July 19, 2019

Arthur Fougner MSSNY Presiident

PRESIDENT’S MESSAGE
Arthur Fougner, MD
MSSNY President

MSSNY eNews
July 19, 2019

Vol. 22  Number 27


MSSNYPAC Seal


Colleagues:

Congress is continuing to work on legislation that aims to deal with “surprise bills.” Keep your eyes peeled to your email inbox for updates. I realize this may seem tiresome but if the wrong legislation is passed, the Uniteds and Aetnas of the world may get handed the ability to set benchmark payments for everyone. Believe me, it won’t be pretty. Attention is soon moving to the House Ways and Means, where we have a shot. NY Reps Tom Suozzi (downstate) and Brian Higgins (western NY) are on Ways and Means and are also cosponsors of HR 3502 which would set up an independent arbitration system similar to NY’s to resolve disputes. Please take a moment and Call Rep Suozzi 202-225-3335 and Rep Higgins 202-226-0347, asking them to oppose HR 3630 and support the bill they co-sponsor— HR3502.

Perhaps contemplating the alternative should Congress get it wrong will get you to dial that much faster.

Now, please allow me to digress.

This weekend marks the 50th anniversary of that “one small step for man, one giant leap for mankind” as the first humans walked on another galactic body. Just three years before in 2016 was another 50th anniversary – that of arguably the most famous split infinitive of all time – as the voyages of the Starship Enterprise embarked on its five-year mission. This now celebrated Science Fiction series made the Science Fact of the moon mission all the more incredible. July 20, 1969 was the day the Impossible became Possible.

Space has been the dream of all humanity from the day the first sentient primate climbed down out of that tree, looked up, saw the night sky and wondered what was out there. Now, folks from all over the world are preparing to return to space. There will no doubt be missteps as there have been in the past – Apollo One and Challenger come to mind – but in the not too distant future, we will once again see explorers, as Ronald Reagan put it in another, more somber context, slip “the surly bonds of earth to touch the face of God.”

Oh, when I look back now
That summer seemed to last forever
And if I had the choice
Yeah, I’d always wanna be there
Those were the best days of my life

Oh, yeah
Back in the summer of sixty-nine

–Bryan Adams, Summer of Sixty-Nine

Arthur Fougner, MD
MSSNY President 

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


MLMIC Insurance Banner

eNews

US House Committee Advances Surprise Billing Legislation Opposed by Physician Community
This week the US House Energy and Commerce Committee reported out by voice vote surprise billing legislation (HR 3630) strongly opposed by MSSNY and other medical associations. The legislation would limit out of network payment for surprise hospital bills to a median in-network rate, for which MSSNY and the medical community has raised strong concerns that it would give enormous new powers to already market dominant health insurers.  An amendment to HR 3630 offered by Rep. Dr. Raul Ruiz MD (D-CA) and Rep. Dr. Larry Bucshon MD (R-IN) was adopted to add an appeals provision.  Appeals would be restricted to complex cases with a payment above $1,250 (indexed to inflation).

Arbitrators would be permitted to consider median contracted in-network rate, provider’s level of training, experience, quality and outcomes measurements and acuity of care/services rendered.  In order to hold down the budget score of the amendment, the arbitrator would be prohibited from considering billed charges.

The AMA has reported that the addition of an appeals process, while imperfect, represents progress on this issue, noting that there will be opportunities with two other House committees (Ways &Means/Education& Labor) to make further improvements on this and other elements in the legislation both before and during floor action in the House and Senate. While this legislation would protect New York’s law for state regulated health insurance products, it would establish this insurer determined default rate for plans governed by ERISA.

Amendments were also adopted by the E&C Committee for HHS and the GAO to conduct studies to assess impact of the legislation on access to providers, network adequacy, premiums and patient out of pocket costs. In addition, a requirement to conduct an audit of at least 25 health plans to assure that in-network median rates are being properly calculated was also adopted.

MSSNY will continue to work with the federation of medicine to fight for a law that is consistent with New York’s acclaimed approach, rather than bills such as HR 3630, which is essentially a gift to the health insurance industry wrapped in a consumer protection package. We thank the many physicians have who have contacted their respective members of Congress, and urge physicians to continue doing so by clicking here.


Physician Action Needed on Bills Awaiting Governor’s Signature
Bills that passed during the 2019 session must now be sent to the governor in order to be enacted into law. There are still a few outstanding pieces of legislation that passed both houses this year that MSSNY has taken strong positions on, and as such it is incumbent upon MSSNY members to take a moment to let the governor know where we stand on these issues. There is power in numbers; the more physicians that reach out to the governor, the louder our message will be heard.

Physicians can quickly and easily send a letter to the Governor here on these issues:

  • Malpractice expansion – two bills passed the legislature that will further tip the scales in lawsuits against physicians and others, adding costs and potentially increasing your liability premiums while doing nothing to reform the current broken system. One would force physician defendants into making a “blind gamble” in cases involving multiple defendants where one defendant settles prior to trial and would enable in many cases the total payout to a plaintiff to actually exceed a jury’s award. The other would allow plaintiffs to collect a judgment from a third party that is not a direct party to the lawsuit in question. The bill would permit this to occur even though the plaintiff had not sued or perhaps could not have sued the third-party defendant in the first instance. Please let the governor know how destructive these bills would be by clicking here.
  • Mid-year formulary changes – would prohibit a health insurer from removing a prescription drug from a formulary during the patient’s policy year. Moreover, if the plan’s drug formulary has two or more tiers of drug benefits with different deductibles, copayments or coinsurance, the plan may not move a drug to a tier with higher patient cost sharing during the policy year. It also prohibits the plan from adding new or additional formulary restrictions during the policy year. Please reach out to the governor and let him know how helpful this bill would be by clicking here.
  • Partial prescription fills – would allow prescribers, in consultation with their patients, to prescribe up to a 30-day supply of a controlled substance with a notation to the pharmacist that they should only dispense the amount agreed to by patient and prescriber. Each partial fill would be dispensed and recorded in the same manner as a normal refill and the aggregate quantity dispensed across partial fillings may not exceed the overall total quantity prescribed. This measure should help to address patients’ pain while reducing the amount of leftover medication in households. Please encourage the governor to sign this legislation by clicking here.



