all health care providers and advance registration is required.  For additional information and to register for this event please see the flyer by clicking here.

Continuing Medical Education Credits will be issued by The School of Public Health, University at Albany which is accredited by the Medical Society of the State of New York (MSSNY) to provide continuing medical education for physicians. The School of Public Health, University at Albany designates this live activity for a maximum of 1.5 AMA PRA Category 1 CreditsTM. Physicians should claim only the credit commensurate with the extent of their participation in the activity.                                                                (CLANCY)


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   mauster@mssny.org  pclancy@mssny.org  

eNews

NY Failing Veterans’ Care; Only 2% of Physicians Qualified
Providers in New York are ill equipped to care for veterans, according to a new RAND Corporation study, which found just 2 percent of physicians and other health providers were capable of offering timely and competent care. There are 800,000 veterans in New York, half of whom are younger than 65. The study, commissioned by the New York State Health Foundation, examined providers on seven measures, and found physicians lacked understanding of military culture and did not know which conditions to screen for. Providers were also asked whether they were accepting new patients. While 90% of physicians were accepting new patients, fewer than 5 %of providers reported being part of VA Community Care, the network of providers who accept VA benefits. Mental health providers were the least likely to be enrolled in the program.

Why it matters: The Veterans Administration has myriad problems including wait times. The federal government is debating whether to encourage veterans to seek care from community based providers so it is important those providers know what to do. “These findings reveal significant gaps and variations in the readiness of community-based health care providers to provide high-quality care to veterans,” said Terri Tanielian, the study’s lead author and a senior behavioral scientist at RAND, a nonprofit research organization, in a press release. “It appears that more work needs to be done to prepare the civilian health care workforce to care for the unique needs of veterans.”

MLMIC Shares Latest Development in Berkshire Hathaway Transaction
On July 15, 2016, MLMIC and National Indemnity Company (NICO), a Berkshire Hathaway company, entered into a definitive agreement to acquire MLMIC. The acquisition will involve the conversion of MLMIC from a mutual to a stock company. The closing of the transaction is subject to various regulatory approvals (including the NYS Department of Financial Services), customary closing conditions and the approval of the MLMIC policyholders eligible to vote on the proposed demutualization and sale.

On February 23, 2018, the parties agreed to an acquisition price of approximately $2.5 billion and signed an amended acquisition agreement to reflect the purchase price and closing procedures. The parties currently expect this acquisition will be completed in the third quarter of 2018.

Please bookmark their FAQs page for the most current information, and if you have any questions, please call 1-888-998-7871.

New York City Council to Probe Alleged $1 Billion Health Insurer Scam
The New York Post (2/28) reports that the New York City Council will probe two of the state’s largest health insurers after the Post reported “on a newly unsealed lawsuit claiming the companies pulled a $1 billion scam on taxpayers.” Former city lawyer Kami Barker brought the whistle-blower case against Empire and Emblem after investigating the insurers when she was hit with over a quarter-million dollars in medical bills despite having full health coverage. Barker “says a summary of her plan promised that using in-network hospitals would save her money – but didn’t warn that many doctors in those hospitals were considered out-of-network.” She also found that the companies used alleged “old-fashioned accounting fraud” to overcharge the city for insurance services by an average of $55 million a year between 2008 and 2014.

Excellus BCBS Doubled Profits in 2017
Excellus BlueCross BlueShield nearly doubled its profits in 2017 and gave its top executive a 13 percent pay raise. (2/28 Syracuse Post Standard)

The Rochester-based health insurer generated net income, or profit, of $182.3 million last year, up from $99.5 million in 2016, according to a report filed today with the state.

Excellus made more money than expected because of lower than anticipated medical expenses, favorable investment income and efficient administrative expenses, the company said in a prepared statement. The insurer’s net income was 3.2 percent of the $5.6 billion it collected in revenue. That’s the highest net income percentage since 2011.

