eNews: August 7, 2020

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Testing, Testing, Should Be 1..2..3
Nearly every day since the beginning of the pandemic, newspapers have reported on testing issues impeding efforts to contain the Covid-19 virus in the United States.  Major journals including a recent Lancet article have concluded that minimizing testing delays has the largest impact on reducing virus transmission and that optimizing testing and tracing is essential.

While New York State has so far staved off a resurgence in the virus, there have been increased rates of COVID-19 transmission throughout the United States, with more than 35 states now on the NYS travel advisory/quarantine list due to significant community-wide spread of disease. Add to this that college students will be shortly arriving from all over the US to NYS; schools in NYS will likely be opened; and that, as the weather in the fall changes, there will be more indoor activity and the perfect storm is brewing.  In order for the NYS virus transmission rate to remain low and prevent a surge similar or worse that was experienced by NYS in the spring, it is vital that we maximize testing and tracing and minimize testing delays NOW.

To this end, we have been in constant communication with the NYSDOH.  We have alerted them to the many concerns raised by MSSNY members about testing results taking up to 14 days to process/receive. We have informed NYSDOH of the challenges faced by patients who are scheduled for elective procedures/surgery when they are trying to comply with the NYSDOH protocol requiring a negative Covid-19 test to be received within 5 days of a procedure.  We have also shared stories of the impact of the testing delays including the inability to quickly quarantine positive patients and nursing home staff and canceled/delayed cancer surgery and cancer care.

We have contacted both Quest labs and Lab Corp who both say that they are expanding capacity and that they have systems in place for physicians to request priority testing. In addition, MSSNY continues to advocate for expansion of inexpensive point-of-care testing in physician offices as this can quickly expand testing capacity and decrease the time to contact tracing.

This week, MSSNY sent out a short survey to quantify the testing bottlenecks and we ask that you take a few minutes to complete this survey. We will continue to work with the NYS DOH and the Governor to achieve universal turnaround times of 2-3 days or less in NYS; and we will continue to keep members alerted as to the status of our efforts to ensure prompt testing results.

Bonnie Litvack
MSSNY President


Please Take the MSSNY Survey on COVID-19 Testing Delays
Recently, New York Governor Cuomo had an op-ed in the New York Times that touted the results of labs operating in New York State whereby 85% of the lab tests took a median of 2 days to complete. We have heard anecdotes from physicians regarding instances where it is taking far longer.  As we continue to dialogue with the New York State Department of Health and Governor’s office regarding addressing testing delays, would you place take just a few minutes to complete this survey?


Snapshot of COVID-19 in the U.S.
Cases: 4,824,230
Deaths: 158,268
Recovered: 1,577,851
Counts reflect data available as of 9 a.m. CDT Aug. 6.


Gov. Cuomo at 6:55 PM Thursday, Aug.6
Today is day 159 of the pandemic

  • The total number of COVID hospitalizations continues to remain low. Yesterday, there were 570 total hospitalizations and 132 people in the ICU. The State conducted 72,370 tests, of which 703, or 0.97%, were positive. Sadly, we lost 3 New Yorkers to the virus.
  • Remember, there are over 750 testing sites across New York State. Testing is available to any New Yorker who wants a test and is free at any state-run facility. Find a testing site near you here.


MSSNY Weekly Podcast Update


MSSNY Statement Re Physicians’ PPE Costs in Today’s Crain’s
The Medical Society of the State of New York is urging the state Department of Financial Services to require health insurers to reimburse providers for personal protective equipment costs. “MSSNY does not condone health plan-participating health care practitioners charging their patients for the huge jumps in the cost of PPE, as state regulations limit the ability of such practitioners to bill patients for these costs,” said Dr. Bonnie Litvack, president of the medical society, in a statement.

“At the same time, given the enormous profits of the health insurance industry, MSSNY and others have been urging the [department] to require health insurers to reimburse health care practitioners for these enormous jumps in PPE costs, and the significant difficulty in even obtaining it in the first place.”


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Study: Northwell Workers Test Positive for COVID at Similar Rate as Public
Health care providers at Northwell Health have not experienced a higher rate of positive Covid-19 tests than the general community, according to a study published in JAMA on Thursday. The study included 40,329 health care personnel in the greater New York area who voluntarily took an antibody test regardless of whether they had Covid-19 symptoms or not. Results showed 13.2% of Northwell staff tested positive for antibodies, or seropositive. Neither age, gender, ethnicity, location nor primary specialty was a significant predictor of seropositivity.

However, what did correlate was the workers’ self-assessment of their exposure risk. Employees were asked to rate their suspicion of having been exposed to Covid-19 on a scale of 1 to 9, with 1 being “no” and 9 being “definitely.” Of subjects who rated themselves in the high category (7 to 9), 60% tested seropositive, whereas those who rated themselves in the low category (1 to 3) had 5.3% who tested positive.

These findings provided two significant takeaways, said Karina Davidson, professor, and senior vice president at the Feinstein Institutes for Medical Research. The 13.2% positive rate is similar to community rates of about 14%, indicating that health care professionals are adequately protected in hospitals. This study should placate concerns of transmissions in a hospital setting, she said.

The next is that because health care workers have shown that their own assessment of risk correlates to whether or not they have Covid-19, free and convenient testing should be made available to them, Davidson said. These include point-of-care tests either near their home or workplace for quick turnaround and availability at all hours to account for late shifts, she said. “As testing becomes more available and the supply chain improves, there’s little reason for public health officials and hospital administrators not to provide convenient access to testing for these essential frontline workers,” Davidson said.


Fauci at Harvard Med School: Does Not Believe US Will Go into Another Shutdown
While speaking at an online event jointly hosted by the Harvard T.H. Chan School of Public Health and the New England Journal of Medicine Wednesday afternoon, Dr. Anthony Fauci told Dr. Sanjay Gupta of CNN that he doesn’t believe the country will need to go into another economic shutdown to stem the spread of COVID-19.

“We can do better without locking down,” Dr. Fauci said. He added that the U.S. has struggled with an ongoing surge of COVID-19 cases due to human behaviors that contribute to the spread of the virus.

“As long as you have any member of society, any demographic group, who’s not seriously trying to get to the end game of suppressing this, it will continue to smolder and smolder and smolder, and that will be the reason why, in a non-unified way, we’ve plateaued at an unacceptable level,” Dr. Fauci said.


MLMIC Presents: Million Dollar Claims: A Closer Look Now on MSSNY CME Website
MSSNY proudly announces the availability of MLMIC Presents: “Million Dollar Claims a Closer Look” on the MSSNY CME website. If you do not have an account, you will be required to create one.

Educational Objectives:

  • Identify the leading causes of loss in million-dollar claims;
  • Analyze the key factors leading to significant payments in these claims;
  • Recognize the chief medical factors identified in these files; and
  • Implement risk management strategies to lessen the risks of high-exposure professional liability claims within your organization.

MLMIC is accredited by the Medical Society of the State of New York (MSSNY) to provide CME for physicians.  

MLMIC designates this live educational activity for a maximum of 1.0 AMA PRA Category 1 Credit™.  Physicians should claim only the credit commensurate with the extent of their participation in the activity.


Beware: HIPAA Compliance Scam
AUGUST 2020

Earlier today the United States Health and Human Services Office for Civil Rights “OCR” issued an alert concerning fraudulent postcards sent to health care organizations claiming to be official communications from OCR. The postcards, with a Washington, D.C. mailing address and claiming to be from the Secretary of Compliance, HIPAA Compliance Division, encourage health care organizations to visit a website, call, or email the sender “to take immediate action on a HIPAA Risk Assessment” and lists potential penalties for noncompliance. Anyone that does contact the sender is diverted to a non-government website offering consulting services.

As a reminder, all communications from OCR will come from either an official office or an email address ending with @hhs.gov. You can find a complete list of OCR’s headquarters and regional offices here.

CLICK HERE TO DOWNLOAD ALERT


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Analysis Shows Millions More Uninsured Due to COVID-19 Pandemic
There is clear evidence that the COVID-19 pandemic and economic downturn are causing millions of Americans to lose not only their jobs but also their employment-based health insurance. What is less well known is how many of these workers are remaining uninsured, and how many are shifting to other coverage—such as a spouse’s plan, Medicaid, or Medicare. Federal data on these changes will not be available until next year. In the interim, a new Families USA analysis seeks to partially fill this information gap.

The Families USA report examines the insurance and employment patterns of adults ages 18 to 64 in order to estimate the number of uninsured workers among the newly unemployed in each state. This methodology reveals that of the 21.9 million Americans who lost their jobs or left the labor force between February and May 2020, 5.4 million became uninsured as a result.

This increase in the number of uninsured adults is 39% higher than any annual increase ever recorded. The highest previous jump took place from 2008 to 2009, when 3.9 million adults became uninsured. Notably, because the Families USA estimate does not capture family members, many of whom also lost health insurance, or workers ages 65 and older, the actual number of uninsured Americans is likely even higher.


Medicaid Recipients May Not be Billed for COVID-19 Related Provider Expenses
This is a reminder that the Medicaid program prohibits enrolled providers from billing recipients for charges for COVID-19 protective measures, including sanitizing exam rooms and using personal protective equipment, such as masks, gowns, and gloves (collectively, “PPE”). Cost-sharing for Medicaid fee-for-service and managed care members is limited to applicable copays based on federal rules, including the New York’s Medicaid State Plan and 1115 Medicaid Redesign Team Waiver.

Billing Medicaid recipients for PPE is considered an “Unacceptable Practice” under Medicaid rules, which may result in provider sanctions up to and including termination from the Medicaid program.


Join MSSNY’s preferred wealth manager Altfest on Wednesday, August 12, 11:00-11:45 am for a free interactive webinar on Retirement Planning for Physicians Amid COVID-19

Topics Include:

  • Evaluating where your retirement plan stands today
  • Recognizing risks in retirement planning and how to manage them
  • Taking advantage of timely retirement planning opportunities

Altfest will also cover key takeaways from the most recent government stimulus plan. Submit questions to webinar@altfest.com by Monday, August 10.

CLICK HERE TO REGISTER

Learn more about Altfest’s custom comprehensive wealth management services for physicians and their families at altfest.com/physicians.


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The 12 Risk Factors Tied to 40% of Dementia Cases
A new report from the Lancet Commission on Dementia Prevention identifies 12 risk factors linked to 40% of all dementia cases, adding three new risk factors to the Commission’s original 2017 report, Sue Hughes reports for Medscape. The 2017 report identified nine modifiable risk factors that were estimated to account for a third of all dementia cases. The Lancet Commission included those same nine risk factors in this year’s report, as well, but the Commission updated the weighted population attributable fraction attributed to the risk factors. They are:

  • Midlife hearing loss, accounting for 8.2% of dementia cases;
  • Not completing secondary education, accounting for 7.1% of cases; Later-life smoking, accounting for 5.2% of cases;
  • Later-life depression, accounting for 3.9% of cases;
  • Later-life physical inactivity, accounting for 1.6% of cases;
  • Later-life social isolation, accounting for 3.5% of cases;
  • Midlife hypertension, accounting for 1.9% of cases;
  • Later-life diabetes, accounting for 1.1% of cases; and
  • Midlife obesity, accounting for 0.7% of cases.

The Commission also included three new modifiable factors in the updated report:


MSSNY’s YPS Calling for Nominations for Councilor, AMA Delegates and Officers
The YPS Governing Council would like to call for nominations from MSSNY YPS members for the following positions:

·        MSSNY Young Physicians Section Councilor for 2021-2024 (1 nomination to be made)

·        MSSNY AMA Delegation (3 nominations to be made)

·        MSSNY YPS Officers Nomination (1 nomination to be made)

Self-nominations will be accepted. Nominees should submit a CV and statement of interest to sbennett@mssny.org.

Nominations will close at 5 pm, Wednesday, August 12th. Nominees, CVs, and statements of interest will be emailed out to members on Thursday, August 13th.

An election ZOOM meeting will be held on Sunday, August 16th at 7pm, when speeches by candidates will be made.

ZOOM meeting call-in information is below:

Topic: MSSNY YPS Election Meeting
Time: Aug 16, 2020 07:00 PM Eastern Time (US and Canada)

Join Zoom Meeting
https://us02web.zoom.us/j/89818933127

Meeting ID: 898 1893 3127
One tap mobile
+16468769923,,89818933127# US (New York)
+13126266799,,89818933127# US (Chicago)

Daniel E. Choi, MD
Chair, Young Physicians Section, Medical Society of the State of NY (MSSNY)


48% of Americans Would Get COVID-19 Vaccine Right Away, Survey Finds
Less than half of Americans would receive the COVID-19 vaccine as soon as it is available, according to a poll from SurveyMonkey and COVID Near You, a joint project of Boston Children’s Hospital and Boston-based Harvard Medical School.

The survey includes insights from more than 1.2 million U.S. adults polled weekly between Feb. 11 and Aug. 2.

Four survey findings, based on responses collected between July 12 and Aug. 2:

  1. 48% of Americans said they would get a COVID-19 vaccine right away.
  2. 29% said they would “wait some time” to receive the vaccine; 10 percent would “not receive the vaccine anytime soon”; and 13 percent said they did not ever want to get the vaccine.
  3. Americans over age 75 were most likely to say they would get the vaccine right away (42%), while millennials were least likely (24 percent).
  4. 35% of Black respondents said they would get the vaccine right away, compared to 50 percent of white respondents, 49 percent of Asian respondents and 46 percent of Hispanic respondents.

To view the full survey, click here.


NYC Setting Up Checkpoints to Track Visitors Residents from COVID Surge States
Those coming into the city from the 35 states and territories on New York’s travel advisory list must complete the state health department’s traveler form and self-quarantine for 14 days. Those who do not comply with quarantine orders will be subject to a $10,000 fine, and those who refuse to fill out the traveler form will be subject to a $2,000 fine. (Becker’s Hospital Review, Aug. 6)


Classifieds

Elegant, Custom Built Home with Unparalleled Craftsmanship – Rhinebeck, NY
Set on 10.6 acres in one of the most sought-after neighborhoods in Rhinebeck, this stunning home borders Drayton Grant Park at Burger Hill (a conservation land and the highest point in Rhinebeck). Features beautifully landscaped gardens with sweeping hilltop views and a well established vegetable garden and barn. This handsome home is generously proportioned throughout, with an inviting foyer entry with tastefully designed staircase, millwork, high ceilings, cherry wood floors and custom windows.

Rhinebeck Estate for SaleA world class kitchen with a marble counter-topped island, enjoys both a cozy fireside seating area perfect for winter evenings, and glass doors in the hexagonal eat-in-kitchen opening onto the expansive stone terrace for three season enjoyment and entertaining.

A luxurious Master suite, with high vaulted ceiling design, his and hers walk-in closets and a gorgeous master bath with cast iron clawfoot tub. The second floor also includes two spacious bedrooms with generous closets and 2 full bathrooms, An additional large sitting room/office could easily make a lovely fourth bedroom. Lower level features a media room, exercise room, bar, wine cellar and full bathroom. Additionally there is a two story barn equipped with water and electricity.

The house is located 7 minutes to the charming center of Rhinebeck village with its many superb restaurants, boutiques & shops. The highly rated Northern Dutchess Hospital, the excellent Rhinebeck schools and the County Fairgrounds, a most desirable venue destination throughout the year, are all nearby. Rhinecliff train station is a mile beyond with Amtrak service south to NYC(1hour 40 minutes) and north to Hudson, Albany, Niagara Falls and Montreal. View full listing Contact Nader Kayal, MD, 845-518-7780 / entdoc53@aol.com or Joshua M. Briggs at Heather Croner RE-Sotheby’s 917 213-9042 / jmb@jmbfineart.com.


Upper East Side Office to Share
Includes waiting room, 2 exam rooms and room for medical assistants. Flexible schedule. Call Bianca at 212-327-1851.

For Sale: 715 Park Avenue
Medical office, 1,800 sq. ft. Rectangular, 11 1/2 ft ceilings, street level access. Private entrance on 70th Street, side of the building. Windows on Park Avenue and 70th Street. Excellent office space for plastic surgeon, dermatologist or dental practice. Central air conditioning, high voltage electric service, two bathrooms. *Sale could include active Cardiac / Medical Practice. Please contact Janet @ 212-288-5468.


