Doctors v Pharma Pricing

Thomas J. Madejski, MD MSSNY President
PRESIDENT’S MESSAGE
Thomas J. Madejski, MD
MSSNY President
MAY 18, 2018
Volume 18
Number 19

Dear Colleagues:

Last Friday, President Trump promised to “derail the gravy train” in the health-care system in a speech in which he unveiled his much-anticipated strategy to lower drug prices. The 44-page blueprint, called “American Patients First,” proposes a laundry list of policy ideas — but no specific timeline for implementation. He said he wanted to “promote competition; get generic drugs to market faster; lower fees paid to so-called middlemen…; and to block foreign countries from negotiating lower prices for their state-run health plans.”

A March 2018 Kaiser Family Foundation Health Tracking Poll found that 80 percent of Americans think prescription drug prices are unreasonably high. Slightly more than half responded that enacting policies to lower them should be our government’s top policy priority. One of the other hats that I wear, and welcomed in anticipation of becoming your President, is as a member of the AMA Council on Medical Service. Our Council has taken a deep dive into the escalating cost of insulin at the request of our AMA members. We have come up with some specific strategies that the practicing physician can use to help their patients now, and some suggestions to improve general affordability moving forward.

I anticipate after presentation (and hopefully, approval) at the AMA Annual meeting in June, that our Council will explore additional strategies to help make medication more available and affordable for our patients.

Additional information for your consideration:

 

• Physicians (and many patients) know that that US drug prices are the highest in the world. Americans spend $1,100 per person per year on prescription drugs. Public outrage over drug costs has been growing for years, because patients are being squeezed in a number of ways—new medicines for cancer and other life-threatening diseases often launch with prices exceeding $100,000 per year. Drugs for common ailments like diabetes and asthma routinely see price hikes around 10 percent annually. Meanwhile, some companies have been buying up once-cheap older drugs and raising prices by 1,000 percent or more.

• While private insurers and government programs pick up the biggest share of the bill, high drug costs are ultimately passed down to the public through premiums and taxes. Lawmakers have probed how they set prices, and the Justice Department is investigating possible price collusion by more than a dozen companies that make generic drugs.

• In 2016, the AMA set a new policy that established guiding principles for advocacy efforts aimed at changing the fundamentals of prescription drug pricing without compromising patient outcomes and access. The 2016 policy acknowledges the carte blanche approach to drug pricing needs to change to align with the health system’s drive for high-quality care based on value.

• Unlike other nations, the U.S. doesn’t directly regulate medicine prices. In Europe, governments negotiate directly with drugmakers to limit what their state-funded health systems pay. For most outpatient drugs reimbursed through Medicaid, drugmakers must provide the government rebates. But most medicine costs are paid for by Medicare or by private insurers. When prescription-drug benefits were added to Medicare under a 2003 law, the pharmaceutical industry successfully lobbied to prohibit the federal government from using its huge purchasing power to negotiate drug prices. Private payers typically rely on third-party pharmacy-benefit managers, such as Express Scripts, to negotiate discounts. Patients directly pay about 17 percent of prescription medicine costs out of their own pockets.

We have a crisis in drug prices in this country, where pharmaceutical companies, distributors and PBMs are able to charge whatever they want hiding their costs and legitimate profit through a labyrinth of pricing schemes, kickbacks, and special considerations.  I have remarked to my fellow Council members that looking at drug prices is like peeling an onion.  Each layer stinks and makes me cry!

We need political leaders that are willing to stand up to the power of the pharmaceutical industry.  We need physicians to call upon our elected officials to create a healthcare system that serves our patients, not middlemen and hedge fund managers, who like Don Fanucci in The Godfather, need to “wet their beak” at our patients’ expense.

Please send your thoughts to comments@mssny.org.

Thomas J. Madejski, MD 
MSSNY President


MLMIC Insurance

Capital Update

MSSNY Physician Participates in Senate Roundtable on Tick Borne Diseases—Senate Passes Package of Bills Addressing Tick Borne Diseases
Dr. William Valenti, chair of the Medical Society of the State of New York Infectious Diseases Committee, participated this week in a Senate Roundtable sponsored by the Senate’s Task Force on Lyme and Tick Borne Diseases.  The roundtable included representatives from the NYS Department of Health, SUNY at Stonybrook; Cornell University, and SUNY Adirondack.  Dr. Valenti discussed with members of the Senate the need to coordinate better laboratory testing and the need to continue to provide educational programing for physicians and other providers.   The New York State Senate also passed legislation this week which includes:

  • 2588, sponsored by Senator Susan Serino, would provide homeowners with vital and reliable information on the best way to protect their property from ticks.
  • 7242, sponsored by Senator Serino, directs the New York State Office of Parks, Recreation and Historic Preservation to install and maintain tick warning signs at all state-managed parks, including trail entryways and campgrounds.
  • 7169, co-sponsored by Senator Serino and Senator Kemp Hannon, would establish a pilot program for Lyme and tick-borne disease testing in children under the direction of the Commissioner of Health.
  • 8534, sponsored by Senator Serino, would direct the Commissioner of Education and the Commissioner of Health to promulgate and review rules and regulations related to pupils who have a tick removed from them during school or a school-sponsored activity.
  • 8539, sponsored by Senator Serino, would require the Department of Financial Services, in consultation with the DOH Commissioner, to conduct a study considering the current scope of health insurance coverage for Lyme and tick-borne diseases. The study would also examine initiatives in other states and the fiscal implications of various proposals.
  • 6926, sponsored by Senator Hannon, directs the Commissioner of Health to establish a standard protocol for the diagnosis and treatment of Lyme and other tick-borne diseases. This legislation requires the commissioner to work with health care providers and experts to develop a standard protocol process and patient notification of related symptoms, risk factors, diagnosis, and other information relating to Lyme and TBDs. During the roundtable, Dr. Valenti did discuss having a “standard protocol” but indicated that much more work needs to be done to establish what type of protocol is suitable and that work also needs to be done to develop a standard for each of the laboratories to follow.
  • 7168, co-sponsored by Senators Serino and Hannon, requires a coroner, pathologist, medical examiner or other qualified examiner that discovers Lyme and tick-borne disease infections during an examination of a deceased person to report the case to the DOH.
  • 7208, co-sponsored by Senators Serino and Hannon, would require that the Council on Human Blood and Transfusion Services review current medical research and guidance regarding the donation of blood by patients with a history of Lyme or tick-borne illnesses.
  • 3816, sponsored by Senator Kenneth LaValle, would allow Town of East Hampton to establish a tick control district.

The bills are now before the NYS Assembly for further action.                                        (CLANCY, AUSTER)

State Senate Advances DMV Reporting Mandate Legislation
The State Senate advanced a bill (S.3569 – Young / A. 10094 – Carroll) from the Transportation committee to the Senate floor that would require a licensed physician, physician assistant or nurse practitioner to report patients that have a chronic condition which cause or may cause unconsciousness or unawareness to the Department of Motor Vehicles.  The conditions include a convulsive disorder, epilepsy, fainting, dizzy spells, coronary ailments or other health conditions that may impair the ability to operate a motor vehicle.  While MSSNY has adopted a comprehensive policy on impaired drivers that supports the ability of a physician to voluntarily report certain patients to DMV whom the physician believes should not operate a motor vehicle, this bill goes too far by mandating physician reporting.  MSSNY has great concerns over the ambiguity of the bill language and the fact that it encompasses a number of medical conditions where there may only be a remote chance that unconsciousness and unawareness may occur.  This bill is also opposed by the Epilepsy Foundation and the New York State Trial Lawyers Association.

Please click here to contact your legislator to express your concerns with this legislation.                                                                                 (BELMONT)

Governor Cuomo Announces Multi-agency Effort To Combat Maternal Depression
Under a directive from Governor Andrew Cuomo, the New York State Department of Financial Services will now require all New York commercial health insurance policies to cover maternal depression screenings, including screening for the mother under the child’s policy.   Additionally, the NYS Department of Health and Office of Mental Health will launch a strategic awareness campaign to provide critical information about symptoms and treatment options for maternal depression. Finally, the Office of Mental Health will open the first state-operated intensive outpatient clinic focused on maternal depression. The new regulations will require health insurance policies issued in New York to include coverage for maternal depression screenings by both adult and pediatric primary care providers, as well as speedy referrals to treatment specialists.   Insurance policies that cover the child but not the mother must provide coverage for maternal depression screening.

The new regulations will take effect 60 days after publication in the State Register.   The Department of Health and the Office of Mental Health’s awareness campaign will provide critical information about symptoms and treatment options, and to more broadly remove the stigma associated with maternal depression. There will be a joint letter to all health care providers reminding them of the seriousness of the issue as well as encouraging expansion of treatment options.                           (CLANCY)

MSSNY Urges for Extension of Committee for Physicians Health Program
MSSNY continues to advocate for legislation (A.10221-A, Gottfried, S.8093-A, Hannon) that would extend for an additional 5 years the continued operations of the MSSNY Committee for Physicians Health (CPH) program.  Authorization for several key components of the program expired on March 31, 2018.   The bill, amended this week to clarify its retroactive applicability to March 31, has advanced to the Senate floor, and likely will be considered at the next meeting of the Assembly Health Committee.

The CPH is a program designed to confront and assist physicians thought to be suffering from alcoholism, substance abuse or mental illness.   Since the inception of this program, CPH has assisted thousands of physicians in returning healthy to medical practice.  The work of the CPH program is an important public service both to our health care system as well as the general public. As a result, the State Budget annually includes an appropriation of $990,000 for the program, which is generated from a $30 assessment on all physicians’ biennial registration fees.

The program has traditionally been extended by the Legislature in 3 or 5 year “demonstration programs” with the most recent extension in 2013.  The recently enacted State Budget included a provision to create another “demonstration program” until 2023.  However, it omitted other provisions historically extended at the same time that are essential to its functioning that could greatly impair its operations unless immediate action is taken.  These includes provisions that set forth the CPH program’s reporting requirements to the Office of Professional Medical Conduct (OPMC), provisions to ensure liability protections for the physician Committee members for work performed in the scope of CPH, and necessary confidentiality protections for the program given the sensitivity of the work they perform.   These protections are absolutely essential to the continued functioning of the program to ensure that physicians with the appropriate expertise are willing to serve on the Committee, as well as to assure that the program has the ability to report sensitive information to OPMC when warranted by the circumstances. (DIVISION OF GOVERNMENTAL AFFAIRS)

Governor, AG Announce Potential Lawsuit Against Opioid Manufacturer
New York Governor  Cuomo and Acting Attorney General Barbara Underwood announced this week that New York State would be initiating a lawsuit against opioid drug manufacturer Purdue Pharma.  To read their joint statement, click here.

Acting AG Underwood stated “We are committed to holding opioid manufacturers and distributors accountable for the damage they’ve wrought on New York’s towns, communities, and families.  After a lengthy investigation, we are preparing a lawsuit against Purdue Pharma for its alleged deception and reckless disregard for the health and wellbeing of New Yorkers. It is clear to us that Purdue profited by deliberately exploiting New Yorkers’ addictions, and by pushing healthcare providers to increase patients’ use and dependence on these potentially fatal drugs. In addition to our impending lawsuit against Purdue, our office will continue to lead the multi-state investigation of opioid manufacturers and distributors across the country.”

Governor Andrew M. Cuomo stated: “In New York, we will not sit idly by as big corporations fuel the opioid epidemic and ignore the consequences of their actions.  We said we would sue to hold opioid manufacturers and distributors responsible, and that’s exactly what we’re doing. By taking Purdue Pharma to court, we are taking this significant step forward to hold corporations accountable and put an end to the opioid crisis once and for all. Too many innocent lives have been lost and too many families destroyed.”

As reported in numerous media outlets, Purdue Pharma responded: “We are disappointed that after months of good faith negotiations working toward a meaningful resolution to help the state of New York address the opioid crisis, the attorney general has unilaterally decided to pursue a costly and protracted litigation process.  We vigorously deny these allegations and look forward to the opportunity to present our defense.”  (AUSTER)

NYSDOH AIDS Institute Launches New Online Provider Directory
The NYSDOH AIDS Institute has launched a new online provider directory.  This new online directory will allow providers and consumers easier access to information regarding HIV, HCV, Buprenorphine, PEP, and PrEP service providers across New York State. This new directory will replace the former HIV and HCV provider directories located on the NYSDOH Health Commerce System (HCS). It will also replace the former PrEP/PEP Provider Voluntary Directory.  A copy of the directory can be found at this link: please click here.                                                                                  (CLANCY)

Medical Society of the State of New York Announces May and June CME Webinar Schedule
The Medical Society of the State of New York is pleased to announce its free Continuing Medical Education (CME) webinars for May and June.  Participation in the webinars will earn physicians one CME credit free of charge.  The webinar schedule for May and June is as follows: 

May 24th at 7:30amCurrent Concepts in Concussion for Pediatric and Adult Patients

Register for this webinar here.
Faculty: Deborah Light, MD & John Pugh, MD, PhD

Educational Objectives:

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

June 20th at 12:30pmMedical Matters: Children’s Mental Health After Disaster

Register for this webinar here.
Faculty: Linda Chokroverty, MD

Educational Objectives:

  • Enhance physician’s understanding of the impact of disaster on children’s and family mental health
  • Improve physician skills to address potential psychiatric problems in children and families following a disaster

To view all of MSSNY’s scheduled programs, click here and select “Training Center” and “Upcoming”.

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

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

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

Ebola Webinars Available on CME Website
The Ebola outbreak in the Democratic Republic of Congo has now spread to Mbandaka city, and urban area with nearly 1.2 million residents.  There have now been 19 deaths and 39 patients infected with Ebola.  Additionally, 393 individuals are being monitored as contacts of Ebola patients.  Previous Ebola outbreaks proved stressful for healthcare providers in New York largely owing to uncertainty and media hype.  The Medical Society has two CME courses available that help to address these concerns regarding Ebola virus.

Please click here to view MSSNY’s free CME courses on this timely and relevant topic.  Ebola: A Perspective from the Field offers a firsthand description of the challenges surrounding Ebola virus.  And Viral Hemorrhagic Fevers with an Ebola Virus Update offers a comprehensive analysis of diagnosis and treatment for Ebola and other viral hemorrhagic fevers.                                                                                                  (HOFFMAN)

Bending the Diabetes Curve CME Course Available Online
Bending the Diabetes Curve webinar is now available to view online; please click here. By educating physicians and connecting more patients to evidence-based lifestyle change programs, this diabetes initiative will help bridge the gap between clinical care settings and communities to reduce the incidence of type 2 diabetes.

Webinar: Bending the Diabetes Curve

Faculty: Geoffrey Moore, MD & Sarah Nosal, MD

Educational Objectives:

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

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

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

Additional information or assistance with registration may be obtained by contacting Carrie Harring at  charring@mssny.org.                                                                                  (HARRING)

Please Join Us on July 28th for Physicians’ Day at the Races
Please join your friends and colleagues for a great event to benefit your profession.  MSSNY PAC uses its resources and mobilizes support to help elect candidates for state office who will stand and fight for us, regardless of what party they are from.  MSSNYPAC allows us to pool our resources and together, make a difference against other special interests that continue to try to undermine the delivery of quality health care.  MSSNY PAC continues to develop new fundraising opportunities for our physicians to become more active.

Please RSVP today. The Physicians’ Day at the Races will take place on Saturday, July 28, 2018 at the Saratoga Race Course in Saratoga Springs, NY.

Ticket prices are:

$500/physician,

$300/guest,

$250/guest under 21

Ticket price includes clubhouse admission, post parade programs, a gourmet buffet lunch at your own trackside table, unlimited open bar, private viewing of the horses as they bring them from the paddock and private betting windows. click here for further details.

Contact Jennifer Wilks at 518-465-8085 or by email at jwilks@mssny.org to secure tickets.  (BELMONT)


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

pschuh@mssny.org   mauster@mssny.org  pclancy@mssny.org  


eNews

$750,000 Fine for Billing Medicaid when Physicians Were Not Enrolled in Program
Here is a cautionary New York tale –

MSSNY has recently heard from the U.S. Department of Justice that a medical practice has agreed to pay a large sum of money to settle a False Claims Act Suit for alleged improper billing practices.  The allegations were brought to the government’s attention through the filing of a complaint pursuant to the qui tam provisions (the whistleblower) of the False Claims Act.  Under the Act, private citizens can bring suit on behalf of the United States and share in any recovery.

The medical group agreed to pay $750,000.00 to resolve allegations that they billed the Medicaid Program for services provided by physicians who were not enrolled in the program.  The government’s investigation revealed that, from July 1, 2004 through December 31, 2010, the medical group employed a number of physicians who were not enrolled in the Medicaid Program who provided care to Medicaid patients.  Because the physicians were not enrolled in the program, the medical group should not have sought reimbursement from Medicaid for the services provided by these non-enrolled physicians.  Regardless, the medical group submitted requests for payment under the Medicaid provider identification numbers of the practice’s Medicaid enrolled physicians, thereby misrepresenting the identities of the individuals who were actually providing treatment to the group’s Medicaid beneficiaries.  This improper billing practice occurred at many of the medical group’s locations.

To avoid any impropriety, physicians must be enrolled in plans to treat and receive payment for a plan’s insured members. 

NY’s Acting AG to Sue Purdue Pharma for Exploiting Addictions
New York’s acting attorney general, Barbara Underwood, announced Wednesday that the state is preparing to sue the maker of the prescription painkiller OxyContin, making New York the seventh state to announce a lawsuit against Purdue Pharma this week.

In a press release, acting Attorney General Barbara Underwood said the state is readying its litigation against the opioid manufacturer for “its alleged deception and reckless disregard for the health and wellbeing of New Yorkers.”

“It is clear to us that Purdue profited by deliberately exploiting New Yorkers’ addictions, and by pushing healthcare providers to increase patients’ use and dependence on these potentially fatal drugs,” she said in a statement.

In its own statement, Purdue said the company “vigorously” denies the allegations and looks “forward to the opportunity to present our defense.”
Over the past year, the number of lawsuits filed against opioid manufacturers and distributors has substantially increased. Many of the suits claim companies aggressively marketed opioids whiledownplaying the risk of addiction and shipped suspiciously large quantities of painkillers without alerting authorities.

Three Firms Account for Over Half of All Medicare Part D Enrollees in 2018 Pending

Mergers Would Further Consolidate the Marketplace

In 2018, three Medicare Part D plan sponsors—UnitedHealth, Humana, and CVS Health—account for more than half of the program’s 43 million Part D enrollees (55 percent) and two-thirds of all stand-alone drug plan enrollees, indicating a marketplace that is dominated by a handful of major insurers, according to a new Kaiser Family Foundation analysis of Part D enrollment, premiums and cost-sharing data.

The proposed mergers of CVS Health and Aetna, and Cigna and Express Scripts would result in further consolidation of the Part D marketplace. If these mergers go through, four firms—the two merged firms plus UnitedHealth and Humana—would cover 71 percent of all Part D enrollees and 86 percent of stand-alone drug plan enrollees, based on 2018 enrollment.

New Yorkers Do Not Eat Enough Fruits, Vegetables, Analysis Finds
The 2018 American Fitness Index analysis indicates “that while New York City ranked 52 out of 100 American cities when it comes to overall health, it is weak in key dietary areas,” particularly in that only “18.4 percent of New Yorkers eat three or more vegetables a day and 31.9 percent eat two or more fruits a day.”

FDA Names Companies “Gaming” Drug Laws to Block Competition
The FDA has followed through on its promise to publicly name companies it says may be gaming drug laws to block generic competition.

The act comes as part of the Trump administration’s recently announced effort to bring down the price of pharmaceuticals. The list  — posted on the FDA’s website May 17— includes dozens of both generic and brand-name companies that the agency said appear to have refused to give up samples of their product to generic companies seeking to make copies. Without the samples, generic manufacturers can’t conduct bioequivalence testing and apply to the agency for approval, said FDA Commissioner Scott Gottlieb, MD, in a statement.

The agency has received more than 150 pleas for help from generic drugmakers who have not been able to get samples from brand companies, said Gottlieb. “We’re also notifying the Federal Trade Commission (FTC) — the agency responsible for addressing anticompetitive business practices — about these inquiries,” he said.

