Council Meeting – January 18, 2018

AGENDA
MSSNY Council Meeting
Thursday, January 18, 2018 at 9:00 a.m.
Courtyard Marriott, Westbury Long Island
1800 Privado Road
Westbury, NY  11590

A.   Call to Order and Roll Call
B.   Approval of the Council Minutes of November 2, 2017
C.   New Business (All New Action & Informational Items) 

  1. President’s Report – Verbal updates on the following:

  • Membership
  • IPAs
  • Northwell Subcommittee
  • Physician Burnout
  • End of Life Survey
  • Out of Network/Fair Health
  • Lavern’s Law
  • Aetna-CVS 

2. Presentation
Diabetes Prevention
:
Clinical and Payment Considerations
Presented by:  Kate Kirley, MD, MS, Director, Chronic Disease Prevention – AMA

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

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

ADJOURNMENT OF COUNCIL 

Approval of the Empire State Medical, Scientific & Educational Foundation, Inc.
Election of Directors

RECONVENE COUNCIL

5. MLMIC Update  –  Mr. Donald Fager will present a verbal report

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

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

8. MESF Update – Mr. Thomas Donoghue will present the report (handout)

9. CME Update Dr. Mark Adams will present the report

10Councilors (All Action Items from County Societies and District Branches)
     (No Action Items Submitted)

D. Reports of Officers     
1. Office of the President  – Charles Rothberg, MD, Meetings attended

  • 2017 Achievements Health Care Award, Brookhaven Hospital
  • First District Branch Meeting @ Queens County Medical Society
  • Westchester County Holiday Party
  • NYS Society of Anesthesiologists HOD
  • MLMIC Executive Committee

2.   Office of the President Elect – Thomas J. Madejski, MD
3.   Office of the Vice President –  Arthur C. Fougner, MD
4.   Office of the Treasurer – Joseph R. Sellers, MD
  Financial Statement for the period1/1/17 to 11/30/17
5.   Office of the Speaker  –  Kira A. Geraci-Ciradullo, MD, MPH

 E.        Reports of Councilors (Informational)

  1.         Kings and Richmond Report – Parag H. Mehta, MD
  2.         Manhattan and Bronx Report – Joshua M. Cohen, MD, MPH
  3.         Nassau County Report – Paul A. Pipia, MD
  4.         Queens County Report – Saulius J. Skeivys, MD
  5.         Suffolk County Report – Maria A. Basile, MD, MBA
  6.         Third District Branch Report – Brian P. Murray, MD
  7.         Fourth District Branch Report – John J. Kennedy, MD
  8.         Fifth District Branch Report –Howard H. Huang, MD
  9.         Sixth District Branch Report – Robert A. Hesson, MD
  10.       Seventh District Branch Report – Janine L. 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 –  Pratistha Koirala (no written report)
  14.       Organized Medical Staff Section Report–Bonnie L. Litvack, MD
        (no written report)
  15.       Resident and Fellow Section Report – Justin Fuehrer, DO
  16.       Young Physician Section Report – L. Carlos Zapata, MD
        (no written report)

F.   Commissioners (Committee Action & Informational Items)
 1. Commissioner of Communications, Maria A. Basile, MD, MBA
     Division of Communications Report
 2. Commissioner of Science and Public Health, Frank G. Dowling, MD
a. Addiction and Psychiatric Medicine Committee Minutes, October 27, 2017
b. Bio Ethics Committee Minutes, November 3, 2017
c. Eliminate Health Disparities Committee Minutes, October 20, 2017
d. Heart, Lung and Cancer Committee Minutes, October 18, 2017
e. Infectious Diseases Committee Minutes,  October 19, 2017
f.  Preventive Medicine and Family Health Committee Minutes, Oct. 26, 2017
 3. Commissioner of Socio Medical Economics, Howard H. Huang, MD
a. Committee on Interspecialty Minutes, October 26, 2017

4. Commissioner of Governmental Relations, Gregory Pinto, MD
a. Long Term Care Subcommittee Minutes, September 27, 2017
         b. Quality Improvement and Patient Safety Committee Minutes, May 10, 2017

5.  Commissioner of Membership, Parag H. Mehta, MD
          Membership Committee Action and Informational Items
         Super Group” Discount Proposal from the Onondaga County Medical Society
      for Physicians Employed by Regional Hospital Groups
      The Membership Committee recommends approval of the pilot project as outlined
      for members of the St. Joseph’s Physician Group in Onondaga County only.
          (For Council Approval)

     Introductory Dues Rate for All New Members
     The Membership Committee discussed the concept of a standard introductory
     rate for new members, and agreed to move forward with the idea and put on paper
     for review at the next meeting. (For Council Information)

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
 1. Memorandum regarding whether it is appropriate for a physician to access the PMP regarding an individual who is not a patient.

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

J.  Other Information/Announcements
1. Dr. Madejski’s letter to Dr. Nora, President & CEO of the ABMS regarding
concerns of our membership on the MOC issue.

K.  Adjournment

 

 

 

January 12, 2018 – Fair Health Should Be Fair


Charles Rothberg, MD - MSSNY President
PRESIDENT’S MESSAGE

Charles Rothberg, MD
January 12, 2018
Volume 18
Number 2

MLMIC Insurance for Physicians


Dear Colleagues: 

We received concerns from a few specialties regarding fee data published by Fair Health in the fall of 2017.

Neurosurgeons, orthopedic and hand surgeons noticed a significant and unexpected decrease in fees relating to some of their most common procedures. The Fair Health database is a reference used in adjudicating out of network insurance payments to physicians.

Subsequently, MSSNY leadership and staff held a conference call with representatives of Fair Health. MSSNY expressed grave concern with regard to the fact that Fair Health should be fair. Their data should be objective and not manipulated. Fair Health identified that their research unveiled significant outliers in several of the surgical specialty fees and after analysis, they tweaked the data that resulted in the significant reductions.

During the course of our teleconference, Fair Health agreed that many of our points of concern were valid and agreed to rerun the fee data. After the re-publication, many of the fees have been corrected.  However, some of our specialists have concerns that remain.  We will ask Fair Health to address them as soon as possible.

We will keep you posted.

I have observed that Fair Health continues to be sensitive and sympathetic to the concerns raised by our physicians.

Once more, MSSNY, in concert with its physician members, was instrumental in seeking correction that would have harmed reimbursement for all physicians.

Sincerely,

Charles Rothberg, MD
MSSNY President

Please send your comments to comments@mssny.org



Governor Cuomo to Release Proposed Budget Tuesday
This Tuesday, January 16th at 1 PM, Governor Cuomo will give a presentation to release his FY 2018-19 proposed State Budget.  The Governor’s proposed Budget, certain to run into the thousands of pages, will seek to close an anticipated deficit of over $4 billion, as well as address uncertainty regarding continued federal funding for key New York health programs such as Child Health Insurance, the Essential plan, Community Health Centers, and Disproportionate Share (DSH) payments for hospitals. Please look for a summary of highlights following an initial MSSNY staff review of the Budget proposal.  (AUSTER)

MSSNY’s Lobby Day (3/7) will be here before You Know it! Register Today!
MSSNY’s “Physician Advocacy Day” will be held on Wednesday, March 7th in the Lewis Swyer Theatre in the Egg located at the Empire State Plaza, Albany NY. Click Here to Register!

Join your colleagues from all around New York State and come to MSSNY’s Physician Advocacy Day to speak with your legislators and key policymakers to ensure they’re making the right choices for New York’s physicians and their patients.

Join us to urge your legislators to:

  • Reduce excessive health insurer prior authorization hassles that needlessly delay patient care
  • Reduce the high cost of medical liability insurance
  • Preserve choice of physician for our patients
  • Reject burdensome mandates that interfere with patient care delivery
  • Preserve opportunities for our medical students and residents to become New York’s future health care leaders

A brief luncheon to which members of each House are invited to speak with their constituents will follow the morning program. Please contact your county Medical Society to coordinate scheduling appointments for physicians to meet with their elected representatives.

If you have any questions/comments, please contact Carrie Harring at charring@mssny.org (HARRING)

Please Urge Governor Cuomo to Support Comprehensive, Not One-Sided, Medical Malpractice Legislation
Legislation (S.6800/A.8516) to significantly expand the medical malpractice statute of limitations was the ONLY bill that passed the State Senate and Assembly in 2017 that has NOT yet been acted upon by the Governor!  Based upon a quirk in our State Constitution, with the bill delivered on December 29, Gov. Cuomo has until the end of January to consider the legislation.  

All physicians are urged to contact the Gov. to urge him to veto this legislation. You can send a letter to the Governor here and/or call 518-474-8390.

Urge him to work to develop comprehensive legislation that addresses the many deficiencies of New York’s malpractice adjudication system.   NY overwhelmingly has the highest medical liability costs in the country and was recently designated by WalletHub as the worst state in the country to be a physician.  The bill would significantly expand the time to bring a medical malpractice lawsuit, in circumstances based upon an “alleged negligent failure to diagnose a malignant tumor or cancer.” 

This week a letter was sent to Governor Cuomo from Dr. Michael Pisacaino, President of the Bronx County Medical Society.

that describes the negative consequences to the Bronx health care delivery system if this bill were to be signed into law without enacting needed reforms to bring down our costs.  The letter was also shared with Assembly Speaker Carl Heastie, whose district is in the Bronx.  

Given that there will be ongoing discussions with the Legislature regarding the ultimate disposition of S.6800, physicians are urged to contact their local senators and assembly members to: 

  • Share their concerns about the impact of this legislation to access to patient          care in their communities, and
  • Urge them to work towards the enactment of comprehensive medical liability        reform.

A letter can be sent from here.
(DIVISION OF GOVERNMENTAL AFFAIRS)

NYS Council on Women and Girls Issues Status Report
Governor Andrew Cuomo Council on Women and Girls issued a 2018 report this week.   Members of Governor Cuomo’s administration crisscrossed the state to hear the concerns of New York women on issues such as the gender wage gap, sexual harassment in the workplace, and lack of educational programs to encourage interest in computer science and engineering. In the healthcare arena the report identifies areas that need to be addressed:

  • Passage of the Contraceptive Coverage Act: The use, accessibility and availability contraception to all women and in 2018 the Governor will advance legislation to codify access to contraception, including emergency contraception in NYS.
  • Codify Roe v Wade Into State Law and Constitution: The governor will again call for legislation that will ensure the right of women to abortion and will also eliminate the criminal component of this act by placing it under the public health law rather than the penal law.
  • Improve Access To IVF and Fertility Preservation Services
  • Launch Multi-Agency Effort to Combat Maternal Depression
  • Partnering with ACOG, establish the Maternal Mortality Review Board to Save Lives
  • Add physician experts in women’s health and health disparities to the state board of medicine


The entire report can be found here. (CLANCY)

Senator DeFrancisco Introduces Legislation to Prohibit Hospitals, Health Plans from Requiring Board Certification
Senate Deputy Majority Leader John DeFrancisco (R-Syracuse) this week introduced legislation (S.7537) supported by MSSNY that would prohibit a hospital from requiring board certification as a condition of having staff privileges, and prohibit a health insurance company from requiring board certification as a condition of being a participating physician in such plan. The legislation is designed to provide physicians with some ability to push back against the extraordinary time and cost demands associated with completing Maintenance of Certification (MOC) requirements imposed by some specialty boards.

In December, MSSNY President-elect Dr. Thomas Madejski along with several other state medical society representatives participated in a meeting with the American Board of Medical Specialties to discuss how best to collaboratively address what many physicians believe are excessive MOC time and cost requirements that go far beyond what is relevant to physicians’ actual practice.  Click here to read Dr. Madejski’s follow-up letter to ABMS.

The Senate legislation is substantially similar to legislation also supported by MSSNY (A.4914) introduced by Assemblymember Robin Schimminger (D-Kenmore).             (AUSTER)

New York State Workers’ Compensation Board Issues Draft Regulations to Establish Drug Formulary
The enacted 2017-18 budget required the New York State Workers’ Compensation Board to establish a drug formulary by the end of the year to include  a tiered list of high-quality, cost-effective medications that are pre-approved to be  prescribed  and  dispensed,  as well as additional non-preferred drugs that can be prescribed with prior approval.

On December 27th, the Workers’ Compensation Board announced draft regulations and initiated a 60-day comment period.  Please click here to read the board’s recommendations for its preferred drug list.  Please click here to review the regulations that set forth how physicians can request a non-formulary drug for their patient. The formulary is proposed to begin  July 1.

MSSNY is continuing to review the proposal and will provide comments.  In particular, MSSNY will argue to assure that pre-authorization hassles be minimized.  Any physicians interesting in submitting comments and requests to add/delete pharmaceuticals to the preferred list of the prescription drug formulary must submit their comments on or before February 26, 2018.

To submit comments, click here.                                                                                    (BELMONT)

Want to Learn More About New York’s New Prescription Step Therapy Override Law?
Please click here to view a webinar discussing New York’s new law that gives physicians a stronger ability to override a health insurer’s step therapy protocol when seeking to assure their patients can receive coverage for necessary prescription medications.    Among the faculty for the program are MSSNY President-elect Dr. Thomas Madejski and MSSNY Senior Vice President Moe Auster    The webinar, sponsored by the National Psoriasis Foundation, will provide physicians with 0.5 hours of CME credit.

As of January 1, the new law is applicable to all NY-regulated health insurance plans, including Medicaid Managed Care plans.  MSSNY has created a template for physicians and their support staff to use in requesting a step therapy protocol override, available here.

Enforcement is the key to assuring that the law is working as intended.  Therefore, please let us know if you or your staff experience instances where health insurers are not following the law.  Moreover, you can file a complaint with </athe State here.(AUSTER)

US Department of Labor Proposes Rules to Expand Use of Cross-State Association Health Plans
The US Department of Labor (DOL) has formally proposed rules that would “broaden the ability of small businesses and sole proprietors to have more freedom to band together” to establish Association Health plans (AHPs).  It follows up a October 2017 Presidential Executive Order which directed the DOL to consider proposing regulations or revising guidance to expand access to health coverage by allowing more employers to form AHPs.

Click here to read the full press release.

Specifically, the proposed rule would broaden the criteria under ERISA for determining when employers may join together in an employer group or association that is treated as the ‘employer’ sponsor of a single multiple-employer ‘employee welfare benefit plan’ and ‘group health plan.   The proposed rule applies only to employer-sponsored health insurance. According to the DOL press release, the rule would:

  • Allow employers to form a Small Business Health Plan on the basis of geography or industry. A plan could serve employers in a state, city, county, or a multi-state metro area, or it could serve all the businesses in a particular industry nationwide;
  • Allow sole proprietors to join Small Business Health Plans, clearing a path to access health insurance for the millions of uninsured Americans who are sole proprietors or the family of sole proprietors

After the Presidential Executive Order was released, consistent with policy adopted at the 2017 MSSNY House of Delegates, MSSNY President Dr. Charles Rothberg issued a statement expressing concerns with the possibility that the expanded use of AHPs could remove oversight of health insurance plans away from state governments, resulting in “more consumers purchasing plans with even more exorbitant out of pocket costs, fewer choices of physicians and a reduction in the ability of patients and physicians to enforce provisions of a health insurance contract”.   MSSNY working together with the AMA and medical </asocieties across the country are analyzing the DOL proposed regulation and will follow up with appropriate comments. (AUSTER)

CMS Announces New Voluntary Bundled Payment Model
The Centers for Medicare & Medicaid Services (CMS) Center for Medicare and Medicaid Innovation (CMMI) announced this week the launch of a new voluntary bundled payment model – the “Bundled Payments for Care Improvement Advanced” (BPCI Advanced model).

Please click here for more information.

The new BCPI Advanced model focuses on 32 different clinical episodes, including major joint replacement of the lower extremity (inpatient) and percutaneous coronary intervention (inpatient or outpatient). CMS notes that the BPCI Advanced will qualify as an Advanced Alternative Payment Model (Advanced APM) under the MACRA’s Quality Payment Program.  As such, BCPI Advanced model participants will bear financial risk, have payments under the model tied to quality performance, and are required to use Certified Electronic Health Record Technology. The new CMMI model would allow participants to earn additional payments if “all expenditures for a beneficiary’s episode of care are under a spending target that factors in quality.”

The Model Performance Period for BPCI Advanced starts on October 1, 2018 and runs through December 31, 2023. The model will include a formal, independent evaluation process to assess the quality of care and changes in spending under the model.  Applications for participate must be submitted by March 12, 2018.  CMMI will also host an Open Forum on the model on Tuesday, January 30th from 12pm-1pm.
(AUSTER

MSSNY and AMA Working Together to Educate Physicians on Prediabetes and the Prevent Diabetes STAT Toolkit
Diabetes affects more than 25 percent of Americans aged 65 or older, and its pervasiveness is projected to increase approximately two-fold for all U.S. adults (ages 18-79) by 2050 if current trends continue.

As part of ongoing work to reduce the incidence of type 2 diabetes nationwide, the American Medical Association (AMA) has commenced a multi-state effort to reach more of the estimated 84 million Americans who unknowingly live with prediabetes.  MSSNY has proudly partnered with the AMA to launch this proactive initiative to educate New York State physicians on how to initiate clinical practice change and prevent diabetes in patient population.

The AMA and Center for Disease Control (CDC) have collaborated to create a comprehensive toolkit that can be utilized by both physicians and patients. The Prevent Diabetes STAT Toolkit incorporates resources to assist with engaging and educating healthcare teams and patients, as well as resources to help healthcare providers seamlessly incorporate screening, testing, and referral systems within their practice. The toolkit enables patients to leave the office with concrete information for later reference. For physicians, the toolkit provides references such as letter/email templates for practices to conduct efficient follow-ups and patient referrals, among other valuable information. To view or download the complete Prevent Diabetes STAT Toolkit, click here.

Please contact Carrie Harring at charring@mssny.org for more information and to express your interest in developing a partnership.                                                  (HARRING)

MSSNY Partners with AMA To Educate New York’s Physicians and Patients on Diabetes Prevention;  Physicians  Encouraged to Take Survey
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 survey.

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. “Improving the quality of prediabetes and diabetes care in medical practices is crucial to the health of New York State’s patient population,” said MSSNY’s President Dr. Charles Rothberg. “Over 700,000 New Yorkers have this disease, yet almost a third are unware.  Educating both physicians and patients about lifestyle changes and diabetes management is a priority, and MSSNY is proud to be partnered with the AMA in an effort to make these necessary changes.”                                                                                                          (HARRING, CLANCY) 

Bill to Prohibit Children From Using Tanning Booths Advances in the Legislature
Senate Bill 5585 A, sponsored by Senator Phil Boyle, has been placed on the Senate Health Committee agenda for next week and would prohibit children under the age of 18 from using tanning facilities.  The bill also removes  the procedures in granting 17 to 18 year olds access to tanning booths and exempts licensed physicians who use or prescribe a phototherapy device with respect to a patient of any age. Current law prohibits children under 16 years of age from using tanning facilities.  Identical legislation (A.7218, Jaffee) is on the Assembly calendar.  The American Cancer Society has noted that the highest risk for skin cancer lies is from the use of indoor tanning facilities.  Moreover, the World Health Organization categorizes tanning devices as its highest cancer risk. It has been found, that using tanning booths before the age of 35 increases the risk of melanoma by 59%, squamous cell carcinoma by 67% a name=”sea”>and basal cell carcinoma by 29%.  The Medical Society of the State of New York strongly supports this measure.  (CLANCY)      

Seasonal Influenza has Hit New York State Early and Hard
New York State saw its first pediatric death from influenza on January 11th.  During the week ending January 6th, there were 3,942 laboratory confirmed cases of influenza, a 37% increase over the previous week.  And there were 1,258 patients hospitalized with laboratory confirmed influenza, a 40% increase over the previous week.  Additionally, 61 counties reported influenza cases during that week.

MSSNY offers several CME courses and podcasts that will help to keep you informed and better prepared to manage this year’s flu season.  Go to https://cme.mssny.org and check out our Medical Matters courses: The Many Faces of Flu, When is the Flu not the Flu, and The Importance of Herd Immunity to learn more about preparing for, diagnosing and treating influenza.

MSSNY also has a podcast available for patients to learn more about the importance of adult vaccines here or you can go to

http://www.buzzsprout.com/51522 for all of MSSNY’s podcasts.                            (CLANCY, HOFFMAN)

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

January 17th at 7:30am – Medical Matters:  Mental Health and Disasters Overview

Register for this webinar here.
Faculty: Craig Katz, MD

Educational Objectives:

  • Explore the psychological impact of mass trauma.
  • Provide physicians with a strong background on both the psychological                  symptoms and syndromes specific to mass trauma.
  • Prepare physicians to conduct acute assessments and interventions.

January 22nd at 7:30amCurrent Concepts in Concussion for Pediatric and Adult Patients

Register for this webinar here.
Faculty: Deborah Light, MD

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

January 30th at 7:30amVeterans Matters:  PTSD & TBI in Veterans

Register for this webinar here.
Faculty: Emerald Lin, MD

Educational Objectives:

  • Identify signs and symptoms of PTSD & TBI
  • Examine evidence-based treatment modalities for PTSD & TBI
  • Explore military culture and methods to overcome unique barriers to treatment intrinsic to military culture

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  

jbelmont@mssny.org charring@mssny.org



enews large


MSSNY Takes Aim at Insurers
From Crain’s NY, 1/2/18:

This year the Medical Society of the State of New York wants the Legislature to take up a number of issues that have made it increasingly difficult to practice as an independent physician in the state.

“Our goal is to help turn around our recent designation as the worst state in the country to be a doctor,” said Moe Auster, senior vice president for legislative and regulatory affairs, referring to rankings published by the website WalletHub.

MSSNY’s top priority is to renew its push for a bill (A.4472/S.3663) allowing independent physicians to form groups to negotiate payment rates with insurers. The organization said this is necessary given actions from insurers, such as EmblemHealth, to cut certain independent doctors out of their networks in favor of larger groups.

It differs from the concept of an independent practice association in that doctors wouldn’t have to be financially or clinically integrated, Auster said. A similar bill was approved by the Senate and Assembly health committees but didn’t make it to a full vote by either chamber.

MSSNY is also advocating for a bill that would give doctors access to an appeal hearing if an insurer doesn’t renew their contract and another that would require health plans to offer a product that covers out-of-network care.

The group will oppose several bills that could increase medical liability costs after suffering a loss last year, when the Legislature passed Lavern’s Law, which pertains only to malpractice cases brought by cancer patients. Gov. Andrew Cuomo has not yet signed the measure, which starts the clock on the statute of limitations at the date of discovery of a medical error, not the date the error occurred. The bill was delivered to the governor on Dec. 29. (Crains)


Don’t ignore what may be our last chance to defeat this detrimental piece of legislation. It takes less than a minute! 

MSSNY Members Only: Unpaid Claims? We Can Help!
In 2016, MSSNY’s Ombudsman Program was successful in recovering $89,815.79 for physicians who had reached a stalemate regarding unpaid claims. From January to June of 2017, the program recovered $121,441.68 for our members who availed themselves of the Ombudsman service. Since then, we recouped an additional $187,447.50.  So, for calendar year 2017, we recovered a total of $308,889.18 for our MSSNY members.

If you are a member in good standing, this service is available to you for FREE! For further information, call 516-488-6100 ext. 334 or 332. 

New York City to Build a New $400 Million Public-Health Laboratory
The Wall Street Journal (1/9) reports that New York City plans to spend $400 million for a new public-health laboratory with greater capacity to handle an emergency, such as Zika or Ebola, after deciding against a renovation of its current facility. The Journal stated that the current facility tests more than 200,000 clinical and environmental samples every year.


Your membership yields results and will continue to do so. When your 2018 invoice arrives, please renew.
KEEP MSSNY STRONG!


How to Make the Physician-Hospital Relationship a Win-Win for All
SAVE THE DATE for this interactive panel discussion with audience participation, which will kick off the Organized Medical Staff Section annual meeting on Thursday, March 22, 2018, 3:00 – 4:00 pm, at the Adam’s Mark Hotel, Buffalo NY. Two medical staff presidents and two hospital administrators will discuss how to make relationships work in the hospital for everybody’s benefit, and will answer audience questions. Moderator will be Andrew Blustein, JD, an attorney with MSSNY’s General Counsel firm, Garfunkel Wild.

Listen and voice your opinion on what it’s like to work with each other, the highs and the lows, and how to communicate and promote dialogue. RSVP sbennett@mssny.org.


LOBBY DAY IS ON WEDNESDAY,

MARCH 7-MEET YOUR LEGISLATORS!

CALL YOUR COUNTY EXEC FOR INFO

MEDICARE / MEDICAID

CMS Launches New Data Submission System for Clinicians in QPP
On Tuesday, January 2, CMS launched a new data submission system for clinicians participating in the Quality Payment Program. Clinicians can now submit all of their 2017 Merit-based Incentive Payment System (MIPS) data through one platform on the qpp.cms.gov website. Data can be submitted and updated any time from January 2, 2018 to March 31, 2018, with the exception of CMS Web Interface users who will have a different timeframe to report quality data from January 22, 2018 to March 16, 2018. Clinicians are encouraged to log-in early to familiarize themselves with the system. 

How to Login to the Quality Payment Program Data Submission System

To login and submit data, clinicians will use their Enterprise Identity Management (EIDM) credentials.

  • The EIDM account provides CMS customers with a single user identification they can use to access many CMS systems.
  • The system will connect each user with their practice Taxpayer Identification Number (TIN). Once connected, clinicians will be able to report data for the practice as a group, or for individual clinicians within the practice.
  • To learn about how to create an EIDM account, see this user guide.

Real-Time Scoring

As data is entered, clinicians will see real-time initial scoring within the MIPS performance categories. Data is automatically saved and clinician records are updated in real time. This means a clinician can begin a submission, leave without completing it, and then finish it at a later time without losing the information. 

Payment Adjustment Calculations

Payment adjustments will be calculated based on the last submission or submission update that occurs before the submission period closes on March 31, 2018. 

Determining Eligibility

There are two eligibility look-up tools available to confirm a clinician�s status in the Quality Payment Program. Clinicians who may be included in MIPS should check their National Provider Identifier (NPI) in the MIPS Participation Status Tool, which will be updated with the most recent eligibility data, to confirm whether they are required to submit data under MIPS for 2017. For clinicians who know they are in an MIPS APM or Advanced APM, CMS is working to improve the Qualifying APM Participant (QP) Look-up Tool to include eligibility information for Advanced APM and MIPS APM participants. We anticipate sharing this updated tool in January 2018.

CMS Claims New York Owes Them $20 million
New York did not follow federal funding requirements for money it used to set up the New York State of Health marketplace and should refund the Centers for Medicare and Medicaid Services more than $20 million, a federal audit found.

The audit, by the Department of Health and Human Services’ Office of the Inspector General, found that New York’s insurance marketplace improperly allocated costs related to its contract with Maximus, which operated the marketplace’s customer service center from June 2012 to March 2015. It reviewed $39.8 million in contract costs that the state attributed to the establishment grants it was given to set up the marketplace.

The report said New York erred in part because it did not have written policies that outlined how to properly allocate costs and did not establish a basis for the amount of profit Maximus would be able to keep at the beginning of the contract.

CDC To Discuss Preparations for Possible Nuclear War
The Centers for Disease Control and Prevention will give a presentation on Jan. 16 called “Public Health Response to a Nuclear Detonation” with the aim of preparing those who “would be responsible for overseeing the emergency response to a nuclear attack.” Bert Kelly, a spokesman for the CDC, said the agency started planning the event last April, and that the workshop “is part of CDC’s longstanding and routine work, similar to work it does to prepare for other possible health emergencies, with the goal of ensuring the public health community is prepared for all types of health threats.”

The workshop will include sessions titled “Preparing for the Unthinkable,” “Roadmap to Radiation Preparedness,” and “Public Health Resources to Meet Critical Components of Preparedness,” according to the agency’s website about the workshop. https://www.cdc.gov/cdcgrandrounds/archives/2018/January2018.htm


CLASSIFIEDS

RENTAL/LEASING SPACE


For Rent or Share (Half days or Full) – Union Turnpike, Queens
A brand new state of the art, beautifully appointed medical building has availability for turnkey share or rent on a busy artery of Queens.  Smartly located in the area bounded by the LIE to the north, Grand Central Parkway to the south, Clearview Expressway to the West and the Cross Island to the East, this office is easily accessible by car with ample parking available at all times of the day.  The building is located on the Q46 bus line with a stop only steps away.  Easy access to all major Queens and western Nassau county hospitals.  There is already in-house patient traffic so this is a great opportunity to build a satellite practice or to start a practice with potential cross-referral benefits.  Very reasonably priced starter options available. Please email queensmedicalhealth@gmail.com or call (917) 860-8307.


Space Available in North Bronx
● Medical Office for Rent
● Located on the Grand Concourse (walking distance from all major transportation)
● 2 Examination Rooms
● Large Waiting Area
● Private Doctor’s Office
● Fully equipped with new furniture
Contact info: jp@bronxheart.com // 718-584-0797


Upper East Side Plastic Surgery Office Available for Rent or Share
Beautifully equipped Plastic Surgery office available for part-time share along with Quad A-certified OR available for rent. Located in a lovely carriage house on the Upper East Side in close proximity to Lenox Hill Hospital and MEETH and conveniently located near all NYC mass transit. 1 exam room/OR and Recovery room along with large administrative space. Free WIFI. Available for </>full or half-days. Suits Plastic/Cosmetic Surgeons/ DERM/ ENT/or other Medical MDs. Please contact Kim at Kim@madisonps.com (212) 628-7600.

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


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


PHYSICIAN OPPORTUNITIES


Paging Primary Care MDs Who Love Technology
98point6 is a Seattle startup who wants your input. We’re seeking practicing physicians to join our council and help shape the next </a?generation of primary care. If the fusion of health care and technology inspires you, please apply here.


 


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


 

January 5, 2018

 

Charles Rothberg, MD - MSSNY President

Charles Rothberg, MD
January 5, 2018
Volume 18
Number 1

MLMIC Insurance for Physicians

 



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Physicians Should Contact Governor Cuomo to Veto Legislation That Significantly Expands the Medical Malpractice Statute of Limitations
Legislation (S.6800/A.8516) to significantly expand the medical malpractice statute of limitations was the ONLY bill that passed the State Senate and Assembly in 2017 that has NOT yet been acted upon by the Governor!  Based upon a quirk in our State Constitution, Gov. Cuomo has until the end of January to consider the legislation.

All physicians are urged to contact the Gov. to urge him to veto this legislation. You can send a letter to the Governor here and/or call 518-474-8390
Urge him to work to develop comprehensive legislation that addresses the many deficiencies of New York’s malpractice adjudication system.   NY overwhelmingly has the highest medical liability costs in the country and was recently designated by WalletHub as the worst state in the country to be a physician.  The bill would significantly expand the time to bring a medical malpractice lawsuit, in circumstances based upon an “alleged negligent failure to diagnose a malignant tumor or cancer.” 

Moreover, given that there will be ongoing discussions with the Legislature regarding the ultimate disposition of S.6800, physicians are urged to contact their local senators and assembly members to: 

  • share their concerns about the impact of this legislation to access to patient          care in their communities, and
  • urge them to work towards the enactment of comprehensive medical liability        reform.

A letter can be sent from here.
(DIVISION OF GOVERNMENTAL AFFAIRS)

Governor Seeks to Reverse the Opioid Epidemic
During the State of the State, Governor Andrew Cuomo emphasized all that his administration has done to confront the national opioid crisis, but did indicate that more can be done.  Governor Cuomo is seeking to address various aspects of the epidemic and his five point proposal included limiting the prescribing of opioids to the same limitations to patients with a diagnosis of chronic pain that have not previously used opioids.  He has indicated that he will advance legislation to restrict subsequent refills to no more than one additional seven day prescription of opioids for acute pain without having an in-person visit with the prescriber.

Additionally, the proposal includes a requirement to have emergency department prescribers to consult the Prescription Monitory Program (PMP) prior to prescribing opioids.  The governor also proposes the establishment of a Statewide Pain Management Steering Committee through the Department of Health and the Office of Alcoholism and Substance Abuse Services (OASAS) to make recommendations on pain management issues, taking into account the latest Centers for Disease Control and Prevention guidelines.  Other proposals include:

  • Elimination of the insurance barriers to addiction treatment and recovery services by limiting requirements for prior authorization and co-payments for outpatient addiction treatment.
  • Directing state agencies to implement regulatory and policy reforms that increase access to substance use disorder services including the development of new regulations to include subacute pain as a qualifying condition for the use of marijuana for medical purposes.
  • Moving 11 fentanyl analogs to Schedule I of the controlled substance schedules under New York Public Health Law and moving 35 different synthetic cannabinoids to New York’s schedule of controlled substances list. The governor also proposed giving the state health commissioner the authority to add to the state controlled substances schedules any new drugs that have been added to the federal schedule.
  • The governor also proposed to hold pharmaceutical companies accountable for their hold in perpetuating the opioid epidemic and he and the New York Attorney General will take enforcement actions action pharmaceutical opioid distributors for breaching their legal duties to monitor, detect and report suspicious orders of prescription opioids.   (DIVISION OF GOVERNMENTAL AFFAIRS)

Your membership yields results and will continue to do so.
When your 2018 invoice arrives, please renew.
KEEP MSSNY STRONG!