Office Space and Quad-A Certified O.R. for Rent
Plastic surgery office and/or quad A – certified operating room available for rent. We welcome you to tour our facility, where safety and luxury are combined in the most prime location on the upper east side. We assure you will be delighted by what you discover. We take pride in our facility, where your patients’ safety and satisfaction are our number one priority.
    • Fully equipped operating room perfect for a board-certified plastic surgeon
  • Pre-op and recovery areas
  • A bright and modern waiting area
  • 3 consultation rooms, administrative room, kitchenette, and 2 bathrooms
  • Full day office rental per week / O.R. rental per case

For inquiries please call 212.737.8700, email polina@specialtyaestheticsurgery.com

Office Space and Quad-A Certified O.R. for Rent


 

 

 

 

 

 

August 5, 2020

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Cuomo Signs Bill to Roll Back Medical Liability Protections
Gov. Andrew Cuomo signed a bill that would reverse some of the medical liability protections provided to doctors, hospitals and nursing homes during the pandemic.

The bill was opposed by lobbying groups representing the health care industry as potentially adding to medical malpractice costs after workers risked their own health to treat Covid-19 patients. The law, which will be applied prospectively, reduces the level of legal immunity for doctors treating non–Covid-19 patients whose care is affected by the pandemic.

Hospitals and doctors had sought that cover as they were asked to take dramatic steps to respond to the pandemic, such as converting non-clinical spaces into treatment areas and asking doctors and nurses to work outside their specialty areas.

“We pray that such a drastic situation will not come again, but if it does, many physicians will again find themselves with the unimaginable choices of triaging which patients are to receive care first, knowing full well that this new law means that the ‘wrong choice’ could result in that physician losing everything they own to a lawsuit,” Dr. Bonnie Litvack, president of the Medical Society of the State of New York, said in a statement.

The Legislature passed the bill in late July following anger among lawmakers that the provisions protected providers, particularly nursing homes, at a time when patients were vulnerable. During Monday’s joint legislative hearing on Covid-19, state Sen. Julia Salazar raised the issue to state Health Commissioner Dr. Howard Zucker, noting the case of Sha-asia Washington, a 26-year-old woman who died during childbirth at NYC Health + Hospitals/Woodhull.

“Is it acceptable that her care team has blanket legal immunity and that her family doesn’t have any recourse?” Salazar asked. Zucker said the budget provision had not shielded doctors who commit egregious acts from lawsuits.

The state would not “allow any kind of egregious behavior to happen whether it’s in a hospital, nursing home or anywhere. That is the premise long before coronavirus and will be long after coronavirus is gone,” he said. “The objective here was to make sure that those who were working there would be able to provide the care while we were in the upsurge of an absolutely unbelievable pandemic, which is still going on.” (Crains, Aug 5)


Statement of MSSNY President Dr. Bonnie Litvack, in Reaction to Governor Signing into Law Rolling Back COVID-19 Liability Protections

“We are deeply concerned with the consequences of the significant narrowing of these liability protections, particularly when there remains a very real possibility of a second surge of cases this fall.   It will put our physicians and other health care workers, who not long ago were regularly lauded as ‘heroes’, into even more extraordinarily challenging circumstances.  During the height of the pandemic, in many downstate hospitals, physicians and physicians in training were regularly being asked to provide health care services outside of their areas of expertise to help manage the overwhelming patient flow. They did so because of their dedication to helping their patients.

We pray that such a drastic situation will not come again, but if it does, many physicians will again find themselves with the unimaginable choices of triaging which patients are to receive care first, knowing full well that this new law means that the “wrong choice” could result in that physician losing everything they own to a lawsuit. Moreover, this narrowing of these liability protections also puts a physician at much greater risk of a lawsuit if the state once again requires the postponement of elective surgeries to preserve resources for patients with Covid-19. This is a grossly unfair position in which to be placed.

We are very concerned that the practical effect of this legislation will be that hospitals will face far more difficulties in attempting to manage a huge influx of patients in the event of a second surge.

To paraphrase David Bowie, apparently our doctors were heroes just for one day.  (See today’s Crain’s article below)


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Governor Cuomo: August 4 Report
The numbers here in New York continue to remain low, with total hospitalizations at 568, down from the April peak of nearly 20,000. For the third straight day in a row, there were no reported COVID deaths in New York City. Yesterday, the State conducted 70,993 tests, of which 746, or 1.05%, were positive — a positive rate that has hovered at around 1% for weeks. While we have worked hard to achieve this progress, we need to work just as hard to maintain it.


Video of the Day: NYS released their third Mask Up America PSA. Watch it here.


MSSNY Survey on COVID-19 Testing Delays
Recently, New York Governor Cuomo had an op-ed in the New York Times that touted the results of labs operating in New York State whereby 85% of the lab tests took a median of 2 days to complete. We have heard anecdotes from physicians regarding instances where it is taking far longer.  As we continue to dialogue with the New York State Department of Health and Governor’s office regarding addressing testing delays, would you place take just a few minutes to complete this survey?


CDC: Polio-Like Condition in Kids Likely to Spike in Coming Months
Based on previous trends, cases of acute flaccid myelitis, a polio-like condition in children, may spike in the U.S. between August and November, a new CDC report shows.

Acute flaccid myelitis is a serious neurologic syndrome that affects mostly children and is characterized by the acute onset of limb weakness or paralysis. The report, published Aug. 4, includes an analysis of data from 238 patients with confirmed acute flaccid myelitis during 2018.

A majority of the patients (86 percent) experienced the onset of the condition between August and November. Most (92 percent) had prodromal fever, respiratory illness, or both, beginning a median of 6 days before experiencing limb weakness.

Overall, 98 percent of patients were hospitalized, 54 percent were admitted to an intensive care unit, and 23 percent required endotracheal intubation and mechanical ventilation.

Another peak acute flaccid myelitis year is anticipated this year, but it is unclear “whether or how the COVID-19 pandemic and recommended social-distancing measures will affect” trends, the report states.

As of July 31, there have been 16 confirmed cases of acute flaccid myelitis in 2020. There have been 633 confirmed cases since CDC began tracking the condition in August 2014. (Becker’s Hospital Review, Aug. 7)


2021 Medicare Payment Rule Proposes Office Visit Payment Increases, but Steep Conversion Factor Cut
On August 3, 2020, CMS issued the proposed 2021 Medicare Part B payment rule. Please see here for a preliminary AMA overview of the 1355-page rule of the highlights of the payment rule.  They also issued this press release, noting concerns with the far-ranging changes this rule could impose: “The AMA appreciates that CMS will implement significant increases to the payment for office visits, based on recommendations on resource costs from the AMA/Specialty Society RVS Update Committee (RUC).

Unfortunately, these office visit payment increases, and a multitude of other new CMS proposed payment increases, are required by statute to be offset by payment reductions to other services, through an unsustainable reduction of nearly 11% to the Medicare conversion factor. For this reason, the AMA strongly urges Congress to waive Medicare’s budget neutrality requirement for the office visit and other payment increases. Physicians are already experiencing substantial economic hardships due to COVID-19, so these pay cuts could not come at a worse time.”


Former HHS Officials Explore Vaccine Hesitancy in Black Community — COVID-19 burden for African Americans Will Only Worsen if They Refuse Immunizations
Past and present U.S. Surgeons General, speaking at the National Medical Association’s virtual annual convention, said vaccine hesitancy in the Black community could worsen the disparate impact of COVID-19.

Current Surgeon General Jerome Adams, MD, MPH, who moderated the online discussion Saturday, said he believes that a COVID-19 vaccine will be ready by the end of this year or early next. “But a safe and effective vaccine means nothing if people don’t actually get vaccinated,” Adams said.

Recent public opinion polls found that just under 50% of those surveyed said that they are either “unlikely” to get a COVID- 19 vaccine or “uncertain” about taking one if it were available today, said Vivek Murthy, MD, who served as surgeon general under President Barack Obama.

Studies have shown that African Americans and Latinx people were more skeptical of the measles vaccine, according to the Pew Research Center.

The Black community hasn’t forgotten the infamous Tuskegee study and remains distrustful of the medical establishment, noted Louis Sullivan, MD, secretary of Health and Human Services under President George H.W. Bush and is founding dean of the Morehouse School of Medicine in Atlanta. 

Partnering with Churches, Celebrities

Adams asked his predecessors — also including David Satcher, MD, surgeon general in the Clinton administration — what can be done to increase buy-in for a COVID-19 vaccine among African Americans. Murthy encouraged partnerships with “messengers” inside the communities that health professionals are trying to reach. “We’ve got to do that right now,” said Murthy, even before a vaccine has been developed.

Satcher said that during his tenure, the government partnered with a national group of Black churches to promote immunizations in children before age 2 — rates of which were then below 30% overall, and even lower in the Black community. 

Doctor Diversity

Sullivan said there needs to be more diversity in the healthcare workforce — by gender, race, and ethnicity — to improve communication and trust among people of color.

“More trust leads to more understanding and results in better adherence to health recommendations, such as utilization of vaccines, of prescription medicines and other health behaviors,” he said.


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Duane M. Cady, MD, MSSNY Past President, Past Chair AMA Board of Trustees, Died August 3
Duane M. Cady, MD, MSSNY Past President, and a general surgeon of more than 30 years New York died at home on August 3 in Lafayette, NY. Dr. Cady was elected to the AMA Board of Trustees in June 2003. He became chair in June 2005 and served on the board’s executive committee. Dr. Cady is also a past president of the AMA Foundation. Dr. Cady’s AMA responsibilities have included membership on the Council on Medical Service (CMS), chair of the CMS Committee on Medical Payments and Review, as well as the CMS Committee on Health Care Access. Dr. Cady served as medical staff president, chair of the department of surgery and member of the board of trustees at St. Joseph’s Hospital in Syracuse, N.Y.

Dr. Cady is also past president of the Onondaga County Medical Society. He was appointed by Gov. George Pataki as chair of the New York State Medicaid Managed Care Advisory Council and was a member of the governor’s Task Force on Hospital Reimbursement Reform and the New York State Public Health Council’s pain management task force. Dr. Cady received a bachelor’s degree in chemistry at Atlantic Union College in Lancaster, Mass., and a medical degree at Loma Linda University School of Medicine in Loma Linda, Calif. Dr. Cady is a former captain of the U.S. Army Medical Corps and served as an Army surgeon in Vietnam.

He and his wife of 65 years, Joyce, have five grown children and 10 grandchildren. A private Celebration of Life will be held in the Fall. Contributions in his memory may be made to the Duane and Joyce Cady Scholarship, AMA Foundation, 330 N. Wabash Ave., Suite 38300 Chicago, IL 6061-5885. The link for online donations is https://amafoundation.org/mssny.


Follow Up: Overnight Youth Camp Sees Large COVID-19 Outbreak

An overnight camp for children and teens in Georgia experienced a large COVID-19 outbreak the first week it opened, demonstrating how quickly the virus can spread among youth, according to an MMWR article.

On June 17, staff members arrived at the camp for orientation, and campers arrived on June 21. The camp followed some COVID-19 mitigation guidelines, but it did not require masks for campers and did not make sure doors and windows were open for increased ventilation. On June 23, a staff member left camp after developing symptoms and later tested positive for SARS-CoV-2. Campers began departing the next day, and the camp closed on June 27.

Nearly 600 Georgia residents attended the camp, including staffers. Of the 344 who were tested, 76% were positive. Researchers calculate an overall attack rate of 44%, but they say this is likely an underestimate. The attack rate was highest among the youngest campers (51% for those aged 6 to 10 years), staff members (56%), and people who stayed in the largest cabins (53% for cabins that held 16 to 26 people).

“Relatively large cohorts sleeping in the same cabin and engaging in regular singing and cheering likely contributed to transmission,” the authors write.

In other COVID-19 news:

  • For patients with COVID-19 who may be candidates for dexamethasone, the authors of a JAMA viewpoint say that ivermectin is a reasonable presumptive treatment for those who have moderate-to-high risk for Strongyloides infection but haven’t been previously tested or treated. Strongyloides hyperinfection or dissemination syndrome is frequently fatal and is often associated with use of an immunosuppressive medication (e.g., corticosteroid) in people who have unrecognized chronic infection with the Strongyloides roundworm. People at risk for Strongyloides infection include those who have lived in endemic areas (e.g., Asia, Oceania, sub-Saharan Africa, South America, Caribbean, Middle East, North Africa, Indian sub-continent). A history of rural residence and labor associated with soil exposure are also risk factors. The authors caution that there are no data to support the use of ivermectin in COVID-19 management, and no group currently recommends it.
  • Clinicians can be reimbursed for counseling patients who are being tested for COVID-19 about the need to self-isolate before they develop symptoms and the need for other members of their household to be tested, the Centers for Medicare and Medicaid Services and the CDC announced.
  • The FDA has authorized the first semi-quantitative tests to display estimated, rather than precise, levels of antibodies to SARS-CoV-2. An FDA official said, “Patients should not interpret results as telling them they are immune, or have any level of immunity, from the virus.”

MMWR article on youth camp (July 31)
JAMA viewpoint on dexamethasone and Strongyloides hyperinfection/dissemination
CDC news release on reimbursement (July 30)
FDA news release on antibody tests (Jul 31)
NEJM Journal Watch COVID-19 page (August 1)
NEJM COVID-19 page (July 29)


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CMS

Now Available: 2019 MIPS Targeted Review
If you participated in the Merit-based Incentive Payment System (MIPS) in 2019, you can now review your performance feedback, including your MIPS final score and payment adjustment factor(s), on the Quality Payment Program website.

Your final score will dictate the payment adjustment you will receive in 2021, with a positive, negative, or neutral payment adjustment being applied to the Medicare paid amount for covered professional services furnished by a MIPS eligible clinician in 2021.

MIPS eligible clinicians, groups, and virtual groups (along with their designated support staff or authorized third-party intermediary), including APM participants, may request CMS to review the calculation of their 2020 MIPS payment adjustment factor(s) through a process called targeted review.

When to Request a Targeted Review

If you believe an error has been made in your MIPS payment adjustment factor(s) calculation, you can request a targeted review until October 5, 2020. Some examples of previous targeted review circumstances include the following:

  • Errors or data quality issues for the measures and activities you submitted
  • Eligibility and special status issues (e.g., you fall below the low-volume threshold and should not have received a payment adjustment)
  • Being erroneously excluded from the APM participation list and not being scored under the APM Scoring Standard
  • Performance categories were not automatically reweighted even though you qualify for automatic reweighting due to extreme and uncontrollable circumstances

Note: This is not a comprehensive list of circumstances. CMS encourages you to submit a request form if you believe a targeted review of your MIPS payment adjustment factor (or additional MIPS payment adjustment factor, if applicable) is warranted. 

How to Request a Targeted Review

You can access your MIPS final score and performance feedback and request a targeted review by:

  • Going to the Quality Payment Program website
  • Logging in using your HCQIS Access Roles and Profile System (HARP) credentials; these are the same credentials that allowed you to submit your MIPS data. Please refer to the QPP Access Guide for additional details.

CMS may require documentation to support a targeted review request that is under our evaluation. If the targeted review request is approved, we may update your final score and/or associated payment adjustment (if applicable), as soon as technically feasible. Please note that targeted review decisions are final and not eligible for further review.

For more information about how to request a targeted review, please refer to the 2019 Targeted Review User Guide. For more information on payment adjustments please refer to the 2021 MIPS Payment Adjustment Fact Sheet.

Questions?

Contact the Quality Payment Program at 1-866-288-8292 or by e-mail at: QPP@cms.hhs.gov. To receive assistance more quickly, please consider calling during non-peak hours—before 10:00 a.m. and after 2:00 p.m. ET.


Classifieds

Elegant, Custom Built Home with Unparalleled Craftsmanship – Rhinebeck, NY
Set on 10.6 acres in one of the most sought-after neighborhoods in Rhinebeck, this stunning home borders Drayton Grant Park at Burger Hill (a conservation land and the highest point in Rhinebeck). Features beautifully landscaped gardens with sweeping hilltop views and a well established vegetable garden and barn. This handsome home is generously proportioned throughout, with an inviting foyer entry with tastefully designed staircase, millwork, high ceilings, cherry wood floors and custom windows.

Rhinebeck Estate for SaleA world class kitchen with a marble counter-topped island, enjoys both a cozy fireside seating area perfect for winter evenings, and glass doors in the hexagonal eat-in-kitchen opening onto the expansive stone terrace for three season enjoyment and entertaining.

A luxurious Master suite, with high vaulted ceiling design, his and hers walk-in closets and a gorgeous master bath with cast iron clawfoot tub. The second floor also includes two spacious bedrooms with generous closets and 2 full bathrooms, An additional large sitting room/office could easily make a lovely fourth bedroom. Lower level features a media room, exercise room, bar, wine cellar and full bathroom. Additionally there is a two story barn equipped with water and electricity.

