MSSNY Statement re: Medical Aid in Dying


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

 

For Immediate Release
May 14, 2019

MSSNY Statement re: Medical Aid in Dying

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

“As physicians, we value the importance of each person’s life. There are great disparities in access and quality of care at the end of life and we are particularly concerned about the impact of Medical Aid in Dying on vulnerable populations.

“Medical Aid in Dying is a complex issue with great variations in the wishes of patients as to the application of care as they approach the end of their natural lifespan or are faced with a terminal illness. The Medical Society of the State of New York is opposed to physician assisted suicide, but we continue to examine the issue through MSSNY’s  Task Force on End of Life Care, which is looking at all aspects of the issue.  MSSNY is committed to work with physicians and groups on both sides of this difficult question to improve access and quality of palliative care for all of our patients, particularly in their last days.“

 

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

 

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

 

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MSSNY eNews – May 10, 2019 – NY State of Fear

Arthur Fougner MSSNY Presiident

PRESIDENT’S MESSAGE<
Arthur Fougner, MD
MSSNY President

MSSNY eNews
MAy 10, 2019

Vol. 22  Number 18


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Colleagues:

Fear is the Mind Killer.”
-Bene Gesserit (from Dune by Frank Herbert)

The 21st Century is not turning out the way I expected. How it could happen that a disease once declared eradicated by the CDC in 2000, now plagues our state? With over 600 cases in NY State, there seems no end to this outbreak. Schools have been closed, families are now under quarantine. Any day, I expect to pick up the paper and learn that someone, like the Israeli flight attendant, is now in an intensive care unit somewhere on life support.

Where once NY enjoyed almost universal vaccination, today there are over 200 schools where less than two thirds of the children are immunized. This is truly disturbing.  You see, there are those who cannot be vaccinated – those infants 6 months of age or younger, those with cancer or transplants on immunosuppression therapy, patients with HIV or autoimmune disease, pregnant women, or those allergic to any of the ingredients in the vaccine. To minimize the likelihood of exposure, the rest of the community needs to be immunized. This is the concept of herd immunity. Today, our herd has been culled.

So what’s going on here? Some might point to religion. Yet there is no major religion that proscribes vaccination. Moreover, religion has been with us since the day that homo sapiens took their first steps. Religion was certainly around while measles was being eradicated through a vigorous vaccination campaign.

So what is different now?

What’s different now is the pervasive state of fear created by a relatively small group who spread the notion that the vaccines are more terrifying than the diseases they are designed to control. We all know who they are. They are powerful, they are media savvy and their influence has spread throughout all sectors of our society, promulgating the false gospel that vaccination causes such afflictions as autism. That notion, which first emerged 20 years ago, has been thoroughly discredited but facts do not deter this cult. Take the two recent Danish studies of over half a million children. These found no significant difference in autism rates between those vaccinated and those not. In fact, the vaccinated group actually had a slightly LOWER incidence of autism.

So we must take this challenge head on and protect those who cannot protect themselves. Re-establish Community Immunity. Remember the words of a former NY governor, President and victim of a now vaccine-preventable disease: “The only thing we have to fear is fear itself.”

Arthur Fougner, MD
MSSNY President 

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

Dr. Fougner and Dr. Sellers at Measles Conference

Vaccinations: Only Medical Exemptions.
MSSNY Vice President Dr. Joseph Sellers and MSSNY President Dr. Art Fougner at a press conference on Tuesday, May 8. Speaking to NYS legislators, Dr. Fougner said, “An important first step is ensuring that medical exemptions are the ONLY exemptions allowable.”


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Capital Update

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This Week’s Podcast of MSSNY’s Legislative Priorities


MSSNY Participates in Congressional Discussion on Addressing Surprise Medical Bills
MSSNY Past-President Dr. Andrew Kleinman was one of the key participants in a meeting this week in Washington DC with the US House of Representatives’ Doctors Caucus to highlight New York’s acclaimed “surprise medical bill” law as a model for Congress to follow as it develops similar legislation for the country.  Dr. Kleinman highlighted that New York’s comprehensive law protected patients and struck a balance among the concerns of physicians, hospitals and health insurers to help preserve needed on-call specialty care availability in hospital emergency departments.

He noted New York’s law not only addressed surprise out of network bills directly, but also addressed other “root causes” of  surprise medical bills, such as inadequate and inaccurate physician networks and inadequate out of network coverage. He also highlighted the expeditious and relatively inexpensive cost of New York’s independent dispute resolution system for resolving surprise out of network bills.  Dr. Kleinman was extensively involved in efforts to help develop and advance New York’s law.

Other participants in the meeting included the American Medical Association, the American Association of Neurological Surgeons, the American College of Emergency Physicians, and the Federation of American Hospitals.  Dr. Kleinman also met with key health policy staff for several other key US Senators developing legislation on this issue, including Senate Minority Charles Schumer (D-NY) and Senator Dr. William Cassidy (R-LA).    

This week, President Trump held a press conference urging action to address surprise medical bills. The AMA released a statement following the press conference agreeing with the goal to protect patients from surprise bills but raising concerns with aspects of the President’s statement.  Read the AMA statement here.

Physicians are urged to send a letter to Senators Schumer and Gillibrand, as well as their respective member of Congress here  to urge that any proposal addressing surprise medical bills be consistent with New York’s law.                      (AUSTER)


Medical Organizations, Public Health and Patient Advocacy Groups Hold Press Conference; Urge Legislators to Enact Medical Exemption
The Medical Society of the State of New York and 27 other medical organizations, public health and patient advocacy groups are urging the New York State Legislature to pass A.2371/S.2984 which ensures that medical reasons are the only exception to vaccination requirements.  MSSNY President Dr. Art Fougner, Vice-President Dr. Joseph Sellers and Assistant Treasurer Dr. Parag Mehta joined many other physicians and patient advocates this week in a press conference urging support for the legislation.  The press conference generated significant media attention. The legislation is sponsored by Assemblymember Dinowitz and Senator Hoylman and is in the Assembly and Senate Health Committees.

Following the press conference, the groups met with various members of the legislature urging their support of the measure; those meetings will continue this week.  It is important to note that many anti-vaccine advocates are expected at the Capitol next week to discuss their views with legislators.  Therefore, it is critically important that all physicians reach out o their legislators and urge passage of A.2371/S.2984.

The measure must go through the Assembly Health Committee and MSSNY’s focus has been on the following individuals:  Assemblymembers Gottfired, Abinanti, Ashby, Barron, Bichotte, Braunstein, K. Byrne, M. Byrnes, Cahall, Cymbrowitz, Dinowitz, Galed, Garbarino, Gunther, Hevesi, Jaffee, Kim, D. McDonought, Paulin, Ra, Raia, Rosenthal, Sayegh, Schimminger, Solages, P. Steck.  You can call the Asssembly at 518-455-4100 and ask to be transferred to their offices.  You may also send a letter to these legislators urging support of A.2371 and S.2984 by going to MSSNY Grassroots Action Center (GAC) here.

With the number of confirmed measles cases exceeding 700, groups are urging passage to ensure that measles – a vaccine preventable disease – does not gain a sustained foothold in New York and across the nation.

The following groups have joined onto a memo in support and many attended this week’s press conference:  American Academy of Pediatrics, NYS District II, Chapters 1, 2 & 3, American Nurses Association – New York (ANA-NY), Associated Medical Schools of New York, Autism Science Foundation, Citizen Committee for Children of New York, Inc., Children’s Defense Fund-New York, Erie County Department of Health,  Ithaca Is Immunized, Kimberly Coffey Foundation, Nurses Who Vaccinate, March of Dimes, Meningitis B Action Project, Medical Society of the State of New York, Nurse Practitioner Association New York State, New York American College of Emergency Physicians, NY Chapter American College of Physicians, NYS Academy of Family Physicians, NYS Association of County Health Officials (NYSACHO), NY Occupational and Environmental Medical Association (NYOEMA) , NY State Neurological Society, NY State Neurosurgical Society, NYS Ophthalmological Society, NYS Society of Otolaryngology-Head and Neck Surgery, NYS Public Health Association, New York State Society of Anesthesiologists, Inc., The New York State Radiological Society, Schuyler Center For Analysis and Advocacy, The Children’s Agenda and the Tompkins County Department of Health.                                  (CLANCY)



Collective Negotiations Bill Advances in the Assembly
Please urge your legislators to support Assemblymember Gottfried’s bill A.2393, which would help to even the playing field between physicians and insurance companies.  A letter can be sent here.

This bill was reported out of the Health committee on 4/30 and has now been reported out of the Codes committee. It currently awaits a vote in the Assembly Ways and Means Committee. If enacted into law it would allow independently practicing physicians to communicate and negotiate collectively with health care plans in limited instances (when health plans have an undue advantage negotiating the terms of contracts with health care providers). Physicians are currently unable to do so due to federal antitrust law. However, a longstanding US Supreme Court precedent enables States to permit these negotiations via the State Action Doctrine.

Passage of this legislation would help to enable physicians to negotiate in order to limit burdensome prior authorization procedures and unfair network participation rules. It also contains protections to help ensure that negotiations do not impair access to patient care by prohibiting collective slowdowns/strikes and would ensure strict oversight of these negotiations by the Department of Health.

The bill, which is also sponsored by Senator Rivera (S.3462) is currently in the Senate Health Committee.             (AVELLA)     


Bill Requiring Physicians to Maintain Excessive Documentation of Discussion of Risks of Prescribing Opioids Moves to Senate Floor; Action Needed!
Physicians are urged to contact their legislators in opposition to legislation (S.4277-A/A.7285-A) which would require physicians and health practitioners who prescribe an opioid or other Schedule II Controlled Substance to discuss with patients’ the risks prior to prescribing the medications. The Medical Society is opposed to this measure and encourages

physicians to send a letter to their legislator at the MSSNY Grassroots Action Center (GAC) here. The bill has moved to the Senate floor and can be voted on at any time.      Specifically the legislation would require physicians to discuss (and by extension document that such discussions took place) the following: a) the risks of addiction and overdose associated with opioid medications, b) the reason why the prescription is necessary, c) alternative treatments that may be available and d) the risks associated with the use of these medications. Moreover it would require the physician each year to counsel the patient on the risks of overdose and the availability of an opioid antagonist.

While the legislation is well intended, it ignores existing Public Health Law that essentially requires the patient’s informed consent. This means that when a patient needs treatment, the physician must give the patient information regarding risks so that they can make an informed decision.

Additionally, this is duplicative of requirements that currently exist under other laws that mandate that after a physician prescribes the medication, the pharmacist is required to again inform the patient about the risks of taking a controlled substance. Moreover, for their patients who are on opioid medications longer than 90 days, physicians are required to have a written treatment plan that includes discussing with patients the risks of these medications and possible alternatives to these medications.  MSSNY is also concerned that such requirements will further discourage physicians from prescribing pain medications for patients who need them – already a growing concern – and could potentially scare patients who truly need pain medication away from taking this medication. (CLANCY,AUSTER)



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Action Needed on Prior Authorization Reform Bill
Prior authorizations continue to be a major roadblock to care and cause endless hassles for physicians and their staff. The burdens caused by excessive and often unjustified prior authorization requirements take away from the time that physicians can spend with their patients and lead to far too many hours being spent on paperwork. Further, surveys continue to demonstrate that a significant number of patients have experienced adverse outcomes due to prior authorizations, either due to the time that insurance companies take to process them or because of improper or unfair denials.

Senator Breslin and Assemblymember Gottfried have introduced an “omnibus bill” (S.2847/A.3038) that would help in reducing prior authorization burdens, updating UR standards and patient protections for prescription drugs.  MSSNY has been working with several specialty societies and patient advocacy groups, including the New York Bleeding Disorders Coalition, on advocacy in support of the legislation.

The bill has picked up additional co-sponsors in both houses this year. It is currently awaiting action in the Senate Health Committee and the Assembly Insurance Committee. Please urge your Assemblymember and Senator to join on as a co-sponsor here(AVELLA)


Single Payer Hearing Scheduled for May 28 in Albany
Health Committee Chairs Senator Rivera and Assemblymember Gottfried will host a hearing on the Proposed New York Health Act on May 28, 2019 in Albany. It will be the first of a series of hearings throughout NY regarding the proposed legislation, which would create a single payor system in New York. MSSNY President Arthur Fougner, MD will be providing testimony on behalf of MSSNY.

The hearing will take place at 10am in Hearing Room A in the Legislative Office Building. Oral testimony will be limited to 10 minutes per participant. More information, including the form that must be submitted by those who wish to testify, can be found here.          (AVELLA)


Uniform Credentialing Bill on Senate Health Committee Agenda
Senate Bill S.4335, sponsored by Senator Salazar, is on the Senate Health Committee’s agenda for Tuesday, May 14. The bill would require the creation and use of uniform credentialing and re-credentialing forms for physicians and other providers to use for the purposes of applying for and being maintained on a health care plan’s network. While many insurance companies now use CAQH’s standard form, not all use it exclusively. As a result, physicians and their staff – who are already overburdened with paperwork and bureaucratic tasks – must sometimes file multiple different forms that serve the same purpose.

It would also require the creation of a standard referral form that a primary care physician may use to facilitate care for a patient from a specialist physician. Similar to the credentialing forms, health care plans may have their own referral forms that are substantially similar, but different enough so that the physician must use each plan’s form instead of a single form. A uniform referral form would alleviate further unnecessary administrative hassles that physicians face in attempting to facilitate appropriate care for their patients.

Assemblymember Gottfried’s companion bill A.3077 passed the Assembly on 3/26.        (AVELLA)


Patient Formulary Protection Bill Ready for Senate Vote
Senator Breslin’s S.2849, which would prohibit a health care plan from making prescription drug formulary changes during the contract year, is currently on the floor of the Senate. While patients are locked into an insurance plan for the contract year – and often choose their plan based on their prescription co-pays and prescription formularies – insurance companies are able to modify their formulary and often move drugs into a higher cost-sharing tier mid-contract. This legislation would ensure that patients are able to access the drugs they need without unexpected cost increases mid-year.  MSSNY has been working with several patient advocacy groups in support of this legislation.

This is the first year that the bill has advanced out of committee in the Senate. Its companion bill, which is sponsored by Assemblymember People-Stokes (A.2969), has passed the Assembly every year since 2015 and is currently in the Assembly Insurance Committee awaiting movement. Please urge your legislator to support this bill by clicking here. (AVELLA)


CMS to Require Pharma Companies to Include List Price during TV Commercials
CMS will now require TV commercials for prescription drugs covered by Medicare or Medicaid to include the list price (Wholesale Acquisition Cost) if the price is greater than or equal to $35 per month or the usual course of therapy. Currently, drug companies are only required to disclose a drug’s potential major side effects. The final rule is effective 60 days after its May 10, 2019 publication in the Federal Register (July 9, 2019).

Per HHS, the 10 most commonly advertised drugs have list prices ranging from $488 to $16,938 per month (or usual course of therapy).  HHS estimates that prescription drug spending in the United States was about $457 billion in 2015, or 16.7 percent of overall personal health care services. Further, over $4.2 billion was spent on prescription drug television advertising.