Gov. Signs Law Raising Tobacco Sales from Age 18 to 21
This week Governor Cuomo signed into law legislation (A.558/S.2833) that would raise the statewide tobacco purchase age from 18 to 21, legislation long supported by MSSNY.  The new law will take effect on November 13, 2019.  MSSNY President Dr. Art Fougner offered the following statement praising the Governor and legislators for taking this action:

“This major public health advancement will help to prevent a generation of New Yorkers from becoming addicted to smoking by delaying children and young adults’ access to tobacco products.  Data shows the earlier a child begins to smoke the more severe the addiction is likely to be and 90% of all smokers begin before age 20.   This new law will reduce the likelihood they ever start smoking and therefore create a healthier state. We thank Governor Cuomo for signing this legislation into law, and Assemblywoman Rosenthal and Senator Savion for advancing this important legislation”


New York Insurer Opens Office in Hospital
CDPHP, a New York health insurer, opened a branch inside Ellis Medicine in Schenectady, N.Y., to connect patients directly with insurance staff if they have questions during treatment and post-discharge, according to the Albany Business Review.

The idea came to CDPHP’s CEO, John Bennett, MD, after a recent hospitalization revealed some of the difficulties patients face when navigating the healthcare system. CDPHP opened its office July 16, which is staffed with representatives tasked with answering questions about what insurance will pay for at Ellis Medicine, among other discussions.

Ellis Medicine CEO Paul Milton told the Albany Business Review he expects to see improved patient satisfaction and readmission rates among CDPHP members because of the partnership. In addition, since Ellis Medicine houses CDPHP’s first hospital office, CDPHP members may seek out the hospital for care. Read the full article here.


 

NY Rx Card Banner


Private Equity Investing Heavily in Physician Practices
Private equity is a big mover in the long-term care continuum, especially in the home care and hospice spaces where the platforms are looking to build growth through acquisition-heavy strategies, Providing’s Kyle Daly told Bloomberg Law  (June 17).

Involvement by BDT Capital Partners and Gryphon Investors in deals in the physical therapy space demonstrated private equity’s continued interest in expanding its presence in key markets through add-on acquisitions, Daly said.

Private equity also is investing heavily in physician practices, Hirschman said. Radiology remains a hot practice area for consolidation, he said.

Private investors have shown the most interest in ophthalmology, gastroenterology, ear-nose-and-throat, obstetrics-gynecology, and orthopedics practices, Hirschman said. This is because those specialties have the greatest potential to increase revenues and profits through additional investments in new and expanded ancillary services, like ambulatory surgical centers, he said.


40% of Physicians Refuse New Patients Who Use Opioids for Chronic Pain
Researchers found that more than 40% of physicians refuse “to take on new patients who need opioids to control pain.” The study surveyed 194 primary care clinics in Michigan. The findings were published in JAMA.


Garfunkel Ad


Our State Fair is a Great State Fair…Don’t Miss it from August 21 to September 5!
Once again the Onondaga County Medical Society will staff the Medical Society of the State of New York/New York State Society of Anesthesiologists booth at the state fair. Medical Society physician members are encouraged to volunteer to work the booth during a time slot. This is a great opportunity to perform public health outreach, and to promote your practice or organization at the NYS Fair, free of charge. Those who work at the booth will receive free admission tickets and free parking (on a limited basis). Feel free to bring handouts about your practice or other timely medical information to share with fair goers. Please let us know if you have any ideas for exhibits, testing, etc., that you feel will be informative and help advance a positive image of the medical profession.

Contact us for available time slots remaining for the 13-day fair, which runs from Wednesday, August 21 – Monday, September 2, 2019 (Labor Day). You can work as little as two hours or the entire day if you’d like. We need only one physician-member group per time slot. This is being updated daily. Time availability is on a first-come, first-served basis.  Contact Patty Corasaniti at (315) 424-8118, or send email to corasaniti@oncms.org for more information.


American Medical Women’s Association Hosts Congress July 25 in Brooklyn
The American Medical Women’s Association will be hosting the Centennial Congress of the Medical Women’s International Association MEDICAL WOMEN: AMBASSADORS OF CHANGE IN A CHALLENGING GLOBAL WORLD from July 25-28, 2019 at the Brooklyn Bridge Marriott Hotel (333 Adams Street, Brooklyn). Keynote speaker Gloria Steinem, author/co-founder of MS. Magazine and New York Magazine will address the audience of more than 1000 female physicians on Friday, July 26, 2019 at 11AM.

The hashtag for the 3-day conference is #MWIA100.  The Centennial Congress will feature discussions on Digital Health, Innovation & Genomics, Gender Specific Medicine, Gender Equity, Global Health, Work-Life Balance, Violence Against Women, Obesity: A Global Health Crisis, Sex & Gender Specific Medicine, and Sexual Harassment, among other professional tracks and topics.To register for the Conference, please follow this link. For more information, please contact: Charlotte Tomic, 917-882-5243; charlotte@tomiccommunications.com.


Frances Foy, Wife of Ret’d MSSNY EVP, Don Foy, Mother of Former Westchester EVP Brian Foy, Died on July 7; Services in St. Augustine FL on Friday, August 2
Frances M. Foy, age 82, of St. Augustine, FL, passed away on July 7, 2019 at her home with family at her side. She was the mother of four children; grandmother of nine; and great grandmother of two. Frances met her husband, Donald, in California where she was a former TWA flight attendant. They were married for nearly 59 years.  A memorial mass will be held at 9:00 am on Friday, August 2, 2019 at St. Anastasia Catholic Church in St. Augustine, FL.