The house is located 7 minutes to the charming center of Rhinebeck village with its many superb restaurants, boutiques & shops. The highly rated Northern Dutchess Hospital, the excellent Rhinebeck schools and the County Fairgrounds, a most desirable venue destination throughout the year, are all nearby. Rhinecliff train station is a mile beyond with Amtrak service south to NYC(1hour 40 minutes) and north to Hudson, Albany, Niagara Falls and Montreal. View full listing  Contact Nader Kayal, MD, 845-518-7780 / entdoc53@aol.com or Joshua M. Briggs at Heather Croner RE-Sotheby’s 917 213-9042 / jmb@jmbfineart.com.


Upper East Side Office to Share
Includes waiting room, 2 exam rooms and room for medical assistants. Flexible schedule. Call Bianca at 212-327-1851.

For Sale:  715 Park Avenue
Medical office, 1,800 sq. ft. Rectangular, 11 1/2 ft ceilings, street level access. Private entrance on 70th Street, side of the building.  Windows on Park Avenue and 70th Street.  Excellent office space for plastic surgeon, dermatologist or dental practice. Central air conditioning, high voltage electric service, two bathrooms. *Sale could include active Cardiac / Medical Practice. Please contact Janet @ 212-288-5468.


Office Space and Quad-A Certified O.R. for Rent
Plastic surgery office and/or quad A – certified operating room available for rent. We welcome you to tour our facility, where safety and luxury are combined in the most prime location on the upper east side. We assure you will be delighted by what you discover. We take pride in our facility, where your patients’ safety and satisfaction are our number one priority.
    • Fully equipped operating room perfect for a board-certified plastic surgeon
  • Pre-op and recovery areas
  • A bright and modern waiting area
  • 3 consultation rooms, administrative room, kitchenette, and 2 bathrooms
  • Full day office rental per week / O.R. rental per case

For inquiries please call 212.737.8700, email polina@specialtyaestheticsurgery.com

Office Space and Quad-A Certified O.R. for Rent


 

 

 

 

 

 

MSSNY COVID-19 Update – Aug. 7, 2020 (Latest Alerts, SBA Loans, Health & Safety)

Physicians are required to report suspect cases to their local department of health.

Jump to: Alerts; Health; Finance; Volunteering and Donations; Testing; Telehealth; Patient Information; Statistics; Webinars; Fraud; Research; Additional Information;


Coronavirus Magnified

Alerts and Notifications

Revised Protocols for Personnel in Healthcare and Other Direct Care 
Settings to Return to Work Following COVID-19 Exposure or Infection


Please Take the AMA Survey on Telehealth Impact (on) Physicians


Please take the Personal Protective Equipment Survey


SBA and Treasury Announce New EZ and Revised Full Forgiveness Applications for the Paycheck Protection Program


COVID-19 Updated Guidance for Hospital Operators Regarding Visitation


Contact Tracing Opportunities in NYS

Interim Guidance for Reopening the Health Care System & Best Practices for Reopening From COVID-19

COVID-19 update for healthcare providers (Recorded)

Physician’s Resource Page (Updated)


Health and Safety

Interim Guidance on Executive Orders 202.17 and 202.18 Requiring Face Coverings in Public During the COVID-19 Outbreak

Requiring Face Coverings for Public and Private Employees Interacting with the Public

COVID-19 and the Use of Cloth Face Coverings

Ensuring the Safety of Our Direct Caregivers

Nursing Home COVID-19 Preparedness Self-Assessment Checklist

Health Advisory: COVID-19 Updated Guidance for Hospital Operators Regarding Visitation

Advance Care Planning Recommendations During COVID-19


Finance

Applications for SBA Loans

FAQs on Medicare Fee-for-Service (FFS) Billing

CMS Approves Approximately $34 Billion for Providers with the Accelerated/Advance Payment Program for Medicare Providers in One Week

Request for Accelerated/Advance Payment

With $349 Billion in Emergency Small Business Capital Cleared, SBA and Treasury Begin Unprecedented Public-Private Mobilization Effort to Distribute Funds

Social Security Benefits Will be Paid on Time and Other Updates Related to the COVID-19 Pandemic

Trump Administration Provides Financial Relief for Medicare Providers

Trump Administration Approves 34th State Request for Medicaid Emergency Waivers

Special Coding Advice During the COVID-19 Crises

Tax Day now July 15: Treasury, IRS extends filing deadline and federal tax payments regardless of amount owed


Volunteering and Donations

Healthcare Workers! New York City Needs You Now!

Nasopharyngeal Swabs Urgent Appeal!

Do You Have Medical Services or Equipment to Donate?

PPE shortage – How to make a request, and steps to preserve equipment

Additional Qualified Health Professionals Needed


Testing

Protocol for COVID-19 Testing Applicable to All Health Care Providers and Local Health Departments

Guidance for Private Physician Practices Operating Specimen Collection Sites

Should ibuprofen be Used to Treat COVID-19?


Telehealth

HHS Telemedicine Hack on Telemedicine (One Hour per Week) Begins on July 22
This course is a free 10-week learning community to accelerate telemedicine implementation for ambulatory providers. It is a learning collaborative from the US Department of Health and Human Services and others addressing telemedicine. Questions should be directed to: c19ECHO@salud.unm.edu

How to Set Up Free Telemedicine for Your Patients (Video)

If you’re using Zoom for teleconferencing, read this FBI report on “zoom-bombing” which is on the increase.

Frequently Asked Questions Regarding Use of Telehealth Including
Telephonic Services During the COVID-19 State of Emergency

Humana Telehealth Update

Emergency Medical Aid and Telemedicine

Comprehensive Guidance Regarding Use of Telehealth 

Expansion of Medicare coverage for telehealth (so it is no longer limited to rural areas)

Assuring physicians can use Facetime and Skype for telehealth without worrying about HIPA

COVID-19 Physical, Occupational and Speech Therapy Telehealth

Telehealth Insurance Circular Letter No. 6 (2020)
Reminder that private insurers must cover telehealth services for patients (including those provided through a smartphone) and without patient cost-sharing.

COVID-19 Telephonic Communication Services
Since Medicare still requires telemedicine to be provided only to patients in a rural setting, you should look at “virtual check-in” services under codes  G2010, G2012, 99421, 99422 and 99423.

State regulated insurers re: required telehealth coverage for all health care services without patient cost-sharing “including technology commonly available on smartphones and other devices”.

Telehealth Benefits in Medicare are  a Lifeline for Patients During Coronavirus


August 7, Statistics

New York State: 418,225 confirmed, 32,432 deaths. New York City: 223,473 confirmed cases; 18,938 deaths.


SBL Frauds and Scams 

FBI Sees Rise in Fraud Schemes Related to the Coronavirus Pandemic

Small Business Scams and Fraud

New funding for Coronavirus SBA loans attracts scammers


Research

Authorization of Licensed Pharmacists to order COVID-19 Tests

Pediatric Multi-System Inflammatory Syndrome Temporally Associated with COVID-19 Interim Case Definition in New York State

Pediatric Multi-System Inflammatory Syndrome Potentially Associated with Coronavirus Disease (COVID-19) in Children


Webinars/Podcasts

Re-Opening Your Medical Practice in COVID-19 Era (Prerecorded)


Veterans Matters Podcasts
Check out MSSNY’s Veterans Matters podcast series on Veterans’ healthcare topics including PTSD in Returning Veterans, TBI in Returning Veterans, Substance Use in Veterans, Suicide in Veterans, The Special Mental Health Needs of Women Veterans and Military Culture: Everything Physicians Need to Know about Veterans as Patients.

Click here to listen to Part 1 of PTSD in Returning Veterans with Dr. Frank Dowling.

Click here to listen to Part 2 of PTSD in Returning Veterans with Dr. Frank Dowling.

Click here to listen to TBI in Returning Veterans with Dr. David Podwall.

Click here to listen to Substance Use Disorders with Dr. Thomas Madejski.

Click here to listen to Suicide in Veterans podcast with Dr. Jack McIntyre.

Click here to listen to The Special Mental Health Needs of Women Veterans with Dr. Malene Ingram, Colonel, U.S. Army Reserves and Retired Chief Master Sergeant, U.S. Air Force, Marcelle Leis.

Click here to listen to Military Culture: Everything Physicians Need to Know about Veterans as Patients with Retired Lieutenant Colonel, U.S. Army, Lance Allen Wang and Retired Chief Master Sergeant, U.S. Air Force, Marcelle Leis.


Additional Information

Stimulus Package Passed by Congress Provided Several Programs to Aid Physicians Through this Crisis
As reported in an AMA summary of the $2 trillion stimulus package enacted into law last Friday, here are some of the key provisions to benefit physicians:

Small business loans. Small businesses, including physician practices, with no more than 500 employees are eligible to apply for the Small Business Administration’s (SBA) section 7(a) Payroll Protection Program. For more information on how physicians can access this program, click here.

This allows a small business to apply to an SBA-approved lender for a loan of up to 250% of the business’ average monthly payroll costs to cover 8 weeks of payroll as well as help with other expenses like rent, mortgage payments, and utilities. The maximum loan amount is $10 million. Sole-proprietors, independent contractors, and other self-employed individuals are eligible.

A loan can be forgiven based on maintaining employee and salary levels. For any portion of the loan that is not forgiven, the terms include a maximum term of 10 years, a maximum interest rate of four percent. Small businesses and organizations will be able to apply if they were harmed by COVID-19 between February 15, 2020 and June 30, 2020. This program is retroactive to February 15, 2020andare available through June 30, 2020.

Emergency loans.  Moreover, there was also Authorization for $10 billion in “emergency” Economic Injury Disaster Loan (EIDL) to eligible entities with not more than 500 employees. Allows an eligible entity that has applied for an EIDL loan to request an advance on that loan, of not more than $10,000, which the SBA must distribute within 3 days. Advance payments may be used for providing paid sick leave to employees, maintaining payroll, meeting increased costs to obtain materials, making rent or mortgage payments, and repaying obligations that cannot be met due to revenue losses

Financial support for hospitals, physicians, and others. Provides $100 billion through the Public Health and Social Services Emergency Fund to provide immediate financial relief by covering non-reimbursable expenses attributable to COVID-19. Health care entities, including physician practices, that provide health care, diagnoses, or testing are eligible. Non-reimbursable expenses attributable to COVID-19 qualify for funding.

Examples include increased staffing or training, personal protective equipment, and lost revenue. HHS is instructed to review applications and make payments on a rolling basis to get money into the health system as quickly as possible. HHS is given significant flexibility in determining how the funds are allocated and is expected to release guidance on the application process shortly.


Business Loan Forgiveness Included in CARES Act
Within the Coronavirus Aid, Recovery and Economic Security (CARES) Act that President Trump signed yesterday is a $350 billion Paycheck Protection Program that will allow businesses and nonprofits with fewer than 500 employees to apply for loans up to $10 million each to cover losses caused by the COVID-19 pandemic. 

What makes this relief even more significant is the possibility of loan forgiveness, which is available to employers who retain their workforce levels through the crisis. If you follow the guidelines carefully, you can essentially convert your business loan to a grant – even if you’ve already laid off employees.

Loan Forgiveness Requirements

Loans may be forgiven if businesses use the money to pay for payroll costs, salaries, benefits, mortgage interest, rent and/or utilities.  The forgiven amount would be equal to the amount actually paid for these expenses during the eight weeks following disbursement of the loan. Additional wages paid to tipped employees under Section 3(m)(2)(A) of the Fair Labor Standard Acts may also be forgiven.

Forgiveness will be scaled back if the business has a reduction in employees, salaries or wages. Reductions in workforce, salaries and wages that occur from February 15, 2020 to April 26, 2020 will be disregarded for purposes of reducing the forgiveness amount, as long as the reductions are eliminated by June 30, 2020.

For purposes of the loan forgiveness, a reduction in workforce and salary or wages will be calculated as follows:

  • Workforce reductions will be calculated by the initial forgiven amount multiplied by the quotient of average full-time equivalents (FTEs) during the eight-week period, divided by the average FTEs for the period from February 15, 2019 through June 30, 2019 or January 1, 2020 through February 29, 2020, as determined by the loan recipient.
  • Salary or wage reductions will be determined by the amount of any salary or wage decrease in excess of 25 percent of the total salary or wages during the most recent full quarter such employee was employed before the eight-week period. Only employees who did not receive, during any single pay period during 2019, wages or salary at an annualized rate of pay in excess of $100,000 are included in this calculation.

Advance Medicare Payments to Help Physicians Through this Period
Moreover, CMS announced over the weekend a process for physicians to receive 100% of predicted Medicare payments for a 3-month period ( Fact Sheet: Advanced Payment Program During COVID-19 Emergency).  Here is a recommended process for applying for these advanced payments shared with MSSNY by a medical practice, as well as some of the particulars of this program:
Process:

1. Go to your National Government Services (NGS) website and fill in, sign, and submit an Accelerated / Advance Payment request form for your practice.

2. Can request up to 100% of Medicare payment for a 3-month period.

3. Check box 2 (“Delay in provider/supplier billing process of an isolated temporary nature beyond the provider’s/supplier’s normal billing cycle and not attributable to other third-party payers or private patients.”); and

3. State that the request is for an accelerated/advance payment due to the COVID-19 pandemic

4. Will receive payment within seven calendar days from the request.

5. Recoupment will begin 120 days after payment issuance date.

 Eligibility:

1.     Have billed Medicare for claims within 180 days immediately prior to the date of signature on the provider’s/supplier’s request form,

2.     Not be in bankruptcy,

3.     Not be under active medical review or program integrity investigation, and

4.     Not have any outstanding delinquent Medicare overpayments.

For further information, contact Regina McNally, VP of MSSNY’s Socio-Economic

Division at 516-488-6100 ext.332 or email rmcnally@mssny.org.



Questions:

• NYS has a coronavirus hotline at 1-888-364-3065.
• The New York State Department of Health has established a provider email account for physicians to ask questions about COVID-19: Covidproviderinfo@health.ny.gov

MSSNY eNews: July 31, 2020

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MSSNY Fights for You on Every Front

This week, I report a storm of healthcare politics on a state and national level with one common theme—MSSNY Fights for You!

Physicians Need Stimulus Funding

MSSNY sent a letter to our NY congressional delegation urging Congress to include needed funding in the next stimulus package to assist community physician practices across the state of New York to keep their doors open, to maintain continuity of care for our patients and to maintain jobs for the hundreds of thousands employed by physicians across our State.

MSSNY urged our Congressional delegation to fight to ensure that the final relief package include important protections to preserve the viability of New York’s health care system including new funding for the CARES Act provider relief pool, a re-start of the Medicare Advance Payment Program including more favorable repayment terms and significant additional funding to states to prevent potentially steep Medicaid cuts.

Barriers to Re-Opening Practices

MSSNY alerted our Congressional delegation to barriers to re-opening faced by physician practices including the need to limit the numbers of patients treated in a day and the continued lack of affordable, reliable personal protective equipment (PPE).  We shared results from a recent MSSNY survey that found that 72% of the physician respondents were still having difficulty in securing PPE and that where available the cost was astronomical, with the vast majority of the respondents indicating that their PPE costs had gone up by at least 30%.

On the home front, in Albany we are still actively advocating for our NYS Legislature and Governor to have insurance companies (who have prospered due to COVID-19) reimburse physician practices for the added cost of PPE needed to care for their insureds.

Surprise Medical Billing Solutions

Once again, some in Washington have tried to tie negotiations dealing with COVID-19 to surprise medical billing solutions.  MSSNY has expressed strong concerns about this to our NY Congressional delegation, stressing that any proposal to address surprise billing must be consistent with New York’s successful, groundbreaking law, rather than one-sided solutions advanced by the market-dominant health insurance industry.  We again asserted that to do otherwise would adversely impact patient access to essential on-call specialty care in emergency departments throughout our state.

You can send a letter to your Congressional representatives in opposition to short-sighted surprise billing approaches, and in support of needed additional funding here.

Repeal of Liability Protections

This week were pleased to see that Coronavirus-related liability protections were a top priority for Senate Majority Leader Mitch McConnell with the Senate stimulus package including liability protections for hospitals and medical professionals.  However, on the home front, despite our best efforts, S.8835/A.10840 passed both houses and has been delivered to the Governor.