The stated intent of this rule change is to incentivize lower list prices and ensuring that beneficiaries are provided all of the information that they need to make informed decisions, minimizing their out-of-pocket costs. 47% of Americans are insured through high-deductible health plans and all seniors on Medicare Part D must pay coinsurance and often a deductible as well. The list price is also what a patient would pay if a drug is not on their insurance formulary.    (AVELLA)  


Measles Outbreak in New York State Continues to Spread
Webinar Available at MSSNY CME Website

The number of measles cases in New York State continues to rise with approximately 665 of the 706 confirmed cases nationwide occurring in New York State (423 in New York City, 206 in Rockland, 23 in Orange, 10 in Westchester, 2 in Sullivan, 1 in Suffolk and 1 in Greene counties) as of May 1st.  MSSNY conducted a just-in-time Medical Matters webinar entitled “The Continued Public Health Threat of Measles 2018” in December, 2018.  This webinar has now been posted to the MSSNY CME website. You can also view MSSNY’s latest Medical Matters webinar entitled “What’s Your Diagnosis? Infectious Diseases” which involves a patient with a fever and a rash.  Please check these out and keep yourself informed about the growing measles outbreak throughout New York State.  You can also listen to MSSNY’s brief podcast on the Measles, Mumps and Rubella vaccine here         (HOFFMAN, CLANCY)


Be Sure to Listen to MSSNY’s Latest Podcast
MSSNY proudly announces our latest podcast entitled Military Culture: Forging an Alliance with Veteran Patients.  Dr. Frank Dowling, MSSNY Secretary, discusses the unique aspects of military culture with Marcelle Leis, CMS (Ret.) USAF/ANG and Lance Allen Want, Lt. Col. (Ret.) USA.  Listen here.                                                                   (HOFFMAN)


Registration Now Open for Medical Matters Webinar on May 15, 2019 @ 7:30am
The Medical Society of the State of New York will host its final Medical Matters webinar of 2019, The Importance of Resilience After a Disaster on May 15th @ 7:30am.  Encouraging post traumatic growth is an essential part of recovery from any type of disaster.  Learn more about how best to encourage resilience behaviors in patients.

The Importance of Resilience After a DisasterRegister here.:

When:  Wednesday, May 15 2019 at 7:30am

Faculty: Craig Katz, MD

Educational Objectives:

  • Define resilience and post traumatic growth
  • Describe how best to measure resilience and post traumatic growth
  • Explore resilience behaviors and how to encourage them in your patients

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. Physician should only claim credit commensurate with the extent of their participation in the activity. (HOFFMAN)


Registration Now Open for Veterans Matters CME Webinar on June 5th
Register now for MSSNY’s next Veterans Matters webinar June 5th at 7:30am. This webinar is entitled Substance Use Disorders in Veterans.  Register for this program here

Veterans Matters: Substance Use Disorders in Veterans

When:  Wednesday June 5 2019 at 7:30am

Faculty: Frank Dowling, MD

Educational Objectives

  • Define Substance Use Disorders (SUDs), symptoms, warning signs, comorbidities
  • Explore evidence-based intervention and treatment options for SUDs among veterans
  • Identify barriers to diagnosis and treatment 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 this live activity for a maximum of 1.0 AMA/PRA Category 1 creditsä. Physician should only claim credit commensurate with the extent of their participation in the activity.   (HOFFMAN)


pschuh@mssny.org mauster@mssny.org  pclancy@mssny.org  mavella@mssny.org
charring@mssny.org

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Empire, Westchester Medical Center Locked in Contract Dispute
Empire BlueCross BlueShield has notified its members that Westchester Medical Center Health Network will become out-of-network on June 1 unless the two sides reach an agreement. The health network’s contract with Empire expired April 1, but discussions have continued during a two-month “cooling off” period.

“We have a strong desire for Westchester Medical Center to be in-network, but we have to provide affordable products,” Alan Murray, Empire’s CEO, told Crain’s. “That’s a constant balance we’re challenged with.”

The hospitals affected are Westchester Medical Center and Maria Fareri Children’s Hospital in Valhalla; Bon Secours Community Hospital in Port Jervis, Orange County; Good Samaritan Hospital in Suffern, Rockland County; St. Anthony Community Hospital in Warwick, Orange County; and MidHudson Regional Hospital in Poughkeepsie, Dutchess County.

The insurer told members that Empire would cover WMCHealth facilities as in-network during emergencies, when services have been previously authorized or where another provider is not within 30 miles of a patient’s home. Crains May 7.


Mayor Unveils NYC Care Card for Uninsured; Will Hire Seven Doctors in Bronx
The city’s public hospital system is hiring seven doctors for Lincoln Hospital in the Bronx to prepare for what officials hope will be an influx of patients this summer who will take advantage of NYC Care, the de Blasio administration’s latest health program.

The city’s effort to connect people without insurance to primary care at NYC Health + Hospitals will officially start Aug. 1 in the Bronx. The mayor’s office expects 10,000 people to sign up for NYC Care within the first six months of the program. The patients will have 24/7 access to a customer-service line and hospital-based pharmacies.

The $100 million NYC Care program does not provide participants with access to medical care at any private doctor, hospital or pharmacy. It will charge sliding-scale payments based on an individual’s income and encourage people to enroll in MetroPlus if they earn too much to qualify. The card includes a member ID number, the name of an individual’s primary-care physician and a customer-service phone number.

People are eligible if they have lived in the city for at least six months and do not have an affordable insurance option or are ineligible for insurance. Of course, NYC Health + Hospitals always has welcomed any patient whether or not they have insurance. The difference is the priority of connecting uninsured patients to primary care before they go to a city emergency room with a crisis. The city will spend $25 million bringing the program to the Bronx, which also includes ramp-up costs, said City Hall spokesperson Marcy Miranda.


NY Improves Its Readiness for Health Emergencies
New York has continued to improve its readiness for health emergencies, according to the 2019 National Health Security Preparedness Index, released by the Robert Wood Johnson Foundation. The state improved its readiness in all areas between 2013 and 2018, the index found. It also bested the national average of 6.7—on a 10-point scale—scoring 6.9. Specifically, New York scored particularly well in community planning and engagement, increasing nearly 21%, to 5.8. The national average was 5.2 last year.

New York also posted its highest score in health security surveillance, 9.2, compared with a national average of 8.3. Health security surveillance is defined by the index as the ability to detect and monitor health threats and identify where they start and spread to contain them rapidly.

The state also exceeded the national average in readiness in environmental and occupational health last year at 6.7, compared with 5.9. New York’s lowest score was in health care delivery—the ability to provide care during and after emergencies—at 4.7. The national average was 4.9. The state also scored significantly below the national average in incident and information management, at 8.2, compared with 8.7. This metric is the ability to deploy people, supplies and funds to locations where they are most effective in protecting health, according to the index.

The index was originally developed by the Centers for Disease Control and Prevention. It is now funded by the Robert Wood Johnson Foundation and involves the collaboration of more than 30 organizations.


Yelp to List NYC and Long Island Maternity Care Metrics on Hospital Pages
As of May 8, Yelp started displaying information about the quality of maternity care at about 50 hospitals in New York City and Long Island through a partnership with the Northeast Business Group on Health. The Yelp pages for hospitals will indicate whether the facilities are above average, average or below average in their rates of Cesarean-section deliveries in low-risk pregnancies, newborns being fed only breast milk before discharge, the administering of an episiotomy and vaginal births among women who’ve had a previous C-section.

The data come from expectny.com, a project of the Northeast Business Group on Health, which provides maternity-care statistics from New York State and patient-safety organization Leapfrog Group. Its work was supported by a grant from the New York State Health Foundation. The ratings include a link to expectny.com where users can get more information about why it has rated hospitals on these measures. A 2017 report from researchers at the Manhattan Institute found Yelp ratings were correlated with better-quality hospitals in New York State. In the analysis, hospitals with lower rates of avoidable readmission were considered higher quality. Crains NY May 8 

“Do I Really Need An Employee Handbook? Absolutely!”
Creating an employee handbook can seem like a daunting task for an employer. Some employers have few, if any, written policies in place when they begin the process. Others may have adopted individual written policies in the past with little, if any, consideration given to how the policies can or should fit together in a handbook. Questions abound over what policies must or should be included, or over how often the handbook should be updated.

Despite such issues, there is no question that every employer should have a handbook in place.  A properly drafted employee handbook can be a critical risk management tool, communication tool and cost containment tool.  Specifically, a handbook informs employees and supervisors of the rules and policies of the workplace in a uniform way, and provides for clarity concerning expectations and standards that must be followed and adhered to by employees.  A handbook is a primary tool for placing employees on notice of an employer’s policies, expectations and benefits.

Moreover, employers can refer to provisions of an employee manual for purposes of establishing legitimate and lawful reasons for taking an adverse employment action against an employee.  Furthermore, a handbook informs the employees of their rights and benefits in a clear consistent manner and of grievance procedures to ensure that complaints are handled appropriately and effectively.  The prospect of supervisors enforcing rules consistently is enhanced by the existence of a handbook.

Finally, a properly drafted handbook can reduce the risks of litigation or provide a defense in should a lawsuit arise.  This is because its existence can show an employer’s intended consistent treatment of employees, the plaintiff-employee’s violation of the workplace rules, and that a plaintiff-employee’s claim for benefits is baseless given the express language of the handbook.

[1]Madelin T. Zwerling is an attorney at Garfunkel Wild, P.C., which she joined in 2011, and a member of the Employment Law Practice Group, which provides legal advice on a full range of employment matters.  She may be reached at mzwerling@garfunkelwild.com or (516) 393-2510.


New Rule Requires Drug Price Disclosure in TV Ads
The HHS finalized a rule on Wednesday that will require drugmakers to post the list prices of their products in TV ads. The policy applies to all drugs covered by Medicare that cost $35 or more per month or over the course of treatment. The rule takes effect 60 days after it is published in the federal register. The drug industry might challenge the rule.

“We’re moving from a system where patients are left in the dark to where patients are put in the driver’s seat,” Alex Azar, secretary of health and human services, said in a speech.

The rule makes drug companies more accountable to New York consumers, said Eric Linzer, president and CEO of the state Health Plan Association.

“While breakthrough medications provide tremendous clinical benefits to patients there’s really little understanding of how drug manufacturers establish their prices,” he said.


Severe Alcohol-Related Liver Disease Rising, Possibly Due to Binge Drinking
Severe alcohol-related liver disease is on the rise,” (which) may be due to heavy binge drinking, especially in young adults,” experts posit. For the study, investigators “turned to data from 2001 to 2016 from the National Health and Nutrition Examination Survey (NHANES).” The researchers then discovered that “while there has been little change in the rate of people developing alcoholic fatty liver disease, there appears to be an increase in those who are at greater risk of cirrhosis, liver cancer and death.” The findings of the 34,423-person study were published May 7 in a research letter in JAMA.


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


Park Avenue Medical Office for Sale
On Park Ave, for sale is a large medical office, in a beautiful full service co-op with two entrances, one of which is an impressive doorman in lobby entrance.The office has high ceilings, easily adaptable to any specialty and priced to sell. Three good size rooms easily converted to five exams, plus consult, bathroom, reception and large waiting room. Outstanding location. A must see. View floorplan http://ow.ly/kKOI30o6MjI. Call Jeff Tanenbaum,  646-234-2226 or email jtanenbaum@halstead.com for showings and more information.


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


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


5th Ave Medical Office for Share
Facing Central Park in exclusive building, ground floor, separate entrance.
Perfect for psychiatrist, physiatrist, osteopath, or other.
880 5th Avenue (between 69th and 70th Sts.), New York, N.Y.
Please call 917-715-2464


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


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Clineeds, the new online platform designed for medical providers. With Clineeds you can lease your medical officeshared your office spacebuy and sell used medical equipment, or post healthcare job opportunities. LISTING IS FREE! Why wait? Click here to sign-up: www.clineeds.com/sign-up

PHYSICIAN OPPORTUNITIES

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

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

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

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

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

Primary Contact: Oksana


Seeking Executive Director of the Onondaga County Medical Society
Concept:
 An exciting opportunity for the right person to provide leadership for physicians Salary: Commensurate with experience Job Description: Direct day-to-day operations of the Onondaga County Medical Society Some evening meetings, travel required. RequirementsExperience with leading political advocacy; political sophistication. Must know how to interface with government officials. Good networking and communication skills. Conversant with budgets and finance. Excellent media relations skills, including electronic, social media, and written communications. Familiar with medical issues and comfortable discussing them. Education: BA/BS required.  MPH or MBA desirable. We expect innovation and project initiation. The Executive Director will receive a contract that increases remuneration commensurate with membership growth. Application Instructions: Please direct your application to: Dr. Brian Johnson, johnsonb@upstate.edu.


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


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

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 


MSSNY Calls on NYS Legislators to Authorize ONLY Medical Exemptions from Vaccination


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

 

For Immediate Release
May 6, 2019

MSSNY Calls on NYS Legislators to Authorize ONLY Medical Exemptions from Vaccination

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

“Today, the Medical Society of the State of New York joins with 25 medical and public health organizations, and patient advocacy groups asking our NYS legislators to authorize ONLY medical exemptions from vaccination.  Once declared eliminated in the United States by the CDC, measles are now making a comeback. We must do everything that we can to prevent measles from gaining a permanent foothold in New York and prevent the further spread of disease nationally.  An important first step is ensuring that medical exemptions are the only exemption allowable.   We must preserve community immunity in order to protect society—especially our most vulnerable, the newborn, pregnant women, the immune-compromised, and those with cancer.”

# # #

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

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

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MSSNY eNews – May 3, 2019 – Dazzled by Ex-Bronco in Buffalo

Arthur Fougner MSSNY Presiident

PRESIDENT’S MESSAGE<
Arthur Fougner, MD
MSSNY President

MSSNY eNews
MAy 3, 2019

Vol. 22  Number 17


MSSNYPAC Seal

 


Colleagues:

“Blinded by the light
Revved up like a deuce, another Runner in the Night
Blinded by the light.”
Bruce Springsteen

It was great to be back in Buffalo for the Erie County Annual Meeting as Dr. John Gillespie turned over the reins to Dr. Kenneth Eckert III, a third generation physician. In his inaugural, Dr. Eckhert shared several quotes from his grandfather – quotes that still ring true today.

The highlight of the evening was former Denver Broncos wide receiver Vance Johnson (I know – a Bronco in Bills country?) who shared with us his life outside the lines. His was a real Wide World of Sports story – from the thrill of victory to the agony of defeat, as he sank steadily into the quagmire of substance abuse and addiction. A few words can hardly recap the emotion of the evening as the man poured out his heart to all in attendance. Suddenly, agonizing about Managed Care or Reimbursement seemed such small matters indeed.

Mr. Johnson credited the care and tough love shown by a physician Mark Twardowski, DO, for the inspiration and the guts to turn his life around. “He cared about me,” Vance shared. Today, Vance Johnson is a substance abuse counselor and motivational speaker who is truly making an impact one life at a time.

After the meeting, I shared with Vance that I had had a hip replacement and had been prescribed powerful opioids. For some reason, I was somehow not susceptible to their allure.  There but for good fortune, indeed. And we spoke about kids in sports and the influence their coaches and trainers have on them and how easily bad advice and unrealistic expectations can lead athletes to a path to self-destruction. As Mr. Vance was speaking, the realization hit like a ton of bricks that we must always strive to see the person behind the mask. For more about Vance Johnson, check out his video here.