According to the list, the largest numbers of inquiries have been for problems getting copies of isotretinoin (14 inquiries), bosentan (14), lenalidomide (13), thalidomide (10), and ambrisentan (10).

Among the companies that appear to be multiple offenders:

  • Actelion Pharmaceuticals, listed for potentially blocking access to macitentan (Opsumit), bosentan (Tracleer), epoprostenol sodium (Veletri), and miglustat (Zavesca);
  • Celgene, for lenalidomide (Revlimid), thalidomide (Thalomid), and pomalidomide (Pomalyst); and
  • Novartis, for everolimus (Afinitor), deferasirox (Exjade), nilotinib hydrochloride monohydrate (Tasigna), and everolimus (Zortress). 

Please Answer Physicians Foundation’s Biennial Survey
This is the Physicians Foundation’s sixth biennial physician survey. Its purpose is to examine the morale, career plans, and practice metrics of today’s physicians – and to give physicians a voice! The goal is to produce a “state of the union” of the medical profession that can have a significant impact on both policy and public perceptions. The survey is expected to take around 10 minutes to complete. It will be open through June 5th and can be accessed here.

Reminder: MSSNY is a Charter Member of the Physicians Foundation.

The Physicians Foundation will make a $5,000 contribution to the state medical society generating the most survey responses and a $5,000 contribution to the state medical society that generates that most responses per-capita.

New PTSD Definition Would Exclude Many Patients, Study Says
A proposed change in how post-traumatic stress disorder is diagnosed could exclude as many as 57% of the people with moderate—and more easily treatable—PTSD worldwide, according to a study led by researchers at NYU School of Medicine.

The study appear May 17 in the journal Psychological Medicine. It looked at almost 4,000 people from six countries to see how changes in the upcoming 11th edition of the International Classification of Diseases would affect their diagnoses.

Most of the patients studied were survivors of traffic accidents, who underwent the Clinically Administered PTSD Scale.

When patients were diagnosed using the revised code, it boosted the incidence of severe PTSD by up to 35%, but the number of moderate cases decreased by more than half.

Proposed changes in the diagnostic tool could negatively affect successful treatment for many victims of PTSD because early treatment leads to the best outcomes, said senior author Dr. Arieh Shalev, the Barbara Wilson Professor in the Department of Psychiatry at NYU School of Medicine.

Shalev also expressed concerns that insurers might not cover cases where patients clearly have symptoms consistent with PTSD but don’t meet the new criteria for diagnosis.

The revised code uses just six criteria for assessing PTSD: dissociative flashbacks, nightmares, hypervigilance, exaggerated startle response, avoidance of external reminders, and avoidance of thoughts and feelings associated with the traumatic event. The current code includes 13 conditions, including sleep disturbances and irritability, which also can be associated with other disorders.

House Passes Bill to Expand Veterans’ Healthcare Access Outside of VA
The AP (5/16) reports that on Wednesday, the US House “voted to give veterans more freedom to see doctors outside the Veterans Affairs health system” although some Democrats “cast it as a risky step toward dismantling the struggling agency.” The plan would “fulfill President Donald Trump’s promise to expand private care to veterans” who feel VA healthcare is inadequate by allowing them to seek care from private physicians. Legislators passed the $5 billion bill in a 347-70 vote.

Congressional Quarterly (5/16) reports the vote comes as “a major overhaul to a veterans’ health care program just two weeks before funds dry up.” The $5.2 billion funding will extend the Veterans Choice Program “before combining the program with other community care programs offered by the Department of Veterans Affairs in 2019.”

IPRO Hosting 34th Annual Membership Meeting at Garden City Hotel

When:   Tuesday, June 5, 2018
Time:    12:30 p.m.—3:30 p.m.
Where:  The Garden City Hotel – 45 Seventh Street, Garden City, NY

For further information, click here.

 

Classified

RENTAL/LEASING SPACE

For Sale-Outpatient Mental Health Clinic
Started in 1998 and located in the NYC metro area, this multi-location business is a well-established, highly reputable, mental health clinic providing outpatient psychotherapy and counseling services.
Revenues 2017 $1.2 mil.
Profits: 2017 $326k
Asking Price: $970k
Terms are available. The clinic’s market consists of Manhattan, Bronx, Brooklyn and Queens Counties. The 25 clinician practice specializes in group, women’s and psycho-educational therapy as well as parenting groups, court mandated services, domestic violence victims groups, anger management and supervised visitation programs. There are 250+ weekly patients and the business accepts most insurances. Buyer must be a NYS licensed physician, NYS licensed mental health consultant, NYS licensed social worker, psychologist or PhD. The owner is retiring.

Direct All Inquiries to:
Steve Epstein, V.P.
Gottesman Company
O: 201-750-9605
C: 201-704-8051


Thriving Internal Medicine Practice for Sale by the Physician.
Has been growing exponentially, with number of patients doubling over last two years.
Has the visits-volume and the potential space & hours to keep expanding
The physician will stay to overlap for at least one year to personally transition all the practice’s patients, to seamlessly transfer all insurance account and to assist with acquirement of hospital privileges

Well established location at street level, with dedicated handicap entrance, easy access to public transportation, a parking lot and within one mile from all three leading local hospitals.
Fully credentialed as a medical practice site with all health insurances in the market, and compliant with Americans with Disability Act requirements. Office space lease guaranteed for extended period of time. Call 917-596-8936


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


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


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


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


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


PHYSICIAN OPPORTUNITIES


Paging Primary Care Doctors Who Love Technology
98point6 is a healthcare technology startup that needs your input.  We’re seeking practicing physicians to join our Primary Care Council to help shape the future of primary care.  If the fusion of healthcare and technology inspires you, please join us and apply today. Visit: www.98point6.com/about/pcc/


Private Multidisciplinary Medical Group Seeking Full Time or Part Time Podiatrist and Full Time or Part Time Internal Medicine/Family Practice/Allergy & Immunology Physicians.
Midtown, Union Square & Lower Manhattan locations. Attractive base salary plus comprehensive benefits package. E-mail CV to tsrgexpress@gmail.com. No recruiters please.


Chief of Medical Services
MINIMUM QUALIFICATIONS: Possession of a license and current registration to practice medicine in New York State, plus six years of experience in the practice of medicine, two years of which must be in an administrative or supervisory capacity. Appointee must be eligible for and maintain eligibility for full and unconditional participation in Medicaid and Medicare programs. Appropriate certification by an American Medical Specialty Board and one year of post certification experience in that specialty can be substituted for four years of general experience.
PREFERRED QUALIFICATIONS: Board certification in Geriatric Medicine and/or Certification as a Medical Director (AMDA), and experience in a long-term care facility.
RESPONSIBILITIES: Serve as Medical Director of a 242-bed skilled nursing facility for veterans and their dependents. Provide medical leadership and oversight ensuring the delivery of quality health care services while also ensuring compliance with clinical, statutory and regulatory standards.Send resume to:  NYS Veterans Home, Attn: Human Resources, 4207 State Highway 220, Oxford, NY 13830

The New York State Veterans Home at Oxford is a 242-bed skilled nursing facility operated by the NYS Department of Health located in Chenango County. It is an Affirmative Action/Equal Opportunity Employer. 


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


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


 

MSSNY eNews: You, Your Patients & MOLST

 

Thomas J. Madejski, MD MSSNY President
PRESIDENT’S MESSAGE
Thomas J. Madejski, MD
MSSNY President
MAY 11, 2018
Volume 18
Number 18

Dear Colleagues:

Several years ago, the New York State Department of Health approved use of a form called Medical Orders for Life-Sustaining Treatment (MOLST) that can be used statewide by health care practitioners and facilities for patients with serious health conditions who:

  • Want to avoid or receive any or all life-sustaining treatment;
  • Reside in a long-term care facility or require long-term care services; and/or
  • Might die within the next year.

The MOLST form is a way to document a patient’s wish concerning life-sustaining treatment.   This is an optional form that physicians and other health care practitioner can use–or they may choose to use other forms.  However, the MOLST form is the only authorized form in New York State for documenting both non-hospital DNR and DNI orders.  In hospitals, hospice and nursing homes, the form may be used to issue any orders concerning life-sustaining treatment and in the community setting, MOLST can be used to notify EMS personnel about a Do Not Resuscitate (DNR) and Do Not Intubate (DNI) order.

The concept for MOLST came from MSSNY member Patricia Bomba, MD, Vice President of Excellus Blue Cross Blue Shield. Dr. Bomba is a strong advocate for physicians to have “that difficult conversation” with their patients about their end of life choices. Over the years, MSSNY has supported MOLST as another “tool” in our medical toolbox and a great way to begin the difficult conversation.

Legislation (A9603), introduced by Assemblymember Joseph Morelle, would create an “eMOLST registry” that calls upon DOH to develop the registry.  If passed, physicians who use the MOLST form will then be required to report patient related information from the MOLST form to the registry within 14 days.

The problems that I see with any compulsory mandate are:

  • Doctors fear OPMC problems if they do not comply with the law
  • Doctors are concerned that the data may not be housed at the NYS DOH.
  • Doctors are concerned about multiple different documents which may have conflicting data

MSNY continues to support improving the care of all of our patients, especially when they approach the end of their lives. Our Council had extensive discussion today on end of life care and approved creation of a task force on end of life care.

What do you think? comments@mssny.org

Thomas J. Madejski, MD 
MSSNY President



MLMIC Insurance

Capital Update
MSSNY Council Approves Formation of a Task Force Death and Dying, Palliative and End Of Life Care
The Medical Society of the State of New York’s Council approved this week the formation of a task force to examine the role of physicians as it relates to death and dying, palliative and end-of-life care.  The task force was formed in lieu of a House of Delegates resolution that requested that MSSNY change its position of opposition to one of neutrality on physician-assisted suicide and euthanasia.  “These are complex issues and it is very important that we address this controversial issue in the most appropriate way,” Thomas Madejski, the society’s president, said in a release. “The Task Force will be ethnically and philosophically diverse and will include members from across MSSNY’s membership — including physicians from the Long-Term Care and Health Disparities committees.”                                                (CLANCY)


Please Urge Your Legislators to Enact Legislation to Address Prior Authorization Hassles and Expand Patient Choice of Physicians

Working together with several other patient advocacy organizations and specialty societies, MSSNY continues to advocate for numerous pieces of legislation in the final weeks of Session that would reduce barriers imposed by health insurance companies that interfere with patient care, and expand patient choice by limiting the ability of health insurers to narrow their networks.   These bills include:

  • 3663 (Hannon)/A.4472 (Gottfried) – would permit independently practicing physicians to collectively negotiate patient care terms with market dominant health insurers under close state supervision. In addition to the ability to push back against exorbitant administrative hassles imposed by insurers, it would also help to protect physicians to have a stronger option to remain in independent practice. The bill is in the Senate Health Committee, and the Assembly Ways and Means Committee.  Please send a letter to your legislators in support here.
  • 7872 (Hannon)/A.9588 (Gottfried) – would reduce prior authorization hassles by requiring health plan utilization review criteria to be evidence-based and peer reviewed; reducing the time frame for reviewing prior authorization requests from 3 business days to 48 hours (and to 24 hours for urgent situations); assuring that a prior authorization, once given, is enduring for the duration of the medication or treatment; prohibiting mid-year prescription formulary changes; and assuring that once a prior authorization is given, it cannot be withdrawn if eligibility is confirmed on the day of the service. We are pleased that several legislators have joined on as co-sponsors of this legislation. Please send a letter to your legislators in support here.
  • 3943 (Hannon)/A.2704 (Lavine) – would provide physicians and other health care practitioners with necessary due process protections where health insurers seek to terminate a physician from its network by failing to renew the physician’s contract.  The bill is on the Assembly floor and in the Senate Health Committee.  Please send a letter in support here.
  • 5022-C (Serino)/A.2317-C (People-Stokes) – would prohibit health insurance companies from making changes to a prescription formulary or shifting a medication to a different cost-sharing tier during a policy year. The bill has passed the Assembly, and is before the Senate Insurance Committee.

            (DIVISION OF GOVERNMENTAL AFFAIRS)

New York Settles Lawsuit Against Federal Government to Preserve Essential Plan Funding
New York State and Minnesota settled a lawsuit this week they had filed against the US Department of Health and Human Services to protest HHS’ action to cut funding for the Basic Health programs operating in New York and Minnesota.   The settlement will result in New York receiving $151 million for its Essential Plan, and $17 million for Minnesota’s plan.  The states will continue to discuss with HHS a revised funding formula for the program.

New York’s Essential Plan provide comprehensive health insurance coverage with little cost-sharing for over 600,000 New Yorkers who earn too much to qualify for Medicaid but make less than 200% of the Federal Poverty Level.  Acting New York Attorney General Barbara Underwood released the following statement:

“The Essential Plan serves hundreds of thousands of low-income New Yorkers. We filed suit earlier this year to protect the quality, affordable health care on which New York’s families rely.  We are gratified that the federal government has agreed to make this interim payment. 

We hope and expect that, in the coming weeks, we’ll reach agreement with the federal government on a payment formula for the program, so that we can resolve this matter fairly and appropriately for all New Yorkers.”  (AUSTER)

Legislation To Require Physicians to Report Patients to DMV on Senate Transportation Committee Agenda
Legislation introduced by Senator Young would require a licensed physician, physician assistant or nurse practitioner to report patients that have chronic condition which may cause unconsciousness or unawareness to the Department of Motor Vehicles. Such conditions may include a convulsive disorder, epilepsy, fainting, dizzy spells, coronary ailments or other health conditions that may impair the ability to operate a motor vehicle.

The bill, S.3569 (Young) / A.10094 (Carroll), is on the Senate Transportation Committee agenda for Tuesday, May 15. The Medical Society understands and supports efforts to ensure pedestrian and driver safety and reduce vehicular accidents.  MSSNY policy supports the ability of physicians to voluntarily report certain patients to DMV whom the physician believes should not operate a motor vehicle.  However, a lack of well-defined medical and legal guidelines may force a physician to “over-report” which in turn could discourage patients from receiving needed medical care.  Please contact your legislators to oppose this legislation imposing burdensome and ambiguous new mandates on physicians that may jeopardize the sanctity of the doctorpatient relationship. They can be reached at 518-455-2800.                          (BELMONT)

MSSNY Urges for Extension of Committee for Physicians Health Program
MSSNY continues to advocate for legislation (A.10221-A, Gottfried, S.8093, Hannon) that would extend for an additional 5 years the continued operations of the MSSNY Committee for Physicians Health (CPH) program.  Authorization for several key components of the program expired on March 31, 2018.   The legislation was amended this week to clarify that the legislation would be retroactive to March 31 once enacted.  It has advanced to the Senate floor, and is before the Assembly Health Committee.

The CPH is a program designed to confront and assist physicians thought to be suffering from alcoholism, substance abuse or mental illness.   Since the inception of this program, CPH has assisted thousands of physicians in returning healthy to medical practice.  The work of the CPH program is an important public service both to our health care system as well as the general public. As a result, the State Budget annually includes an appropriation of $990,000 for the program, which is generated from a $30 assessment on all physicians’ biennial registration fees.

The program has traditionally been extended by the Legislature in 3 or 5 year “demonstration programs” with the most recent extension in 2013.  The recently enacted State Budget included a provision to create another “demonstration program” until 2023.  However, it omitted other provisions historically extended at the same time that are essential to its functioning that could greatly impair its operations unless immediate action is taken.  These includes provisions that set forth the CPH program’s reporting requirements to the Office of Professional Medical Conduct (OPMC), provisions to ensure liability protections for the physician Committee members for work performed in the scope of CPH, and necessary confidentiality protections for the program given the sensitivity of the work they perform.   These protections are absolutely essential to the continued functioning of the program to ensure that physicians with the appropriate expertise are willing to serve on the Committee, as well as to assure that the program has the ability to report sensitive information to OPMC when warranted by the circumstances.  (DIVISION OF GOVERNMENTAL AFFAIRS)

MSSNY Continues to Express Concerns with Cuts to Patient-Centered Medical Home Program
MSSNY continues to work with primary care associations to respond to Medicaid cuts to the Patient Centered Medical Home (PCMH) program.  As reported last week, earlier this year the NYS Health Department announced its intent to implement a huge cut in Medicaid payments to physicians participating in the PCMH program. Specifically, DOH intended to slash the current $7.50 Per Member Per Month (PMPM) payment for each Medicaid patients to $2.00 for May and June.  The amount would increase to $5 or $5.50 PMPM in July but would also have required that each PCMH participant have a Level 1 Value-Based Payment contract with a Medicaid Managed Care plan.

If permitted to go forward, these cuts and new requirements would likely have pushed many physicians away from participating in the PCMH program, which in turn would have significantly impaired access to primary care services for many patients insured through Medicaid.   As a result of these concerns, MSSNY worked together with the New York Chapters of the American College of Physicians, Academy of Family Physicians and American Academy of Pediatrics, as well as the Community Healthcare Association of New York State (CHCANYS), to successfully advocate for the Legislature to include $20 million in the State Budget to prevent these Medicaid payment cuts from being implemented.

While a NYS Assembly summary of the final State Budget noted that these funds were intended to “reject a reduction in reimbursement rates for patient centered medical home services”, that point has been disputed by the NYSDOH. Last week DOH released a letter noting payment changes to the PCMH program starting in May.  Importantly, DOH has indicated that it was not going forward with a requirement for PCMH participants to have VBP contract by July 1.  However, of significant concern, the letter indicated that there are still going to be cuts to Medicaid PCMH payment, as follows:

  1. Effective May 1, 2018 – June 30, 2018, the MMC PCMH PMPM for providers recognized under NCQA 2014 Level 3, NCQA 2017, or NYS PCMH standards will be $5.75.
  1. Effective July 1, 2018 to the end of SFY 18-19, the MMC PCMH PMPM for providers recognized under NCQA 2014 Level 3, NCQA 2017, or NYS PCMH standards will be $6.00.
  1. Effective May 1, 2018, the PCMH incentive payments for providers recognized under NCQA’s 2014 Level 2 standards will be permanently eliminated for both MMC and FFS.

MSSNY continues to work with the ACP, AFP, AAP and CHCANYS to express significant concerns to the Legislature, DOH and Governor’s Office with these PCMH cuts, even at a reduced level, in spite of the action taken by the Legislature.  An article discussing these concerns that quoted MSSNY President Dr. Thomas Madejski appeared in Politico-NY this week.  Physicians are urged to contact the Governor and their legislators to express their concerns here.                                                             (AUSTER)

New CMS Tool for Physicians To Check Whether They Need to Comply with MIPS
The Centers for Medicare and Medicaid Services (CMS) has announced that physician practices/groups may now log into the CMS QPP website to check their 2018 eligibility for Medicare’s Merit-based Incentive Payment System (MIPS), according to an alert from the American Medical Association.

After groups log in, they will be able to click into a details screen to see the eligibility status of every clinician in the group (based on their National Provider Identifier or NPI) to find out whether they need to participate during the 2018 performance year for MIPS.  The AMA also advised that CMS will not be sending out letters to advise physicians of their eligibility status this year so checking on the QPP participation status look-up tool is the only way to determine or verify eligibility status.  Eligibility rules in 2018 are different than in 2017 so status this year may be different than last.  Also as is indicated in the look-up tool, exempt individual clinicians still will need to report if their group is eligible and chooses to report as a group.

The look-up tool can be found here.                                                 (AUSTER)

Physicians Encouraged to Take Survey; Bending the Diabetes Curve CME Course Available Online
The Medical Society of the State of New York has partnered with the American Medical Association to bring its Prevent Diabetes STAT initiative to New York.  MSSNY has developed a short survey to sample physician’s knowledge of the National Diabetes Prevention Program (DPP) and the Prevent Diabetes STAT program. The survey also serves as a platform to physicians to express what specific boundaries they have experienced or anticipate experiencing regarding the implementation of the DPP and/or Prevent Diabetes STAT. Participation in this survey is essential to the development of various educational components that will benefit both the physician and patient communities. Click here to take the one-minute survey.

Bending the Diabetes Curve webinar is now available to view online; click here. By educating physicians and connecting more patients to evidence-based lifestyle change programs, this diabetes initiative will help bridge the gap between clinical care settings and communities to reduce the incidence of type 2 diabetes.