This legislation prospectively repeals the liability protections for physicians and other health care providers enacted in the State Budget for patient care provided as part of the Covid-19 response effort. These protections were not only for direct care provided to Covid-19 patients but also for the extremely difficult triaging decisions made when hospitals particularly downstate were being overwhelmed with patients. These protections were essential for physicians who were required by state government to postpone “elective” procedures to prioritize health care resources for Covid-19 patients.

As we prepare for a potential second “surge” of COVID19, please use this link to send a letter to the Governor urging him to VETO this legislation and ensure the availability of physicians and other frontline health care workers by protecting them from liability for decisions made under the most overwhelming circumstances.

The AMA recently reported on a study showing that doctors had significantly higher resilience scores than the general employed population.  I believe we all knew this to be empirically true.  However, our resilience has been tested over the past six months like never before. Fortunately, we don’t just have any port in a storm.

We have MSSNY to see us through all the stormy weather, political and otherwise.

Bonnie Litvack, MD
MSSNY President

Note: “Governor Cuomo had an op-ed in today’s New York Times noting that, over the last week, 85% of New York’s COVID tests took a median of just 2 days to complete.  Is this your experience?  Please let us know. MSSNY has been in regular communication with the NYS Department of Health and Governor’s office regarding our concerns with unnecessary delays regarding receiving COVID testing results.”

https://www.nytimes.com/2020/07/31/opinion/coronavirus-testing-cuomo.html


Snapshot of COVID-19 in the U.S.

Cases: 4,427,620
Deaths: 150,717
Recovered: 1,389,425

Counts reflect data available as of 8:45 a.m. CDT July 30.


MSSNY’s Peer to Peer (P2P) Program
If you or someone you know is struggling with everyday life stressors, reach out to the P2P program to be connected with a peer supporter to help!

  • Email: P2P@mssny.org and request that you be connected with a peer supporter
  • Phone: 1-844-P2P-PEER (1-844-727-7337) and request that you be connected with a peer supporter

MSSNY is seeking volunteer peer supporters!
A peer supporter is an individual who has shared experiences, listens without judgement, can validate feelings and provide SUPPORT, EMPATHY AND PERSPECTIVE. This is someone who also provides supports to systems and practices and encourages the use of positive coping skills. They also help connect the individual with needed treatment.

Physicians, residents, or medical students who are members of MSSNY can become volunteer peer supporters.

How are peers trained? MSSNY will provide free training to the volunteer peer through a training program. This training program will be offered virtually and consists of peer support and what makes a good peer (How to be a Peer), psychological first aid, and how the program will operate. There will also be other on-line course work that a peer can avail themselves of through MSSNY’s CME website. The virtual training programs will be offered more than once.

How to become a volunteer peer: Volunteer peers can be nominated by county medical society presidents, county medical society executives, or another physician, resident, or medical students. To nominate an individual please send an email to Cayla Lauder at clauder@mssny.org or call (518) 465-8085.

The Medical Society of the State of New York now offers to physicians, residents, and medical students an opportunity to talk with a peer about some of life stressors. MSSNY’s Physician Wellness and Resiliency Committee launched a Peer 2 Peer (P2P) program to assist their colleagues who are need of help in dealing with work and family stressors. With the advent of the COVID-19 pandemic, some of the emotional issues related to this event, may also be troubling for our colleagues.



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When He Got Sick with COVID, He Saw the Best of Humanity
MSSNY Vice President Dr. Parag H. Mehta, Senior Vice Chairman of the Department of Medicine at NYP Brooklyn Methodist Hospital, his wife and daughters are all COVID-19 survivors. Dr. Mehta shares his touching story of his ordeal.

Have you seen heaven? I found it during my COVID journey.

My wife, daughters, and I are all COVID survivors. I had a fever for 13 days, hypoxia, and tachycardia. When I returned to work, I was 12 pounds lighter with reduced stamina and endurance. At the same time, I also felt much healthier, mentally and spiritually. I am grateful for my recovery, and it is uplifting to be back at work to see my friends, colleagues, and residents.

During the weeks I was sick, I was able to reflect on my life. The adversities I faced have transformed me into a more positive person. I have found a new appreciation for life and the opportunity to help people as a physician. All the people who surrounded me while I was sick made me realize the amount of support, love, friendship, and care that cocooned me. Friends and family sent food, cleaning supplies, masks, and blessings. While there were many days I had no appetite, when my daughters cooked for me I knew I had to try. Food made with such love forced me to eat something. There were days when it was difficult to engage in conversation, but a simple FaceTime with my family uplifted my spirits. Even though I had been alone with no physical contact with anyone for 13 days, these sentiments pushed me through. I continued to feel the warmth of these acts of kindness around me when I returned to work. All of my colleagues and residents took care of me — making sure I was well hydrated, well fed, and healthy mentally and physically.

This journey was not easy. I saw and heard too many dying patients. I lost my mother-in-law and couldn’t be by her side. I lost two of my physician friends and many others I knew. I wondered how lonely they felt with no one by their sides. While I am impressed with the compassion of nurses and doctors, I am tormented for the families not able to be there for their loved ones, including my own.

My experiences with loss, grief, and loneliness, as well as those of my loved ones, have made me more committed to my work. I spent so much time reading about COVID to understand the treatment and timely interventions. I called numerous hospitals, caregivers, nurses, and doctors. I also read a great deal about the leadership during the crisis and reopening, going back to normal. As the elected vice president of the Medical Society of the State of New York and a governor in the New York Chapter of the American College of Physicians, I am participating in advocacy for patients and healthcare workers. I am also part of initiatives like telehealth, remote monitoring, and employee testing.

In this time of uncertainty, there is one certainty: There is love, support, and positivity all around me. This world is beautiful and filled with compassionate people. If there is heaven, it is here with you. When the line between life and death was blurry, I thank you all for giving me the courage to go on.

https://healthmatters.nyp.org/my-covid-19-story/?ogi=MjEwNTA


MSSNY IN THE MEDIA

MSSNY Weekly Podcast


AMA Survey on Treating Pain During COVID-19 Pandemic
The AMA Advocacy Resource Center is asking for MSSNY’s help to survey physicians specifically on the issue of treating patients with pain. We know that your members have received many surveys, and we’re highly sympathetic to the time and other pressures on their practices, but this is the first to specifically address issues affecting and physicians who treat patients with pain during the COVID-19 pandemic. The results will help inform future advocacy efforts.

The survey is available here.

The AMA will keep the survey open for approximately 2-3 weeks. We will then analyze and communicate the results if we obtain a representative sample of responses.

If you have any questions, please contact the AMA’s daniel.blaney-koen@ama-assn.org


Study Suggests 78% of Recovered COVID-19 Patients May Have Heart Damage
 “78% of recovered COVID-19 patients had permanent heart damage,” according to a new study published in JAMA Cardiology. The study “examined the cardiovascular MRIs of 100 people who had recovered from the coronavirus.” The heart images “showed that almost 80% of recovered COVID-19 patients had structural changes to their hearts.”



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Study Suggests: Spring School Closures May Have Saved Tens of Thousands
In a new analysis, pediatric researchers have estimated that the states’ decisions to close schools last spring likely saved tens of thousands of lives from [COVID-19] and prevented many more coronavirus infections. The study, published in JAMA, “focuses on a six-week period in the spring and concluded that school closure ‘may have been associated with approximately 1.37 million fewer cases of [COVID-19] over a 26-day period and 40,600 fewer deaths over a 16-day period.’”


Emergency Physicians’ Main Stressor: 96% Said Availability of PPE
A vast majority of emergency medicine physicians said increasing the availability of personal protective equipment would relieve their stress related to the COVID-19 pandemic, a new survey shows.

The survey was emailed to all emergency medicine physicians at seven U.S. academic emergency departments. A total of 426 physicians responded. Survey results were published in the journal Academic Emergency Medicine.

When asked what measures would relieve their stress related to the COVID-19 pandemic, respondents said:

  1. Enhanced availability of PPE: 96.2%
  2. Rapid turnaround testing (less than six hours): 92%
  3. Testing for COVID‐19 for patients at my discretion (instead of being limited by current protocols): 82.4%
  4. Clearer communication about changes in protocols: 73.5%
  5. Assurances that I can take leave to care for myself and family members: 71.8%
  6. Ability to request testing of myself for COVID‐19 even if I don’t have symptoms: 69.2%
  7. Greater clarity about my risk for exposure: 66.7%
  8. Assurances that my medical care and that of my dependants will be covered by my employer: 63.4%
  9. Assurances about disability benefits: 57%
  10. Easily available mental health consultations for me and other healthcare providers: 56.8%
  11. Departmental video sessions to discuss COVID-19 response and changes: 55.4%

Academic Emergency Medicine Physicians’ Anxiety Levels, Stressors, and Potential Stress Mitigation Measures During the Acceleration Phase of the COVID19 Pandemic First published: 22 June 2020 https://doi.org/10.1111/acem.14065


Health Advisory: Revised Protocols for Personnel in Healthcare and Other Direct Care Settings to Return to Work Following COVID-19 Exposure or Infection


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AMA’S Dr. Duane & Joyce Cady Honor Fund Awards Two $10,000 Scholarships
The Duane & Joyce Cady $10,000 Physicians of Tomorrow Scholarships have been awarded to medical students attending school in New York and who are also actively involved in organized medicine and plan to practice in New York.

The 2020 awardees are:

Gabrielle J. Sagesse, who graduated Cum Laude from Binghamton University in 2017 with a degree in Integrative Neuroscience where she was actively involved as Treasurer and President of the Student National Medical Association. Gabrielle intends on being a Family Medicine physician with a focus on health disparities and working with our most vulnerable patient populations – the very young and the very old, low-income, and homeless, chronically ill, and disabled. She hopes to open a community center where her passions for mental health advocacy, health policy and education, fitness and nutrition may come together to serve specifically, Black, and undeserved communities, like her own in Canarsie, Brooklyn, NY.

Cameron Bosinski was born and raised in Buffalo. He received a BS in Biology and Psychology from Stony Brook University and an MS in Neuroscience from the University of Hartford. After graduating, he worked as a medical scribe at Mercy Hospital in Buffalo and taught biology courses at Villa Maria College. During medical school, he was awarded a fellowship by the Foundation for Anesthesia Education and Research and won first place for best abstract at the American Society of Anesthesiologists’ annual meeting.

He has held several leadership positions, including Anesthesiology Interest Group President, Class of 2021 Curriculum Committee Representative, and founded the Association of Native American Medical Students Chapter at SUNY Upstate. Bosinki has been instrumental in planning an annual pre-admission workshop for Native American premedical students and continues to mentor several of the students that he has met.

The AMA Foundation brings together physicians and communities to improve our nation’s health. Support our shared mission: make a gift today. This year, the Scholarship Fund wanted to offer two scholarships and the committee thanks MLMIC for its generosity.


2020 MSSNY Poster Symposium Virtual Posters Online
The 2020 MSSNY Poster Symposium could not be held due to uncontrollable circumstances, but you can still view a selection of accepted posters here. Password is houseny.

Please take a look at the work of our resident, fellow and medical student members!


Yale Research: Students Need COVID-19 Testing Every 2 Days to Contain Virus
Testing students for COVID-19 more frequently using a less sensitive test may be the most cost-effective way to control the virus on college campuses this fall, according to research published on the medical preprint server medRxiv.

Researchers at New Haven, Conn.-based Yale University modeled various testing strategies for a hypothetical group of 5,000 uninfected college students in an 80-day semester. Models varied based on the frequency, sensitivity, specificity, and cost of testing.

Screening students for COVID-19 daily using a test with 70 percent sensitivity would limit infections to just 85 a semester, costing about $920 per student. Testing students every two days would limit infections to 135 over the same time period and cost about $470 per person. In contrast, screening students just once a week would result in more than 3,600 cases. “Rapid, inexpensive and frequently conducted screening (even if only 70 percent sensitive) would be cost-effective and produce a modest number of COVID-19 infections,” researchers said. “While the optimal screening frequency hinges on the success of behavioral interventions to reduce the base severity of transmission, this could permit the safe return of student[s] to campus.”

The research has not been peer-reviewed. To learn more, click here.


CDC

CDC Webinar Aug. 4 on COVID-19 Telehealth Lessons
The Centers for Disease Control and Prevention Aug. 4 at 2 p.m. ET will host a Clinician Outreach and Communication Activity webinar on telehealth’s benefits and challenges, based on lessons learned during the COVID-19 pandemic. The presenters will share their experiences implementing telehealth across diverse health care settings and address considerations for its future use. Join the webinar here using webinar ID 160 872 1092. A recording will be available for viewing on the COCA Call webpage a few hours after the live event concludes.


CMS and CDC Announce Provider Reimbursement Available for Counseling Patients to Self-Isolate at Time of COVID-19 Testing
On July 30, CMS and the Centers for Disease Control and Prevention (CDC) are announcing that payment is available to physicians and health care providers to counsel patients, at the time of Coronavirus Disease 2019 (COVID-19) testing, about the importance of self-isolation after they are tested and prior to the onset of symptoms.

The transmission of COVID-19 occurs from both symptomatic, pre-symptomatic, and asymptomatic individuals emphasizing the importance of education on self-isolation as the spread of the virus can be reduced significantly by having patients isolated earlier, while waiting for test results or symptom onset. The CDC models show that when individuals who are tested for the virus are separated from others and placed in quarantine, there can be up to an 86 percent reduction in the transmission of the virus compared to a 40 percent decrease in viral transmission if the person isolates after symptoms arise.

Provider counseling to patients, at the time of their COVID-19 testing, will include the discussion of immediate need for isolation, even before results are available, the importance to inform their immediate household that they too should be tested for COVID-19, and the review of signs and symptoms and services available to them to aid in isolating at home. In addition, they will be counseled that if they test positive, to wear a mask at all times, and they will be contacted by public health authorities and asked to provide information for contact tracing and to tell their immediate household and recent contacts in case it is appropriate for these individuals to be tested for the virus and to self-isolate as well.

CMS will use existing evaluation and management payment codes to reimburse providers who are eligible to bill CMS for counseling services no matter where a test is administered, including doctor’s offices, urgent care clinics, hospitals, and community drive-thru or pharmacy testing sites.

For More Information:


Classifieds

Upper East Side Office to Share
Includes waiting room, 2 exam rooms and room for medical assistants. Flexible schedule. Call Bianca at 212-327-1851.

For Sale:  715 Park Avenue
Medical office, 1,800 sq. ft. Rectangular, 11 1/2 ft ceilings, street level access. Private entrance on 70th Street, side of the building.  Windows on Park Avenue and 70th Street.  Excellent office space for plastic surgeon, dermatologist or dental practice. Central air conditioning, high voltage electric service, two bathrooms. *Sale could include active Cardiac / Medical Practice. Please contact Janet @ 212-288-5468.


Office Space and Quad-A Certified O.R. for Rent
Plastic surgery office and/or quad A – certified operating room available for rent. We welcome you to tour our facility, where safety and luxury are combined in the most prime location on the upper east side. We assure you will be delighted by what you discover. We take pride in our facility, where your patients’ safety and satisfaction are our number one priority.
  • Fully equipped operating room perfect for a board-certified plastic surgeon
  • Pre-op and recovery areas
  • A bright and modern waiting area
  • 3 consultation rooms, administrative room, kitchenette, and 2 bathrooms
  • Full day office rental per week / O.R. rental per case

For inquiries please call 212.737.8700, email polina@specialtyaestheticsurgery.com
Office Space and Quad-A Certified O.R. for Rent


 

 

 

 

 

 

eNews: July 29, 2020

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Thursday July 30th at 1-2PM for a COVID-19 update for healthcare providers
To accommodate the large number of participants, find our webinar streaming via YouTube Live (and available for viewing immediately thereafter) on the NYSDOH COVID website for providers or audio only, please dial in: 844-512-2950 and access code: 7653573.


Eastman Kodak to Create New Business Unit, KodakPharmaceuticals
The Eastman Kodak Company, a storied New York manufacturer based in Rochester, was awarded a $765 million federal loan under the Defense Production Act. This loan will allow Kodak to create a new business unit, Kodak Pharmaceuticals, dedicated to producing pharmaceutical ingredients that are essential for vital medications. New York’s long-term support for Eastman Business Park helped allow the company to take advantage of this opportunity.

Today’s announcement means 300 direct jobs and 1,200 indirect jobs for New Yorkers. More importantly, it will help ensure that America can provide for our own needs in a pandemic like this one. Never again do we want to rely on shipments from China or elsewhere in order to get lifesaving medical supplies. It is not just a public health issue—it’s a national security issue. This is a great step forward and a great business opportunity for New York.