 

 

Classified

RENTAL/LEASING SPACE

Photo of Park Ave building facade
Prestigious Park Ave Office Near Lenox Hill Hospital for Sale
2,400 sq/ft on two levels with a separate 6×12 ft. storage closet. Fireplace in waiting room and consult room. Perfect for plastic surgeons, cosmetic dermatologists or other. $2,950,000 Call for details and appoint to view. 212-570-6060



 

Ground Floor Office with Private Street Entrance in Luxury Park Avenue Building
Rental includes: two consultation rooms, private office, private bathroom.  Common waiting room, back office filing space and reception desks included.  Affordable rent.  Location East 60s between Park and Lexington.  Easy distance to Lenox Hill Hospital and New York Cornell.  Subway access within 1 block. Immediate occupancy available.  Call James: 917-710-7643


For Lease – Buffalo Area Urgent Care / Primary Care Clinic
Next door to only grocery store in town: Sav-a-Lot 4+ exam rooms, X-Ray room, Lab, Offices, etc. 3300 Sq Ft. – Fully built-out facility  ADA compliant Dunkirk New York
View full listing https://reporting.loopnet.com/report/3008dc65-60b8-4476-ab01-df4ffa2bc628.Contact geoff_jenkins@hotmail.com / (917) 825-4542


Upper East Side Medical Office Space for Rent Part–Time
Beautiful, newly renovated medical office on the Upper East Side between Lexington and Park Ave. Full service building with 2 entrances, conveniently located near all public transportation. Office includes 2 consult rooms, 3 exam rooms, treatment area, 2 bathrooms, kitchenette and reception area with waiting room. The office is available on a part-time basis. Please call 212-288-2278 or e-mail eastsidemedical@usa.net for further information.
Upper East Side Office lobby and receptions area


Park Avenue Office Share-3 Days Per Week
Tasteful, bright, well-maintained medical office in prestigious building on Park Avenue at 94th Street.  Large waiting room and reception area, consultation room and 2 exam rooms available 3 days per week. Room for an
assistant or clerical help 5 days per week. Please emailabgmdpc@gmail.com or call 987-5000


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




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



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


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


  

 


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

PHYSICIAN OPPORTUNITIES

Great Career Opportunities for Clinical Physicians
The NYS Department of Corrections and Community Supervision has great career opportunities for Clinical Physicians. You must have possession of a license and current registration to practice medicine in New York State, and have two years of post-licensure medical experience.

Starting salary is $143,381 – $171,631 *(Additional $10,000 or $20,000). Benefits include comprehensive health insurance, NYS retirement system, deferred compensation plan, flexible spending plan, and paid time off.

We have openings in the following counties offering a choice of urban, suburban or rural living:

Clinton*                  Clinton Correctional Facility (sporting and recreational outlets)
Dutchess                 Fishkill and Green Haven Correctional Facilities (Hudson River Valley Beauty)
Franklin*                 Franklin and Upstate Correctional Facility (North Country, 1 hour to Montreal)
Greene*                  Greene Correctional Facility (rural charm yet only 2 hours to New York City)
Oneida                    Mohawk Correctional Facility (Cooperstown, breweries)
Sullivan                   Woodbourne Correctional Facility (mountains, outlets, casinos and entertainment)
Seneca*                  Five Points Correctional Facility (heart of wine country)
St. Lawrence           Riverview Correctional Facility (hiking, boating and museums)
Washington             Great Meadow Correctional Facility (Between Vermont & the Green Mountains)
Westchester            Bedford Hills Correctional Facility (Less than 1 Hour to NYC)

Contact: www.doccs.ny.gov or DOCCS Personnel Office at (518) 457-8132 for more information and to apply.

 


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


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

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 


MSSNY eNews: July 12, 2019 – Oppose Disastrous Surprise Med Bill Now

Arthur Fougner MSSNY Presiident

PRESIDENT’S MESSAGE
Arthur Fougner, MD
MSSNY President

MSSNY eNews
July 12, 2019

Vol. 22  Number 26


MSSNYPAC Seal

 


Colleagues:

Congress, Don’t Harm Patients With The Wrong Surprise Medical Bills Solution
by Dustin Corcoran and Phil Schuh

Dustin Corcoran is chief executive officer of the California Medical Association, and Phil Schuh, CPA, is executive vice president and chief financial officer of the Medical Society of the State of New York.

Former Supreme Court Justice Louis Brandeis said in the early 1930s that states are laboratories of democracy that can experiment with various policies without harming the rest of the country. Now that more than 10 states have enacted laws to end surprise medical bills, Congress is discussing various policies that work toward the same goal.

Everyone agrees patients need to be held harmless from surprise medical bills to prevent financial hardship. What hasn’t been resolved is how the anticipated federal law will direct insurers and physicians to resolve billing disputes and enter into fair contracts. As Congress continues to consider this question, the experiences of California and New York offer important lessons that can ensure patients don’t inadvertently lose access to essential medical services in an emergency as they gain important new financial protections from surprise bills.

California’s law instituted a government-mandated benchmark to resolve disputes, championed by the health insurance industry. Instead of promoting fairness, the benchmark has become an artificial ceiling.

It fails to consider the actual cost of medical services and has emboldened insurers to avoid entering into contracts with doctors, meaning even more physicians will remain outside of insurers’ networks. Experience has shown this creates a huge hardship for patients and is precisely what surprise medical bills legislation is supposed to solve.

With more doctors forced out of network, patients will encounter more difficulty finding an in-network doctor. When they seek care out of network, it will substantially increase their deductibles and out-of-pocket costs.

Importantly, fewer hospital-based physicians, such as surgeons, obstetricians and anesthesiologists, will be able to serve patients in emergencies, a direct result of empowering insurance companies to decide how disputes should be settled. It’s not an exaggeration to assume that California’s approach will eventually destroy access to emergency and “on-call” safety net physicians.

The difference between life and death in some emergencies is a matter of minutes. Patients need to know that the right physician specialist will be there to treat them.