Dr. Fougner Speaks in Buffalo

“Let’s get the collective negotiation football across the goal line,” said MSSNY President Art Fougner at the Erie County Medical Society Annual Meeting this week.

Arthur Fougner, MD
MSSNY President

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


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Capital Update

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This Week’s Podcast of MSSNY’s Legislative Priorities


Medical Organizations, Public Health and Patient Advocacy Groups Join Together to Urge Further Limits on Exemptions For Immunizations
This Monday, May 6, the Medical Society of the State of New York will join 25 other medical organizations, public health and patient advocacy groups urging the New York State Legislature to pass A.2371/S.2984 which ensures that medical reasons are the only exception to vaccination requirements.  The legislation is sponsored by Assemblymember Dinowitz and Senator Hoylman and is in the Assembly and Senate Health Committees. Following the press conference, the groups will meet with various members of the legislature urging their support of the measure.  With the number of measles cases exceeding 700 confirmed cases, all the groups are urging passage to ensure that measles, a vaccine preventable disease, does not gain a sustained foothold in New York and the nation.  The following groups have joined onto a memo in support and many representatives will be attending the press conference:

American Academy of Pediatrics, NYS District II, Chapters 1, 2 & 3, American Nurses Association – New York (ANA-NY), Associated Medical Schools of New York, Autism Science Foundation, Citizen Committee for Children of New York, Inc., Children’s Defense Fund-New York, Ithaca Is Immunized, Kimberly Coffey Foundation, Nurses Who Vaccinate, March of Dimes, Meningitis B Action Project, Medical Society of the State of New York, Nurse Practitioner Association New York State, New York American College of Emergency Physicians, NY Chapter American College of Physicians, NYS Academy of Family Physicians, NYS Association of County Health Officials (NYSACHO), NY Occupational and Environmental Medical Association (NYOEMA) , NY State Neurological Society, NY State Neurosurgical Society, NYS Ophthalmological Society, NYS Society of Otolaryngology-Head and Neck Surgery, NYS Public Health Association, New York State Society of Anesthesiologists, Inc., The New York State Radiological Society

Schuyler Center For Analysis and Advocacy and The Children’s Agenda.

Physicians are encouraged to send a letter to their legislators urging support of A.2371 and S.2984 by going to MSSNY Grassroots Action Center (GAC). Please click here.                               (CLANCY)


Bill Requiring Physicians to Maintain Excessive Documentation of Discussion of Risks of Prescribing Opioids Moves to Senate Floor; Action Needed!
Legislation which would require physicians and health practitioners, who prescribe an opioid or other Schedule II Controlled Substance, to discuss with patients’ the risks prior to being prescribed a CSII drug, has moved to the Senate floor and can be voted on at any time.  The measure, S.4277-A, is sponsored by Senator Harckham.  There is now a companion measure, A.7285-A, sponsored by Assemblywoman Rosenthal.   Specifically the legislation would require physicians to discuss and, by extension, document that such discussions took place: a) the risks of addiction and overdose associated with opioid medications, b) the reason why the prescription is necessary, c) alternative treatments that may be available and d) the risks associated with the use of these medications. Moreover it would require the physician each year to counsel the patient on the risks of overdose and the availability of an opioid antagonist.

While the legislation is well intended, it ignores existing law essentially requiring the patient’s informed consent under the Public Health Law—which means that when a patient needs treatment, the physician must give the patient the information regarding risks to make an informed decision. Additionally, this is duplicative of requirements that currently exist under the ISTOP law, whereby, after the physician prescribes the medication, the pharmacist is required to again inform the patient about the risks of taking a controlled substance. Moreover MSSNY is concerned that such requirements will further discourage physicians from prescribing pain medications for patients who need them – already a growing concern, as well as potentially scaring patients away from taking pain medications who may truly need them.

The Medical Society is opposed to this measure and encourages physicians to send a letter to their legislator at the MSSNY Grassroots Action Center (CAC) here.
(CLANCY, AUSTER)



Collective Negotiations Bill Advances in the Assembly
Assemblymember Gottfried’s bill A.2393, which would help to even the playing field between physicians and insurance companies, has been reported out of the health committee and is now on the Assembly Codes Committee agenda for next week. This bill would allow independently practicing physicians to communicate and negotiate collectively with health care plans in limited instances (when health plans have an undue advantage negotiating the terms of contracts with health care providers). Currently physicians are unable to do so due to federal antitrust law. However, a longstanding US Supreme Court precedent enables States to permit these negotiations via the State Action Doctrine.

Passage of this legislation would help to enable physicians to negotiate to limit burdensome prior authorization procedures and unfair network participation rules. It also contains protections to help ensure that negotiations do not impair access to patient care by prohibiting collective slowdowns/strikes and would ensure strict oversight of these negotiations by the Department of Health.

The same as bill, which is sponsored by Senator Rivera (S.3462) is currently in the Senate Health Committee.

Please urge your legislator to support this bill by clicking here.
(AVELLA, AUSTER)


Senate Health Committee to Consider Legislation to Reduce MOC Hassles
Legislation is on the agenda of the Senate Health Committee for next week (S.5280, Rivera) that would prohibit health insurance companies and hospitals from requiring that their participating network and staff physicians continue to complete often unnecessarily burdensome Maintenance of Certification requirements as a condition of participation in their panels and medical staffs. The Medical Society of the State of New York supports this legislation.

The cost of updating board certification status is increasingly becoming prohibitively expensive and excessively time-consuming for many physicians. With demands on physician time greater than ever before (which is leading to a significant increase in “burnout”), many physicians find that they do not have sufficient time to prepare for ever more cumbersome specialty recertification exams. While efforts are being made by some of the national specialty boards to simplify this re-credentialing process in response to an outcry from the physician community about these excessive requirements, the needed relief is not happening quickly enough. This bill would help to ensure that continuing board certification remains aspirational for physicians, but not mandatory, by ensuring that hospitals and health insurance companies cannot impose such ongoing requirements as a condition of participation, thereby reducing one barrier to delivering medical care in New York State.

Similar legislation (A.5140, Schimminger) is in the Assembly Health Committee. (AUSTER)



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Bill to Restrict Physicians’ Defense in Medical Liability Cases Reported Out of Committee
The Assembly Codes Committee has reported Assemblymember Dinowitz’s bill A.2370 to the floor. The bill, which is opposed by MSSNY, would prohibit a physician’s defense counsel in a medical liability action from conducting an interview with the plaintiff’s treating physician.

This legislation would overturn a New York State Court of Appeals decision that affirmed a long-standing principle in our legal system that no party has a proprietary interest in a particular witness in a civil liability action.  Were this Court of Appeals decision to be overturned through legislation, it would present significant problems for a physician defendant in seeking to defend him or herself in a medical liability action by unfairly limiting the opportunity to fully examine the plaintiff’s health condition to evaluate the merit of the plaintiff’s claim.

New York already has the most burdensome liability environment for physicians in the entire nation, leading to escalating costs and driving physicians out of the state. Analyses have repeatedly stated that New York is the worst state in the country in which to be a doctor, in large part due to its overwhelming liability exposure as compared to other states. Indeed a recent report by LeverageRx showed that New York once again overwhelmingly had the highest liability costs in the country and up 11% between 2017 and 2018.  This legislation would exacerbate these already onerous costs, further drive increases in defensive medicine costs and would make worse the imbalance in our medical liability adjudication system.                                                                                    (AVELLA, AUSTER)


Patient Formulary Protection Bill Advances in Senate
Senator Breslin’s bill S.2849, which would prohibit a health care plan from making prescription drug formulary changes during the contract year, has been reported out of the Senate Insurance Committee for the first time. While patients are locked into an insurance plan for the contract year – and often choose their plan based on their prescription co-pays – insurance companies are able to modify their formulary and often move drugs into a higher cost-sharing tier mid-contract. This legislation would ensure that patients are able to access the drugs they need without unexpected cost increases mid-year.

The bill, which is sponsored by Assemblymember People-Stokes (A.2969), has passed the Assembly every year since 2015 and is currently in the Assembly Insurance Committee awaiting movement.

Please urge your legislator to support this bill by clicking here.  (AVELLA)


Measles Outbreak in New York State Continues to Spread
Webinar Available at MSSNY CME Website

The number of measles cases in New York State continues to rise with approximately 665 of the 706 confirmed cases nationwide in New York State (423 in New York City, 206 in Rockland, 23 in Orange, 10 in Westchester, 2 in Sullivan, 1 in Suffolk and 1 in Greene counties) as of May 1st.  MSSNY conducted a just-in-time Medical Matters webinar entitled “The Continued Public Health Threat of Measles 2018” in December, 2018.  This webinar has now been posted to the MSSNY CME website. You can also view MSSNY’s latest Medical Matters webinar entitled “What’s Your Diagnosis? Infectious Diseases” which involves a patient with a fever and a rash.  Please check these out and keep yourself informed about the growing measles outbreak throughout New York State.  You can also listen to MSSNY’s brief; podcast on the Measles, Mumps and Rubella vaccine here. (HOFFMAN, CLANCY)

https://tinyurl.com/PublicHealthThreatofMeasles


Registration Now Open for Medical Matters Webinar on May 15, 2019 @ 7:30am
The Medical Society of the State of New York will host its final Medical Matters webinar of 2019, The Importance of Resilience After a Disaster on May 15th @ 7:30am.  Encouraging post traumatic growth is an essential part of recovery from any type of disaster.  Learn more about how best to encourage resilience behaviors in patients.

The Importance of Resilience After a DisasterRegister here.

When:  Wednesday, May 15 2019 at 7:30am

Faculty: Craig Katz, MD

Educational Objectives:

  • Define resilience and post traumatic growth
  • Describe how best to measure resilience and post traumatic growth
  • Explore resilience behaviors and how to encourage them in your patients

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. Physician should only claim credit commensurate with the extent HOFFMAN)


Registration Now Open for Veterans Matters CME Webinar on June 5th
Register now for MSSNY’s next Veterans Matters webinar June 5th at 7:30am. This webinar is entitled Substance Use Disorders in Veterans.  Register for this program here.  

Veterans Matters: Substance Use Disorders in Veterans

When:  Wednesday June 5 2019 at 7:30am

Faculty: Frank Dowling, MD

Educational Objectives

  • Define Substance Use Disorders (SUDs), symptoms, warning signs, comorbidities
  • Explore evidence-based intervention and treatment options for SUDs among veterans
  • Identify barriers to diagnosis and treatment 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 this live activity for a maximum of 1.0 AMA/PRA Category 1 credits. Physician should only claim credit commensurate with the extent of their participation in the activity.           (HOFFMAN)


pschuh@mssny.org mauster@mssny.org  pclancy@mssny.org  mavella@mssny.org
charring@mssny.org

eNews

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Zocdoc – The Concern About Their Directory
MSSNY continues to raise concerns on behalf of our member physicians.  Most recently, MSSNY had a conversation with the NYS AG’s office regarding the propriety of the Zocdoc new pricing arrangement.  The AG’s staff agreed with the decision of the NYS DOH indicating that the new pricing protocol does not equate to fee splitting.

We also raised concerns about Zocdoc’s directory. We know that Zocdoc lists the names of physicians who have never had an agreement or who have chosen to non-renew their agreement. These physician names appear in the Zocdoc directory. This present Zocdoc system of listing physicians without an agreement appears to steer patients to physicians with Zocdoc agreements.  This process is unacceptable. We have enlisted our General Counsel, Garfunkel Wild, to ask that Zocdoc amend their directory to include only those physicians who have a Zocdoc agreement.  As soon as we receive a response from Zocdoc, we will inform the membership.


Check Vaccination History if Born Between 1957 through 1989
The total number of U.S. measles cases reported so far in 2019 has reached the highest level in a single year since 1994, according to a CDC report released this week. CDC now is recommending that all U.S. residents check to ensure they have been adequately vaccinated against measles—particularly, individuals who were born in the years 1957 through 1989, since it is likely they were given a weaker version of the vaccine and, during those years, it was common for children to receive just one dose of the immunization. (Source: Vox,4/29)


New York Trails in Toddler Vaccination Rate
New York state ranked 43rd in the rate of children 19 months old to 35 months old who have received the full course of recommended immunizations, at 67.5% in 2017, according to data from the CDC. The U.S. average was 70.4%, and Massachusetts had the highest rate, 82.1%. The data come from the 2017 National Immunization Survey, which tracks whether children have received vaccines against 14 illnesses, such as diphtheria, hepatitis B, measles, meningitis and pneumonia.


FDA Approves First Vaccine to Prevent Dengue Disease
The US Food and Drug Administration (FDA) has approved the first vaccine to prevent dengue disease caused by all dengue virus serotypes (1, 2, 3, and 4) for people aged 9 through 16 years who have previously had laboratory-confirmed dengue infection and who live in endemic areas. The vaccine, Dengvaxia (Sanofi Pasteur), is a live, attenuated vaccine given in three injections. The initial dose is followed by two additional injections 6 and 12 months later.

“Dengue disease is the most common mosquito-borne viral disease in the world and global incidence has increased in recent decades. While there is no cure for dengue disease, [this] approval is an important step toward helping to reduce the impact of this virus in endemic regions of the United States,” Anna Abram, FDA deputy commissioner for policy, legislation, and international affairs, said in a news release. Dengue is endemic in the US territories of American Samoa, Guam, Puerto Rico, and the US Virgin Islands.


Enrollment Declines in Medicaid or Children’s Health Insurance Program
The latest CMS data show that nationally 2.2 million fewer people were enrolled in Medicaid or the Children’s Health Insurance Program from January 2018 to January 2019. CMS says the decline could stem from the improving economy, but other health experts say the drop could stem from stricter eligibility redetermination processes. The New York stats are:

Total Medicaid and CHIP Enrollment 6,527,141 1
·        Medicaid Enrollment 5,883,397
·        CHIP Enrollment 643,744
Total Medicaid Child and CHIP Enrollment 2,499,955 1

Doctors Without Borders Informational Session in NYC
On Wednesday, May 22nd, 2019 physicians are invited to join Doctors Without Borders/Médecins Sans Frontières (MSF) for a recruitment information session in New York, NY. This is your opportunity to meet our recruitment team and learn about how you can join our pool of dedicated aid workers. We’re currently recruiting a variety of positions. Recruitment Information Session Doctors Without Borders 40 Rector St 16th Floor New York, NY 10006 Wednesday, May 22nd, 2019 at 7:00 – 8:30 pm.

Register Now Button


Investors Sue UnitedHealth Directors: Four Things to Know
Central Laborers Pension Fund and a set of investment funds managed by Amalgamated Bank LongView sued UnitedHealth Group’s directors and former CEO in Delaware Chancery Court, according to Law360.

Four things to know:

  1. The derivative action, filed April 24, alleges 15 current or past UnitedHealth directors permitted the company to submit inflated risk adjustment claims to CMS for Medicare Advantage patients.
  2. The lawsuit accuses the directors of breaching their corporate duty, according to Law360.
  3. The lawsuit includes specific allegations against Stephen J. Hemsley, UnitedHealth Group executive chairman and former CEO. He “bore ultimate responsibility for overseeing and executing UHG’s efforts to improperly increase revenues by defrauding Medicare,” the lawsuit states, according to Law360.
  4. The pension fund and bank-managed investment funds are seeking damages on behalf of UnitedHealth for the alleged billing violations. The damages include liabilities for practices dating back roughly 13 years to 2006.becker’s hospital review Ap 30

Millennials’ Health: One-Third Have Lower Life Expectancy
One-third of millennials have a health condition that will lower their life expectancy and quality of life, according to a recent study from the Blue Cross Blue Shield Health Index published last week. The Health Index found that “millennials as a group were living at about 95% of their optimal health.”