CMS Posts FAQs on Medicare Fee Billing During COVID-19
Today, CMS posted an updated set of Frequently Asked Questions (FAQs) on Medicare Fee-for-Service (FFS) billing during the COVID-19 public health emergency (PHE).  The FAQs outline policies for Medicare-covered items and services that are in effect “for the duration of the public health emergency, unless superseded by future legislation.”

The agency adds that it is “thoroughly assessing” legislation passed by Congress, including the CARES Act, and will issue updated FAQs “as implementation plans are announced.”


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Facebook’s Vaccine Misinformation Faces New Test with COVID-19
As scientists begin to clear a path to a potential coronavirus vaccine, researchers and advocates are increasingly sounding the alarm over what they see as a looming threat: Facebook’s apparent inability to police dangerous falsehoods about vaccines. Since the outset of the pandemic, vaccine-related falsehoods have ballooned on the platform — and recent research suggests some of those inaccurate posts are gaining traction among people who were not previously opposed to vaccinations. Part of the problem appears to be the way Facebook’s algorithms capitalize on divisive or extremist content. (KFF 7/28)


Pfizer & BioNTech Began Late-Stage Human Trial for Vaccine
The trial will include up to 30,000 participants between the ages of 18 and 85 across 120 sites globally, including 39 U.S. states, the companies announced. If successful, they expect to submit it for final regulatory review as early as October. They plan to supply up to 100 million doses by the end of 2020 and approximately 1.3 billion doses by the end of 2021.


VIDEO: How medical schools are planning to accommodate students this fall (AMA, July 27, 2020)


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Classifieds

Upper East Side Office to Share
Includes waiting room, 2 exam rooms and room for medical assistants. Flexible schedule. Call Bianca at 212-327-1851.

For Sale:  715 Park Avenue
Medical office, 1,800 sq. ft. Rectangular, 11 1/2 ft ceilings, street level access. Private entrance on 70th Street, side of the building.  Windows on Park Avenue and 70th Street.  Excellent office space for plastic surgeon, dermatologist or dental practice. Central air conditioning, high voltage electric service, two bathrooms. *Sale could include active Cardiac / Medical Practice. Please contact Janet @ 212-288-5468.


Office Space and Quad-A Certified O.R. for Rent
Plastic surgery office and/or quad A – certified operating room available for rent. We welcome you to tour our facility, where safety and luxury are combined in the most prime location on the upper east side. We assure you will be delighted by what you discover. We take pride in our facility, where your patients’ safety and satisfaction are our number one priority.
  • Fully equipped operating room perfect for a board-certified plastic surgeon
  • Pre-op and recovery areas
  • A bright and modern waiting area
  • 3 consultation rooms, administrative room, kitchenette, and 2 bathrooms
  • Full day office rental per week / O.R. rental per case

For inquiries please call 212.737.8700, email polina@specialtyaestheticsurgery.com
Office Space and Quad-A Certified O.R. for Rent


 

 

 

 

 

 

eNews: July 24, 2020

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How Soon They Forget They Called Us Heroes
Despite MSSNY’s best efforts, including several thousand physician contacts to their legislators during this week the New York State legislature passed legislation (S.6678-A/A.7991-A) requiring “all physicians’ practice settings to conspicuously post signage, visible to their patients, directing patients to the office of professional medical conduct’s website for information about their rights and how to report professional misconduct”.

The distrust that will be fostered by legislation would be concerning at any time but passage at this time in the middle of a healthcare crisis is particularly ill timed and harmful on multiple fronts.  Patients are often nervous when they arrive at a physician’s office and even more so now in the middle of a pandemic.  Our staffs are committed to ensuring patients feel welcome, and comfortable upon entering our offices and a prominent sign about how a patient can file a complaint against their physician upon entering the office is counter-productive to initiating and developing a positive, collaborative doctor/patient relationship.

This signage will increase patient anxiety and create unnecessary confusion.  On the physician end it will contribute to increased physician demoralization, further threatening the health and well-being of our physician work force, already under significant stress.

We as physicians and a medical society are committed to ensuring a strong disciplinary process to remove those aberrant practitioners who betray the trust of their patients and their professional oaths.  However, this legislation entirely misses the mark.  This is not re-imaging healthcare in a constructive positive fashion.  This serves to drive a wedge between a doctor and a patient and potentially increase the number of frivolous claims brought to OPMC. We will be urging Governor Cuomo to veto this legislation.

You can join us in this effort by sending a letter to the Governor urging a veto here. 

Bonnie Litvack, MD
MSSNY President


This Week’s MSSNY Podcast


Notes from Governor Cuomo’s Briefing:
OF NOTE: Governor said Congress is looking at August (now) for COVID-related legislation.

COVID:

Day 146 of COVID
– 650 hospitalizations, 56 lower than yesterday
– 156 total ICU COVID patients
– 9 lives lost on 7/23: 7 in hospitals, 2 in nursing homes
– 76,000 tests completed yesterday, 0.98% positive
– Gov. stated enforcement of safety protocols is improving
– SLA and State Police Task Force conducted compliance checks in NYC yesterday, 37 violations were issued

RESPONSE TO DHS

– Dept. of Homeland Security (DHS) recently issued statement they are dropping opposition to NY’s lawsuit for stopping the Trusted Traveler Program
– This statement cited the amendment of Green Light Law being the reason
– Dept. of Justice (DOJ) then filed a brief stating DHS position was not truthful
– It was found that other states also have Green Light Laws and action taken toward NY to cease Trusted Traveler Program was “punitive” and unjustified
– Gov. stated DHS Secretary Wolf “violated his oath of office” by claiming it was unknown that other states besides NY had Green Light Laws
– Gov. called on U.S. AG Barr to launch an investigation
– Gov. also called for a congressional investigation
– Gov. stated he believes NY entitled to damages

Q&A

– Asked if Gov. is asserting stopping TTP contributed to spread of COVID
– Gov. stated it’s possible stopping the program caused backlogs which contributed to COVID spread
– Gov. again discussed inadequate federal response allowing COVID to reach NY
– Asked if CDC guidelines are consulted for school reopenings
– Gov. stated he looks at CDC guidelines but will open schools if it is safe
– Asked about deadline for budget, potential bill in Congress
– Gov. said Congress is saying August, which is acceptable
– Asked about DOH internal report on nursing homes and why an independent investigation isn’t being conducted
– Gov. said this issue is politically motivated, and facts do not support those politically-charged claims
– Asked about municipal departments of health claiming to be “usurped”
– Gov. said local departments of health can issue guidelines, and counties have “primary responsibility”
– Asked about immunity law for hospitals and nursing homes passed earlier this year
– Gov. stated we asked hospitals to take on burden during COVID, that law made sure they had no liability as a result of those burdens. Law passed yesterday is consistent with that, but specifies they are not relieved of liability for non-COVID related issues.


State Legislature Passes Bill Over Objection of Health Care Groups to Limit COVID Liability Protections
Over the objection of MSSNY, numerous specialty societies, and hospital and nursing home associations, the State Legislature passed a bill this week (S.8835/A.10840) that would limit previously established liability protections prospectively so that it would only apply to care which is provided to patients related to the diagnosis and treatment of a patient with a confirmed or suspected case of Covid-19.

MSSNY worked with the specialty societies to send a letter to the entire Legislature objecting to this measure and will be urging the Governor to veto this bill.  Specifically, we raised concerns that, should there be a second surge, this legislation would eliminate these important protections and unfairly invite lawsuits for care to non-Covid patients that may need to be delayed to prioritize health care resources, as we had to do in March in April.

As noted in this article in the NY Times from Thursday and many other news articles, several legislators and the AARP have been aggressively pushing for legislation to retroactively and entirely eliminate these essential liability protections for health care workers and health care entities that had been enacted in the State Budget adopted in early April.

While the focus of these legislators has been on the several thousand nursing home patients that died during the height of the pandemic, the legislation they seek would invite lawsuits and second guessing of all care provided by physicians in any health care setting.

These essential liability protections were not only applicable for treatment of patients with Covid-19 but also extended to other patients whose care may have been impacted by the Covid emergency response, such as the countless numbers of patients whose scheduled surgery or other treatment was postponed due to the Executive Order prohibiting elective surgery. The State Legislature is planning multiple hearings next month examining the impact of the nursing homes’ response to the pandemic.

Last week, MSSNY President Dr. Bonnie Litvack’s letter to the editor of the Albany Times-Union was published objecting to this short-sighted legislation.

The provisions of the bill that passed this week would eliminate liability protections for care to non-Covid patients based upon “acts or omissions” that occur on or after the effective date of the legislation.  It is not clear yet whether Governor Cuomo will sign or veto this legislation.

Today, the American Medical Association(AMA) sent a joint letter with the American Hospital Association and the American Nurses Association asking Congress to allocate as part of the next COVID-19 relief package at least an additional $100 billion for the emergency relief fund to provide direct funding to front line health care personnel and providers, including physicians, nurses, hospitals and health systems, as they continue to respond to the COVID-19 pandemic.

Please send a letter to the Governor here.


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Litany of Adverse Legislation to Expand Damages, Change Scope and Create New Mandates Not Taken Up
While 2 bills strongly opposed by MSSNY passed both Houses of the Legislature this week, there were also a litany of adverse bills that had been on the floor of both Houses or moving in either House that were not passed following MSSNY advocacy together with the specialty societies and other allied groups.  These include bills that would have:

  • greatly expanded damages in wrongful death actions (S.4006/S.5612);
  • Inappropriately granted optometrists the right to prescribe certain oral medications without proper training and/or documentation of training (S.4035-A/A.1193-C);
  • Bypassed recently adopted state regulations establishing criteria for the creation of midwife led birth centers (A.10440/S.8307);
  • Mandated co-prescribing of naloxone for many patients on opioid medications (A.5603/S.5150-B)
  • Mandated posting in a physician’s office of where a patient can obtain information about Consumer Product Safety Commission recalls (A.2631/S.3583);
  • Mandated notification to epileptic patients of the risk of sudden death due to epilepsy (A.7807-A/S.5397-A)
  • Mandated reporting to the Statewide Immunization system of a prescription of a rescue inhaler (S.7337/A.10085).

The AMA also sent a sign-on letter with over 100 Federation members to the Centers for Medicare & Medicaid Services (CMS) supporting many of the temporary regulatory waivers that CMS issued in response to COVID-19. However, we express concern about and urge CMS to sunset the waivers involving scope of practice and licensure.

We also affirm our organizations’ support for the physician-led team-based approach to care and vigorously oppose efforts that undermine the physician-patient relationship during and after the pandemic. There has been concern from some physicians who strongly disagree with a recent Joint Commission letter that took the opposing view on the scope waivers. This sign-on letter was already being circulated to the Federation at that time.


AMA Partners with Project N95 to Make PPE Available to AMA Members
The AMA partnered with Project N95 (a not-for-profit, National COVID-19 Clearinghouse) to make personal protective equipment (PPE) available exclusively to its members. Starting June 22, AMA members receive a series of three emails which describe the program. Members sign in using their AMA Sign In username and password and complete the Registration Form to express an interest in ordering PPE shown below.

  1. Makrite 9500 N95 surgical respirator; size S

    2. Makrite 9500 N95 surgical respirator; size M/L

    3. Disposable Isolation gown

All AMA member orders will be aggregated and shipped no later than August 26, via UPS ground.  Gowns may start shipping as early as August 17. Members receive email and text order status and shipping confirmation notices.

Project N95 has written policies on order cancellations, refunds, and handling of damaged goods. See attached Frequently Asked Questions (FAQ) for those and other details about the program and order process.

This pilot program has specific deadlines for registration, orders, and shipping, which are summarized below:

Registration: Last date to submit registration form (July 30, 3:00 PM, CST)

Orders: Last date to submit an order (August 30, 3:00 PM, CST)

  1. Cancel Order: Last date to cancel order (August 2 – open timeframe)
  2. Shipping:  Orders shipped by date (August 26 – open timeframe)

For this program, AMA and Project N95 established the purchasing business guidelines shown below in order to support as many members as are interested in participating.

Minimum Purchase

1 box of Surgical N95 Respirator (20 masks) or 1 bag of Isolation Gowns (15 gowns)

Maximum Purchase

Surgical N95 Respirator, Size S & Standard (M/L): 50 boxes (20 masks/box) – 1000 masks

Isolation Gowns: 66 bags (15 gowns/bags) – 990 gowns

Questions about this collaboration should be directed to Kristen Tinney at a href=”mailto:kristen.tinney@ama-assn.org”>kristen.tinney@ama-assn.org.


HHS Extends COVID-19 Emergency for Another 90 Days
HHS extended COVID-19 public health emergency designation for another 90 days.

Significant funding and regulatory relief for hospitals and other healthcare providers are tied to the emergency, which was set to expire on July 25. HHS officials had repeatedly signaled HHS’ intention to continue the emergency designation, and the agency previously renewed it in April.

The renewal gives the healthcare industry certainty through the fall on several key policies to assist with the COVID-19 response. Some notable policies tied to the public health emergency are the 20% Medicare inpatient add-on payment for COVID-19 patients, increased federal Medicaid matching funds for states, a mandate that insurers cover medically necessary COVID-19 tests without cost-sharing, relaxed telehealth restrictions, and Section 1135 waivers that give providers additional flexibility to respond to COVID-19.

The public health emergency length is also connected to CMS’ adjustments to the Medicare Shared Savings Program for accountable care organizations. The number of months the emergency lasts affects the amount of shared losses an ACO must pay back to CMS.

The public health emergency doesn’t have any bearing on how long providers have to spend their grants from the $175 billion Provider Relief Fund. (Modern Health, 6/23)


 

Garfunkel Wild Ad


Emergency Physicians’ Main Stresser: 96% Said Availability of PPE
A vast majority of emergency medicine physicians said increasing the availability of personal protective equipment would relieve their stress related to the COVID-19 pandemic, a new survey shows.

The survey was emailed to all emergency medicine physicians at seven U.S. academic emergency departments. A total of 426 physicians responded. Survey results were published in the journal Academic Emergency Medicine.

When asked what measures would relieve their stress related to the COVID-19 pandemic, respondents said:

  1. Enhanced availability of PPE: 96.2%
  2. Rapid turnaround testing (less than six hours): 92%
  3. Testing for COVID‐19 for patients at my discretion (instead of being limited by current protocols): 82.4%
  4. Clearer communication about changes in protocols: 73.5%
  5. Assurances that I can take leave to care for myself and family members: 71.8%
  6. Ability to request testing of myself for COVID‐19 even if I don’t have symptoms: 69.2%
  7. Greater clarity about my risk for exposure: 66.7%
  8. Assurances that my medical care and that of my dependants will be covered by my employer: 63.4%
  9. Assurances about disability benefits: 57%
  10. Easily available mental health consultations for me and other healthcare providers: 56.8%
  11. Departmental video sessions to discuss COVID-19 response and changes: 55.4%

Academic Emergency Medicine Physicians’ Anxiety Levels, Stressors, and Potential Stress Mitigation Measures During the Acceleration Phase of the COVID19 Pandemic

First published: 22 June 2020 https://doi.org/10.1111/acem.14065


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Classifieds

Upper East Side Office to Share
Includes waiting room, 2 exam rooms and room for medical assistants. Flexible schedule. Call Bianca at 212-327-1851.

For Sale:  715 Park Avenue
Medical office, 1,800 sq. ft. Rectangular, 11 1/2 ft ceilings, street level access. Private entrance on 70th Street, side of the building.  Windows on Park Avenue and 70th Street.  Excellent office space for plastic surgeon, dermatologist or dental practice. Central air conditioning, high voltage electric service, two bathrooms. *Sale could include active Cardiac / Medical Practice. Please contact Janet @ 212-288-5468.


Office Space and Quad-A Certified O.R. for Rent
Plastic surgery office and/or quad A – certified operating room available for rent. We welcome you to tour our facility, where safety and luxury are combined in the most prime location on the upper east side. We assure you will be delighted by what you discover. We take pride in our facility, where your patients’ safety and satisfaction are our number one priority.
  • Fully equipped operating room perfect for a board-certified plastic surgeon
  • Pre-op and recovery areas
  • A bright and modern waiting area
  • 3 consultation rooms, administrative room, kitchenette, and 2 bathrooms
  • Full day office rental per week / O.R. rental per case

For inquiries please call 212.737.8700, email polina@specialtyaestheticsurgery.com
Office Space and Quad-A Certified O.R. for Rent


 

 

 

 

 

 

eNews: July 22, 2020

.