Governor Cuomo Outlines Plan to Reduce Health-Care Costs
During his State of the State address, Governor Andrew Cuomo indicated that he will advance legislation that will include price transparency proposals to address the rising costs of health care.  One of these proposals would require health plans to provide members with information, such as cost-estimator tools and quality ratings about healthcare providers in their network.   Additionally, current law requires hospitals to provide financial assistance for patients with incomes of 300 percent of the federal poverty level or less.  Governor Cuomo indicated he wants to expand awareness and guidance for financial assistance programs.  Other health care initiatives include expanding existing patient legal protections, simplifying medical billing and expanding telehealth services.   (BELMONT)

Governor Proposes To Implement a Lyme and Tick-borne Disease Control Plan
In his State of the State address, Governor Andrew Cuomo proposed an initiative to reduce the incidence of Lyme disease and other tick-borne illnesses in New York State.  Under this initiative, the governor will direct the Departments of Health and Environmental Conservation and the Office of Parks, Recreation and Historic Preservation to launch a tick reduction strategy targeting priority counties and public lands that have the highest risk of tick exposure by employing application of eco-friendly tick control treatments.  The governor has also proposed the establishment of a new working group on Lyme and other tick-borne disease to review current strategies and improve the prevention, diagnosis and treatment of tick-borne diseases in New York State.   The proposals also includes having the Department of Health continue its public outreach campaigns, and to convene a tick borne disease summit in the spring.

MSSNY looks forward to assisting the governor in this initiative as there are approximately 8,000 cases of Lyme disease, and over 1200 cases of other tick-borne illnesses reported to the New York State Department of Health each year.
(DIVISION OF GOVERNMENTAL AFFAIRS)

US Attorney General Rescinds Obama Guidelines Allowing the Use of Marijuana
The United States Attorney General Jeff Sessions has rescinded the Obama Administration guidelines that allowed states that had authorized the use of marijuana under state law without fear federal prosecution.  New York State has authorized the use of marijuana for certain medical conditions. This action may allow federal prosecutors on Thursday to more aggressively enforce marijuana laws. It remains unclear how this action will impact states where marijuana is legal for medical purposes.

The Medical Society of the State of New York has always expressed concerns about federal prosecution against physician who certified a patient for the use of marijuana.    Under the New York State statute establishing the marijuana program, the governor or the commissioner of health has the ability to suspend the program at any point.   MSSNY will continue to monitor this situation closely and will provide updates.  According to the Department of Health, New York State’s marijuana program for medical use has 1,384 providers that are approved to certify patients for marijuana and has 40,286 patients that use marijuana for medical conditions.  (CLANCY)

MSSNY Partners with AMA to Educate New York’s Physicians and Patients on Diabetes Prevention; Physicians Encouraged to Take Survey
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 survey.

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. “Improving the quality of prediabetes and diabetes care in medical practices is crucial to the health of New York State’s patient population,” said MSSNY’s President Dr. Charles Rothberg. “Over 700,000 New Yorkers have this disease, yet almost a third are unware.  Educating both physicians and patients about lifestyle changes and diabetes management is a priority, and MSSNY is proud to be partnered with the AMA in an effort to make these necessary changes.”                                                                                                            (HARRING, CLANCY)

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

January 17th at 7:30am – Medical Matters:  Mental Health and Disasters Overview

Register for this webinar here . 

Faculty: Craig Katz, MD

Educational Objectives:

  • Explore the psychological impact of mass trauma.
  • Provide physicians with a strong background on both the psychological symptoms and syndromes specific to mass trauma.
  • Prepare physicians to conduct acute assessments and interventions.

January 22nd at 7:30amCurrent Concepts in Concussion for Pediatric and Adult Patients

Register for this webinar here.

Faculty: Deborah Light, MD

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

January 30th at 7:30amVeterans Matters:  PTSD & TBI in Veterans

Register for this webinar here.

Faculty: Emerald Lin, MD

Educational Objectives:

  • Identify signs and symptoms of PTSD & TBI
  • Examine evidence-based treatment modalities for PTSD & TBI
  • Explore military culture and methods to overcome unique barriers to treatment intrinsic to military culture

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, CLANCY)

 

 

December 22, 2017 – Oh, Those 7 Words!

 

Charles Rothberg, MD - MSSNY President
PRESIDENT’S MESSAGE

Charles Rothberg, MD
December 22, 2017
Volume 17
Number 47

MLMIC Insurance for Physicians


Dear Colleagues: 

Last Friday, the Washington Post reported that an unnamed “analyst” said, at a meeting on December 14, unnamed officials told CDC workers that they were “banned” from the use of seven words: entitlement, diversity, vulnerable, transgender, science-based, evidence-based and fetus.

Other sources later reported that it was not accurate to say that CDC had been “ordered” not to use the seven words. The “corrected” story was that agency budget analysts were told that some words and phrasing might be more likely to win support for the CDC’s budget in the current Congress.

After careful consideration, I thought I should end this year on a note of well-intentioned levity.

According to my entitlement as president of MSSNY, I am proud to report that in my inaugural speech, one of my “Three Pillars” specified that “the future must include ALL contributors to adverse health outcomes—gender, LGBTQ, geography, poverty and even physician diversity…For example, while there is very little research on transgender people in New York State, it is clear they struggle with discrimination, poor access to education and employment and a lack of economic opportunities that impact their health status and access to health care services… Failure to examine any one group’s adverse health outcomes compromises the solutions for all of the other groups.”

For the CDC to leave physicians out of the loop of word elimination and directed only to their own employees, it leaves physicians vulnerable as we try to explain that all our medical decisions are not only science-based, but also evidence-based as we were taught in medical school. When politics intercedes with science, it is no longer science.

Even a child knows that—maybe even a precocious fetus.

I hope the late comedian George Carlin, author of the “Seven Words You Can’t Say on Television” is listening and chortling along with us.

I wish you and your families a Happy and Healthy New Year!

Sincerely,

Charles Rothberg, MD
MSSNY President

Please send your comments to comments@mssny.org



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WHAT CAN I DO?

Please Urge Governor Cuomo to Veto Disastrous Liability Expansion Bill and Work for Comprehensive Reform Instead
All physicians are urged to contact the Governor to continue to urge that he veto legislation (S.6800/A.8516) that would significantly expand the time to bring a medical malpractice lawsuit, in circumstances based upon an “alleged negligent failure to diagnose a malignant tumor or cancer”.  Please urge him to work to develop comprehensive legislation that addresses the many deficiencies of New York’s malpractice adjudication system, particular given that New York overwhelmingly has the highest medical liability costs in the country.  You can send a letter to the Governor here and call 518-474-8390.

S.6800 is the only bill remaining that has passed both Houses of the Legislature in 2017 but has not been delivered to the Governor.  It is required to be delivered to the Governor by the end of 2017.  However, the State Constitution provides the Governor with up to an additional 30 days to consider legislation if the Legislature adjourns its Session within 10 days of a bill being delivered to the Governor.   As a practical matter, this likely means that the Legislature and the Governor will be having discussions on this legislation in January after the beginning of the new Legislative Session.  Therefore, we need physicians to keep up their contacts to the Governor urging the need for comprehensive medical liability reform legislation, rather than one-sided bills that will add to our already exorbitant costs and exacerbate already challenging access to care issues for patients.

House Passes Resolution to Fund Federal Government through January 19
Last night, the United States House of Representatives and Senate passed a Continuing Resolution to fund the federal government through January 19, 2018. Importantly, the bill included extended funding for the Children’s Health Insurance Program (CHIP) through March 31, 2018, among other provisions. It also importantly contains provisions to prevent Medicare sequestration cuts to physician and hospital payments that otherwise may have been required as a result of the major tax reform legislation passed by Congress earlier this week.  The Act also includes provisions that would extend the Community Health Centers program, National Health Service Corps program, and program for Teaching Health Centers that operate GME programs, as well as the Special Diabetes Program for Type 1 Diabetes and Special Diabetes Program for Indians, with funding available for the first and second fiscal quarters of 2018. It is expected to be signed into law by the President. 

OBS Reporting Requirement Delayed Until April
Physicians with accredited Office Based Surgery (OBS) practices should soon be receiving a letter from the New York State Department of Health (DOH) requesting they report information regarding the total number of procedures performed in their OBS setting for 2017.  While DOH initially proposed to require OBS practices to begin reporting this information starting January 1, after meeting with MSSNY and specialty society representatives, the DOH indicated that it intends to pursue a regulation to impose such a requirement, with the requested time period for making this reporting not beginning until March 31, 2018 (and running through June 30, 2018).

Earlier this year MSSNY reported in its e-news and News of New York regarding this DOH proposal.

Past-MSSNY President Dr. William Rosenblatt had raised concerns at meetings of the NYS Office-Based Surgery Advisory Committee that such a burdensome reporting requirement was unnecessary when much of this information is already collected by one of the major OBS accrediting bodies.  Moreover, there were serious concerns with the proposed requirement to report this information by CPT code, when many OBS practice do not regularly include the CPT code in when detailing the procedural information in their medical record systems.  These concerns were also raised by MSSNY Board of Trustees member Dr. Andrew Kleinman at a recent meeting with DOH along with representatives of MSSNY, New York State Society of Plastic Surgeons and the New York Chapter of the American College of Physicians.

To reduce physician administrative burdens associated with complying with this requirement, DOH staff have indicated that there are considering the physician community’s suggestion that the information be collected from the accrediting body, as well as permitting reporting by procedure name instead of CPT code.  DOH is also requesting that the information be reported via the HERDS application of the Health Commerce System (HCS).  Discussions are ongoing how to reduce the challenges of physicians using the HERDS system.

As this issue remains fluid, please remain alert for further updates as MSSNY and its General Counsel, (the Garfunkel Wild law firm) continues to dialogue with DOH staff on this issue.

New Member Benefit:
Discount Tickets to Knicks and Rangers Games

We are pleased to provide MSSNY members with special access to discounted tickets for upcoming Rangers & Knicks games. This offer provides savings off of individual game tickets and can be shared with your friends & family. Your tickets will be emailed to you 48 hours prior to the start of each game. For all questions and to purchase, please reach out to cole.schlesinger@msg.com or by phone at 212-631-5739 or go to their website here.

MSSNY Participates in DOH Meeting to Discuss Physician Profile and Collaborative Drug Therapy Expansion
This week MSSNY staff participated in a meeting convened by the NYS Department of Health with several health provider organizations to discuss legislative proposals for which MSSNY has previously have expressed concerns.  These included legislation to expand the information required to be included on the NYS Physician Profile and legislation to significantly expand the scope of the existing physician-pharmacist Collaborative Drug Therapy (CDT) program.  These proposals will likely be given great attention during the 2018 Legislative Session.

Regarding the physician profile proposal, the legislation would require the Physician Profile to include a) the office hours of the physician’s primary practice location b) whether they are accepting new patients c) the availability of assistive technology, and d) health plan participation information that would be provided by the DOH.  In addition, it would require physicians to complete a workforce survey when they complete their profile update.  MSSNY, along with representatives of the NY Chapter of the American College of Physicians, expressed concerns that many of these proposed additional Profile items do not lend themselves to a fixed answer unlike other existing Profile items.  It could require frequent updating when there a changes made by a health system, or large group practice, which could create extraneous administrative reporting requirements at a time when physicians are already overwhelmed with administrative tasks that interfere with the time needed for patient care delivery.  MSSNY also raised concerns that the Profile could contain inaccurate health plan participation information, given that physicians often raise concerns about being listed inappropriately.

Regarding the CDT proposal, DOH is seeking to expand the existing demonstration program scheduled to expire in 2018, which is currently limited to pharmacists employed by Article 28 facilities.  DOH would like to expand the program to include pharmacists not connected to Article 28 facilities and to permit nurse practitioners to participate in CDT with pharmacists.  MSSNY noted the existing demonstration program has been positive so far, but expressed concern that, of the 46 other states implementing similar CDT programs, very few have permitted these arrangements between NPs and pharmacists.


Your membership yields results and will continue to do so. When your 2018 invoice arrives, please renew.
KEEP MSSNY STRONG!


YPS/RFS/MSS SAVE THE DATE

Save the date for the joint YPS/RFS/MSS Annual Meetings on Saturday, February 3, 2018 at the Courtyard Marriott, 1800 Privado Road, Westbury.
Colleagues will discuss policy, participate in important presentations, and hold section leadership elections. Lectures will include an interactive dialogue/discussion on Physician Burnout and a presentation, Your Medical Records: An Asset or Liability? Your Employment Contract: Protecting Yourself Before You Sign…Or At Least Know What’s In It.”* Webinar available. MSS RSVP to mreyes@mssny.org. RFS and YPS RSVP sbennett@mssny.org. RSVP sbennett@mssny.org

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

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

WEBINARS

 “Mental Health and Disasters Overview” CME Webinar on January 17, 2018; Registration Now Open

Upcoming in MSSNY’s Medical Matters continuing medical education (CME) webinar series is: Mental Health and Disasters Overview”.  This webinar will take place on Wednesday, January 17, 2018 at 7:30 a.m.   Craig Katz, MD Clinical Professor of Psychiatry and Medical Education at the Icahn School of Medicine at Mount Sinai in New York City since 2000 will conduct this presentationRegister for this webinar here.

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

Educational objectives are:

  • Explore the psychological impact of mass trauma.
  • Provide physicians with a strong background on both the psychological symptoms and syndromes specific to mass trauma.
  • Prepare physicians to conduct acute assessments and interventions.

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. 

Medicare/Medicaid/CMS

Medicare Preventive Services
For those of you interested in an educational tool on Medicare Preventive Services, please click here.

This is a 37-Page tool from CMS Medicare outlining the HCPCS procedure codes, ICD-10 codes and Medicare patient responsibility for deductible and/or coinsurance for each preventive service covered by Medicare.  The document also defines the frequency that each service is available.  This should be helpful to those of you treating Medicare patients.

MACRA QPP Information
2018 is fast approaching, which will mean some changes to Medicare’s Quality Payment Program (QPP).  Physicians who weren’t exempted based on treating less than 100 Medicare patients or receiving less than $30,000 in approved charges will have to submit their 2017 data by March 31, 2018.

To read more about the 2018 changes, CME credit courses on QPP and other resources, go to the CMS QPP website here. You can also link to IPRO at www.NYQPPHELP.ORG  for additional information. To directly request IPRO’s technical assistance, go here. If you use twitter, follow IPRO for other important updates@ipro_qpp.

Low Volume Appeals Settlement Option Call — Tuesday, Jan. 9 1:30 to 2:30 pm ET
Register for Medicare Learning Network events.

As part of the broader HHS commitment to improving the Medicare appeals process, CMS will make available a settlement option for providers and suppliers (appellants) with fewer than 500 appeals pending at the Office of Medicare Hearings and Appeals (OMHA) and the Medicare Appeals Council (the Council) at the Departmental Appeals Board.

During this call, learn about the low volume appeals settlement option and how the settlement process will work. CMS speakers discuss how to identify whether you are eligible and which of your pending appeals may be settled. Visit the Low Volume Appeals Initiative webpage for more information.

This call will not include a question and answer session. Submit questions in advance to MedicareSettlementFAQs@cms.hhs.gov. Questions may be addressed during the call or used for materials following the call.

WORKERS COMP REGISTRATION

Workers Compensation Will Be Proposing a Drug Formulary
Next week, the NYS WCB will be producing a drug formulary for WC claimants.  It will be formally proposed next week, but not implemented until 7/1/18.  It is anticipated to be consistent with the Medical Treatment Guidelines (MTGs).  It is expected that patients stabilized on non-formulary medications can continue after 7/1/18, but after 1/1/19 will require a Prior Authorization. WC Carriers will have 4 days to review requests for non-preferred drug, but a patient can get 4-day supply of pain medication or muscle relaxant in interim. The PROPOSED WC drug formulary will be subject to public comment after publication in the State Register.

Please look for more information on this next week from the WCB in their WC Board notices. The WCB website is here.

Workers Compensation Health Provider Registration Is Now Open
The Workers’ Compensation Board has initiated a registration process to update the list of medical providers who are authorized to treat injured workers. The updated list will ensure that an injured worker can easily identify Board authorized providers.

Authorized providers are required to register by January 15, 2018Providers who have not registered by the deadline will:

  • Be removed from the public directory of authorized providers
  • Become ineligible for the Board’s disputed bill process.

The up-to-date list will ensure that an injured worker can easily identify Board authorized providers.
How to Register
The Board is using the existing New York State Health Commerce System (HCS) for the registration process and future updates to your registration information. You will need to create an HCS account if you do not already have one. Information on creating an account can be found on the New York State Department of Health website.

Existing HCS account users – How to Access the Registration Form

  1. Log in here.
    2. Select My Content > All Applications from the Main Menu.
    3. Select P from Browse by list, and then add Person-based Electronic Response Data System (PERDS) to your application list by selecting + under the column add/remove.
    4. On the top of the page, select Home.
    5. On the home page, select Refresh My Applications List.
    If PERDS does not appear in My Applications List call (800)-781-2362, option 6.
    6. Select PERDS on the My Applications list to open it.
    7. Select the Data Entry tab located on the top left of page.
    8. In the Activity field, select WCB Registration from the drop-down list.
    9. The following default values will be shown:
Activity:  WCB Registration
Form:  WCB Registration for Health Care Provider
Data Entity Type:  WCB Provider
Data Entity Name:  Please Select Name
  1. Select the Search WCB Provider button.

Search Entity (Validation of Information)
When you select the Search WCB Provider button, you are brought to the Search Entity page. On this page, please do the following:

  1. The field Entity Id must be left blank for your initial registration.
    2. Select the Profession from the drop-down list.
    3. Complete the License Number, Birth Month and Birth Day fields.
    4. Select the Search button.
    5. If your information is correct, an Entity Id is displayed below the blue Search Entity line. Keep this number for your records. It is not stored in the registration form.
    6. If the name that appears on the page is the same as it is on your license, click the Select button to proceed. If it is incorrect, select the Name Field Help icon for further assistance.

Complete the Registration Form
Complete your registration, be sure to click the Save All, Review & Submit and Submit to DOH buttons. This will ensure you are found on the public directory of authorized providers and remain eligible for the Board’s disputed medical bill process.

If you are registering multiple providers on their behalf, do not close the PERDS application after you register the first provider. For each subsequent provider:

  1. Select the Home tab located at the top left of the page (next to the Data Entry tab).
    2. Follow steps 7-10 in the How to Access the Registration Form section.
    3. Follow steps 1-5 described above in the Search Entity (Validation of Information) section.

If you do not have computer access to complete the registration online, you may request a paper copy be mailed to you by contacting the NYS Workers’ Compensation Board Medical Director’s Office at (800)-781-2362, option 6.

Questions?
For instructions that include screen shots of the registration process, please see the PDF link at the bottom of this email titled “Health Provider Registration Instructions” or email wcbcustomersupport@wcb.ny.gov with the subject “Provider Registration Instructions”.

If you have general questions regarding health care provider registration, please contact the NYS Workers’ Compensation Board Medical Director’s Office at (800)-781-2362, option 6.


GARFUNKEL WILD, P.C.
GENERAL COUNSEL TO MSSNY

 GW’s attorneys can advise and represent you in matters including: OPMC; compliance issues; employment disputes; real estate leases and purchases; wills and estate planning; corporate transactions; litigation and arbitrations; audits and investigations; and payor disputes.
Offices in Albany and Great Neck, New York
516.393.223


Women Outnumber Men Enrolling In Medical School
New data released Monday show that the number of women enrolling in medical school has exceeded the number of male first-year students for the first time.

According to the Association of American Medical Colleges, women represented 50.7% of the more than 21,000 new medical school enrollees in 2017. Men still make up 51% of total enrollment in U.S. medical schools in 2017, but the number of women applying to medical school has been on the rise in recent years, compared to a decline in male applicants.

The number of female first-year medical students increased by 3.2% in 2017 over the previous year, and has grown by more than 9% since 2015 while the number of male enrollees fell by 2.3% over the past two years.

The changing demographic reflects an overall shift in priorities for physicians, as more hope to achieve a positive work-life balance. A recent AAMC survey of first-year medical school students found 47% of respondents reported having a good work-life balance as their top consideration when they were ready to start their career.

Potential employers increasingly use incentives like flexible work hours to entice physicians to join their ranks. A growing number of doctors leaving the profession have cited increased anxiety as a factor in their decision, with about half of physicians reporting plans to retire, reduce their hours or leave their clinical positions as a result, according to a 2016 report from the Physicians Foundation.

Potential employers have noticed the change. More companies are offering flexible work hours to entice physicians to join their ranks.

Roughly a third of physicians in the U.S. are women.

MLMIC: New Public Health Law Allows NPs to Write DNR/ MOLST Orders
On November 29, Governor Cuomo signed Senate Bill S1869A into law, amending the New York State Public Health Law to allow attending nurse practitioners (NPs) to sign Do Not Resuscitate (DNR) orders and Medical Orders for Life-Sustaining Treatment (MOLST). The law goes into effect on May 28, 2018, at which time patients will have the option of making healthcare decisions with a healthcare provider of their choice, including nurse practitioners who are acting as primary care providers. Under the existing law, only an attending physician may sign DNR and MOLST orders on behalf of patients and their families.

The new law acknowledges that nurse practitioners are increasingly serving as primary care providers, especially in the nursing home setting, that NPs possess the required expertise and training to execute DNR and MOLST orders, and that end-of-life decisions will no longer require an order from a physician with whom the patient may not have had an established relationship.

To read Bill S1869A in its entirety, please click here and select “text” in the tool bar.

Tip of the Week

By Jacqueline Thelian, CPC, CPC-I, CHCA, Medco Consultants, Inc.

Hundreds of Laboratory Codes See a Reduction on Reimbursement for 2018

Many of the common laboratory tests performed in physicians’ practices such as CBC (85025) Comprehensive Metabolic Panel (80053) Prothrombin (85610) and hundreds of others are set to for a 10% payment reduction and an additional 115 codes will see a 9% reduction in reimbursement.

The new fees will go into effect on January 1, 2018. The reduction is due to the Protecting Access to Medicare Act (PAMA) 2014 which instructs Medicare to bring the lab rates in line with the lab rates reimbursed by private payers.

Many physicians running labs are doing so on a very slim profit margin and the reduction will bring the sustainability of in office laboratory testing in question.

More information on the laboratory reduction as well as the 2018 Laboratory fee schedule visit the CMS website https://www.cms.gov/Medicare/Medicare-Fee-for-Service-Payment/ClinicalLabFeeSched/PAMA-Regulations.html

Source:

  • Current Procedural Terminology (CPT) 2018
  • CMS Laboratory Fee Schedule 2018

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

CLASSIFIEDS

RENTAL/LEASING SPACE


Space Available in North Bronx
● Medical Office for Rent
● Located on the Grand Concourse (walking distance from all major transportation)
● 2 Examination Rooms
● Large Waiting Area
● Private Doctor’s Office
● Fully equipped with new furniture
Contact info: jp@bronxheart.com // 718-584-0797


Want to Work in NYC but Live 100 Yards from the Atlantic Ocean?
Ocean views abound in this beautiful Rockaway Beach 1 family brick home. 5 bedrooms, 3 bathrooms. 60×100, detached 1 car garage, central air, sprinkler, alarm, large rear deck and heated pool. New finished basement, master bedroom on main floor and full bath. Tons of storage, solar panels. Beautiful front porch with ocean views. Located in Rockaway beach on a block 100 yards from the ocean! $1,750,000. Call 718-634-6004.

Upper East Side Plastic Surgery Office Available for Rent or Share
Beautifully equipped Plastic Surgery office available for part-time share along with Quad A-certified OR available for rent. Located in a lovely carriage house on the Upper East Side in close proximity to Lenox Hill Hospital and MEETH and conveniently located near all NYC mass transit. 1 exam room/OR and Recovery room along with large administrative space. Free WIFI. Available for full or half-days. Suits Plastic/Cosmetic Surgeons/ DERM/ ENT/or other Medical MDs. Please contact Kim at Kim@madisonps.com (212) 628-7600.

For Rent or Share – Woodbury, Long Island
Beautiful recently renovated Plastic Surgery office available for part-time share and AAAA-certified (by end of summer). OR available for rent. Centrally located
on Long Island.Close to expressways. 3 exam rooms, 1 procedure room /OR.
Waiting room, break room and personal office. Free WIFI. Available for full or half-days. Suits Plastic/Cosmetic Surgeons/Derm/ENT/
ObGyn/Podiatry or other Medical MDs.
Contact Patricia at info@cosmetichg.com
or 631-318-4008

PHYSICIAN OPPORTUNITIES


Paging Primary Care MDs Who Love Technology
98point6 is a Seattle startup who wants your input. We’re seeking practicing physicians to join our council and help shape the next generation of primary care. If the fusion of health care and technology inspires you, please apply here.


Medical Director: Binghamton University College Physician (SL-6)
Department: Student Health ServicesLocations:   Binghamton, NYPosted: Oct 24, ’17Type:  Full-timeRef. No.: 49225The Decker Student Health Services Center at Binghamton University (The State University of New York at Binghamton) invites New York State Medical or Osteopathic Board Certified Physicians (Internal Medicine, Family Practice) to apply for a full-time, twelve-month position. This position plans, directs, supervises, and participates in the outpatient medical care of undergraduates and graduate students of a diverse student base.  The person will have excellent, primary care diagnostic skills as well as experience and proficiency in common outpatient surgical procedures, EKG and pulmonary function study interpretation, office laboratory and clinical microscopy.  This position functions as an on-site medical consultant and collaborative physician to the professional staff that includes 10 nurses, 5 nurse practitioners and 7 physicians.The individual will have five years of clinical experience after residency training and experience with staff oversight and leadership.The Medical Director provides the university campus with infectious disease direction (e.g. meningitis, measles and tuberculosis) and emergency management; participates on the Crisis Response Team; provides direction and consultation to the Dean of Students, University Counseling Center and Residential Life.  This person will be responsible for accreditation activities including; completion of internal and external benchmark studies peer chart review; completion of assessment plans, survey and risk management reports; meeting with site visitors; and following through on recommendations.Requirements: Required qualifications: NYS Board Certified Medical or Osteopathic Physicians (Internal Medicine, Family Practice) from an accredited institution; 5 years of clinical experience after residency; NYS medical license and DEA certificate that are free from special conditions or limitations. Salary: commensurate with qualifications and experience. Preferred qualifications are, but not limited to: college health familiarity; experience with diverse populations; electronic health record navigation; quality assurance, and continuous quality improvement; public health and policy experience. Payroll information can be found on our website http://www.binghamton.edu/human-resources/payroll/Cover letters may be addressed “To the Search Committee.” Postings active on the website accept applications until closure. For information on the Dual Career Program, please visit:
https://www.binghamton.edu/human-resources/dual-career-program/
Application Instructions:Deadline for Internal Applicants:  11/07/2017 Deadline for External Applicants:  Open until filled Review of applications will begin immediately and continue until the vacancy is filled.Persons interested in this position should apply online.Please submit: 1. Resume 2.Cover letter, and 3.Contact information for three professional references You may add additional files/documents after uploading your resume. After you fill out your contact information, you will be directed to the upload page. Please login to check/edit your profile or to upload additional documents: http://binghamton.interviewexchange.com/login.jsp Payroll information can be found on our website http://www.binghamton.edu/human-resources/payroll/
Additional Information:Offers of employment may be contingent upon successful completion of a pre-employment background check and verification of degree(s) and credentials.Binghamton University is a tobacco-free campus.Pursuant to Executive Order 161, no State entity, as defined by the Executive Order, is permitted to ask, or mandate, in any form, that an applicant for employment provide his or her current compensation, or any prior compensation history, until such time as the applicant is extended a conditional offer of employment with compensation.  If such information has been requested from you before such time, please contact the Governor’s Office of Employee Relations at (518) 474-6988 or via email at info@goer.ny.govEqual Opportunity/Affirmative Action Employer
The State University of New York is an Equal Opportunity/Affirmative Action Employer.  It is the policy of Binghamton University to provide for and promote equal opportunity employment, compensation, and other terms and conditions of employment without discrimination on the basis of age, race, color, religion, disability, national origin, gender, sexual orientation, veteran or military service member status, marital status, domestic violence victim status, genetic predisposition or carrier status, or arrest and/or criminal conviction record unless based upon a bona fide occupational qualification or other exception.
As required by title IX and its implementing regulations Binghamton University does not discriminate on the basis of sex in the educational programs and activities which it operates.  This requirement extends to employment and admission.  Inquiries about sex discrimination may be directed to the University Title IX Coordinator or directly to the Office of Civil Rights (OCR).  Contact information for the Title IX Coordinator and OCR, as well as the University’s complete Non-Discrimination Notice may be found here. The State University of New York is an Equal Opportunity/Affirmative Action Employer.  As required by title IX and its implementing regulations Binghamton University does not discriminate on the basis of sex in the educational programs and activities which it operates.  This requirement extends to employment and admission.  Inquiries about sex discrimination may be directed to the University Title IX Coordinator or directly to the Office of Civil Rights (OCR).  Contact information for the Title IX Coordinator and OCR, as well as the University’s complete Non-Discrimination Notice may be found here.

Medical Director – AIDS Institute
Minimum Qualifications:
Current license and registration to practice medicine in New York State and board certification AND either a Master’s Degree in Public Health or two years of experience in an HIV program or public health program.Preferred Qualifications:
Master’s Degree in Public Health.  Five years of experience including clinical service in an HIV program or clinical fellowship program (infectious diseases/HIV medicine).  Experience in quality management/quality improvement.  Knowledge of the HIV health care delivery system in New York State. Experience in/knowledge of the New York State Ending the Epidemic initiative.  Experience in STD prevention and care, drug user health, and/or LGBT health.  Experience in health policy development, analysis and evaluation.  Experience with evolving health information technologies.  Experience in health program management and administration.
Responsibilities: The Medical Director, AIDS Institute, plays a significant role in shaping HIV, hepatitis C, and STD care and services, drug user health, and LGBT health care throughout New York State.Please click the link below for more information pertaining to this position and to apply: “https://careers-healthresearch.icims.com/jobs/search?ss=1&hashed=-435829071” Affirmative Action/Equal Opportunity Employer/Qualified Individuals with Disabilities/Qualified Protected Veterans

Multiple Physician Positions with DOHMH Office of School Health
Office of School Health is the largest program of the New York City Department of Health and Mental Hygiene (DOHMH). This bureau is responsible for managing the health issues and promoting the well-being of the over 1.3 million children and adolescents enrolled in New York City’s 1700 school buildings.

Positions with the Office of School Health (OSH) combine clinical skills and public health training.

Adolescent School Health Physician
This position offers to the interested physician the opportunity to help address the clinical and public health needs of adolescents in NYC high schools. The physician will work with the innovative Connecting Adolescents to Comprehensive Health Care (CATCH) Program, which provides select reproductive health services to adolescents in select NYC high schools. In addition, the physician will provide medical care and public health services through additional programs offered to adolescents by the Office of School Health.

Under the supervision of the High School Supervising Physician, the Adolescent School Health Physician’s responsibilities will include but are not limited to:

  • Provide CATCH reproductive health services in select high schools.
  • Perform mandated physical examinations (New Admission Exams, Sports Physicals, and Working Paper Physicals).
  • Function as a liaison for students with community health providers to resolve medical issues that affect school performance.
  • Support the development and implementation of initiatives that promote positive health behaviors and reduce high risk behaviors in the adolescent population.
  • Serve as a consultant to the school nurse and administration on school related health concerns.
  • Provide clinical assistance in the event of an environmental or communicable disease occurrence.
  • Function as a liaison for students with community health providers to resolve medical issues that affect school performance.
  • Support all medical initiatives established by the Office of School Health, e.g. programs and protocols in asthma, reproductive health, obesity and diabetes.
  • Maintain good public relations and communicate effectively within the school community and community-based organizations.
  • Keep abreast of health management policy statements and emerging clinical research related to school health.
  • Participate in OSH research activities.
  • Work within the mandates, policies and protocols of the Office of School Health.
  • Attend all mandated DOHMH and OSH trainings.

To Apply: Please email your resume and cover letter to Dr. Caroline Volel: osh@health.nyc.gov OR  Apply online at https://a127-jobs.nyc.gov/.  In the Job ID search bar, enter: job ID number # 277208. 

School Health Field Physician
Under the direction of the Supervising Physician, the School Health Physician’s will:

  • Improve the health of school children through case management of chronic disease, preventive health screening and counseling, health education, and referrals.
  • Perform mandated physical examination (new entrant, sport physical, working paper physicals.
  • Develop relationships with community health providers in order to optimize medical management of students with health issues.
  • Attend to the health needs of your assigned school community.
  • Utilize the Automated Student Health Record (ASHR) to maintain adequate student health records.
  • Serve as a consultant to the school nurse and administration on school related health concerns.
  • Support the development of school educational and prevention programs promoting the health and wellness of all students.
  • Provide clinical assistance in the event of an environmental or communicable disease occurrence.
  • Develop and maintain professional relationships within the school community.
  • Support all medical initiatives put forth by the Office of School Health, e.g. Asthma, Reproductive health, Obesity and Diabetes initiatives.
  • Provide trainings/presentations to school staff, community organizations, or parents.
  • Stay abreast of health management policy statements and emerging research within the health community related to school health.
  • Participate in School Health research and quality improvement activities.
  • Participate in all mandated DOHMH and Office of School Health trainings and professional development sessions.
  • Attend all program meetings and Continuing Medical Education classes provided by the Office of School Health.