Contrast this cautionary tale with the overwhelmingly positive results attributed to New York’s surprise medical bills law. It should be the basis for federal legislation because consumers are no longer financially responsible for payment; complaints have plummeted; premiums have grown more slowly in New York than the rest of the country; physicians’ out-of-network charges are down 13 percent; and out-of-network billing is down 34 percent, according to a recent Georgetown University analysis. In other words, New York has prevented the serious problems that arise in a marketplace, like California’s, that’s unduly dominated by insurers.

Most importantly, the New York law ensures patients can continue to see the doctors they need in an emergency because arbitration is deterring disputes from ever reaching that point. When they do, outcomes are grounded in fair, transparent and independent data, in stark contrast to California’s arbitrary, insurer-championed approach that’s adding to the ranks of out-of-network doctors and diminishing access to essential emergency physicians.

As Congress continues to debate federal legislation to end surprise medical bills, the approach it ultimately adopts to resolve insurer-physician disputes could be the difference between a health care system where insurance coverage includes an adequate number of in-network physicians to protect patients and a system that empowers even bigger, more powerful insurance companies to encourage health care consolidation that decreases access to doctors and raises prices.

As leaders of two of the nation’s largest medical societies, we know from experience that federal surprise medical bills legislation needs to look like New York’s law, which is why Congress should support the House of Representatives’ bipartisan Protecting Patients from Surprise Medical Bills Act introduced by Reps. Raul Ruiz, MD (D-Calif.), and Phil Roe, M.D. (R-Tenn.). The Senate Health, Education, Labor and Pensions Committee’s legislation, which uses the so-called “median in-network” rate, another government-mandated benchmark, is far too much like California’s law, which experience shows has been devastating for patients and physicians.

Arthur Fougner, MD
MSSNY President 

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


MLMIC Insurance Banner

eNews

Physicians Urged to Contact Schumer, Gillibrand and Members of Congress to Oppose Disastrous Surprise Medical Bill Legislation
Please do not let the US Congress make it even harder for physicians to be able to negotiate fairly with market dominant health insurers, and force even more physicians into employment arrangements.   Physicians are urged to continue to contact Senators Schumer and Gillibrand, as well as their respective US Representative, to oppose disastrous legislation that would mandate out of network payment at insurer determined in-network levels, and in support of legislation to align with New York’s approach to surprise medical bills.  A letter can be sent from here.

While these bills would protect New York’s law for state regulated health insurance products, it would establish this insurer determined default rate for plans governed by ERISA.

This week, the US Energy& Commerce Health Subcommittee reported to the full Committee legislation (HR 3630) that would tie out-of-network payments for surprise medical bills to an insurer determined in-network payment level.  Legislation (S.1895) with a similar “default rate” remedy for these surprise bills was also recently advanced from the US Senate Health, Education, Labor and Pensions (HELP) Committee.  Both bills ignore New York’s successful approach that resolves these disputes through a simplified independent dispute resolution system based upon “baseball arbitration” that includes consideration of regional charges for health care services.

MSSNY President Dr. Art Fougner issued a statement noting that “New York’s physicians are extremely concerned about the impact to patient care of a bill before the US House Energy& Commerce Health Subcommittee…that would further enable abusive health insurer practices by establishing an insurer determined “default rate” for surprise medical bills (HR 3630). New York’s physicians very much agree with the goal of the legislation to protect patients from facing these bills, but disagree strongly with the solution being offered by Rep. Frank Pallone and Rep. Greg Walden, Chair and Ranking Member of the E&C Committee…”

Instead, MSSNY has supported legislation (HR 3502) that had been introduced by Representative Raul Ruiz, MD (D-CA) and Representative Phil Roe, MD (R-TN) based on New York’s model that has the support of a number of New Yorkers, including Representatives Clarke (D-Brooklyn), Higgins (D-Buffalo), Lowey (D-Westchester), Maloney (D-Westchester), Morelle (D-Rochester), Rice (D-Long Island), Stefanik (R-North Country), Suozzi (D-Long Island) and Velasquez (D-NYC).  While this legislation has some drafting errors that need to be fixed, it most closely follows New York’s approach.

MSSNY has been working closely with other state medical associations, national specialty associations, the Physicians Advocacy Institute and the AMA to oppose the health insurance industry gift that is S.1895 and HR 3630, and to instead support legislation that aligns with New York’s approach.  MSSNY’s letter to Senators Alexander and Murray expressing strong concerns with S.1895 can be found here.


Physician Action Needed on Bills Awaiting Governor’s Signature
While the legislative session may be over, there is still ample opportunity to influence the policy-making process. Many bills that passed both houses of the legislature have yet to be sent to the Governor for his signature or veto. Please take just a few minutes to send letters to the Governor from MSSNY’s Grassroots Action Center in support or opposition of the following issues:

  • Mid-year formulary changes (MSSNY supports)– would prohibit a health insurer from removing a prescription drug from a formulary during the patient’s policy year. Moreover, if the plan’s drug formulary has two or more tiers of drug benefits with different deductibles, copayments or coinsurance, the plan may not move a drug to a tier with higher patient cost sharing during the policy year. It also prohibits the plan from adding new or additional formulary restrictions during the policy year. Please reach out to the governor and let him know how helpful this bill would be by clicking here. 
  • Partial prescription fills (MSSNY supports) – would allow prescribers, in consultation with their patients, to prescribe up to a 30-day supply of a controlled substance with a notation to the pharmacist that they should only dispense the amount agreed to by patient and prescriber. Each partial fill would be dispensed and recorded in the same manner as a normal refill and the aggregate quantity dispensed across partial fillings may not exceed the overall total quantity prescribed. This measure would help to address patients’ pain control needs while also reducing the amount of leftover medication in households. Please encourage the governor to sign this legislation by clicking here. 
  • Malpractice expansion (MSSNY opposes) – two bills passed the legislature that will further tip the scales in liability actions against physicians and others, adding costs and potentially increasing liability premiums while doing nothing to help reform our current broken system.