Webinar: Bending the Diabetes Curve

Faculty: Geoffrey Moore, MD & Sarah Nosal, MD

Educational Objectives:

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

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

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

Additional information or assistance with registration may be obtained by contacting Carrie Harring at 2020 charring@mssny.org.                                       (HARRING)

Learn How You Can Help Meet the Mental Health Needs of Veterans at the Dwyer Peer Project Annual Day of Wellness
The Suffolk County United Veterans and the Suffolk County Veterans Service Agency are jointly hosting the 5th annual Joseph P. Dwyer Veterans Peer Support Project Day of Wellness. The event will take place on Saturday, June 9 at Camp Pa-Qua-Tuck, 2 Chet Swezey Road, Center Moriches, NY. It will from 9 am to 4 pm with provider demonstrations from 10 am to 3 pm. The day will include educational activities for veterans and their families with a focus on dealing with post-service transition issues as well as family-oriented entertainment by veterans. Complimentary breakfast and lunch will be served. 

To register for the live event, CLICK HERE.  Both registrants and walk-ins are accepted. 

Ebola Webinars Available on MSSNY CME Website
An Ebola outbreak has been confirmed in the Democratic Republic of Congo.  Following 17 deaths and 21 patients showing signs of hemorrhagic fever, an Ebola outbreak was declared in the Democratic Republic of Congo this week.  The Medical Society has two CME courses available that help to address these concerns regarding Ebola virus.  Go to https://cme.mssny.org to view MSSNY’s free CME courses on this timely and relevant topic.  Ebola: A Perspective from the Field offers a firsthand description of Ebola virus.  And Viral Hemorrhagic Fevers with an Ebola Virus Update offers a comprehensive analysis of diagnosis and treatment for Ebola and other viral hemorrhagic fevers.         (HOFFMAN)


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

pschuh@mssny.org   mauster@mssny.org  pclancy@mssny.org  


eNews

Council Notes—May 10, 2018

  • MSSNY will convene a Task Force on Death and Dying to develop a white paper regarding the physicians’ role in end of life and palliative care. The paper will also discuss the impact of these issues on the disparate populations and the disabled community. Click here to read MSSNY’s press statement.
  • Dean P. McElwain, President and COO of Castle Connolly Private Health Partners, presented information about transitioning to a concierge practice model. McElwain noted that the standard concierge practice has 55-60 patients and doesn’t differ greatly from a traditional practice model, but offers both patients and physicians convenience, connectivity and care. Castle Connelly currently focuses on IM practices, but is currently in experimental stages with specialty practices. Council approved pursuing a member benefit that would assist physicians in transitioning to a concierge practice.
  • As a pilot project in participating counties, MSSNY and the county medical society will offer member benefits and services to international medical students engaged locally in New York State-approved clinical rotations free of charge until they are eligible for student or other membership. This will include invitations to county and state medical society meetings, without the right to vote unless and until formal membership is obtained.
  • MSSNY Burnout Committee will change its name to MSSNY Committee for Physician Wellness and Resilience. The mission is to increase education, awareness and recognition of stress and their effects on both the individual physician and the physician workforce and to support physicians in optimizing their physical, emotional, cognitive and psychological well-being in order to recover the intrinsic joy of the practice of medicine in a dynamic healthcare environment. The vision of the Committee for Physician Wellness and Resilience is for physicians to have a workforce and environment free of extraneous stressors and to be free from the effects of stress and their wide-ranging consequences.
  • Council discussed and approved a request from MSSNY’s General Counsel, Garfunkel Wild, to support an Amicus brief. The issue on appeal involves whether the NYS Comptroller is required to obtain a patient’s written authorization in order to subpoena patient medical records for the purpose of conducting an audit of payments made under the Empire Plan to a medical practice.

Help Patients Find You: Confirm Your Practice Info Using NYS’s New Tool
On April 25, the New York State Department of Health (NYSDOH) and the New York State of Health launched a new tool called NYS Provider & Health Plan Look-Up.

It’s an online tool that allows consumers to quickly locate information about their doctors and the health insurance plans in which their doctors participate. To make sure plan members can find you, go to the website to review and ensure your practice information is accurate.

To report an error in the listing, go to the NYS Provider & Health Plan Look-Up home page and select the Contact/Report an Error button. Then, select the health plan and the reason you are contacting them. The issue will be routed electronically to the NYSDOH and to the selected health plan(s) for review and follow-up.

Rockefeller Institute Study: Medical Marijuana v. Opioid
According to the Albany-based Rockefeller Institute of Government, some states allowing medical marijuana and recreational pot saw declines in opioid prescribing as authorities pushed urgent efforts to combat the historic American drug crisis. Medicaid patients, for example, are getting about 5.9 percent fewer prescription painkillers in medical marijuana states. Further, the opioid prescription declines are deeper where recreational pot is allowed, down nearly 6.4 percent. http://rockinst.org/blog/can-marijuana-alleviate-the-opioid-crisis-data-suggest-yes/

One high-profile National Institutes of Health study was awarded recently to researchers at Albert Einstein College of Medicine and Montefiore Health System in the Bronx. The five-year, $3.8 million grant is for the first long-term study to test whether medical marijuana reduces opioid use among adults with chronic pain, including those with HIV, the health system said.

Against that backdrop, the Rockefeller Institute report detailed a range of studies from medical journals and universities. They include:

  • Overall, patients in medical marijuana states filled fewer daily doses of opioids, University of Georgia research found. For example, they saw a 14.4 percent reduction by Medicare patients in states with access to a medical marijuana dispensary.
  • Marijuana reforms have also saved taxpayers’ money, according to recent JAMA Internal Medicine
  • Recreational marijuana laws were tied to 9.78 percent lower Medicaid spending on prescription opioids, an annual savings of $1,815 Medicaid spending per 1,000 enrollees, the study found.
Physicians’ Day at the Races 2018 – Secure Your Tickets Today!
Join your colleagues for MSSNYPAC’s Physicians’ Day at the Races on Saturday, July 28, 2018 at Saratoga Race Track in Saratoga Springs, NY.  All physicians, including non-members of MSSNY are welcome to support this state-wide fellowship event for MSSNYPAC while supporting a great cause which strengthens our profession.  Tickets are $500/physician, $300/guest and $250/guests under 21.  As it’s the day of the renowned “Jim Dandy” stakes, tickets for this event are limited. Visit www.mssnypac.org/events for details or to download an invitation.  Ticket requests and questions can be directed to Jennifer Wilks at518-465-8085.

Study: Older Adults’ Hearing Aid Use Linked To Lower Hospitalizations, ER Visits
A report published in JAMA Otolaryngology–Head & Neck Surgery suggests that older adults with hearing loss who wear hearing aids “are less likely to be hospitalized or to visit the emergency room…compared to those who don’t” wear the aids. However, the article says, “people with hearing aids also averaged 1.4 more doctor visits than those without the devices.” Researchers also published an accompanying editorial.

New York Rx Card Helps Patients Fill Their Prescriptions
The Medical Society of the State of New York (MSSNY) in partnership with New York Rx Card reminds physicians that patients who are not insured or who take prescription drugs that are not covered by their health insurance plans, can use the New York Rx Card to obtain discounts of up to 75 percent off the retail price for FDA-approved medications.

New York Rx Card has been working closely with MSSNY, as well as numerous clinics and hospitals around the state to distribute free discount prescription cards so that all New York residents will have access to this free program. The program can also be used by people that have health insurance coverage with no prescription benefits, which is common in many health savings accounts (HSA) and high deductible health plans.

Please help by encouraging your patients to print a free New York Rx Card at the MSSNY website or at www.newyorkrxcard.com.  New York Rx Card also has an available app for your iPhone and Android phones. You can visit www.newyorkrxcard.com and download the app today.  Any physicians who are interested in ordering free cards for their clinic/hospital can email Chez Ciccone, via email at fciccone@nyrxcard.com or by phone at 800-931-2297.

Five Opioid Distributor Execs: Four of Five Deny Contributing to Opioid Abuse
Five of the nation’s top opioid distributors on Tuesday told a House panel that responsibility for the opioid crisis rests with “bad actors” at pharmacies and doctors who wrote too many prescriptions, not with their companies. Executives from four of the five distributors denied contributing to widespread painkiller abuse when questioned by Energy and Commerce Oversight and Investigations Chairman Gregg Harper (R-Miss.). Joseph Mastandrea, chairman of Ohio drug wholesaler Miami-Luken, answered “yes” and blamed prior management.

Another executive, Cardinal Health Executive Chairman George Barrett, apologized for not catching bad actors faster. Several of the other executives expressed contrition for not catching large requests for opioids more quickly. Earlier this year, the committee released documents alleging that between 2006 and 2014, McKesson and Cardinal Health shipped 12.3 million pills to one pharmacy in Mount Gay-Shamrock, West Virginia, which has fewer than 2,000 residents. Likewise, over five years, AmerisourceBergen distributed 60.9 million doses of hydrocodone and 29.4 million doses of oxycodone to West Virginia.

Energy and Commerce Chairman Greg Walden (R-Ore.) recounted how one West Virginia town of about 400 people received 9 million opioid pills in two years and how a single pharmacy in a town of 1,800 people got 17 million opioid pills in a decade.

Since the 1970s, drug distributors have been responsible for flagging suspicious orders and monitoring sales — something Walden suggested has not been done.

The executives largely shifted blame, despite their role in supplying the drugs at the center of the nationwide crisis. Three of the companies that testified — McKesson, Cardinal Health and AmerisourceBergen — account for about 85 percent of the opioid drug supply, Walden said.

https://www.politico.com/story/2018/05/08/opioid-distributors-blame-pharmacies-docs-522433

MLMIC to Host Spring 2018 Network Meetings Across NYS
These programs are designed to provide risk management education to MLMIC’s insured physicians, medical directors, facility risk managers, office practice administrators, nursing staff, marketing and IT staff and other healthcare professionals. This year’s program, which can qualify participants for CME credits, focuses on “Managing Your Social Media Presence.” It will:

  • examine the use of social media in healthcare;
  • analyze the positive and negative aspects of social media;
  • describe the appropriate use of social media in marketing;
  • formulate approaches to address negative online patient reviews;
  • evaluate the potential legal implications of social media on patient privacy and confidentiality; and
  • select strategies to develop and monitor social media policies.

The program is part of MLMIC’s ongoing efforts to provide education, promote patient safety and reduce potential liability exposure for all our insured providers and entities.

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 2.0 AMA PRA Category I Credits™.

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

Click here to read the program brochure and obtain registration information for a spring Network Meeting near you. 

USPSTF: Neutral Stance on Prostate Cancer Screening in Middle-Aged Men
Prostate-specific antigen (PSA) screening for prostate cancer isn’t recommended unless men request the test after being informed of its potential benefits and risks, the U.S. Preventive Services Task Force (USPSTF) says in new guidance published in JAMA. The grade C recommendation applies to asymptomatic men aged 55 to 69. The group recommends against PSA screening in men aged 70 and older (grade D recommendation). USPSTF recommendation statement in JAMA ; JAMA Internal Medicine editorial ; USPSTF grade definitions

Geisinger Health: Now Offering DNA Sequencing to All Patients
Geisinger Health this week announced that over the next six months it will offer DNA sequencing to all of its patients as part of their “routine” preventive care in an effort to inform patients about potential genomic risk factors for cancer or heart disease. Geisinger said it plans on making DNA sequencing a “routine screening,” just like colonoscopies, cholesterol checks, and mammograms, and will have doctors work with patients on responding to any identified risk factors.

CMS

CMS’ Eight-Page Plan for Rural Health Strategy; Commitment to Telehealth
On May 8, CMS unveiled an eight-page rural health strategy, which detailed the agency’s commitment to improve access to telehealth, improve outreach to rural health care providers, and find practical solutions to improve care in those areas. The strategy marks CMS’ first focused on rural health, but it did not contain any specific policy changes.

CMS Hosting a Medicare Learning Network Call: QPP FAQs
The Centers for Medicare & Medicaid Services (CMS) is hosting a call on Wednesday, May 16 at 1:30 PM ET to discuss the most frequently asked questions (FAQs) about the Quality Payment Program that came up during the 2018 Healthcare Information and Management Systems Society (HIMSS) Annual Conference & Exhibition.

Attendees will have the opportunity to listen to 2018 programmatic updates and FAQs that were discussed at HIMSS 2018. CMS will also open the phone lines for participants to ask questions about the Quality Payment Program.

Call Details

Title: Quality Payment Program: Answering Your Frequently Asked Questions Call

Date: Wednesday, May 16, 2018

Time: 1:30-3:00 p.m. ET

Registration Link: https://blh.ier.intercall.com

Classified

RENTAL/LEASING SPACE

Thriving Internal Medicine Practice for Sale by the Physician.
Has been growing exponentially, with number of patients doubling over last two years.
Has the visits-volume and the potential space & hours to keep expanding
The physician will stay to overlap for at least one year to personally transition all the practice’s patients, to seamlessly transfer all insurance account and to assist with acquirement of hospital privileges

Well established location at street level, with dedicated handicap entrance, easy access to public transportation, a parking lot and within one mile from all three leading local hospitals.
Fully credentialed as a medical practice site with all health insurances in the market, and compliant with Americans with Disability Act requirements. Office space lease guaranteed for extended period of time. Call 917-596-8936


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


For Rent – Medical Office 715 W 170 Street New York
Ground floor just completed build out 4 exam rooms with sinks and wall cabinets
Waiting and reception areas, windows throughout.
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$1900-$7900/ month for one to 4 exam rooms.
Drdese@gmail.com or 917.8618273


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


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


PHYSICIAN OPPORTUNITIES


Paging Primary Care Doctors Who Love Technology
98point6 is a healthcare technology startup that needs your input.  We’re seeking practicing physicians to join our Primary Care Council to help shape the future of primary care.  If the fusion of healthcare and technology inspires you, please join us and apply today. Visit: www.98point6.com/about/pcc/


Private Multidisciplinary Medical Group Seeking Full Time or Part Time Podiatrist and Full Time or Part Time Internal Medicine/Family Practice/Allergy & Immunology Physicians.
Midtown, Union Square & Lower Manhattan locations. Attractive base salary plus comprehensive benefits package. E-mail CV to tsrgexpress@gmail.com. No recruiters please.


Chief of Medical Services
MINIMUM QUALIFICATIONS: Possession of a license and current registration to practice medicine in New York State, plus six years of experience in the practice of medicine, two years of which must be in an administrative or supervisory capacity. Appointee must be eligible for and maintain eligibility for full and unconditional participation in Medicaid and Medicare programs. Appropriate certification by an American Medical Specialty Board and one year of post certification experience in that specialty can be substituted for four years of general experience.
PREFERRED QUALIFICATIONS: Board certification in Geriatric Medicine and/or Certification as a Medical Director (AMDA), and experience in a long-term care facility.
RESPONSIBILITIES: Serve as Medical Director of a 242-bed skilled nursing facility for veterans and their dependents. Provide medical leadership and oversight ensuring the delivery of quality health care services while also ensuring compliance with clinical, statutory and regulatory standards.Send resume to:  NYS Veterans Home, Attn: Human Resources, 4207 State Highway 220, Oxford, NY 13830

The New York State Veterans Home at Oxford is a 242-bed skilled nursing facility operated by the NYS Department of Health located in Chenango County. It is an Affirmative Action/Equal Opportunity Employer. 


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


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


 

Doing Right for Patients & Members

 

Thomas J. Madejski, MD MSSNY President
PRESIDENT’S MESSAGE
Thomas J. Madejski, MD
MSSNY President
MAY 4, 2018
Volume 18
Number 17

Doing Right by Our Patients and Our Members

Dear Colleagues:

I related to you last week my testimony before the Assembly Health Committee explaining MSSNY’s policy on physician assisted suicide/aid in dying. I testified to MSSNY’s existing policy, which was last reviewed and updated at our 2015 House of Delegates.  Our HOD explicitly indicated that physicians should not participate in physician assisted suicide or euthanasia.

Contentious Issue

I acknowledged that this is a difficult and contentious issue amongst our members, and that there are reasoned arguments on both sides.  My testimony indicated what MSSNY’s present policy is, and that there has not been any attempt to change that policy.

MSSNY was asked at the last House of Delegates to conduct a survey of our members’ attitudes toward physician assisted suicide/aid in dying.  Of note, the 2017 resolution DID NOT ask MSSNY to change its policy; just that a survey be conducted. I testified that the survey has been completed and that the results are being analyzed and reviewed by the MSSNY Bioethics Committee.

MSSNY routinely conducts surveys on many different issues throughout the course of the year.  We use various instruments and recognize that all surveys have inherent bias and methodological issues.  We consider the information and potential flaws of all the data that we use when we formulate policy.

Under Consideration Now in NY

The Medical Aid in Dying Act (S3151/ A2383) is currently under consideration during this legislative session.  Our Council and Bioethics Committee did not have an opportunity to discuss their work prior to the completion of public hearings. After discussion with MSSNY leadership and staff, I wanted to provide as much information as we could to aid the legislators in their deliberations, acknowledging that we had not completed our consideration of the information.

No good deed goes unpunished.

In response to my testimony, organizations that support aid in dying accused MSSNY of mishandling the survey. The organizations are: Compassion and Choices; End of Life Choices New York; Death with Dignity National Center; and Death with Dignity-Albany.

I testified at the hearing that MSSNY is committed to improving care for all of our patients, especially those near the end of their life.  One of the core principles of the practice of medicine is the easing of suffering, and I acknowledged in my testimony that sometimes physicians may hasten a patient’s death in an attempt to ease their pain.

My job as MSSNY President is to represent MSSNY policy— which I believe I did.

Response

The organizations chose to attack us, rather than work with MSSNY to improve the care of our patients at end of life.  I think it is important to respond to some of the criticism in an attempt to clear the air, and hopefully move forward together:

  • The organizations indicated we released information “unexpectedly.” MSSNY members who are part of the Aid in Dying movement have been asking for information, and questioning why MSSNY wasn’t giving out results. Again, we continue to work on the analysis, but with time constraints and pending legislation, I felt it was important to try and give some information about the results, fully acknowledging that these were preliminary conclusions and will be reviewed further.
  • The organizations indicated that MSSNY did not produce an unbiased survey.  Our Bioethics Committee took great care in creating a survey instrument to minimize bias, and created an instrument that would help to inform leadership on the concerns of MSSNY members.
  • The organizations were concerned that non-MSSNY members participated in the survey.  MSSNY became aware of this early in the survey process.  In fact, Compassion and Choices interfered in the survey process only hours after MSSNY released the survey and several days later we learned that the Catholic Conference was also sending out the MSSNY survey. The organizations don’t indicate that MSSNY legal counsel had to have a discussion with organizations advocating for and against Aid in Dying to cease and desist redistributing the survey to their non-MSSNY members.
  • MSSNY shares Assemblymember Paulin’s concern about the participation of non-MSSNY members and will consider that in our evaluation of the data.
  • One of the difficulties in discussing physician assisted suicide/aid in dying is conflation of related issues. The organizations quoted a number of different studies, but does not seem to be concerned about sources of bias in their parsing of data favorable to their position.
  • Those organizations indicated that it defies logic that a majority of MSSNY physicians oppose medical aid in dying in the light of other national surveys. If that is truly the case, then why be concerned with our process? Then why are the organizations so vested in our process?    We have a very democratic and open process in determining policy through our House of Delegates.

I have already tasked some of our committees with reviewing the issues related to death and dying.  This issue will also be discussed at the MSSNY Council Meeting.

MSSNY has been advocating for the care of patients, the proper practice of medicine, and the betterment of public health since 1807. The last time the majority of MSSNY members spoke through our House of Delegates they opposed physician assisted suicide. That policy has not changed.

NY Is a Policy Leader 

New York State is a national leader in educating physicians and creating health care policy.  I think we can work together to create policy and systems of care that ease our patients’ suffering without creating additional disparities in care.

As President of MSSNY, I am committed to leading a discussion amongst all physicians on how best to care for patients at end of life.

Excelsior!

I am interested in hearing your comments on this topic: comments@mssny.org.

Thomas J. Madejski, MD 
MSSNY President


Dr. Donald Moore, host of the well-attended, all-day HIT Symposium at Brooklyn Boro Hall on Saturday, April 28. Dr. Sal Volpe, Dr. Parag Mehta were featured speakers.