Chris Booth, the insurer’s CEO, said the company’s annual goal is to keep its annual profit below 2 percent of premium revenue. Since 1998, the percentage has averaged 1.8 percent. Because it is a nonprofit, Excellus puts profits into a reserve fund to protect members from higher-than-expected claims expenses or lower-than-expected revenues. At the end of 2017, the insurer’s reserves totaled $1.4 billion, up from $1.2 billion in 2016. “Achieving a margin is critical for the business to be financially healthy for the security of our members,” Booth said in a prepared statement. “New York has recently experienced what occurs when an insurer incurs losses and lacks adequate reserves.”

Opioid Deaths Decrease in New York’s Erie County
The Buffalo News  (2/27) reports that New York’s Erie County Health Department “recorded 268 suspected and confirmed opioid-related drug deaths in 2017,” an 11 percent decline from 2016 but still higher than in 2015. They report that New York’s I-STOP program “has brought a halt to doctor shopping for duplicate opioid pain prescription,” and Erie County’s Medicaid data show “opioid prescriptions for the popular combination drug hydrocodone-acetaminophen have fallen considerably in recent years as more physicians are educated about the addictive properties of such drugs.” 

Opioid Crisis Costs New York City $500 Million Annually
The Wall Street Journal (2/26) reports New York City aims to recover about $500 million from opioid manufacturers and distributors through litigation, shedding light on the city’s annual opioid-related costs. City officials say that $450 million of the sum fell on NYC Health+Hospitals, the city’s public health system, while $355 million is for inpatient and emergency department care, the Journal reports, adding that Health+Hospitals sees about 60 percent of the city’s emergency visits for opioids.

CVS Clinics Could Overtake Traditional Primary Care, MSSNY Says
As CVS Health and Aetna went before Congress Tuesday to defend their proposed merger, the Medical Society of the State of New York spoke out against the deal.

In a statement, Dr. Charles Rothberg, president of MSSNY, elaborated on his misgivings about the $69 billion deal. “Perhaps of greatest concern,” he said, “is the possibility that the merger will lead to the proliferation of CVS’ Minute Clinics.” The clinics would “be owned by an insurance company that would have great incentive to steer patients to these sites instead of a community-based primary care practice that typically serves as a patient’s medical home,” Rothberg said. He added that the move could also reduce patients’ pharmacy choices if Aetna limits the number of non-CVS pharmacies in its networks.

Meanwhile Mark Bertolini, chief executive of Aetna, told CBS this week that a partnership with CVS would simply increase access to one-stop-shop health care for consumers. CVS has more than 10,000 pharmacies and clinics across the country, which Bertolini said could be “10,000 new front doors to the health care system.”

CVS has some 500 retail locations in New York State. 

Death and Dying Opinion Survey coming your way on Monday!

Give it a few minutes to let us know what you are thinking on this important topic.

MSSNY President Charles Rothberg, MD to Participate in America’s Chronic Condition: The Rising Cost of Your Healthcare Forum on March 21
Westchester County Association and The Journal News will join forces to present a community forum on March 21 that will focus on the complex problems plaguing American medicine.
Moderated by The Journal News/lohud’s health care reporter David Robinson, the questions will touch on issues ranging from out-of-pocket costs and premiums to employer-sponsored health insurance and the Affordable Care Act.  The panelists include:

  • Charles Rothberg, President, Medical Society of the State of NY
  • Kevin Dahill, Suburban Hospital Alliance
  • Mary Jo Jacobs, USI Insurance Services
  • Leslie Moran, NY Health Plan Association

The forum will be held Wednesday, March 21 from 8 to 10 a.m. at DoubleTree by Hilton Hotel, 455 South Broadway, Tarrytown. The cost is $35 for WCA members and young professionals and $45 for non-members.

Register for the forum at www.westchester.org.

Five Classifications of Diabetes Proposed
Researchers have proposed five new ways to categorize patients with diabetes based on clinical and genetic parameters. Their work appears in the Lancet Diabetes & Endocrinology.