The first would require a non-settling co-defendant in a tort action, where another co-defendant has settled, to make a “blind gamble” prior to trial (instead of after) whether to reduce the overall jury determined amount by the settlement amount or the settling defendant’s equitable share, instead of after a jury verdict has been reached.

The other would allow plaintiffs to collect a judgment from a third party that is not a direct party to the lawsuit in question. The bill would permit this to occur even though the plaintiff had not sued or perhaps could not have sued the third-party defendant in the first instance.

Please let the Governor know that these bills would unnecessary costs to an already broken system by clicking here.


Hospital Association Urges Support for Bill to Repeal Medicaid DSH Cuts
Ahead of an important congressional hearing, the Greater New York Hospital Association is urging its members to express support for a bill that repeals impending Medicaid disproportionate share hospital cuts. The House Energy and Commerce Health Subcommittee will consider the bill. If approved, House leaders have said they would like the full chamber to vote on the bill before the end of the month.

MSSNY weighed in on surprise billing ahead of Thursday’s hearing.

“New York’s physicians very much agree with the goal of the legislation to protect patients from facing these bills but disagree strongly with the solution being offered by Rep. Frank Pallone and Rep. Greg Walden, chair and ranking member of the [Energy and Commerce Health Subcommittee],” said Dr. Art Fougner, president of the medical society, in a statement.

“Their proposal would greatly limit the ability of physicians to negotiate patient-care terms fairly with already market-dominant insurance companies. It would also make it much harder for hospitals to ensure needed on-call specialty care in their emergency departments. Moreover, it could have a particularly significant adverse impact on rural and smaller hospitals.

Kenneth Raske, president of the association, wrote in a letter to members Wednesday stating, “Eliminating Medicaid DSH cuts is GNYHA’s top federal priority, and we worked closely with Rep. Engel on getting this amendment included,” Raske wrote.

Safety-net hospitals that serve high numbers of low-income and uninsured patients operate on tight margins, Engel recently said of his efforts to repeal Medicaid DSH cuts. “If Medicaid DSH cuts were implemented, it would have a devastating impact on these critical facilities, potentially leading many to close their doors.” (Crains July 11)


RFK Jr. and NY Families Sue State for Ending Religious Exemptions to Vaccines
Attorneys Michael Sussman and Robert F. Kennedy Jr. filed a lawsuit Wednesday in the New York State Supreme Court that questions the constitutionality of the vaccination exemption changes, which took effect on June 13. The challenge, filed on behalf of 55 New York families who had lawful religious exemptions, requests that the court “enjoin the enactment of the repeal temporarily, preliminarily and permanently.” Kennedy, chief legal counsel for Children’s Health Defense, argued that it’s “unconstitutional for the state to deprive people of such important rights when religious animus has played a key role.”

Sussman, an attorney with Goshen-based Sussman & Associates, further argued that “to deprive families of the rights to freedom of religious expression, parental rights and the right to either a public or private education, the state must demonstrate a ‘compelling state interest’ that the state has failed to prove here.” Under New York Department of Health guidance issued in response to the new law, children attending daycare or public, private or parochial school who had a religious exemption were required to receive the first age appropriate dose in each immunization series by June 28. Parents and guardians must show that they have scheduled appointments for all required follow-up doses by July 14 for their children to remain in school or daycare. (Politico, July 10)



Female Physicians Paid Less Than Males
Female primary care providers are paid an average of 25% less than their male counterparts in the United States, according to Medscape‘s Female Physician Compensation Report released last week. The report noted that, overall, male physicians were more likely than female physicians to say they felt fairly compensated.


FCC Approves New Telehealth Pilot Program, Issues Proposed Rulemaking
The Federal Communications Commission voted unanimously to approve a notice of proposed rulemaking to establish a new $100 million “Connected Care Pilot Program” to support telehealth for low-income Americans, including veterans and those living in rural areas. “The future of health care is connected care, and this is the future that I want the FCC to support,” said FCC Chairman Ajit Pai.

The AHA has said the program is a critical next step toward delivering affordable telehealth services to those Americans who need it the most, and in September shared comments and recommendations with the FCC on its notice of inquiry about the program. Among other areas, FCC’s proposed rule seeks comments on who should participate in the pilot, including eligible health care providers and broadband service providers; the goals of the pilot; and the project application submission and evaluation. FCC will accept comments for 30 days after the rule is published in the Federal Register.


Federal Judge Blocks Rule Mandating Drug Prices in TV Ads
A federal judge on Monday blocked a rule that would have required pharmaceutical companies to disclose the prices of their drugs in television ads, according to media reports.

The rule, set to go into effect on Jul. 9, would have mandated cost disclosure for any drug covered by Medicare or Medicaid that has a list price above $35 for a month’s supply or the usual course of treatment. In June, three drug companies filed a lawsuit against the regulation, and on Monday, Judge Amit P. Mehta ruled that the Department of Health and Human Services had “exceeded its regulatory authority” in requiring such disclosure, the New York Times reports.

For now, TV ads will stay as they are. An HHS spokesperson said that “the administration … was consulting with the Justice Department on what to do next,” according to the Times.  Physician’s First Watch coverage of lawsuit


Doctors Without Borders Information Session in Queens
Every day, Doctors Without Borders/ Médecins Sans Frontières aid workers from around the world to provide assistance to people whose survival is threatened by violence, neglect, or catastrophe—treating those most in need regardless of political, religious, or economic interest. Whether an emergency involves armed conflicts or epidemics, malnutrition or natural disasters, Doctors Without Borders is committed to bringing quality medical care to people caught in crisis.

On Wednesday, July 31st, medical and non-medical professionals are invited to an evening presentation in Queens to learn more about joining Doctors Without Borders’ pool of dedicated aid workers. This is your opportunity to meet the recruitment team and learn about how you can join the pool of dedicated aid workers. The organization is currently recruiting for a variety of medical and non-medical positions.

Where:
Sunnyside Community Services
Seminar Room
43-31 39th St.
Sunnyside, Queens 11104

When:
July 31st, 2019, 7-8:30 pm

Register here.