MLMIC Insurance

Capital Update

MSSNY Joins Patient Groups to Advocate to Prevent Mid-Year Formulary Changes
This week MSSNY representatives participated with representatives of several other patient advocacy groups as well as the bill sponsors in a press conference and legislative meetings in support of legislation (A.2317-C, People-Stokes/S.5022-C, Serino) that would (in most cases) prohibit a health insurer from making a change to their prescription drug formulary or moving a prescription drug to a higher tier during a policy year.  The legislation passed the Assembly unanimously this week, and is before the Senate Insurance Committee.

The measure is supported by many patient and physician advocacy groups, including the Global Healthy Living Foundation, Lupus and Allied Diseases Association, NAACP, AARP, New Yorkers for Accessible Health Coverage, the Epilepsy Foundation, the Arthritis Foundation, the American Cancer Society, the National Association on Mental Illness-NY, the NY Chapter of the American College of Physicians, the NYS Osteopathic Medical Society, and the American College of Rheumatology.  This week’s event received significant media coverage, including through Newsday and Capital Tonight.

Also participating in the press conference and meetings were parents of children with chronic diseases who shared stories of the impact of these mid-year formulary changes.

The press release referenced a survey released by the Global Healthy Living Foundation found that 65% of New Yorkers reported that their insurance company switched their medication to a drug that was different from the one their physician prescribed; 86% reported paying more out-of-pocket for their prescription medications due to formulary changes; and 93% reported that the medication they were switched to worked worse than the original prescribed medication.

MSSNY President Dr. Thomas Madejski stated the following for the press release:Continuation of a medication regimen prescribed by a patient’s treating physician is critical to assuring a patient’s recovery from illness, maintaining their health, or preventing worsening of their condition. Unexpected changes to a medication formulary could result in significantly higher out-of-pocket costs for patients. This could seriously interfere with their continued ability to obtain these needed medications.  Insurance company formulary changes are not made with the intimate knowledge of the patient’s personal physician.  Additionally, this legislation would help to protect consumers from unforeseen higher cost-sharing requirements.  (AUSTER, BELMONT)

Update on the Patient-Centered Medical Home Program – Physicians Concerned that Some PMPM Cuts Going Forward
To respond to State Budget constraints, earlier this year the NYS Health Department announced its intent to implement a huge cut in Medicaid payments to physicians participating in the Patient-Centered Medical Home program. Specifically, DOH intended to slash the current $7.50 Per Member Per Month (PMPM) payment for each Medicaid patients to $2.00 for May and June.  The amount would increase to $5 or $5.50 PMPM in July but would also have required that each PCMH participant have a Level 1 Value-Based Payment (VBP) contract with a Medicaid Managed Care plan.

If permitted to go forward, these cuts and new requirements would likely have forced many physicians out of the Medicaid PCMH program, which in turn would have significantly impaired access to primary care services for many patients insured through Medicaid.   As a result of these concerns, MSSNY worked together with the New York Chapters of the American College of Physicians, Academy of Family Physicians and American Academy of Pediatrics, as well as the Community Healthcare Association of New York State (CHCANYS), to successfully advocate for the Legislature to include $20 million in the State Budget to prevent these Medicaid payment cuts from being implemented.

While a NYS Assembly summary of the final State Budget noted that these funds were intended to “reject a reduction in reimbursement rates for patient centered medical home services”, that point has been disputed by the NYSDOH.     This week DOH released a letter noting payment changes to the PCMH program starting in May.  We are pleased that, DOH has indicated that it was not going forward with its original proposal to require PCMH participants to have VBP contract by July 1.  However, of significant concern, the letter indicated that there are still going to be cuts to Medicaid PCMH payment, as follows:

  1. Effective May 1, 2018 – June 30, 2018, the MMC PCMH PMPM for providers recognized under NCQA 2014 Level 3, NCQA 2017, or NYS PCMH standards will be $5.75.
  1. Effective July 1, 2018 to the end of SFY 18-19, the MMC PCMH PMPM for providers recognized under NCQA 2014 Level 3, NCQA 2017, or NYS PCMH standards will be $6.00.
  1. Effective May 1, 2018, the PCMH incentive payments for providers recognized under NCQA’s 2014 Level 2 standards will be permanently eliminated for both MMC and FFS.

MSSNY continues to work with the ACP, AFP, AAP and CHCANYS to express significant concerns to the Legislature, DOH and Governor’s Office with these PCMH cuts, even at a reduced level, in spite of the action taken by the Legislature.  Physicians are urged to contact the Governor and their legislators to express their concerns here(AUSTER) 

MSSNY Urges for Extension of Committee for Physicians Health Program
This week the Senate Health Committee unanimously advanced legislation (S.8093, Hannon) to the Senate floor that would extend for an additional 5 years the continued operations of the MSSNY Committee for Physicians Health (CPH) program.  Authorization for several key components of the program expired on March 31, 2018.   Identical legislation (A.10221, Gottfried) is before the Assembly Health Committee.

The CPH is a program designed to confront and assist physicians thought to be suffering from alcoholism, substance abuse or mental illness.   Since the inception of this program, CPH has assisted thousands of physicians in returning healthy to medical practice.  The work of the CPH program is an important public service both to our health care system as well as the general public. As a result, the State Budget annually includes an appropriation of $990,000 for the program, which is generated from a $30 assessment on all physicians’ biennial registration fees.

The program has traditionally been extended by the Legislature in 3 or 5 year “demonstration programs” with the most recent extension in 2013.  The recently enacted State Budget included a provision to create another “demonstration program” until 2023.  However, it omitted other provisions historically extended at the same time that are essential to its functioning that could greatly impair its operations unless immediate action is taken.  These includes provisions that set forth the CPH program’s reporting requirements to the Office of Professional Medical Conduct (OPMC), provisions to ensure liability protections for the physician Committee members for work performed in the scope of CPH, and necessary confidentiality protections for the program given the sensitivity of the work they perform.   These protections are absolutely essential to the continued functioning of the program to ensure that physicians with the appropriate expertise are willing to serve on the Committee, as well as to assure that the program has the ability to report sensitive information to OPMC when warranted by the circumstances.
(DIVISION OF GOVERNMENTAL AFFAIRS)

Physicians Encouraged to Take Survey; Bending the Diabetes Curve CME Course Available Online
The Medical Society of the State of New York has partnered with the American Medical Association to bring its Prevent Diabetes STAT initiative to New York.  MSSNY has developed a short survey to sample physician’s knowledge of the National Diabetes Prevention Program (DPP) and the Prevent Diabetes STAT program. The survey also serves as a platform to physicians to express what specific boundaries they have experienced or anticipate experiencing regarding the implementation of the DPP and/or Prevent Diabetes STAT. Participation in this survey is essential to the development of various educational components that will benefit both the physician and patient communities. Click here to take the one-minute survey.

Bending the Diabetes Curve webinar is now available to view online; click here. By educating physicians and connecting more patients to evidence-based lifestyle change programs, this diabetes initiative will help bridge the gap between clinical care settings and communities to reduce the incidence of type 2 diabetes.

Webinar: Bending the Diabetes Curve

Faculty: Geoffrey Moore, MD & Sarah Nosal, MD

Educational Objectives:

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

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

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

Additional information or assistance with registration may be obtained by contacting Carrie Harring at charring@mssny.org.  (HARRING)

Register now for the Medical Society of the State of New York’s May 2018 Medical Matters CME Webinar Program
The Medical Society of the State of New York is pleased to announce its free Continuing Medical Education (CME) webinar for May, 2018.  Participation in this webinar will earn physicians one CME credit free of charge.

May 16 at 7:30am – Medical Matters: Physically and Biologically Derived Chemical Agents: An Overview

Register for this webinar here.
Faculty: Arthur Cooper, MD

Educational Objectives:

  • Acquire a basic understanding of physically and biologically derived chemical agents
  • Identify types of physically and biologically derived chemical agents used as chemical weapons
  • Understand the indicators of each type of chemical agent
  • Describe the treatment of each type of chemical agent
  • Identify local and state resources

To view all of MSSNY’s scheduled programs, click here and select “Upcoming”.

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

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

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

Medical Society of the State of New York Announces May and June CME Webinar Schedule
The Medical Society of the State of New York is pleased to announce its free Continuing Medical Education (CME) webinars for May and June.  Participation in the webinars will earn physicians one CME credit free of charge.   The webinar schedule for May and June is as follows: 

May 24th at 7:30amCurrent Concepts in Concussion for Pediatric and Adult Patients

Register for this webinar here.
Faculty: Deborah Light, MD & John Pugh, MD, PhD

Educational Objectives:

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

June 20th at 12:30pmMedical Matters: Children’s Mental Health After Disaster
Register for this webinar here.
Faculty: Linda Chokroverty, MD

Educational Objectives:

  • Enhance physicians’ understanding of the impact of disaster on children’s and family mental health
  • Improve physician skills to address potential psychiatric problems in children and families following a disaster

To view all of MSSNY’s scheduled programs, click here and select “Training Center” and “Upcoming”.

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

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

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

Warmer Weather Means More Disease
As the summer months and warmer weather draw near, there is the inevitable onslaught of pests that cause disease.  The New York Times reported on Tuesday, May 1st that the incidence of diseases transmitted by mosquito, tick and flea bites has more than tripled in the United States between 2004 and 2016, with nine such diseases newly discovered or introduced in the U.S. since 2004.

Prepare yourself for the season by going to https://cme.mssny.org for MSSNY’s free CME courses on Mosquito Borne diseases and Zika Virus.   If you do not already have an account, you will need to create one.  And while you’re there, check out all of MSSNY’s CME offerings. (Hoffman)


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

pschuh@mssny.org   mauster@mssny.org  pclancy@mssny.org  


eNews

Insys’ Controversial Opioid Sales Tactic Examined
In an 8,112-word feature, the New York Times (5/2) spotlights Insys Therapeutics’ controversial opioid sales practices and outreach to physicians to push its fentanyl drug, Subsys. “The Insys speaker program was central to Insys’ rapid rise as a Wall Street darling, and it was also central to the onslaught of legal troubles that now surround the company,” and seven former top executives “now await trial on racketeering charges in federal court in Boston.” The pieces profiles Insys founder John Kapoor who “flirted with legal trouble throughout his long career as a pharmaceutical entrepreneur” and “bankrolled Insys almost entirely on his own for over a decade” as he pursued the Food and Drug Administration’s approval for Subsys.

Three Nonprofit Insurers in Western New York Posted Higher Profits For 2017
The Buffalo (NY) News (4/30) reports, “Three of Western New York’s major nonprofit health insurers performed better in 2017, each of them helped by gains in investments and lower administrative expenses.” The article says Independent Health posted a surplus of $22.4 million for 2017, compared to $13 million in 2016, while HealthNow New York had “a $55 million surplus, up from $4.2 million in 2016, on revenue of $2.5 billion.” For its part, Univera Healthcare had net income “of $182.3 million last year, up from $99.5 million in 2016, on total premium revenue of $5.6 billion.”

Calling All IMGs! Symposium on May 23 at Jacobi Medical Center in the Bronx
Essen Health Care will host an IMG Symposium on May 23 from 5-8 pm at Jacobi Medical Center in the Bronx. Topics range from Navigating Residency: What to Expect to Residency Application and Interview Tips; and from Primary Care Pathway to IMG Onboarding and Training. IMGs are invited to participate in a pre-symposium networking from 5-6 pm. RSVP at internship@essenmd.com or by calling 929.239.4160. Click here for more information on the symposium

WORKERS COMP

Workers’ Comp: Schedule Loss of Use Informational Webinars
As part of the 2017 executive budget, Workers’ Compensation law §15(3)(x) required the Workers’ Compensation Board to implement new Permanency Impairment Guidelines for Schedule Loss of Use (SLU) evaluations. The new 2018 SLU Guidelines took effect January 1, 2018.

The Board’s Medical Director and Senior Policy Advisor, Elain Sobol Berger, MD, JD will provide training in the 2018 Guidelines’ approach to assessing SLU permanent impairment. Case studies will demonstrate how to apply the SLU principles and objective criteria in making an SLU determination.

There will be four webinars, so you can register for the time that works best for you. Each webinar will last approximately one hour and will include time for questions and answers. Space is limited, so please register early. When you click ‘register here’, you will be taken to a general information page. You must click ‘Register’ on the bottom of that page to sign up.

Register

Wednesday, May 16, 8:30 a.m. – 9:45 a.m. Register here
Wednesday, May 16, 4:00 p.m. – 5:15 p.m. Register here
Wednesday, May 23, 8:30 a.m. – 9:45 a.m. Register here
Wednesday, May 23, 4:00 p.m. – 5:15 p.m. Register here 

More information

For more information on the Schedule Loss of Use Guidelines, please see Subject No. 046-1011. The enabling regulation is set forth at 12 NYCRR 325-1.6, and is also available at the Board’s website.

FDA

FDA Suggests Reexamination of Safe Harbor Protecting Drug Rebates
Bloomberg News (5/3) reports Food and Drug Administration Commissioner Scott Gottlieb, MD, asked whether the legality of drug-plan rebates should be reconsidered. Dr. Gottlieb asked if the federal government should reexamine the safe harbor provision that prevents such rebates from being considered kickbacks.

Reuters (5/3) reports that Dr. Gottlieb has repeatedly criticized the common industry practice of setting high list prices for drugs, which are then lowered for health insurers through large rebates. Dr. Gottlieb asked in remarks prepared for a Food and Drug Law Institute conference, “What if we took on this system directly, by having the federal government reexamine the current safe harbor for drug rebates under the Anti-Kickback Statute?”

CMS

New Yorkers Will Be Getting New Medicare Cards Soon
CMS has three ways for card recipients to find out when they should expect new Medicare card in the mail:

  • Check out the map on Medicare.gov/NewCard. Remember, once card mailings begin in New York, it will take about a month from start to finish.
  • Keep an eye on email. CMS will send an email update when new Medicare cards start mailing in your state.
  • Log in to MyMedicare.gov account to see if a new card has been mailedSign up now at MyMedicare.gov —  it’s a free, secure, and easy way to access all your Medicare information in one place.

Brexit Starting to Drain U.K. Health Workforce
The National Health Service is bracing for an exodus of European doctors and nurses, POLITICO Europe reports. A new survey of 68 NHS hospitals and other care institutions found 1 in five have already altered recruitment plans, despite the U.K. not being scheduled to leave for another year. More than a third say the workforce impact of Brexit has been negative. The NHS relies heavily on non-British European doctors and nurses. Polls indicated one of the factors driving support for Brexit was improved funding for the U.K.’s taxpayer-funded health service. The Vote Leave campaign claimed free movement from the EU was creating unsustainable demands on health services. (Politico 5/1/18)

Uninsured Can Get Appointments but Cannot Pay Average Cost of $160
The US uninsurance rate has nearly been cut in half under the Affordable Care Act, and access to care has improved for the newly insured, but less is known about how the remaining uninsured have fared. In 2012–13 and again in 2016 Health Affairs conducted an experiment in which trained auditors called primary care offices, including federally qualified health centers, in ten states. The auditors portrayed uninsured patients seeking appointments and information on the cost of care and payment arrangements. In both time periods, about 80% of uninsured callers received appointments, provided they could pay the full cash amount. However, fewer than one in seven callers in both time periods received appointments for which they could make a payment arrangement to bring less than the full amount to the visit. Visit prices in both time periods averaged about $160. Trends were largely similar across states, despite their varying changes in the uninsurance rate. Federally qualified health centers provided the highest rates of primary care appointment availability and discounts for uninsured low-income patients. (Health Affairs April 2018) https://bit.ly/2HETH3K


Classified

RENTAL/LEASING SPACE

Thriving  Internal Medicine Practice for Sale by the Physician.
Has been growing exponentially, with number of patients doubling over last two years.
Has the visits-volume and the potential space & hours to keep expanding
The physician will stay to overlap for at least one year to personally transition all the practice’s patients, to seamlessly transfer all insurance account and to assist with acquirement of hospital privileges

Well established location at street level, with dedicated handicap entrance, easy access to public transportation, a parking lot and within one mile from all three leading local hospitals.
Fully credentialed as a medical practice site with all health insurances in the market, and compliant with Americans with Disability Act requirements. Office space lease guaranteed for extended period of time. Call 917-596-8936


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


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


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


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


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



PHYSICIAN OPPORTUNITIES


Private Multidisciplinary Medical Group Seeking Full Time or Part Time Podiatrist and Full Time or Part Time Internal Medicine/Family Practice/Allergy & Immunology Physicians.
Midtown, Union Square & Lower Manhattan locations. Attractive base salary plus comprehensive benefits package. E-mail CV to tsrgexpress@gmail.com. No recruiters please.


Chief of Medical Services
MINIMUM QUALIFICATIONS: Possession of a license and current registration to practice medicine in New York State, plus six years of experience in the practice of medicine, two years of which must be in an administrative or supervisory capacity. Appointee must be eligible for and maintain eligibility for full and unconditional participation in Medicaid and Medicare programs. Appropriate certification by an American Medical Specialty Board and one year of post certification experience in that specialty can be substituted for four years of general experience.
PREFERRED QUALIFICATIONS: Board certification in Geriatric Medicine and/or Certification as a Medical Director (AMDA), and experience in a long-term care facility.
RESPONSIBILITIES: Serve as Medical Director of a 242-bed skilled nursing facility for veterans and their dependents. Provide medical leadership and oversight ensuring the delivery of quality health care services while also ensuring compliance with clinical, statutory and regulatory standards.Send resume to:  NYS Veterans Home, Attn: Human Resources, 4207 State Highway 220, Oxford, NY 13830

The New York State Veterans Home at Oxford is a 242-bed skilled nursing facility operated by the NYS Department of Health located in Chenango County. It is an Affirmative Action/Equal Opportunity Employer. 


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


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


 

Council – May 10, 2018


AGENDA
    MSSNY Council Meeting
                  Courtyard Marriott Westbury Long Island
         1800 Privado Road
         Westbury, NY  11590
         Thursday, May 10, 2018, 9:00 a.m

A. Call to Order and Roll Call

B. Approval of the Council Minutes of Sunday, March 25, 2018

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

  1. President’s Report
    1. 2018 HOD Resolutions referred to Council (For Council Approval)
    2. Discussion on Physician Assisted Suicide – Jeffrey Berger, MD & Jay Federman, MD
  1. PresentationConcierge Medicine
    Dr. Dean P. McElwain, President and COO
    Castle Connolly Private Health Partners LLC

Dr. McElwain is a seasoned healthcare executive with nearly 30 years of progressive leadership in a variety of healthcare settings. Dr. McElwain has a professional doctorate (DPT) from Simmons College Graduate School for Health Studies, with a specialty in Health Care Administration.A recognized national thought leader in the area of Concierge Medicine, Dr. McElwain has provided guidance, leadership and innovation to more than 70 providers, as well as regional and national corporate clients over the last 9 years. Renowned organizations, such as the Lown Cardiovascular Institute, have relied on Dr. McElwain’s guidance for effective design and management when evaluating and or transitioning their practices to the subscription-based or concierge membership model.

A lifelong endurance athlete, Dr. McElwain is also a respected leader in the areas of Health Coaching, Wellness and Human Performance. Having completed undergraduate studies in exercise physiology as well as graduate studies in Physical Therapy, Dr. McElwain combines his passion and expertise in the areas of exercise, nutrition and wellness in leading a robust initiative to incorporate wellness into the practices and members he guides.

Dr. McElwain is a member of the American Academy of Private Physicians (AAPP) as well as the Healthcare Financial Managers Association (HFMA) and is an external consultant member of the Medical Group Managers Association (MGMA).

  1. Board of Trustees Report – Robert Hughes will present the report (handout)
  2. Secretary’s Report – Dr. Frank Dowling will present the report for Nominations for Life Membership, Dues Remissions & Special Life Membership requests
  3. MLMIC Update  –  Mr. Donald Fager will present a verbal report
  4. MSSNYPAC Report –   Joseph Sellers will present the report (handout)
  5. MESF Update – Dr. Charles Rothberg will present the report
  6. CME Update – Dr. Mark Adams (no written report submitted)
  7. Councilors (All Action Items, For Council Approval)
    a. Motion from New York County Medical Society:
        Joshua M. Cohen, MD, MPH, Manhattan and The Bronx Councilor
    Because of membership deals in recent years, county medical society leaders are more often asked to explain to members and prospective members why some pay full dues and others pay significantly less. Although MSSNY staff may have letters and information in place to formally send on such inquiries, the NYCMS Board agreed that when possible, doctors should be equipped to respond in the best way themselves.
    Therefore, the New York County Medical Society is asking the MSSNY Council to craft talking points so that members can respond to colleagues about dues differentials.