Gov. Cuomo Press Conference Highlights 

COVID: 

– Day 144 of pandemic 

– 67,00 tests yesterday, 705 were positive, infection rate is 1.04% 

– 9 lives lost on 7/21 

– 714 hospitalizations, 10 less than yesterday 

– NY “doing very well” 

– It was expected infection rate would go up after reopening, but has continued to go down 

– Still concern over increase in infection rate across U.S., virus could have a “ricochet effect” throughout the country  

FEDERAL: 

– President said yesterday masks should be worn, Gov. called this a “positive step forward”, but President needs to issue federal mandate for masks 

– IHME model showed mask mandate could save 40,000 lives 

– Gov. spoke with Pres. Yesterday; Pres. said he is considering sending federal agents to NY to deal with “increasing crime problem;” Gov. stated he is also concerned about crime in NYC, but the situation can be managed by the state, no need for federal involvement at this point 

– Gov. expressed concern over federal COVID bill – state and local governments excluded 

– Gov. cited “numerous experts” that have stated economy will not rebound if state and local governments do not receive relief.  

Q&A: 

– Asked about conversation with President – what will state do to impact crime rate in NYC 

– Gov. stated if there is a public safety emergency in NYC that requires assistance, additional resources can be brought in to address emergency; Gov. said he will declare an emergency if he believes necessary 

-Asked about the parameters for declaring a public emergency, Gov. said he “will know it when [he] sees it”, but has been working with the city to make changes to   

NYPD: 

– While concerned, Gov. said he does not believe aggressive action is required at this time by federal government 

– Asked about bill legislature is considering this week to end civil/legal immunity for nursing homes during pandemic; Gov. said he will have to see the bill, but he believes it deals with non-COVID situations 

– Asked whether Trump is engaging in personal politics; Gov. cited “different tone with President” yesterday, believes there was a recognition by Pres. that federal govt. has been in denial over COVID 

– Asked about widespread graffiti in NYC; Gov. stated concern is worse than graffiti – NYC is in “troubling times” due to COVID, increased crime, impact on economy; Graffiti “another manifestation of deterioration of NYC,” city should work harder on this 

– Asked about positive infection rate and the period of time tests cover due to backlogs in labsGov stated results are from tests coming back yesterdayGov. stated only national labs experiencing backlog of test results 

– Rhodes added that about 72% of tests yesterday were done within the last 2-3 days, and tests in hotspots are processed more quickly 

– DeRosa added that results are also looked at as a 5-day average


Daily COVID-19 Stats, State-By-State 

(Becker’s Hospital Via hhs)


HHS Extends Medicaid and CHIP Physicians from July 20 to August 3!
HHS extended the deadline for eligible Medicaid and CHIP physicians and organizations to submit information and apply for funding from the CARES Act Provider Relief Fund from July 20 until August 3, 2020.

HHS is distributing approximately $15 billion to eligible physicians who have not previously received a payment from the Provider Relief Fund. The payment amount will be at least 2 percent of reported gross revenue from patient care, and the final amount will be determined based on submitted data, including the number of Medicaid patients served. HHS has created a fact sheet explaining the application process and answering frequently asked questions.

The American Medical Association (AMA) has made HHS aware of an issue where physicians who primarily care for patients with Medicaid and CHIP coverage received a small amount of money from the automatic Medicare allotment in April because they treated one or two patients with ESRD. They are ineligible to apply for this round of funding even if they rejected and returned the money. HHS has indicated they are working on a policy to address this issue.


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Around 20% of Pregnant Women Misused Opioids in 2019, CDC Reports
About one in five U.S. women reported that they misused prescription opioids during pregnancy, a CDC analysis of survey data showsCDC analyzed data from surveys conducted in 2019 polling 21,488 women who had given birth in the last two to six months. Learn more about the data and methodology here. 

Of the women polled, 20,643 (96.1 percent) provided information regarding prescription opioid use during their most recent pregnancy. Overall, 1,405 (6.6 percent) reported prescription opioid use during pregnancy. A little over 21 percent of women who used prescription opioids during pregnancy reported misuse, with 4 percent reporting getting the opioids from a non-healthcare provider source and using them for reasons other than pain. Among women who used prescription opioids during pregnancy, 27.1 percent indicated wanting or needing to cut down or stop using. 

About 68 percent of the women reported that a healthcare provider counseled them about the effect of opioid use on an infant. (CDC)


NYSDOH: Procedures for Testing/Reporting of Mosquito & TickBorne Illnesses
NYSDOH is reminding healthcare providers of the procedures for testing and reporting of mosquito- and tick-borne illnesses. As NYS residents may be spending more time outdoors this spring/summer due to social distancing recommendations and symptoms of vector-borne diseases may be similar to some associated with COVID-19 disease, providers are reminded to ask patients about outdoor activities as part of routine telehealth, outpatient, and inpatient assessments. Prompt recognition of and treatment for tick-borne diseases, in particular, is crucial to minimizing morbidity and mortality. 


NY Senators: Over $680 Million In Additional Emergency Federal Funding For ‘Hot Spot’ Hospitals


 

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Classifieds

Upper East Side Office to Share
Includes waiting room, 2 exam rooms and room for medical assistants. Flexible schedule. Call Bianca at 212-327-1851.

For Sale:  715 Park Avenue
Medical office, 1,800 sq. ft. Rectangular, 11 1/2 ft ceilings, street level access. Private entrance on 70th Street, side of the building.  Windows on Park Avenue and 70th Street.  Excellent office space for plastic surgeon, dermatologist or dental practice. Central air conditioning, high voltage electric service, two bathrooms. *Sale could include active Cardiac / Medical Practice. Please contact Janet @ 212-288-5468.


Office Space and Quad-A Certified O.R. for Rent
Plastic surgery office and/or quad A – certified operating room available for rent. We welcome you to tour our facility, where safety and luxury are combined in the most prime location on the upper east side. We assure you will be delighted by what you discover. We take pride in our facility, where your patients’ safety and satisfaction are our number one priority.
  • Fully equipped operating room perfect for a board-certified plastic surgeon
  • Pre-op and recovery areas
  • A bright and modern waiting area
  • 3 consultation rooms, administrative room, kitchenette, and 2 bathrooms
  • Full day office rental per week / O.R. rental per case

For inquiries please call 212.737.8700, email polina@specialtyaestheticsurgery.com
Office Space and Quad-A Certified O.R. for Rent


 

 

 

 

 

 

eNews: July 17, 2020


.

Dear Colleagues:

Legislators Are Back! MSSNY Issues at Stake!
The pandemic caused all of us to have our years unfold in ways far different than we thought it was going to be.

The New York State Legislature is no exception.

With several state legislators contracting the virus in mid-March and most of the state smartly following instructions to stay “socially distant” the State Legislature essentially suspended proceedings in early April after enactment of the State Budget (with limited returns for focused agendas in late May and mid-June).

Now with our low infection rates having made New York a model for the country, the Legislature is returning to Session next week, mostly virtually, to take up a “robust agenda” (as one legislator described it) of items that had been put on hold due to the pandemic response.  While many of the items under consideration are local issues important for the constituents of a particular Assembly or Senate district, there are also numerous health care items that could be brought up for discussion and have a significant impact on physicians and their patients.

One of these items is legislation (A.10427/S.8497) strongly opposed by MSSNY that would repeal the liability protections for physicians and other health care providers enacted in the State Budget for patient care provided as part of the Covid-19 response effort. These protections were not only for direct care provided to Covid-19 patients but also for the extremely difficult triaging decisions made when hospitals particularly downstate were being overwhelmed with patients.  These protections are also absolutely essential for physicians who were required by state government to postpone so-called elective procedures to prioritize health care resources for Covid-19 patients.

MSSNY worked together with the specialty societies to send a letter to the Legislature expressing its strong objections to this proposal.  I also had a letter to the editor of the Albany Times-Union published this week objecting to this short-sighted legislation.

While the bill’s proponents have focused on nursing home issues as the basis for repealing these liability protections, the impact of the legislation goes far beyond nursing homes.  In both our letter to the Legislature and to the Albany T-U, we noted our strong concerns that this legislation will not only prevent hospitals and other health care facilities from re-developing capacity in case of a second “surge” but also would unfairly retroactively remove the liability protection that healthcare professionals and facilities believed they had in responding to the crisis of patient load exceeding capacity.

As you know, we found ourselves making extraordinary medical decisions in confronting a new deadly disease with an unprecedented volume of patients. At the same time were asked to provide health care services that were not within our usual scope of services, and often without adequate protective equipment, threatening our health and our families’ health.

Certainly, it is important to assess our pandemic response for the purposes of improving how we can respond if there is a “second surge” in New York, or for future pandemics.  But undoing protections to our healthcare heroes who bravely treated patients on the frontlines would be extremely unfair and counterproductive for future response efforts.

Please remain alert for further updates.  We are continuing to work closely with our allies across healthcare sectors to advocate for the protection of this important law.

Bonnie Litvack, MD
MSSNY President


MSSNY Continues to Oppose Numerous Legislative Mandate Bills
With the Legislature set to return to Session next week, MSSNY continues to oppose countless well-intended but problematic bills under active consideration that would add significant new mandates on medical care delivery.

Taken together, these proposals would add significant new record keeping responsibilities that would also impose civil sanctions and/or disciplinary action for failing even in one instance to properly follow the mandate.  These proposals include:


Urge Your Legislator to Oppose Massive Liability Expansion Bill
With the State Legislature to return to Session next week to take up many items that had been set aside due to the pandemic, all physicians are urged to contact their legislators to have them oppose legislation (A.5612/S.4006) that has advanced that would greatly expand the possible damages awardable in a wrongful death action, and have the effect of greatly expanding our already outrageously high liability insurance premiums.  

You can send a letter here.

One recent actuarial estimate indicated that passage of this legislation could require a liability premium increase of nearly 50%.  

These kinds of increases are untenable particularly at a time when physician practices have been struggling to stay afloat due to the enormous drop in patient visits arising from the pandemic.

Please urge your legislators to oppose this legislation today!


MSSNY Working with NYSOS Urges Legislature to Keep Patient Safety Standards for Ophthalmological Care
Proposed legislation (A.1193-C/S.4035-A) to permit optometrists to prescribe certain oral medications has been amended, over the objection of ophthalmologists, to weaken optometrist training requirements designed to ensure patient safety. The bill was advanced by the Assembly Higher Education and Codes Committees this week.

To send a letter in opposition, click here: https://p2a.co/HsyXbSp

The bill had been negotiated between the NYS ophthalmological society and NYS Optometry Association but has been amended as follows:

  • Significantly reducing the training required of optometrists to prescribe these oral medications;
  • Removing the requirement that optometrists taking the required certification course and final examination retake the course if they have failed the final examination three times; and
  • Eliminating a proposed requirement that optometrists to furnish evidence that they have completed required continuing education courses when they submit an application for license renewal;

To read MSSNY’s memo in opposition to this legislation, click here.


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Members of New York’s Congressional Delegation Team Up in Bipartisan Push for Additional Funding for Community Physicians in CARES Act
Representatives Anthony Brindisi (D-Utica) and Elise Stefanik (R-Plattsburgh) teamed up this week to send a letter to the Secretary of Health & Human Services (HHS), Alex Azar, urging support for additional funding in the federal CARES Act, to help community physicians across New York State as they work to recover from the economic impact of the COVID19 crisis.

Specifically, the letter notes that, “Like many businesses, community physicians in New York have experienced a devastating impact on their practices because of the COVID-19 crisis, with patients having to appropriately limit their trips out of the house, including to their doctor’s office, along with the suspension of all elective procedures for months during lockdowns. The impact has devastated practices and jeopardized jobs for millions across the state.”

The letter also quotes a MSSNY survey this spring that found that 79% of physicians had seen a reduction of more than 50% in the volume of patients visiting their practices. Nearly 3/4 of physicians had a greater than 50% drop in practice revenue; and 40% had to lay off, or furlough, at least 25% of their staff. A recent Fair Health report indicating that patient visits to physician practices were down by nearly 80% in the Northeast.[1]

MSSNY’s Division of Governmental Affairs will continue to engage on this important issue and provide updates to members. CARY, AUSTER

[1] FAIR Health, Healthcare Professionals and the Impact of COVID-19, A FAIR Health Brief, June 10, 2020,https://s3.amazonaws.com/media2.fairhealth.org/brief/asset/Healthcare%20Professionals%20and%20the%20Imp act%20of%20COVID-19%20-%20A%20Comparative%20Study%20of%20Revenue%20and%20Utilization%20- %20A%20FAIR%20Health%20Brief.pdf

Quality Health Plans of NY (QHPNY) No Longer Contracted with Medicare
Please be aware, QHPNY no longer has a contract with Medicare effective February 29, 2020.  QHPNY is responsible for all payment of claims for its (prior) members. CMS understands that QHPNY is in the process of being liquidated by the New York State Department of Insurance.  Once that happens, that State will pay the remaining claims.  CMS heard from physicians regarding outstanding claims. CMS has advised them to file a complaint for unpaid claims with the New York State Department of Financial Services.  Complaints can be made by submitting to www.dfs.ny.gov/consumer/filecomplaint.htm  After which, calls can be made to 212 480 6400. (Regina McNally, VP Socio-Med Div.)


New York’s Health Premiums Remain Among the Highest in the U.S.
The average cost of New Yorkers’ health benefits increased by less than the national average in 2019 but remained among the highest in the U.S., according to recently published federal data.

The average cost for family coverage rose 4 percent to $22,874, which was 12 percent above the national average and second only to Alaska, according to an annual survey of private-sector employers by the U.S. Agency for Healthcare Research and Quality (see first chart). The average cost of single coverage rose 2 percent to $7,890, which was 13 percent above the national average and third behind Alaska and Delaware.

Those increases were a bit lower than the nationwide jumps of 5 percent for family coverage and 4 percent for single coverage.

Still, all those figures were two or three times the general inflation rate – continuing a long-term pattern for New York and the U.S.

New York’s insurance has traditionally been more expensive than national norms, but the gap has been getting wider in recent decades (see second chart).

The state’s high cost of living is likely a factor, especially in the New York City area. State policy also drives up premiums by heavily taxing health insurance and continually adding to a long list of coverage mandates. (empire Center, July 17)


Missed Childhood Vaccines Could Be Bigger Threat than COVID-19, WHO says
The COVID-19 pandemic has spurred a major decline in childhood immunization rates worldwide, the consequences of which could be more severe than the pandemic, the World Health Organization warned.

“The avoidable suffering and death caused by children missing out on routine immunizations could be far greater than COVID-19 itself,” WHO Director-General Tedros Adhanom Ghebreyesus, PhD, said in a statement cited by The Hill.

The WHO, CDC and other health partners polled 82 countries June 5-20. Sixty-nine percent of countries reporting on their vaccine programs said efforts were disrupted or suspended due to the pandemic. The most common reasons for disrupted vaccine programs were shortages of personal protective equipment, travel restrictions and a lack of available health workers.

Preliminary data for January through April also shows a “substantial drop” in the number of children receiving three doses of the vaccine against diphtheria, tetanus and pertussis, the WHO said. This could be the first time the world sees a drop in immunization coverage for these diseases in 28 years.

The WHO and UNICEF said they are providing resources and services to help countries make up lost ground on childhood vaccinations.

To learn more, click here.


HHS Telemedicine Hack on Telemedicine (One Hour per Week) Begins on July 22
This course is a free10-week learning community to accelerate telemedicine implementation for ambulatory providers. It is a learning collaborative from the US Department of Health and Human Services and others addressing telemedicine. Questions should be directed to: c19ECHO@salud.unm.edu


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Managing Your Social Media Presence Webinar on August 12
On August 12, at 12 noon, MLMIC and HANYS will present a one-hour webinar designed to help healthcare providers optimize their social media strategy and minimize risks associated with its use. Read more at MLMIC.com


Please Take the AMA Survey on Telehealth Impact (on) Physicians
The American Medical Association has been working on a Telehealth Impact Physician survey in collaboration with MITRE, Mayo and others as part of an effort of the COVID-19 Healthcare Coalition.

You are invited to complete the Telehealth Impact Study Provider Questionnaire by clicking on the link below.  The study has been approved by the Mayo Clinic IRB and is part of our efforts in the COVID-19 Healthcare Coalition to address the pandemic. Since COVID-19 started, we have experienced a significant shift towards telehealth.  The goal of this project is to learn more about your experience with telehealth to identify the challenges and barriers, as well as the benefits. 