Scandinavian patients with newly diagnosed diabetes had the following elements collected at baseline: age at diagnosis, BMI, glutamate decarboxylase antibodies (GADA), hemoglobin A1c (HbA1c) levels, and homeostatic model assessment 2 to estimate beta-cell function (HOMA2-B) and insulin resistance (HOMA2-IR) using C-peptide concentrations. Based on these factors, patients were classified into one of the following clusters:

  1. Severe autoimmune diabetes (formerly type 1 diabetes):affected 6% of patients in the derivation cohort; characteristics include early-onset disease, relatively low BMI, and GADA-positive
  2. Severe insulin-deficient diabetes:18% of patients; GADA-negative but similar to cluster 1; lowest HOMA2-B scores
  3. Severe insulin-resistant diabetes:15%; higher HOMA2-IR scores
  4. Mild obesity-related diabetes:22%; obese, but not insulin resistant
  5. Mild age-related diabetes:39%; older than other clusters, but largely similar to cluster 4

The clusters were genetically distinct. Patients with severe insulin-deficient diabetes had the highest rates of retinopathy, while those with severe insulin-resistant diabetes had higher rates of end-stage renal disease and coronary events. The authors say these clusters “represent two new, severe forms of diabetes previously masked within type 2 diabetes.” They add, “It would be reasonable to target individuals in these clusters with intensified treatment to prevent diabetic complications.”

Lancet Diabetes & Endocrinology article 

RESIDENTS

Apply Now: Regents Physician Loan Forgiveness Program; Deadline July 2
The Regents Physician Loan Forgiveness Program can award up to 80 applicants up to $10,000 per year for two years; and we would like physicians to apply for this program, if they meet the eligibility criteria.  The deadline is July 2, 2018.

To be considered for a Regents Physician Loan Forgiveness Award, applicants must meet the following eligibility criteria:

  1. Applicants must be licensed to practice medicine in New York State.
  2. Applicants must have completed a professional residency program within the five years immediately preceding the period for which the first award would be granted or will complete training in 2018 in an accredited residency program in family practice, pediatrics, internal medicine, emergency medicine or obstetrics.  Psychiatry is also considered primary care in certain State facilities.
  3. Applicants must be residents of New York State.
  4. Applicants must also be:
  5. citizens of the United States, or
  6. aliens lawfully admitted for permanent residence in the United States, or
  7. individuals of a class of refugees paroled by the Attorney General of the United States under the parole authority pertaining to the admission of aliens to the United States.
  8. Applicants cannot currently be a recipient of any of the Federal Loan Physician Repayment Award programs.

Information and application forms can be found here.

CMS / MIPS / QPRS

Low Volume Appeals Settlement Process
On February 5, 2018, CMS started accepting Expressions of Interest for the Low Volume Appeals (LVA) settlement process. The LVA settlement option is for providers, physicians, and suppliers (appellants) with:

  • Fewer than 500 appeals pending at the Office of Medicare Hearing and Appeals and the Medicare Appeals Council at the Departmental Appeals Board, combined, as of November 3, 2017
  • A total billed amount of $9,000 or less per appeal

If you are interested in participating in LVA to address your pending appeals:

Visit the Low Volume Appeals Initiative webpage.

Register for the Medicare Learning Network call on March 13

MIPS Reporting Deadlines Fast Approaching: Important Dates to Keep in Mind
Deadlines are fast approaching if you plan to submit data for the 2017 Merit-based Incentive Payment System (MIPS) performance period. Don’t wait until the last minute to submit your data.  Submit early and often.

Here are key upcoming dates for MIPS:

  • March 16 at 8 pm ET – deadline for 2017 data submission for groups reporting via the CMS web interface.
  • March 31 – deadline for 2017 data submission for all other MIPS reporting, including via qpp.cms.gov.

Classified

RENTAL/LEASING SPACE


For Rent – Medical Office 715 W 170 Street New York
Ground floor just completed build out 4 exam rooms with sinks and wall cabinets
Waiting and reception areas, windows throughout.
Street and private entrances, two bathrooms and storage/lab/staff room.
One block to bus and two blocks to Presbyterian Medical Center and subway.
$1900-$7900/ month for one to 4 exam rooms.
Drdese@gmail.com or 917.8618273


For Share – Plastic Surgeon’s Office Facing Central Park Ground Floor Lobby Entrance/Private exit
One to three exam rooms, consult/private office and procedure room for full or part time use.
Elegant, modern and spacious secretarial, waiting and two exam rooms.
Accredited operating rooms and recovery rooms on site.
One block to bus and 20 feet to subways.
$1275-$3750/day monthly for one to three exam rooms.
Drdese@gmail.com or 917.861.8273