CMS

Conscience Rule Finalized to Protect Healthcare Workers’ Religious Beliefs
The Trump administration on Thursday finalized a “conscience rule” to protect healthcare workers who refuse to perform certain services—such as abortion—due to religious beliefs.

The HHS’ Office for Civil Rights issued the 440-page final rule, which offers protections for providers, health insurers and employers that decline to provide, participate in, pay for, provide coverage of or offer referrals for services that violate their religious or moral beliefs. The rule also covers healthcare staff that “assist in the performance” of such services, including schedulers and those who prepare rooms.

The rule is meant to protect individuals and healthcare organizations in HHS-funded programs from discriminating on the basis of religion, according to Roger Severino, director of the OCR. “Finally, laws prohibiting government-funded discrimination against conscience and religious freedom will be enforced like every other civil rights law,” he said.

The OCR said that the rule largely reinforces current laws and regulations that protect a medical provider’s rights to refuse to perform certain procedures, while adding new standards that Medicare and Medicaid providers will need to follow to comply with. Under the rule, applicants for HHS funding must provide assurances and certifications that they are complying with its regulations.

“No new law is being made here,” Severino said on a call with reporters Thursday. “What is being done is the provision of enforcement tools for existing conscience and religious freedom protections in healthcare.”

If providers don’t comply with the conscience regulations, they could lose federal funding. The OCR’s Conscience and Religious Freedom Division, which the office established in 2018, will oversee complaints from providers that feel their rights have not been respected.


Open Payments Data Available for Review
Pre-publication Review and dispute for the Program Year 2018 Open Payments data publication began on April 1, 2019 and will end on May 15, 2019. The Centers for Medicare & Medicaid Services (CMS) will publish the Open Payments Program Year 2018 data and updates to the previous program years’ data in June 2019.

Physician and teaching hospital review of the data is voluntary, but strongly encouraged. Please keep in mind the following:

  • Records eligible for review and dispute: all records submitted during the submission period of the current calendar year, including newly edited, submitted, and re-attested records from previous calendar years. For detailed information refer to the Physician and Teaching Hospital Review and Dispute Tutorial
  • Disputes must be initiated by May 15, 2019 in order to be reflected in the June 2019 data publication. For more information on review and dispute timing and publication refer to the Review and Dispute Timing and Data Publication Quick Reference Guide.
  • CMS does not meditate or facilitate disputes. Physicians and teaching hospitals should work directly with reporting entities to resolve disputes.
  • Registration in the Open Payments system is required in order to participate in review and dispute activities.

Registration Details

If you have never registered with Open Payments before:

Make sure you have your National Provider Identifier (NPI) number and State License Number (SLN). Initial registration is a two-step process:

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

For users who have previously registered:  Users that have registered during previous program years do not need to re-register.


New Study on Physician Compensation

2019 Physician Compensation Report: Doximity, March 2019


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RENTAL/LEASING SPACE


Bronx Physician’s Office for Sale or Lease
Fully equipped physician’s office for sale or lease. Features three exam rooms, lab room, reception area and waiting room, computer and storage rooms. Bronx location near Einstein Hospital and subway. Call 914-882 3797/ shiva381@yahoo.com


Park Avenue Medical Office for Sale
On Park Ave, for sale is a large medical office, in a beautiful full service co-op with two entrances, one of which is an impressive doorman in lobby entrance.The office has high ceilings, easily adaptable to any specialty and priced to sell. Three good size rooms easily converted to five exams, plus consult, bathroom, reception and large waiting room. Outstanding location. A must see. View floorplan http://ow.ly/kKOI30o6MjI. Call Jeff Tanenbaum,  646-234-2226 or email jtanenbaum@halstead.com for showings and more information.


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


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


5th Ave Medical Office for Share
Facing Central Park in exclusive building, ground floor, separate entrance.
Perfect for psychiatrist, physiatrist, osteopath, or other.
880 5th Avenue (between 69th and 70th Sts.), New York, N.Y.
Please call 917-715-2464


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


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

PHYSICIAN OPPORTUNITIES

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

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

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

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

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

Primary Contact: Oksana


Seeking Executive Director of the Onondaga County Medical Society
Concept:
 An exciting opportunity for the right person to provide leadership for physicians Salary: Commensurate with experience Job Description: Direct day-to-day operations of the Onondaga County Medical Society Some evening meetings, travel required. RequirementsExperience with leading political advocacy; political sophistication. Must know how to interface with government officials. Good networking and communication skills. Conversant with budgets and finance. Excellent media relations skills, including electronic, social media, and written communications. Familiar with medical issues and comfortable discussing them. Education: BA/BS required.  MPH or MBA desirable. We expect innovation and project initiation. The Executive Director will receive a contract that increases remuneration commensurate with membership growth. Application Instructions: Please direct your application to: Dr. Brian Johnson, johnsonb@upstate.edu.


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


Pediatrician BC, P/T
Seeking motivated, enthusiastic pediatrician for P/T position in solo practice in Long Island. Coverage will increase over time. Great opportunity or those seeking part time hours in an established practice. Fax resume to 516-858-2389.


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

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 


Medical, Public Health, and Patient Advocacy Groups to Hold Press Conference Calling for Medical Exemptions for Vaccines


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

 

For Immediate Release

MEDIA ADVISORY

MEDICAL, PUBLIC HEALTH, AND PATIENT ADVOCACY GROUPS TO HOLD PRESS CONFERENCE CALLING FOR MEDICAL EXEMPTIONS FOR VACCINES 

When:  Monday, May 6, 2019 12:30 p.m.

Where:  Room 130, Legislative Office Building, Albany, NY

Speakers at the press conference will be:

  • Joseph Sellers, MD, Secretary, Medical Society of the State of New York
  • Senator Brad Hoylman
  • Assemblymember Jeffrey Dinowitz
  • Linda Efferen, MD, MACP, Chair, NYACP’s Health and Public Policy Committee
  • Shetal Shah, MD, FAAP, NYS AAP, District II, Vice President of Chapter 2, Chair of the Chapter 2 Legislative Committee 
  • Sarah Ravenhall, MHA, CHES, Executive Director, New York State Association of County Health Officials (NYSACHO)
  • Stephen Ferrara, DNP, FNP, FAANP, Executive Director, The Nurse Practitioner Association New York State, Associate Dean of Clinical Affairs, Columbia University School of Nursing
  • Erin E. Jones, Regional Director of Advocacy and Government Affairs, March of Dimes
  • Patricia A. Wukovits, RN, Executive Director, Kimberly Coffey Foundation 

# # #

MSSNY Contact:
Pat Clancy
Senior Vice President, Public Health and Education/Managing Director
Medical Society of the State of New York
pclancy@mssny.org
518-465-8085

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

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MSSNY eNews – April 26, 2019 – Standing Up for All Doctors

Arthur Fougner MSSNY Presiident

PRESIDENT’S MESSAGE<
Arthur Fougner, MD
MSSNY President

MSSNY eNews
April 26, 2019

Vol. 22  Number 16


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Colleagues:

John Natale, MD, age 63, was a cardiothoracic and vascular surgeon who practiced in Arlington, IL. Dr. Natale says he made simple coding and billing mistakes. The government believes the doctor tried to rip off taxpayers.

In 2012, government prosecutors accused Dr. Natale of fraud for using CPT (current procedural terminology) codes that allegedly represented more complicated procedures than the surgical ones he performed.  Dr. Natale incorrectly stated that he had used a bifurcation or Y-graft in repairing an abdominal aortic aneurysm instead of a straight tube graft actually used. Government prosecutors accused Natale of fraud for using CPT codes that allegedly represented more complicated procedures than the surgical ones he performed.
                                                     

Prison Sentence


Dr. Natale served a 10-month prison sentence after being convicted in U.S. district court of two counts of making false statements in connection with surgical codes submitted between August 2002 and October 2003. He was acquitted of two counts of Medicare fraud. When he was prosecuted, the MSSNY Council discussed the case at length and Councilors were shocked at the outcome of his trial and it was generally felt that CMS was using Dr. Natale as an example to warn all physicians that erroneous coding was a serious crime.

At this year’s 213th House of Delegates, Resolution 204, “Pardon Dr. Natale,” was adopted. The resolution asks that MSSNY petition President Trump to pardon Dr. Natale, offering some solace for the loss of his career and good name. The reference committee heard testimony that Dr. Natale was convicted and served a prison sentence, based on a coding error, despite having been cleared of the original charge of Medicare fraud in the matter. The AMA and MSSNY supported the overturning of his conviction several years ago, but did not prevail. Those who testified at the reference committee hearing felt strongly that Dr. Natale has been unfairly treated.

Just last week, I received the following note from Dr. Natale:

“Happy Easter to you, Art, and God bless you and your family.
I am working with Kirkland and Ellis in Washington D.C. (the same
lawyers that wrote my amicus brief to SCOTUS). I will send this
email to them. I am hoping for the best. I will keep you informed.
Again thanks for all your support.”

Then, a few days later, I found this in my inbox:

“Dr. Fougner, You’re always a light in a never ending terrible situation.
The leadership that you and the MSSNY provided over my father’s
government targeting was a relief at some of the lowest parts of
our lives. Our fight and resolve continues due to the strength and
kindness you and the MSSNY have provided to my father, our family,
and his community of support. Please express to the MSSNY board
and community our overwhelming gratitude we feel for this very
impactful measure your board has taken. We are proceeding
with this pardon, and when we are successful it will be larger
in part to you and the MSSNY. We should never forget the
medical profession is an easy & soft target, my father’s case
gives presence to future cases that should have all practitioners
fearful for their freedom, but his pardon will have large
implications and hopefully push the judicial system to think
twice on targeting doctors. I have been blessed to have you as
a supporter through much darkness and we look forward to
meeting you and MSSNY in person when we are successful.”

Kindest regards,
Michael Natale

Very proud son of Dr. John Natale

Honestly, I think the underlying story is the real story: All we have is each other.

What matters matters.


Arthur Fougner, MD
MSSNY President

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

 


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Capital Update

Public Health and Patient Advocacy Groups Join Together to Urge Further limits on Exemptions For Immunizations
This week, the Medical Society of the State of New York, the American Academy of Pediatrics, NYSAAP, Chapter 1,2,3, the New York Chapter American College of Physicians Services, Inc.,  the New York Academy of Family Physicians and the NYS Association of County Health Officials met to work together to help enact A. 2371/S. 2984 which ensures that medical reasons are the only exception to vaccination requirements.  The legislation is sponsored by Assemblymember Jeffrey Dinowitz and Senator Brad Hoylman and is the Assembly and Senate Health Committees.  Also joining MSSNY in supporting this measure are Nurses Who Vaccinate and the Kimberly Coffey Foundation.  This week the number of measles cases rose to 695—and have exceeded the entire number of cases from 2018.   According to the CDC  “the high number of cases in 2019 is primarily the result of a few large outbreaks – one in Washington State and two large outbreaks in New York that started in late 2018. The outbreaks in New York City and New York State are among the largest and longest lasting since measles elimination in 2000.  The longer these outbreaks continue, the greater the chance measles will again get a sustained foothold in the United States.”  Physicians are encouraged to send a letter to their legislators urging support of Assembly Bill 2371 and Senate Bill 2984 by going to MSSNY Grassroots Action Center (GAC) Please Click Here   (CLANCY)

 

Bill Requiring Physicians to Discuss Risks of Prescribing Opioids on Senate Health Committee
Legislation which would require physicians and health practitioners who prescribe an opioid or other Schedule II Controlled Substance to discuss with patients’ the risks prior to being prescribed a CSII drug, is on the Senate Health Committee for action this Tuesday 4/30.  The measure, S. 4277, is sponsored by Senator Peter B. Harckham.  There is currently no Assembly same as. While the legistlation is well intended, it ignores the principle of informed consent—which essentially means that when a patient needs treatment, the physician gives the patient the information to make an informed decision. Additionally, this is duplicative of requirements that currently exist under the ISTOP law, whereby, after the physician prescribes the medication, the pharmacist is required to again inform the patient about the risks of taking a controlled substance. Moreover MSSNY is concerned that such requirements will further disincentive physicians from prescribing pain medications for patients who need them – already a growing concern. The Medical Society is opposed to this measure and encourages physicians to contact members of the Senate Health Committee to express their opposition.  Committee members are:  Senator Gustavo Rivera, Chair, Senators:  Patrick Gallivan, Robert Antonacci, Brian Benjamin, Alessandra Biaggi, David Carlucci, Brad Hoylman, Chris Jacobs, Todd Kaminsky, Betty Little, Jen Metzger, Velmanette Montgomery, Patty Ritchie, Julia Salazar, Toby Stavisky.  Members of the Senate can be reached at 518-455-2800.  (CLANCY)


CDC Advises Against Misapplication of the Guideline for Prescribing Opioids for Chronic Pain
The Center for Disease Control and Prevention (CDC) this week in a statement said that the authors of the 2016 CDC Guideline for Prescribing Opioids for Chronic Pain (Guideline) advise against misapplication of the guideline that can risk patient health and safety. The statement said, in part, that the “CDC commends efforts by healthcare providers and systems, quality improvement organizations, payers, and states to improve opioid prescribing and reduce opioid misuse and overdose. However, some policies and practices that cite the guideline are inconsistent with, and go beyond, its recommendations.  In the NEJM commentary, the authors outline examples of misapplication of the guideline, and highlight advice from the Guideline that is sometimes overlooked but is critical for safe and effective implementation of the recommendations.  The full text of CDC release of “CDC Advises Against Misapplication of the Guideline for Prescribing Opioids for Chronic Pain,” is available by Clicking Here.

The American Medical Association (AMA)’s Opioid Task Force Chair, Patrice Harris, MD, MA and President-Elect of the AMA, issued a statement that said in part, that “the CDC’s clarification underscores that patients with acute or chronic pain can benefit from taking prescription opioid analgesics at doses that may be greater than the guidelines or thresholds put forward by federal agencies, state governments, health insurance companies, pharmacy chains, pharmacy benefit managers and other advisory or regulatory bodies.”  A copy of that statement can be found here.

Last year, as part of the New York State budget, a provision was included that required a treatment plan for those on opioid therapy expected to last more than 90 days.  There was a recent letter that NYS Department of Health Bureau of Narcotics sent to physicians who prescribed controlled substances.  This letter stated that the treatment plan must follow generally accepted national professional or governmental guidelines, and shall include (but is not limited to) the documentation and discussion of the following clinical criteria within the medical record:

  • goals for pain management and functional improvement based on diagnosis, and a discussion on how opioid therapy would be tapered to lower dosages or tapered and discontinued if benefits do not outweigh risks;
  • an evaluation of risk factors for opioid-related harms.
  • Such documentation and discussion of the above clinical criteria shall be done, at a minimum, on an annual basis.