Building on existing research, your response will help inform additional resources needed across the industry and health care community, provide insights to federal and state policymakers, and identify gaps in current research. Respondent and organization information will remain confidential and will only be reported in aggregate. The findings will be shared and made available to all on the COVID-19 Healthcare Coalition website, as well as shared by the various organizations participating in the Coalition Telehealth Workgroup*. 

The COVID-19 Healthcare Coalition is focused on understanding your experience of telehealth as an individual physician, nurse practitioner, or physician assistant. Please click here to start the survey https://src.co1.qualtrics.com/jfe/form/SV_6KAkyEVfhtGj3vL. The survey is expected to take up to 15-20 minutes and we ask that you complete the survey by August 13th, 2020.  Please remember to press submit when you get to the end of the survey. 

We want to hear from as many clinicians as possible to inform our work. If you have colleagues who use telehealth, please consider forwarding this invitation to them. 

Thank you in advance for your consideration and valuable insights. 

Best Regards,
Steve R. Ommen, MD
Medical Director, Center for Connected Care, Mayo Clinic
Francis X. Campion, MD, FACP
Principal Lead, Digital Health
MITRE Corporation 

*COVID-19 Healthcare Coalition Telehealth Workgroup: American Medical Association (AMA), American Telemedicine Association (ATA), Digital Medical Society (DiMe), MassChallenge Health Tech, Mayo Clinic and MITRE Corporation. The AMA, while a part of the Coalition Telehealth Workgroup, is not a formal member of the COVID-19 Healthcare Coalition.


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What is the Cost of COVID-19 Hospitalization?
The median in-network commercial charge for COVID-19 hospitalizations ranged from $34,662 for the 23 to 30 age group to $4

5,683 for the 51 to 60 age group, new data show.

The 51 to 60 age group was the most expensive to treat as well as the most common to be hospitalized for COVID-19, accounting for nearly 30% of related hospitalizations, according to an analysis of commercial claims from January through May by not-for-profit research firm Fair Health. Although, the age distribution may be in flux, researchers said, pointing to recent reports indicating that the average age of new COVID-19 cases dropped by about 15 years.

In the South, Midwest and West, individuals aged 19 to 40 accounted for larger shares of COVID-19 claims than in the Northeast and the nation as a whole.

The study mirrored Medicare claims data showing that chronic kidney disease and kidney failure were the most common comorbidities of hospitalized COVID-19 patients.

Many Medicare beneficiaries, which Fair Health’s analysis excludes, end up under the Medicare severity-diagnosis related group of respiratory system diagnosis with ventilator support, which yields more than $42,000, said Glenn Melnick, a healthcare economist at the University of Southern California who has been studying COVID-19-related utilization and reimbursement trends. That may explain why the commercial claims for those 61 and older are relatively lower, he said, noting that it could also be related to claims lag since a lot of older patients are staying in the hospital longer. Still, the charges and payments for the upper age groups seem low, especially since commercial insurers typically pay more than Medicare, Melnick said.

The total charges to treat COVID-19 within hospital settings are projected to range from at least $362 billion to as high as $1.45 trillion, Fair Health estimates.

The Fair Health analysis revealed that males were associated with a larger share (54%) of COVID-19 commercial claims, according to Fair Health data. The office setting was the most common venue for initial diagnoses, except for patients aged 61 and older, who were most commonly diagnosed initially in an inpatient setting.

Notably, the Northeast had the highest percentage of COVID-19 patients first diagnosed via telehealth, which was typically the least-common medium.

Physicians and data experts at Santa Clara (Calif.) Valley Medical Center developed a COVID-19 risk score that aims to maximize resources and direct treatment. If they are male, over the age of 60, have a body-mass index of at least 30 and have comorbidities like diabetes or heart conditions, they are more likely to get sick, Santa Clara Valley Medical Center experts’ analysis of nearly 7,000 emergency department visits revealed. Patients who have fewer than three of those characteristics are extremely unlikely to require hospitalization. And 1 in 8 patients who meet at least three of the criteria will likely get very sick.


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Classifieds

Upper East Side Office to Share
Includes waiting room, 2 exam rooms and room for medical assistants. Flexible schedule. Call Bianca at 212-327-1851.

For Sale:  715 Park Avenue
Medical office, 1,800 sq. ft. Rectangular, 11 1/2 ft ceilings, street level access. Private entrance on 70th Street, side of the building.  Windows on Park Avenue and 70th Street.  Excellent office space for plastic surgeon, dermatologist or dental practice. Central air conditioning, high voltage electric service, two bathrooms. *Sale could include active Cardiac / Medical Practice. Please contact Janet @ 212-288-5468.


Office Space and Quad-A Certified O.R. for Rent
Plastic surgery office and/or quad A – certified operating room available for rent. We welcome you to tour our facility, where safety and luxury are combined in the most prime location on the upper east side. We assure you will be delighted by what you discover. We take pride in our facility, where your patients’ safety and satisfaction are our number one priority.
  • Fully equipped operating room perfect for a board-certified plastic surgeon
  • Pre-op and recovery areas
  • A bright and modern waiting area
  • 3 consultation rooms, administrative room, kitchenette, and 2 bathrooms
  • Full day office rental per week / O.R. rental per case

For inquiries please call 212.737.8700, email polina@specialtyaestheticsurgery.com
Office Space and Quad-A Certified O.R. for Rent


 

 

 

 

 

 

eNews: July 15, 2020


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MSSNY Peer to Peer (P2P) Program for Colleagues
The Medical Society of the State of New York is excited to offer to physicians, residents, and medical students the opportunity to talk with a peer about some of life stressors. 

MSSNY’s Physician Wellness and Resiliency Committee has launched the MSSNY Peer to Peer (P2P) program for colleagues to avail themselves and reach out to peer supporters to discuss every daily stressors such as work, school, family, or financial stressors. And, with the advent of COVID-19 pandemic, there may also be some additional stress in our colleague lives.

The P2P program is an opportunity for our colleagues to have a one-time confidential discussion with a peer supporter.  The peer supporter is a trained individual who can share experiences, listens without judgment, who can validate your feelings and provide you with Support, Empathy and Perspective.

Peer supporters can also provide information on organizations that can support you and will provide you with positive coping skills.  They can also help connect you to organizations and individuals should you need more focused assistance.

Any physician, resident, or medical students who wishes to relate to a peer supporter, may contact the Medical Society of the State of New York in the following ways:

  • MSSNY has established a separate email at P2P@mssny.org and requests that you be connected with a peer supporter
  • Or you can call MSSNY at 1-844-P2P-PEER (844-727-7337) and request that you be connected with a peer supporter.  The line is answered by MSSNY staff during regular business hours (Monday – Friday, 8:30-5 p.m.) and the call will be responded to by an MSSNY staff person.  After 5 p.m. the call will be answering by a live answering service who will take down contact information for MSSNY staff to follow up with.

It is well documented that physicians, residents, medical residents have enormous stressors that can range from the emotions arising in the context of patient care to the environment in which we practice medicine.   Now, with the COVID-19 pandemic, those stressors may be exacerbated.

Please know that you are not alone.  MSSNY has trained peer supporters that are ready to support and take time to talk with you. Please reach out to us and know that we care about you and the issues that you face.

The words “Be Well” apply to all of us.

Bonnie Litvack, MD
MSSNY President

Charles Rothberg, MD, Chair
MSSNY Committee on Physician Wellness and Resiliency


MSSNY to HHS: CARES Act Provider Relief Fund for Survival of Practices
Physicians are essential to the health of their communities, as well as their economic well-being. Physicians contribute to their local economies and are important employers, providing jobs to nearly 700,000 New Yorkers according to a 2018 report from the American Medical Association. The fall-out from this crisis threatens to fundamentally alter the long-term stability of physician practices, and could lead to increased consolidation, which hurts competition and drives up costs for patients and employers.

The need is clear – our community-based physicians are important bedrocks of our communities and the nation’s economy. We urge you to do all in your power to ensure that adequate funds are allocated from the CARES Act Provider Relief Fund to help ensure the survival of community physician practices. Should you need additional resources to accomplish this, we stand ready to work with you to make that possible. Thank you for your continued work to address the COVID-19 pandemic and we look forward to continuing to work with you to serve the American people. Letter to Honorable Alex Azar II.


MSSNY Reaches Out to DOH re COVID-19 Tests Taking Too Long to Process
MSSNY has reached out to the New York State Health Department to raise concerns brought by some physicians that certain labs processing Covid-19 tests in some parts of the State, including one of the national lab companies, are reporting that it will take them over a week to complete and report testing results.  What makes this particularly challenging for patients is that NYSDOH protocols for elective surgery require a negative Covid-19 test to be received within 5 days of the procedure.  This means that some patients in need of medical care may not be able to receive the care they need.

An article in New York Daily News noted “some test results are taking a week or longer to reach patients”.  During the Governor’s press briefing today, he noted that national laboratories are getting overwhelmed, but they process only 30% of New York’s testing.  The Governor’s chief of staff also added that, as New York has a network of 215 labs performing tests with the typical turn-around time of 2-3 days for tests, patients could opt to use these other labs instead.

MSSNY will continue to keep members alerted as to the status of our efforts to ensure testing results will be returned promptly. (See article below.).


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Quest Diagnostics Will Expedite Pre-Surgical Clearance
MSSNY EVP Phil Schuh asked our Socio-Med Division to check with Quest Diagnostics for information about their COVID test results turn-around time. Please see the attachment that should provide some clarity for their Priority Specimen Handling Program. Apparently, if the patient identifies that their test is related to pre-surgical clearance, the lab will expedite handling.  The following is a press release  from Quest:  https://newsroom.questdiagnostics.com/COVIDTestingUpdates

When the physician obtains the COVID specimen which is sent to Quest, the physician needs to stress to the Quest lab that the test is part of pre-surgical clearance. When the patient goes to a testing site for a pre-surgical clearance, the patient needs to stress to the site that the test is for pre-surgical clearance. Quest indicated that they believe other labs have created similar protocols for pre-surgical clearance procedures.  If the specimen is not treated as a priority, the physician can call 866MYQUEST to complain that a specific lab site is not compliant with Quest’s priority process.

Quest has only this one number for the entire US. Quest call center is divided into pods that service different parts of the country. The call will be directed to the appropriate pod that serves New York. If you have questions, call Regina McNally at 516-488-6100 ext.332. (Regina McNally, VP MSSNY Scio-Med Div.)


New Coronavirus Cases Shift to Affluent New York Neighborhoods
Coronavirus cases are popping up in more affluent Brooklyn and Manhattan neighborhoods that were not hard hit at the height of the pandemic, city health officials said Tuesday. As the infection rate rises among New Yorkers in their 20s, the geography of the virus has also shifted, with young adults now contracting the disease outside the working-class outer borough areas that have been the epicenter.

“We’re seeing cases in parts of Manhattan and parts of Brooklyn among that age group, that doesn’t exactly overlay with our poverty and racial disparities that we’ve seen in the past,” said Dr. Jay Varma, a senior adviser for public health in the mayor’s office.

As the pandemic cut a deadly course across the city, where it has killed more than 23,000 people, lower-income neighborhoods in the outer boroughs suffered the most cases and the most deaths. Latino and Black New Yorkers have died at twice the rate of whites.

The virus’ spread has decreased dramatically from its height, but the city is still seeing several hundred new cases each day. Total cases have stayed relatively flat, but data shows the infection rate is rising for New Yorkers in their 20s, while it is falling for people over 40. Neighborhoods in Manhattan and brownstone Brooklyn, which were largely spared earlier in the pandemic, are among those now seeing increases among young adults as the city reopens.

Officials pointed to young adults who had been quarantined at home venturing out and socializing more as the main driver of the uptick, though they have not identified exactly where the new cases are being transmitted. “People are now moving around more. They’re socializing more,” Varma said. “The most important way that we dropped transmission was to keep people separated from each other. People were essentially confined to their homes.”

Restaurants and bars reopened for outdoor service on June 22, and gatherings of up to 25 people are now legal as long as social distancing is maintained. Varma said it was “possible” people have gotten infected at recent protests police brutality but argued protests are unlikely to be the main cause. (Politico July 15)


List Prices for COVID-19 Tests Range: $20 to $850 at Large Hospitals Nationwide
A new KFF analysis of what large hospitals nationwide charge for out-of-network COVID-19 tests show a wide range of publicly posted prices — from $20 to $850 for a single test. In many cases, the prices exceed what Medicare pays for COVID testing, which is either $51 or $100 depending on the test.

Federal law now requires private insurers, Medicare and Medicaid to cover COVID-19 tests without any cost to the patient and provides funding to support free testing for some people without health insurance, though it does not guarantee access to no-cost tests for the uninsured. Those laws ensure that most people will not have to pay out of pocket for COVID tests, though limits to the federal requirements mean that some people with and without health insurance could receive bills for COVID-19 tests.

The analysis finds:

  • The median price for a COVID-19 was $127, and about half of hospitals price their tests between $100 and $199. About one in five price their tests at more than $200.
  • Some hospitals list a discounted rate for self-pay individuals, which range from $36 to $180. Other hospitals indicate that uninsured or self-pay individuals could receive free or discounted care through their financial assistance programs.
  • Prices also vary for COVID-19 antibody tests, which are not used to diagnose active infections, from $35 to $300 at hospitals that list their prices.

The analysis set out to examine publicly posted prices at the two largest hospitals in each state and the District of Columbia. Although federal law requires hospitals to make COVID-19 prices publicly available on their websites, prices could only be found for 78 of the 102 hospitals examined. The prices reflect what they would charge for out-of-network services. Data on the negotiated rates for in-network services is not available. The analysis is part of the Peterson-KFF Health System Tracker, an online information hub dedicated to monitoring and assessing the performance of the U.S. health system.



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The Risk of Dying From COVID-19-by Age, Sex. Weight and Ethnicity
A newly published study of more than 17 million people in England sheds light on how much a person’s age, race/ethnicity, body mass index, and more are correlated with their risk of dying from Covid-19. See the patterns on our interactive chart. (Advisory Board, July 13)


COVID-19 Study from FAIR Health Examines Patient Characteristics
FAIR Health released the fourth in its series of COVID-19 studies, Key Characteristics of COVID-19 Patients: Profiles Based on Analysis of Private Healthcare Claims. This new brief uses the nation’s largest repository of private healthcare claims to illuminate some of the key characteristics of patients diagnosed with COVID-19. These characteristics include age, gender, rural versus urban area by age, venue of care where first diagnosed, venue of care by age, comorbidities of hospitalized patients and median costs of hospitalization. The patient characteristics are analyzed nationally and by US census region. The data studied are from the period January-May 2020.

Among the findings:

  • Nationally and in every US census region, chronic kidney disease and kidney failure were the most common comorbidity in hospitalized COVID-19 patients, accounting for 13 percent of all such patients.
  • All regions except one resembled the nation in having type 2 diabetes as the second most common comorbidity; the exception, the South, had hypertension in that rank.
  • Nationally, the median charge amount for hospitalization of a COVID-19 patient ranged from $34,662 for the 23-30 age group to $45,683 for the 51-60 age group. The median estimated in-network amounts ranged from $17,094 for people over 70 years of age to $24,012 for people aged 51-60 years.
  • The West was the region with the widest range of costs for COVID-19 hospitalizations. There, median charge amounts ranged from $21,407 for the 19-22 age group to $93,459 for the over 70 age group. Median estimated in-network amounts ranged from $15,289 for the 19-22 age group to $60,205 for the over 70 age group.
  • Nationally, an office was the most common setting for initial presentation of patients with COVID-19: 33.3 percent of COVID-19 patients presented to an office and 23.0 percent presented to an inpatient facility. However, older people (age 61 and above) most commonly presented first to an inpatient setting.
  • In the Northeast, telehealth was more common for initial diagnosis of COVID-19 than emergency rooms (6.7 versus 6.2 percent of COVID-19 patients). The Northeast was the region with the highest percentage of COVID-19 patients who received their initial diagnosis via telehealth.
  • Nationally, males were associated with a larger share (54 percent) of the distribution of COVID-19 claim lines than females (46 percent).
  • The first brief in FAIR Health’s series on the COVID-19 pandemic examined projected US costs for COVID-19 patients requiring inpatient stays, the second the impact of the pandemic on hospitals and health systems, and the third the impact on healthcare professionals.For the new brief, click here.

Health Organizations Speak in Support of Dr. Anthony Fauci
Health and medical organizations are speaking out in support of Anthony Fauci, MD, a member of the White House’s coronavirus task force, as he is coming under attack from some members of the Trump administration, including the president himself.