Primary Care First Seriously Ill Population Webinar: Scheduling Update
In an effort to share model details and to include Center for Medicare and Medicaid Innovation leadership, the upcoming webinar on the Primary Care First Seriously Ill Population (SIP) payment option will now be held at the following date and time:

Wednesday, July 24th at 12:00 PM EDT

We apologize for any inconvenience and appreciate your continued interest in Primary Care First. Webinar slides will be available for download on the Primary Care First webpage shortly after the event.

Please forward the registration link below to colleagues who may be interested in learning more about the Seriously Ill Population payment model option of Primary Care First.

Register to attend here.

If you registered for the event on July 10th, then you do not need to re-register for the event as the link you received is still valid.

For additional information about Primary Care First, please visit the model webpage here.

Questions or Feedback?

If you have questions or feedback, please email PrimaryCareApply@telligen.com.


Thanks from Anti-Recreational Marijuana Group
The following letter of gratitude from Kevin Sabot, PhD, President of Smart Approaches to Marijuana (SAM), was sent to MSSNY’s Moe Auster thanking him for MSSNY’s support regarding our opposition to the legalization of recreational marijuana and convincing the legislature from legalizing recreational marijuana during this year’s legislative session.


 

NY Rx Card Banner


 


Garfunkel Ad


Classified

RENTAL/LEASING SPACE

Photo of Park Ave building facade
Prestigious Park Ave Office Near Lenox Hill Hospital for Sale
2,400 sq/ft on two levels with a separate 6×12 ft. storage closet. Fireplace in waiting room and consult room. Perfect for plastic surgeons, cosmetic dermatologists or other. $2,950,000 Call for details and appoint to view. 212-570-6060

 


 

Ground Floor Office with Private Street Entrance in Luxury Park Avenue Building
Rental includes: two consultation rooms, private office, private bathroom.  Common waiting room, back office filing space and reception desks included.  Affordable rent.  Location East 60s between Park and Lexington.  Easy distance to Lenox Hill Hospital and New York Cornell.  Subway access within 1 block.  Immediate occupancy available.  Call James: 917-710-7643


For Lease – Buffalo Area Urgent Care / Primary Care Clinic
Next door to only grocery store in town: Sav-a-Lot 4+ exam rooms, X-Ray room, Lab, Offices, etc. 3300 Sq Ft. – Fully built-out facility  ADA compliant Dunkirk New York
View full listing https://reporting.loopnet.com/report/3008dc65-60b8-4476-ab01-df4ffa2bc628.Contact geoff_jenkins@hotmail.com / (917) 825-4542


Upper East Side Medical Office Space for Rent Part–Time
Beautiful, newly renovated medical office on the Upper East Side between Lexington and Park Ave. Full service building with 2 entrances, conveniently located near all public transportation. Office includes 2 consult rooms, 3 exam rooms, treatment area, 2 bathrooms, kitchenette and reception area with waiting room. The office is available on a part-time basis. Please call 212-288-2278 or e-mail eastsidemedical@usa.net for further information.
Upper East Side Office lobby and receptions area


Park Avenue Office Share-3 Days Per Week
Tasteful, bright, well-maintained medical office in prestigious building on Park Avenue at 94th Street.  Large waiting room and reception area, consultation room and 2 exam rooms available 3 days per week. Room for an
assistant or clerical help 5 days per week. Please emailabgmdpc@gmail.com or call 987-5000


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




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



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


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


  

 


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

PHYSICIAN OPPORTUNITIES

Great Career Opportunities for Clinical Physicians
The NYS Department of Corrections and Community Supervision has great career opportunities for Clinical Physicians. You must have possession of a license and current registration to practice medicine in New York State, and have two years of post-licensure medical experience.

Starting salary is $143,381 – $171,631 *(Additional $10,000 or $20,000). Benefits include comprehensive health insurance, NYS retirement system, deferred compensation plan, flexible spending plan, and paid time off.

We have openings in the following counties offering a choice of urban, suburban or rural living:

Clinton*                  Clinton Correctional Facility (sporting and recreational outlets)
Dutchess                 Fishkill and Green Haven Correctional Facilities (Hudson River Valley Beauty)
Franklin*                 Franklin and Upstate Correctional Facility (North Country, 1 hour to Montreal)
Greene*                  Greene Correctional Facility (rural charm yet only 2 hours to New York City)
Oneida                    Mohawk Correctional Facility (Cooperstown, breweries)
Sullivan                   Woodbourne Correctional Facility (mountains, outlets, casinos and entertainment)
Seneca*                  Five Points Correctional Facility (heart of wine country)
St. Lawrence           Riverview Correctional Facility (hiking, boating and museums)
Washington             Great Meadow Correctional Facility (Between Vermont & the Green Mountains)
Westchester            Bedford Hills Correctional Facility (Less than 1 Hour to NYC)

Contact: www.doccs.ny.gov or DOCCS Personnel Office at (518) 457-8132 for more information and to apply.


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


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

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 


MSSNY eNews: June 28, 2019 – Surprise Bills Go National

Arthur Fougner MSSNY Presiident

PRESIDENT’S MESSAGE
Arthur Fougner, MD
MSSNY President

MSSNY eNews
June 28, 2019

Vol. 22  Number 25


MSSNYPAC Seal

 


Colleagues:

We’ve all seen Geico’s humorous “Surprising” ad campaign. Unanticipated or “Surprise Bills” are not so funny. This situation most often occurs when a patient seeks services from a participating physician or hospital but then requires services not covered by the patient’s insurance plan. Consequently, the patient receives a surprise bill, often a significant amount. Everyone agrees this issue is problematic. The real issue becomes how to deal with it. Caution: this may get wonky.