MOTION: THAT MSSNY CRAFT TALKING POINTS FOR COUNTY MEDICAL SOCIETY LEADERS TO USE TO ADDRESS QUERIES ABOUT MEMBERSHIP DEALS SOME RECEIVE AT SIGNIFICANTLY LOWER DUES RATES.

D. Reports of Officers (Verbal Reports)    

  1. Office of the President  – Thomas J. Madejski, MD
  2. Office of the President Elect – Arthur C. Fougner, MD
  3. Office of the Vice President –  Bonnie L. Litvack, MD
  4. Office of the Treasurer – Joseph R. Sellers, MD Financial Statement for the period 1/1/18 to 3/31/18
  5. Office of the Speaker – Kira A. Geraci-Ciradullo, MD

E. Reports of Councilors (Informational)

  1.           Kings and Richmond Report – Parag H. Mehta, MD
  2.           Manhattan and Bronx Report – Joshua M. Cohen, MD
  3.           Nassau County Report – Paul A. Pipia, MD
  4.           Queens County Report – Saulius J. Skeivys, MD
  5.           Suffolk County Report – Maria A. Basile, MD 
  6.           Third District Branch Report – Brian P. Murray, MD
  7.           Fourth District Branch Report – Gregory Pinto, MD
                  (no written report submitted)
  8.           Fifth District Branch Report –Howard H. Huang, MD
  9.           Sixth District Branch Report – Robert A. Hesson, MD
  10.         Seventh District Branch Report – Janine L. Fogarty, MD
  11.         Eighth District Branch Report – Edward Kelly Bartels, MD
  12.         Ninth District Branch Report  –  Thomas T. Lee, MD
  13.         Medical Student Section Report –  Breyen Coffin
  14.         Organized Medical Staff Section – Stephen F. Coccaro, MD
                  (no written report submitted)
  15.         Resident and Fellow Section Report – Justin Fuehrer, DO
  16.         Young Physician Section Report – L. Carlos Zapata, MD
                  (no written report submitted)

F. Commissioners (Committee Action & Informational Items)

  1. Commissioner of Communications, Maria A. Basile, MD, MBA
         Report of the Division of Communications
  1. Commissioner of Governmental Relations, Gregory Pinto, MD
        Report From The Division Of Governmental Affairs
  2. Commissioner of Membership, Parag H. Mehta, MD
    Membership Committee Discussion & Action Items:
    At the 2018 meeting of the MSSNY House of Delegates, the International Medical Graduate caucus considered a number of issues and focused on ways to increase participation of IMGs in the medical societies.
    One suggestion was to engage those international medical students doing clinical rotations in New York at the stage of their career when they are starting out on the difficult path to New York State medical licensure.  To exclude a segment of the future NYS physician workforce from membership when they most need support runs counter to our mission as a medical society and is likely to have a negative effect on those individuals’ future membership decisions.
    The IMG Caucus agreed to ask MSSNY to change its definition of medical student for the purposes of society membership so that it will also include those attending medical school outside the United States who are doing approved clinical rotations in New York State.
    It’s understood that a Bylaw change would be needed to make this happen, and the draft language below will be circulated to members of the IMG Committee and the IMG Caucus for feedback before submitting it as a resolution for the 2019 HOD.


    PROPOSED BYLAW AMENDMENT:
    Student members shall be those members
    (1)(a) enrolled in an LCME-accredited medical or AOA-accredited osteopathic school or (b) enrolled in a medical or osteopathic school that is approved to place students in clinical clerkships in teaching hospitals in New York State, and (2) attend such medical or osteopathic school or maintain a residence in New York State.  (FOR COUNCIL DISCUSSION)


    PROPOSED PILOT PROJECT:
    MSSNY’s Membership Committee is drawing up plans with the Medical Student Section to make the most of the House of Delegates’ decision to offer free membership to medical students.  We would like to be able to take advantage of the energy being focused on medical student recruitment in our contacts with international students during the nearly three years it will take for a Bylaws amendment to be passed.

    Therefore it has been suggested that we consider other ways to appeal to international students and make them feel welcome in the meantime.

    I propose that as a pilot project in participating counties, MSSNY and the county medical society offer member benefits and services to international medical students engaged locally in New York State-approved clinical rotations free of charge until such time as they are eligible for student or other membership in the societies.  This would include invitations to county and state medical society meetings, without the right to vote unless and until formal membership is obtained.  (FOR COUNCIL APPROVAL)

  1. Commissioner of Science and Pubic Health, Joshua M. Cohen, MD
  1. Commissioner of Socio Medical Economics, Howard H. Huang, MD
        Interspecialty Committee Minutes, March 1, 2018

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

  1. Membership Dues Revenue Schedule
  2. Group Institutional Dues Schedule

H. Report of the General Counsel, Garfunkel Wild, P.C.
     Request for assistance as amicus curiae (handout)

I. Report of the Alliance, Barbara Ellman, Co-President
    Alliance Report

J. Other Information/Announcements

  1. PAI Letters to U.S. House of Representatives – Improving 340B Program Transparency, Child Site Eligibility and the Patient Definition
  2. Final E-Prescribing Controlled Substances Letter
  3. NYS Society of Plastic Surgeons/Opposition to MOC Bill

K. Adjournment

April 27, 2018 – Preserving, Not Ending, Life

 

Thomas J. Madejski, MD MSSNY President
PRESIDENT’S MESSAGE
Thomas J. Madejski, MD
MSSNY President
April 27, 2018
Volume 18
Number 16

Dear Colleagues:

Physicians Should Preserve Life, Not End Life
This week, I testified before the Assembly Committee on Health. The topic was one of great sensitivity—Medical Aid in Dying. I am a practicing internist who specializes in geriatric medicine and palliative care and have dealt with the question of physician assisted suicide or aid in dying with some frequency over the years.  First and foremost, I believe that we, as a profession, and as a society, need to create an environment that eliminates the desire for a patient to contemplate ending their life due to fear of inadequate care at the end of their life. I have tasked the MSSNY Long-Term Care committee and our Health Care Disparities committees— in addition to our Bioethics Committee— to explore this controversial topic further.

A bill (2383A) is before the Assembly that would permit a terminally patient to request medication from a physician to be self-administered for the purpose of hastening the patient’s death. Until the law changes, aid in dying or assisted suicide by a physician is illegal in New York. The New York Court of Appeals September 7, 2017, Myers v Schneiderman, decision reaffirms that.

At the request of the House of Delegates, MSSNY sent out a survey in an attempt to get a pulse on what physicians were thinking.  The Bioethics Committee took great care to create a survey that would not influence the response in either direction. We know there were attempts by organizations with interests on both sides that sought to influence the outcome.

We are in the process of reviewing the survey.  Preliminary results revealed a large majority indicated that such a measure could have a negative impact on healthcare among racial and ethnic minorities and the physically disabled. Equally troubling were physicians’ concerns regarding the negative impact on trust between the physician and patients.

Here are a few excerpts from my testimony:

  • This is a very complicated and controversial issue within our membership.  There are passionate physicians on both sides making well-reasoned arguments. MSSNY’s long-standing position against “aid in dying” is based upon the sacred principle that physicians are dedicated to healing and preserving life, not ending it.
  • Although relief of suffering has always been a fundamental duty in medical practice, relief of suffering through shortening of life has not. Moreover, the social and societal implications of such a fundamental change cannot be fully contemplated.
  • Many physicians are deeply troubled by the potential abandonment of a patient by their physician at their time of greatest need of their physician’s skill and caring. Although the proposed legislation requires two physicians to certify a patient, prognostication, particularly with regards to time left before death is one of our most difficult assessments.

Full testimony here. 

MSSNY is committed to work with physicians and groups on both sides of this difficult question to continue to improve the access to and the quality of palliative care for all of our patients, particularly in our last days.

I am interested in hearing your comments on this topic: comments@mssny.org

Thomas J. Madejski, MD 
MSSNY President

 


HIT MLMIC Symposium


Capital Update

Please Urge Your Legislators to Enact Legislation to Address Prior Authorization Hassles and Expand Patient Choice of Physicians
Physicians are urged to express their support for several health insurance reform bills strongly supported by MSSNY that would reduce administrative barriers imposed by health insurance companies that interfere with patient care, and expand patient choice by limiting the ability of health insurers to narrow their networks.  These bills include:

  • 3663 (Hannon)/A.4472 (Gottfried) – would permit independently practicing physicians to collectively negotiate patient care terms with market dominant health insurers under close state supervision. In addition to the ability to push back against exorbitant administrative hassles imposed by insurers, it would also help to protect physicians to have a stronger option to remain in independent practice. The bills have is in the Senate Health Committee, and the Assembly Ways and Means Committee.  Please send a letter to your legislators in support here.
  • 3943 (Hannon)/A.2704 (Lavine) – would provide physicians and other health care practitioners with necessary due process protections where health insurers seek to terminate a physician from its network by failing to renew the physician’s contract.  The bill is on the Assembly floor and in the Senate Health Committee.  Please send a letter of support here.
  • 5675 (Hannon)/A.7671 (Rosenthal) – would require health insurers to make out of network coverage options available through the New York Health Insurance Exchange. Currently, there are no out of network coverage options in the Exchange in downstate New York, despite Exchange officials strongly encouraging the offering of these options by insurers.  The bills are in the Senate Health and Assembly Insurance Committee. Please send a letter to your legislators in support here.
  • 7872 (Hannon)/A.9588 (Gottfried) – would reduce prior authorization hassles by requiring health plan utilization review criteria to be evidence-based and peer reviewed; reducing the time frame for reviewing prior authorization requests from 3 business days to 48 hours (and to 24 hours for urgent situations); assuring that a prior authorization, once given, is enduring for the duration of the medication or treatment; prohibiting mid-year prescription formulary changes; and assuring that once a prior authorization is given, it cannot be withdrawn if eligibility is confirmed on the day of the service. Please send a letter to your legislators in support here.

MSSNY shared with the entire State Legislature the results of a recent AMA survey (here) that showed that a staggering 92% of physicians believe that prior authorization programs have a negative impact on patient clinical outcomes.   Moreover, the survey also showed that 84% of responding physicians said that burdens associated with prior authorization were high or extremely high; and that 86% reported that these PA requirements had increased in the last 5 years.  Moreover, every week a medical practice completes an average of 29 PA requirements per physician, which take an average 14.6 hours to process.                                                                      (AUSTER)

Election Updates and the Need for the MSSNY PAL Program
Democratic Assembly members Luis Sepulveda and Shelley Mayer won two special elections for the New York State Senate on Tuesday.  While this gives them a numerical one-vote advantage in the Senate, Brooklyn Senator Simcha Felder indicated that he will continue to caucus with Republicans.  If this continues throughout the rest of the legislative session, the Republicans will maintain control of the State Senate.

In one of the special election race on Long Island, Democrats “flipped “a long-Republican State Assembly district that has been held by a Republican for forty years.  For a complete breakdown of all the election results, please click here.

MSSNY’s Physician Advocacy Liaison (PAL) program continues to grow and is an integral part of our advocacy  efforts.  With nine new members of the legislature brand new to the Assembly and two Assembly members moving to the Senate, the PAL program continues to be a vital way for elected officials to hear directly from their physicians.  Additionally, Senator DeFrancisco, Senator Marchione and Senator Bonacic have announced that they will not seek re-election in November.  The MSSNY PAL program will be an engine to help drive our efforts to engage all of our elected officials regarding how best to improve our health care system.  This will take one conversation at a time and is reliant upon physicians taking the time to meet with their elected officials regularly.

Please contact John Belmont at jbelmont@mssny.org to sign up. (BELMONT)

MSSNY President Testifies on Aid in Dying Legislation
Thomas J. Madejski, MD, President of the Medical Society of the State of New York testified on Monday, April 23, 2018 before the Assembly Committee on Health on the issue of aid in dying legislation.  To read the press release about his testimony, (click here).  A. 2883A/S.3151, sponsored by Assemblywoman Amy Paulin and Senator Diane Savino, would permit a terminally ill patient to request medication from physicians to be self-administered for the purpose of hastening the patient’s death.  This measure is within each houses respective health committee.

There were physicians, patients, individuals from the disabled community, and clergy that spoke in support and opposition to this legislation.   There will be another public Assembly Health Committee hearing on this issue on May 3, 2018 in New York City.   More information on this and a copy of Dr. Madejski’s testimony can be found in his weekly column.
(CLANCY)

Cross-Sector Health Care Mega-Mergers of Growing Concern to Health Care Delivery
Recently MSSNY President Dr. Thomas Madejski issued a press release (click here) reiterating the significant concerns that many physicians have with the potentially serious encroachment of corporate interests into medical care delivery arising from proposed cross-sectors mergers such as CVS-Aetna, Cigna-Express Scripts and Walmart-Humana.

At the same time, MSSNY has written to the New York State Attorney General’s office urging that they assess the potential antitrust implications of these potential acquisitions and, as appropriate, convey these concerns to the federal agencies such as the Department of Justice reviewing these proposed transactions.   Among the concerns of these proposed “mega-mergers” include:

  • Further reduction of patient choice of pharmacy, as it may become harder for pharmacies not affiliated with CVS or Walmart to be incorporated into these merged entities’ pharmaceutical networks;
  • Enabling subsidiary PBMs to impose even more burdensome prior authorization hassles for physicians and their staff as a pre-condition for patients receiving needed prescription medications.
  • The potential proliferation of so-called “retail clinics,” owned by an insurance company/retailer, that could have great incentive to steer patients to these sites instead of a community based primary care practice that typically serves as a patient’s medical home, and the adverse impact to patient care that could result from the loss of physician-led medical homes.

MSSNY also shared with the New York Attorney General’s office written testimony from the American Medical Association to the U.S. House of Representatives Judiciary Committee expressing very serious concerns with these cross-sector mergers (click here).

“It is imperative that our state and federal investigatory agencies carefully review the impact of this cross-sector consolidation on patient care delivery and access before any such consolidation is permitted to move forward,” stated Dr. Madejski, “We also urge the enactment of measures that would enable independently practicing physicians to counter such consolidation by being permitted to come together to negotiate on behalf of their patients against these corporate behemoths.”                                                          (AUSTER)



Bending the Diabetes Curve CME Course Available Online
The Medical Society of the State of New York is proud to announce that the Bending the Diabetes Curve webinar is now available to view online! MSSNY has partnered with the American Medical Association to bring its Prevent Diabetes STAT initiative to New York.  MSSNY has created a free CME program to educate New York State physicians on prediabetes prevention and the CDC’s National Diabetes Prevention program.  To share your current knowledge of the diabetes prevention program, click here to take a quick survey.

Webinar: Bending the Diabetes Curve
Faculty: Geoffrey Moore, MD & Sarah Nosal, MD

Educational Objectives:

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

To view this course, click here.

MSSNY is dedicated to educating the physician population on prediabetes and will be providing educational webinars and podcasts in the coming weeks. Physicians are encouraged to visit our Diabetes webpage to learn more about MSSNY’s collaboration with the AMA and the Prevent Diabetes STAT toolkit.

The Medical Society of the State of New York is accredited by the Accreditation Council for Continuing Medical Education (ACCME) to provide continuing medical education for physicians.  The Medical Society of the State of New York designates each of these live activities for a maximum of 1.0 AMA/PRA Category 1 credits™.  Physicians should claim only the credit commensurate with the extent of their participation in the activity.

Additional information or assistance with registration may be obtained by contacting Carrie Harring at charring@mssny.org.                                        (CLANCY, HARRING)

Medical Society of the State of New York Announces May and June CME Webinar Schedule
The Medical Society of the State of New York is pleased to announce its free Continuing Medical Education (CME) webinars for May and June.  Participation in the webinars will earn physicians one CME credit free of charge.   The webinar schedule for May and June is as follows: 

May 16th at 7:30amMedical Matters: Physically &Biologically Derived Chemical Agents: An Overview

Register for this webinar here.

Faculty: Arthur Cooper, MD, MS

Educational Objectives:

  • Acquire a basic understanding of physically and biologically derived chemical agents
  • Identify types of physically and biologically derived chemical agents used as chemical weapons
  • Understand the indicators of each type of chemical agent
  • Describe the treatment of each type of chemical agent
  • Identify local and state resources

May 24th at 7:30amCurrent Concepts in Concussion for Pediatric and Adult Patients

Register for this webinar here.
Faculty: Deborah Light, MD & John Pugh, MD, PhD

Educational Objectives:

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

June 20th at 12:30pmMedical Matters: Children’s Mental Health After Disaster

Register for this webinar here.
Faculty: Linda Chokroverty, MD

Educational Objectives:

  • Enhance physician’s understanding of the impact of disaster on children’s and family mental health
  • Improve physician skills to address potential psychiatric problems in children and families following a disaster

To view all of MSSNY’s scheduled programs, click here and select “Training Center” and “Upcoming”.

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

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

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

National Drug Take Back Day April 28
The Medical Society of the State of New York supports National Prescription Drug Take Back Day which will be held Saturday, April 28, 2018.  Take Back Day allows anyone who has unused, unwanted, and expired prescription medications to drop them off at one of the thousands of drop-off sites on Saturday. The Drug Enforcement Administration website and Google have locators for the closest sites to where patients live. Last year, the DEA reported that 456 tons of prescriptions were turned in.                            (CLANCY)  


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

pschuh@mssny.org   mauster@mssny.org  pclancy@mssny.org  


eNews

E. Coli Outbreak Is Largest In US Since 2006
The New York Times (4/26) reports on the multistate E. coli outbreak linked to romaine lettuce from Yuma, Arizona. It is “the largest multistate food-borne E. coli outbreak since 2006, according to data from the Centers for Disease Control and Prevention,” the Times reports, adding that the larger 2006 incident “was traced to spinach and linked to 238 illnesses and five deaths.”

CDC data “suggest that leafy greens cause roughly a fifth of all foodborne illnesses,” and food safety experts say convenience greens “carry an extra risk because they come in contact with more people and machinery” before distribution.

Patient Groups, Providers Pushing Back Against Opioid Prescription Limits
The Wall Street Journal (4/2,) reports on the growing number of obstacles faced by individuals with legitimate need of opioid medications. Patient groups and healthcare providers are increasingly challenging opioid prescription limits being implemented to curb abuse. The groups say such measures do little to curtail increasingly illicit opioid abuse, and the Journal reports the American Hospital Association has warned lawmakers against a proposed three-day limit on first-time opioid prescriptions.

DOH Presents Update on Doctors Across New York Application Process
The New York State Department of Health held a webinar that updated the funding opportunities for the New York State Doctors Across New York (“DANY”) program.  DANY programs make funds available to help recruit physicians to practice in medically underserved areas of the state.

Applicants must be registered in the Grants Gateway in order to apply for this grant opportunity. If you have any potential interest in applying for this program, DOH recommends that you start the process now by applying for a Grants Gateway account by clicking here.  Additionally, organizations must register in the New York State Grants Gateway system prior to applying for a Grant Opportunity with a State Agency.  Here is a tutorial on how to apply.

While the application eligibility process doesn’t open until May 16, 2018, applicants are encouraged to register in Grants Gateway immediately.  The status will change on May 16, 2018 when it will become an open grant opportunity in the Gateway under the following ID number: DOH01-DRPLR5-2019. Again this opportunity will not be OPEN until May 16, 2018.

The recording of the webinar will be posted to the Department’s web site soon. Additionally, here is a link to additional Grants Gateway Videos.

Black Physicians Network of Rochester Hosted Conference on Substance Abuse
The Black Physicians Network of Greater Rochester, in conjunction with National Black Commission on AIDS, the Interdenominational Health Ministry Coalition and Colgate Rochester Crozer Divinity School presented a conference on substance abuse disorders in African Americans on Saturday, April 14th at the Rochester Riverside Hotel in Rochester New York.  This was the 6th annual “Faith and Medicine – Working Together to Eliminate Health Disparities” Conference in Rochester. Health professionals joined with faith leaders and community members to understand substance abuse disorders in African Americans – using data, case studies and personal stories.