To Apply: Please email your resume and cover letter to Dr. Caroline Volel:osh@health.nyc.gov OR Apply online at https://a127-jobs.nyc.gov/.  In the Job ID search bar, enter: job ID number # 279844. 

Supervising School Health Physician 
Job Description
Under the supervision of the Deputy Medical Director, the Supervising Medical Doctor’s responsibilities will include but not be limited to:

  • Supervise School Health Physicians.
  • Work within the mandates, policies and protocols of the Office of School Health (OSH).
  • Attend to the health needs of a designated school community.
  • Utilize the Automated Student Health Record (ASHR) to maintain accurate student health records.
  • Serve as a consultant to the school nurse and school administrative staff regarding school related health concerns.
  • Support the development of school educational and prevention programs promoting the health and wellness of students.
  • Participate in policy development and revisions as indicated.
  • Provide clinical assistance in the event of an environmental or communicable disease occurrence.
  • Function as a liaison for students with community health providers to resolve health issues that affect school functioning.
  • Develop and maintain professional relationships within the school community and the community at large.
  • Support all medical initiatives put forth by the Office of School Health, e.g. Asthma, Reproductive health, Obesity and Diabetes Initiatives.
  • Keep abreast of health management policy statements and emerging research within the health community affecting school health.
  • Assist with or provide trainings/presentations to school health physicians, nurses, school staff, community organizations or parents
  • Participate in School Health research and quality improvement activities
  • Participate in all mandated DOHMH and Office of School Health trainings and professional development sessions
  • Attend all program meetings and Continuing Medical Education classes provided by the Office of School Health.

To Apply: Please email your resume and cover letter to Dr. Caroline Volel: osh@health.nyc.gov  OR  Apply online at https://a127-jobs.nyc.gov/.  In the Job ID search bar, enter: job ID number # 277026


MEDICAL EQUIPMENT


Retiring from pediatrics. I have medical equipment to donate: examining table, pediatric examining table with a scale, medical scale, examining instruments and miscellaneous office items. Forest Hills. Call 718 275-5858 or email mkolak59@gmail.com


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


 

December 15, 2017 – Opioids: A Challenge for All

 

Charles Rothberg, MD - MSSNY President
PRESIDENT’S MESSAGE

Charles Rothberg, MD
December 15 2017
Volume 17
Number 46

MLMIC Insurance for Physicians


Dear Colleagues: 

New York’s physicians continue to be on the front line of efforts to respond to the heroin and opioid abuse epidemic in New York and across the country.

This week, I, along with President Elect Dr. Tom Madejski and other MSSNY physician leaders and staff, met with the NYS Department of Health’s Bureau of Narcotics Enforcement (BNE) officials to discuss a number of issues regarding how best we can work together in confronting this problem.

One of the topics we discussed is streamlining the way by which physicians and their staff can check the I-STOP database.  New York is already a leader in these efforts.  For example, in 2016, physicians and other prescribers made over 18 million checks of I-STOP – a 9% increase from 2015.   As a result, the prescribing of opioids in New York State has decreased 13% from 2013-2016.  However, other states have simplified a sometimes cumbersome search process by inter-connecting the physicians’ EHRs and that state’s prescription database, saving valuable minutes (hours?) throughout the work day.  We are looking to create a similar system in New York.

I am happy to report that BNE has been working on a number of tracks to make this a reality, both in working with the local RHIOs to create a “single sign on” possibility but also obtaining a CDC grant that would facilitate a direct connection between the I-STOP database and physician EHRs.

Please stay tuned for more information on this exciting development.

We also discussed a letter the BNE sent out in September to many physicians across the State advising these physicians that they may have “engaged in high risk opioid prescribing.”   We noted that many physicians receiving these letters expressed concern that they felt at risk for OPMC prosecution despite treating their patients in a way they believed was medically appropriate to the patient’s condition.

Similar to statements made by NY DOH representatives Keith Servis and Dr. Gregory Young at a recent public forum in Buffalo convened by the Erie County Medical Society, BNE staff assured that the goal of the letter was not intimidation, but education for these physicians regarding the CDC’s chronic pain guidelines.

We offered our assistance in helping the DOH and BNE communicate to physicians regarding prescribing issues that could put them and their patients at risk, and will continue to work proactively with them.

The opioid abuse epidemic is a challenge to all of us.  The physician community has been and must continue to be a leader in responding to this challenge.  We will continue to push back against potentially overbroad enforcement efforts that may intimidate physicians from providing needed patient care.  At the same time, we will also continue to assure that physicians have the information and tools they need to assure their patients receive the most appropriate care.

Sincerely,

Charles Rothberg, MD
MSSNY President

Please send your comments to comments@mssny.org



enews large


WHAT CAN I DO?

Please Urge Governor Cuomo to Veto Disastrous Liability Expansion Bill and Work for Comprehensive Reform Instead
Legislation (S.6800/A.8516) that would significantly expand the time to bring a medical malpractice lawsuit, in circumstances based upon an “alleged negligent failure to diagnose a malignant tumor or cancer” remains one of 7 bills that have passed both Houses of the Legislature, but have not yet delivered to the Governor for his approval or veto.

Because it has not been paired with badly needed medical liability reforms, if signed into law this measure is predicted to prompt an 11% increase in malpractice premiums at a time when New York already has by far and away the highest cumulative liability costs in the country.  Please urge the Governor to veto this bill and in support of needed comprehensive medical liability reform by sending a letter to the Governor here and call 518-474-8390.

This week the Empire Center for Public Policy released a report regarding the compelling need for liability reform in New York to make it more competitive, including highlighting the exorbitant costs for medical liability insurance compared to other states.  It was the subject of an article in Crains’ Health Pulse, featuring a quote from MSSNY President Dr. Charles Rothberg: “It is imperative that Gov. Cuomo veto this liability expansion measure and for the state Legislature to work with the governor to enact comprehensive medical-liability reform.

News

New Report: NY Doctors Pay Higher Liability Costs than Any Other US Doctors
Statement attributed to: Charles Rothberg, MD, MSSNY President,

The Empire Center’s new report on tort liability confirms a reality that New York doctors (particularly those practicing in downstate New York) already know. New York physicians pay higher liability costs than physicians in almost every other state. For decades, reasonable proposals to bring some balance to our tort system have been systematically rejected by the New York Legislature. This year, not only were these needed reform proposals again not passed, our legislators voted to greatly lengthen the time to bring malpractice suits that are going to cause significant increases to our already exorbitant costs!

With New York potentially facing huge cuts and significant tax changes from the federal government, the need for balanced comprehensive medical liability reform is more important than ever. New York State has already received the dubious distinction of being the worst state to practice medicine, in part due to our excessive liability costs.

It is imperative that Governor Cuomo veto this liability expansion measure, and for the State Legislature to work with the Governor to enact comprehensive medical liability reform that addresses systemic deficiencies that plague doctors, hospitals, and in turn, hurt our patients.”

NY Files $575M Lawsuit against Federal Govt. to Help Pay Health Republic Claims
As part of the liquidation process for the dissolution of Health Republic, the New York Department of Financial Services (DFS) has initiated a lawsuit against the federal government seeking to recover over $575 million owed to Health Republic under various ACA programs, such as Risk Corridor payments, Reinsurance, Risk Adjustment payments, Advanced Premium Tax Credits, and Cost-Sharing Reduction payments.  The lawsuit was noted as part of the Order to Show Cause filed by the attorney for the Department of Financial Services (DFS) overseeing the dissolution of Health Republic.  Health Republic was shut down in the fall of 2015 after it was determined it was unable to pay its claims, and it has been in liquidation proceedings since that time.

A report shows that, as of September 30, 2017, Health Republic had total assets of approximately $40 million and total liabilities exceeding $700 million. The liquidator began issuing explanations of benefits (EOBs) to members and providers with policy claims from August to October 7.  It was noted that there are over $211 million in outstanding claims to providers to be paid.

Possible Delay in Jan. 1 Requirement for OBS Practices to Report Procedural Info
Earlier this year MSSNY reported in its e-news and News of New York regarding a DOH proposal that would have, starting January 1, 2018, required physicians with Accredited Office-Based Surgery (OBS) practices to electronically report extensive information by CPT code of the total number of procedures performed in the physician’s office.  However, this week we received word from DOH staff that it was not moving forward with the January 1 reporting requirement, examining whether it may be necessary to impose this reporting requirement with a formal regulation.  However, reporting could still be required later in 2018.

Past-MSSNY President Dr .William Rosenblatt had raised concerns at meetings of the NYS Office-Based Surgery Advisory Committee that such a burdensome reporting requirement was unnecessary when much of this information is already collected by one of the major OBS accrediting bodies.

Moreover, MSSNY Board of Trustees member Dr. Andrew Kleinman, together with representatives of MSSNY, New York State Society of Plastic Surgeons and the New York Chapter of the American College of Physicians recently met with NYS DOH representatives to echo these concerns about the potentially burdensome nature of the requirement, and in support of obtaining the needed information from the accrediting bodies.

As this issue remains fluid, please remain alert for further updates as MSSNY and its General Counsel, (the Garfunkel Wild law firm) continue to dialogue with DOH staff on this issue.

NYS Department of Health: 1,800 Cases Confirmed; 54 Hospitalized
The New York Health Department said the flu has grown prevalent throughout the state, meaning healthcare workers who have not been vaccinated must don procedural masks around patients. The Health Department has confirmed more than 1,800 cases of flu in 54 counties and all of New York City’s boroughs, more than 600 of which “required hospitalization.”  The NYS Weekly Surveillance Report is available here.

The Regulation for Prevention of Influenza Transmission went into effect during the 2013-14 influenza season.  It requires unvaccinated health care workers in Article 28 facilities regulated by the NYSDOH to wear surgical or procedure masks during those times when the commissioner declares that influenza is prevalent in NYS.  Amendments to the regulations allow for the removal of masks when health care workers are accompanying patients in the community, providing speech therapy services, or communicating with persons who lip read. This influenza season, New York has had 1,820 laboratory-confirmed cases of influenza in 54 counties and all boroughs of New York City. There have been 612 influenza-related hospitalizations reported, and no reports of pediatric deaths from influenza. Over the last three seasons, there have been 19 pediatric influenza deaths in New York and an average of 11,183 influenza-related hospitalizations each season.

Dr. Monica Sweeney Represents MSSNY at Hearing on Immigrant Access to Care
This week Dr. Monica Sweeney, Co-Chair of MSSNY’s Committee to Eliminate Health Disparities and Vice-Dean and Clinical Professor at SUNY Downstate, delivered testimony at a NYS Assembly hearing examining Immigrant Access to Health Care.

Specifically, she highlighted MSSNY’s advocacy (together with many other health advocacy organizations) to New York’s Congressional delegation in support of continued funding for the Child Health Insurance Program and the Essential Health Plan—both of which provide low-cost health insurance coverage for many New Yorkers including immigrants.  Specifically, she noted that “Failing to assure this continued funding will almost certainly result in many New Yorkers, including many immigrants, waiting until a health care emergency to seek needed medical care.”  Moreover, she noted MSSNY’s support for continuing Congressional funding for community health centers, noting that many immigrants receive care at Federally Qualified Health Centers (FQHCs).

Furthermore, she highlighted MSSNY’s work with the AMA to urge Congress to support the continuation of the Deferred Action for Childhood Arrivals (DACA) program.  She noted that those with DACA status “help contribute to a diverse and culturally responsive physician workforce, which benefits all patients”, and that “Failure to continue this program could have significant consequences, for the healthcare workforce, and of course the patients who depend on their care”.

To view Dr. Sweeney’s testimony, please go here, and go to the 3:55 mark. 

MSSNY Member Dr. Anthony Szema’s New Book Unusual Diseases with Common Symptoms: A Clinical Casebook Is Now Available
Anthony M. Szema, MD, FCCP. FACAAI, FAAAAI, FACP, author of Unusual Diseases with Common Symptoms: A Clinical Casebook, details case reports of uncommon diseases that present with common symptoms, many of which have emerged in the past decade as a result of nature, advances in medical treatment, and increasing recognition of specific underpinnings of human biology and immunology. These rare diseases must now be considered when the mundane diagnoses do not exactly fit the patient’s clinical history or treatment fails. Some of these diseases include: eosinophilic esophagitis, blastocystis hominis infection, and paromyces allergic fungal sinusitis.

Chapters provide in depth clinical examples of a wide range of diseases affecting multiple organ systems. Each case is structured by: a vignette of the case, background/salient features of the case, diagnosis, treatment, key points, and questions to aid in critical thinking. Unusual Diseases with Common Symptoms: A Clinical Casebook is of great interest to practicing physicians and as a teaching resource for students and residents who will one day encounter conditions more complex than they initially appear. It includes historical context, reviews early and later literature, and makes recommendations for clinical care.
Dr. Szema is also the editor of World Trade Center Pulmonary Diseases and Multi-Organ System Manifestations.

His book is available here.

UnitedHealth Buys DaVita Unit for $4.9B
UnitedHealth Group has agreed to buy dialysis provider DaVita’s medical unit for $4.9 billion in cash to expand the national insurer’s outpatient care services, the company said December 13. DaVita Medical Group will be combined with UnitedHealth’s Optum, which runs the non-insurance portions of UnitedHealth’s business including primary and secondary care, consulting and data analytics. DaVita’s physician network provides care to approximately 1.7 million patients every year in Florida, California, Colorado, Washington, Nevada and New Mexico. The group also runs 35 urgent-care centers and six outpatient surgery centers.

Optum’s New York footprint includes the medical group ProHealth in Lake Success, Long Island. Westmed, a medical practice with locations in Westchester County, New York City and Fairfield County in Connecticut, collaborates with Optum on its Medicare Shared Savings Program accountable care organization. (Modern Healthcare) 

Another Opinion re CVS-Aetna Merger: Hazardous to Hospitals
As previously reports, CVS intends to expand its retail clinic model and will aim for one-stop shopping for wellness, clinical and pharmacy services, vision, hearing, nutrition, beauty and medical equipment. Its goal is for its locations to serve as “community-based health hubs” that can answer patients’ questions about prescription drugs, insurance coverage and their own health conditions. But Forbes contributor Bruce Japsen said this model may prove to be hazardous to the health of the nation’s largest hospital operators. Many hospitals admit they haven’t lowered costs enough to remain competitive to insurers and consumers, according to the article. And CVS already has a large geographic reach of 9,600 retail pharmacies that include 1,600 Target pharmacies. The megamerger will give the retail pharmacy 22 million health plan members who can take advantage of its 1,100 retail clinics, notes Forbes. Aetna’s network (PDF) includes 5,700 hospitals (out of 1.3 million providers total).

MSSNY Joins Other Physician Advocates to Urge Congress to Prevent Cuts to Medicare and Other Health Insurance Programs
As reported last week, MSSNY joined with several other physician advocacy associations in a letter to New York’s Congressional delegation urging continued funding for various health insurance programs as Congress debates a spending resolution required by the end of the year as well as the massive tax restructuring proposal.  This includes continued funding for the Child Health Insurance Program (CHIP), which helps to provide coverage for over 300,000 children in New York State, and continued authorization for health insurance subsidies including for New York’s Essential Plan, which provides low-cost “first dollar” coverage to nearly 700,000 New Yorkers who earn too much to qualify for Medicaid.   A report issued this week noted New York’s CHIP funding will run out by March if Congress does not allocate new funding.

Moreover, the physician associations’ letter urged our Congressional delegation to work to prevent potential further sequestration cuts to Medicare physician payments that could be imposed as a result of deficits potentially created through with the tax reform bill being negotiated between the House and Senate.   While several House and Senate leaders have stated that such sequestration cuts will be prevented, it is imperative that the physician and patient community continue to advocate assure that already inadequate Medicare physician payments are not even further reduced, and seniors’ access to care is not diminished.  Others joining on to the letter to New York’s Congressional delegation included the NYS Academy of Family Physicians, NYS Academy of Pediatrics, the New York County Psychiatric Association, the Doctors’ Council/SEIU and the local affiliate of the National Medical Association. 


Your membership yields results and will continue to do so. When your 2018 invoice arrives, please renew. KEEP MSSNY STRONG!


WELCOME: NEW MEMBER BENEFIT VeCyber

Your patient data continues to be at risk. With new threats arising every day, cybersecurity needs to be part of your daily operations to maintain HIPAA compliance and patient trust.

VeCyber takes a hands-on approach, partnering with your practice to measure and remediate your business risks.  We align with industry best practices and use a holistic approach that responds to current ground truth and brings your practice into a better defensive posture.

VeCyber removes the complexity from HIPAA compliance & cybersecurity risk management – so you can focus on patient care.

What you don’t know CAN hurt you.  We are here to help. GET STARTED TODAY.

In partnership with MSSNY, we’re offering MSSNY members an exclusive product & service package.  Please visit https://www.vecyber.com/mssny  to find out more or contact us at mssny@vecyber.com.

NEW SCAM ALERT

Caution to a New Scam; Caller Claims to Be from DEA and Requests Money
This week, MSSNY received a call from one our physician members in Huntington, NY.  He spent over an hour of his time dealing with a phone contact that was eventually deemed to be to a scam. The name the caller used was “Karl Kolder.” The physician was asked to confirm a shipment of drugs and the physician was informed of the need to send a bond. This was a rather sophisticated operation as the scam caller was from 1(800) 883-9539 (based on the caller ID),  which is the actual number of the Drug Diversion Unit of the US DEA.  When the physician did a “Google” search of the number it resulted in the name of the DEA Drug Diversion Unit. Please go here.

Regina McNally, VP Socio-Med Division, called the DEA. They responded, “This was a scam.  DEA confirmed that they would not telephone you to request anything like thisThese scammers try different ways to getting people/registrants to send moneyDO NOT EVER send money to DEA as they will never ask anyone to send money.”

The caller had the physician’s NPI number and the physician’s DEA number. We seriously urge physicians not to disclose any personal information to anyone over the phone unless the physician initiates the call.

On the DEA website under “Publication and Manuals,” there is a section named “Advisories.”  This is where the scams are listed.

DEA officials said that this scam in NOT currently listed but they are aware of it.

The DEA also advised: “To protect yourself you should also contact the local DEA office in your area to ask questions before giving out any information. The diversion of any controlled substance is a serious social and health-related problem in the United States. Always safeguard your personal and professional data. Always verify the need and authority of unusual requests for information.

MEDICARE/MEDICAID

AMA Reminds Physicians of Steps to Take Now to Avoid 2019 Medicare Penalties
The American Medical Association (AMA) issued a press release reminding physicians that if, if they have not done so already, they have until December 31, 2017, to take a few simple steps to avoid a Medicare payment penalty in 2019.  To read the full press release, click here.

The press release notes that, for those who were not prepared for full participation this year, reporting quality information on just one patient and one measure in 2017 will allow physicians to avoid a Medicare payment penalty in 2019. A full MACRA resource center is available on the AMA’s website, and to promote awareness of this option, the AMA launched the “one patient, one measure, no penalty” campaign, which offers a step-by-step guide to completing the process. The AMA has also produced a MACRA podcast series on ReachMD, including an episode with tips for small practices.

There is also information available from the Physicians Advocacy Institute (PAI) regarding how physicians can avoid a 2019 Medicare payment penalty, as well as information regarding steps they will need to take in 2018 to avoid Medicare payment penalties in 2020.  MSSNY is a board member of the PAI.

SEMINARS/WEBINARS

“Mental Health and Disasters Overview” CME Webinar on January 17; Registration Now Open
Upcoming in MSSNY’s Medical Matters continuing medical education (CME) webinar series is: Mental Health and Disasters Overview”.  This webinar will take place on Wednesday, January 17, 2018 at 7:30 a.m.   Craig Katz, MD Clinical Professor of Psychiatry and Medical Education at the Icahn School of Medicine at Mount Sinai in New York City since 2000 will conduct this presentation.  Register for this webinar here.

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

Educational objectives are:

  • Explore the psychological impact of mass trauma.
  • Provide physicians with a strong background on both the psychological symptoms and syndromes specific to mass trauma.
  • Prepare physicians to conduct acute assessments and interventions.

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.  

CLASSIFIEDS

RENTAL/LEASING SPACE


Space Available in North Bronx
● Medical Office for Rent
● Located on the Grand Concourse (walking distance from all major transportation)
● 2 Examination Rooms
● Large Waiting Area
● Private Doctor’s Office
● Fully equipped with new furniture
Contact info: jp@bronxheart.com // 718-584-0797


Want to Work in NYC but Live 100 Yards from the Atlantic Ocean?
Ocean views abound in this beautiful Rockaway Beach 1 family brick home. 5 bedrooms, 3 bathrooms. 60×100, detached 1 car garage, central air, sprinkler, alarm, large rear deck and heated pool. New finished basement, master bedroom on main floor and full bath. Tons of storage, solar panels. Beautiful front porch with ocean views. Located in Rockaway beach on a block 100 yards from the ocean! $1,750,000. Call 718-634-6004.

Upper East Side Plastic Surgery Office Available for Rent or Share
Beautifully equipped Plastic Surgery office available for part-time share along with Quad A-certified OR available for rent. Located in a lovely carriage house on the Upper East Side in close proximity to Lenox Hill Hospital and MEETH and conveniently located near all NYC mass transit. 1 exam room/OR and Recovery room along with large administrative space. Free WIFI. Available for full or half-days. Suits Plastic/Cosmetic Surgeons/ DERM/ ENT/or other Medical MDs. Please contact Kim at Kim@madisonps.com (212) 628-7600.

For Rent or Share – Woodbury, Long Island
Beautiful recently renovated Plastic Surgery office available for part-time share and AAAA-certified (by end of summer). OR available for rent. Centrally located
on Long Island.Close to expressways. 3 exam rooms, 1 procedure room /OR.
Waiting room, break room and personal office. Free WIFI. Available for full or half-days. Suits Plastic/Cosmetic Surgeons/Derm/ENT/
ObGyn/Podiatry or other Medical MDs.
Contact Patricia at info@cosmetichg.com
or 631-318-4008

PHYSICIAN OPPORTUNITIES


Paging Primary Care MDs Who Love Technology
98point6 is a Seattle startup who wants your input. We’re seeking practicing physicians to join our council and help shape the next generation of primary care. If the fusion of health care and technology inspires you, please apply here.


Medical Director: Binghamton University College Physician (SL-6)
Department: Student Health ServicesLocations:   Binghamton, NYPosted: Oct 24, ’17Type:  Full-timeRef. No.: 49225The Decker Student Health Services Center at Binghamton University (The State University of New York at Binghamton) invites New York State Medical or Osteopathic Board Certified Physicians (Internal Medicine, Family Practice) to apply for a full-time, twelve-month position. This position plans, directs, supervises, and participates in the outpatient medical care of undergraduates and graduate students of a diverse student base.  The person will have excellent, primary care diagnostic skills as well as experience and proficiency in common outpatient surgical procedures, EKG and pulmonary function study interpretation, office laboratory and clinical microscopy.  This position functions as an on-site medical consultant and collaborative physician to the professional staff that includes 10 nurses, 5 nurse practitioners and 7 physicians.The individual will have five years of clinical experience after residency training and experience with staff oversight and leadership.The Medical Director provides the university campus with infectious disease direction (e.g. meningitis, measles and tuberculosis) and emergency management; participates on the Crisis Response Team; provides direction and consultation to the Dean of Students, University Counseling Center and Residential Life.  This person will be responsible for accreditation activities including; completion of internal and external benchmark studies peer chart review; completion of assessment plans, survey and risk management reports; meeting with site visitors; and following through on recommendations.Requirements: Required qualifications: NYS Board Certified Medical or Osteopathic Physicians (Internal Medicine, Family Practice) from an accredited institution; 5 years of clinical experience after residency; NYS medical license and DEA certificate that are free from special conditions or limitations. Salary: commensurate with qualifications and experience. Preferred qualifications are, but not limited to: college health familiarity; experience with diverse populations; electronic health record navigation; quality assurance, and continuous quality improvement; public health and policy experience. Payroll information can be found on our website http://www.binghamton.edu/human-resources/payroll/Cover letters may be addressed “To the Search Committee.” Postings active on the website accept applications until closure. For information on the Dual Career Program, please visit:
https://www.binghamton.edu/human-resources/dual-career-program/
Application Instructions:Deadline for Internal Applicants:  11/07/2017 Deadline for External Applicants:  Open until filled Review of applications will begin immediately and continue until the vacancy is filled.Persons interested in this position should apply online.Please submit: 1. Resume 2.Cover letter, and 3.Contact information for three professional references You may add additional files/documents after uploading your resume. After you fill out your contact information, you will be directed to the upload page. Please login to check/edit your profile or to upload additional documents: http://binghamton.interviewexchange.com/login.jsp Payroll information can be found on our website http://www.binghamton.edu/human-resources/payroll/
Additional Information:Offers of employment may be contingent upon successful completion of a pre-employment background check and verification of degree(s) and credentials.Binghamton University is a tobacco-free campus.Pursuant to Executive Order 161, no State entity, as defined by the Executive Order, is permitted to ask, or mandate, in any form, that an applicant for employment provide his or her current compensation, or any prior compensation history, until such time as the applicant is extended a conditional offer of employment with compensation.  If such information has been requested from you before such time, please contact the Governor’s Office of Employee Relations at (518) 474-6988 or via email at info@goer.ny.govEqual Opportunity/Affirmative Action Employer
The State University of New York is an Equal Opportunity/Affirmative Action Employer.  It is the policy of Binghamton University to provide for and promote equal opportunity employment, compensation, and other terms and conditions of employment without discrimination on the basis of age, race, color, religion, disability, national origin, gender, sexual orientation, veteran or military service member status, marital status, domestic violence victim status, genetic predisposition or carrier status, or arrest and/or criminal conviction record unless based upon a bona fide occupational qualification or other exception.
As required by title IX and its implementing regulations Binghamton University does not discriminate on the basis of sex in the educational programs and activities which it operates.  This requirement extends to employment and admission.  Inquiries about sex discrimination may be directed to the University Title IX Coordinator or directly to the Office of Civil Rights (OCR).  Contact information for the Title IX Coordinator and OCR, as well as the University’s complete Non-Discrimination Notice may be found here. The State University of New York is an Equal Opportunity/Affirmative Action Employer.  As required by title IX and its implementing regulations Binghamton University does not discriminate on the basis of sex in the educational programs and activities which it operates.  This requirement extends to employment and admission.  Inquiries about sex discrimination may be directed to the University Title IX Coordinator or directly to the Office of Civil Rights (OCR).  Contact information for the Title IX Coordinator and OCR, as well as the University’s complete Non-Discrimination Notice may be found here.

Medical Director – AIDS Institute
Minimum Qualifications:
Current license and registration to practice medicine in New York State and board certification AND either a Master’s Degree in Public Health or two years of experience in an HIV program or public health program.Preferred Qualifications:
Master’s Degree in Public Health.  Five years of experience including clinical service in an HIV program or clinical fellowship program (infectious diseases/HIV medicine).  Experience in quality management/quality improvement.  Knowledge of the HIV health care delivery system in New York State. Experience in/knowledge of the New York State Ending the Epidemic initiative.  Experience in STD prevention and care, drug user health, and/or LGBT health.  Experience in health policy development, analysis and evaluation.  Experience with evolving health information technologies.  Experience in health program management and administration.
Responsibilities: The Medical Director, AIDS Institute, plays a significant role in shaping HIV, hepatitis C, and STD care and services, drug user health, and LGBT health care throughout New York State.Please click the link below for more information pertaining to this position and to apply: “https://careers-healthresearch.icims.com/jobs/search?ss=1&hashed=-435829071” Affirmative Action/Equal Opportunity Employer/Qualified Individuals with Disabilities/Qualified Protected Veterans

Multiple Physician Positions with DOHMH Office of School Health
Office of School Health is the largest program of the New York City Department of Health and Mental Hygiene (DOHMH). This bureau is responsible for managing the health issues and promoting the well-being of the over 1.3 million children and adolescents enrolled in New York City’s 1700 school buildings.

Positions with the Office of School Health (OSH) combine clinical skills and public health training.

Adolescent School Health Physician
This position offers to the interested physician the opportunity to help address the clinical and public health needs of adolescents in NYC high schools. The physician will work with the innovative Connecting Adolescents to Comprehensive Health Care (CATCH) Program, which provides select reproductive health services to adolescents in select NYC high schools. In addition, the physician will provide medical care and public health services through additional programs offered to adolescents by the Office of School Health.

Under the supervision of the High School Supervising Physician, the Adolescent School Health Physician’s responsibilities will include but are not limited to:

  • Provide CATCH reproductive health services in select high schools.
  • Perform mandated physical examinations (New Admission Exams, Sports Physicals, and Working Paper Physicals).
  • Function as a liaison for students with community health providers to resolve medical issues that affect school performance.
  • Support the development and implementation of initiatives that promote positive health behaviors and reduce high risk behaviors in the adolescent population.
  • Serve as a consultant to the school nurse and administration on school related health concerns.
  • Provide clinical assistance in the event of an environmental or communicable disease occurrence.
  • Function as a liaison for students with community health providers to resolve medical issues that affect school performance.
  • Support all medical initiatives established by the Office of School Health, e.g. programs and protocols in asthma, reproductive health, obesity and diabetes.
  • Maintain good public relations and communicate effectively within the school community and community-based organizations.
  • Keep abreast of health management policy statements and emerging clinical research related to school health.
  • Participate in OSH research activities.
  • Work within the mandates, policies and protocols of the Office of School Health.
  • Attend all mandated DOHMH and OSH trainings.

To Apply: Please email your resume and cover letter to Dr. Caroline Volel: osh@health.nyc.gov OR  Apply online at https://a127-jobs.nyc.gov/.  In the Job ID search bar, enter: job ID number # 277208. 

School Health Field Physician
Under the direction of the Supervising Physician, the School Health Physician’s will:

  • Improve the health of school children through case management of chronic disease, preventive health screening and counseling, health education, and referrals.
  • Perform mandated physical examination (new entrant, sport physical, working paper physicals.
  • Develop relationships with community health providers in order to optimize medical management of students with health issues.
  • Attend to the health needs of your assigned school community.
  • Utilize the Automated Student Health Record (ASHR) to maintain adequate student health records.
  • Serve as a consultant to the school nurse and administration on school related health concerns.
  • Support the development of school educational and prevention programs promoting the health and wellness of all students.
  • Provide clinical assistance in the event of an environmental or communicable disease occurrence.
  • Develop and maintain professional relationships within the school community.
  • Support all medical initiatives put forth by the Office of School Health, e.g. Asthma, Reproductive health, Obesity and Diabetes initiatives.
  • Provide trainings/presentations to school staff, community organizations, or parents.
  • Stay abreast of health management policy statements and emerging research within the health community related to school health.
  • Participate in School Health research and quality improvement activities.
  • Participate in all mandated DOHMH and Office of School Health trainings and professional development sessions.
  • Attend all program meetings and Continuing Medical Education classes provided by the Office of School Health.

To Apply: Please email your resume and cover letter to Dr. Caroline Volel:osh@health.nyc.gov OR Apply online at https://a127-jobs.nyc.gov/.  In the Job ID search bar, enter: job ID number # 279844. 

Supervising School Health Physician 
Job Description
Under the supervision of the Deputy Medical Director, the Supervising Medical Doctor’s responsibilities will include but not be limited to:

  • Supervise School Health Physicians.
  • Work within the mandates, policies and protocols of the Office of School Health (OSH).
  • Attend to the health needs of a designated school community.
  • Utilize the Automated Student Health Record (ASHR) to maintain accurate student health records.
  • Serve as a consultant to the school nurse and school administrative staff regarding school related health concerns.
  • Support the development of school educational and prevention programs promoting the health and wellness of students.
  • Participate in policy development and revisions as indicated.
  • Provide clinical assistance in the event of an environmental or communicable disease occurrence.
  • Function as a liaison for students with community health providers to resolve health issues that affect school functioning.
  • Develop and maintain professional relationships within the school community and the community at large.
  • Support all medical initiatives put forth by the Office of School Health, e.g. Asthma, Reproductive health, Obesity and Diabetes Initiatives.
  • Keep abreast of health management policy statements and emerging research within the health community affecting school health.
  • Assist with or provide trainings/presentations to school health physicians, nurses, school staff, community organizations or parents
  • Participate in School Health research and quality improvement activities
  • Participate in all mandated DOHMH and Office of School Health trainings and professional development sessions
  • Attend all program meetings and Continuing Medical Education classes provided by the Office of School Health.

To Apply: Please email your resume and cover letter to Dr. Caroline Volel: osh@health.nyc.gov  OR  Apply online at https://a127-jobs.nyc.gov/.  In the Job ID search bar, enter: job ID number # 277026


MEDICAL EQUIPMENT


Retiring from pediatrics. I have medical equipment to donate: examining table, pediatric examining table with a scale, medical scale, examining instruments and miscellaneous office items. Forest Hills. Call 718 275-5858 or email mkolak59@gmail.com


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


 

December 8, 2017 – Welcome to CVS-Aetna?