The letter then goes on to note: “For an example of a generally accepted national governmental guideline for prescribing opioids for chronic pain from the Centers for Disease Control and Prevention (CDC), visit by Clicking Here

The CDC clarification says that the guideline does not support abrupt tapering or sudden discontinuation of opioids, nor does it suggest discontinuation of opioids already prescribed at higher dosages.       (CLANCY)     

 



Advocating to Improve Insurance Regulations – Take Action Now!
As we progress toward the end of session, it is vital that physicians let legislators know how they feel about a variety of insurance-related legislative measures that would impact physicians and their patients ‘ability to have coverage for the care they need. The following three bills would improve the way that insurance companies operate to allow for better and timelier treatment of patients in New York. Please take action by contacting your legislators and asking them to support these bills.

  • Collective negotiations: Negotiating with insurance companies is extremely difficult, especially when monolithic payers control a huge portion (or all) of the market in which you practice. The fact that Physicians are barred from advocating together with their colleagues is unfair, so we strongly support legislation introduced by Senator Rivera and Assemblymember Gottfried (S.3462/A.2393) that would allow physicians to collectively negotiate with insurance companies in certain situations. The bill is currently on the Assembly Health Committee’s agenda for Tuesday, 4/30 and is in the Senate Health Committee. Please urge your Assemblymember and Senator to join on as a co-sponsor  Here 
  • Mid-year formulary changes: Surprisingly, current law does not restrict insurance companies from making substantial changes to their prescription formularies mid-year. This is an egregious practice when you consider the fact that patients choose insurance plans based on the coverage presented to them – and they generally are not able to switch plans mid-year. Senator Breslin and Assemblymember Peoples-Stokes have introduced legislation (S.2849/A.2969) that would prevent mid-year formulary changes so that patients do not experience removal of a drug or changes in tiering. The bill is currently on the Senate Insurance Committee’s agenda for Monday, 4/29 and is in the Assembly Insurance Committee. Please urge your Assemblymember and Senator to join on as a co-sponsor  Here:
  • Prior authorizations: Prior authorizations continue to be a major roadblock to care and cause endless hassles for you and your staff. The burdens caused by excessive and often unjustified prior authorization requirements take away from the time that Physicians can spend with thei patients and lead to far too many hours being spent on paperwork. Senator Breslin and Assemblymember Gottfried have introduced an “omnibus bill” (S.2847/A.3038) that would help in reducing prior auth burdens, updating UR standards and patient protections for prescription drugs. The bill is currently in the Senate Health Committee and the Assembly Insurance Committee. Please urge your Assemblymember and Senator to join on as a co-sponsor Here   (AVELLA, AUSTER)


Advocacy Continues to be Needed Urging a “Go Slow” Approach on Legalizing Recreational Marijuana Use
While a proposal to legalize “recreational” or “adult use” marijuana was removed from consideration from the recently enacted State Budget, it remains under strong consideration on a “stand-alone” basis by the State Legislature with 8 weeks left to go in the 2019 Legislative Session. MSSNY continues to work with Parent-Teacher associations, school administration officials, county health officials, substance abuse providers, law enforcement and Smart Approaches to Marijuana (SAM) to raise concerns with these proposals.  MSSNY remains supportive of efforts to remove the threat of criminal sanction for marijuana use to address concerns related to selective enforcement of these laws, but remains very concerned regarding various adverse public health effects that have arisen in other states that have legalized recreational marijuana use.  Physicians are urged to continue to send a letter to their legislators urging a “go slow” approach Here     (AUSTER, CLANCY)                     


SED Grants Extension on Use of School Health Forms
The State Education Department (SED) has notified school districts that it has again delayed implementation of a new NYS School Health Examination Form.   In an April 16, 2019 letter to school superintendents and principals, SED instructed that schools accept any physician examination form from students for the 2019-2020 school year, regardless of the form used.  The Medical Society of the State of New York and the American Academy of Pediatrics, Chapters I, II, III, have been working with the SED and health officials on revisions to the school health form.   The new form was required by Commissioner’s Regulation 136.3 which became effective on July 1, 2018.   Physicians throughout the state have indicated that the new form was not compatible with the various electronic health record systems in use by physicians.  MSSNY, AAP and SED have been working collaboratively to make the form compatible to EHR.   A copy of SED’s letter to the school superintendents and principals can be found Here   (CLANCY)

 



NY Rx Card Banner


Workers Compensation Board Issues Updated Regulations to Implement Prescription Medication Formulary
The New York Workers’ Compensation Board (WCB) recently announced its 3rd revision of proposed regulations to implement a prescription drug formulary for injured workers’ medication needs.  To read the latest draft regulation, proposed formulary and summary documents, Click Here.

Comprehensive Workers Compensation reform legislation enacted by the State Legislature in 2017 directed the WCB to develop and implement a formulary.  The proposed regulation and formulary (By Clicking Here:) sets forth a listing of medications that may be prescribed for injured worker patient care needs without prior authorization during the first 30 days after the worker’s injury (Phase A), as well as a listing of medications that may be prescribed and dispensed, up to a 90- day supply, without obtaining Prior Authorization after 30 days following an accident or injury (Phase B).

The proposed regulation also notes that drugs listed as “Perioperative Formulary drugs” may be prescribed without Prior Authorization when prescribed four days before and four days after the patient goes into the hospital, clinic, or doctor’s office for surgery; with the day of surgery being day zero.  When prior authorization is needed for certain medications, the proposed rules require the carrier, employer, or PBM to approve, partially approve or deny a PA request within 4 calendar days of submission by the physician or other care provider.

The proposed regulation also sets forth that new prescriptions must be prescribed pursuant to the Formulary within 6 months of the effective date of the Formulary, and that refills and renewals must be prescribed pursuant to the Formulary within 12 months of the effective date of the Formulary.

Comments will be accepted by the WCB on the revised proposal until May 17.  (AUSTER)


Coalition of State Medical Societies Responds to CMS Report Describing Physician Participation In Medicare MIPS/APM Programs
This week MSSNY joined on to a letter to the Center for Medicare and Medicaid Services (CMS) along with 7 other state medical societies raising concerns with aspects of a CMS report (Click Here:) released in late March summarizing the results of physician and other care provider participation in the Medicare Quality Payment Program for 2017, effecting 2019 Medicare payments.

As reported in last week’s MSSNY e-news, according to CMS, a total of 1,057,824 “clinicians” were eligible for MIPS in 2017, of which 95% participated in the program and avoided a negative payment adjustment by receiving at least 3 points as their MIPS final score.    Physicians had a 94.2% overall participation rate, and non-physician clinicians had a 97.5% participation rate.  The report also noted that 81% of clinicians practicing in small practices participated with MIPS, and 94% of those practicing in a rural area participated with MIPS.

The medical societies’ letter raised concerns that the report failed to provide greater specificity as to the state by state results of small practice participation, as well as creating misimpressions by including within its definition of “participation” those practices unable to submit data due to being a designated disaster.  The report also raises concerns that “while the number of our states’ clinicians who did not participate appears relatively low, the fact that 15,238 of our clinicians would prefer to sit out of the QPP in 2017 and suffer a 4% payment penalty this year rather than hassle with participation is significant to us and bad for medicine”.  Moreover, because some of the mitigating factors no longer exist, the societies noted that “we foresee future outcomes in our states in which potentially thousands more receive the payment penalty. We believe there is an urgent need for CMS to prioritize QPP improvements to ensure broad physician participation.”

Other highlights of the CMS report include:

  • Of the over 1,000,000 clinicians that participated in QPP, 54% received their final score based on participation as part of a group; 12% of received their final score based on individual participation; and 34%  received final scores based on participating in the QPP through an Advanced Payment Model (APM).
  • Bonuses: 71% overall received positive adjustments ranging from +0.28% to +1.88%; 22% received bonuses of up to +0.2%; and 2% received no positive or negative adjustment.
  • Of the over 340,000 clinicians who participated in the APM track, the overwhelming majority participated via the Medicare Shared Savings Program (as an Accountable Care Organization).
  • Of those who successfully participated, 74.3% reported data for a full 12 months, and another 24.9% reported data for 90 days to 12 months.  With regard to small practices, 44.5% reported for the full 12 months, and 53.9% reported data for 90 days to 12 months.
  • The most frequent quality measures reported were: 1) controlling high blood pressure 2) screening for tobacco use and cessation 3) Breast Cancer screening 4) pneumococcal vaccine and 5) encouraging use of aspirin or other anti-platelet
  • The most frequent Quality Improvement measures reported were 1) Having 24/7 access to a patient’s medical record 2) Use of decision support and standardized treatment protocols 3) Patient Centered Medical Home attestation 4) Engaging with patients through patient portal and 5) Collection of data and follow up regarding patient experience.      (AUSTER)


Measles Outbreak in New York State Continues to Spread
Webinar Available at MSSNY CME Website
The measles outbreak in New York State continues to spread with approximately 622 (390 in New York City, and 200 in Rockland, 20 in Orange, 10 in Westchester and 2 in Sullivan counties) confirmed cases as of April 24.  MSSNY conducted a just-in-time Medical Matters webinar entitled “The Continued Public Health Threat of Measles 2018” in December, 2018.  This webinar has now been posted to the MSSNY CME website. Please check it out and keep yourself informed about the growing measles outbreak throughout New York State.  You can also listen to MSSNY’s brief podcast on the Measles, Mumps and Rubella vaccine Here(HOFFMAN, CLANCY)


Registration Now Open for Veterans Matters CME Webinar on April 30th
Register now for MSSNY’s next Veterans Matters webinar on April 30th at 7:30am. This webinar is entitled Suicide in Veterans.  Register for this program Here .
Veterans Matters: Suicide in Veterans
When: Thursday April 30, 2019 at 7:30am – Register Here
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

Additional information or assistance with registration can be obtained by contacting Melissa Hoffman at mhoffman@mssny.org or (518)465-8085

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 creditsä.  Physicians should claim only the credit commensurate with the extent of their participation in the activity.  (HOFFMAN, CLANCY)


Registration Now Open for Medical Matters Webinar on May 15, 2019 @ 7:30am
The Importance of Resilience After a DisasterRegister here:

The Medical Society of the State of New York will host its final Medical Matters webinar of 2019, The Importance of Resilience After a Disaster on May 15th @ 7:30am.  Encouraging post traumatic growth is an essential part of recovery from any type of disaster.  Learn more about how best to encourage resilience behaviors in patients.

Faculty: Craig Katz, MD

Educational Objectives:

Define resilience and post traumatic growth

Describe how best to measure resilience and post traumatic growth

Explore resilience behaviors and how to encourage them in your patients

Additional information or assistance with registration can be obtained by contacting Melissa Hoffman at mhoffman@mssny.org or (518)465-8085

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 creditsä.  Physician should only claim credit commensurate with the extent of their participation in the activity.


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  mavella@mssny.org
charring@mssny.org

eNews

NYC DOHMH Issue Health Advisory on Measles
The New York City Department of Health and Mental Hygiene (DOHMH) released a health advisory related to the current measles outbreak which now totals almost 400. While most cases have been in the Orthodox Jewish communities of Williamsburg, a small number have occurred outside of this area. The advisory includes recommendations about vaccinations and proof of immunity, and provides specific guidance for individuals residing in the four zip codes in Williamsburg impacted by the Order of the Commissioner.

The Medical Society of the State of New York has created a just-in-time Medical Matters online course entitled “The Continued Public Health Threat of Measles 2018”.  This free CME program is on the MSSNY CME website. If you are new to the website, please follow the steps to create an account.  For those who have been on the site, please log in to your account.  Please contact Melissa Hoffman at mhoffman@mssny.org if there are any questions about the CME site.  

 

Rockland County Renews State Of Emergency Despite Court Order
Rockland County renewed its state of emergency order, despite it being struck down by a judge earlier this month, as the state’s worst measles outbreak in a generation continues, officials said Thursday afternoon. Under the renewed state of emergency, which is extended to May 25, 16 schools are forbidden from allowing students to attend class until they are vaccinated or provide a legal exemption. The order affects 331 students, according to county officials. Rockland County has 200 reported cases of measles as of April 25, up from 186 last week, and brings New York’s total to more than 600 reported cases.

The county’s numbers make up about 29 percent of the country’s measles cases, despite Rockland County representing 0.1 percent of the population, according to the state of emergency order.

 

NY Primary Care Doctors in PCMH Rose by 35% from 2018-2018
The number of primary care providers in New York State adopting a high-performing, health care delivery model known as the patient-centered medical home (PCMH) rose by more than 35 percent between May 2017 and May 2018, a dramatic increase in the rate of growth over prior years, according to a United Hospital Fund report released on April 18. Over the past eight years the number of clinicians working in PCMH practices has increased at an average rate of roughly 15 percent a year, from 3,400 clinicians in 2011 to more than 9,000 at the end of May 2018. The recent growth coincides with the Delivery System Reform Incentive Payment (DSRIP) program, the state’s Medicaid reform initiative, in which all or most of a patient’s health care needs are coordinated through a primary care physician. The report, Patient-Centered Medical Homes in New York, 2018 Update: Drivers of Growth and Challenges for the Future, is part of a series UHF has produced since 2011 tracking the adoption of the PCMH model across New York State. New York State continues to lead the nation in the adoption of the medical home model, accounting for 15 percent of the nation’s NCQA-recognized PCMH clinicians.

PCMH is a patient-centric model of care that strengthens relationships between patients and their clinical teams, focusing on improving the health of the population served by the practice. It is especially valuable for treating people with multiple chronic conditions, who generate a disproportionate share of U.S. health care costs.

Primary care practices that have adopted the PCMH model are also struggling with a rapidly changing, and challenging health care landscape. The emergence of, telemedicine, convenient care (e.g., retail clinics and urgent care centers), and concierge medicine, among other innovations, threatens to make it more difficult for PCMH practices to thrive. The report offers suggestions that could make medical homes better able to compete, including: improving access by expanding hours; focusing on prevention and health education; helping patients negotiate the health system during and after acute episodes and hospitalization; and helping patients with multiple chronic diseases better manage their conditions.


MSSNYPAC Welcomes New Co-Chairs And Members

With the transition of Dr. Joseph R. Sellers, MD into the role of MSSNY Vice President, Dr. Arthur Fougner, MSSNY President, has seated two new Co-Chairs with the appointment of Dr. Thomas T Lee, MD, Neurosurgeon of Westchester County and Dr. Rose Berkun, MD Anesthesiologist of Erie County.  Each Chair brings their own strengths, vast experience in fundraising, astute political awareness, and great love for their profession.   Additional appointments to the MSSNYPAC Executive Committee are: Dr. Malcolm Reid, MD, MPP Physical Medicine & Rehabilitation of New York County, Dr. Inderpal Chhabra, MD Internal Medicine of Nassau County, Dr. Michael A. Pisacano, MD, Ophthalmologist of Bronx County, Janine L. Fogarty, MD Radiologist of Monroe County, Yongsoo Joo as Medical Student Representative.  See the full committee list.

All leaders of MSSNYPAC extend their deep gratitude to the hundreds of MSSNYPAC donors in New York State who continue to support the great work MSSNYPAC has helped New York physicians to achieve on behalf of our patients.  MSSNYPAC is a powerful tool essential to amplify the voice of physicians, helping to expand the opportunities for meaningful dialogue with key health care policymakers, and build strong relationships that last.

Become a supporter today www.mssnypac.org/contribute Thank you.