“The AAMC is extremely concerned and alarmed by efforts to discredit Anthony Fauci, MD, our nation’s top infectious disease expert,” Association of American Medical Colleges President and CEO David J. Skorton, MD, and AAMC Chief Scientific Officer Ross McKinney, Jr., MD, said in a statement Monday. “America should be applauding Dr. Fauci for his service and following his advice, not undermining his credibility at this critical time.”

“The only way out of this pandemic is by following the science, and developing evidence-based prevention practices and treatment protocols as new scientifically rigorous data become available,” said Thomas File Jr., MD, president of the Infectious Diseases Society of America (IDSA), in a statement. “If we have any hope of ending this crisis, all of America must support public health experts, including Dr. Fauci, and stand with science.”

In addition to AAMC and IDSA, the HIV Medicine Association also weighed in on the issue. “We have been very fortunate to have Dr. Fauci at the helm directing infectious diseases research at NIH for so many years,” association chair Judith Feinberg, MD, said in a statement. “His leadership and support of a rigorous scientific process has been critical to transforming HIV from a death sentence to a chronic condition​, saving millions of lives worldwide. His voice and expertise need to be amplified not silenced if we are going to get control of the COVID-19 pandemic​, which has now taken the lives of more than 135,000 Americans and more than 570,000 people worldwide.”

Fauci’s last reported meeting with President Trump was during the first week of June, but he has no plans to leave his position, according to the Washington Post. Fauci is a civil servant and not a political appointee, meaning the White House cannot fire him directly. Dr. Fauci has been at his post since 1984 and has advised six presidents, according to his biography on the NIAID website. At the institute he oversees a budget of nearly $6 billion. (MedPage Today, July 14).


Please join the NYS Department of Health on
Thursday July 16th at 1-2PM for a COVID-19 update for healthcare providers

To accommodate the large number of participants, find our webinar streaming via YouTube Live (and available for viewing immediately thereafter) on the NYSDOH COVID website for providers.

For audio only, please dial in: 844-512-2950 and access code: 7519629


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AMA Statement on Trump Administration Decision on Student Visas
“The AMA is pleased that the Administration has reconsidered what would have been a setback for U.S. public and rural health. International medical students can now focus on their studies — rather than their immigration status — as they prepare to enter the health field and help fight this pandemic.” The following statement is attributable to: AMA President Susan R. Bailey, M.D.


School Reopening Guidance Includes Student Mask Requirements
Teachers and students will likely be required to wear masks or facial coverings in school buildings, under an outline of New York’s reopening guidance announced on Monday. Masks will be required anytime social distancing cannot be maintained, and “strongly encouraged” all other times except during meals, Gov. Andrew Cuomo said at a Monday press conference.

Faculty members working with special education students will be allowed to wear clear face shields so that they can better communicate with the children, according to a presentation to the Board of Regents.


Some of the youngest children can also be exempted. 
Other details about mask requirements and safety protocols will be left to local school officials. Once the full guidance is available, local district officials will have until the end of the month to develop individualized reopening plans, down to a school-by-school level, and submit them for approval. But even that does not guarantee classrooms will be open this fall. Cuomo said he will begin making reopening determinations during the first week of August.


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Classifieds

Upper East Side Office to Share
Includes waiting room, 2 exam rooms and room for medical assistants. Flexible schedule. Call Bianca at 212-327-1851.

For Sale:  715 Park Avenue
Medical office, 1,800 sq. ft. Rectangular, 11 1/2 ft ceilings, street level access. Private entrance on 70th Street, side of the building.  Windows on Park Avenue and 70th Street.  Excellent office space for plastic surgeon, dermatologist or dental practice. Central air conditioning, high voltage electric service, two bathrooms. *Sale could include active Cardiac / Medical Practice. Please contact Janet @ 212-288-5468.


Office Space and Quad-A Certified O.R. for Rent
Plastic surgery office and/or quad A – certified operating room available for rent. We welcome you to tour our facility, where safety and luxury are combined in the most prime location on the upper east side. We assure you will be delighted by what you discover. We take pride in our facility, where your patients’ safety and satisfaction are our number one priority.
  • Fully equipped operating room perfect for a board-certified plastic surgeon
  • Pre-op and recovery areas
  • A bright and modern waiting area
  • 3 consultation rooms, administrative room, kitchenette, and 2 bathrooms
  • Full day office rental per week / O.R. rental per case

For inquiries please call 212.737.8700, email polina@specialtyaestheticsurgery.com
Office Space and Quad-A Certified O.R. for Rent


 

 

 

 

 

 

eNews: WHO YOU GONNA CALL?  MSSNY, Your Ghostbusters


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WHO YOU GONNA CALL?  MSSNY, Your Ghostbusters

GhostBusters Emblem

Colleagues:

While we all love New York, practicing medicine in New York State has significant challenges that seem to increase year after year and have been compounded this year by the Covid 19 pandemic. So it is no wonder that in my travels (or these days my Zooms) around the state that doctors are often wondering where to turn for help. For MSSNY members, the answer is your dedicated MSSNY team.  So, this week let me remind you/introduce you to some of your MSSNY Ghostbusters so you know who to call.

  • Insurers trying to back off on telehealth payments? Physician extenders trying to practice medicine? Covid testing turnaround too long? Who you gonna call?  Your MSSNY government relations team at 518-465-8085, Moe Auster, Senior VP and Chief Legislative Counsel (mauster@mssny.org) and staff are hard a work every day lobbying on your behalf.
  • Need CME?  Who you gonna call?  Through MSSNY lobbying efforts, the deadline to renew your NY State-required pain management course in now October 2020.  The course can be completed on the MSSNY.org website and is FREE to members.  Nonmembers pay $150.
  • Need legal help? Thinking of selling your practice, joining a partnership, becoming employed?  Who you gonna call?   MSSNY members get FREE consults and discounted rates with Garfunkel Wild P.C., specialists in health care law. bcepelewicz@garfunkelwild.com, 516-393-2200.
  • Having trouble with insurers? Didn’t get your Cares ACT money? Who you gonna call? Regina McNally, Senior VP Socio-Medical Economics, rmcnally@mssny.org, 516-488-6100.  MSSNY staff provides FREE assistance to members.  They have contacts and experience with all major insurance companies, Medicare, Medicaid and Workers’ Comp and can give you Free advice on submitting claims and expert help in handling payment disputes.  They make the proper arguments to the right individuals.
  • Feeling Stressed?  Need to talk? Who you gonna call? MSSNY Peer to Peer (P2P) at 1-844-P2P-PEER or P2P@mssny.org.  You are not alone. Your MSSNY PEERS are there to listen and help. Want to volunteer to train as a peer supporter? Contact Pat Clancy, Senior VP for Public Health and Education at pclancy@mssny.org, 518-465-8085.
  • Need Affordable PPE? Who you gonna call? MSSNY has been working tirelessly to raise state and national awareness of the problem and to find solutions.  MSSNY procured and distributed 36,000 NIOSH/FDA approved masks this week at < $1/mask and continues to actively search for more options for our members.

Our staff, our committees, our council, our house of delegates, our officers and our counties are all on your side working hard to banish those things haunting your ability to practice medicine and care for your patients.

We are Team MSSNY—Your Ghostbusters.

Bonnie Litvack, MD
MSSNY President



.This Week’s MSSNY Podcast


NY COVID-19 Statistics: 32,283 deaths; 71,279 recovered
The U.S. set another daily case record, with about 60,000 new COVID-19 infections confirmed July 7. On July 8, the total number of cases reported in the U.S. surpassed 3 million.


MSSNY Joins with Other Associations Urging Congress for Enhanced Stimulus Funding
As the US Congress debates the scope and size of its next stimulus package, MSSNY joined on two letters this week to DC leaders to ensure needed funding was provided or maintained for hard-hit community physician practices.

The first letter, along with the California, Florida and Texas medical associations, asks Senate Majority Leader Mitch McConnell and Senate Minority Leader Chuck Schumer to increase funding to the HHS Provider Relief Fund by another $100 billion to sustain physician practices and protect patient access to care.

It also asks Congress to adopt the Provider Relief Fund distribution methodology included in the “HEROES Act” that had been passed by the US House of Representatives that provides funding that is commensurate with each provider’s COVID-19 related expenses and revenue losses from all payers in order to target funds to physicians who still desperately need it.

In the second letter, MSSNY joined with the National Governors Association, AMA, HANYS, the Greater NY Hospital Association and several state medical societies in support of an enhanced federal medical assistance percentage (FMAP) for the Medicaid program in the next bipartisan COVID relief bill. This increased Medicaid funding for the states is essential to help prevent against potentially steep Medicaid payment cuts that may be required due to the severe drop in revenue.

Congress is scheduled to return to Washington DC on July 20.
 in the U.S. surpassed 3 million.


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Physicians’ Offices Big Beneficiaries of Small-Business COVID-19 Relief Loans
Physicians’ offices hard-hit by the COVID-19 pandemic received a significant share of forgivable small-business COVID-19 relief loans, according to new government data. After intense public pressure, the Treasury Department and Small Business Administration released loan-level data about Paycheck Protection Program loans above $150,000. The healthcare sector received more than 12% of the total loans disclosed, and the biggest recipients in the healthcare sector were physicians’ offices.

Physicians’ offices received at least $8.4 billion in PPP loans, according to the dataset. The COVID-19 pandemic has ravaged primary care practices’ revenues, and many healthcare industry analysts expect that consolidation could ensue in the coming months as practices in financial peril evaluate their options. Skilled-nursing facilities received at least $3.4 billion, home health services providers received at least $3 billion, dentists received at least $2.2 billion, and hospitals received at least $2 billion.

Physicians’ offices and dentists were initially the hardest-hit portions of the healthcare sector in March and April. Dentists’ offices shed 503,000 jobs in April, and physicians’ offices lost 243,000. However, things are looking up, as dentists saw the strongest recovery in the healthcare sector in May, adding back 244,800 jobs, and physicians’ offices added 51,300.

Nursing homes, however, are still losing jobs as of June employment data, and a Moody’s Investors Service report from May said that the pandemic was hurting the nursing home and senior living sectors more than any other sector of U.S. public finance.

Many hospitals didn’t qualify for PPP loans because they are only open to businesses that employ 500 people or fewer. The SBA chose to apply affiliation rules that counted many hospitals’ affiliated physician practices toward the employee threshold. The affiliation rules and related guidance also led to many medical practices owned by private equity firms being shut out of the aid program, despite lobbying efforts to include them.

The SBA allowed most community-owned hospitals to apply for PPP loans in April, as long as the facilities receive less than half their funding from state or local government sources, exclusive of Medicaid. However, hospitals in bankruptcy proceedings aren’t eligible for the loans, an appeals court ruled.

Congress tweaked the PPP program in June. The changes gave borrowers 24 weeks instead of eight weeks to spend the PPP funds, allowed them to delay paying payroll taxes, and would only require them to spend 60% of the loan expenses on payroll costs instead of 75% as originally stipulated. The data release accounts for nearly 75% of the loan dollars, the agencies said. The PPP loans are forgivable as long as borrowers use the loans for specified expenses. (Modern Healthcare, July 8).


How Airborne COVID-19 Transmission Has Evolved: A Timeline of Key Studies
Since March, researchers worldwide have published several studies exploring how the new coronavirus interacts with the air. These findings have evolved as the world continues to learn more about the new virus.

Here are six studies and reports covered by Becker’s Hospital Review about airborne transmission of the new coronavirus:

March 4: An early study published in the Journal of the American Medical Association suggested that the new coronavirus may not linger in the air, but does contaminate hospital environments and surfaces.

March 17: Later that month, a study published in The New England Journal of Medicine found that the new virus can remain infectious in the air for up to three hours and last on some surfaces for more than a day.

April 27: Another study from China published in the journal Nature found that the new virus can potentially be spread via fine airborne particles and may linger in patient bathrooms, medical staff areas and areas prone to crowding, though it did not establish how infectious the virus detected in these hospital areas were.

July 6: More than 200 scientists wrote an open letter to the World Health Organization stating that airborne spread indoors could be a significant mode of COVID-19 transmission and that evidence shows the virus lingers in the air in indoor spaces.

July 7: Following the letter’s publication, WHO officials acknowledged “emerging evidence” about the airborne spread of COVID-19.

July 9: WHO officials officially acknowledged that droplets carrying the new coronavirus may be airborne indoors and that people who spend long periods in crowded settings with poor ventilation may be at risk of becoming infected. (Becker’s Hospital Review, July 9)


NIH Launches COVID-19 Clinical Trial Network
The National Institutes of Health today said it established a clinical trial network for large-scale clinical testing of COVID-19 investigational vaccines and monoclonal antibodies. The COVID-19 Prevention Trials Network will operate under the National Institute of Allergy and Infectious Diseases to enroll thousands of volunteers, according to NIH, as a functional unit of federal “Operation Warp Speed” initiative.

The network will use a harmonized vaccine protocol developed by a public-private partnership to enable analyses of results across multiple clinical trials. 


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With COVID Surging and Workforce Stretched, AMA Implores Administration to Change Proposed Regulation on International Students
The AMA urged Trump administration officials today to reconsider its ill-advised regulation on international students that could jeopardize the status of current medical students. In the letter, the AMA said the United States already is facing a physician shortage, and the pandemic has generated an even greater need for physicians all across the country.

Ideally, this would be a time that the country provides medical students with as many options as possible to successfully obtain their education. Instead, the regulation would change the status of these student merely because their classes are moving online.

“At a time when physicians are needed in the U.S. more than ever, it is unwise to deter medical professionals from coming to the U.S. now and potentially in the future. Moreover, this modification will likely cause medical students to attend school in other countries leading … to a brain drain as other countries obtain and likely retain the brightest young medical minds from across the world,” the letter said.

The letter noted that hundreds of international medical students who would be affected by the administration’s proposal should be allowed to remain in the country even if their medical instruction moves online because of the pandemic. “To ask these students to transfer to a new school or program weeks before the beginning of the term is not a viable solution and is completely unfair to students that have worked for years of their lives to be able to go to medical school.”


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FDA Warns of False Positives From BD-Brand COVID-19 Test
The Food and Drug Administration on Monday warned of an increased risk of false positive results from the BD SARS-CoV-2 Reagents for the BD Max System test. FDA said the manufacturer reported approximately 3% of results were false positives. The agency recommends clinical laboratory staff and health care providers consider presumptive any positive result from tests using the BD SARS-CoV-2 Reagents for the BD Max System and confirm results using an alternate, authorized test.


Dr. Donald Moore’s Interview “Keeping Ourselves Healthy-A Race to Action”
Dr. Donald Moore (Kings), an emergency medicine specialist and primary physician in Brooklyn, and affiliated with New York Methodist Hospital, is a MSSNY Member and President of Provident Clinical Society. Dr. Moore was interviewed on the topic, “Keeping Ourselves Healthy—A Race to Action.”

The video is available here.


MSSNY in the News:

Also ran in:
Star Gazette
Ithaca Journal
LoHud
Poughkeepsie Journal
MSN.com


Garfunkel Wild Ad

Classifieds

Upper East Side Office to Share
Includes waiting room, 2 exam rooms and room for medical assistants. Flexible schedule. Call Bianca at 212-327-1851.

For Sale:  715 Park Avenue
Medical office, 1,800 sq. ft. Rectangular, 11 1/2 ft ceilings, street level access. Private entrance on 70th Street, side of the building.  Windows on Park Avenue and 70th Street.  Excellent office space for plastic surgeon, dermatologist or dental practice. Central air conditioning, high voltage electric service, two bathrooms. *Sale could include active Cardiac / Medical Practice. Please contact Janet @ 212-288-5468.


Office Space and Quad-A Certified O.R. for Rent
Plastic surgery office and/or quad A – certified operating room available for rent. We welcome you to tour our facility, where safety and luxury are combined in the most prime location on the upper east side. We assure you will be delighted by what you discover. We take pride in our facility, where your patients’ safety and satisfaction are our number one priority.
  • Fully equipped operating room perfect for a board-certified plastic surgeon
  • Pre-op and recovery areas
  • A bright and modern waiting area
  • 3 consultation rooms, administrative room, kitchenette, and 2 bathrooms
  • Full day office rental per week / O.R. rental per case

For inquiries please call 212.737.8700, email polina@specialtyaestheticsurgery.com
Office Space and Quad-A Certified O.R. for Rent


 

 

 

 

 

 

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