 

Charles Rothberg, MD - MSSNY President
PRESIDENT’S MESSAGE

Charles Rothberg, MD
December 8, 2017
Volume 17
Number 45

 

 

 

 

 

Dear Colleagues: 

On Monday, MSSNY sent out my press statement regarding the proposed merger of Aetna and CVS. It received a lot of media coverage. I am hopeful that other groups raise similar concerns.

Without mincing words, our message was that the front door to health care should be a physician’s front door— not an insurer’s and definitely not a store. 

This merger is also bad news for hospitals, which still see millions of patients in their emergency departments and provide care for ailments that CVS and Aetna executives say could be avoided or directed to an outpatient location. How could it do this? CVS is not just drugstores. In 2006, it acquired MinuteClinic—that operates more than a thousand walk-in clinics. They are not only in their stores but also in some Target locations.

As far as these vertical mergers go, the DOJ said it would sue to block a very similar deal, between Time Warner and AT&T. It will be interesting to see their take on this proposal.

The CEO of CVS said that the merger will be a new “front door” to healthcare. His vision is out of sync. In a merger of this magnitude, the involved parties are expected show the financial benefit to shareholders, but who is looking out for the benefit of patients?

The regulators are typically less interested in vertically integrated entities than horizontal ones. For example, if physicians wanted to merge, they would have to show a benefit to consumers (e.g. clinical integration). I believe that all entities should play by the same rules. This merger has the potential to keep other health insurers from entering the market and forcing others out of business. This sort of consolidation has not been good for consumers or their doctors. Who is looking out for the thousands of community physicians across our state? Will physician practices join too many of our local pharmacies and become the ghosts of Main Street?

A physician’s purpose is to serve patients, not to sell them prescription drugs and other goods. The distinction between patient and purpose is getting very blurry. Patients should not be looked upon solely as consumers. What is wrong with this picture? At MSSNY, we are concerned about significant adverse implications for patients if this immense merger goes forward. It is troubling that patients may face even more burdensome and excessive prior authorizations along with other unnecessary barriers to needed health care.

We hope that other medical associations and individual physicians will prompt both federal and our own state regulators to take a hard look into the future as to the impact of a merger of this magnitude.

One thing we all know—when it comes to medicine, corporate consolidation is rarely better for patients and their physicians.

Sincerely,

Charles Rothberg, MD
MSSNY President

Please send your comments to comments@mssny.org


enews large




Promo Code: MSSNY


 

 

 

 


MSSNY President Reacts to UHF Study “NY ACOs Often Exceed Cost Benchmarks”
This week the United Hospital Fund released a report that concluded that, even though New York’s Accountable Care Organization (ACOs) are providing quality care above the level of other ACOs across the nation, they still struggle to generate savings against their benchmark expenditure targets. Specifically, the study reported New York’s 32 Medicare Shared Savings Program ACOs performed better than the national average on most measures of prevention, including the management of diabetes, hypertension, and cardiovascular disease, as well as immunizations and tobacco screening and intervention.

At the same time, in 2016, only one-third (12 of 32) of the state’s ACOs generated savings against benchmark, while two-thirds (20 of 32) had expenses that exceeded their benchmarks.

In response to the report, MSSNY President Dr. Charles Rothberg issued the following statement:

“The United Hospital Fund report regarding the performance of ACOs in New York confirms a principle of which most physicians are aware – that the provision of quality patient care very often cannot be provided at a discount.

We are proud that our New York ACOs have exceeded the performance of their counterparts across the country. MSSNY has supported efforts to enable the creation of ACOs because it enabled independently practicing physicians to collaborate on resources to improve patient care, and the opportunity to secure additional funding to facilitate the investment in these patient care resources.  However, while we support efforts to assist physicians with “practice transformation” as a means to improve patient care delivery, policymakers must understand that the incentives that have been used for institutions do not transition easily to physician care delivery.  The UHF report appears to validate concerns many physicians have expressed with some “value based” payment programs imposed by public and commercial payors that payments for needed medical care could be unfairly cut based upon comparison to unrealistic cost benchmarks.”

MSSNY Joins Other Physician Advocates to Urge Congress to Prevent Cuts to Medicare and Other Health Insurance Programs
Noting that “Congress must act to prevent the loss of needed health insurance coverage for millions here in New York and across the country”, MSSNY joined with several other physician advocacy associations in a letter to New York’s Congressional delegation urging continued funding for various health insurance programs as Congress debates a spending resolution required by the end of the year as well as a massive tax restructuring proposal.  This includes continued funding for the Child Health Insurance Program (CHIP), which helps to provide coverage for over 300,000 children in New York State, and continued authorization for health insurance subsidies including for New York’s Essential Plan, which provides low-cost “first dollar” coverage to nearly 700,000 New Yorkers who earn too much to qualify for Medicaid.

Moreover, the letter urged our Congressional delegation to work to prevent potential further sequestration cuts to Medicare physician payments that could be imposed as a result of deficits potentially created through with a tax reform bill.  Others joining on to the letter to New York’s Congressional delegation included the NYS Academy of Family Physicians, NYS Academy of Pediatrics, the New York County Psychiatric Association, the Doctors’ Council/SEIU and the local affiliate of the National Medical Association.


Your membership yields results and will continue to do so. When your 2018 invoice arrives, please renew. KEEP MSSNY STRONG!


MSSNY Raises Strong Concerns with CVS-Aetna Merger Proposal
Noting that “the front door to health care should be a physician’s front door – not an insurer’s and definitely not a store,” MSSNY President Dr. Charles Rothberg was quoted in a number of media outlets this week expressing strong concerns with the announcement by CVS of its intention to purchase Aetna.  Articles where he was quoted included:

Dr. Rothberg noted that physicians “are very concerned about significant adverse implications for patients if this immense merger goes forward. The possibility of even more burdensome and excessive prior authorization barriers for prescription medications needed by our patients, combined with further marginalization of many community pharmacies and community physicians that our patients depend upon is an equation for disaster.” (See Dr. Rothberg’s editorial above.)

Moreover, Assembly Insurance Committee Chair Kevin Cahill has written to the New York Department of Financial Services and Department of Health urging an investigation of this proposed transaction. To read his press release, click here.  Specifically, he noted that “CVS has been leading the lobbying effort to legalize so-called “minute clinics” in New York State, in direct competition with private practice doctors and not for profit health clinics. We have already seen the way prescription business has been steered to this giant entity, often at the expense of the neighborhood pharmacy.”

Dr. David Barbe, President of the AMA, issued the following statement in reaction to the proposal: “This proposed $69 billion transaction – one of the largest merger deals in the history of American health care – would have long-term impact on the markets for health insurance and pharmaceutical benefit management services. These markets are already dominated by few participants with large market shares, including Aetna in health insurance and CVS in pharmaceutical benefit management. The AMA is committed to reviewing all issues triggered by this proposed merger to preserve the benefits of competition, including increased access and choice, lower prices and higher quality care for patients.”

Massachusetts Medical Society Has Adopted a Neutral Position on Assisted Suicide
The Massachusetts Medical Society is no longer opposed to medical aid in dying as an end-of-life option for the terminally ill. The Massachusetts Medical Society’s governing body has voted to adopt a neutral position on the issue of medical aid in dying.   The society will now serve as a medical and scientific resource as part of legislative efforts that will support “shared decision making” between terminally ill patients and their physicians. The statewide organization says physicians shouldn’t be required to practice medical aid in dying if it violates their ethical principles.

The Massachusetts legislature is considering legislation that would allow people with incurable conditions who are likely to die within six months to request medication from their doctors that can be self-administered to bring about a peaceful death. The bill includes provisions ensuring the patient is of sound mind.  The Medical Society of the State of New York’s Bioethics Committee is in the process of developing a survey on death and dying and the physicians’ role in process.  This survey will be sent to MSSNY members and is in keeping with a 2017 resolution the passed the MSSNY House of Delegates.

HOW CAN I HELP?

Please Urge Governor Cuomo to Veto Disastrous Liability Expansion Bill and Work for Comprehensive Reform Instead
While 98 bills were delivered to Governor Cuomo this week for his consideration, not among them was legislation (S.6800/A.8516) that would significantly expand the time to bring a medical malpractice lawsuit, in circumstances based upon an “alleged negligent failure to diagnose a malignant tumor or cancer”.  It is one of 7 bills that have passed both Houses of the Legislature, but have not yet delivered to the Governor for his approval or veto.

Because it has not been paired with badly needed medical liability reforms, if signed into law this measure would likely prompt a significant increase in physician and hospital malpractice premiums at a time when New York has by far and away the highest cumulative liability costs in the country.  Please urge the Governor to veto this bill and in support of needed comprehensive medical liability reform by sending a letter to the Governor here and call 518-474-8390.

Physician leaders have been active in warning the public about the patient care access problems this bill will exacerbate if it is signed into law.  Recently, a letter to the Editor from MSSNY’s President Dr. Charles Rothberg urging a veto was published in the Albany Times-Union (letter).   Similar letters from regional and statewide physician leaders have also appeared in:

WEBINARS/SEMINARS

NYSDOH Hosts Training Session of Clinical Support for Implementation of Buprenorphine
The NYSDOH AIDS Institute will presents a training session on Clinical Support for Implementation of Buprenorphine on Saturday, December 16, 2017 from 9:30AM – 12:30PM on Long Island at the Hilton Garden Inn Stony Brook, 1 Circle Road, Shirley Kenny Room, Stony Brook, NY 11794. This free training is for physicians, nurse practitioners, and physician assistants whom have completed the required buprenorphine waiver training and would like to learn best practices with implementing buprenorphine to treat patients with an opioid use disorder. Attached is a flyer with further information, including location, online registration, and more details. Further information will be sent out to confirmed attendees. Space is limited so register fast!

Trainers:
Bruce Trigg, MD, Harm Reduction Coalition, New York, NY
Kelly Ramsey, MD, Hudson River Healthcare, Poughkeepsie, NY & Suffolk County Locations. For more information about NYSDOH buprenorphine related trainings, mentoring, coaching, technical assistance and more, please contact us at buprenorphine@health.ny.gov or 1-800-692-8528. 

Home Care Association Announces Sepsis Training Sessions
The Home Care Association (HCA) will present eight regional sepsis training sessions coming to every part of the state as part of HCA’s grant-funded sepsis initiative.   The HCA also announces that under this program there is now a website. The site includes sepsis-related news and information, tools and resources, background about our “Stop Sepsis at Home” initiative, and a calendar for upcoming training sessions that were recently announced to the membership and are again highlighted below.

Register Today for Training

Physicians are encouraged to register today for one of the eight upcoming sepsis training sessions.  The first session will be held Friday, December 15 session in the Syracuse region, followed by a December 18 session in Buffalo.   The sessions are for all home care and applicable providers on sepsis, steps for provider adoption and clinical application of the sepsis screening tool, clinical case application integration into agency procedures and records, and more.

Other sessions and regions follow in January through March.  A flyer with additional information is here.

Or register directly online for any of the sessions here.

The calendar listings at www.stopsepsisathomeny.org

With 80 to 90 percent of sepsis cases originating in the community, among other compelling data, the New York State Health Foundation (NYSHealth) has awarded HCA a major grant to support home care’s statewide adoption and use of HCA’s sepsis screening and intervention tool, which was developed and piloted in conjunction with partner organizations over the past two years.  Supported by the NYSHealth grant, HCA and sepsis leaders (including IPRO, national Sepsis Alliance, Rory Staunton Foundation for Sepsis Prevention, MSSNY and others) the training sessions are intended to create greater awareness for sepsis. Hospitals, physician practices, EMS, health plans and other community partners engaged in sepsis education, prevention, intervention and treatment are urged to attend. These sessions will include cross-sector collaboration segments to exchange critical information, best practices and other planning.

Coding Tip of the Week

Opioid Use, Abuse and Dependence in ICD-10-CM

By Lorna Simons, CPC Medco Consultants, Inc.

It is seldom that we go a week without seeing a new opioid linked headline in the news. As medical coders and healthcare professionals it is important to understand the nuances of coding for opioid use (prescribed or recreational), abuse and dependence. Though three separate sections of the ICD-10-CM book can be used to code patients using opioids (Chapter 21 Factors influencing health status and contact with health services (Z00-Z99); Chapter 5 Mental, Behavioral and Neurodevelopmental disorders (F01 – F99) and; Chapter 19: Injury, poisoning, and certain other consequences of external causes (S00-T88)), we will be focusing on the difference between prescribed and recreational use, abuse and dependence (chapters 21 and 5).

Prescription use of opioids is identified in Chapter 21 of the ICD-10-CM manual. When a patient is receiving prophylactic prescription maintenance for a condition using an opioid it should be documented and coded with Z79.891 Long term (current) use of opiate analgesic. Do not use this code for patients who have addiction or are seeking treatment for addiction. The Chapter 21 Guidelines state: “This subcategory is not for use of medications for detoxification or maintenance programs to prevent withdrawal symptoms in patients with drug dependence (e.g., methadone maintenance for opiate dependence). Assign the appropriate code for the drug dependence instead.”

The codes for opioid related disorders are found in Chapter 5 under category F11. The term “use” in Chapter 5 can mean non-prescription (recreational) use or any use not documented as abuse or dependence. The distinction between use, abuse and dependence is based on clinical evaluation and documentation. As per the ICD-10-CM guidelines for coding substance use, abuse and dependence, “only one code should be assigned to identify the pattern of use based on the following hierarchy:

  • If both use and abuse are documented, assign only the code for abuse
  • If both abuse and dependence are documented, assign only the code for dependence
  • If use, abuse and dependence are all documented, assign only the code for dependence
  • If both use and dependence are documented, assign only the code for dependence.”

A patient with a history of opioid abuse or dependence should be coded with the appropriate remission code (F11.11 Opioid abuse, in remission or F11.21 Opioid dependence, in remission). ICD-10-CM does not include a code for history of opioid use.

Sources
ICD-10-CM Coding Guidelines Section C.5. Psychoactive Substance Use, Abuse and Dependence
ICD-10-CM Coding Guidelines Section C.21. Factors influencing health status and contact with health services (Z00-Z99)
ICD-10-CM Coding Guidelines Section C.19.  Injury, poisoning, and certain other consequences of external causes (S00-T88)
MEDICARE/MEDICAID

QPP Hardship Exception Application Deadline: December 31
The deadline to submit a Quality Payment Program Hardship Exception Application for the 2017 transition year is December 31. Merit-based Incentive Payment System eligible clinicians and groups may submit a hardship exception application for one of the following reasons:
• Insufficient internet connectivity
• Extreme and uncontrollable circumstances
• Lack of control over the availability of Certified Electronic Health Record Technology
For More Information:
• About Hardship Exceptions webpage
• Quality Payment Program website
• For questions, contact the Quality Payment Program Service Center at QPP@cms.hhs.gov or 866-288-8292 (TTY: 877-715-6222)
Do You Want to Comment on the Workers Comp Draft Impairment Guidelines? The public comment period will remain open through December 22, 2017. Please submit to comments here.

The Case of the Patient Tattooed with “Do Not Resuscitate”
A case study published last week in the New England Journal of Medicine details the case of a 70-year-old patient with a “DO NOT RESUSCITATE” tattoo who arrived unconscious and critically ill at a Florida emergency department—but in absence of identification or guidance from next of kin, hospital staff had to determine if his tattoo counted as a legally binding request.



CLASSIFIEDS

RENTAL/LEASING SPACE


Space Available in North Bronx
● Medical Office for Rent
● Located on the Grand Concourse (walking distance from all major transportation)
● 2 Examination Rooms
● Large Waiting Area
● Private Doctor’s Office
● Fully equipped with new furniture
Contact info: jp@bronxheart.com // 718-584-0797


Want to Work in NYC but Live 100 Yards from the Atlantic Ocean?
Ocean views abound in this beautiful Rockaway Beach 1 family brick home. 5 bedrooms, 3 bathrooms. 60×100, detached 1 car garage, central air, sprinkler, alarm, large rear deck and heated pool. New finished basement, master bedroom on main floor and full bath. Tons of storage, solar panels. Beautiful front porch with ocean views. Located in Rockaway beach on a block 100 yards from the ocean! $1,750,000. Call 718-634-6004.

Upper East Side Plastic Surgery Office Available for Rent or Share
Beautifully equipped Plastic Surgery office available for part-time share along with Quad A-certified OR available for rent. Located in a lovely carriage house on the Upper East Side in close proximity to Lenox Hill Hospital and MEETH and conveniently located near all NYC mass transit. 1 exam room/OR and Recovery room along with large administrative space. Free WIFI. Available for full or half-days. Suits Plastic/Cosmetic Surgeons/ DERM/ ENT/or other Medical MDs. Please contact Kim at Kim@madisonps.com (212) 628-7600.

For Rent or Share – Woodbury, Long Island
Beautiful recently renovated Plastic Surgery office available for part-time share and AAAA-certified (by end of summer). OR available for rent. Centrally located
on Long Island.Close to expressways. 3 exam rooms, 1 procedure room /OR.
Waiting room, break room and personal office. Free WIFI. Available for full or half-days. Suits Plastic/Cosmetic Surgeons/Derm/ENT/
ObGyn/Podiatry or other Medical MDs.
Contact Patricia at info@cosmetichg.com
or 631-318-4008

PHYSICIAN OPPORTUNITIES


Paging Primary Care MDs Who Love Technology
98point6 is a Seattle startup who wants your input. We’re seeking practicing physicians to join our council and help shape the next generation of primary care. If the fusion of health care and technology inspires you, please apply here.


Medical Director: Binghamton University College Physician (SL-6)
Department: Student Health ServicesLocations:   Binghamton, NYPosted: Oct 24, ’17Type:  Full-timeRef. No.: 49225The Decker Student Health Services Center at Binghamton University (The State University of New York at Binghamton) invites New York State Medical or Osteopathic Board Certified Physicians (Internal Medicine, Family Practice) to apply for a full-time, twelve-month position. This position plans, directs, supervises, and participates in the outpatient medical care of undergraduates and graduate students of a diverse student base.  The person will have excellent, primary care diagnostic skills as well as experience and proficiency in common outpatient surgical procedures, EKG and pulmonary function study interpretation, office laboratory and clinical microscopy.  This position functions as an on-site medical consultant and collaborative physician to the professional staff that includes 10 nurses, 5 nurse practitioners and 7 physicians.The individual will have five years of clinical experience after residency training and experience with staff oversight and leadership.The Medical Director provides the university campus with infectious disease direction (e.g. meningitis, measles and tuberculosis) and emergency management; participates on the Crisis Response Team; provides direction and consultation to the Dean of Students, University Counseling Center and Residential Life.  This person will be responsible for accreditation activities including; completion of internal and external benchmark studies peer chart review; completion of assessment plans, survey and risk management reports; meeting with site visitors; and following through on recommendations.Requirements: Required qualifications: NYS Board Certified Medical or Osteopathic Physicians (Internal Medicine, Family Practice) from an accredited institution; 5 years of clinical experience after residency; NYS medical license and DEA certificate that are free from special conditions or limitations. Salary: commensurate with qualifications and experience. Preferred qualifications are, but not limited to: college health familiarity; experience with diverse populations; electronic health record navigation; quality assurance, and continuous quality improvement; public health and policy experience. Payroll information can be found on our website http://www.binghamton.edu/human-resources/payroll/Cover letters may be addressed “To the Search Committee.” Postings active on the website accept applications until closure. For information on the Dual Career Program, please visit:
https://www.binghamton.edu/human-resources/dual-career-program/
Application Instructions:Deadline for Internal Applicants:  11/07/2017 Deadline for External Applicants:  Open until filled Review of applications will begin immediately and continue until the vacancy is filled.Persons interested in this position should apply online.Please submit: 1. Resume 2.Cover letter, and 3.Contact information for three professional references You may add additional files/documents after uploading your resume. After you fill out your contact information, you will be directed to the upload page. Please login to check/edit your profile or to upload additional documents: http://binghamton.interviewexchange.com/login.jsp Payroll information can be found on our website http://www.binghamton.edu/human-resources/payroll/
Additional Information:Offers of employment may be contingent upon successful completion of a pre-employment background check and verification of degree(s) and credentials.Binghamton University is a tobacco-free campus.Pursuant to Executive Order 161, no State entity, as defined by the Executive Order, is permitted to ask, or mandate, in any form, that an applicant for employment provide his or her current compensation, or any prior compensation history, until such time as the applicant is extended a conditional offer of employment with compensation.  If such information has been requested from you before such time, please contact the Governor’s Office of Employee Relations at (518) 474-6988 or via email at info@goer.ny.govEqual Opportunity/Affirmative Action Employer
The State University of New York is an Equal Opportunity/Affirmative Action Employer.  It is the policy of Binghamton University to provide for and promote equal opportunity employment, compensation, and other terms and conditions of employment without discrimination on the basis of age, race, color, religion, disability, national origin, gender, sexual orientation, veteran or military service member status, marital status, domestic violence victim status, genetic predisposition or carrier status, or arrest and/or criminal conviction record unless based upon a bona fide occupational qualification or other exception.
As required by title IX and its implementing regulations Binghamton University does not discriminate on the basis of sex in the educational programs and activities which it operates.  This requirement extends to employment and admission.  Inquiries about sex discrimination may be directed to the University Title IX Coordinator or directly to the Office of Civil Rights (OCR).  Contact information for the Title IX Coordinator and OCR, as well as the University’s complete Non-Discrimination Notice may be found here. The State University of New York is an Equal Opportunity/Affirmative Action Employer.  As required by title IX and its implementing regulations Binghamton University does not discriminate on the basis of sex in the educational programs and activities which it operates.  This requirement extends to employment and admission.  Inquiries about sex discrimination may be directed to the University Title IX Coordinator or directly to the Office of Civil Rights (OCR).  Contact information for the Title IX Coordinator and OCR, as well as the University’s complete Non-Discrimination Notice may be found here.

Medical Director – AIDS Institute
Minimum Qualifications:
Current license and registration to practice medicine in New York State and board certification AND either a Master’s Degree in Public Health or two years of experience in an HIV program or public health program.Preferred Qualifications:
Master’s Degree in Public Health.  Five years of experience including clinical service in an HIV program or clinical fellowship program (infectious diseases/HIV medicine).  Experience in quality management/quality improvement.  Knowledge of the HIV health care delivery system in New York State. Experience in/knowledge of the New York State Ending the Epidemic initiative.  Experience in STD prevention and care, drug user health, and/or LGBT health.  Experience in health policy development, analysis and evaluation.  Experience with evolving health information technologies.  Experience in health program management and administration.
Responsibilities: The Medical Director, AIDS Institute, plays a significant role in shaping HIV, hepatitis C, and STD care and services, drug user health, and LGBT health care throughout New York State.Please click the link below for more information pertaining to this position and to apply: “https://careers-healthresearch.icims.com/jobs/search?ss=1&hashed=-435829071” Affirmative Action/Equal Opportunity Employer/Qualified Individuals with Disabilities/Qualified Protected Veterans

Multiple Physician Positions with DOHMH Office of School Health
Office of School Health is the largest program of the New York City Department of Health and Mental Hygiene (DOHMH). This bureau is responsible for managing the health issues and promoting the well-being of the over 1.3 million children and adolescents enrolled in New York City’s 1700 school buildings.

Positions with the Office of School Health (OSH) combine clinical skills and public health training.

Adolescent School Health Physician
This position offers to the interested physician the opportunity to help address the clinical and public health needs of adolescents in NYC high schools. The physician will work with the innovative Connecting Adolescents to Comprehensive Health Care (CATCH) Program, which provides select reproductive health services to adolescents in select NYC high schools. In addition, the physician will provide medical care and public health services through additional programs offered to adolescents by the Office of School Health.

Under the supervision of the High School Supervising Physician, the Adolescent School Health Physician’s responsibilities will include but are not limited to:

  • Provide CATCH reproductive health services in select high schools.
  • Perform mandated physical examinations (New Admission Exams, Sports Physicals, and Working Paper Physicals).
  • Function as a liaison for students with community health providers to resolve medical issues that affect school performance.
  • Support the development and implementation of initiatives that promote positive health behaviors and reduce high risk behaviors in the adolescent population.
  • Serve as a consultant to the school nurse and administration on school related health concerns.
  • Provide clinical assistance in the event of an environmental or communicable disease occurrence.
  • Function as a liaison for students with community health providers to resolve medical issues that affect school performance.
  • Support all medical initiatives established by the Office of School Health, e.g. programs and protocols in asthma, reproductive health, obesity and diabetes.
  • Maintain good public relations and communicate effectively within the school community and community-based organizations.
  • Keep abreast of health management policy statements and emerging clinical research related to school health.
  • Participate in OSH research activities.
  • Work within the mandates, policies and protocols of the Office of School Health.
  • Attend all mandated DOHMH and OSH trainings.

To Apply: Please email your resume and cover letter to Dr. Caroline Volel: osh@health.nyc.gov OR  Apply online at https://a127-jobs.nyc.gov/.  In the Job ID search bar, enter: job ID number # 277208. 

School Health Field Physician
Under the direction of the Supervising Physician, the School Health Physician’s will:

  • Improve the health of school children through case management of chronic disease, preventive health screening and counseling, health education, and referrals.
  • Perform mandated physical examination (new entrant, sport physical, working paper physicals.
  • Develop relationships with community health providers in order to optimize medical management of students with health issues.
  • Attend to the health needs of your assigned school community.
  • Utilize the Automated Student Health Record (ASHR) to maintain adequate student health records.
  • Serve as a consultant to the school nurse and administration on school related health concerns.
  • Support the development of school educational and prevention programs promoting the health and wellness of all students.
  • Provide clinical assistance in the event of an environmental or communicable disease occurrence.
  • Develop and maintain professional relationships within the school community.
  • Support all medical initiatives put forth by the Office of School Health, e.g. Asthma, Reproductive health, Obesity and Diabetes initiatives.
  • Provide trainings/presentations to school staff, community organizations, or parents.
  • Stay abreast of health management policy statements and emerging research within the health community related to school health.
  • Participate in School Health research and quality improvement activities.
  • Participate in all mandated DOHMH and Office of School Health trainings and professional development sessions.
  • Attend all program meetings and Continuing Medical Education classes provided by the Office of School Health.

To Apply: Please email your resume and cover letter to Dr. Caroline Volel:osh@health.nyc.gov OR Apply online at https://a127-jobs.nyc.gov/.  In the Job ID search bar, enter: job ID number # 279844. 

Supervising School Health Physician 
Job Description
Under the supervision of the Deputy Medical Director, the Supervising Medical Doctor’s responsibilities will include but not be limited to:

  • Supervise School Health Physicians.
  • Work within the mandates, policies and protocols of the Office of School Health (OSH).
  • Attend to the health needs of a designated school community.
  • Utilize the Automated Student Health Record (ASHR) to maintain accurate student health records.
  • Serve as a consultant to the school nurse and school administrative staff regarding school related health concerns.
  • Support the development of school educational and prevention programs promoting the health and wellness of students.
  • Participate in policy development and revisions as indicated.
  • Provide clinical assistance in the event of an environmental or communicable disease occurrence.
  • Function as a liaison for students with community health providers to resolve health issues that affect school functioning.
  • Develop and maintain professional relationships within the school community and the community at large.
  • Support all medical initiatives put forth by the Office of School Health, e.g. Asthma, Reproductive health, Obesity and Diabetes Initiatives.
  • Keep abreast of health management policy statements and emerging research within the health community affecting school health.
  • Assist with or provide trainings/presentations to school health physicians, nurses, school staff, community organizations or parents
  • Participate in School Health research and quality improvement activities
  • Participate in all mandated DOHMH and Office of School Health trainings and professional development sessions
  • Attend all program meetings and Continuing Medical Education classes provided by the Office of School Health.

To Apply: Please email your resume and cover letter to Dr. Caroline Volel: osh@health.nyc.gov  OR  Apply online at https://a127-jobs.nyc.gov/.  In the Job ID search bar, enter: job ID number # 277026


MEDICAL EQUIPMENT


Retiring from pediatrics. I have medical equipment to donate: examining table, pediatric examining table with a scale, medical scale, examining instruments and miscellaneous office items. Forest Hills. Call 718 275-5858 or email mkolak59@gmail.com


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


December 1, 2017 – No Bureaucrats in Medicine!

 

Charles Rothberg, MD - MSSNY President
PRESIDENT’S MESSAGE

Charles Rothberg, MD
December 1, 2017
Volume 17
Number 44

 

 

 

 

 

Dear Colleagues: 

Recently, I discussed the nonsense of the ongoing alphabet soup in healthcare initiatives. We now need to stop the cacophony of this insanity.

These days, we have MACRA, APNs, MIPS, SHIP, DSRIP and VBPs to contend with.  This is being foisted upon us by a bureaucracy desperate to make healthcare better. What’s the problem? Bureaucrats do not practice medicine. They just want to save the almighty dollar—not mine, not yours—but theirs. Many physicians have experienced the downside of “incentive” programs. Initially, physicians appear to be able to benefit financially. However, due to subsequent “gotchas,” physicians are sometimes penalized and forced to refund the incentive payment.

These same bureaucrats who believe they can fix healthcare can’t seem to balance even their own checkbook. According to reliable sources, there is a possibility they will be out of money on December 7.

Already, tasked by the government to help meet arbitrary, non-health related budgetary constraints, physicians are already subjected to a 2% sequestration. Based on the current budgetary climate, there is concern that we might be subjected to additional sequestration in the coming year (4% total).

Physicians need to transform their practices in order to enhance the patient experience and to promote better health outcomes. Policymakers do not recognize that incentives applied with some success to institutional stakeholders do not work on physicians. For example, bad policy has forced us to expend too much time completing fields on our computers at the expense of more valuable patient-centered activity. Additionally, financial penalties further constrain a physician’s ability to add value-enhancing services such as care managers and mental health services. Unlike institutional stakeholders, in physician practices, there is typically no down-stream revenue to add services.

Many physicians, feeling great pressure to conform and comply with regulatory puzzles, are leaving independent practice in hope that employment with a health system might resolve their regulatory woes. After all, large healthcare stakeholders are capable of “working the system” to generate money—money that in turn can be shifted to overcome these regulatory burdens. But in many instances, this trend has neither promoted innovation, physician satisfaction nor has it resulted in cost containment. From the perspective of the payer, one payment issued to a facility for an entire episode of care seems more efficient than issuing multiple payments to a variety of specialty physicians for the components of an episode of care. However, if this sort of “payment reform” is to be successful, the hospital institutions and facilities must recognize and pay the physicians for their vital contributions.

Payment methodologies, senseless reporting and administrative overhead are not effective mechanisms to transform physician practice. Until goals are aligned between the government, insurers, hospitals, engaged patients and physicians, strife and stress will continue.  And better outcomes will remain elusive.

To be clear, MSSNY will always be supportive of the independent practice of medicine.

Sincerely,

Charles Rothberg, MD
MSSNY President

Please send your comments to comments@mssny.org



enews large

Several Health Care Issues on Congress’ Plate for Year End
With the current federal Budget continuing resolution set to expire on December 8, and the US House and Senate simultaneously debating items to be included in a massive tax restructuring bill, there are numerous health care related issues “on the table” that could have a significant impact on physicians and patients.  Among the issues under discussion where MSSNY continues to dialogue with the New York Congressional delegation (as well as the AMA before the full Congress) include:

Health Insurance Coverage/ACA

  • Continuation of funding to states for the Child Health Insurance Program
  • Continuation of funding to states for health insurance cost-sharing subsidies, including those that help to provide subsidized health insurance coverage offered through New York’s Health Insurance Exchange, as well as its Essential Plan for over lower-income New Yorkers who earn too much to qualify for Medicaid.

Medicare Physician Payment

  • Preventing a possible further Medicare “sequestration” cut of up to 4% as a result of increasing the deficit through the tax bill.
  • Continuation of the Medicare GPCI “floor” which helps to prevent cuts to Medicare physician payments for less densely populated areas across the country including upstate New York
  • Targeted changes to the MACRA MIPS program, to grant continued flexibility to CMS in implementing Medicare value-based payments and prevent cuts for reimbursement for medications covered through Medicare Part B.
  • Repeal of the Independent Payment Advisory Board.

Taxes

  • The deductibility of student loan interest
  • The deductibility of medical expenses

The debate on these issues is very fluid, so please be alert for further details and possible action alerts.

Deadline for Resolutions for 2018 House of Delegates Due by February 9, 2018
Be advised that the deadline for resolutions will be FRIDAY, FEBRUARY 9.  The Speaker has established a window during which resolutions are to be submitted:  from Monday, January 22 to 5 PM, February 9.  The 5 PM deadline is a hard deadline.

The resolutions must be researched utilizing both the MSSNY Position Papers and the Legislative Agenda.  Resolutions that are not substantively different from existing policy or initiatives will be recommended for reaffirmation.

Workers Comp Registration Is Open; Physicians Must Register by Jan. 15 2018
The NYS WCB issued their notice and instructions for re-registration for the WC authorized physicians who bill WC.  Any physician who has an individual WCB authorization number must register. PAs and NPs are not authorized to bill so the registration is for the physician(s).  Please see the Board’s notice, here. The updated list will ensure that an injured worker can easily identify Board authorized providers.