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


Magnificent medical suites for lease – 184 East 70th St . New York, NY.
The space has just undergone a complete STATE OF THE ART renovation.
Located in a luxury building with a separate elevator entrance on the prestigious upper east side of Manhattan, this recently renovated space is conveniently situated steps from Lenox Hill Hospital , Cornell /Columbia Presbyterian, HSS and Memorial Sloan Kettering. Includes exam rooms, new custom cabinetry, new exam beds, scale, waiting area – new furniture, new TV, water cooler etc. Space A : one consultation room plus 2 exam rooms . $6000 per month
Space B:One consultation room plus one exam room. $4500 per month
Space C: one consultation plus one exam $4500.
other combination may work as well. Available for sharing
For full details and photos see listing at http://bit.ly/2E3Zvh0 or contact Karen Tamir at 917-865-1006 or KarenTamir@Yahoo.com.  


PHYSICIAN OPPORTUNITIES

Patient Navigation and Patient Advocacy Services for Your Patients
Barbara A. Brody & Associates, LTD., founded in 1992, is a private “Value–Added” resource for practices and patients. Barbara A. Brody, MPA analyses medical insurance policies, long–term care policies, and insurance billing (physicians, healthcare facilities and pharmaceutical plans). We provide an understanding of the details of Medicare, Group and Individual policies to your patients and, in return, to you and your staff.  We can help your patients with long–term claim filing and medical financial management too.  We help your patients figure out their insurance so you don’t have to.  Contact us at (212) 517–5100 or www.barbarabrody.com


Hypertension Initiative Coordinator
In collaboration with relevant DOHMH bureaus and the intra-agency HTN workgroup, support the research, development, planning and implementation of HTN initiative projects.

    • Oversee Initiative Plan activities and partner activity implementation, including year-to-year activity development and management.
    • In partnership with stakeholders, provide direct support and management of HTN activity implementation among coalition member organizations.
    • In partnership with the HTN Initiative Manager and other staff, contribute to evaluation tracking, data collection, metrics and monitoring, especially as relates to activity implementation.
    • Assess Initiative Plan activities for evidence base; conduct literature reviews and other relevant research to identify evidence-based strategies for activity implementation.
    • In collaboration with programs, develop new project ideas and programming; contribute to grant writing and fundraising for new programming.
  • As part of the HTN team, direct strategic growth and development of a citywide hypertension coalition.
  • Establish and maintain relationships with key stakeholders across New York City, including strategic engagement and management of technology and entrepreneurial stakeholders.
  • As part of the HTN team, represent the initiative at various community or key stakeholder programs; serve as liaison with outside offices as required.
  • Contribute to research-driven manuscripts, memos, reports as well as give presentations reporting data analysis and evaluation results. 
  • Preferred Skills: Experience working across multiple sectors and with diverse stakeholders, experience and ability to critically review and assess the scientific literature, exceptional written and oral communication skills, keen ability to prioritize and handle multiple assignments; keen attention to detail and logistics management, ability to work independently and exercise a high degree of initiative, apply project management strategies, accomplish tasks and solve problems; excellent interpersonal, collaborative and team skills.View full job description / apply online at http://ow.ly/Ox6b30inpLh

Hypertension Initiative Director The Division of Prevention and Primary Care is seeking a high-level director for a new citywide hypertension initiative. Hypertension (HTN) is one of the leading contributors to death and a key driver of health inequities. This initiative will create collaborations across the work of multiple stakeholder groups engaged in clinical, community or population approaches to reducing hypertension, to enhance and expand hypertension efforts across the city.