We learned from data compiled by Common Ground Health that ER visits for substance use disorders were three times higher in blacks than whites in the Finger Lakes region.  We also learned that blacks live longer with substance abuse and die of overdose at a much older age that whites.

Mark Sanders, a substance abuse professional from Chicago, IL spoke about substance abuse issues in the African American population, putting a historical perspective in place, and relating this directly to Rochester, when noting that Frederick Douglass was the first noted African American in recovery from alcohol abuse. Roland Lamb, the deputy commissioner of the Department of Behavioral Health and Intellectual Disability Services, responsible for planning and innovation.

He challenged us to think creatively about the problem of substance abuse, and understand that social determinants, such as stable housing, play a critical role in building and environment conducive to recovery.  Felicia Lee-Sexton brought her very personal story of addiction and recovery to us, and showed how she was able to triumph, providing inspiration and motivation to us all.

The culmination of the program resulted in bringing forth ideas of how to improve the workplace, the doctor’s office / clinic, houses of worship and the home so that they are helpful to those in recovery. Many of these involved specific ways to reduce stigma, provide education and tangible assistance to those in need in a confidential manner. Conference director, Dr. Linda Clark, co-chair of the MSSNY Committee to Eliminate Health Disparitie,s is now working with the planning team to help implement some of the suggestions put forth by conference attendees.

Congress Moves On Opioids
The House Energy and Commerce Committee’s Subcommittee on Health yesterday advanced 56 bills intended to address the U.S. opioid epidemic though several committee Democrats raised concerns that the bills were approved too quickly. The House subcommittee’s votes came one day after the Senate Health, Education, Labor and Pensions committee approved a separate bipartisan package of opioid bills. (The Hill, 4/25)

Hospital Cash Flow Margin Declined Below 20008-2009 Levels
The median operating cash flow margin for nonprofit and public hospitals declined to 8.1% last year, falling below levels recorded during the 2008-2009 economic recession, according to a preliminary analysis released this week by Moody’s Investors Service. The analysis is based on financial statements for fiscal year 2017 from 160 nonprofit and public hospitals and health systems with credit ratings from Moody’s. (Wall Street Journal, 4/23)


LUPUS WALK to End Lupus NOW, Sat., May 5, Seaport District Pier 17, 89 South Street NYC @ 8:30 Registration

For Info: https://bit.ly/2FgTpKi


 

CMS

CMS Seeks to Allow Doctors to Bill Patients Directly
The CMS wants to launch a new model that will allow Medicare enrollees to contract directly with physicians. Advocates warn the approach could undermine access to care for the sickest patients.  In its announcement Monday, the CMS said that a direct provider contract model would allow providers to take further accountability for the cost and quality of a designated population to drive better beneficiary outcomes. 
“Such a model would have the potential to enhance the doctor-patient relationship by eliminating administrative burden for clinicians and providing increased flexibility to provide the high-quality care that is most appropriate for their patients, thus improving quality while reducing expenditures,” the CMS said in an announcement.

The CMS said it plans to launch the model in response to comments received late last year to an RFI on what new priorities the CMS Innovation Center should pursue. The agency received 1,000 comments, which were all posted on Monday.

CMS is looking for your comments of the following RFI.

https://innovation.cms.gov/Files/x/dpc-rfi.pdf



Classified

RENTAL/LEASING SPACE

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


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


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


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


PHYSICIAN OPPORTUNITIES


Chief of Medical Services
MINIMUM QUALIFICATIONS: Possession of a license and current registration to practice medicine in New York State, plus six years of experience in the practice of medicine, two years of which must be in an administrative or supervisory capacity. Appointee must be eligible for and maintain eligibility for full and unconditional participation in Medicaid and Medicare programs. Appropriate certification by an American Medical Specialty Board and one year of post certification experience in that specialty can be substituted for four years of general experience.
PREFERRED QUALIFICATIONS: Board certification in Geriatric Medicine and/or Certification as a Medical Director (AMDA), and experience in a long-term care facility.
RESPONSIBILITIES: Serve as Medical Director of a 242-bed skilled nursing facility for veterans and their dependents. Provide medical leadership and oversight ensuring the delivery of quality health care services while also ensuring compliance with clinical, statutory and regulatory standards.Send resume to:  NYS Veterans Home, Attn: Human Resources, 4207 State Highway 220, Oxford, NY 13830

The New York State Veterans Home at Oxford is a 242-bed skilled nursing facility operated by the NYS Department of Health located in Chenango County. It is an Affirmative Action/Equal Opportunity Employer. 


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


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


 

April 20, 2018 – Medical & Non-Medical Marijuana?

 

Thomas J. Madejski, MD MSSNY President
PRESIDENT’S MESSAGE
Thomas J. Madejski, MD
MSSNY President
April 20, 2018
Volume 18
Number 15

Dear Colleagues:

The use of marijuana to treat medical conditions is a very complicated topic that merits further in-depth study.

While MSSNY has policy (MSSNY Policy 65.985 MSSNY Opposes Recreational Marijuana Legalization) that opposes legalization of marijuana, I salute Governor Cuomo’s efforts to ensure that the health, criminal justice, and economic  impacts of marijuana be fully examined should New York State move to a regulated marijuana program in the state. Our Governor understands fully that there could be public health and economic impacts as more and more of New York’s surrounding states move to legalize marijuana. The governor also acknowledges and recognizes recent action by the United States Attorney General Jeff Sessions to rescind the Obama Administration guidelines that allowed states that had authorized the use of marijuana under state law to operate without fear of federal prosecution.

Governor Cuomo has charged the New York State Department of Health with the formation of an interagency task force to consider the health, criminal justice, public safety, economic and education effects of non-medicinal use of marijuana.  His newly developed website indicates the  task force will look at:

  • the benefits and consequences of a regulated marijuana program
  • Public Health Impact on individual populations from a social justice perspective

The task force will also look at the impact on public safety; the overall financial impact, economic development and revenue, and education of the public with public health and public safety messaging.

Increased availability of marijuana has contributed to marijuana becoming the number one illicit substance detected in motor vehicle accidents.

One of MSSNY’s top concerns with New York’s medical marijuana law has been with the possibility of federal prosecution for physicians who are participating in New York’s marijuana program for medicinal use.  With the US Attorney General’s action increasing the possibility of such prosecution, New York must gain a greater understanding of how this could affect prescribers.

There is still a relative dearth of knowledge about the usefulness and potential harm associated with medicinal and recreational use of marijuana. At MSSNY’s recent House of Delegates, we reaffirmed our call for moving marijuana from Schedule I to Schedule II.  Reclassification to Schedule II will remove major barriers to research on marijuana and whether marijuana is a safe and effective treatment for pain and other medical conditions. Due to a lack of evidence based medicine and studies, particularly longitudinal studies that can evaluate the long term consequences of marijuana use, we don’t know the long term impact upon adults and children from continued use of marijuana.

Most importantly, New York State does not want to create a new type of industry, similar to the tobacco industry that addicted millions of adults and children. We have spent a lifetime trying to combat the scourge of tobacco. Our current opioid crisis was fueled in part by poor data, misguided regulatory advice to treat pain more aggressively, and perhaps overly aggressive marketing efforts by some opioid drug manufacturers.

Certainly, a “go slow approach” is the correct way to approach any type of legalization of marijuana and I applaud Governor Cuomo efforts on this.

Those who cannot recall history often re-experience it.

I’d appreciate hearing your thoughts at comments@mssny.org

Thomas J. Madejski, MD 
MSSNY President


HIT MLMIC Symposium


Capital Update
Please Urge Your Legislators to Enact Legislation to Address Prior Authorization Hassles and Expand Patient Choice of Physicians
Physicians are urged to express their support for several health insurance reform bills strongly supported by MSSNY that would reduce administrative barriers imposed by health insurance companies that interfere with patient care, and expand patient choice by limiting the ability of health insurers to narrow their networks. These bills include:
  • 3663 (Hannon)/A.4472 (Gottfried) – would permit independently practicing physicians to collectively negotiate patient care terms with market dominant health insurers under close state supervision. In addition to the ability to push back against exorbitant administrative hassles imposed by insurers, it would also help to protect physicians to have a stronger option to remain in independent practice. The bills are is in the Senate Health Committee, and the Assembly Ways and Means Committee. Please send a letter to your legislators in support please click here.
  • 3943 (Hannon)/A.2704 (Lavine) – would provide physicians and other health care practitioners with necessary due process protections where health insurers seek to terminate a physician from its network by failing to renew the physician’s contract. The bill is on the Assembly floor and in the Senate Health Committee. Please send a letter in support please click here.
  • 5675 (Hannon)/A.7671 (Rosenthal) – would require health insurers to make out of network coverage options available through the New York Health Insurance Exchange. Currently, there are no out of network coverage options in the Exchange in downstate New York, despite Exchange officials strongly encouraging the offering of these options by insurers. The bills are in the Senate Health and Assembly Insurance Committee. Please send a letter to your legislators in support please click here.
  • 7872 (Hannon)/A.9588 (Gottfried) – would reduce prior authorization hassles by requiring health plan utilization review criteria to be evidence-based and peer reviewed; reducing the time frame for reviewing prior authorization requests from 3 business days to 48 hours (and to 24 hours for urgent situations); assuring that a prior authorization, once given, is enduring for the duration of the medication or treatment; prohibiting mid- year prescription formulary changes; and assuring that once a prior authorization is given, it cannot be withdrawn if eligibility is confirmed on the day of the service.

Last week, MSSNY shared with the entire State Legislature the results of a recent AMA survey (please click here.)

that showed that a staggering 92% of physicians believe that prior authorization programs have a negative impact on patient clinical outcomes. Moreover, the survey also showed that 84% of responding physicians said that burdens associated with prior authorization were high or extremely high; and that 86% reported that these PA requirements had increased in the last 5 years. Moreover, every week a medical practice completes an average of 29 PA requirements per physician, which take an average 14.6 hours to process.
(AUSTER)

WCB Announces Efforts to Expand Care Availability for Injured Workers by Addressing Physician Concerns with WC System
New York Workers Compensation Board Chair Clarissa Rodriguez announced this week that the WCB intends to pursue measures to “increase provider participation in the workers’ compensation system and improve injured workers’ access to timely, quality medical care”. To read the announcement please click here. The proposals would address a number of concerns raised by MSSNY regarding the functions of the WC program.

Specifically, she noted that the WCB will be advancing a regulation to increase medical care delivery fees and enable use of the universal CMS-1500 form in lieu of existing board forms to reduce administrative burden. According to the  written announcement, these proposals are being advanced to respond to “claimants’ challenges in finding treating providers, and concerns from health care providers around low fees and complexity that keep some from participating.”

With regard to the proposed fee increase, the WCB will advance a regulation in June to increase medical fees for  services provided after October 1, 2018. The proposal will include an overall statewide fee increase for all provider types, with additional increases for certain specialty provider groups that have an extreme shortage of authorized providers. The announcement noted that “these new fees will ensure providers in New York are receiving fair and reasonable reimbursement for prompt, quality treatment to our injured workers.” However it is not clear yet the manner by which these fees will be raised.

The announcement also noted that Board will propose replacing the current Board treatment forms (C-4 and C-4.2, and equivalent OT/PT and PS forms) with the CMS-1500. The Board will be working towards a January 1, 2019, implementation date.

The announcement also noted other efforts the Board is pursuing including:

  • Implementing an “electronic medical portal” which will allow physicians “to quickly and easily identify whether their course of treatment is consistent with the Board’s medical treatment guidelines and, if not, advise them that a variance is needed”; and
  • A comprehensive legislative proposal that would expand the types of providers that may treat injured workers. Including nurse practitioners, physician’s assistants, licensed clinical social workers, and other providers. It should be noted that MSSNY has expressed concerns with similar legislative proposals in previous years because it did not include provisions to require patient care coordination with a physician. MSSNY has also expressed concerns that such legislature proposals have removed the ability of county medical societies to credential physicians to participate in workers

Please remain alert for further updates on this issue.      (AUSTER, BELMONT)



Opioid Prescribing By Physicians Decreases 20% in New York State Between 2013-2017
Opioid prescribing by physicians and other health care professionals in New York decreased by 20.3% between 2013 and 2017 according to State and National Totals of Retail Filled Prescriptions: All Opioid Analgesics, 2013-2017 report issued by IQVIA. New York State opioid prescribing levels decrease by 8.4% in the 2016-17.

This reflects a nationwide trend — 22.2% fewer opioid prescriptions were filled in 2017 than had been filled in 2013. Every state in the nation has shown a significant reduction in opioid analgesic prescriptions since 2013, and every state showed a decline in the last year. Patrice A. Harris, MD, MA, chair of the AMA Opioid Task Force said that the fact that physicians and other health care professionals are increasingly judicious when prescribing opioids is “tempered by the fact that deaths related to heroin and illicit fentanyl are increasing at a staggering rate, and deaths related to prescription opioids also continue to rise.

These statistics again prove that simply decreasing prescription opioid supplies will not end the epidemic. We need well-designed initiatives that bring together public and private insurers, policymakers, public health infrastructure, and communities with the shared goal to improve access and coverage for comprehensive pain management and treatment for substance use disorders.” MSSNY’s is one of seven state medical societies that are on the AMA’s Opioid Task Force. A copy of the IQVIA report and its analysis can be found here: (CLANCY)

MSSNY Urges for Extension of Committee for Physicians Health Program
MSSNY continues to advocate for legislation (A.10221, Gottfried, S.8093, Hannon) that would extend for an additional 5 years the continued operations of the MSSNY Committee for Physicians Health (CPH) program. Authorization for several key components of the program expired on March 31, 2018.
The CPH is a program designed to confront and assist physicians thought to be suffering from alcoholism, substance abuse or mental illness. Since the inception of this program, CPH has assisted thousands of physicians in returning healthy to medical practice. The work of the CPH program is an important public service both to our health care
system as well as the general public.

As a result, the State Budget annually includes an appropriation of $990,000 for the program, which is generated from a $30 assessment on all physicians’ biennial registration fees.

The program has traditionally been extended by the Legislature in 3 or 5 year “demonstration programs” with the most recent extension in 2013. The recently enacted State Budget included a provision to create another “demonstration program” until 2023. However, it omitted other provisions historically extended at the same time that are essential to its functioning that could greatly impair its operations unless immediate action is taken. These includes provisions that set forth the CPH program’s reporting requirements to the Office of Professional Medical Conduct (OPMC), provisions to ensure liability protections for the physician Committee members for work performed in the scope of CPH, and necessary confidentiality protections for the program given the sensitivity of the work they perform.

These protections are absolutely essential to the continued functioning of the program to ensure that physicians with the appropriate expertise are willing to serve on the Committee, as well as to assure that the program has the ability to report sensitive information to OPMC when warranted by the circumstances. (DIVISION OF GOVERNMENTAL AFFAIRS)

MSSNY Participates in Interagency Workgroup on Organ and Tissue Donation
The Interagency Workgroup on Organ and Tissue Donation convened in Albany this week to discuss ways to increase the number of organ donors on the New York State Donate Life Registry. Representatives from multiple State agencies including the Department of Motor Vehicles and Department of Environmental Conservation worked alongside executives from HANYS, Greater NY, and MSSNY to discuss best practices and next steps.

Currently, there are over 10,000 New Yorkers waiting for a transplant, however only 32% of the eligible population is registered to be a donor. This means 1 person dies while waiting for a transplant every 19 hours. To learn more about organ donation, please click here: (CLANCY, HARRING)

Register now for the Medical Society of the State of New York’s May 2018 Medical Matters CME Webinar Program
The Medical Society of the State of New York is pleased to announce its free Continuing Medical Education (CME) webinar for May, 2018.  Participation in this webinar will earn physicians one CME credit free of charge.  

May 16 at 7:30am – Medical Matters: Physically and Biologically Derived Chemical Agents: An Overview

Register for this webinar here:
Faculty: Arthur Cooper, MD

Educational Objectives:

  • Acquire a basic understanding of physically and biologically derived chemical agents
  • Identify types of physically and biologically derived chemical agents used as chemical weapons
  • Understand the indicators of each type of chemical agent
  • Describe the treatment of each type of chemical agent
  • Identify local and state resources

To view all of MSSNY’s scheduled programs, click here: and select “Upcoming”.

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

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

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

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

pschuh@mssny.org   mauster@mssny.org  pclancy@mssny.org  


eNews

Five Million Organ Donors Enrolled in NYS Donate Life Registry
Efforts by the state and nonprofit organizations to boost the number of New Yorkers registered to donate their organs are paying off. Gov. Andrew Cuomo has announced that more than 5 million New Yorkers are now enrolled in the New York State Donate Life Registry as organ donors. The Governor said that organ donation rates have reached historic levels due to several coordinated efforts. Those efforts include the state Department of Health working with the group Donate Life New York State to create a more modernized and expanded registry that streamlined the process.

An executive order issued last year by Cuomo has also helped increase donors by allowing state agencies to provide opportunities for people to enroll in the registry when applying for government benefits, services and licenses. 

Insurer–PBM Mergers to Lower Medical Costs, Says Moody’s
Moody’s Investors Service issued a report Tuesday with an optimistic outlook on the impact of recent mergers on medical costs as well as on the credit ratings of the companies involved.

The recently announced Aetna–CVS Health and Cigna–Express Scripts mergers are likely to be credit-positive in the long term because of their ability to lower health care costs, Moody’s said. Cigna is likely to benefit incrementally from its purchase of Express Scripts by integrating Express Scripts’ ability to manage pharmacy costs, although Express Scripts does not have the benefit of CVS’ retail presence, Moody’s noted.

MSSNY has expressed concern that the CVS–Aetna deal will drive patients away from doctors’ offices and into the company’s local retail clinics.

Researchers Find Antibiotic-Resistant Bacteria and New Viruses in NYC Mice
The New York Times (4/17) reports that in two studies, a team of researchers found antibiotic-resistant bacteria and viruses in mice living in the basements of apartment buildings in New York City. The researchers “collected feces from more than 400 mice captured over a year in eight buildings in Manhattan, Brooklyn, Queens and the Bronx,” and “then analyzed the droppings for bacteria and viruses.

In one study, published in mBio, the researchers found that the mice carried dangerous bacteria, including antibiotic-resistant bacteria. In the other study, also published in mBio, the researchers identified 36 types of viruses. The study’s authors collaborated with researchers at the Centers for Disease Control and Prevention who “matched the strains of C. difficile from these mice to types known to cause infections in humans.” The researchers also identified six new viruses. The researchers found that 14 percent of the mice carried Shigella, 12 percent carried Clostridium perfringens, 4 percent carried C. difficile, 4 percent carried E. coli, and 3 percent carried salmonella.

Advocates Want NY to Take Action to Reduce Black Women’s Maternal Mortality
The AP (4/17) reports women’s health advocates are calling for New York to take action to reduce maternal mortality among black women. On Monday, “Planned Parenthood of New York leaders, state Assembly members and maternity health services providers held a news conference in Albany…to call for action to reduce the state’s national ranking of 30 out of 50 states when it comes to maternal deaths.”

MSSNY Is Accepting Nominations for the 2017 Albion O. Bernstein, MD Award
This prestigious award is given to: “…the physician, surgeon or scientist who shall have made the most widely beneficial discovery or developed the most useful method in medicine, surgery or in the prevention of disease in the twelve months prior to December, 2017.” The $2,000 award will be presented to the recipient during a MSSNY Council Meeting. Nominations must be submitted on an official application form and must include the nominator’s narrative description of the significance of the candidate’s achievements as well as the candidate’s curriculum vitae, including a list of publications or other contributions. To request an application, please contact: Miriam Hardin, PhD, Manager, Continuing Medical Education, Medical Society of the State of New York, 99 Washington Avenue, Suite 408, Albany, NY 12210 518-465-8085 mhardin@mssny.org. DEADLINE FOR NOMINATIONS: May 31, 2018

Researchers Find High Rates of T1D Near “Food Swamps”
Endocrine News (4/17) reports that research suggests “hot spots of type 1 diabetes in New York City are found in “food swamps,” areas with a higher proportion of fast food restaurants, for children and adults with type 1 diabetes.” The findings were published in the Journal of the Endocrine Society. One of the study’s authors, David C. Lee, MD, MS, said, “Our research suggests that an adverse food environment has an important influence in type 1 diabetes, and a more thorough investigation of genetics, health behaviors and cultural influences should be considered for type 2 diabetes.” Clinical Endocrinology News (4/17) also covers the story.