New York State took the lead on this issue with the nation’s first surprise bill law, Article 6 of Financial Services Law: Emergency Medical Services and Surprise Bills. Most importantly, this law removed the patient from this troubling billing situation, leaving the dispute now between payer and provider. The out of network provider bills the plan for the services. If the claim cannot be resolved, the plan pays “an amount the health care plan determines is reasonable for the health care services rendered, except for the insured’s copayment, coinsurance or deductible” and the dispute may now go for independent resolution much like baseball arbitration – the arbitrator decides which number – the physician’s charge or the plan’s proposed payment is more appropriate.  One of the factors utilized by independent resolution is the usual and customary charge for that service.

History

Let’s back up for some history. In 2009, a settlement was reached between then NY State Attorney General Andrew Cuomo and UnitedHealth Group over using Ingenix, a wholly-owned subsidiary of United, as the resource for “usual, customary, and reasonable” pay rates. This settlement established FAIR Health. For NY, FAIR Health is now the resource for UCR.

NY’s law works. No, make that NY’s law works well. Arbitration decisions have gone 50 – 50. Surprise Bill complaints have dwindled down to a trickle. So NY’s law should be the model for the nation, right? Well … not so fast. Congress is now dealing with this issue as well other vexing pricing problems. Because of this, the insurers are now getting another bite at this apple. Proposed legislation would similarly remove the patient from any dispute but would establish the In Network payment as the standard. This is troubling for several reasons not the least of which is that that rate most commonly is felt to be a “low ball” payment. For this reason, many specialty care physicians had chosen not to participate with the plan in the first place.  Perhaps even more often, health insurers chose to not contract with these physicians because they were trying to limit their networks.  Heck, if this were going to be the case, why do the plans fight so bitterly against “any willing provider” clauses and insist on narrowing networks?

Why would Congress choose to reward the health insurance industry for this abusive behavior?

Proposed Solution

Another proposed solution is an All Payer Database. (I warned you this would get wonky.) Turns out the APD often excludes information about many employer-provided ERISA plans which tend to be the highest payers and are therefore more heavily weighted toward lower payers such as Medicaid. Perhaps we should call them Some Payer Databases. NY uses FAIR Health. The nation should do the same.

This issue is important because it involves all physicians – employed and independent, in-network and out-of-network. Employed physicians depend on the success of independent doctors the same as in network doctors depend on the success of their out of network colleagues.  What is being debated ultimately becomes a ceiling and the insurers know this. They are mobilizing all resources for this issue. We need to do the same. The wrong national law may undo much of what NY has successfully accomplished. You have received and will continue to receive MSSNY alerts on this issue. Please answer the call. We need all hands on deck. Please send a letter to your Representative, and Senators Schumer and Gillibrand here.

 

Arthur Fougner, MD
MSSNY President 

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


MLMIC Insurance Banner Ad


 

eNews

Physicians Urged to Contact Schumer, Gillibrand and Members of Congress to Oppose Disastrous Surprise Medical Bill Legislation

All physicians are urged to contact Senators Schumer and Gillibrand, as well as their respective US Representative, to oppose disastrous legislation that would mandate out of network payment at insurer determined in-network levels, and in support of legislation to align with New York’s approach to surprise medical bills.  A letter can be sent from here.

This week the Senate Health, Education, Labor and Pensions (HELP) Committee advanced by a 20-3 vote S. 1895, the Lower Health Care Costs Act.  The surprise billing provisions of the bill are problematic because they would tie out-of-network payments to average in-network rates in situations where a patient did not have the opportunity to choose an in-network provision.  It also omits the independent payment arbitration process that has been supported by the AMA and state medical associations, and has been a successful model for New York.  Senator Dr. William Cassidy (R-LA) made strong comments against the surprise billing section in S.1895, noting that is it skewed heavily in favor of insurance companies.  He warned that letting insurance companies set rates will have dire consequence for rural and critical access hospitals that are already closing due to inadequate payments and it will exacerbate health care market consolidation problems.  Senators Hassan, Romney and Murkowski were also outspoken, expressing concerns with the contracted in-network rate benchmark and speaking in favor of including of an independent dispute resolution mechanism.

Separately, Congressman Ruiz, MD (D-CA) and a significant number of cosponsors from both sides of the aisle, including Representatives Morelle (D-Rochester), Stefanik (R-North Country) and Clarke (D-Brooklyn) from New York, introduced surprise billing legislation in the House that is based on New York model’s.

MSSNY has been working closely with other state medical associations, national specialty association, the Physicians Advocacy Institute and the AMA to oppose the health insurance industry gift that is S.1895, and to instead support legislation that aligns with New York’s approach.  MSSNY’s letter to Senators Alexander and Murray expressing strong concerns with S.1895 can be found here.


Physician Action Needed – Urge Governor Cuomo to Veto Liability Expansion Bills
Physicians are urged to contact the Governor to urge that he veto 2 bills passed at the end of the Legislative Session over the objections of many groups that could have the effect of driving up liability costs and creating an even more toxic malpractice adjudication system. Please take a minute to go to http://tiny.cc/VetoLiabilityBills and send a letter to Governor Cuomo urging him to veto these two bills and instead act to help bring down these costs through comprehensive reform.

S.6081/A.2372 will add costs to the system by requiring non-settling co-defendants in a tort action to choose whether to reduce their liability exposure by the stated settlement amount of a co-defendant or the settling co-defendant’s allocated percentage of fault prior to the first opening statement of the trial.  It would force these defendants into making a “blind gamble” and would enable in many cases the total payout to a plaintiff to actual exceed a jury’s award. There is little justification to this proposal other than increasing lawyer fees.

S.6552/A.2373 will also add new costs to the system, again with little justification. The bill would allow plaintiffs to collect a judgment from a third party that is not a direct party to the lawsuit in question. The bill would permit this to occur even though the plaintiff had not sued or perhaps could not have sued the third-party defendant in the first instance.

These bills have also been opposed by hospital associations and the insurance industry.

These bills would exacerbate an already onerous system. New York was recently granted the dubious distinction of having by far and away the highest cumulative medical liability payouts in the country. Of course, this is not the first time that our state has been “honored” with this distinction. In New York we pay out nearly two times as much as in the state with the next highest amount. We also pay out the highest amount per capita.