Reporting to Deputy Commissioner, the Citywide Hypertension Initiative Director will guide the strategic development, planning, and implementation of this new initiative. The team consists of a Hypertension Initiative Manager and a Coordinator, as well as short-term staff. The Director will establish high-level relationships and oversee the initiative’s work, including coalition engagement and activity implementation. Leadership, supervision of program design and evaluation, fundraising, and staff management are key components of this position. The Director will also be responsible for engaging stakeholders within the Health Department and external to the Health Department to achieve the initiative’s goals. The Director’s responsibilities include the following:

  • Guide and oversee the strategic development, planning, and implementation of the Citywide Hypertension Initiative including program design and structure, evaluation, needs assessments and other data and research needs.
  • Manage an initiative team consisting of the Hypertension Initiative Manager, Coordinator(s), and short-term staff; liaise with other staff within the Agency contributing to the Hypertension Initiative.
  • Lead and facilitate internal and external meetings and other convenings with Coalition members, DOHMH staff, and prospective partners.
  • Oversee launch of yearly Coalition meeting or summit with Coalition stakeholders from across NYC.
  • Lead reporting and communication efforts with both internal and external partners; oversee outreach and communication with Steering Committee and Coalition members
  • Draft and oversee the development of memos and reports, as well as give presentations.
  • Establish high-level relationships with key stakeholders across New York City, including recruitment for the initiative advisory panel and steering committee and other clinical and community working groups.
  • Lead fundraising efforts to expand initiative activities by identifying and developing new funding opportunities; serving as the principal lead for key grants and funding, where appropriate; and leading development of a fundraising plan to achieve long-term initiative goals.
  • Along with the team, represent the initiative at various community or key stakeholder programs; serve as liaison with outside offices as required.

Preferred Skills: Clinical training a plus, strategic thinker, strong manager, public health training; content expertise in heart disease, stroke, chronic disease a plus; ability to work independently, project manage strategies, accomplish tasks and solve problems; exceptional writing and communication skills; experience working on high-profile strategic campaigns; experience interpersonal, collaborative and team skills is a must.

View full job description / apply online at http://ow.ly/3vAO30inpXU


Family Practice Physician – Schenectady/Amsterdam, NY
Hometown Health Centers is a Federally Qualified Community Health Center in the Upstate, Schenectady and Amsterdam, NY areas. Bi-lingual in English/Spanish is a plus.  Excellent total compensation package.  No hospital rounding. Flexible and part-time schedules available.  Sign-on bonus. For additional information please send inquiries or resumes to jobs@hhchc.org. www.hometownhealthcenters.org


Pediatric Medical Director , NY State Office of Health Insurance Programs
The position of Medical Director of Pediatric Policy in the Office of Health Insurance Programs will focus on 4 primary initiatives over the next year, to include the First 1000 Days on Medicaid initiative, Value-Based Payment (VBP) Clinical Advisory Groups on Children’s Health and Maternity Care,  Children’s Health Homes and the Behavioral Health Transition into Managed Care, and Performance Measurement in the various quality programs. The Medical Director will collaborate with colleagues in the Department’s Office of Public Health and serve as a resource for Division staff who are seeking expert advice concerning medical and behavioral health issues involving children. For more information on how to apply, please go to this link: https://www.facebook.com/FuscoPersonnel/?sk=app_127890887255323&app_data=job-3059994


NYC Office of School Health PT and FT Positions for MDs and DOs
The New York City Office of School Health has both part-time and full-time job openings in the five boroughs for board certified/board eligible Physicians (MD, DO) specializing in Pediatrics, Adolescent Medicine, and Family Medicine with an emphasis on the school-aged population (K through 12) and/or Reproductive Health.

New York City School Health Physicians have flexible schedules (Minimum 20hrs/week to Maximum 35hrs/week).  Physicians working 20 or more hours per week receive comprehensive health insurance and other employment benefits.  Duties involve a balance of clinical work in New York City schools, administrative tasks, and public health assignments.  Work days are generally 9am to 5pm with no evening or weekend calls.  Physicians have the option to work or be furloughed during holidays and summers when schools are not in session. For more information, please send email inquiries to osh@health.nyc.govTo apply directly online and for job descriptions, please upload your resume and cover letter to https://a127-jobs.nyc.gov. For the Field Doctor positions, School Health Physician (K – 8), enter Job ID 319959

For the CATCH Reproductive School Health Physician (High School) positions, enter Job ID 297081
For the Supervising School Health Physician Positions, enter Job ID 307390


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


 

 

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