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NYState of Health Providing Grants for Multi-Specialty Groups to Use Open Notes
NYSHealth has supported the spread of OpenNotes in hospital systems throughout New York State, providing patients with access to the visit notes written by their doctors, nurses, or other clinicians. Now, they are eager to spread the program to other health care settings, such as multispecialty group practices and federally qualified health centers. Through a new Request for Proposals, we will provide grants of up to $100,000 in support of the adoption or spread of OpenNotes in non-hospital settings. Proposals are due Thursday, May 2nd.


Pediatrics:
Telemedicine Tied to More Antibiotics for Kids
Telemedicine may be leading to the overprescribing of antibiotics to sniffling children, a new study suggests. The study was published Monday in the journal Pediatrics. Children with cold symptoms seen via telemedicine visits were far more likely to be prescribed antibiotics than those who went to a doctor’s office or clinic, researchers found. And a higher proportion of those prescriptions disregarded medical guidelines, raising the risk they could cause side effects or contribute to the rise of antibiotic-resistant germs.

“I understand the desire for care that’s more convenient and timely,” said the study’s lead author, Dr. Kristin Ray of the University of Pittsburgh. “But we want to make sure that we don’t sacrifice quality or safety or effectiveness in the process.” Ray and her colleagues looked at more than 340,000 insured children who had acute respiratory illness medical visits in 2015 and 2016.

Children received prescriptions for antibiotics more than half the time during telemedicine visits, compared with 42% at urgent care clinics and 31% at doctors’ offices.

The researchers also found that in looking at telemedicine doctors’ decisions about whether to prescribe or not prescribe antibiotics, 4 out of 10 failed to meet medical guidelines on matching treatment to diagnosis. That mainly had to do with doctors prescribing bacteria-fighting drugs to treat viral illnesses, such as colds and flus, that are unaffected by antibiotics. In comparison, 3 out of 10 urgent care clinic decisions were inappropriate, and about 2 out of 10 doctors’ office decisions were. The researchers also found telemedicine physicians appeared to be ignoring other guidelines. For example, doctors are supposed to take a throat swab and run a lab test before diagnosing strep throat. But that rarely happened in telemedicine visits, Ray said.

A large recent study on antibiotic prescribing patterns for adults found little difference between telemedicine and office visits. But there has been little study of the issue in children. The American Academy of Pediatrics, which publishes the journal, encourages parents not to use such direct-to-consumer programs. Academy officials say limited physical examinations and lack of access to patient records can harm care. (AP)


Federal Judge Will Enjoin Family-Planning Physician Gag Rule
U.S. District Judge Michael J. McShane said yesterday that he plans to issue a temporary injunction against the Trump administration’s gag rule dictating what physicians can and cannot say about family planning to their patients in the Title X program. The AMA is the lead plaintiff in the lawsuit to stop the rule, which was set to take effect May 3.


Erie County: NFL Champ Vance Johnson Keynote “How a Doctor Saved My Life

Wednesday, May 1@ Shea’s Seneca

Erie County Medical Society’s 198th Annual Meeting and Installation of Officers will feature Vance Johnson, retired NFL wide receiver Superbowl Champion, as keynote speaker, to tell  “How A Doctor Saved My Life” will be held Wednesday, May 1, 2019 at 5:45 PM – location is The Historic Shea’s Seneca, 2188 Seneca St., Buffalo. Tickets are available at $110 per person – contact Emily McMullen at 716-852-1810.


Services for Dr. Anthony Santomauro on Saturday, May 11 in Amherst, NY
Services for retired surgeon Anthony Santomauro, a MSSNY member since 1963, will be held on Saturday, May 11, 2019 at 10:00 AM at the University at Buffalo Newman Center, 495 Skinnersville Road, Amherst, NY 14228.

CMS

Open Payments Data Available for Review
Pre-publication Review and dispute for the Program Year 2018 Open Payments data publication began on April 1, 2019 and will end on May 15, 2019. The Centers for Medicare & Medicaid Services (CMS) will publish the Open Payments Program Year 2018 data and updates to the previous program years’ data in June 2019.

Physician and teaching hospital review of the data is voluntary, but strongly encouraged. Please keep in mind the following:

  • Records eligible for review and dispute: all records submitted during the submission period of the current calendar year, including newly edited, submitted, and re-attested records from previous calendar years. For detailed information refer to the Physician and Teaching Hospital Review and Dispute Tutorial
  • Disputes must be initiated by May 15, 2019 in order to be reflected in the June 2019 data publication. For more information on review and dispute timing and publication refer to the Review and Dispute Timing and Data Publication Quick Reference Guide.
  • CMS does not meditate or facilitate disputes. Physicians and teaching hospitals should work directly with reporting entities to resolve disputes.
  • Registration in the Open Payments system is required in order to participate in review and dispute activities.

Registration Details
If you have never registered with Open Payments before:

Make sure you have your National Provider Identifier (NPI) number and State License Number (SLN). Initial registration is a two-step process:

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

For users who have previously registered:  Users that have registered during previous program years do not need to re-register.

Please note:  If the account has not been accessed within the last 60 days the account will have been locked due to inactivity. To unlock an account go to the CMS Enterprise Portal, enter your user ID and correctly answer all challenge questions to gain access to your account. You will be prompted to create a new password.

If the account has not been accessed for 180 days or more, the account will be deactivated. To reinstate the account contact the Open Payments Help Desk at 1-855-326-8366; (TTY line: 1-844-649-2766) 

For more information about the registration process, visit the physician and teaching hospital registration page on the Open Payments website. Need help or have questions? Contact the Open Payments Help Desk at openpayments@cms.hhs.gov or call 1-855-326-8366 (TTY Line: 1-844-649-2766). The Help Desk is available Monday through Friday, from 8:30 a.m. to 7:30 p.m. (ET).


Join Primary Care First Model Options Informational Sessions
CMSInnovation Center recently announced the CMS Primary Cares Initiative that will provide primary care practices and other providers with five new payment model options, two of which are under the Primary Care First path.

The Primary Care First payment model options will test whether financial risk and performance-based payments that reward primary care practitioners and other clinicians for easily-understood, actionable outcomes will reduce total Medicare expenditures, preserve, or enhance quality of care, and improve patient health outcomes. Primary Care First also includes a payment model option that provides higher payments to practices that specialize in care for high need patients, including those with complex, chronic needs and seriously ill populations (SIP).

Please attend one of our upcoming informational sessions to learn more about Primary Care First. During the one-hour event, you’ll hear from senior leaders and the team behind Primary Care First about the model aims, requirements, benefits of participation, and application next steps.

For your convenience, we will offer multiple informational sessions. Session information and registration links are included below:

Informational Session 1: Tuesday, April 30th at 12 PM EDT
Register to attend

Informational Session 2: Tuesday, April 30th at 3 PM EDT
Register to attend

Informational Session 3: Thursday, May 16th at 12 PM EDT
Register to attend

Informational Session 4: Thursday, May 16th at 3 PM EDT
Register to attend

Feel free to forward this invitation to colleagues who may be interested in learning more about the Primary Care First Model. Reference materials will also be available for download during the event.

For additional information about Primary Care First, please visit the model website at https://innovation.cms.gov/initiatives/primary-care-first-model-options/.

 


Classified

RENTAL/LEASING SPACE


Bronx Physician’s Office for Sale or Lease
Fully equipped physician’s office for sale or lease. Features three exam rooms, lab room, reception area and waiting room, computer and storage rooms. Bronx location near Einstein Hospital and subway. Call 914-882 3797/ shiva381@yahoo.com


Park Avenue Medical Office for Sale
On Park Ave, for sale is a large medical office, in a beautiful full service co-op with two entrances, one of which is an impressive doorman in lobby entrance.The office has high ceilings, easily adaptable to any specialty and priced to sell. Three good size rooms easily converted to five exams, plus consult, bathroom, reception and large waiting room. Outstanding location. A must see. View floorplan http://ow.ly/kKOI30o6MjI. Call Jeff Tanenbaum,  646-234-2226 or email jtanenbaum@halstead.com for showings and more information.


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


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


5th Ave Medical Office for Share
Facing Central Park in exclusive building, ground floor, separate entrance.
Perfect for psychiatrist, physiatrist, osteopath, or other.
880 5th Avenue (between 69th and 70th Sts.), New York, N.Y.
Please call 917-715-2464


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


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

PHYSICIAN OPPORTUNITIES

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

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

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

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

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

Primary Contact: Oksana


Seeking Executive Director of the Onondaga County Medical Society
Concept:
 An exciting opportunity for the right person to provide leadership for physicians Salary: Commensurate with experience Job Description: Direct day-to-day operations of the Onondaga County Medical Society Some evening meetings, travel required. RequirementsExperience with leading political advocacy; political sophistication. Must know how to interface with government officials. Good networking and communication skills. Conversant with budgets and finance. Excellent media relations skills, including electronic, social media, and written communications. Familiar with medical issues and comfortable discussing them. Education: BA/BS required.  MPH or MBA desirable. We expect innovation and project initiation. The Executive Director will receive a contract that increases remuneration commensurate with membership growth. Application Instructions: Please direct your application to: Dr. Brian Johnson, johnsonb@upstate.edu.


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


Pediatrician BC, P/T
Seeking motivated, enthusiastic pediatrician for P/T position in solo practice in Long Island. Coverage will increase over time. Great opportunity or those seeking part time hours in an established practice. Fax resume to 516-858-2389.



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

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 


MSSNY eNews – April 19, 2019 – Empowering Physicians Once Again

Arthur Fougner MSSNY Presiident

 

PRESIDENT’S MESSAGE
Arthur Fougner, MD
MSSNY President

MSSNY eNews
April 19, 2019
Vol. 22  Number 15


MSSNYPAC Seal

 


Colleagues:

When Gerald Ford took the oath of office, he offered that he was a Ford not a Lincoln. Heck, I’m a Fougner, not a Madejski.

I just hope I’m not an Edsel!

In the early 1980s while a young attending at North Central Bronx Hospital, Dr. George Kleiner decided they needed someone with ultrasound skills for his department and was kind enough to get me going. Fast forward to 1986 and I was now offering my services to private patients in the community, including many patients from other OB-GYNs. One physician then told me that the reason that he did not refer was that he somehow felt his patients would be so impressed that they’d leave his practice for mine. Ridiculous right? But I thought about it long and hard and decided to get a life and no longer respond to the 3AM hospital calls. I delivered my last baby in 1992 and consider myself ahead of the unfortunate trend of OB’s abandoning obstetrics for “gynecology only” practice which is collateral damage on the med-mal front.

Forces Against Us

And the front it is. For many years, there has been a War on Doctors. While there have been few pitched battles, there has been the daily toll of minor skirmishes. About ten years ago, I likened the forces confronting medicine to Cerberus, the Hound of Hades, who stood guard over the Greek Underworld. As often is the case, I was wrong. Today, that beast has morphed into an ugly, multi-headed Hydra. Yes, we still battle Trial Lawyers, Government Regulators and Insurers, but there are also Health Policy Wonks, Administrators of all sorts, Pharma and PBMs, EHRs, and— yes— even our own Boards confront us over Certification.

In Christopher Nolan’s 2005 movie “Batman Begins,” the martial arts expert who schools Bruce Wayne and remarks that “Criminals thrive on the indulgence of society’s goodwill.” Folks, today EVERYONE thrives on the indulgence of Doctors’ goodwill. Medicine is known as a learned profession yet its practitioners have so little say in the manner in which they practice their profession. We’re a Doctors’ Organization. Without doctors, what will our patients do? 

On every flight, the attendant runs a drill. The rule is that the fit place their oxygen masks on first before attending to others. Otherwise, no one is fit. Physicians, we need to learn to care for ourselves first. If something is not good for doctors, how can it be good for patients?

Our largesse is killing us. And it shows. Whatever you choose to name it, Burnout, Abuse, Moral Injury, Disillusionment, it’s real and it is killing doctors. Suicide among physicians is double that of the general public.

Fourth Pillar

Two years ago, Dr. Charles Rothberg introduced Three Pillars – Wellness, Diversity, and Engagement.

This year, I propose a fourth – EMPOWERMENT!

The good book tells us that the Father’s House has many mansions. Well, the House of Medicine has many silos. We have specialty societies, ethnic societies, alumni societies, staff societies. We have employed physicians and independent physicians. All too easily, our differences morph into opposition. Others see this … and they use it against us. Divide and conquer – Specialty vs. Specialty, Specialty vs Primary Care, Ethnic vs Ethnic, Upstate vs Downstate, Independent vs Employed, Health System vs Health System. Our differences ultimately lead to division, disillusionment and defeat.

The good book tells us that the Father’s House has many mansions. Well, the House of Medicine has many silos. We have specialty societies, ethnic societies, alumni societies, staff societies. We have employed physicians and independent physicians. All too easily, our differences morph into opposition. Others see this … and they use it against us. Divide and conquer – Specialty vs. Specialty, Specialty vs Primary Care, Ethnic vs Ethnic, Upstate vs Downstate, Independent vs Employed, Health System vs Health System. Our differences ultimately lead to division, disillusionment and defeat.

Solidarity is the key to Empowerment. Doctors everywhere, tear down these silos!

Physician Wellness is today’s buzzword. And kudos to the Northwell Health System for showing a private screening of the film “Do No Harm,” a powerful expose on the forces that can drive intelligent, talented physicians to despair—sometimes— even suicide. In fact, Dr. Ira Nash, head of Northwell’s Physician Partners, was able to intervene in a physician’s cry for help in response to the email announcing the film. Many resources are available for doctors in need. But in NY State, a physician’s plaintive cry can lead to an OPMC investigation! Our Society is negotiating with OPMC to institute a system similar to the POPPA program available for police officers in need. If all NY’s physicians to cry out in unison, this would certainly happen.

Make it so! The path to wellness runs through empowerment!

Getting Onboard

We need all physicians to get onboard. So what’s holding up engagement? The inertia of past frustrations stands in the way of the enthusiasm of winning. The silos remain intact. I get this all the time: “But what have you done for ME lately?”

Engagement without a sense of Empowerment is an exercise in futility. Defeatism is a tough nut to crack. While there are articles bemoaning the End of the Doctors’ Lounge, know that there are new Doctors’ Lounges every day called Social Media. Here our younger colleagues can show us the way because we need all the help we can get!  If the truth is out there, then let’s mobilize our younger physicians to spread the word.

Start small. Pick issues where most agree and roll with it! When folks get in the habit of working together successfully, the feeling perpetuates itself, making the harder stuff easier.

We’re the ones who managed to pass Gross Anatomy.

We can do this! This is not about me, it’s about everyone. E pluribus unum!

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

Arthur Fougner, MD
MSSNY President


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eNews

Resolution Highlights: MSSNY’s 2019 House of Delegates
Nuisance Prior Authorizations
Medication prior authorizations must have a sound clinical justification, including, but not limited to, promotion of adherence to guidelines, promotion of generic alternatives, prevention of adverse reactions, and be available upon request from the Pharmacy Benefit Manager. MSSNY will advocate with the NYS Department of Health and NYS Department of Financial Services to prevent health insurers from imposing prior authorizations without appropriate clinical justification. MSSNY will advocate to the NYSDOH to instruct Medicaid managed care contractors to approve prior authorizations for a minimum of one year. 