The goal of this process is to enable an injured worker to easily and accurately identify Board-authorized medical providers.

Registering. Authorized providers are asked to register with the Board and update their office address (es) and contact information by January 15, 2018. This registration process will be an ongoing initiative every two to three years.

Medical providers who have not registered by January 15, 2018 will:

  • be removed from the public directory of Board authorized providers, and
  • become ineligible for the Board’s disputed bill process.

Creating an Account in the New York State Health Commerce System (HCS)

The Board will use the existing New York State Health Commerce System (HCS) for this registration process. For the initial registration and for future updates to your practice information, you will need to have an HCS account. If you don’t already have one, you can view directions to create an account on the New York State Department of Health website.

Need Help?
If you are not sure if you already have an HCS account, contact the Commerce Account Management unit (CAMU) at (866) 529-1890 and select option 1. For general questions about health care provider registration, please contact the Board’s Customer Support at (844) 337-6305.

Worker Comp Questions? Email us or call Customer Service at (877) 632-4996

Note from Regina McNally, VP MSSNY Socio-Med Economic Division

I recently spoke with staff from the WCB.  They indicated that they will be sending a mailing out to the 40K addresses they have on file next week.

For background, they indicate that they have around 30K authorized providers on their listings.  However, they receive complaints from patients, lawyers and others that the listings are out of date (doctor no longer at the address, phone number is disconnected, the practice is no longer taking comp, etc.).  Their intent is to have authorized providers do this re-registration every 2 or 3 years geared to the time frame of medical license registration.

As I learn more, I will let you know.

Regina

Do You Want to Comment on the Workers Comp Draft Impairment Guidelines? The public comment period will remain open through December 22, 2017. Please submit to comments here.

Workers’ Compensation Guidelines for Determining Impairment



Promo Code: MSSNY


 

 

 

 


NYS Has Lowest Opioid Prescribing Rate in Nation Under Medicare Opioid Prescribing Mapping Tool
New York State has the lowest opioid prescribing rates in the country for Medicare Part D prescriptions, as reported under Medicare’s new opioid prescribing mapping tool.  According to the Centers for Medicare and Medicaid Services (CMS), the 2015 national average percentage for prescribing opioids to the Medicare population stands at 5.52 %, while New York’s is 3.05.  Nevada has the highest prescribing rate with 7.66%.   The Centers for Medicare and Medicaid Services (CMS) has updated its Medicare opioid prescribing mapping tool and this tool is an “interactive, web-based resource that visually presents geographic comparisons of Medicare Part D opioid prescribing rates.”  It also identifies county-level hot-spots and outliers, which “may identify areas that warrant attention.” The updated version of the mapping tool presents Medicare Part D opioid prescribing rates for 2015 as well as the change in opioid prescribing rates from 2013 to 2015; it also includes additional information on extended-release opioid prescribing rates.  The Medicare Part D Opioid Drug Mapping Tool can be found here.

MSSNY Partners with AMA to Educate NY Physicians & Patients on Diabetes Prevention; Physicians Encouraged to Take Diabetes Awareness Survey
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. Take the survey by clicking here.

This initiative will help bridge the gap between the clinical care setting and communities to reduce the incidence of type 2 diabetes by educating and connecting more patients to evidence-based lifestyle change programs that are available in their communities, including programs offered where they work, through community and faith-based organizations, and online.

“MSSNY’s partnership with the AMA is a key step towards making an immediate impact on the health of New Yorkers,” said Dr. Geoffrey Moore, Chair of MSSNY’s Preventative Medicine and Family Health Committee and a lifestyle medicine physician based in Ithaca, NY. “The Centers for Disease Control and the American Medical Association have developed a great educational toolkit and, through our partnership, we seek to extend the benefits of these tools to all physicians and patients throughout New York State.”

In the coming year, MSSNY will be developing education sessions and articles outlining important information about diabetes in the MSSNY Daily and E-News.  Educational webinars and podcasts tailored to both physicians and patients on prediabetes and diabetes are also being developed. MSSNY’s website showcases a Diabetes webpage where physicians can find more information about Type 2 Diabetes and to learn more about MSSNY’s partnership with the AMA.

Global Physician Ethics Pledge Makes Most Substantial Makeover in Decades
Physician leaders have given the international modern-day Hippocratic Oath the most substantial update in nearly 70 years, with revisions reflecting changes in the relationship between patients and physicians, and changes in interactions between physicians and their colleagues.

The World Medical Association (WMA) first adopted the Declaration of Geneva in 1948 as the contemporary successor to the 2,500-year-old Hippocratic Oath. Since then, just minimal amendments were made. After two years of gathering feedback from WMA member national medical associations, external experts and the public—the WMA adopted the revised Declaration of Geneva at its General Assembly meeting in Chicago.

In addition to the declaration’s being called “The Physician’s Pledge” for the first time, the policy:

  • References respecting the autonomy and dignity of the patient, which was not previously recognized in the declaration.
  • Adds that the “well-being” of a patient will be a physician’s first consideration, amending a clause to state that the “health and well-being of my patient will be my first consideration.”
  • Establishes an obligation for physicians to share medical knowledge for the benefit of their patients and the advancement of health care.
  • Requires physicians to attend to their own health, well-being and ability so they can provide the highest standard of care. This comes at a time when physicians have seen an increase in workload and a rise in occupational stress.
  • Augments an existing clause that calls for a physician to practice with conscience and dignity by having physicians pledge to practice with conscience and dignity “in accordance with good medical practice.” This was done to more explicitly invoke the standards of ethical and professional conduct that patients and physicians’ peers expect.

These changes “have enabled this pivotal document to more accurately reflect the challenges and needs of the modern medical profession,” German physician Ramin Walter Parsa-Parsi, MD, MPH, wrote in a JAMA Viewpoint essay about the revised policy.

The AMA has offered ethical guidance since the organization’s founding meeting in 1847, when the Association adopted the principles of the AMA Code of Medical Ethics. That living document guides physicians on meeting the ethical challenges of practicing medicine. Also it its General Assembly meeting, the WMA adopted policy on quality assurance in medical education, as well as bullying and harassment in the medical profession, the role of physicians in preventing exploitive adoption practices, and more.


Your membership yields results and will continue to do so. When your 2018 invoice arrives, please renew. KEEP MSSNY STRONG!


GOVERNMENTAL AFFAIRS

Please Urge Governor Cuomo to Veto Disastrous Liability Expansion Bill and Work for Comprehensive Reform Instead
With just a few weeks left in 2017, legislation will soon be delivered to Governor Cuomo  (S.6800/A.8516) that would significantly expand the time to bring a medical malpractice lawsuit, in circumstances based upon an “alleged negligent failure to diagnose a malignant tumor or cancer”.   If signed into law this measure would likely prompt a double digit increase in physician and hospital malpractice premiums.   Please urge the Governor to veto this bill by sending a letter to the Governor here and call 518-474-8390.

While thousands of physicians across New York State have already contacted the Governor, there needs to be an overwhelming demonstration from physicians regarding how this bill will harm access to care in their communities if this bill is not paired with needed tort reforms to bring down the exorbitant costs of medical liability insurance in New York.

Physician leaders have been active in warning the public about the patient care access problems this bill will exacerbate if it is signed into law.  Recently, a letter to the Editor from MSSNY’s President Dr. Charles Rothberg urging a veto was published in the Albany Times-Union (letter).   Similar
letters from regional and statewide physician leaders have also appeared in:

Want to Learn More About New York’s New Step Therapy Override Law?
Please click here to view a webinar discussing New York’s new law that gives physicians a stronger ability to override a health insurer’s step therapy protocol when seeking to assure their patients can receive coverage for necessary prescription medications. Among the faculty for the program are MSSNY President-elect Dr. Thomas Madejski and MSSNY Senior Vice President Moe Auster.

The webinar, sponsored by the National Psoriasis Foundation, will provide physicians with 0.5 hours of CME credit. The new law will be applicable to all NY-regulated health plans as of January 1, 2018.  However, since the law applies to health insurance plans “delivered, issued for delivery issued or >renewed” after January 1, 2017, many group health insurance plans across the State are already required to follow the new law.

MSSNY, AMA and Patient Advocacy Groups Urge Increased Formulary Transparency and Continuity
As health insurer/PBM prior authorization requirements seem to be ever increasing, MSSNY has joined on to a letter to the National Association of Insurance Commissioners (NAIC) along with several other state medical associations, the AMA and patient advocacy organizations urging NAIC to expand upon an existing effort to improve the transparency and development of health plan medication formularies.  Specifically, the groups call upon the NAIC to assure its updated model regulation would:

  • Prohibit mid-year formulary changes (similar to efforts by advocacy efforts by        MSSNY and other groups in New York in support of A2317/S.5022 in the New        York State Legislature)
  • Improved formulary disclosure; and
  • Stronger conflict of interest standards. Specifically, concerns were noted that the current Model Act draft does not address any potential conflicts of interest that may arise with respect to designees of the health carrier (including PBMs).
Coding Tips of the Week

By Jacqueline Thelian, CPC, CPC-I, CHCA, Medco Consultants, Inc.

What CPT code is used to report VEP (Visual Evoked Potential Testing)?
This is a good question. CPT 2018 provides clear guidance on reporting VEP. CPT code 95930 Visual evoked potential (VEP) testing central nervous system, checkerboard or flash has been revised for 2018.

The revised CPT code 95930 now reads Visual evoked potential (VEP) checkerboard or flash testing, central nervous system except glaucoma with interpretation and report.

The CPT parentheticals provide additional guidance as follows:

  • (For visual evoked potential testing for glaucoma use 0464T)
  • (For screening of visual acuity using automated visual evoked potential devices use 0333T)

CPT now clearly defines the Category 1 CPT code 95930 used for testing of the central nervous system now includes an interpretation and report.

If a vision screening using an automated VEP machine is utilized, starting in 2018 it would be reported with a Category III code 0333T Visual evoked potential, screening of visual acuity, automated with report. (e.g. a 3-year-old presents for vision screening by use of automated VEP machine).

When VEP is utilized for glaucoma you would report the Category III code 0464T.

As a reminder a Category III CPT codes represent a temporary set of codes for emerging technologies, services, and procedures. Category III codes are usually excluded from coverage by many payers.

Source:

  • Current Procedural Terminology (CPT) 2018
  • CPT Changes an Insider’s View 2018


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

Targeted Probe and Educate (TPE)

By Medco Consultants, Inc Lorna Simons, CPC

Have you ever been caught in the avalanche of paperwork and uncertainty that is entailed with a Medicare appeal? Medicare audits are never a fun topic to discuss. They can at times be a long, drawn out process. In an effort to “reduce appeals, decrease provider burden and improve the medical review and education process,” Medicare has expanded the Targeted Probe and Educate (TPE) pilot program to all of their Medicare Administrative Contractors (MACs) for Part A, B, HHH and DME.

How will this reduce the number of appeals?

The providers/suppliers will have one (1) to three (3) pre- or post-payment rounds of review. After or during each review, the healthcare provider /supplier will be educated based on MACs findings. The educational sessions are offered via webinar or telephone conference by a nurse reviewer. Other educational methods are available if necessary. If the healthcare provider/supplier is found to be non-compliant with Medicare, they will be reviewed again.

Only when the provider/supplier is found to be non-compliant following the third review, will they be referred to the Centers of Medicare and Medicaid Services (CMS) for additional action. These actions include “extrapolation, referral to Zone Program Integrity Contractor(ZPIC) or Unified Program Integrity Contractor (UPIC), referral to the RAC or 100% pre-pay review,” etc. (i.e. audit).

How will this decrease provider/supplier burden?

The MACs will be reviewing limited samples of 20 to 40 claims per review round. This will decrease the amount of documentation being sent out and ease the economic burden of being on 100% pre-payment review for providers/suppliers with high Medicare patient populations. After each round of audit and education, non-compliant providers/suppliers will have a minimum of 45 days to improve documentation and become compliant before the next round commences.

Sources:

Targeted Probe and Educate (TPE) http://ow.ly/JB5N30fDG7u

CMS PUB 100-20 One-Time Notification, Transmittal 1919, SUBJECT: Targeted Probe and Educate, http://ow.ly/sf9A30fDGjQ

NGS Compliance & Audits, Targeted Probe and Educate http://ow.ly/IshY30fDGyM

Noridian Healthcare Solutions, Targeted Probe & Educate http://ow.ly/s6HN30fDGLX

RESIDENTS/STUDENTS

13th Annual Poster Symposium at MSSNY House of Delegates March 23

Deadline for Abstract Submission: 4:00 pm, Friday, January 5, 2018

To: Residents, Fellows, Medical Students and New York State Program Directors

The Medical Society of the State of New York is very pleased to announce the 13th

Resident/Fellow/Medical Student Poster Symposium.

When:        Friday, March 23, 2018
Where:       Adam’s Mark Hotel Buffalo, New York
What time: 2:00 pm – 4:30 pm

Click here for detailed guidelines.

We welcome the participation of your residents and fellows. Participants must be MSSNY members, and a name=”nys”>membership is free for first-time resident members. Join online.

WEBINARS/SEMINARS

NYS Sees Increase in C-auris Cases;  MSSNY To Hold CME Webinar on C-auris on December 6th
At the New York State Antimicrobial Resistance (AR) Prevention and Control Task Force meeting  in Albany, participants learned cases of Candida auris (a drug-resistant fungal infection) is increasing in New York State.  According to officials from NYS Department of Health, there have 105 clinical cases and 117 screening cases since 2013 in New York State.   The majority of the outbreak is a name=”unu”>occurring in the New York City and Long Island area in hospitals and long term care facility.   The Medical Society of the State of New York will conduct a webinar on C-auris on December 6, 2017.  An Unusual and Highly Resistant Fungus in NYS: An Update on Candida auris for the Practicing Physician will be at 7:30am and there is still time to register by clicking on the link here.    

Emily Lutterloh, MD, MPH will serve as faculty for this webinar.  Dr. Lutterloh was an Epidemic Intelligence Service Officer with the Centers for Disease Control and Prevention before joining the New York State Department of Health, where she currently works as the Director of the Bureau of Healthcare Associated Infections. 

Medical Matters is a series of Continuing Medical Education (CME) webinars sponsored by MSSNY’s Committee on Emergency Preparedness and Disaster/Terrorism Response.  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. 

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

CMS INFORMATION

CMS Announces End to 2 Mandatory Bundled Payment Programs, and Deletes Required Participation in Joint Replacement Program in Western New York
CMS announced this week that it finalized a rule to cancel two of its Medicare bundled payment demonstration programs and make substantial changes to a third program. Specifically, the Episode Payment Models (EPMs) and Cardiac Rehabilitation (CR) incentive payment model announced last year are cancelled. and the number of regions across the country required to participate in the Comprehensive Care for Joint Replacement (CJR) model adopted in 2015 would be cut in half.

To read the full press release, click here.

The EPM and Cardiac Rehabilitation Incentive Payment models were scheduled to begin in January 2018. CMS stated that was proposing to eliminate these two models to give the agency “greater flexibility to design and test innovations that will improve quality and care coordination across the in-patient and post-acute-care spectrum.” According to the press release, CMS expects in the future to “increase opportunities for providers to participate in voluntary initiatives rather than large mandatory episode payment model efforts.”

Moreover, the number of regions required to participate in the Joint Replacement bundled payment program was cut from 67 to 34. Hospitals in the other 33 regions could continue to participate voluntarily. To read the entire rule, click here. Based upon an initial review of the rule, it appears the Buffalo-Niagara Falls metropolitan area has been removed entirely from mandatory participation in this program (p.48) While the New York City metropolitan area will remain in the mandatory program, 13 hospitals in the MSA have been exempted from voluntary participation (p. 52).

CMS Requests Specialty Feedback on Possible RAC Review Topics
At an AMA meeting with CMS officials earlier this year, the medical specialty societies offered to provide feedback to Recovery Audit Contractors (RACs) on possible RAC review topics prior to the approved work being posted on the RACs website. CMS recently informed the AMA that it is moving forward with this process. CMS said that it will take comments on the topics until late December. Here are the topics.



CLASSIFIEDS

RENTAL/LEASING SPACE


Want to Work in NYC but Live 100 Yards from the Atlantic Ocean?
Ocean views abound in this beautiful Rockaway Beach 1 family brick home. 5 bedrooms, 3 bathrooms. 60×100, detached 1 car garage, central air, sprinkler, alarm, large rear deck and heated pool. New finished basement, master bedroom on main floor and full bath. Tons of storage, solar panels. Beautiful front porch with ocean views. Located in Rockaway beach on a block 100 yards from the ocean! $1,750,000. Call 718-634-6004.

Upper East Side Plastic Surgery Office Available for Rent or Share
Beautifully equipped Plastic Surgery office available for part-time share along with Quad A-certified OR available for rent. Located in a lovely carriage house on the Upper East Side in close proximity to Lenox Hill Hospital and MEETH and conveniently located near all NYC mass transit. 1 exam room/OR and Recovery room along with large administrative space. Free WIFI. Available for full or half-days. Suits Plastic/Cosmetic Surgeons/ DERM/ ENT/or other Medical MDs. Please contact Kim at Kim@madisonps.com (212) 628-7600.>/div>


Saratoga Springs, NY – Professional Office Space for Lease
Medically oriented building currently occupied by five parties.  The Suite, Suite 700, has 2904 sq. ft., second floor (elevator), excellent off-road parking with drive-thru patient portico in a well maintained and attractive building close to the local hospital.
The lease area has a large waiting room, administrative rooms, lunch room, four examining rooms, one procedure room and one for storage.  Separate staff entrance.  Attractively priced without triple net obligations.  $4,500/month + heat + utilities.  Call Lauren regarding Suite 700 at (518) 587-2020.

Riverdale Medical Office for Sale – Prime Location
Co-op with private entrance features 2 exam rooms, lab, office & bathroom. Must see! Call 718-230-7069


For Rent or Share – Woodbury, Long Island
Beautiful recently renovated Plastic Surgery office available for part-time share and AAAA-certified (by end of summer). OR available for rent. Centrally located
on Long Island.Close to expressways. 3 exam rooms, 1 procedure room /OR.
Waiting room, break room and personal office. Free WIFI. Available for full or half-days. Suits Plastic/Cosmetic Surgeons/Derm/ENT/
ObGyn/Podiatry or other Medical MDs.
Contact Patricia at info@cosmetichg.com
or 631-318-4008

PHYSICIAN OPPORTUNITIES


Medical Director: Binghamton University College Physician (SL-6)
Department: Student Health ServicesLocations:   Binghamton, NYPosted: Oct 24, ’17Type:  Full-timeRef. No.: 49225The Decker Student Health Services Center at Binghamton University (The State University of New York at Binghamton) invites New York State Medical or Osteopathic Board Certified Physicians (Internal Medicine, Family Practice) to apply for a full-time, twelve-month position. This position plans, directs, supervises, and participates in the outpatient medical care of undergraduates and graduate students of a diverse student base.  The person will have excellent, primary care diagnostic skills as well as experience and proficiency in common outpatient surgical procedures, EKG and pulmonary function study interpretation, office laboratory and clinical microscopy.  This position functions as an on-site medical consultant and collaborative physician to the professional staff that includes 10 nurses, 5 nurse practitioners and 7 physicians.The individual will have five years of clinical experience after residency training and experience with staff oversight and leadership.The Medical Director provides the university campus with infectious disease direction (e.g. meningitis, measles and tuberculosis) and emergency management; participates on the Crisis Response Team; provides direction and consultation to the Dean of Students, University Counseling Center and Residential Life.  This person will be responsible for accreditation activities including; completion of internal and external benchmark studies peer chart review; completion of assessment plans, survey and risk management reports; meeting with site visitors; and following through on recommendations.Requirements: Required qualifications: NYS Board Certified Medical or Osteopathic Physicians (Internal Medicine, Family Practice) from an accredited institution; 5 years of clinical experience after residency; NYS medical license and DEA certificate that are free from special conditions or limitations. Salary: commensurate with qualifications and experience. Preferred qualifications are, but not limited to: college health familiarity; experience with diverse populations; electronic health record navigation; quality assurance, and continuous quality improvement; public health and policy experience. Payroll information can be found on our website http://www.binghamton.edu/human-resources/payroll/Cover letters may be addressed “To the Search Committee.” Postings active on the website accept applications until closure. For information on the Dual Career Program, please visit:
https://www.binghamton.edu/human-resources/dual-career-program/
Application Instructions:Deadline for Internal Applicants:  11/07/2017 Deadline for External Applicants:  Open until filled Review of applications will begin immediately and continue until the vacancy is filled.Persons interested in this position should apply online.Please submit: 1. Resume 2.Cover letter, and 3.Contact information for three professional references You may add additional files/documents after uploading your resume. After you fill out your contact information, you will be directed to the upload page. Please login to check/edit your profile or to upload additional documents: http://binghamton.interviewexchange.com/login.jsp Payroll information can be found on our website http://www.binghamton.edu/human-resources/payroll/
Additional Information:Offers of employment may be contingent upon successful completion of a pre-employment background check and verification of degree(s) and credentials.Binghamton University is a tobacco-free campus.Pursuant to Executive Order 161, no State entity, as defined by the Executive Order, is permitted to ask, or mandate, in any form, that an applicant for employment provide his or her current compensation, or any prior compensation history, until such time as the applicant is extended a conditional offer of employment with compensation.  If such information has been requested from you before such time, please contact the Governor’s Office of Employee Relations at (518) 474-6988 or via email at info@goer.ny.govEqual Opportunity/Affirmative Action Employer
The State University of New York is an Equal Opportunity/Affirmative Action Employer.  It is the policy of Binghamton University to provide for and promote equal opportunity employment, compensation, and other terms and conditions of employment without discrimination on the basis of age, race, color, religion, disability, national origin, gender, sexual orientation, veteran or military service member status, marital status, domestic violence victim status, genetic predisposition or carrier status, or arrest and/or criminal conviction record unless based upon a bona fide occupational qualification or other exception.
As required by title IX and its implementing regulations Binghamton University does not discriminate on the basis of sex in the educational programs and activities which it operates.  This requirement extends to employment and admission.  Inquiries about sex discrimination may be directed to the University Title IX Coordinator or directly to the Office of Civil Rights (OCR).  Contact information for the Title IX Coordinator and OCR, as well as the University’s complete Non-Discrimination Notice may be found here. The State University of New York is an Equal Opportunity/Affirmative Action Employer.  As required by title IX and its implementing regulations Binghamton University does not discriminate on the basis of sex in the educational programs and activities which it operates.  This requirement extends to employment and admission.  Inquiries about sex discrimination may be directed to the University Title IX Coordinator or directly to the Office of Civil Rights (OCR).  Contact information for the Title IX Coordinator and OCR, as well as the University’s complete Non-Discrimination Notice may be found here.

Medical Director – AIDS Institute
Minimum Qualifications:
Current license and registration to practice medicine in New York State and board certification AND either a Master’s Degree in Public Health or two years of experience in an HIV program or public health program.Preferred Qualifications:
Master’s Degree in Public Health.  Five years of experience including clinical service in an HIV program or clinical fellowship program (infectious diseases/HIV medicine).  Experience in quality management/quality improvement.  Knowledge of the HIV health care delivery system in New York State. Experience in/knowledge of the New York State Ending the Epidemic initiative.  Experience in STD prevention and care, drug user health, and/or LGBT health.  Experience in health policy development, analysis and evaluation.  Experience with evolving health information technologies.  Experience in health program management and administration.
Responsibilities: The Medical Director, AIDS Institute, plays a significant role in shaping HIV, hepatitis C, and STD care and services, drug user health, and LGBT health care throughout New York State.Please click the link below for more information pertaining to this position and to apply: “https://careers-healthresearch.icims.com/jobs/3742/medical-director—aids-institute/job” Affirmative Action/Equal Opportunity Employer/Qualified Individuals with Disabilities/Qualified Protected Veterans

Multiple Physician Positions with DOHMH Office of School Health
Office of School Health is the largest program of the New York City Department of Health and Mental Hygiene (DOHMH). This bureau is responsible for managing the health issues and promoting the well-being of the over 1.3 million children and adolescents enrolled in New York City’s 1700 school buildings.

Positions with the Office of School Health (OSH) combine clinical skills and public health training.

Adolescent School Health Physician
This position offers to the interested physician the opportunity to help address the clinical and public health needs of adolescents in NYC high schools. The physician will work with the innovative Connecting Adolescents to Comprehensive Health Care (CATCH) Program, which provides select reproductive health services to adolescents in select NYC high schools. In addition, the physician will provide medical care and public health services through additional programs offered to adolescents by the Office of School Health.

Under the supervision of the High School Supervising Physician, the Adolescent School Health Physician’s responsibilities will include but are not limited to:

  • Provide CATCH reproductive health services in select high schools.
  • Perform mandated physical examinations (New Admission Exams, Sports Physicals, and Working Paper Physicals).
  • Function as a liaison for students with community health providers to resolve medical issues that affect school performance.
  • Support the development and implementation of initiatives that promote positive health behaviors and reduce high risk behaviors in the adolescent population.
  • Serve as a consultant to the school nurse and administration on school related health concerns.
  • Provide clinical assistance in the event of an environmental or communicable disease occurrence.
  • Function as a liaison for students with community health providers to resolve medical issues that affect school performance.
  • Support all medical initiatives established by the Office of School Health, e.g. programs and protocols in asthma, reproductive health, obesity and diabetes.
  • Maintain good public relations and communicate effectively within the school community and community-based organizations.
  • Keep abreast of health management policy statements and emerging clinical research related to school health.
  • Participate in OSH research activities.
  • Work within the mandates, policies and protocols of the Office of School Health.
  • Attend all mandated DOHMH and OSH trainings.

To Apply: Please email your resume and cover letter to Dr. Caroline Volel: osh@health.nyc.gov OR  Apply online at https://a127-jobs.nyc.gov/.  In the Job ID search bar, enter: job ID number # 277208. 

School Health Field Physician
Under the direction of the Supervising Physician, the School Health Physician’s will:

  • Improve the health of school children through case management of chronic disease, preventive health screening and counseling, health education, and referrals.
  • Perform mandated physical examination (new entrant, sport physical, working paper physicals.
  • Develop relationships with community health providers in order to optimize medical management of students with health issues.
  • Attend to the health needs of your assigned school community.
  • Utilize the Automated Student Health Record (ASHR) to maintain adequate student health records.
  • Serve as a consultant to the school nurse and administration on school related health concerns.
  • Support the development of school educational and prevention programs promoting the health and wellness of all students.
  • Provide clinical assistance in the event of an environmental or communicable disease occurrence.
  • Develop and maintain professional relationships within the school community.
  • Support all medical initiatives put forth by the Office of School Health, e.g. Asthma, Reproductive health, Obesity and Diabetes initiatives.
  • Provide trainings/presentations to school staff, community organizations, or parents.
  • Stay abreast of health management policy statements and emerging research within the health community related to school health.
  • Participate in School Health research and quality improvement activities.
  • Participate in all mandated DOHMH and Office of School Health trainings and professional development sessions.
  • Attend all program meetings and Continuing Medical Education classes provided by the Office of School Health.

To Apply: Please email your resume and cover letter to Dr. Caroline Volel:osh@health.nyc.gov OR Apply online at https://a127-jobs.nyc.gov/.  In the Job ID search bar, enter: job ID number # 279844. 

Supervising School Health Physician 
Job Description
Under the supervision of the Deputy Medical Director, the Supervising Medical Doctor’s responsibilities will include but not be limited to:

  • Supervise School Health Physicians.
  • Work within the mandates, policies and protocols of the Office of School Health (OSH).
  • Attend to the health needs of a designated school community.
  • Utilize the Automated Student Health Record (ASHR) to maintain accurate student health records.
  • Serve as a consultant to the school nurse and school administrative staff regarding school related health concerns.
  • Support the development of school educational and prevention programs promoting the health and wellness of students.
  • Participate in policy development and revisions as indicated.
  • Provide clinical assistance in the event of an environmental or communicable disease occurrence.
  • Function as a liaison for students with community health providers to resolve health issues that affect school functioning.
  • Develop and maintain professional relationships within the school community and the community at large.
  • Support all medical initiatives put forth by the Office of School Health, e.g. Asthma, Reproductive health, Obesity and Diabetes Initiatives.
  • Keep abreast of health management policy statements and emerging research within the health community affecting school health.
  • Assist with or provide trainings/presentations to school health physicians, nurses, school staff, community organizations or parents
  • Participate in School Health research and quality improvement activities
  • Participate in all mandated DOHMH and Office of School Health trainings and professional development sessions
  • Attend all program meetings and Continuing Medical Education classes provided by the Office of School Health.

To Apply: Please email your resume and cover letter to Dr. Caroline Volel: osh@health.nyc.gov  OR  Apply online at https://a127-jobs.nyc.gov/.  In the Job ID search bar, enter: job ID number # 277026


MEDICAL EQUIPMENT


Retiring from pediatrics. I have medical equipment to donate: examining table, pediatric examining table with a scale, medical scale, examining instruments and miscellaneous office items. Forest Hills. Call 718 275-5858 or email mkolak59@gmail.com


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


November 17, 2017 – Talking “The Talk” at Thanksgiving

 

Charles Rothberg, MD - MSSNY President
PRESIDENT’S MESSAGE

Charles Rothberg, MD
November 17, 2017
Volume 17
Number 43

Dear Colleagues:

Longtime MSSNY member, Dr. Pat Bomba, has been working enthusiastically on end-of-life issues for well over two decades. The champion of “the tough conversation” has earned  her national recognition for her work; other states have followed New York’s lead. Dr. Bomba created and promoted the end-of-life-care document called MOLST (Medical Orders for Life Sustaining Treatment) for people who are in good health and those who are seriously ill.  MOLST helps fill in the gaps of a living will, and makes sure everyone in the health care system is guided by the patient’s own preferences for care.

According to a recent editorial Dr. Bomba wrote, her family has a Thanksgiving tradition dating back to 1992 that has nothing to do with food or football. Her message is something you may want to think about for yourself, your family, your patients and your practice.

As a health plan medical director with an expertise in geriatrics, palliative care and end-of-life issues, Dr. Bomba knows opening this topic leads to difficult but meaningful conversation. She recommends that everyone 18 years and older complete a Health Care Proxy and then, should share copies with their physician, lawyer and most importantly, their families.

At the Bomba’s annual family turkey dinner, they have an advance care planning discussion whereby they “focus on what makes life worth living at this point in our lives. I encourage every family to embrace our Thanksgiving tradition. Our Thanksgiving and thoughtful MOLST discussions helped our family honor our mom’s wishes at the end of her life.”

As she writes, “Advance care planning is a gift to yourself and your family. Choose the person you trust to make medical decisions if you lose the ability to make medical decisions and share your values, beliefs and what matters most with your family and loved ones.

While at first you might think it’s morbid to discuss such issues at a festive gathering, we’ve found sharing our wishes for end-of-life care actually brings us closer. We gain peace of mind knowing our own wishes will be understood and honored in the event we can’t speak for ourselves.”

As she succinctly puts it, “No pumpkin pie, until you tell me how you want to live until you die.” After dinner, “the adults in our family stay at the table and talk about what matters most in our lives. We review our advance directives to make sure they reflect our current feelings.”

The New York eMOLST Registry is an electronic database centrally housing MOLST forms and CDFs to allow 24/7 access in an emergency. eMOLST allows for electronic completion of the current New York State Department of Health-5003 MOLST form.  By moving the MOLST form to a readily accessible electronic format and creating the New York eMOLST Registry, physicians and EMS professionals, can have access to MOLST forms at all sites of care including hospitals, nursing homes and in the community.

Discussing and documenting each family member’s wishes when they are well will save family turmoil in the future.

For physicians, you can download the doctor-specific information here.

This is not just for your patients. This information is for you and your family.

I wish you and your families a Happy Thanksgiving.

Sincerely,

Charles Rothberg, MD
MSSNY President

Please send your comments to comments@mssny.org



enews large

MSSNY Phone Number for Garfunkel Wild
Our new law firm, Garfunkel Wild, has established a phone number for exclusive use by MSSNY members: 516-393-2230.
  We also have a group of attorneys dedicated to receiving the phone calls to ensure that any MSSNY member who calls will receive prompt service.

They want to hear from you!

DFS Imposes $2 Million Fine on Cigna for Selling Unapproved Health Insurance Policies
This week, New York Department of Financial Services Superintendent Maria Vullo announced the imposition of a $2 million fine on Cigna for violations of New York State Insurance Law involving the illegal sale of stop-loss insurance and unapproved health insurance policies that would otherwise have been part of New York’s small-group market.

According to a consent order entered into with Cigna, DFS found that Cigna improperly sold stop-loss and fully insured health insurance policies outside of New York to New York-based small groups with employees in New York State.  The press release noted that Cigna sold 81 group health insurance policies in violation of New York Insurance Law, including 38 stop-loss insurance policies to New York small groups seeking to self-insure and 43 fully insured health insurance policies to small groups as if they were selling to non-New York small groups.

To read the full press release, click here.