Ambulatory BP Monitoring May Be a Superior Predictor of Mortality
Ambulatory blood pressure monitoring may be a better mortality predictor than office-based monitoring, a study in the New England Journal of Medicine finds. Using registry data, Spanish researchers examined blood pressure readings from over 60,000 patients. During a median follow-up of 4.7 years, 6% of patients died. After adjusting for clinic blood pressure readings and other variables, increases in ambulatory blood pressure were associated with increased mortality risk (hazard ratio, 1.58 for each standard deviation increase), compared with normal blood pressure. Elevated clinic BP readings were associated with less increased risk after adjusting for ambulatory readings (HR, 1.02).  NEJM article

CMS

Visit the JIRA Website to Submit Official Comments by May 9, 2018
CMS technical clinical quality language (CQL)-based measure specifications for the Quality Payment Program is now available for public comment. CMS encourages all comments regarding the draft measure specifications for two measures currently under development, but is particularly interested in feedback on the technical CQL-based specifications. Specific questions to stakeholders about the PC-02 measure are included in the measure-specific framing document. To read the measure specifications and framing documents, please visit this link.

How to Submit Comments

Log in to your JIRA account here.

A JIRA account is required to submit a comment. If you are new to JIRA and do not have an account, sign up here. 

Comments will be accepted until 11:59 p.m. ET on May 9, 2018 

Apply to Participate in the 2018 CMS Study on Burdens Associated with Reporting Quality Measures to Receive Improvement Activity Credit for 2018
The CMS is conducting the 2018 Burdens Associated with Reporting Quality Measures Study, as outlined in the Quality Payment Program Year 2 final rule (CMS 5522- FC).

CMS is conducting this study to:

  • Examine clinical workflows and data collection methods using different submission systems;
  • Understand the challenges clinicians face when collecting and reporting quality data; and
  • Make future recommendations for changes that will attempt to eliminate clinician burden, improve quality data collection and reporting, and enhance clinical care.

Clinicians and groups who are eligible for the Merit-based Incentive Payment System (MIPS) that participate successfully in the study will receive full credit for the 2018 MIPS Improvement Activities performance category. Applications for this study will be accepted through April 30, 2018 and will be notified in spring of 2018 if selected.

Who Should Apply

MIPS-eligible clinicians participating in MIPS as an individuals or as part of a group.  Clinicians do not need any outside knowledge of MIPS to participate in the study; rather the study team is interested in learning more about clinicians’ experience participating in MIPS.

A limited number of clinicians who are not eligible for MIPS in 2018 will also be included in the study. To check you participation status please see the QPP Website.

Study Requirements

The study runs from April 2018 to March 2019.  Study participants will have to meet the following requirements in order to complete the study and receive full Improvement Activity credit. For participants reporting as a group, their entire group will receive credit.  For participants reporting as individuals, only the participating clinician will receive credit.

To Apply

Click here to begin your application.

Applicants will be notified by email of their status in spring of 2018.

For more information about the study, please visit the CMS website or email MIPS_Study@abtassoc.com.

Upcoming Webinar: APG Educational Series 2018, MIPS APMs to Advanced APMs: How to Make the Valuable Transition
This year, America’s Physician Groups (APG) is pleased to continue our webinar series with the Centers for Medicare and Medicaid Services (CMS) for physicians and physician groups implementing the Medicare Access and CHIP Reauthorization Act (MACRA) through the Quality Payment Program, focusing on Alternative Payment Models (APMs). Through a co-branding agreement with CMS, the sessions will combine CMS expertise on the regulation’s content with APG’s members’ knowledge of how clinicians are responding on the ground to these important changes and care models.

APG designed the series to provide physicians and physician organizations the “how-to” for APM implementation. Given America’s Physician Groups’ leadership with advanced payment models, we are well positioned to share best practices and lessons learned in this area. Each session will include Q&A time with the presenters. We hope the webinars will be a valuable resource to help you successfully participate in APMs in 2018 and beyond. Our next session in the series will focus on:

Title: MIPS APMs to Advanced APMs: How to Make the Valuable Transition

Date: April 30, 2018

Time: 9:00am -10:30am PT / 12:00pm – 1:30pm ET

Register:  http://eventcenter.commpartners.com/se/Rd/Rg.aspx?516875

Subject matter experts from CMS will review the MIPS APM model and requirements for qualifying to become an advanced APM. Additionally, CMS will answer specific audience questions on the final rule for 2018 and provide information and resources relevant to the transition from MIPS APM to advanced APMs.

For more information, please contact Dr. Amy Nguyen, anguyen@capg.org or 213.239.5051.


 

Classified

RENTAL/LEASING SPACE

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

up: www.clineeds.com/sign-up


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



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


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


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


 PHYSICIAN OPPORTUNITIES


Chief of Medical Services
MINIMUM QUALIFICATIONS: Possession of a license and current registration to practice medicine in New York State, plus six years of experience in the practice of medicine, two years of which must be in an administrative or supervisory capacity. Appointee must be eligible for and maintain eligibility for full and unconditional participation in Medicaid and Medicare programs. Appropriate certification by an American Medical Specialty Board and one year of post certification experience in that specialty can be substituted for four years of general experience.
PREFERRED QUALIFICATIONS: Board certification in Geriatric Medicine and/or Certification as a Medical Director (AMDA), and experience in a long-term care facility.
RESPONSIBILITIES: Serve as Medical Director of a 242-bed skilled nursing facility for veterans and their dependents. Provide medical leadership and oversight ensuring the delivery of quality health care services while also ensuring compliance with clinical, statutory and regulatory standards.Send resume to:  NYS Veterans Home, Attn: Human Resources, 4207 State Highway 220, Oxford, NY 13830

The New York State Veterans Home at Oxford is a 242-bed skilled nursing facility operated by the NYS Department of Health located in Chenango County. It is an Affirmative Action/Equal Opportunity Employer. 


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


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


 

April 13, 2018 – NO Aetna/CVS! NO Walmart/Humana!

Thomas J. Madejski, MD MSSNY President

PRESIDENT’S MESSAGE
Thomas J. Madejski, MD
MSSNY President
April 13, 2018
Volume 18
Number 14

 

Dear Colleagues:

Physicians should be leading patient care delivery, not corporations.

Last Saturday’s New York Times included a lengthy article analyzing the proposed health care mega-mergers such as CVS-Aetna and Walmart-Humana that touched upon concerns that many physicians have with the significant encroachment of corporate interests into medical care delivery.

MSSNY has been outspoken in its opposition to the proposed takeover of insurance behemoth Aetna by retailer and PBM owner CVS.  Our concerns about the impact of this proposal have been reported in several media outlets, and were heard loudly and clearly by the State Legislature, which rejected a proposal originally contained in the State Budget that would have authorized corporate owned retail clinics.

And we were pleased that the AMA echoed our concerns in its recent testimony to the US House of Representatives Judiciary Committee that set forth its very serious concerns with this transaction.  Having led efforts to defeat the Anthem-Cigna and Aetna-Humana mergers, the AMA can be a powerful voice in opposition to excessive market concentration that harms our patients.

With recent reports of a similar proposed takeover of insurance giant Humana by ubiquitous big box retailer Walmart, MSSNY again sent a letter to the New York State Attorney General and issued a press release urging federal and state antitrust enforcement agencies to undertake a careful investigation of this proposed cross-sector mega-merger that would likely have adverse consequences for physicians and patients.

Our concerns with these mega-mergers are numerous and include:

  • The adverse impact to patient care that could result from the loss of physician-led medical homes.
  • Further reduction of patient choice of pharmacy, as it may become harder for pharmacies not affiliated with CVS or Walmart to be incorporated into these merged entities’ pharmaceutical networks.
  • Enabling PBM’s to impose even more burdensome prior authorization hassles for physicians and their staff as a pre-condition for patients receiving needed prescription medications.
  • The proliferation of so-called “retail clinics,” owned by an insurance company/retailer that could have great incentive to steer patients to these sites instead of a community based primary care practice that typically serves as a patient’s medical home.   This will result in the fragmentation of patient care instead of helping to better coordinate it.
  • Loss of physician advocacy for the best treatment for their patient, not the corporate bottom line.

While careful review by our state and federal investigatory agencies of these cross-sector consolidations is one avenue, another is legislative. If these entities are permitted to merge, independently practicing physicians should then have the power to counter such consolidation by being permitted to come together to negotiate on behalf of their patients against these corporate behemoths. MSSNY continues to advocate for legislation (A.4472, Gottfried/S.3663, Hannon) that would enable this. Please add your voice of support to this legislation by clicking here. Our patients’ ability to continue to receive needed care from the physician of their choice depends upon it.

Thomas J. Madejski, MD 
MSSNY President

 


HIT MLMIC Symposium


Capital Update

AMA Study: More Than 9 in 10 Physicians Believe Prior Authorization Programs Harm Patient Care Delivery
MSSNY has shared with the State Legislature the results of a recent AMA survey that showed that a staggering 92% of physicians believe that prior authorization programs have a negative impact on patient clinical outcomes.   The information was shared with legislators in support of legislation advocated for MSSNY, the NY-ACP, and the New York State Academy of Family Physicians (A.9588, Gottfried/S.7872, Hannon) that seeks to reduce some of the prior authorization hassles experienced by physicians when they seek to assure their patients can receive the treatment or medications they need.The survey also showed that 84% of responding physicians said that burdens associated with prior authorization were high or extremely high; and that 86% reported that these PA requirements had increased in the last 5 years.  Moreover, every week a medical practice completes an average of 29 PA requirements per physician, which take an average 14.6 hours to process.Among the provisions of A.9588/S.7872 that would address these hassles:

    • Requiring health plan utilization review criteria to be evidence-based and peer reviewed;
    • Reducing the time frame for reviewing prior authorization requests from 3 business days to 48 hours (and to 24 hours for urgent situations);
    • Assuring that a prior authorization, once given, is enduring for the duration of the medication or treatment.
    • Prohibiting mid-year prescription formulary changes; and

  • Assuring that once a prior authorization is given, it cannot be withdrawn if eligibility is confirmed on the day of the service.                           (AUSTER)

MSSNY Urges for Extension of Committee for Physicians Health Program
As the Legislature returns to Albany next week after a brief post-Budget break, MSSNY is advocating for legislation (A.10221, Gottfried, S.8093, Hannon) that would extend for an additional 5 years the continued operations of the MSSNY Committee for Physicians Health (CPH) program.  Authorization for several key components of the program expired on March 31, 2018.

The CPH is a program designed to confront and assist physicians thought to be suffering from alcoholism, substance abuse or mental illness.   Since the inception of this program, CPH has assisted thousands of physicians in returning healthy to medical practice.  The work of the CPH program is an important public service both to our health care system as well as the general public. As a result, the State Budget annually includes an appropriation of $990,000 for the program, which is generated from a $30 assessment on all physicians’ biennial registration fees.

The program has traditionally been extended by the Legislature in 3 or 5 year “demonstration programs” with the most recent extension in 2013.  The recently enacted State Budget included a provision to create another “demonstration program” until 2023.  However, it unintentionally omitted other provisions historically extended at the same time that are essential to its functioning that could greatly impair its operations unless immediate action is taken.

These includes provisions that set forth the CPH program’s reporting requirements to the Office of Professional Medical Conduct (OPMC), provisions to ensure liability protections for the physician Committee members for work performed within the scope of CPH, and necessary confidentiality protections for the program given the sensitivity of the work they perform.   These protections are absolutely essential to the continued functioning of the program to ensure that physicians with the appropriate expertise are willing to serve on the Committee, as well as to assure that the program has the ability to report sensitive information to OPMC when warranted by the circumstances.              
(DIVISION OF GOVERNMENTAL AFFAIRS)



Cross-Sector Health Care Mega-Mergers of Growing Concern to Health Care Delivery
Following last Sunday’s New York Times article about the proposed health care “mega-mergers” of Aetna by CVS, and of Humana by Walmart, MSSNY President Dr. Thomas Madejski issued a press release reiterating the concerns that many physicians have with the significant encroachment of corporate interests into medical care delivery.

At the same time, MSSNY has written to the New York State Attorney General’s office urging that they assess the potential antitrust implications of these potential acquisitions and, as appropriate, convey these concerns to the federal agencies such as the Department of Justice reviewing these proposed transactions.   Among the concerns of these proposed “mega-mergers” include:

  • Further reduction of patient choice of pharmacy, as it may become harder for pharmacies not affiliated with CVS or Walmart to be incorporated into these merged entities’ pharmaceutical networks;
  • Enabling subsidiary PBMs to impose even more burdensome prior authorization hassles for physicians and their staff as a pre-condition for patients receiving needed prescription medications.
  • The potential proliferation of so-called “retail clinics,” owned by an insurance company/retailer, that could have great incentive to steer patients to these sites instead of a community based primary care practice that typically serves as a patient’s medical home, and the adverse impact to patient care that could result from the loss of physician-led medical homes.

“It is imperative that our state and federal investigatory agencies carefully review the impact of this cross-sector consolidation on patient care delivery and access before any such consolidation is permitted to move forward,” stated Dr. Madejski, “We also urge the enactment of measures that would enable independently practicing physicians to counter such consolidation by being permitted to come together to negotiate on behalf of their patients against these corporate behemoths.”  Legislative (A.4422/S.3663 to permit physician collective negotiation has been introduced by Assemblymen Gottfried  & Senator Hannon. (AUSTER)

New AAMC Study Concludes a Significant Physician Shortage by 2030
The United States could see a shortage of up to 120,000 physicians by 2030, according to new data published this week by the Association of American Medical Colleges (AAMC). The study estimates a shortfall of between 14,800 and 49,300 primary care physicians, as well as a shortage in non-primary care specialties of between 33,800 and 72,700 physicians.

Importantly, the press release notes that the shortages will continue to exist despite modeling that takes into account the use of other health professions and changes in care delivery.

Much of the increased demand comes from a growing, aging population. The U.S. population is estimated to grow by nearly 11%, with those over age 65 increasing by 50% by 2030. Additionally, the aging population will affect physician supply, since one-third of all currently active doctors will be older than 65 in the next decade. When these physicians decide to retire could have the greatest impact on supply.

The press release calls for a number of approaches to address this shortage including: legislation sponsored by Rep. Joe Crowley (D-NY) and Senate Minority Leader Charles Schumer (D-NY) that would increase federal support for an additional 3,000 new residency positions each year over the next five years, as well as federal incentive programs such as the National Health Service Corps, Public Service Loan Forgiveness, the Conrad 30 Waiver Program, and Title VII/VIII workforce development and diversity pipeline programs. (AUSTER)

Medical Society of the State of New York Announces its Spring Medical Matters CME Webinar Schedule
The Medical Society of the State of New York is pleased to announce its free Continuing Medical Education (CME) webinars for April and May.  Participation in the webinars will earn physicians one CME credit free of charge.   The Medical Mattes webinar schedule for April and May is as follows:

April 18th at 7:30amMedical Matters: Plague & Q Fever

Register for this webinar here.

Faculty: Kira Geraci-Ciardullo, MD, MPH

Educational Objectives:

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

May 16 at 7:30am – Medical Matters: Chemical Overview
Register for this webinar here.
Faculty: Arthur Cooper, MD

Educational Objectives:

  • Acquire a basic understanding of physically and biologically derived chemical agents
  • Identify types of physically and biologically derived chemical agents used as chemical weapons
  • Understand the indicators of each type of chemical agent
  • Describe the treatment of each type of chemical agent
  • Identify local and state resources

To view all of MSSNY’s scheduled programs, click here and select the Training Center tab and click on “Upcoming”.

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

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

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

“Bending the Diabetes Curve” Webinar is Now Available Online!
The Medical Society of the State of New York has partnered with the American Medical Association to bring its Prevent Diabetes STAT initiative to New York. MSSNY has created a free CME program to educate New York State physicians on prediabetes prevention and the CDC’s National Diabetes Prevention program.

Webinar: Bending the Diabetes Curve
Faculty: Geoffrey Moore, MD & Sarah Nosal, MD
Click here to view the webinar!

Educational Objectives:

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

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

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

Additional information may be obtained by visiting our diabetes webpage or by contacting Carrie Harring at charring@mssny.org.                                                  (HARRING) 

A Big Thank You for Physician Advocacy Efforts, But More Advocacy Needed
Throughout the budget season, MSSNY shared its concerns and input on the many State Budget proposals that impacted upon physicians and their patients. MSSNY staff and leaders worked around the clock while the State Budget was being finalized in helping to ensure that many adverse proposals were completed eliminated, or substantially improved.

The newly created Physician Advocacy Liaison (PAL) program was instrumental in helping to achieve our numerous Budget victories, by helping us in quickly responding to legislators who wanted to hear the physician perspective on a number of issues. As always, thank you for the work all of you do on a daily basis and taking the additional time to be active in the legislative and budgetary process.  There is no doubt that your efforts were a major contributor to our successes.

While another budget has wrapped up in Albany, several items MSSNY is championing need your help, including in support of legislation to address health insurer hassles and needed liability reforms, and in opposition to inappropriate scope of practice changes and practice mandates that interfere with patient care delivery.

When issues arise, it takes collective action to impact change. It cannot just be left to a few individuals. Every rank and file legislator needs to be informed of our issues.  Legislators are often bombarded with paper, phone calls, emails and meeting requests.   We need to cut through the clutter with our elected officials by establishing personal relationships with every member of the legislature so that they will be better informed how legislative proposals will impact the care received by their constituents.

If you are not a member of the PAL network, but would like to join, please e-mail jbelmont@mssny.org (BELMONT)

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

pschuh@mssny.org   mauster@mssny.org  pclancy@mssny.org  

Please Note: The January 2019 Council Meeting has been rescheduled for Thursday, January 24th. Also, the Board of Trustees meeting has been rescheduled for Wednesday, January 23rd. The revised MSSNY meeting schedule has been posted on the home page of the MSSNY website.


eNews

BCBS Releases Study on Children with Allergies and Allergic Reactions
The Blue Cross Blue Shield (BCBS) Association, in collaboration with Blue Health Intelligence, examines American children diagnosed with different kinds of allergies and allergic reactions. Nearly 1.7 million, or 18 percent, of children suffer from one or more allergy. This report specifically studies anaphylaxis, dermatitis and rhinitis. The study analyzes how many young BCBS members were diagnosed with any type of allergy and the number of emergency room visits those members made from 2010 to 2016. The scope of the research includes approximately 9.6 million commercially insured American children age 18 and under per year.  

NY’s Aging Mastery Program Improved Seniors’ Activity Levels/Eating Habits
The Health Foundation for Western and Central New York has partnered with the New York State Office for the Aging on a 30-month initiative to embed the National Council on Aging’s Aging Mastery Program® in all eight counties of Western New York (Erie, Cattaraugus, Chautauqua, Niagara, Wyoming, Orleans, Allegany and Genesee).

Preliminary results from pilot projects across the country show that after taking the 10 sessions, AMP participants significantly increased their physical activity levels, had healthier eating habits, increased their use of advanced planning, stayed more socially connected and participated in evidence-based self-management programs.

AMP is a nationally recognized, fun and interactive class for adults 55 and older that encourages developing sustainable behaviors that lead to health improvements, stronger economic security, enhanced well-being and increased participation in society. The 10-session program combines sharing knowledge in a classroom-like structure with goal setting, daily practice, peer support and small rewards. Expert local speakers lead a curriculum based on the challenges older adults may encounter as they age, and participants gain the skills and tools they need to master aging.

The Health Foundation will be working with the Population Health Collaborative to implement AMP across western New York over the next two years.To learn more about the Foundation, the programs and projects it is currently funding and the many other ways it is involved in the communities it serves, visit www.hfwcny.org.

No One Knows New York Better Than MLMIC!
For 40+ years, MLMIC has been providing New York medical professionals from Buffalo to the Bronx with localized risk management insights, claims protection, and 24/7 legal advice. Our policyholders enjoy benefits and expertise not found anywhere else – supported by concierge-level service every step of the way. For medical malpractice insurance in New York, nothing compares to MLMIC. Learn more at MLMIC.com/better or call (888) 996-1183. Brochure is available here.