Single Payer
MSSNY reaffirmed its opposition to the concept of single payer. MSSNY will continue to consider the feasibility of other payment methodologies including single payer and will also continue to work collaboratively with physicians who both support and oppose such proposals in order to assess the strengths and weaknesses of such proposals. MSSNY will continue to advocate that physicians are ensured direct input and ongoing involvement on all aspects of any single payer system or other system that may be considered by the New York State Legislature or United States Congress. 

Mental Health Services for Medical Students
MSSNY will encourage Medical Schools in New York State to provide confidential in-house mental health services at no cost to students, without billing health insurance, and set up programs to educate both students and staff about burnout, depression and suicide and bring this resolution to the AMA. MSSNY will encourage Medical Schools in New York State to offer, affordable, confidential off-site counseling. 

Continuing Certification of Medical Competence
MSSNY will adopt the position that verifiable demonstration of currency and competence in medical practice should include as an acceptable alternative to continuing board certification by the appropriate medical specialty board(s) the following: written attestation of good professional standing in the appropriate community(s) of practice by a minimum of two peers also in good standing in the same community; satisfactory completion of a minimum of 50 hours every two years of CME experiences related to the specialty(s) of medicine in which one currently practices, in accordance with the current practices of the appropriate medical specialty(s); and validated self-assessment of current cognitive knowledge following no fewer than 20 hours every two years from the above cited CME experiences. 

Advancing Gender Equity in Medicine
MSSNY will promote pay structures based on objective, gender-neutral criteria; promote educational programs to empower physicians of all genders to negotiate equitable compensation; advocate for training to identify and mitigate implicit bias in compensation decision making for those in positions to determine salary and bonuses; collect and analyze comprehensive demographic data and produce a report on gender equity within MSSNY with recommendations to support ongoing gender equity efforts. 

MSSNY Policy on Gender Equity in Medicine
MSSNY will support institutional, departmental and practice policies that promote transparency in defining the criteria for initial and subsequent physician compensation; advocate for pay structures based on objective, gender-neutral criteria; encourage a specified approach, sufficient to identify gender disparity to oversight of compensation models and create an awareness campaign to inform physicians about their rights under the Lilly Ledbetter Fair Pay Act and Equal Pay Act.

Right for Gamete Preservation Therapies
MSSNY will officially recognize fertility preservation services as an option for the members of the New York transgender and non-binary community who wish to preserve future fertility through gamete preservation prior to undergoing gender affirming medical or surgical therapies and will officially support the right of transgender or non-binary individuals to seek gamete preservation therapies. 

Increased Accessibility of Emergency Epinephrine for Anaphylactic Response
MSSNY will support legislative action to bring about training on and accessibility to emergency epinephrine in areas deemed to be high risk, including but not limited to those focused on children and food service, such as childcare facilities, schools, school buses, food-service areas and restaurants. 

Physician Credentialing Improvement
MSSNY will advocate for regulation or legislation asserting that a physician who has submitted a completed application for credentialing, until which time that application is accepted or rejected, may bill for services under the general supervision of a physician who is already credentialed by that plan. This shall be applied to all insurance plans, including state sponsored plans such as worker’s compensation. 

Reducing Physician Barriers to Mental Health Care
MSSNY will promote the work of its Physician Wellness and Resilience Committee and the survey on physicians’ stressors that are faced on a daily basis.  MSSNY will design educational resources and continuing medical educational programs on physician wellness and resiliency and will explore the possibility of establishing a physician, resident and medical student wellness program. 

Laser Hair Removal
MSSNY will advocate that laser hair removal only be performed by an appropriately trained and educated individual under physician supervision and will encourage provision of public education regarding the risks of laser use for aesthetic services. 

Financial Penalties and Clinical Decision-Making
MSSNY opposes the practice of a payer utilizing statistical targets to determine the cost-effectiveness of a therapeutic choice and opposes the practice of a payer imposing financial penalties upon individual imposing financial penalties upon individual physicians and/or associated physicians based upon use of statistical targets without fist considering the clinical factors unique to each patient’s claim. 

Benzodiazepine and Opioid Warning
MSSNY will raise the awareness of its members of the increased use of illicit sedative/opioid combinations leading to addiction and overdose death and will bring this resolution to the AMA so that it may warn members and patients about this public health problem. 

Promoting Addiction Medicine during a Time of Crisis
MSSNY will endorse and support the incorporation of addiction medicine science to medical student education and residency training and will send the resolution to AMA, Liaison Committee on Medical Education, Commission on Osteopathic College Accreditation, American Osteopathic Association, and Accreditation Council of Graduate Medical Education.

The following two resolutions were referred to Council for further study:

  • Urgent Care in the Doctor’s Office
    This resolution asks that MSSNY seek payment reform to ensure site neutrality such that urgent, same-day services provided outside of usual business hours or for emergency care are paid equivalently regardless of the site of service.
  • Shortage of Specialists in Workers’ Compensation System
    This resolution asks that MSSNY work with the Workers’ Comp Board, and, if necessary, the legislature to promulgate new regulations or laws that are necessary to increase voluntary participation of necessary specialists and subspecialists in locations and in specialties where there is a shortage of qualified providers and work with specialty societies that represent the specialties that are in short supply in the Workers’ Comp system to develop a joint strategy, including review of the current inadequate payment structure, to resolve this public health problem.

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Office-Based Surgery Mandated Reporting Update
The NYS Department of Health has sent Office-based Surgery (OBS) practices a letter indicating that it was not moving forward in 2019 with a proposed requirement for OBS practices to report information to DOH regarding the numbers of each type of procedure performed in their OBS practices.

MSSNY, working together with the NYS Society of Plastic Surgeons and NY Chapter of the American College of Physicians, had indicated its support for the goals of the proposed reporting requirements to provide necessary context to assess the frequency/lack of frequency of certain adverse events reported to DOH.  However, given the potential complexity this presented for some practices, MSSNY, NYSSPS and ACP also suggested alternatives to this reporting requirement such as having DOH request such cumulative procedural information from the accrediting entities from which OBS practices are required to receive accreditation.

Instead, the DOH will be placing additional efforts to ensure all OBS physician practices are complying with the New York law that requires all adverse events arising in an OBS setting to be reported to the DOH patient safety center within three business days of the adverse event.  NYS Public Health Law Section 230-d defines an “Adverse event” as a “(i) patient death within 30 days;  (ii) unplanned  transfer  to  a hospital or emergency department visit within 72 hours of office-based surgery for  reasons  related  to  the   office-based  surgery encounter; (iii) unscheduled hospital admission or assignment to observation services,  within 72 hours of the office-based surgery, for longer than 24 hours; or (iv) any other serious or life-threatening event”.

MSSNY looks forward to partnering with the DOH to educate and ensure physicians in complete compliance with these adverse event reporting requirements.


MSSNYPAC Congratulates and Thanks Joseph R. Sellers, Md for His Leadership
We would like to thank Dr. Joseph R. Sellers, MD of Schoharie County for his dedicated and steadfast leadership of MSSNYPAC from April 2010 until April 2019. He has skillfully steered MSSNYPAC through challenging changes in the medical practice landscape and we are confident he will do the same as he continues to progress through MSSNY leadership. Dr. Sellers has been elected to serve as Vice President of MSSNY and is on track to become President of MSSNY in 2021.

On behalf of the MSSNYPAC members and Executive Committee, we thank you for your many years of selfless service to the profession of medicine. Your professionalism in advocacy on behalf of the patients, physicians and medical community as a whole, both in New York State and nationally, has been exemplary. We extend our sincere and heartfelt gratitude and honor your service. We appreciate the foundation that you have laid for our future success and the example that you have set for our future PAC leaders and members. We wish you the best of luck in your endeavors and look forward to your continued service to MSSNY.


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Mount Sinai Medical School to Cap Debt at $75K for Students with Financial Need
The Icahn School of Medicine at Mount Sinai will begin capping debt at $75,000 for students with a demonstrated financial need during the next academic year, making it the latest institution to address the massive debt burden that often accompanies medical education.

Students who qualify will take out no more than $18,750 per year in loans to cover costs such as tuition, housing, food and books.

The initiative follows NYU School of Medicine’s decision to offer free tuition for all medical students and a move by Columbia University’s Vagelos College of Physician and Surgeons in 2017 to offer scholarships that cover 100% of students’ financial needs.

Mount Sinai’s strategy is unique in that it applies not just to tuition but to living expenses. Tuition for the current academic year is nearly $53,000, but the school estimates the cost of attendance, which includes expenses such as rent and health insurance, will run students an additional $25,000 to $35,000 a year. Three-quarters of medical students nationwide finance their education with some debt, and the median amount for the class of 2018 was $194,000, according to the Association of American Medical Colleges.

“The program won’t benefit all students. It will award money based on a student’s expected family contribution, which is determined through federal and private financial aid applications. A first-year student with an expected family contribution of $79,000, which is above the cost of attendance, wouldn’t receive any aid, for example.

The news was shared with students via email Wednesday and wasn’t met with unanimous praise. One student, who doesn’t expect to qualify but will graduate with about $200,000 in debt, said it was “honestly a little bit of a disappointment” because many middle-class students won’t be eligible.

The program does not, as some do, compel students to enter specialties such as family medicine and pediatrics or to work in underserved areas. Crains Health Plus Ap 11.


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New York Leads All States in Malpractice Payouts
Medical malpractice claims against New York health care
professionals paid out $685.3 million last year, over $300 million more than in the second-highest state, Pennsylvania.

New York’s cases paid $35.07 in malpractice payouts per capita, which was also the highest nationwide, according to data from online insurance broker LeverageRx. The payments were 11% higher than during the previous year.

New York’s medical community has for years pointed to the high rate of malpractice claims as creating a hostile environment for doctors here. Consumer-finance website WalletHub named New York the worst state to practice in as a physician, which has led the Medical Society of the State of New York to call for tort reform.


Northwell Enters Management Agreement with Nassau County Med Center
Northwell Health has received state approval to form a management services agreement with Nassau University Medical Center and create a five-year strategic plan for the hospital.

Winnie Mack, Northwell’s senior vice president of operations, will run the hospital as president and chief executive of NuHealth, the public corporation that operates the facility. She will be working on behalf of True North Healthcare Consulting but will report to NuHealth’s board.

The board has agreed to a three-year strategic advisory services agreement with Northwell, which will have its leaders assess the hospital’s needs and make recommendations.

Nassau University Medical Center is a safety-net provider for the county, and more than half of its patients either are uninsured or pay through Medicaid, which provides lower reimbursement than other forms of insurance. Northwell said the deal would be similar to its work advising One Brooklyn Health System, the three-hospital network that enlisted Northwell’s consulting arm to produce a strategic plan. That comparison is notable in that Northwell has acted as an adviser, not an acquirer, for the Brooklyn facilities, which rely on significant state subsidies. The announcement said NuHealth and Northwell will keep separate governance structures. Crains Health Plus Ap11.


Physicians Day at the Races 2019 – Secure Your Tickets Today!
Join your colleagues for MSSNYPAC’s Physicians Day at the Races on Saturday, July 27, 2019 at Saratoga Race Track in Saratoga Springs, NY. All physicians, including non-members of MSSNY are welcome to support this state-wide fellowship event for MSSNYPAC while supporting a great cause that strengthens our profession. Tickets are $500/physician and $300/guest. Visit www.mssnypac.org/events for details or to download an invitation. Ticket or sponsorship inquiries can be directed to Jennifer Wilks at 518-465-8085.


Measles Update: Recent Measles Outbreak in Brooklyn and Queens
As of April 15, 2019, there have been 329 confirmed cases of measles in Brooklyn and Queens since October. Most of these cases have involved members of the Orthodox Jewish community.

The initial child with measles was unvaccinated and acquired measles on a visit to Israel, where a large outbreak of the disease is occurring. Since then, there have been additional people from Brooklyn and Queens who were unvaccinated and acquired measles while in Israel. People who did not travel were also infected in Brooklyn or Rockland County.

Vaccination Requirement in Brooklyn

On April 9, the Health Commissioner ordered (PDF) every adult and child who lives, works or resides in the following ZIP codes and has not received the measles, mumps and rubella (MMR) vaccine to be vaccinated:

  • 11205
  • 11206
  • 11211
  • 11249

People who demonstrate they are immune from measles have a medical condition that prevents them from receiving the vaccine will not need to get vaccinated.

If the Health Department identifies a person with measles or an unvaccinated child exposed to measles in one of the above ZIP codes, that individual or their parent or guardian could be fined $1,000. (NYCDOHMH)


Potential Risks of Direct-to-Consumer Pediatric Telemedicine Visits
Children were more likely to receive antibiotics for acute respiratory infections via DTC telemedicine visit versus in-person urgent care or primary care visit.

Commercial companies now offer acute pediatric care via direct-to-consumer (DTC) telemedicine visits with physicians who are outside of the child’s medical home. The American Academy of Pediatrics and American Telemedicine Association have cautioned that because such care lacks continuity and access to the child’s past medical history, it could lead to lower quality of care, especially in nonverbal children.

To test this hypothesis, researchers used commercial health plan claims data to compare children’s receipt of antibiotics for acute respiratory infection from 4600 DTC telemedicine visits, 38,400 urgent care visits, and 485,200 primary care pediatrician (PCP) visits. Patients were newborn to age 17 years. Children with chronic conditions that could affect antibiotic management decisions were excluded. Groups were matched on patient demographics, insurance, medical complexity, and diagnosis category.

Children seen via DTC telemedicine visit were more likely to receive antibiotics (52%) compared with those seen in urgent care (42%) or by PCPs (31%) and less likely to receive guideline-concordant care regarding antibiotic management (59% vs. 67% for urgent care and 78% for PCP; P<0.001 for both comparisons). Lower guideline concordance in DTC telemedicine was primarily attributable to inappropriate antibiotic prescribing for viral infections. (Pediatrics 2019 Apr 8 Gerber JS).


Garfunkel Ad


SED Grants Extension on Use of School Health Forms
The State Education Department (SED) has notified school districts that it has again delayed implementation of a new NYS School Health Examination Form. In an April 16, 2019 letter to school superintendents and principals, SED instructed that school accept any physician examination form from students for the 2019-2020 school year, regardless of the form used. MSSNY and the American Academy of Pediatrics, Chapters I, II, III, have been working with the SED and health officials on revisions to the school health form. The new form was required by Commissioner’s Regulation 136.3 which became effective on July 1, 2018. Physicians throughout the state have indicated that the new form was not compatible to electronic health record. MSSNY, AAP and SED have been working collaboratively to make the form compatible to EHR. A copy of SED’s letter to the school superintendents and principals can be found here.


UnitedHealth posts $3.5B profit in Q1
UnitedHealth Group recorded strong financial results in the first quarter of fiscal year 2019, ending the period with a $3.5 billion profit. The company recorded revenues of $60.3 billion for the three months ended March 31, up 9.3 percent from $55.2 billion reported in the same period a year earlier. Revenue gains were led by growth across its UnitedHealthcare Medicare and Retirement, OptumRx, and OptumHealth lines. The company’s health insurance arm, UnitedHealthcare, added 880,000 members in the past year.