Governor Again Vetoes Legislation to Permit Prescription Refills Longer than Original Prescription
Recently, Governor Cuomo vetoed legislation (A.6731-B/S.5171-B) that would have authorized pharmacists to refill non-controlled substance prescriptions in a quantity greater than that set forth in the prescriber’s original prescription. In effect, it would have enabled pharmacists to provide 90-day refills of particular prescription medication even if the original prescription called for a shorter refill duration, such as 30 days.

While there were some changes to a similar bill that was vetoed last year, Governor Cuomo noted in the veto message his concerns that “the bill retains the provisions that would risk contributing to the distribution of larger quantities of prescription medications than may be necessary for a specific patient”.  Moreover, he noted his concern that “it would still allow the pharmacist to infringe on the physician-patient relationship” because the notification to the prescriber would not occur until after the prescription is filled.



Promo Code: MSSNY

 

 

 

 

 


AHA and ACC Redefine High Blood Pressure Reading
Acting for the first time in 14 years, the American Heart Association, the American College of Cardiology and nine other groups redefined high blood pressure as a reading of 130 over 80, down from 140 over 90.” This “change means that 46 percent of US adults, many of them under the age of 45, now will be considered hypertensive.” The Post points out that “under the previous guideline, 32 percent of US adults had” hypertension.

On its front page, the New York Times (11/14) reports that “under the guidelines…the number of men under age 45 with a diagnosis of high blood pressure will triple, and the prevalence among women under age 45 will double. The guidelines presented at a heart association meeting and published in the Journal of the American College of Cardiology, also spell out exactly how health care providers and people at home should check blood pressure.” For instance, physicians “and nurses are urged to let patients rest five minutes first and then to average at least two readings over two visits.” Meanwhile, “patients are urged to take regular readings at home, with a device checked out by their health care providers.”

Click here to read the AMA statement on the updated guideline for measuring blood pressure.

Tip of the Week: Is it Appropriate to Report Kinesio Taping with Strapping Codes?
By Jacqueline Thelian, CPC, CPC-I, CHCA, Medco Consultants, Inc.

As per Current Procedural Guidelines (CPT), the CPT Assistant and the Centers for Medicare and Medicaid Services (CMS) Local Coverage Determination (LCD) L33631 it is inappropriate to report Kinesio taping with any of the CPT codes for strapping (29200, 29240, 29260, 29280, 29520, 97799, 97039, 29799).

Strapping may be used to treat strains, sprains, dislocations, and some fractures. The strapping codes are intended to be used when the desired effect is to provide total immobilization or restriction of movement.”

Kinesio taping is not utilized for immobilization; rather its function is to provide support and stability to joints and muscles without affecting circulation and range of motion.

The CPT Assistant goes on to state the Kinesio taping is considered to be an inclusive part of neuromuscular re-education or therapeutic exercise and would not be separately reported.

The Centers for Medicare and Medicaid Services (CMS) Local Coverage Determination (LCD) L33631 Outpatient Physical and Occupational Therapy Services under the General Guidelines for Strapping also considers the Kinesio taping to be considered inclusive to CPT codes 97110 and 97112.

Source:

  • National Government Services Inc. Local Coverage Determination (LCD) L33631
  • CPT Assistant March 2012, Surgery Musculoskeletal System

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


Your membership yields results and will continue to do so. When your 2018 invoice arrives, please renew. KEEP MSSNY STRONG!


What Can I Do?

Help Us Advocate Legislation to Prevent Mid-Year Prescription Formulary Changes
Concerned about changes to health insurer prescription drug formularies that may adversely impact your patients? MSSNY has been working collaboratively with several patient advocacy groups to support legislation (A.2317, People-Stokes/S.5022-A, Serino) that would prohibit health insurers from moving a drug to a higher-cost tier or removing a prescription drug from a formulary during a policy year.  To help facilitate advocacy in support of this legislation, the group New York Health Works has developed a survey to enable physicians and patients to better document the full extent of this problem.  Please take just a few minutes to respond to the survey by clicking here.

Share Your Personal Stories about Challenges You Face as a Physician
MSSNY wants legislators to hear directly from New York Physicians about the challenges they face as medical practitioners.  Personal stories are vital for enhancing our messages on issues of concern to the medical professionals, particularly to legislators who represent the area where those professionals practice.

We plan to gather personalized stories from physicians and medical students to print as flyers and articles that can be distributed to legislators and journalists. Opting in to share your stories is entirely voluntary. We value and respect your privacy, which is why your permission is needed for us to share these stories. Please click here to fill out the brief Physician Questionnaire.

MSSNY to Implement National Diabetes Prevention Program; Physicians Encouraged to Take Diabetes Awareness Survey
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 STATTM program.  This survey can be taken by clicking here.

The AMA previously rolled out the program through partnerships with state medical societies in California, Michigan and South Carolina. New York is one of eight states where the AMA is extending the program. The DPP model encourages physicians to screen patients for prediabetes, a condition in which blood glucose levels are higher than normal but below the threshold for a diabetes diagnosis. Patients identified as pre-diabetic are referred to diabetes prevention programs that meet certain criteria established by the Centers for Disease Control and Prevention.

This initiative will help bridge the gap between the clinical care setting and communities to reduce the incidence of type 2 diabetes by educating and connecting more patients to evidence-based lifestyle change programs that are available in their communities, including programs offered where they work, through community and faith-based organizations, and online.

“MSSNY’s partnership with the AMA is a key step towards making an immediate impact on the health of New Yorkers,” said Dr. Geoffrey Moore, Chair of MSSNY’s Preventative Medicine and Family Health Committee and a lifestyle medicine physician based in Ithaca, NY. “The Centers for Disease Control and the American Medical Association have developed a great educational toolkit and, through our partnership, we seek to extend the benefits of these tools to all physicians and patients throughout New York State.”

In the coming year, MSSNY will be developing education sessions and articles outlining important information about diabetes in the MSSNY Daily and E-News.  Educational webinars and podcasts tailored to both physicians and patients on prediabetes and diabetes are also being developed. MSSNY’s website includes a Diabetes webpage and physicians are encouraged to visit for more information about Type 2 Diabetes and to learn more about MSSNY’s partnership with the AMA.

Please Urge Governor Cuomo to Veto Disastrous Liability Expansion Bill and Work for Comprehensive Reform Instead
With just a few weeks left in 2017, please help us to urge Governor Cuomo to veto legislation (S.6800/A.8516) that would significantly expand the time to bring a medical malpractice lawsuit, in circumstances based upon an “alleged negligent failure to diagnose a malignant tumor or cancer.”  If signed into law it would likely prompt a double digit increase in physician and hospital malpractice premiums.  You can send a letter to the Governor here and call 518-474-8390.

The bill will likely be delivered to Governor within the next few weeks, upon which he will have 10 days to decide to sign it or veto it.  While many physicians have contacted the Governor to urge a veto of this legislation, we need an overwhelming demonstration from physicians regarding how this bill will harm access to care in their communities if this bill is not paired with needed tort reforms to bring down the exorbitant costs of medical liability insurance in New York.

Physicians have been active in warning the public about the patient care access problems this bill will exacerbate if it is signed into law.  Recently Albany radiologist and MSSNY member and Albany radiologist Dr. Robert Rapaport had a commentary published in the Albany Times-Union urging that the Governor veto this bill and instead work for comprehensive reform.  Moreover, a letter to the Editor from MSSNY’s Dr. Rothberg urging a veto was also recently published in the Albany Times-Union (letter).   Similar letters from regional and statewide physician leaders have also appeared in:

MEDICAL STUDENTS

Share Your Personal Stories about Challenges You Face as a Medical Student
MSSNY wants legislators to hear directly from medical students about the challenges they face as future physicians.  Personal stories are vital for enhancing our messages on issues of concern to the medical professionals, particularly to legislators who represent the area where those professionals practice.

We plan to gather personalized stories from physicians and medical students to print as flyers and articles that can be distributed to legislators and journalists. Opting in to share your stories is entirely voluntary. We value and respect your privacy, which is why your permission is needed for us to share these stories. Please click here to fill out the brief Medical Student Questionnaire.

WEBINARS/SEMINARS

CME Webinar on December 6: An Unusual and Highly Resistant Fungus in NYS: An Update on Candida auris for the Practicing Physician:
Upcoming in MSSNY’s Medical Matters continuing medical education (CME) webinar series is: An Unusual and Highly Resistant Fungus in NYS: An Update on Candida auris for the Practicing Physician.  This webinar will take place on Wednesday, December 6, 2017 at 7:30 a.m.  Emily Lutterloh, MD, MPH, Director, Bureau of Healthcare Associated Infections, from the New York State Department of Health will conduct this presentation.  Register for this webinar here.

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

Educational objectives are:

  • Provide an update on the emerging multi-drug resistant yeast, Candida auris ( auris), globally and in New York State
  • Describe the risk factors for auris infection and the recommended diagnostic approach
  • Review the recommendations for auris, including infection prevention and control measures

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. 

Educate Your Patients About the Flu
It’s flu season!  New York State Department of Health has had reports of seasonal influenza in nearly every county. Encourage your patients to listen to MSSNY’s brief and informative podcast on influenza vaccine here.

MSSNY also has a podcast on the pneumococcal vaccine for patient’s 60 and older here. Or click here listen to all 13 of MSSNY’s podcasts on topics such as the Zika virus, emergency preparedness and a variety of adult vaccines.

Buprenorphine Training to be held in Sullivan County December 2nd
The NYSDOH AIDS Institute and the Sullivan County Public Health Department are hosting a Buprenorphine Eligibility Waiver Training for Clinical Providers on Saturday, December 2,

from 8:00AM to 1:00PM at Catskill Regional Medical Center, 68 Harris-Bushville Rd, Board Room, Harris, NY 12742.

This training is for physicians, nurse practitioners, physician assistants, pharmacists, and medical residents. Sullivan County has some of the highest rates of opioid overdose in New York State. In just the first seven months of 2017, Sullivan County has experienced a reported 20 overdose deaths.  From 2013-2016, there were approximately 75 reported opioid overdose deaths.

DOH is seeking to increase the volume of providers in and around the county that are able to offer medication assisted treatment (MAT) to people using opioids whom could benefit from buprenorphine (or “suboxone”).  Attached is a flyer with further information, including locationonline registration, and more details. Further information will be sent out to confirmed attendees. Light refreshments will be provided. Registration closes on November 29th at 5pm.Trainers: Sharon Stancliff, MD, Harm Reduction Coalition, New York, NY; Bruce Trigg, MD, Harm Reduction Coalition, New York, NY

Please Note: CME Credits will be made available. This is the first half of the minimum required 8 hours of training, and the second half must be completed online after attendance to the live training. Currently NPs & PAs are required to take an additional 16 hours of online training which is available on the PCSS-MAT website (Part 2). For more information about buprenorphine related trainings, mentoring, coaching, technical assistance and more, please contact us at buprenorphine@health.ny.gov or 1-800-692-8528.

Want to Learn More about New York’s New Step Therapy Override Law?
Please click here to view a webinar discussing New York’s new law that gives physicians a stronger ability to override a health insurer’s step therapy protocol when seeking to assure their patients can receive coverage for necessary prescription medications. Among the faculty for the program are MSSNY President-elect Dr. Thomas Madejski and MSSNY Senior Vice President Moe Auster. The webinar, sponsored by the National Psoriasis Foundation, will provide physicians with 0.5 hours of CME credit.

The new law will be applicable to all NY-regulated health plans as of January 1, 2018.  However, since the law applies to health insurance plans “delivered, issued for delivery issued or renewed” after January 1, 2017, many group health insurance plans across the State are already required to follow the new law.

MSSNY has created a template for physicians and their support staff to use in requesting a step therapy protocol override, available here.

Enforcement is the key to assuring that the law is working as intended.  Therefore, please let us know if you see instances where health insurers are not following the law.  Moreover, you can file a complaint with the State here.

MEDICARE/MEDICAID INFORMATION

You Must Enroll In Medicaid FFS to Treat MMC Patients
In September, MSSNY alerted the membership of a new federal regulation resulting from the 21st Century Cures Act.  The regulation requires that any physician treating Medicaid recipients in a Medicaid Managed Care (MMC) plan must now enroll in Medicaid Fee-for-Service (FFS) in order to continue treating MMC patients.  By now, you should have received letters from your MMC plan explaining this requirement.

Some of our members raised concerns about the requirement.  To research the matter, Regina McNally, VP of SME, called the Director of Medicaid provider enrollment at the NYS DOH.  Based on that contact, we have been advised of the following:

Regarding Medicaid Managed Care physicians who want to continue treating Medicaid Managed care recipients, the DOH has no intention of terminating any physician who has his/her application on file before the deadline.  So, if the provider enrollment application is submitted before January 1, 2018, the DOH will work with the physician(s) to ensure that the information is properly on file.  Since the application is submitted to CSC, the Medicaid Intermediary, first for scanning into their system and then forwarded to the NYS DOH for review to ensure accuracy, it would be advisable to have the application filed by December 1, 2017.  This should give sufficient time to ensure that the application is on file.

Note:  Physicians do not have to treat Medicaid fee-for-service recipients even though they have enrolled in the program.  However, physicians do need to enroll in order to continue treating Medicaid Managed care recipients.

New Deadline: Participate in Field Testing of Episode-Based Cost Measures by November 20
The Centers for Medicare & Medicaid Services (CMS) has extended the deadline for feedback on its cost measures field test to November 20, 2017.

As a reminder, CMS is conducting a field test for eight episode-based cost measures before consideration of their potential use in the cost performance category of the Merit-based Incentive Payment System (MIPS) of the Quality Payment Program. During the field test, clinicians may access confidential feedback reports with information about their performance on these new measures. All stakeholders are also invited to comment on the measures and supplemental documents.

The eight episode-based cost measures are:

    1. Elective Outpatient Percutaneous Coronary Intervention (PCI)

  1. Knee Arthroplasty
  2. Revascularization for Lower Extremity Chronic Critical Limb Ischemia
  3. Routine Cataract Removal with Intraocular Lens (IOL) Implantation
  4. Screening/Surveillance Colonoscopy
  5. Intracranial Hemorrhage or Cerebral Infarction
  6. Simple Pneumonia with Hospitalization
  7. ST-Elevation Myocardial Infarction (STEMI) with (PCI) 

Participate in Field Testing through November 20, 2017
The field test is a voluntary opportunity for stakeholders to comment on the measure specifications and the report template for the eight measures in their current stage of development. This feedback will be considered in refining the measures and for future measure development activities.

If you or your clinician group perform(s) or manage(s) the care for one or more of the procedures or medical conditions represented in the measures above, you might have a confidential Field Test Report on the CMS Enterprise Portal. For group practices, reports are available for the TIN of the group practice. Please refer to the “2017-10-cost-measure-field-test-access-guide.pdf” in the zip file linked below for instructions on setting up or activating your EIDM account. The supplemental documentation listed below is included in a zip file on the MACRA page under the “What’s new” section and “Episode-based cost measures” subsection. To download the zip file directly, please click here.

  • Field Test Mock Report
  • Draft Cost Measure Methodology
  • Draft Measure Codes List

Please provide comments through this online survey by 11:59 PM ET on November 20, 2017.

For More Information. You may refer to the fact sheet or FAQs
document for additional information. If you have any questions, please contact QPPCostMeasureTesting@ketchum.com.

New Medicare Card: Provider Ombudsman Announced
The Provider Ombudsman for the New Medicare Card serves as a CMS resource for the provider community. The Ombudsman will ensure that CMS hears and understands any implementation problems experienced by clinicians, hospitals, suppliers, and other providers. Dr. Eugene Freund will be serving in this position. He will also communicate about the New Medicare Card to providers and collaborate with CMS components to develop solutions to any implementation problems that arise. To reach the Ombudsman, contact: NMCProviderQuestions@cms.hhs.gov.

The Medicare Beneficiary Ombudsman and CMS staff will address inquiries from Medicare beneficiaries and their representatives through existing inquiry processes. Visit Medicare.gov for information on how the Medicare Beneficiary Ombudsman can help you.

Summary and Statement: 2018 QPP Final Rule
Last week, CMS issued the long-awaited Medicare Quality Payment Program final regulation for 2018.  PAI’s comments discussed the need for continued physician flexibility and greater simplicity to allow physicians to transition to the program successfully.

The final regulation’s impact on physician practices is a mixed bag, as discussed in PAI’s statement, released earlier this week. PAI applauds CMS for finalizing its policy to increase the low-volume threshold and include an interim final rule to support the needs of those impacted by recent natural disasters.

However, PAI is disappointed that the final regulation includes certain policies that could unintentionally put some patients, physicians, and practices at a disadvantage. One policy of concern will increase the weight of the cost category from 0% in 2017 to 10% in 2018, utilizing the Medicare Spending per Beneficiary (MSPB) and total per capita cost measures, while new episode-based cost category measures that more accurately assess health care service utilization and appropriately attribute costs are still under development and not part of the scoring.

A summary of the final rule provisions is available here; a CMS Fact Sheet is available here. Blood Eosinophil And Neutrophil Concentrations May Predict Lung Function Declines In WTC-Exposed Firefighters, Research Suggests.


CLASSIFIEDS


RENTAL/LEASING SPACE


Want to Work in NYC but Live 100 Yards from the Atlantic Ocean?
Ocean views abound in this beautiful Rockaway Beach 1 family brick home. 5 bedrooms, 3 bathrooms. 60×100, detached 1 car garage, central air, sprinkler, alarm, large rear deck and heated pool. New finished basement, master bedroom on main floor and full bath. Tons of storage, solar panels. Beautiful front porch with ocean views. Located in Rockaway beach on a block 100 yards from the ocean! $1,750,000. Call 718-634-6004.

Upper East Side Plastic Surgery Office Available for Rent or Share
Beautifully equipped Plastic Surgery office available for part-time share along with Quad A-certified OR available for rent. Located in a lovely carriage house on the Upper East Side in close proximity to Lenox Hill Hospital and MEETH and conveniently located near all NYC mass transit. 1 exam room/OR and Recovery room along with large administrative space. Free WIFI. Available for full or half-days. Suits Plastic/Cosmetic Surgeons/ DERM/ ENT/or other Medical MDs. Please contact Kim at Kim@madisonps.com (212) 628-7600.>/div>


Saratoga Springs, NY – Professional Office Space for Lease
Medically oriented building currently occupied by five parties.  The Suite, Suite 700, has 2904 sq. ft., second floor (elevator), excellent off-road parking with drive-thru patient portico in a well maintained and attractive building close to the local hospital.
The lease area has a large waiting room, administrative rooms, lunch room, four examining rooms, one procedure room and one for storage.  Separate staff entrance.  Attractively priced without triple net obligations.  $4,500/month + heat + utilities.  Call Lauren regarding Suite 700 at (518) 587-2020.

Riverdale Medical Office for Sale – Prime Location
Co-op with private entrance features 2 exam rooms, lab, office & bathroom. Must see! Call 718-230-7069


For Rent or Share – Woodbury, Long Island
Beautiful recently renovated Plastic Surgery office available for part-time share and AAAA-certified (by end of summer). OR available for rent. Centrally located
on Long Island.Close to expressways. 3 exam rooms, 1 procedure room /OR.
Waiting room, break room and personal office. Free WIFI. Available for full or half-days. Suits Plastic/Cosmetic Surgeons/Derm/ENT/
ObGyn/Podiatry or other Medical MDs.
Contact Patricia at info@cosmetichg.com
or 631-318-4008

PHYSICIAN OPPORTUNITIES


Medical Director: Binghamton University College Physician (SL-6)
Department: Student Health ServicesLocations:   Binghamton, NYPosted: Oct 24, ’17Type:  Full-timeRef. No.: 49225The Decker Student Health Services Center at Binghamton University (The State University of New York at Binghamton) invites New York State Medical or Osteopathic Board Certified Physicians (Internal Medicine, Family Practice) to apply for a full-time, twelve-month position. This position plans, directs, supervises, and participates in the outpatient medical care of undergraduates and graduate students of a diverse student base.  The person will have excellent, primary care diagnostic skills as well as experience and proficiency in common outpatient surgical procedures, EKG and pulmonary function study interpretation, office laboratory and clinical microscopy.  This position functions as an on-site medical consultant and collaborative physician to the professional staff that includes 10 nurses, 5 nurse practitioners and 7 physicians.The individual will have five years of clinical experience after residency training and experience with staff oversight and leadership.The Medical Director provides the university campus with infectious disease direction (e.g. meningitis, measles and tuberculosis) and emergency management; participates on the Crisis Response Team; provides direction and consultation to the Dean of Students, University Counseling Center and Residential Life.  This person will be responsible for accreditation activities including; completion of internal and external benchmark studies peer chart review; completion of assessment plans, survey and risk management reports; meeting with site visitors; and following through on recommendations.Requirements: Required qualifications: NYS Board Certified Medical or Osteopathic Physicians (Internal Medicine, Family Practice) from an accredited institution; 5 years of clinical experience after residency; NYS medical license and DEA certificate that are free from special conditions or limitations. Salary: commensurate with qualifications and experience. Preferred qualifications are, but not limited to: college health familiarity; experience with diverse populations; electronic health record navigation; quality assurance, and continuous quality improvement; public health and policy experience. Payroll information can be found on our website http://www.binghamton.edu/human-resources/payroll/Cover letters may be addressed “To the Search Committee.” Postings active on the website accept applications until closure. For information on the Dual Career Program, please visit:
https://www.binghamton.edu/human-resources/dual-career-program/
Application Instructions:Deadline for Internal Applicants:  11/07/2017 Deadline for External Applicants:  Open until filled Review of applications will begin immediately and continue until the vacancy is filled.Persons interested in this position should apply online.Please submit: 1. Resume 2.Cover letter, and 3.Contact information for three professional references You may add additional files/documents after uploading your resume. After you fill out your contact information, you will be directed to the upload page. Please login to check/edit your profile or to upload additional documents: http://binghamton.interviewexchange.com/login.jsp Payroll information can be found on our website http://www.binghamton.edu/human-resources/payroll/
Additional Information:Offers of employment may be contingent upon successful completion of a pre-employment background check and verification of degree(s) and credentials.Binghamton University is a tobacco-free campus.Pursuant to Executive Order 161, no State entity, as defined by the Executive Order, is permitted to ask, or mandate, in any form, that an applicant for employment provide his or her current compensation, or any prior compensation history, until such time as the applicant is extended a conditional offer of employment with compensation.  If such information has been requested from you before such time, please contact the Governor’s Office of Employee Relations at (518) 474-6988 or via email at info@goer.ny.govEqual Opportunity/Affirmative Action Employer
The State University of New York is an Equal Opportunity/Affirmative Action Employer.  It is the policy of Binghamton University to provide for and promote equal opportunity employment, compensation, and other terms and conditions of employment without discrimination on the basis of age, race, color, religion, disability, national origin, gender, sexual orientation, veteran or military service member status, marital status, domestic violence victim status, genetic predisposition or carrier status, or arrest and/or criminal conviction record unless based upon a bona fide occupational qualification or other exception.
As required by title IX and its implementing regulations Binghamton University does not discriminate on the basis of sex in the educational programs and activities which it operates.  This requirement extends to employment and admission.  Inquiries about sex discrimination may be directed to the University Title IX Coordinator or directly to the Office of Civil Rights (OCR).  Contact information for the Title IX Coordinator and OCR, as well as the University’s complete Non-Discrimination Notice may be found here. The State University of New York is an Equal Opportunity/Affirmative Action Employer.  As required by title IX and its implementing regulations Binghamton University does not discriminate on the basis of sex in the educational programs and activities which it operates.  This requirement extends to employment and admission.  Inquiries about sex discrimination may be directed to the University Title IX Coordinator or directly to the Office of Civil Rights (OCR).  Contact information for the Title IX Coordinator and OCR, as well as the University’s complete Non-Discrimination Notice may be found here.


Medical Director – AIDS Institute
Minimum Qualifications:
Current license and registration to practice medicine in New York State and board certification AND either a Master’s Degree in Public Health or two years of experience in an HIV program or public health program.Preferred Qualifications:
Master’s Degree in Public Health.  Five years of experience including clinical service in an HIV program or clinical fellowship program (infectious diseases/HIV medicine).  Experience in quality management/quality improvement.  Knowledge of the HIV health care delivery system in New York State. Experience in/knowledge of the New York State Ending the Epidemic initiative.  Experience in STD prevention and care, drug user health, and/or LGBT health.  Experience in health policy development, analysis and evaluation.  Experience with evolving health information technologies.  Experience in health program management and administration.
Responsibilities: The Medical Director, AIDS Institute, plays a significant role in shaping HIV, hepatitis C, and STD care and services, drug user health, and LGBT health care throughout New York State.Please click the link below for more information pertaining to this position and to apply: “https://careers-healthresearch.icims.com/jobs/3742/medical-director—aids-institute/job” Affirmative Action/Equal Opportunity Employer/Qualified Individuals with Disabilities/Qualified Protected Veterans

Multiple Physician Positions with DOHMH Office of School Health
Office of School Health is the largest program of the New York City Department of Health and Mental Hygiene (DOHMH). This bureau is responsible for managing the health issues and promoting the well-being of the over 1.3 million children and adolescents enrolled in New York City’s 1700 school buildings.

Positions with the Office of School Health (OSH) combine clinical skills and public health training.

Adolescent School Health Physician
This position offers to the interested physician the opportunity to help address the clinical and public health needs of adolescents in NYC high schools. The physician will work with the innovative Connecting Adolescents to Comprehensive Health Care (CATCH) Program, which provides select reproductive health services to adolescents in select NYC high schools. In addition, the physician will provide medical care and public health services through additional programs offered to adolescents by the Office of School Health.

Under the supervision of the High School Supervising Physician, the Adolescent School Health Physician’s responsibilities will include but are not limited to:

  • Provide CATCH reproductive health services in select high schools.
  • Perform mandated physical examinations (New Admission Exams, Sports Physicals, and Working Paper Physicals).
  • Function as a liaison for students with community health providers to resolve medical issues that affect school performance.
  • Support the development and implementation of initiatives that promote positive health behaviors and reduce high risk behaviors in the adolescent population.
  • Serve as a consultant to the school nurse and administration on school related health concerns.
  • Provide clinical assistance in the event of an environmental or communicable disease occurrence.
  • Function as a liaison for students with community health providers to resolve medical issues that affect school performance.
  • Support all medical initiatives established by the Office of School Health, e.g. programs and protocols in asthma, reproductive health, obesity and diabetes.
  • Maintain good public relations and communicate effectively within the school community and community-based organizations.
  • Keep abreast of health management policy statements and emerging clinical research related to school health.
  • Participate in OSH research activities.
  • Work within the mandates, policies and protocols of the Office of School Health.
  • Attend all mandated DOHMH and OSH trainings.

To Apply: Please email your resume and cover letter to Dr. Caroline Volel: osh@health.nyc.gov OR  Apply online at https://a127-jobs.nyc.gov/.  In the Job ID search bar, enter: job ID number # 277208. 

School Health Field Physician
Under the direction of the Supervising Physician, the School Health Physician’s will:

  • Improve the health of school children through case management of chronic disease, preventive health screening and counseling, health education, and referrals.
  • Perform mandated physical examination (new entrant, sport physical, working paper physicals.
  • Develop relationships with community health providers in order to optimize medical management of students with health issues.
  • Attend to the health needs of your assigned school community.
  • Utilize the Automated Student Health Record (ASHR) to maintain adequate student health records.
  • Serve as a consultant to the school nurse and administration on school related health concerns.
  • Support the development of school educational and prevention programs promoting the health and wellness of all students.
  • Provide clinical assistance in the event of an environmental or communicable disease occurrence.
  • Develop and maintain professional relationships within the school community.
  • Support all medical initiatives put forth by the Office of School Health, e.g. Asthma, Reproductive health, Obesity and Diabetes initiatives.
  • Provide trainings/presentations to school staff, community organizations, or parents.
  • Stay abreast of health management policy statements and emerging research within the health community related to school health.
  • Participate in School Health research and quality improvement activities.
  • Participate in all mandated DOHMH and Office of School Health trainings and professional development sessions.
  • Attend all program meetings and Continuing Medical Education classes provided by the Office of School Health.

To Apply: Please email your resume and cover letter to Dr. Caroline Volel:osh@health.nyc.gov OR Apply online at https://a127-jobs.nyc.gov/.  In the Job ID search bar, enter: job ID number # 279844. 

Supervising School Health Physician 
Job Description
Under the supervision of the Deputy Medical Director, the Supervising Medical Doctor’s responsibilities will include but not be limited to:

  • Supervise School Health Physicians.
  • Work within the mandates, policies and protocols of the Office of School Health (OSH).
  • Attend to the health needs of a designated school community.
  • Utilize the Automated Student Health Record (ASHR) to maintain accurate student health records.
  • Serve as a consultant to the school nurse and school administrative staff regarding school related health concerns.
  • Support the development of school educational and prevention programs promoting the health and wellness of students.
  • Participate in policy development and revisions as indicated.
  • Provide clinical assistance in the event of an environmental or communicable disease occurrence.
  • Function as a liaison for students with community health providers to resolve health issues that affect school functioning.
  • Develop and maintain professional relationships within the school community and the community at large.
  • Support all medical initiatives put forth by the Office of School Health, e.g. Asthma, Reproductive health, Obesity and Diabetes Initiatives.
  • Keep abreast of health management policy statements and emerging research within the health community affecting school health.
  • Assist with or provide trainings/presentations to school health physicians, nurses, school staff, community organizations or parents
  • Participate in School Health research and quality improvement activities
  • Participate in all mandated DOHMH and Office of School Health trainings and professional development sessions
  • Attend all program meetings and Continuing Medical Education classes provided by the Office of School Health.

To Apply: Please email your resume and cover letter to Dr. Caroline Volel: osh@health.nyc.gov  OR  Apply online at https://a127-jobs.nyc.gov/.  In the Job ID search bar, enter: job ID number # 277026


MEDICAL EQUIPMENT


Retiring from pediatrics. I have medical equipment to donate: examining table, pediatric examining table with a scale, medical scale, examining instruments and miscellaneous office items. Forest Hills. Call 718 275-5858 or email mkolak59@gmail.com


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


November 3, 2017 – The Word “Meaningful” & CMS?

Charles Rothberg, MD - MSSNY President
PRESIDENT’S MESSAGE

Charles Rothberg, MD
November 3, 2017
Volume 17
Number 42


Dear Colleagues:

For quite some time, physicians have been rightfully complaining that they are being forced to concentrate and focus on bureaucratic paperwork and trying to fit square pegs in round holes rather than practicing medicine. Regrettably, patients, too, have noted the lack of direct interaction with their physicians during their visits. During office visits, this bureaucratic nonsense has turned face-to-face time into patients looking at their physician’s back while fields on a computer screen are being completed.

Seema Verma, CMS Administrator, said in a speech this week, “We are moving the agency to focus on patients first. To do this, one of our top priorities is to ease regulatory burden that is destroying the doctor-patient relationship. We want doctors to be able to deliver the best quality care to their patients.” She announced that that CMS is “revising current quality measures across all programs to ensure that measure sets are streamlined, outcomes-based and meaningful to doctors and patients.” She then announced the “new” comprehensive initiative named “Meaningful Measures.”

New York physicians welcome the announcement by CMS Administrator Verma of her intention to work to reduce regulatory burdens on physicians including streamlining quality reporting requirements. The time required of physicians to spend on administrative tasks instead of providing patient care is unconscionable. Recent studies show that, for every hour a physician spends delivering patient care, two more hours are spent on administrative tasks.  Much of this overwhelming minutiae is the result of well-intentioned but misguided quality reporting requirements and electronic medical record “meaningful use” standards (including the new MIPS value based payment system) that often disrupt, rather than improve, care delivery.

We look forward to working with CMS on efforts to reduce regulatory burden so that physicians can focus on taking care of their patients, instead of updating their computer systems.

I really want to learn the difference between “Meaningful Use” and “Meaningful Measures.”

Sincerely,

Charles Rothberg, MD
MSSNY President

Please send your comments to comments@mssny.org



enews large

Want to Learn More about New York’s New Step Therapy Override Law?
Please click here to view a webinar discussing New York’s new law that gives physicians a stronger ability to override a health insurer’s step therapy protocol when seeking to assure their patients can receive coverage for necessary prescription medications.  Among the faculty for the program are MSSNY President-elect Dr. Thomas Madejski and MSSNY Senior Vice President Moe Auster. The webinar, sponsored by the National Psoriasis Foundation, will provide physicians with 0.5 hours of CME credit.

MSSNY, together with many other patient advocacy organizations and specialty societies, supported the enactment of this law.  It requires all NY-regulated health insurers to grant an override of that insurer’s step therapy protocol upon receipt of information from the physician “that includes supporting rationale and documentation” which demonstrates that the drug(s) being required by the health insurer:

  • Is contraindicated or will likely cause an adverse reaction by physical or mental harm to the patient;
  • Is expected to be ineffective based on the known clinical history and conditions of the patient and his/her drug regimen;
  • Has been tried by the patient or another prescription drug(s) in the same pharmacologic class or with the same mechanism for action and such drug(s) was discontinued due to a lack of efficacy or effectiveness, diminished effect or an adverse event;
  • Should not be required because the patient is stable on a drug other than the drug being required by the insurer; or
  • Is not in the best interest of the patient because it will likely cause a significant barrier to a patient’s adherence with his/her plan of care, will likely worsen a comorbid condition of a the patient, or will likely decrease the patient’s ability to achieve or maintain reasonable functional ability in performing daily activities.