CVS Health Will Offer Discount on Overdose Antidote for Uninsured Customers
CVS Health will provide a discount on the overdose-antidote Narcan for customers who are uninsured, the company announced Thursday. The coupon will bring the cost from a list price of $125 for two nasal sprays containing naloxone down to $94.99. The Narcan spray, manufactured by Adapt Pharma, reawakens someone who is overdosing from OxyContin, heroin or fentanyl. CVS’s announcement coincided with a public health advisory by Surgeon General Jerome Adams, who urged more people to stock the antidote so they could intervene when they see someone overdosing. 

IPRO Hosting 34th Annual Membership Meeting at Garden City Hotel

When :   Tuesday, June 5, 2018
Time  :   12:30 p.m.—3:30 p.m.
Where:  The Garden City Hotel – 45 Seventh Street, Garden City, NY

For further information, click here.

NYS’s First Memory Care Assisted Living Program for Medicaid Recipients Opens
Buffalo (NY) Business First (4/9) reports that Briarwood Manor, an assisted living company in Lockport, “has opened the state’s first memory care assisted living program for Medicaid recipients.” The company “will accept 20 Medicaid-eligible seniors with dementia or Alzheimer’s disease for the program, a new demonstration project through the New York State Department of Health.” A company official said this “offers an option for families” who cannot afford $5,000 to $6,500 per month for private care. 

DEA Warns Public of Extortion Scam by DEA Special Agent Impersonators
The Drug Enforcement Administration is warning the public about criminals posing as DEA Special Agents or other law enforcement personnel as part of an international extortion scheme.

The criminals call the victims (who in most cases previously purchased drugs over the internet or by telephone) and identify themselves as DEA agents or law enforcement officials from other agencies. The impersonators inform their victims that purchasing drugs over the internet or by telephone is illegal, and that enforcement action will be taken against them unless they pay a fine. In most cases, the impersonators instruct their victims to pay the “fine” via wire transfer to a designated location, usually overseas. If victims refuse to send money, the impersonators often threaten to arrest them or search their property. Some victims who purchased their drugs using a credit card also reported fraudulent use of their credit cards.

Impersonating a federal agent is a violation of federal law. The public should be aware that no DEA agent will ever contact members of the public by telephone to demand money or any other form of payment.

The DEA reminds the public to use caution when purchasing controlled substance pharmaceuticals by telephone or through the Internet. It is illegal to purchase controlled substance pharmaceuticals online or by telephone unless very stringent requirements are met. And, all pharmacies that dispense controlled substance pharmaceuticals by means of the internet must be registered with DEA. By ordering any pharmaceutical medications online or by telephone from unknown entities, members of the public risk receiving unsafe, counterfeit, and/or ineffective drugs from criminals who operate outside the law. In addition, personal and financial information could be compromised.

Anyone receiving a telephone call from a person purporting to be a DEA special agent or other law enforcement official seeking money should refuse the demand and report the threat using the online form below. Please include all fields, including, most importantly, a call back number so that a DEA investigator can contact you for additional information. Online reporting will greatly assist DEA in investigating and stopping this criminal activity.
https://apps.deadiversion.usdoj.gov/esor/spring/main?execution=e1s1

Feinstein/NIH Recruiting Patients with Lupus/Active Joint Disease for Trial
Feinstein Institute, NIH launch Groundbreaking Clinical Trial Lupus Trial examines use of synthetic endocannabinoid mimetic with no psychotropic properties to treat lupus inflammation. Researchers at Northwell Health’s Feinstein Institute for Medical Research are leading a nationwide National Institutes of Health (NIH) National Institute of Allergy and Infectious Diseases (NIAID) sponsored clinical trial testing the efficacy of a synthetic cannabinoid derivative with no psychotropic properties for the treatment of joint inflammation in lupus.

The 15-site, two-year study plans to recruit 100 patients in total. If you have a patient with lupus and active joint disease with at least moderate pain and are interested in finding out more about this clinical trial, contact Andrew Shaw at 516-562-2591 or Latchmin Persaud at 516-562-3814. This trial is supported by the (NIAID) under trial number NCT03093402.

CMS

CMS Releases 2018 MIPS Eligibility Tool
You can now use the updated CMS MIPS Participation Lookup Tool to check on your 2018 eligibility for the Merit-based Incentive Payment System (MIPS).

Just enter your National Provider Identifier, or NPI, to find out whether you need to participate during the 2018 performance year.

Changes to Low-Volume Threshold

To reduce the burden on small practices, we’ve changed the eligibility threshold for 2018. Clinicians and groups are now excluded from MIPS if they:

  • Billed $90,000 or less in Medicare Part B allowed charges for covered professional services under the Physician Fee Schedule (PFS)

OR

  • Furnished covered professional services under the PFS to 200 or fewer Medicare Part B -enrolled beneficiaries

This means that to be included in MIPS for the 2018 performance period  you need to have billed more than $90,000 in Medicare Part B allowed charges for covered professional services under the PFS AND furnished covered professional services under the PFS to more than 200 Medicare Part B enrolled beneficiaries.

Note: The 2018 Participation Lookup Tool Update for Alternative Payment Model (APM) participants will be updated at a later time. 

Find Out Today

Find out whether you’re eligible for MIPS today. Prepare now to earn a positive payment adjustment in 2020 for your 2018 performance.


 

Classified

RENTAL/LEASING SPACE

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

up: www.clineeds.com/sign-up


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



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


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


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


 

PHYSICIAN OPPORTUNITIES

 

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


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


 

MSSNY eNews: April 6, 2018 – Difficult NYS Budget Passes

 

Thomas J. Madejski, MD MSSNY President

PRESIDENT’S MESSAGE
Thomas J. Madejski, MD
MSSNY President
April 6, 2018
Volume 18
Number 13

Dear Colleagues:

Nearly 75 percent of practices do not like the technology they use for the most part. This is according the 2017 Annual Physicians Practice Technology Survey, which looks at the usage of technology at the practice level from more than 500 (mostly independent) practices across the country.

According to the survey, only 12.6 percent of practices have used telemedicine. About six years ago, one of the physician executives of United Healthcare gave a presentation regarding telemedicine to the MSSNY Council. When the Power Point concluded the Councilors were silent. Then, the outrage flowed freely with several physicians commenting that telemedicine violated every code of ethics including the Hippocratic Oath.

Well, telemedicine is here to stay and many physicians are interested in integrating it into their practices as a patient convenience, especially in rural areas. MSSNY has been working with telemedicine expert Peter Caplan for two years as a source for our physicians who are interested in adopting this technology into their practice.

Mr. Caplan’s Telemedicine Resource Guide was created to assist MSSNY members in navigating the telemedicine service industry. Its purpose is to provide physicians with information about companies that either:

  • Recruit physicians to be part of a regional/national provider network offering direct-to-consumer tele-consults (a monthly subscription vs. fee-per-call or a hybrid of both models) that are available as part of an employer health plan or as an independent, standalone service paid by the individual employee
  • Sell practice-based turnkey solutions (hardware, software, network connectivity, videoconferencing services, peripheral devices and vital sign monitors) used by physicians offering a customized and branded telemedicine program to their own patients. Click here for the Telemedicine Resource Guide (Excel)

If we can better understand and integrate the use of telemedicine as part of a patient management strategy to improve care, increase access to treatment, reduce transportation costs, and more effectively engage patients who are not able to get to a physician’s practice location, we will have created real value for patients and their physicians.

MSSNY’s Telemedicine Task Force continues to review options for our members to consider for the addition of telemedicine into their practices to enhance patient care.  I think it is critical we continue to review the evolving landscape of telemedicine options to the benefit of our patients.  We also need to review what type of care is not appropriate for a telemedicine program and ensure the safety of patients.

Proper integration of telemedicine will enhance the care of our patients and limit the intrusion of non-physician retailers like CVS and WalMart and their potential interference in the physician patient relationship.

I’d appreciate your thoughts.  Send your comments to csouthard@mssny.org

Thomas J. Madejski, MD 
MSSNY President

 


HIT MLMIC Symposium


eNews

State Legislature Completes Passage of Difficult Budget that Rejects Several Items Opposed by MSSNY
As reported last week, the New York State Legislature recently completed passage of a $168 Billion State Budget that closed a $4.4 Billion Budget deficit.    Importantly, the final adopted State Budget rejected numerous proposals of great concern that MSSNY together with specialty societies and other allies had been advocating against, including:

  • Independent practice authority for CRNAs
  • Authorization for corporate-owned retail clinics;
  • Steep Medicaid cuts to the Patient-Centered Medical Home program;
  • Elimination of “Prescriber prevails” protections for prescriptions for patients covered by Medicaid;
  • Overbroad state powers to penalize physicians and other health care providers for Medicaid billing errors
  • Authorization for patient drug management protocols between Nurse Practitioners and pharmacists.  Instead, there was a 2-year extension of the current Collaborative Drug Therapy pilot program (between physicians and pharmacists) that MSSNY supports;
  • Authorizations for EMTs to provide non-emergency care in patient homes without any express coordination requirement with that patient’s treating physician;
  • Provisions which would have reduced from 7 days to 3 days the length of an initial prescription for acute pain.  The final bill did include a requirement, consistent with CDC Chronic pain guidelines, for a prescriber to have a written treatment plan that follows generally accepted professional or government guidelines for a patient on opioid medications longer than 90 days or past the time of normal tissue healing;
  • Significant expansion of the DOH’s Commissioner’s power to investigate physician misconduct, including provisions that would have a) greatly reduced the time to respond to document requests and b) expanded the power to search and seize records and equipment.  The final bill did include a provision to permit the Commissioner to summarily suspend a physician who is both been charged with a felony crime and believed to be an imminent danger to the public as determined by the Commissioner;

At the same time, the final Budget included the following items supported by MSSNY:

  • Continued funding for the Excess Medical Malpractice Insurance Program at the historical level.
  • A new $150,000 allocation for the MSSNY’s Veterans Mental Health Initiative;
  • Reducing some of the insurance barriers to substance abuse treatment
  • Consistent with policy recently adopted at the MSSNY Council, prohibiting PBMs from disclosing to patients drug cost options that may be less than what is specified in their insurance
  • Continued historical funding and a 5-year extension of the MSSNY Committee for Physicians Health until 2023.

Thank you to all the physicians who took the time to make phone calls, send letters, or meet with their local legislators over the last few months to advocate on all these issues.  Certainly, our success on these fronts is in large part due to these extensive grassroots efforts.  However, we can’t exhale just yet – many of these proposals will continue to be raised during the remainder of the legislative session.

 

DEA Warns Public of Extortion Scam by DEA Special Agent Impersonators
The Drug Enforcement Administration is warning the public about criminals posing as DEA Special Agents or other law enforcement personnel as part of an international extortion scheme.

The criminals call the victims (who in most cases previously purchased drugs over the internet or by telephone) and identify themselves as DEA agents or law enforcement officials from other agencies. The impersonators inform their victims that purchasing drugs over the internet or by telephone is illegal, and that enforcement action will be taken against them unless they pay a fine. In most cases, the impersonators instruct their victims to pay the “fine” via wire transfer to a designated location, usually overseas. If victims refuse to send money, the impersonators often threaten to arrest them or search their property. Some victims who purchased their drugs using a credit card also reported fraudulent use of their credit cards.

Impersonating a federal agent is a violation of federal law. The public should be aware that no DEA agent will ever contact members of the public by telephone to demand money or any other form of payment.

The DEA reminds the public to use caution when purchasing controlled substance pharmaceuticals by telephone or through the Internet. It is illegal to purchase controlled substance pharmaceuticals online or by telephone unless very stringent requirements are met. And, all pharmacies that dispense controlled substance pharmaceuticals by means of the internet must be registered with DEA. By ordering any pharmaceutical medications online or by telephone from unknown entities, members of the public risk receiving unsafe, counterfeit, and/or ineffective drugs from criminals who operate outside the law. In addition, personal and financial information could be compromised.

Anyone receiving a telephone call from a person purporting to be a DEA special agent or other law enforcement official seeking money should refuse the demand and report the threat using the online form below. Please include all fields, including, most importantly, a call back number so that a DEA investigator can contact you for additional information. Online reporting will greatly assist DEA in investigating and stopping this criminal activity.

 



Complimentary Webinar by MSSNY Counsel Garfunkel Wild: How to Handle Medicare and Medicaid Overpayments

Friday, April 20, 201812:00 PM – 1:00 PM EST

Providers who identify Medicaid or Medicare overpayments have a legal obligation to timely report, return and explain the overpayments.  Knowing how to appropriately handle Medicare and Medicaid overpayments is both necessary and an essential part of an effective compliance program.

 This complimentary webinar will:

  • Educate providers on the applicable laws
  • Discuss the various mechanisms that exist for returning overpayments to the government
  • Provide practical ideas for how best to report, return and explain identified overpayments

Click Here To Register

After registering, you will receive a confirmation email containing information about joining the webinar.

SYMPOSIUM

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

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

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

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


The HIT Symposium is designed for physicians in all specialties.

Click here to register.

Supported by MLMIC and MSSNY

CME

“Current Concepts in Concussion for Pediatric and Adult Patients” CME Webinar on April 12, 2018, Registration Now Open
The Medical Society of the State of New York will hold a free Continuing Medical Education (CME) webinar on the “Current Concepts in Concussion for Pediatric & Adult Patients” on Thursday, April 12th at 12:30pm.

Register for this webinar here.

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

Educational Objectives:

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


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

Register for this webinar here.

Educational objectives are:

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

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

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

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

Bolstering Small-Practice “Medical Home” Capabilities
Small independent primary care providers are a vital lifeline for New Yorkers, providing services to many diverse and often disadvantaged communities. While they make up approximately 40 percent of all primary care providers in New York City and State, these practices are at risk of falling behind in the race toward medical home recognition and value-based purchasing.

Understanding that challenge, UHF brought together more than 30 experts last year to discuss the potential for shared services among small practices-a way to pool resources for practice transformation and eventual value-based purchasing (VBP). The results of that convening and subsequent efforts are now being finalized, with an anticipated release this spring.

Part of UHF’s partnership with the New York City Department of Health and Mental Hygiene and the New York City Population Health Improvement Program, the roundtable discussion solicited expert feedback on a white paper entitled New York City Population Health Improvement Program (PHIP) Small Primary Care Practice Project, Draft Interim Report, which was provided to participants in advance for their review and comment.

That report reviewed:

  • Findings from a series of focus groups of small-practice providers in New York City, describing a specific set of capacities the practices felt they needed to operate as medical homes and participate in VBP contracts, but could not afford on their own. Providers reported willingness to consider sharing services with other small practices if those services were affordable and provided by a trusted organization with a track record of competence;
  • Findings from a series of interviews with organizations in New York State that are providing a range of services to small practices, describing the types of services offered and how they are organized, deployed, and supported.

The conversation reinforced the findings of this qualitative research, particularly related to the core competencies of medical homes and preparation for value based payment. Of particular value were discussions on the scope of the shared service “bundle” that was envisioned, with discussants recommending that it include support in two priority areas with which many small practices often struggle:

  • The adoption and best use of electronic medical records, and
  • Practice management consultation and support on operational issues and on compliance with complex and changing requirements related to billing and coding.


The Draft Interim Report and roundtable findings served as the foundation for subsequent quantitative work describing the legal and regulatory issues involved in establishing a shared service program, and modeling the economics of such a venture.

The final report will bring together both the qualitative and quantitative reports findings of the project.

More Info: Can Small Physician Practices Survive? (JAMA April 3, 2018) 

 

Crain’s Reports MSSNY’s HOD Gun Safety Resolution
New York Business (3/28, Lewis) reports, “The Medical Society of the State of New York is endorsing a set of proposed gun-control measures through a resolution that was passed at its annual House of Delegates meeting over the weekend.” MSSNY supports “bans on high-capacity magazines and bump stocks, legislation requiring a background check and waiting period before someone can purchase a gun, and the ability of the Centers for Disease Control and Prevention to conduct public health research on gun violence.” Dr. Thomas Madejski, the president of MSSNY, said that MSSNY members disagree about how restricted gun ownership should be. Madejski also said that there have been difficulties implementing the New York SAFE Act, which “requires mental health practitioners to report when a patient is likely to harm himself or others.”


Correction re Third Party Payers Being Billed
On March 30, it was reported that Resolution 261, which required that all 3rd party payers be billed before any patient is billed, was adopted.  This was incorrect.  The House voted NOT adopt this resolution.  We apologize for any confusion.

 

CVS Health Sued for Revealing HIV Status of 6000 Patients in Ohio
CVS Health is being sued for allegedly revealing the HIV status of 6,000 patients in Ohio.

A federal lawsuit claims CVS mailed letters last year that showed the status of participants in the state’s HIV drug assistance program through the envelopes’ glassine window.

The complaint, which was filed March 21 in federal court in Ohio, also names Fiserv, the company that CVS hired to mail the letters. On the envelopes used by Fiserv, the patients’ HIV status could be seen through the clear window, just above their name and address, the documents states. The letters included the patients’ new benefits cards and information about a mail prescription program.

The attorneys claim that CVS failed to announce the breach of privacy data and did not contact all the patients whose status was revealed. In a statement to CNN, CVS Health said the envelope window was intended to show a reference code for the assistance program and not the recipient’s health status. “CVS Health places the highest priority on protecting the privacy of those we serve, and we take our responsibility to safeguard confidential information very seriously,” the statement said. “As soon as we learned of this incident, we immediately took steps to eliminate the reference code to the plan name in any future mailings.”

 

Surgeon General Releases Advisory on Naloxone
Naloxone is already carried by many first responders, such as EMTs and police officers. The Surgeon General is now recommending that more individuals, including family, friends and those who are personally at risk for an opioid overdose, also keep the drug on hand.MSSNY endorses the surgeon general’s call for more availability/use of naloxone. MSSNY quickly endorsed the bill/law that passed a few years ago calling for more widespread availability of Naloxone including without a patient specific script.  Naloxone is available in pharmacies throughout NY State.  With endorsement by MSSNY and other groups, the bill passed quickly and as a result, thousands of lives have been saved in NY by overdose reversals.  MSSNY appreciates and supports the Surgeon General’s call for more widespread availability and use.


FDA Orders Recall of Powdered Kratom Products Due To Salmonella
The Food and Drug Administration “ordered a mandatory recall of” Triangle Pharmanaturals’ “powdered kratom products because salmonella was found in the herbal supplement.” The agency “said the company did not cooperate with the agency’s request for a voluntary recall.” The Wall Street Journal (4/3) reported that FDA said that the recall was the first of its kind under the Food Safety Modernization Act of 2011.

Physician Medicine and Drug Procedure Codes and Fee Schedule Updated
The Physician Medicine and Drugs Procedure Codes and Fee Schedule have been updated for 2018. For details, click here. 

Classified

RENTAL/LEASING SPACE

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


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


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


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


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


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


PHYSICIAN OPPORTUNITIES

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


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


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

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


 

March 30, 2018 – Happy Doctors’ Day

Thomas J. Madejski, MD MSSNY President

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


Dear Colleagues:

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

Who Am I?

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

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

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

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

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

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

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

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

I’ll Be Seeing You

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

Thomas J. Madejski, MD 
MSSNY President

Please send your comments to comments@mssny.org


HIT MLMIC Symposium



Northwell Physicians at 2018 House of Delegates

MSSNY - Northwell

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



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

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

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

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

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

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

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

Please remain alert for further updates.

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

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

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

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


2018 MSSNY HOD HIGHLIGHTS

Public Health and Education

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

Governmental Affairs and Legal Matters A

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

Governmental Affairs and Legal Matters B

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

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

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

Socio-Medical Economics

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

Reports of Officers

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


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

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

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

SYMPOSIUM

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

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

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

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


The HIT Symposium is designed for physicians in all specialties.

Supported by MLMIC and MSSNY

CME

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

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

Educational objectives are:

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

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

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

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

CMS

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

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

How to Get Started

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

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

Real-Time Score Projections

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

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

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

Get Help and Learn More

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

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

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

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

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

If You Have Never Registered In Open Payments Before:

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

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

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

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

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

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

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

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

Classified

RENTAL/LEASING SPACE

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


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


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


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


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


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


PHYSICIAN OPPORTUNITIES

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


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


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

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


 

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