This helped increase the unit’s first-quarter revenues by $3.4 billion to $48.9 billion.
UnitedHealth’s Optum unit continued to be a significant source of revenue growth for the company. Optum’s revenue climbed by 11.7 percent year over year to $26.4 billion in the first quarter of this year, up from $23.6 billion recorded in the same quarter a year prior.
Overall, UnitedHealth saw its operating expenses increase year over year to $55.5 billion in the first quarter of this year, up 8.5 percent year over year from $51.1 billion.
UnitedHealth ended the first quarter with net earnings attributable to shareholders of $3.5 billion, up 22 percent from a profit of $2.8 billion reported in the first quarter of 2018. (Beckers Hospital Review)


CMS

Physicians Advocacy Institute Comments on CMS Releases QPP Year 1 Report
On March 20, CMS released the 2017 QPP Reporting Experience Report with an appendix providing an overview of the participation results from the first year of the QPP. PAI does not believe the report comprehensively reflects the experience of QPP participation, which is of great concern. For example, the report does not reflect the disproportionate number of small and rural practices who received a penalty under MIPS (details below), which underscores PAI’s ongoing concern about the burden placed on these practices that often results in a shift into employed status. In response, PAI is working to develop a thoughtful response to policymakers highlighting our concerns and providing recommendations to improve the report to accurately and fully capture the 2017 QPP experience. Additionally, PAI wants to ensure a report portraying an incomplete picture of QPP participation is not utilized to make adjustments to the program in future rulemaking. A few of CMS’ key findings are shared below in addition to initial observations from PAI.

CMS’ Key Findings

  • Ninety-five percent of all eligible clinicians participated in MIPS and avoided a negative payment adjustment
  • Ninety-three percent of those who participated in MIPS earned a positive payment adjustment
  • Fifty-four percent of eligible clinicians participated as a group, 12 percent as individuals, and 34 percent through MIPS APMs
  • A majority of eligible clinicians opted to report data for 90 days or longer
  • MIPS eligible clinicians who were in small or rural practices had participation rates of 81 and 94 percent, respectively

PAI’s Observations

  • Ninety-nine percent of individual participants submitted their quality measures data using claims emphasizing the importance of retaining this submission mechanism for small practices
  • Seventy-one percent of eligible clinicians received a positive adjustment with the additional adjustment for exceptional performance; however, the range for the overall payment adjustment for this group was low at 0.28-1.88 percent, indicating the marginal reward for participation in the program
  • It appears that the participation rate includes eligible clinicians who actively participated as well as those who did not submit any data but were deemed as meeting the minimum threshold for avoiding a negative payment adjustment (i.e. automatically received three points as their final score) due to the 2017 Extreme and Uncontrollable Circumstances Policy
  • About 83 percent of negative payment adjustments were collected from individual and small practices (15 or fewer eligible clinicians), indicating how the positive payment adjustments are mostly being funded off the backs of those in individual and small practices who may be disadvantaged and face barriers to successful participation in MIPS

Only 37 percent of eligible clinicians participated in the Promoting Interoperability (formerly ACI) category which requires use of Certified Electronic Health Records (CEHRT), indicating the continued challenges and barriers with CEHRT requirements.


CMS New Report: 94% Overall Physician Participation in Medicare MIPS/APM
In late March, the Center for Medicare and Medicaid Services (CMS) released a report (https://qpp-cm-prod-content.s3.amazonaws.com/uploads/491/2017%20QPP%20Experience%20Report.pdf) summarizing the results of physician and other care provider participation in the Medicare Quality Payment Program for 2017, effecting 2019 Medicare payments.  Among the highlights of the report:

  • According to the report, a total of 1,057,824 “clinicians” were eligible for MIPS in 2017, of which 95% participated in the program and avoided a negative payment adjustment by receiving at least 3 points as their MIPS final score. This exceeded the CMS established goal of having 90% of MIPS eligible clinicians participate during the 2017 performance year. Physicians had a 94.2% participation rate, and non-physician clinicians had a 97.5% participation rate.
  • Of the over 1,000,000 clinicians that participated in QPP, 54% received their final score based on participation as part of a group; 12% of received their final score based on individual participation; and 34% received final scores based on participating in the QPP through an Advanced Payment Model (APM).
  • Bonuses: 71% overall received positive adjustments ranging from +0.28% to +1.88%; 22% received bonuses of up to +0.2%; and 2% received no positive or negative adjustment.
  • 81% of clinicians practicing in small practices participated with MIPS, and 94% of those practicing in a rural area participated with MIPS.
  • Of the over 340,000 clinicians who participated in the APM track, the overwhelming majority participated via the Medicare Shared Savings Program (as an Accountable Care Organization).
  • Of those who successfully participated, 74.3% reported data for a full 12 months, and another 24.9% reported data for 90 days to 12 months. With regard to small practices, 44.5% reported for the full 12 months, and 53.9% reported data for 90 days to 12 months.
  • The most frequent quality measures reported were: 1) controlling high blood pressure 2) screening for tobacco use and cessation 3) Breast Cancer screening 4) pneumococcal vaccine and 5) encouraging use of aspirin or other anti-platelet
  • The most frequent Quality Improvement measures reported were 1) Having 24/7 access to a patient’s medical record 2) Use of decision support and standardized treatment protocols 3) Patient Centered Medical Home attestation 4) Engaging with patients through patient portal and 5) Collection of data and follow up regarding patient experience.

Here is a chart detailing specialty by specialty participation in the QPP program in New York:

MIPS/APM PARTICIPATION LEVELS – NEW YORK – 2017

Specialty MIPS/APM Participation
Addiction Medicine 87.5%
Allergy/Immunology 91.28%
Anesthesiology 93.14%
Cardiac Surgery 93.65%
Cardiology 91.91%
Colorectal Surgery 93.57%
Critical Care Intensivists 97.37%
Dermatology 85.73%
Diagnostic Radiology 94.45%
Emergency Medicine 97.83%
Endocrinology 93.78%
Family Practice 93.91%
Gastroenterology 92.6%
General Surgery 94.32%
Geriatric Medicine 96.23%
Gynecology/Oncology 96.43%
Hand Surgery 92.68%
Hematology 97.06%
Hematology/Oncology 95.05%
Hospitalist 100%
Infectious Disease 92.6%
Internal Medicine 92.63%
Interventional Cardiology 95.51%
Interventional Pain Management 83.16%
Interventional Radiology 95.21%
Medical Oncology 96.42%
Nephrology 91.87%
Neurology 91.95%
Neurosurgery 94.66%
Nuclear Medicine 94.92%
OB-GYN 96.41%
Ophthalmology 91.14%
Orthopedic surgery 92.46%
Otolaryngology 92.43%
Pain Management 83.78%
Pathology 93.16%
Pediatric Medicine 99.32%
Physical Medicine and Rehabilitation 87.26%
Plastic and Reconstructive Surgery 90.26%
Psychiatry 93.7%
Pulmonary Disease 91.54%
Radiation Oncology 97.37%
Rheumatology 95.03%
Surgical Oncology 95.56%
Thoracic Surgery 96.37%
Urology 91.6%
Vascular Surgery 94.21%

Webinars

MSSNY CME Webinar Health Matters for Women Registration Now Open
The Medical Society of the State of New York is proud to announce a live continuing medical education (CME) webinar on a women’s health topic entitled “Health Matters for Women: Endometriosis” on Tuesday, April 23rd, 2019 from 7:30 AM to 8:30 AM for all physicians and other health care providers. Registration for the webinar is now open.

Health Matters for Women: Endometriosis.  Register here.

When:  Tuesday, April 23rd at 7:30am
Faculty: Lisa Eng, DO

Educational Objectives:

Review potential causes of pelvic pain and discuss how to identify endometriosis

Discuss the benefits and risks as well as the efficacy and limitations of available medical therapies for long-term treatment of endometriosis

Discuss implementation of individualized endometriosis treatment plans and options

The Medical Society for 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 credit TM. Physicians should claim only the credit commensurate with the extent of their participation in the activity.


Classified

RENTAL/LEASING SPACE


Bronx Physician’s Office for Sale or Lease
Fully equipped physician’s office for sale or lease. Features three exam rooms, lab room, reception area and waiting room, computer and storage rooms. Bronx location near Einstein Hospital and subway. Call 914-882 3797/ shiva381@yahoo.com


Park Avenue Medical Office for Sale
On Park Ave, for sale is a large medical office, in a beautiful full service co-op with two entrances, one of which is an impressive doorman in lobby entrance.The office has high ceilings, easily adaptable to any specialty and priced to sell. Three good size rooms easily converted to five exams, plus consult, bathroom, reception and large waiting room. Outstanding location. A must see. View floorplan http://ow.ly/kKOI30o6MjI. Call Jeff Tanenbaum,  646-234-2226 or email jtanenbaum@halstead.com for showings and more information.


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


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


5th Ave Medical Office for Share
Facing Central Park in exclusive building, ground floor, separate entrance.
Perfect for psychiatrist, physiatrist, osteopath, or other.
880 5th Avenue (between 69th and 70th Sts.), New York, N.Y.
Please call 917-715-2464


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


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

PHYSICIAN OPPORTUNITIES

Seeking Executive Director of the Onondaga County Medical Society
Concept:
 An exciting opportunity for the right person to provide leadership for physicians Salary: Commensurate with experience Job Description: Direct day-to-day operations of the Onondaga County Medical Society Some evening meetings, travel required. RequirementsExperience with leading political advocacy; political sophistication. Must know how to interface with government officials. Good networking and communication skills. Conversant with budgets and finance. Excellent media relations skills, including electronic, social media, and written communications. Familiar with medical issues and comfortable discussing them. Education: BA/BS required.  MPH or MBA desirable. We expect innovation and project initiation. The Executive Director will receive a contract that increases remuneration commensurate with membership growth. Application Instructions: Please direct your application to: Dr. Brian Johnson, johnsonb@upstate.edu.


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


Pediatrician BC, P/T
Seeking motivated, enthusiastic pediatrician for P/T position in solo practice in Long Island. Coverage will increase over time. Great opportunity or those seeking part time hours in an established practice. Fax resume to 516-858-2389.



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

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 


Parag Mehta, MD Elected Assistant Treasurer of the Medical Society of the State of New York


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

Parag Mehta, MD Elected Assistant Treasurer of the Medical Society of the State of New York

MSSNY is the State’s Primary Professional Organization for Physicians

Parag Mehta, MDWestbury, NY—April 15, 2019— Internist Parag Mehta, MD was elected Assistant Treasurer of the Medical Society of the State of New York (MSSNY) at its 213th annual House of Delegates (HOD) meeting in Tarrytown on April 13, 2019.  Dr. Mehta is the Senior Vice Chairman of the Department of Medicine and the Chief Medical Information Officer at New York Presbyterian Brooklyn Methodist Hospital (NYPBMH). In addition, he is a Clinical Assistant Professor of Medicine at Weill Medical College at Cornell University.

Dr. Mehta has been involved with the implementation of EHR at NYPBMH for the last 15 years and has helped the institution to reach HIMSS Level 7. In this role, he brings IT and clinicians together to improve the user’s experience based on the user’s input.

A graduate of NHL Medical College in Ahmedabad, India, Dr. Mehta completed his residency in OB/GYN at NHL Medical College and his residency in Internal Medicine at NYPBMH in Brooklyn, New York. He is Board Certified in Internal Medicine, Hospice and Palliative Care and Integrative and Holistic Medicine. He has taken courses in Health Information Technology from Cornell University and Artificial Intelligence from MIT Sloan School of Management.

An active member of organized medicine, Dr. Mehta is the Governor for the New York Chapter of the American College of Physicians (NYACP) for Brooklyn, Queens and Staten Island. In addition to MSSNY and NYACP, he is a member of AMA, Kings County Medical Society, American Association of Physicians of Indian Origin and Indian Medical Association.  In 2011, NYACP awarded him its highest honor, the Laureate Award, in recognition of his extraordinary contributions in the areas of governance, quality, public policy and education. As a Physician Wellbeing Champion, he promotes wellness and engages discussion through grand rounds.

Dr. Mehta’s many contributions to MSSNY include service as Commissioner of the Membership Division, Chair of the Future Task Force for Infrastructure/Organization, Chair of the International Medical Graduate Committee, and Young Physician Councilor. He presently serves as Councilor for Kings and Richmond County and as a New York Alternate Delegate to the American Medical Association.

Dr. Mehta lives in Manhasset Hills with his wife, Isha Mehta, MD, who is Chief of Gynecology at Elmhurst Hospital and is a founder of “A Stitch in Time,” an organization that treats gynecological conditions at no cost to women around the world. They have two daughters, Ruju, an environmental engineer, and Setu, a pre-med student at Harvard College.

# # #

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

Media Contact:
Roseann Raia

Medical Society of the State of New York
865 Merrick Ave.
Westbury, New York
516.488.6100 x 302
rraia@mssny.org
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Maria A. Basile, MD Elected Vice Speaker of the Medical Society of the State of New York


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

Maria A. Basile, MD Elected Vice Speaker of the Medical Society of the State of New York

MSSNY is the State’s Primary Professional Organization for Physicians

Maria A. BasileWestbury, NY—April 15, 2019— Maria A. Basile, MD was elected Vice Speaker at MSSNY’s 213th annual House of Delegates meeting in Tarrytown on April 13, 2019.  Dr. Basile is Assistant Vice President, Medical Affairs at Mather Hospital – Northwell Health, where her responsibilities include professional credentialing, physician engagement, medical staff quality improvement, and leadership development.

Prior to assuming this role in Hospital Administration, Dr. Basile was a Colorectal Surgeon in private practice. She is a Diplomate of the American Board of Quality Assurance and Utilization Review Physicians, and is Board Certified in Health Care Quality Assurance, with specialty certification as a Physician Advisor. Dr. Basile has spoken nationally on the topics of physician engagement, medical humanities, physician wellness and resilience, medical ethics, and practice transformation.

A cum laude graduate of Georgetown University, Dr. Basile earned her Medical Degree at Georgetown University School of Medicine. She completed a General Surgery residency at Mercy Catholic Medical Center in Philadelphia and a Colon and Rectal Surgery residency at St Vincent’s Medical Center in Erie, PA.  She is a graduate of the United Hospital Fund/Greater NY Hospital Association’s Clinical Quality Fellowship Program, and received a Master’s in Business Administration from Adelphi University in Garden City, NY.

Dr. Basile is on the Core Faculty at Stony Brook University Renaissance School of Medicine’s Center for Medical Humanities, Compassionate Care and Bioethics, where she teaches medical school and graduate-level courses in Literature and Medicine.  A physician-poet, she is author of Minimally Invasive: poems from a life in surgery.  Her poems and articles have been published in Journal of the American Medical Association, Touch: the Journal of Healing, and The Pharos.

An active member of MSSNY, Dr. Basile currently serves as Suffolk County Councilor and as the Commissioner of Communications. Through her leadership efforts at the local and statewide levels, she has been appointed Vice Chair of the MSSNY Committee on Physician Wellness and Resilience, Co-chair of the MSSNY Committee on Women, and a Vice Chair of the MSSNY Committee on Quality. She is a Past President of the Suffolk County Medical Society.

Dr. Basile lives in East Setauket, NY, with her two college-aged children, George and Christina, and two puppies, Parker and Miles.

# # #

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

Media Contact:
Roseann Raia

Medical Society of the State of New York
865 Merrick Ave.
Westbury, New York
516.488.6100 x 302
rraia@mssny.org
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