Health insurers must respond to a step therapy override request within 72 hours of the request.  A health insurer is required to respond within 24 hours if the request is for a patient with a medical condition that places the health of the patient in serious jeopardy without the prescription drug or drugs prescribed by the patient’s physician.  If the health insurer fails to act within these 72 or 24-hour time periods, the request will be granted in favor of the patient.

The new law also requires that health insurers’ step therapy protocols be based upon evidence-based and peer-reviewed clinical criteria that also take into account the needs of atypical patients.  These criteria must be made available to physicians upon request.

The new law will be applicable to all NY-regulated health plans as of January 1, 2018.  However, since the law applies to health insurance plans “delivered, issued for delivery issued or renewed” after January 1, 2017, many group health insurance plans across the State are already required to follow the new law.

MSSNY has created a template for physicians and their support staff to use in requesting a step therapy protocol override, available here.

Enforcement is the key to assuring that the law is working as intended.  Therefore, please let us know if you see instances where health insurers are not following the law.  Moreover, you can file a complaint with the State here.

Council Notes: November 2, 2017

  • Patricia Gagliano, MD, VP of Health Care Quality Improvement for IPRO, provided an overview of the Quality Payment Program (QPP) and the Merit-Based Incentive Payment System (MIPS). Her presentation focused on helping physicians maximize success in the QPP/MIPS programs. Dr. Gagliano noted that there is still time to collect data from 10/2/17-12/31/17 and avoid the negative payment adjustment in 2019. To view the entire presentation, which includes IPRO contact information and links to additional helpful information, click here.
  • MLMIC’s Donald Fager, Esq. reported that the MLMIC/Berkshire deal is still in a holding pattern, and that it will likely happen in early 2018.
  • Council approved the following:
  • MSSNY 2018 Legislative Program
  • Resolution 111 (referred by the 2017 House of Delegates): MSSNY affirms Policy 130.941 and will seek, through legislation and/or regulation, requirements for insurer to accept and reimburse, at in-network level, out-of-network providers willing to provide elective services to patients with no out-of-network benefits as long as the provider meets nationally recognized credentialing criteria.
  • In lieu of Resolutions 62 and 63 (referred by the 2017 House of Delegates), MSSNY re-affirms Policy 130.996 (Single Payor Reimbursement System-Opposition to) and will continue to consider the feasibility of other payment methodology including single payor and continue to work collaboratively with physicians who both support and oppose such proposals to assess the strengths and weaknesses of any such proposals. MSSNY will continue to advocate to assure that physicians have direct input and ongoing involvement on all aspects of any single payer system or other system that may be considered by the NYS Legislature or US Congress.
  • MSSNY Speaker Dr. Geraci announced that Andrew W. Gurman, MD, Immediate Past President of the AMA, will address MSSNY’s 2018 House of Delegates.

Workers’ Comp Board: Physicians Must Register by Dec.29
The Workers’ Compensation Board (Board) has initiated a registration process to update and maintain a current list of medical providers who are authorized to treat injured workers. The goal of this process is to enable an injured worker to easily and accurately identify Board-authorized medical providers.

Registering
You will be notified in November when registration opens for Board-authorized medical providers. Authorized providers are asked to register with the Board and update their office address (es) and contact information by December 29, 2017. This registration process will be an ongoing initiative every two to three years.

Medical providers who have not registered by December 29, 2017 will:

  • be removed from the public directory of Board authorized providers,        and
  • become ineligible for the Board’s disputed bill process.

30 Days Left to Submit an Informal Review Request – Review Your 2016 PQRS Feedback Report and 2016 Annual Quality and Resource Use Report Now


Promo Code: MSSNY


DOH Releases Updated DSRIP Spending Report; Still Very Little Goes to Physicians
The New York Department of Health (DOH) announced this week that New York’s DSRIP Performing Provider Systems (PPS) have substantially increased the amount of funds flowing down to its network partners including physicians.  The announcement noted that “PPS funds distributed to network partners increased by 112% or double the amount of cumulative distributions prior to the DSRIP mid-point.”

It was also noted that, of the $885 million that had been distributed through June 30, 2017, over $38 million had been distributed to primary care providers, of which over $22 million had been distributed since September 30, 2016.  The report also noted that $5 million had been distributed to non-primary care providers, of which $2.3 million had been distributed since September 30, 2016.

However, even with this increase, the funding distribution to health care practitioners is barely more than 5% of the PPS spending, and as such is still woefully insufficient.  MSSNY continues to raise concerns to state officials that funds allocated to many of these PPS across the State are not ultimately being distributed to PPS participating physicians to support their efforts in helping to bring about reductions in potentially preventable readmissions and ER visits.


Your membership yields results and will continue to do so. When your 2018 invoice arrives, please renew. KEEP MSSNY STRONG!


Creating an Account in the New York State Health Commerce System (HCS)The Board will use the existing New York State Health Commerce System (HCS) for this registration process. For the initial registration and for future updates to your practice information, you will need to have an HCS account. If you don’t already have one, you can view directions to create an account on the New York State Department of Health website.

Need Help?
If you are not sure if you already have an HCS account, contact the Commerce Account Management unit (CAMU) at (866) 529-1890 and select option 1. For general questions about health care provider registration, please contact the Board’s Customer Support at (844) 337-6305.

Worker Comp Questions? Email us or call Customer Service at (877) 632-4996

HOW YOU CAN HELP?

Please Urge Governor Cuomo to Veto Disastrous Liability Expansion Bill and Work for Comprehensive Reform Instead
Physicians are urged to continue to contact Governor Cuomo to request that he veto legislation (S.6800/A.8516) that would significantly expand the time to bring a medical malpractice lawsuit, in circumstances based upon an “alleged negligent failure to diagnose a malignant tumor or cancer”.   If signed into law it would likely prompt a double digit increase in physician and hospital malpractice premiums.   You can send a letter here and call 518-474-8390.

While many physicians have made these contacts, we need an overwhelming demonstration from physicians regarding how this bill will harm access to care in their communities if this bill is not paired with needed tort reforms to bring down the exorbitant costs of medical liability insurance in New York.

Physicians have been active in warning the public about the patient care access problems this bill will exacerbate if it is signed into law.  Recently Albany radiologist and MSSNY member and Albany radiologist Dr. Robert Rapaport had a commentary published in the Albany Times-Union urging that the Governor veto this bill and instead work for comprehensive reform.  Moreover, a letter to the Editor from MSSNY’s Dr. Rothberg urging a veto was also recently published in the Albany Times-Union (letter).   Similar letters from regional and statewide physician leaders have also appeared in:

There was also a recent lengthy article in the New York Law Journal highlighting the problems with this bill that included a quote from MSSNY’s Dr. Rothberg.

MSSNY’s CME Provider Conference a Success
On Friday, September 15, 2017, MSSNY held a CME Provider Conference at the Courtyard by Marriott in Westbury, Long Island.  The program was designed to help keep MSSN-accredited CME providers up to date with the latest developments and requirements of the Accreditation Council for Continuing Medical Education (ACCME) and the American Medical Association (AMA).  Speakers included Steve Singer, PhD, ACCME Vice President of Education and Outreach, and Mary Kelly, Project Administrator, AMA PRA Standards and Policy.  Also featured was a panel discussion by James Braun, DO, President, Physicians’ Research Network (PRN); Dorothy Lane, MD, Chair, CME Committee, Suffolk Academy of Medicine; and

Jeffrey Rothman, MD, Director, Department of CME, Staten Island University Hospital.

The panel topic was improving compliance with ACCME accreditation criteria.  In addition, attendees participated in an interactive session on identifying compliance examples for the ACCME’s new criteria for accreditation with commendation.

As an ACCME-Recognized Accreditor, MSSNY is the state/regional accreditor of 34 CME providers in New York State.  Attendees traveled from as far north as Plattsburgh and as far west as Rochester to attend the conference.  MSSNY President Charles Rothberg, MD set the tone for the day with opening remarks that emphasized the importance of continuing medical education. CME professionals shared their strategies and approaches to physician education. The positive feedback of attendees stressed the value of conducting live, in-person conferences.

MSSNY Official: MAT Effective, But Underutilized Treatment for Opioid Use Disorder
On page 16 of the Fall 2017 issue of Behavioral Health News (10/26), Dr. Frank Dowling, a clinical associate professor of psychiatry at SUNY-Stony Brook and the Secretary of the Medical Society of the State of New York, writes that medication-assisted treatment (MAT) is an effective, but underutilized treatment for opioid use disorder. Dowling says that “there is a shortage of access to MAT,” and that many patients and clinicians remain opposed to MAT, because of “well intended but misguided perceptions” that “are often reinforced by drug treatment program staff and by peers in 12-step programs.”

Open Enrollment Opened November 1
Open enrollment for Obamacare plans began November 1 and the Cuomo administration, in an ongoing effort to ignore the negative vibes emanating from the Trump administration, announced Monday that it has expanded its outreach campaign to additional pharmacies. Rite Aid will advertise New York State of Health, the online insurance marketplace created by the Affordable Care Act, joining CVS Pharmacy, Kinney Drugs, ShopRite Supermarkets and TOPS Pharmacies.

NY Physician Accused of Accepting Cash from Patients for Opioid Scrips
Ernesto Lopez, 74, a New York-licensed doctor who operates medical clinics in Manhattan, Flushing, and Franklin Square, is accused, along with his assistant, 49-year-old Audra Baker, of accepting cash payments in exchange for the prescriptions, court papers say.

Dr. Lopez typically charged $200 to $300 in cash for patient visits during which he allegedly performed perfunctory examinations and then prescribed large quantities of oxycodone and fentanyl patches. Since 2015, Dr. Lopez wrote more than 8,000 prescriptions and collected $2 million in fees, prosecutors said.

Dr. Lopez’s assistant at two of his clinics, allegedly steered patients to an individual who could buy the prescriptions and resell the drugs on the street, court papers say.

“As alleged, these defendants acted like drug dealers in lab coats, directly contributing to the glut of highly-addictive opioids flooding the streets of New York City and its surrounding communities,” Acting U.S. Attorney Joon H. Kim said in a statement. The investigation and practitioner-among-three-defendants-charged-manhattan-federal-court”>arrests were conducted by the DEA’s Tactical Diversion Squad comprised of investigators from the DEA, NYPD, and NYC Department of Investigation.

US House Passes IPAB Repeal Legislation
By a 307-111 vote, the US House of Representatives passed legislation that would repeal the Independent Payment Advisory Board (IPAB).  The statutory authority to create the IPAB was established under the ACA, but the Board has never been formally created.  Its purpose is to make recommendations to reduce Medicare spending if it exceeds a certain threshold, which would go into effect if Congress fails to achieve a supermajority vote to override its recommendations.  MSSNY and the AMA support repeal of the IPAB given its potential to significantly and arbitrarily cut physician payments for care to seniors, at a time when overwhelming and rising practice costs require increases, not cuts. It is unclear at this time whether there will be sufficient votes in the US Senate to also pass the bill.

Of New York’s House Delegation, 16 voted “Yes” and 11 voted “no”.   Those voting “Yes” included Rep. Clarke (D-Brooklyn); Rep. Collins (R-Erie County); Rep. Donovan (R-Staten Island); Rep. Engel (D-Bronx/Westchester); Rep. Faso (R-Columbia County); Rep. Higgins (D-Erie County); Rep. Katko (R-Onondaga County); Rep. King (R-Nassau County); Rep. Sean Maloney (D-Westchester); Rep. Meeks (D-Queens County); Rep. Meng (D-Queens); Rep. Reed (R-Southern Tier); Rep. Stefanik (R-North Country); Rep. Suozzi (D-Nassau County); Rep. Tenney (R-Oneida County) and Rep. Zeldin (R-Suffolk County).

Those voting “No” included Rep. Crowley (D-Bronx/Queens); Rep. Espaillat (D-Manhattan); Rep. Jeffries (D-Brooklyn); Rep. Lowey (D-Westchester); Rep. Carolyn Maloney (D-Manhattan); Rep. Nadler (D-Manhattan); Rep. Rice (D-Nassau County); Rep. Serrano (D-Bronx); Rep. Slaughter (D-Monroe County); and Rep. Tonko (D-Albany/Schenectady); and Rep. Velasquez (D-Brooklyn)


WEBINARS/SEMINARS

An Unusual and Highly Resistant Fungus in NYS: An Update on Candida auris for the Practicing Physician

CME Webinar on December 6; Registration Now Open

Upcoming in MSSNY’s Medical Matters continuing medical education (CME) webinar series is: An Unusual and Highly Resistant Fungus in NYS: An Update on Candida auris for the Practicing Physician.  This webinar will take place on Wednesday, December 6, 2017 at 7:30 a.m.  Emily Lutterloh, MD, MPH, Director, Bureau of Healthcare Associated Infections, from the New York State Department of Health will conduct this presentation.  Register for this webinar here.

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

Educational objectives are:

  • Provide an update on the emerging multi-drug resistant yeast, Candida auris ( auris), globally and in New York State
  • Describe the risk factors for auris infection and the recommended diagnostic approach
  • Review the recommendations for auris, including infection prevention and control measures 

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. 

Preventing Diabetes in Patients: NYS Physicians Encouraged to Attend AMA Webinar
November is National Diabetes Awareness Month and the American Medical Association (AMA) and the Medical Society of the State of New York (MSSNY) has partnered to provide educational information to New York State physicians on how to initiate clinical practice change and prevent diabetes in patient population.  Physicians can participate in a webinar on November 15 from 1-2 p.m.  Click here to register.

The session will review the evidence base for clinical approaches to diabetes prevention and describe how physicians and care teams can implement a diabetes prevention initiative within their practice. Kate Kirley, MD, MS, Director of Chronic Disease Prevention and Janet Williams, MA, Senior Program Manager will be presenters.

Dr. Kirley is director of Chronic Disease Prevention at the American Medical Association.  Prior to joining the AMA, she was a practicing family physician and health services researcher at NorthShore University Health System, and a clinical assistant professor in the Department of Family Medicine at the University of Chicago.  Janet Williams is senior manager of physician and health system engagement at the American Medical Association.  She has more than 30 years public health program and policy development experience.   She manages the AMA’s prediabetes initiative to develop and test clinical tools and resources for engaging health systems, clinicians and health departments in diabetes prevention.

MEDICARE/MEDICAID INFORMATION

2018 MIPS Quality Payment Rule Released by CMS
CMS this week released its final rule implementing the MIPS quality reporting rules for 2018 which will impact Medicare physician payment in 2020.  According to the MACRA statute, Medicare physician payment could be increased or decreased by up to 5% in 2020 based upon physician “performance” in 2018.

To read a comprehensive summary of these changes for 2018, click here.

To read the entire rule, click here.

Among the rule’s highlights:

  • Decreasing the number of physicians required to participate by excluding individual MIPS eligible clinicians or groups with ≤$90,000 in Part B allowed charges or ≤200 Medicare Part B beneficiaries.
  • Permitting the use of 2014 Edition and/or 2015 Certified Electronic Health Record Technology (CEHRT) in Year 2 for the Advancing Care Information (ACI) performance category, and giving a bonus for using only 2015 CEHRT.
  • Adding 5 bonus points to the MIPS final scores of small practices.
  • Adding “Virtual Groups” as a participation option for MIPS for solo or small practice physicians.
  • Awarding up to 5 bonus points on the MIPS final score for treatment of complex patients.
  • 50% of the score will be based on quality reporting; 25% based on ACI reporting (the new “meaningful use”); 15% based on clinical improvement activity reporting; and 10% based on the “cost category”

Review of the 1,653 page rule is ongoing by many across organized medicine.  Physicians can receive free technical assistance in complying with the MIPS program through IPRO, which has a contract with the federal government to provide this assistance.  Please click here more information.  Additional information from the Physicians Advocacy Institute, of which MSSNY is a Board member, is available here.

2018 Medicare Payment Rule Announced – Review Ongoing
This week CMS announced the Medicare Part B payment rule for 2018.  To review a fact sheet about the new rule, click here.

The fact sheet notes the final 2018 conversion factor will be $35.99, a 0.41% increase from the 2017 PFS conversion factor of $35.89.

A specialty by specialty breakdown of the impact of 2018 payment rule for allowed charges is available on p. 1152 of the entire rule.  The chart notes that the 2018 payment rule will have 0% impact for many specialties.  However, it is estimated that there will be 1% increases for cardiology, dermatology, infectious disease, plastic surgery, psychiatry, radiation oncology and rheumatology.  There will be a 1% decrease for anesthesiology, pathology, urology and vascular surgery, a 2% decrease for otolaryngology; and a 3% decrease for allergy/immunology.

MSSNY together with the AMA and the federation of medicine is reviewing the 1,250 page rule and will follow up with a more comprehensive summary.

CMS Unveils MACRA Rule Changes
Modern Healthcare (11/2) reports CMS finalized a proposed rule which would exempt 134,000 providers from complying with MACRA. The rule finalized on Tuesday will exclude “Physician practices with less than $90,000 in Medicare revenue or fewer than 200 unique Medicare patients per year.” As a result of the change, a total of 934,000 providers will be exempt from MACRA’s Merit-based Incentive Payment System, leaving only 39 percent of the 1.5 million clinicians billing under Medicare required to comply with MIPS.

2016 PQRS Feedback Reports Are Ready for Viewing
2016 Physician Quality Reporting System (PQRS) feedback reports and 2016 Annual Quality and Resource Use Reports (QRURs) were released on September 18, 2017. The PQRS feedback reports show your program year 2016 PQRS reporting results, including if you are subject to the 2018 PQRS downward payment adjustment. The 2016 Annual QRURs show how physicians, physician assistants (PAs), nurse practitioners (NPs), clinical nurse specialists (CNSs), and certified registered nurse anesthetists (CRNAs) in groups and solo practitioners performed in 2016 on the quality and cost measures used to calculate the 2018 Value Modifier as well as their practice’s 2018 Value Modifier payment adjustment.

The payment adjustments shown in the reports are based on proposals that were included in the 2018 Medicare Physician Fee Schedule Proposed Rule. If the policies are not finalized as proposed, CMS will provide an update to report recipients.

Access and review your 2016 PQRS feedback report and 2016 Annual QRUR now to determine whether you are subject to the 2018 PQRS downward payment adjustment and your practice’s 2018 Value Modifier payment adjustment.

If you believe your payment adjustment status was made in error, you may request an informal review of your 2016 PQRS results and/or 2018 Value Modifier calculation during the informal review period from now until 8:00 pm Eastern Time (ET) on December 1, 2017. 

An Enterprise Identify Management (EIDM) account with the appropriate role is required for participants to obtain their 2016 PQRS Feedback Reports and 2016 Annual QRURs. Both reports can be accessed on the CMS Enterprise Portal using the same EIDM account. Visit the How to Obtain a QRUR webpage for instructions on accessing both reports.

To find out which reports are available for your practice and your current and past PQRS and Value Modifier payment adjustments, you can use the new Payment Adjustments and Reports Lookup feature on the CMS Enterprise Portal. An EIDM account is not needed to use this feature. Instructions for using this feature are located in the “Guide for Accessing the Payment Adjustment and Reports Lookup Feature”.

For more information on your PQRS feedback report:

For more information on your Annual QRUR:

For the 2016 reporting period, the majority of eligible professionals (EPs) successfully reported to PQRS and avoided the downward payment adjustment. CMS anticipates that successful trend to continue under the new Quality Payment Program. The Quality Payment Program began January 2017 and replaces PQRS, the Value Modifier program, as well as the separate payment adjustments under the Medicare Electronic Health Record (EHR) Incentive Program for EPs. The Quality Payment Program streamlines these legacy programs, reduces quality reporting requirements and offers many flexibilities that allow eligible clinicians to pick their pace for participating in the first year. To prepare for success in the Quality Payment Program, we encourage EPs to review their PQRS feedback report, Annual QRUR, and visit qpp.cms.gov to learn about the Quality Payment Program.

Questions?

  • For assistance with Enterprise Identity Management or PQRS feedback reports, contact the QualityNet Help Desk at 866-288-8912 (TTY 877-715- 6222) or qnetsupport@hcqis.org.
  • For assistance with the QRURs or Value Modifier, contact the Physician Value Help Desk at pvhelpdesk@cms.hhs.gov or 888-734-6433 (select option 3).

CMS: Wants More Flexibility with “Providers” and Increase Competition
CMS Administrator Seema Verma announced the agency’s efforts to streamline quality measures and reduce regulatory burden with a new approach to quality measurement called “Meaningful Measures.”

In addition to focusing on quality measurement, CMS announced in September that it would be moving the Center for Medicare and Medicaid Innovation (Innovation Center) in a new direction to give providers more flexibility with new payment models and to increase healthcare competition.

In September, the agency issued a “request for information” to collect ideas on the best path forward.  On the CMS Innovation Center website, CMS said the Innovation Center’s new direction will promote patient-centered care and test market-driven reforms that empower beneficiaries as consumers, provide price transparency, increase choices and competition to drive quality, reduce costs, and improve outcomes.

In particular, CMS says the Innovation Center is interested in testing models in the following eight focus areas—increased participation in Advanced Alternative Payment Models (APMs); consumer-directed care and market-based innovation models; physician specialty models; prescription drug models; Medicare Advantage (MA) innovation models; state-based and local innovation, including Medicaid-focused models; mental and behavioral health models; and program integrity.

New Medicare Card Project Special Open Door Forum — Nov. 9 from 2 to 3pm ET
This call will educate State Medicaid Agencies, Medicaid providers, Managed Care Organizations, Medicaid partners, and other Medicaid stakeholders about the change from Social Security Number-based Health Insurance Claim Numbers to new Medicare Beneficiary Identifiers (MBIs). A question and answer session follows the presentation.

CMS discusses:

  • Background and implementation
  • MBI format
  • Timeline and milestones, including the transition period
  • Beneficiary outreach and education
  • How to get ready for the new number

To participate:

  • Dial-In Number: 800-837-1935; conference ID #: 49255212

For more information, visit the New Medicare Project website and Transcripts webpage.

MSSNY CME Provider Conference

CMS Opened 30 Day Preview for 2016 Performance
On October 18, CMS opened the 30-Day Preview Period for the 2016 performance information targeted to be publicly reported on Physician Compare starting in December 2017. The preview was scheduled to end on November 17 at 8pm ET. Due to a technical issue preventing the data from properly displaying in the preview portal, the Provider Quality Information Portal (PQIP), all data were not viewable for the first week of preview. This display issue has now been resolved. We are extending preview through Friday, December 1 at 8pm ET to provide more time for clinicians and groups to preview their performance data as a result of this technical issue.

Additionally, the Physician Compare team is currently outreaching to all clinicians and groups that have already accessed PQIP to preview their data to share the information above.  We would appreciate the AMA helping us disseminate the Physician Compare preview extension information to stakeholders.  The Physician Compare team will also be disseminating this information via our listserv.

For more information about preview and the measures available for preview, visit the Physician Compare Initiative page.

For assistance with accessing PQIP, or obtaining your EIDM user role, contact the QualityNet Help Desk at 866-288-8912 or qnetsupport@hcqis.org.

If you have any questions about Physician Compare, public reporting, or the preview period, please contact us at PhysicianCompare@Westat.com.


CLASSIFIEDS


MEDICAL EQUIPMENT


Retiring from pediatrics. I have medical equipment to donate: examining table, pediatric examining table with a scale, medical scale, examining instruments and miscellaneous office items. Forest Hills. Call 718 275-5858 or email mkolak59@gmail.com


RENTAL/LEASING SPACE


Upper East Side Plastic Surgery Office Available for Rent or Share
Beautifully equipped Plastic Surgery office available for part-time share along with Quad A-certified OR available for rent. Located in a lovely carriage house on the Upper East Side in close proximity to Lenox Hill Hospital and MEETH and conveniently located near all NYC mass transit. 1 exam room/OR and Recovery room along with large administrative space. Free WIFI. Available for full or half-days. Suits Plastic/Cosmetic Surgeons/ DERM/ ENT/or other Medical MDs. Please contact Kim at Kim@madisonps.com (212) 628-7600.


Saratoga Springs, NY – Professional Office Space for Lease
Medically oriented building currently occupied by five parties.  The Suite, Suite 700, has 2904 sq. ft., second floor (elevator), excellent off-road parking with drive-thru patient portico in a well maintained and attractive building close to the local hospital.
The lease area has a large waiting room, administrative rooms, lunch room, four examining rooms, one procedure room and one for storage.  Separate staff entrance.  Attractively priced without triple net obligations.  $4,500/month + heat + utilities.  Call Lauren regarding Suite 700 at (518) 587-2020.


Riverdale Medical Office for Sale – Prime Location
Co-op with private entrance features 2 exam rooms, lab, office & bathroom. Must see! Call 718-230-7069


For Rent or Share – Woodbury, Long Island
Beautiful recently renovated Plastic Surgery office available for part-time share and AAAA-certified (by end of summer). OR available for rent. Centrally located
on Long Island.Close to expressways. 3 exam rooms, 1 procedure room /OR.
Waiting room, break room and personal office. Free WIFI. Available for full or half-days. Suits Plastic/Cosmetic Surgeons/Derm/ENT/
ObGyn/Podiatry or other Medical MDs.
Contact Patricia at info@cosmetichg.com
or 631-318-4008

PHYSICIAN OPPORTUNITIES


Medical Director – AIDS Institute
Minimum Qualifications:
Current license and registration to practice medicine in New York State and board certification AND either a Master’s Degree in Public Health or two years of experience in an HIV program or public health program.Preferred Qualifications:
Master’s Degree in Public Health.  Five years of experience including clinical service in an HIV program or clinical fellowship program (infectious diseases/HIV medicine).  Experience in quality management/quality improvement.  Knowledge of the HIV health care delivery system in New York State. Experience in/knowledge of the New York State Ending the Epidemic initiative.  Experience in STD prevention and care, drug user health, and/or LGBT health.  Experience in health policy development, analysis and evaluation.  Experience with evolving health information technologies.  Experience in health program management and administration.
Responsibilities: The Medical Director, AIDS Institute, plays a significant role in shaping HIV, hepatitis C, and STD care and services, drug user health, and LGBT health care throughout New York State.Please click the link below for more information pertaining to this position and to apply: “https://careers-healthresearch.icims.com/jobs/3742/medical-director—aids-institute/job” Affirmative Action/Equal Opportunity Employer/Qualified Individuals with Disabilities/Qualified Protected Veterans

Multiple Physician Positions with DOHMH Office of School Health
Office of School Health is the largest program of the New York City Department of Health and Mental Hygiene (DOHMH). This bureau is responsible for managing the health issues and promoting the well-being of the over 1.3 million children and adolescents enrolled in New York City’s 1700 school buildings.

Positions with the Office of School Health (OSH) combine clinical skills and public health training.

Adolescent School Health Physician
This position offers to the interested physician the opportunity to help address the clinical and public health needs of adolescents in NYC high schools. The physician will work with the innovative Connecting Adolescents to Comprehensive Health Care (CATCH) Program, which provides select reproductive health services to adolescents in select NYC high schools. In addition, the physician will provide medical care and public health services through additional programs offered to adolescents by the Office of School Health.

Under the supervision of the High School Supervising Physician, the Adolescent School Health Physician’s responsibilities will include but are not limited to:

  • Provide CATCH reproductive health services in select high schools.
  • Perform mandated physical examinations (New Admission Exams, Sports Physicals, and Working Paper Physicals).
  • Function as a liaison for students with community health providers to resolve medical issues that affect school performance.
  • Support the development and implementation of initiatives that promote positive health behaviors and reduce high risk behaviors in the adolescent population.
  • Serve as a consultant to the school nurse and administration on school related health concerns.
  • Provide clinical assistance in the event of an environmental or communicable disease occurrence.
  • Function as a liaison for students with community health providers to resolve medical issues that affect school performance.
  • Support all medical initiatives established by the Office of School Health, e.g. programs and protocols in asthma, reproductive health, obesity and diabetes.
  • Maintain good public relations and communicate effectively within the school community and community-based organizations.
  • Keep abreast of health management policy statements and emerging clinical research related to school health.
  • Participate in OSH research activities.
  • Work within the mandates, policies and protocols of the Office of School Health.
  • Attend all mandated DOHMH and OSH trainings.

To Apply: Please email your resume and cover letter to Dr. Caroline Volel: osh@health.nyc.gov OR  Apply online at https://a127-jobs.nyc.gov/.  In the Job ID search bar, enter: job ID number # 277208. 

School Health Field Physician
Under the direction of the Supervising Physician, the School Health Physician’s will:

  • Improve the health of school children through case management of chronic disease, preventive health screening and counseling, health education, and referrals.
  • Perform mandated physical examination (new entrant, sport physical, working paper physicals.
  • Develop relationships with community health providers in order to optimize medical management of students with health issues.
  • Attend to the health needs of your assigned school community.
  • Utilize the Automated Student Health Record (ASHR) to maintain adequate student health records.
  • Serve as a consultant to the school nurse and administration on school related health concerns.
  • Support the development of school educational and prevention programs promoting the health and wellness of all students.
  • Provide clinical assistance in the event of an environmental or communicable disease occurrence.
  • Develop and maintain professional relationships within the school community.
  • Support all medical initiatives put forth by the Office of School Health, e.g. Asthma, Reproductive health, Obesity and Diabetes initiatives.
  • Provide trainings/presentations to school staff, community organizations, or parents.
  • Stay abreast of health management policy statements and emerging research within the health community related to school health.
  • Participate in School Health research and quality improvement activities.
  • Participate in all mandated DOHMH and Office of School Health trainings and professional development sessions.
  • Attend all program meetings and Continuing Medical Education classes provided by the Office of School Health.

To Apply: Please email your resume and cover letter to Dr. Caroline Volel:osh@health.nyc.gov OR Apply online at https://a127-jobs.nyc.gov/.  In the Job ID search bar, enter: job ID number # 279844. 

Supervising School Health Physician 
Job Description
Under the supervision of the Deputy Medical Director, the Supervising Medical Doctor’s responsibilities will include but not be limited to:

  • Supervise School Health Physicians.
  • Work within the mandates, policies and protocols of the Office of School Health (OSH).
  • Attend to the health needs of a designated school community.
  • Utilize the Automated Student Health Record (ASHR) to maintain accurate student health records.
  • Serve as a consultant to the school nurse and school administrative staff regarding school related health concerns.
  • Support the development of school educational and prevention programs promoting the health and wellness of students.
  • Participate in policy development and revisions as indicated.
  • Provide clinical assistance in the event of an environmental or communicable disease occurrence.
  • Function as a liaison for students with community health providers to resolve health issues that affect school functioning.
  • Develop and maintain professional relationships within the school community and the community at large.
  • Support all medical initiatives put forth by the Office of School Health, e.g. Asthma, Reproductive health, Obesity and Diabetes Initiatives.
  • Keep abreast of health management policy statements and emerging research within the health community affecting school health.
  • Assist with or provide trainings/presentations to school health physicians, nurses, school staff, community organizations or parents
  • Participate in School Health research and quality improvement activities
  • Participate in all mandated DOHMH and Office of School Health trainings and professional development sessions
  • Attend all program meetings and Continuing Medical Education classes provided by the Office of School Health.


To Apply: Please email your resume and cover letter to Dr. Caroline Volel: osh@health.nyc.gov  OR  Apply online at https://a127-jobs.nyc.gov/.  In the Job ID search bar, enter: job ID number # 277026


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


October 27, 2017 – Drugs: Everyone’s Problem

Charles Rothberg, MD - MSSNY President
PRESIDENT’S MESSAGE
Charles Rothberg, MD
October 27, 2017
Volume 17
Number


Dear Colleagues:

Today, as a guest, I will be attending the NYS and NJ Societies of Interventional Pain Physicians Conference in Jersey City. These doctors already have a target on their back.

When drug addiction became everyone’s problem— kids, adults, law and drug enforcement—not just ours, New York stepped up in a meaningful way with ISTOP. We did not like it and thanks to our Government Affairs division, we were able to make the process less draconian than what was proposed. Most of the complaints about using the DOH’s system have died down. Many doctors reported that, to their surprise, yes, some of their patients were doctor shopping because they were either addicted to or diverting their prescribed opioids. Other states have used our comprehensive ISTOP program as a model to treat their own epidemics.

In reality, the epidemic is a failure of public health, public policy, and law enforcement. Blame and remedies should be shared. What about the role various national organizations promoting pain as a vital sign? What about the role of Congress in limiting DEA enforcement of diversion? What about drug makers that misstated the safety of opioids?  What about the role of insurers and PBMs in disfavoring alternatives to opioids? Many drug companies claimed that the opioids they manufactured were not addictive.

This week, President Trump addressed the problem in a somber press conference. His long-awaited public health emergency declaration on the opioid epidemic does not yet contain any new funding to combat the problem. However, federal health agencies will be able to reallocate existing resources and hire educated personnel. The declaration disappointed state officials and public health experts who maintain that a lot more money is needed to respond and confront this deadly epidemic. One of President Trump’s intentions is to break a logjam preventing doctors from treating opioid addiction through telemedicine consults as a way to reach addicts living in rural areas.

The CDC Has released guidelines on how to treat Chronic Pain which includes best practices.  This speaks to something that is often lost when discussing the opioid epidemic—there are still many patients who need pain medication, and there are some concerns that because of new prescribing limits and the fear of feeding addiction, they will have no access.

President Trump’s Commission on Combating Drug Addiction and the Opioid Crisis is set to release its final recommendations on Nov. 1. I expect that they will map out solid short and long term solutions.

Our President stated, “As Americans, we cannot allow this to continue. It is time to liberate our communities from this scourge of drug addiction…..We can be the generation that ends the opioid epidemic. We can do it.”

As physicians, I am confident that we are up to the challenge, too.

Sincerely,

Charles Rothberg, MD
MSSNY President

Please send your comments to comments@mssny.org



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MSSNY’s Statement Re Merger of CVS and Aetna Insurance Company
“The proposed purchase of Aetna by CVS, as reported by the Wall Street Journal, demands an immediate investigation by the federal Departments of Justice and Federal Trade Commissions. Physicians and patients are already often powerless to push back against barriers imposed by market dominant health insurance behemoths that interfere with needed medical care, such as limited choice of doctors and burdensome pre-authorization rules.

At the same time, corporate pharmacy interests are increasingly trying to take away prescribing and health care decision making authority from physicians, thereby interfering with continuity of care for our patients.  These companies need to prove why these problems will not become even worse for our patients if this proposed conglomeration were permitted to go forward.”

NYS Senate Releases Report on Lyme and Tick-Borne Disease
The New York State Senate’s Task Force on Lyme and Tick-Borne Diseases has released a report,” Ticking Time Bomb: An Update on the Lyme and Tick-Borne Disease Epidemic in New York State”.  This report recommends that there be established a comprehensive action plan, developed by the NYS Department of Health, in 2018 to implement a comprehensive approach to surveillance, prevention and detection in Lyme and other tick borne diseases.

Additionally, the report calls for the development of a specific medical protocol and notification for diagnosis and treatment;  that a comprehensive assessment of insurance practices related to tick borne disease; calls for increased testing for children and the use of informational technical technology to inform the public about the dangers of tick-borne diseases.  A copy of the report may be found HERE.

Concerns with Anthem’s New Prior Authorization Policy for Imaging Services
This past week, MSSNY staff joined representatives of the New York State Radiological Society to meet with the New York Department of Financial Services to express strong concerns with Anthem’s new policy imposing new prior authorization requirements as a precondition of patients receiving hospital-based imaging services.  In particular,

MSSNY expressed concerns regarding the additional administrative hassles imposed on referring physicians seeking to assure their patients can receive needed MRIs or CTs in a timely manner.  Moreover, concerns were expressed regarding the likely continuity of care issues for some patients, as well as the fact that such additional criteria for accessing these services of particular radiologists may not be clearly identified when a patient is looking at which physicians participate in a particular health insurer’s network.

To aid in its investigation, DFS representatives asked MSSNY and NYSRS for examples of instances where patients have been unable to receive the care they need, or have had their care unduly delayed, as a result of this new prior authorization requirement.   Please contact rmcnally@mssny.org if you would like to share your story.

Similar prior authorization requirements have been imposed in other states by Anthem.  As a result, the American Medical Association EVP Dr. James Madara wrote a letter to Anthem EVP Dr. Craig Samitt urging Anthem to reconsider this policy given the “potential adverse impact on patients’ timely access to medically necessary care”, and concerns that the “new policy interferes with the patient-physician relationship and may disrupt ongoing care coordination”.

AMA Action Item: IPAB Repeal Moving Ahead in Congress; Be Heard
Legislation to repeal the Independent Payment Advisory Board (IPAB) is moving on Capitol Hill, but Congress needs to hear from America’s physicians in order to push it over the finish line.

The “Protecting Seniors’ Access to Medicare Act of 2017” (H.R. 849) would permanently repeal the IPAB; a panel that puts significant health care payment and policy decisions in the hands of an unelected body with far too little accountability.  Unless the IPAB is repealed, access to care for millions of Medicare patients could be threatened by arbitrary cost-cutting targets year after year.

Getting rid of IPAB will allow physicians and policymakers to focus on long-term efforts to improve care quality, improve health outcomes and make Medicare more sustainable while preserving access to care for seniors now and in the future. Please urge your legislators to support H.R. 849 to repeal the arbitrary and flawed IPAB by calling our toll-free grassroots hotline: (800) 833-6354 or emailing them today! Click this link to log in and send your message.


Promo Code: MSSNYCorporate-Huddle-uQAB4IbD?promo”>


About New York’s New Step Therapy Override Law
This week, MSSNY President-Elect and Medina internist/geriatrician Dr. Thomas Madesjki and MSSNY Senior Vice President Moe Auster participated in a webinar to discuss the provisions of New York’s new law to better regulate health insurers’ use of “step therapy” or “fail first” protocols. The forum was sponsored by the National Psoriasis Foundation.

A “step therapy protocol” is a policy that establishes a specific sequence in which prescription drugs for a medical condition are approved for coverage by a health insurance plan for a patient.  The new law provides that all NY-regulated health insurers shall grant an override of that insurer’s step therapy protocol upon receipt of information from the physician “that includes supporting rationale and documentation” which demonstrates that the drug(s) being required by the health insurer:

  • Is contraindicated or will likely cause an adverse reaction by physical or mental harm to the patient;
  • Is expected to be ineffective based on the known clinical history and conditions of the patient and his/her drug regimen;
  • Has been tried by the patient or another prescription drug(s) in the same pharmacologic class or with the same mechanism for action and such drug(s) was discontinued due to a lack of efficacy or effectiveness, diminished effect or an adverse event;
  • Should not be required because the patient is stable on a drug other than the drug being required by the insurer; or
  • Is not in the best interest of the patient because it will likely cause a significant barrier to a patient’s adherence with his/her plan of care, will likely worsen a comorbid condition of a the patient, or will likely decrease the patient’s ability to achieve or maintain reasonable functional ability in performing daily activities.

Health insurers must respond to a step therapy override request within 72 hours of the request.  A health insurer is required to respond within 24 hours if the request is for a patient with a medical condition that places the health of the patient in serious jeopardy without the prescription drug or drugs prescribed by the patient’s physician.  If the health insurer fails to act within these 72 or 24-hour time periods, the request will be granted in favor of the patient.

The new law also requires that health insurers’ step therapy protocols be based upon evidence-based and peer-reviewed clinical criteria that also takes into account the needs of atypical patients.  These criteria must be made available to physicians upon request.

The new law will be applicable to all NY-regulated health plans as of January 1, 2018.  However, since the law applies to health insurance plans “delivered, issued for delivery issued or renewed” after January 1, 2017, many group health insurance plans across the State are already required to follow the new law.

Enforcement is the key to assuring that the law is working as intended.  Therefore, please let us know if you see instances where health insurers are not following the law.  Moreover, you can file a complaint with the State here  or here. 

Governor Signs Bill into Law to Regulate Biosimilar Substitutions
Governor Cuomo signed into law this week a bill (S.4788-A/A.7509-A) passed by the State Legislature   that would establish rules regarding the substitution of interchangeable biological products.  While New York State law regulates the substitution by pharmacists of generic drugs for their branded counterparts, the existing law has not been updated to set forth the circumstances under which a biologic product can be substituted with a FDA approved interchangeable biologic.

Importantly, it would prohibit a pharmacist from substituting an interchangeable biological product (as defined by the FDA) prescribed by a physician if the physician affirmatively requests that the product be “dispensed as written”.  If the physician does not specify on the prescription that the biological medication should be “dispensed as written”, then the pharmacist may substitute an interchangeable biological product but only if the pharmacist provides notice to the physician within 5 days of the substitution.  The new law provides that this notice from the pharmacist to the physician be conveyed by:

·        making an entry that is electronically accessible to the prescriber through an interoperable electronic medical records system, an electronic prescribing technology or a pharmacy record; ·        using fax, electronic transmission or other electronic means, or ·        by telephone if an electronic means is not available to the pharmacist at the time of communication.  It would also establish a 5-year sunset on all these provisions.


Your membership yields results and will continue to do so. When your 2018 invoice arrives, please renew. KEEP MSSNY STRONG!


Urge Gov. Cuomo to Veto Disastrous Liability Bill; Instead Work for Reform
Physicians are urged to continue to contact Governor Cuomo to request that he veto legislation (S.6800/A.8516) that would significantly expand the time to bring a medical malpractice lawsuit, in circumstances based upon an “alleged negligent failure to diagnose a malignant tumor or cancer”.   If signed into law it would likely prompt a double digit increase in physician and hospital malpractice premiums.   You can send a letter here and call 518-474-8390.

While many physicians have made these contacts, we need an overwhelming demonstration from physicians regarding how this bill will harm access to care in their communities if this bill is not paired with needed tort reforms to bring down the exorbitant costs of medical liability insurance in New York.

Significant pressure is being placed on the Governor to sign the bill by trial lawyers, and by some consumer groups and media outlets.  For example, this past week, a consumer group representative appeared on a statewide political show to urge the Governor to sign the bill. There was also an article in the New York Daily News, which has engaged in a multi-year crusade for this bill, regarding the significant number of groups that supported the bill.  The article did reference concerns from several groups, including MSSNY, the Lawsuit Reform Alliance, and the New York State Radiological Society.  MSSNY President Dr. Charles Rothberg stated “We’re in favor of comprehensive reform. We want to make sure any reforms protect the public, but also that they are reasonable and don’t unfairly burden our hospitals and physicians.”

In response, physicians have been active in warning the public about the patient care access problems this bill will exacerbate if it is signed into law.  Last week Albany radiologist and MSSNY member and Albany radiologist Dr. Robert Rapaport had a commentary published in the Albany Times-Union urging that the Governor veto this bill and instead work for comprehensive reform.  Moreover, a letter to the Editor from MSSNY’s Dr. Rothberg urging a veto was also recently published in the Albany Times-Union (letter).   Similar letters from regional and statewide physician leaders have also appeared in:

There was also a lengthy article in the New York Law Journal this week highlighting the problems with this bill that included a quote from MSSNY’s Dr. Rothberg. 

NYS/NYC Department of Health Report Increase in Hepatitis A Infections
The New York State and New York City Departments of Health are reporting recent increases in hepatitis A infections in men who have sex with men (MSM) in New York City and that state DOH has documented a similar risk profile among individuals with hepatitis A who reside in NYS outside of NYC. Western Europe is also experiencing outbreaks of hepatitis A among men that have sex with men.

The state DOH has sent a letter to all physicians and health care providers requesting that  efforts be intensified to implement existing recommendations for completion of a hepatitis A vaccine series in all men and transgender individuals who have sex with men who are either not previously immunized or who do not know their vaccination or disease status.  There is also information in the letter that physicians can provide to their patients.  A copy of the letter can be found here.

Asian New Yorkers Face Barriers to Mental Health Care
New York City’s diverse and growing Asian population needs dedicated resources to increase access to mental health care, according to a report released by the Asian American Federation.

Suicide was among the 10 leading causes of death for Asian New Yorkers every year between 1997 and 2015, but that was not the case for other racial groups, according to stats from the city’s Department of Health and Mental Hygiene.

Through a series of roundtable discussions, focus groups and interviews conducted with mental health providers and others working with Asian New Yorkers, the federation identified key barriers to accessing mental health care in Asian communities. These include a shortage of providers that are culturally and linguistically competent, a lack of awareness and understanding of mental health issues in some Asian communities, less access to health insurance and a lack of research on alternative services that bear less stigma.

In addition to highlighting the need to develop more culturally appropriate models for addressing mental health issues, the federation faulted the city for not dedicating enough social-services dollars to Asian New Yorkers.

Physicians Needed for Martial Arts Tournament November 4-5 SUNY Old Westbury
The US Muay Thai Open will take place on November 4 and 5, 2017 at SUNY College at Old Westbury. The tournament will feature approximately 400 amateur Muay Thai athletes from around the nation and world. The physicians’ duties will be to observe each bout, permanently stop bouts if in the physicians’ opinion, the competitor is no longer medically fit to compete, and to perform post-bout interviews to assess the competitors’ condition.  They will need physicians for the following dates:

Saturday, November 4, 2017
7:30 a.m. – 1:30 p.m.
7:30 a.m. – 7:30 p.m.

Sunday, November 5, 2017
7:30 a.m. – 1:30 p.m.
7:30 a.m. – 7:30 p.m.

Compensation will be $100/hr for physician services. Call 480-245-0094 or 917-318-7988

MEDICARE/MEDICAID INFORMATION

Tip of the Week
By Jacqueline Thelian, CPC, CPC-I, CHCA, Medco Consultants, Inc. 

Q: What is all this buzz about new Medicare audits?
A:  In an effort to “reduce appeals, decrease provider burden and improve the medical review and education process,” Medicare has expanded the Targeted Probe and Educate (TPE) pilot program to all their Medicare Administrative Contractors (MACs) for Part A, B, HHH and DME.

The TPE program went into effect on Oct. 1, 2017 and it applies to all medical reviews for all MAC lines of business. It is very similar to a pre-payment audit only the TPE has a definitive time line.

The providers/suppliers will have one (1) to three (3) pre- or post-payment rounds of review. After or during each review, the healthcare provider /supplier will be educated based on MACs findings. The educational sessions are offered via webinar or telephone conference by a nurse reviewer. Other educational methods are available if necessary. If the healthcare provider is found to be non-compliant with Medicare, they will be reviewed again.

Failing the third round of reviews can result in dire consequences such as a referral to the Centers of Medicare and Medicaid services (CMS) for additional action. These actions may include “extrapolation, referral to Zone Program Integrity Contractor(ZPIC) or Unified Program Integrity Contractor (UPIC), referral to the RAC or 100% pre-pay review,” etc. (i.e. audit).

If you are targeted the best advice is to take advantage of the education provided by your MAC as well as additional education from an outside certified coder with experience with these types of reviews.

Remember the sooner you get it right, the sooner you will be removed from the TPE.

Sources:
Targeted Probe and Educate (TPE), http://ow.ly/JB5N30fDG7u
CMS PUB 100-20 One-Time Notification, Transmittal 1919, SUBJECT: Targeted Probe and Educate, http://ow.ly/sf9A30fDGjQ
NGS Compliance & Audits, Targeted Probe and Educate http://ow.ly/IshY30fDGyM
Noridian Healthcare Solutions, Targeted Probe & Educate http://ow.ly/s6HN30fDGLX
If you have a coding or compliance question you would like to have answered please send your question to MSSNY at eskelly@mssny.org, and complete the subject line with Tip of the Week.

Medical Provider Direct Deposit FAQs

  • How do I start?
    Visit nysif.com and log in to your online account. If you do not have one, please create a NYSIF account by clicking Login >> Create an Account and choosing “medical provider” as the account type. Visit our Medical Provider Portal page for more information on registration.
    You will need a check received from NYSIF within the last 12 months and a valid email address to begin. When you’ve completed your registration, log into your account and choose “Enroll/Manage Direct Deposit.”
  • What do I need to enroll?
    A valid checking or savings account, the name of your financial institution, your bank routing number and your bank account number. Foreign bank accounts cannot be enrolled in NYSIF direct deposit.
  • How will NYSIF verify my identity?
    Once the application is completed, you will be redirected to DocuSign to authenticate your identity and sign electronically.
  • When will my direct deposit begin?
    Once NYSIF receives a completed direct deposit application, it will take several business days to verify your bank information. Until that time, you will receive your payments by mail.
  • Will I be notified by NYSIF when payments are deposited?
    Once direct deposit begins, you will receive an email every time NYSIF deposits a payment to your account. You can then log in to the medical provider portal to review the associated Explanation of Benefits (EOB) by using the draft number in the payment notification email to “Search Payments by Check Number.” Each direct deposit can contain payment for up to 25 separate bills.
  • Will funds be available on a holiday?
    If your payment date falls on a bank holiday, your payment will post on the next business day.
  • What if I want to change bank accounts?
    If you need to change the bank account for your direct deposit, please log in to your account and choose “Manage/Enroll Direct Deposit” to provide your new bank account information. Please note, you will be directed to DocuSign again to verify your identity. Once NYSIF approves your new application, it will take several business days to process the change to the new account. If a payment is due in the interim, it will be sent by mail.
  • What if I want to cancel direct deposit?
    Log in to your NYSIF online account, visit your Account Management page and click “Unsubscribe” to cancel direct deposit at any time. It may take another cycle of payments to stop this transaction, after which your next scheduled payment will be sent by mail.
  • What if I move?
    Always notify NYSIF if your address changes. However, moving will not affect your direct deposit unless you close or change bank accounts.

Please carefully review the Medical Provider’s Rights and Authorizations, applicable to any NYSIF provider payments.

Attention Managed Care Network Providers: Medicaid Enrollment Requirement
Section 5005(b)(2) of the 21st Century Cures Act amended Section 1932(d) of the Social Security Act (SSA) and requires that effective January 1, 2018, all Medicaid Managed Care and Children’s Health Insurance Program providers must enroll with state Medicaid programs.

The SSA requires that the enrollment include providing identifying information including name, specialty, date of birth, social security number, National Provider Identifier (NPI), federal taxpayer identification number, and the state license or certification number.

For example, if a physician currently participates in a network with a Medicaid managed care plan that provides services to, or orders, prescribes, or certifies eligibility for services for, individuals who are eligible for medical assistance, the physician must enroll with New York State Medicaid.

Common Enrollment Questions:

  • To check on your enrollment status, please call CSRA at 1-800-343-9000. Practitioners may also check the Enrolled Practitioners Search function at: https://www.emedny.org/info/opra.aspx
  • If you are already enrolled as a Medicaid fee-for-service (FFS) provider and are listed as active, you will not have to enroll again.
  • If at one time you were a FFS provider, and your enrollment has lapsed (no longer actively enrolled), you may be able to keep your original Provider Identification Number (PID), also known as MMIS ID, by reinstating.
  • Practitioners who do not wish to enroll as a Medicaid FFS billing provider may enroll as a non-billing, Ordering/Prescribing/Referring/Attending (OPRA) provider.
  • Enrollment in Medicaid FFS does not require providers to accept Medicaid FFS patients.

If you are not actively enrolled, please go here  and navigate to your provider type. Print the Instructions and the Enrollment form. At this website, you will also find a Provider Enrollment Guide, a How Do I Do It? Resource Guide, FAQs, and all forms related to enrollment in New York State Medicaid. 

As a point of information, under 42 CFR 455.104 defines the following providers as excluded from the definition of “disclosing entity”:

  • Solo practitioners such as an individual physician, psychologist, or chiropractor.
  • Group of individual practitioners, such as a group of cardiologists, or a group of radiologists.”



Therefore, physicians do not need to complete Section 5.

If you have questions, please contact Regina McNally at 516-488-6100 ext 332.

SEMINARS

Rebuild Puerto Rico Health Symposium in NYC TOMORROW
The Puerto Rican Studies Association (PRSA) and the Center for Puerto Rican Studies will host several concurrent panels that will discuss various health topics related to rebuilding Puerto Rico.

When:  Saturday, October 28, 2017, 11:30-12:45
Where: Silberman School of Social Work, Hunter College, 2180 Third Avenue (at 119th St)

The panelists will include Irwin Redlener, MD, Director of the National Center for Disaster Preparedness, Columbia University; Sarah Schuyler, Director of Operations, The Afya Foundation; Jodie Roure, JD, PhD, Associate Professor, St. John’s University School of Law. In addition, physicians who have volunteered in Puerto Rico will share their experiences.

If you’re unable to attend in person, click here for the zoom webinar link.

DOH Commissioner Zucker to Speak on Pain Management and Medical Marijuana
As a partner with the New York State Department of Health Medical Grand Rounds Committee, the enclosed information on the first session of the 2017-2018 Commissioner’s Medical Grand Rounds series: Pain Management and Medical Marijuana at Flushing Hospital

Who:     Hosted by DOH Commissioner Howard A. Zucker, MD, JD
When:   Monday, October 30th, 2017
Time:    6:30 PM – 8:30 PM
Where: Flushing Hospital Medical Center – Medical Science Building, 5th Floor, Auditorium
4500 Parsons Blvd (at the corner of 45th Ave and Burling Street)      Flushing, NY 11355

The purpose of this presentation is to enhance the learner’s knowledge of cannabinoids and their pharmacology, demonstrate how medical marijuana may fit into medical practice for pain management, explain safety, potential risks and benefits of medical marijuana use, provide information on the effect marijuana may have on opioid use and opioid related risks, and discuss the regulatory requirements of the Medical Marijuana Program in New York State. Practitioners will have the opportunity to ask questions of the Department and physicians currently using these treatments to help patients.

This session will be streamed as a live webcast for those unable to attend in person, and it will also be offered on the New York State Department of Health webpage as an archived webinar. This is a free event and participation is encouraged from providers all over the state of New York. Participants are eligible for CME credits whether they view in-person, via the live webcast, or via the archived webcast. Please;

Buprenorphine Training to be held in Sullivan County December 2nd
The NYSDOH AIDS Institute and the Sullivan County Public Health Department are hosting a free Buprenorphine Eligibility Waiver Training for Clinical Providers on Saturday, December 2nd, 2017 from 8:00AM to 1:00PM at Catskill Regional Medical Center, 68 Harris-Bushville Rd, Board Room, Harris, NY 12742. This training is for physicians, nurse practitioners, physician assistants, pharmacists, and medical residents. Sullivan County has some of the highest rates of opioid overdose in New York State. In just the first seven months of 2017, Sullivan County has experienced a reported 20 overdose deaths.  From 2013-2016, there were approximately 75 reported opioid overdose deaths.

DOH is seeking to increase the volume of providers in and around the county that are able to offer medication assisted treatment (MAT) to people using opioids whom could benefit from buprenorphine (or “suboxone”).  Attached is a flyer with further information, including location, online registration, and more details. Further information will be sent out to confirmed attendees. Light refreshments will be provided. Registration closes on November 29th at 5pm.

Trainers: Sharon Stancliff, MD, Harm Reduction Coalition, New York, NY; Bruce Trigg, MD, Harm Reduction Coalition, New York, NY

Please Note: CME Credits will be made available. This is the first half of the minimum required 8 hours of training, and the second half must be completed online after attendance to the live training. Currently NPs & PAs are required to take an additional 16 hours of online training which is available on the PCSS-MAT website (Part 2).
For more information about buprenorphine related trainings, mentoring, coaching, technical assistance and more, please contact us at buprenorphine@health.ny.gov or 1-800-692-8528.

An Unusual and Highly Resistant Fungus in NYS: An Update on Candida auris for the Practicing Physician” CME Webinar on December 6; Registration Now Open
Upcoming in MSSNY’s Medical Matters continuing medical education (CME) webinar series is: An Unusual and Highly Resistant Fungus in NYS: An Update on Candida auris for the Practicing Physician”.  This webinar will take place on Wednesday, December 6, 2017 at 7:30 a.m.  Elizabeth DuFort, MD, Medical Director, Division of Epidemiology from the New York State Department of Health will conduct this presentation.  Register for this webinar here

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

Educational objectives are:

  • Provide an update on the emerging multi-drug resistant yeast, Candida auris ( auris), globally and in New York State
  • Describe the risk factors for auris infection and the recommended diagnostic approach
  • Review the recommendations for auris, including infection prevention and control measures

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. 

Physicians Encouraged to Attend AMA Webinar Re Preventing Diabetes in Patients
November is National Diabetes Awareness Month and the American Medical Association (AMA) and the Medical Society of the State of New York (MSSNY) has partnered to provide educational information to New York State physicians on how to initiate clinical practice change and prevent diabetes in patient population.  Physicians can participate in a webinar on November 15 from 1-2 p.m.  Click here to register.

The session will review the evidence base for clinical approaches to diabetes prevention and describe how physicians and care teams can implement a diabetes prevention initiative within their practice. Kate Kirley, MD, MS, Director of Chronic Disease Prevention and Janet Williams, MA, Senior Program Manager will be presenters.  Dr. Kirley is director of Chronic Disease Prevention at the American Medical Association.  Prior to joining the AMA, she was a practicing family physician and health services researcher at NorthShore University Health System, and a clinical assistant professor in the Department of Family Medicine at the University of Chicago.  Janet Williams is senior manager of physician and health system engagement at the American Medical Association.  She has more than 30 years public health program and policy development experience.   She manages the AMA’s prediabetes initiative to develop and test clinical tools and resources for engaging health systems, clinicians and health departments in diabetes prevention.

New Alzheimer’s Association Continuing Medical Education (CME) Course Now Available
The Alzheimer’s Association is offering Challenging Conversations about Dementia, a free five-module online CME course intended to meet the educational needs of primary care clinicians — including internists, family physicians, nurse practitioners and physician assistants — who are seeking additional education in the assessment, diagnosis and ongoing health care of patients with cognitive impairment and dementia.

The course takes approximately 75 minutes and upon completion, participants will be able to:

    • Recognize the signs indicative of dementia and mild cognitive impairment versus normal aging.
    • Identify and explain the benefits of early detection and diagnosis of mild cognitive impairment and/or dementia.
    • Discuss next steps in the diagnostic process with patients who fail a cognitive screen in a clinical setting and prompt them to complete the process.
    • Evaluate the behavioral, safety and functional needs of patients with AD as part of the care planning process.

  • Assess patients’ fitness to drive.

CLASSIFIEDS


Saratoga Springs, NY – Professional Office Space for Lease
Medically oriented building currently occupied by five parties.  The Suite, Suite 700, has 2904 sq. ft., second floor (elevator), excellent off-road parking with drive-thru patient portico in a well maintained and attractive building close to the local hospital.
The lease area has a large waiting room, administrative rooms, lunch room, four examining rooms, one procedure room and one for storage.  Separate staff entrance.  Attractively priced without triple net obligations.  $4,500/month + heat + utilities.  Call Lauren regarding Suite 700 at (518) 587-2020.


Riverdale Medical Office for Sale – Prime Location
Co-op with private entrance features 2 exam rooms, lab, office & bathroom. Must see! Call 718-230-7069

Medical Family Practice For Sale – Long Beach, NY
Established 14 years. Newly renovated. Fully equipped ground floor premises. 3 exam rooms. Must see! Call Carol – 516-238-3422


For Rent or Share – Woodbury, Long Island
Beautiful recently renovated Plastic Surgery office available for part-time share and AAAA-certified (by end of summer). OR available for rent. Centrally located
on Long Island.Close to expressways. 3 exam rooms, 1 procedure room /OR.
Waiting room, break room and personal office. Free WIFI. Available for full or half-days. Suits Plastic/Cosmetic Surgeons/Derm/ENT/
ObGyn/Podiatry or other Medical MDs.
Contact Patricia at info@cosmetichg.com
or 631-318-4008

Want to Sell Your Medical Practice? Do You Have Medical Office Space to Sell or Share?
Clineeds is a new online platform designed to help medical providers sell their practice or buy, sell and share medical office space. Listing is FREE! No contracts. No commitments. No fees. Sign up today at  http://www.clineeds.com/sign-up

PHYSICIAN OPPORTUNITIES


Medical Director – AIDS Institute
Minimum Qualifications:
Current license and registration to practice medicine in New York State and board certification AND either a Master’s Degree in Public Health or two years of experience in an HIV program or public health program.Preferred Qualifications:
Master’s Degree in in Public Health.  Five years of experience including clinical service in an HIV program or clinical fellowship program (infectious diseases/HIV medicine).  Experience in quality management/quality improvement.  Knowledge of the HIV health care delivery system in New York State. Experience in/knowledge of the New York State Ending the Epidemic initiative.  Experience in STD prevention and care, drug user health, and/or LGBT health.  Experience in health policy development, analysis and evaluation.  Experience with evolving health information technologies.  Experience in health program management and administration.
Responsibilities: The Medical Director, AIDS Institute, plays a significant role in shaping HIV, hepatitis C, and STD care and services, drug user health, and LGBT health care throughout New York State.Please click the link below for more information pertaining to this position and to apply: “https://careers-healthresearch.icims.com/jobs/3742/medical-director—aids-institute/job” Affirmative Action/Equal Opportunity Employer/Qualified Individuals with Disabilities/Qualified Protected Veterans

Multiple Physician Positions with DOHMH Office of School Health
Office of School Health is the largest program of the New York City Department of Health and Mental Hygiene (DOHMH). This bureau is responsible for managing the health issues and promoting the well-being of the over 1.3 million children and adolescents enrolled in New York City’s 1700 school buildings.

Positions with the Office of School Health (OSH) combine clinical skills and public health training.

Adolescent School Health Physician
This position offers to the interested physician the opportunity to help address the clinical and public health needs of adolescents in NYC high schools. The physician will work with the innovative Connecting Adolescents to Comprehensive Health Care (CATCH) Program, which provides select reproductive health services to adolescents in select NYC high schools. In addition, the physician will provide medical care and public health services through additional programs offered to adolescents by the Office of School Health.

Under the supervision of the High School Supervising Physician, the Adolescent School Health Physician’s responsibilities will include but are not limited to:

  • Provide CATCH reproductive health services in select high schools.
  • Perform mandated physical examinations (New Admission Exams, Sports Physicals, and Working Paper Physicals).
  • Function as a liaison for students with community health providers to resolve medical issues that affect school performance.
  • Support the development and implementation of initiatives that promote positive health behaviors and reduce high risk behaviors in the adolescent population.
  • Serve as a consultant to the school nurse and administration on school related health concerns.
  • Provide clinical assistance in the event of an environmental or communicable disease occurrence.
  • Function as a liaison for students with community health providers to resolve medical issues that affect school performance.
  • Support all medical initiatives established by the Office of School Health, e.g. programs and protocols in asthma, reproductive health, obesity and diabetes.
  • Maintain good public relations and communicate effectively within the school community and community-based organizations.
  • Keep abreast of health management policy statements and emerging clinical research related to school health.
  • Participate in OSH research activities.
  • Work within the mandates, policies and protocols of the Office of School Health.
  • Attend all mandated DOHMH and OSH trainings.

To Apply: Please email your resume and cover letter to Dr. Caroline Volel: osh@health.nyc.gov OR  Apply online at https://a127-jobs.nyc.gov/.  In the Job ID search bar, enter: job ID number # 277208. 

School Health Field Physician
Under the direction of the Supervising Physician, the School Health Physician’s will:

  • Improve the health of school children through case management of chronic disease, preventive health screening and counseling, health education, and referrals.
  • Perform mandated physical examination (new entrant, sport physical, working paper physicals.
  • Develop relationships with community health providers in order to optimize medical management of students with health issues.
  • Attend to the health needs of your assigned school community.
  • Utilize the Automated Student Health Record (ASHR) to maintain adequate student health records.
  • Serve as a consultant to the school nurse and administration on school related health concerns.
  • Support the development of school educational and prevention programs promoting the health and wellness of all students.
  • Provide clinical assistance in the event of an environmental or communicable disease occurrence.
  • Develop and maintain professional relationships within the school community.
  • Support all medical initiatives put forth by the Office of School Health, e.g. Asthma, Reproductive health, Obesity and Diabetes initiatives.
  • Provide trainings/presentations to school staff, community organizations, or parents.
  • Stay abreast of health management policy statements and emerging research within the health community related to school health.
  • Participate in School Health research and quality improvement activities.
  • Participate in all mandated DOHMH and Office of School Health trainings and professional development sessions.
  • Attend all program meetings and Continuing Medical Education classes provided by the Office of School Health.

To Apply: Please email your resume and cover letter to Dr. Caroline Volel:osh@health.nyc.gov OR Apply online at https://a127-jobs.nyc.gov/.  In the Job ID search bar, enter: job ID number # 279844. 

Supervising School Health Physician 
Job Description
Under the supervision of the Deputy Medical Director, the Supervising Medical Doctor’s responsibilities will include but not be limited to:

  • Supervise School Health Physicians.
  • Work within the mandates, policies and protocols of the Office of School Health (OSH).
  • Attend to the health needs of a designated school community.
  • Utilize the Automated Student Health Record (ASHR) to maintain accurate student health records.
  • Serve as a consultant to the school nurse and school administrative staff regarding school related health concerns.
  • Support the development of school educational and prevention programs promoting the health and wellness of students.
  • Participate in policy development and revisions as indicated.
  • Provide clinical assistance in the event of an environmental or communicable disease occurrence.
  • Function as a liaison for students with community health providers to resolve health issues that affect school functioning.
  • Develop and maintain professional relationships within the school community and the community at large.
  • Support all medical initiatives put forth by the Office of School Health, e.g. Asthma, Reproductive health, Obesity and Diabetes Initiatives.
  • Keep abreast of health management policy statements and emerging research within the health community affecting school health.
  • Assist with or provide trainings/presentations to school health physicians, nurses, school staff, community organizations or parents
  • Participate in School Health research and quality improvement activities
  • Participate in all mandated DOHMH and Office of School Health trainings and professional development sessions
  • Attend all program meetings and Continuing Medical Education classes provided by the Office of School Health.


To Apply: Please email your resume and cover letter to Dr. Caroline Volel: osh@health.nyc.gov  OR  Apply online at https://a127-jobs.nyc.gov/.  In the Job ID search bar, enter: job ID number # 277026


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


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