Yet instead of trying to address this problem, these two bills would make this problem even worse.

It is imperative that the Governor and legislators take action to ensure that physicians and hospitals remain available to deliver the quality and timely care our patients expect and deserve to receive. A critical element to this is acting to reduce the choking costs of medical liability insurance and stopping one-sided proposals that will undoubtedly raise these costs. We urge the Governor to work towards comprehensive reform to enable a comprehensive supply of physicians across New York, rather than enabling cynical attempts to increase lawyer fees at the expense of patient care.

URGE A VETO OF ONEROUS LIABILITY EXPANSION BILLS! CLICK HERE

 



Two NY Healthcare Groups Lose EHR Access Following Ransomware Attacks
Both Olean (N.Y.) Medical Group and Seneca Nation Health System in Salamanca, N.Y., have lost access to their computer and EHR systems following recent cyberattacks on the organizations, Olean Times Herald reports.

OMG, which serves around 40,000 patients, said that no patient records or information were compromised as a result of the ransomware attack, according to the publication. The medical group has been completing patient charting by paper since the organization’s computer systems and EHR were infected with the ransomware June 11, OMG CEO Christine Strade told Becker’s Hospital Review.

The hacker demanded “a significant amount of money,” in exchange for access to the systems’ files, which OMG did pay, Ms. Strade confirmed. The group is working to restore all the encrypted files.

Seneca, which is not affiliated with OMG, also maintained security of patients’ protected health information following the attack on its health system, according to a statement from Mark Halftown, acting CEO, published to the health system’s website. He added that while access to patients’ electronic charts and the hospital’s scheduling system is currently down, Seneca is still seeing patients.

“We are working feverishly to rebuild our system and we apologize for any inconvenience,” Mr. Halftown wrote.

OMG hired Kivu, a cybersecurity forensic group, to investigate the attack, according to the report. After its review, the forensic group determined numerous attacks, which mostly came from Eastern Europe and Africa, against OMG had been stopped by the medical group’s security system prior to the breach.

It is not clear whether the ransomware attacks on both organizations originated from the same hacker. (Becker’s Hospital Review June 20)


Opioid Prescriptions Tied to Higher Overdose Risk among Family Members
People whose family members have opioid prescriptions face increased risk for opioid overdose themselves, according to a case-control study in JAMA Internal Medicine.

Using claims data from 2004 to 2015, researchers matched roughly 2300 people with opioid overdose to 9200 controls without overdose. Having a family member with a prior opioid prescription was associated with nearly triple the odds of overdose. Additionally, the overdose odds increased when more opioids were prescribed. Children aged 0 to 12 years had a fourfold increase in overdose risk when a family member had a prescription, but risk was increased across most age groups.

The authors conclude: “Interventions may focus on opioid dispensing limits, encouraging patients to properly dispose of prescription opioids after use, enhancing patient and public education, and using secure medication storage boxes to limit the risk of opioid overdose among other household family members. Treating and preventing opioid overdose events at the family level, as well as expanding access to opioid antagonists, should also be considered.”

JAMA Internal Medicine article; Background: Physician’s First Watch coverage of parental opioid use and suicide attempts among offspring

 


 

NY Rx Card Banner


Lawsuit Filed in North Dakota Claims State Law Forces Physicians to Lie
The AP (6/25) reports a federal lawsuit filed by the only abortion clinic in North Dakota claims state law “forces doctors to lie, including one measure passed this year requiring physicians to tell women that they may reverse a so-called medication abortion if they have second thoughts.” The suit was filed by “the Center for Reproductive Rights on behalf of the Red River Women’s Clinic and the American Medical Association” and “also targets an existing law requiring doctors to tell patients that abortion terminates ‘the life of a whole, separate, unique, living human being.’” The suit “asks a judge to block enforcement.” AMA President Patrice A. Harris, M.D., told the AP, “The AMA will step in when there is any interference with our ability to talk to our patients about legal, evidence-based medical procedures.” Dr. Harris also “said AMA lawyers are monitoring abortion laws in all states and decided North Dakota’s was the next case to be ‘actively involved in.’”

For more information on this lawsuit, see the AMA’s press release

Vaccine Panel Downgrades Pneumonia Shot Recommendation for Seniors
The AP (6/26) reports the Advisory Committee on Immunization Practices “said routine vaccination with Pfizer’s Prevnar 13 [pneumococcal vaccine] shot was no longer necessary for all healthy people 65 and older.” The panel’s recommendation will likely be adopted by the Centers for Disease Control and Prevention. Vaccine injury claims are rare, federal data show

Research Offers Clue to Lyme Arthritis Found in Patients’ Inflamed Joints
“A small but significant number of people with Lyme disease continue to suffer from symptoms long after finishing an antibiotic treatment,” and “the mystery of why may have come closer to being solved with a study…that found that bits of the Lyme bacteria can persist in patients’ inflamed joints even after taking antibiotics.” Investigators “examining synovial fluid from those inflamed joints also found antibodies to the persisting molecules, called peptidoglycans, that come from the outer covering of the Lyme bacteria, according to the study.” The findings were published in the Proceedings of the National Academy of Sciences. https://www.pnas.org/content/early/2019/06/11/1904170116

 


Garfunkel Ad


Classified

RENTAL/LEASING SPACE

Prestigious Park Ave Office Near Lenox Hill Hospital for Sale
2,400 sq/ft on two levels with a separate 6×12 ft. storage closet. Fireplace in waiting room and consult room. Perfect for plastic surgeons, cosmetic dermatologists or other. $2,950,000 Call for details and appoint to view. 212-570-6060


Ground Floor Office with Private Street Entrance in Luxury Park Avenue Building
Rental includes: two consultation rooms, private office, private bathroom.  Common waiting room, back office filing space and reception desks included.  Affordable rent.  Location East 60s between Park and Lexington.  Easy distance to Lenox Hill Hospital and New York Cornell.  Subway access within 1 block.  Immediate occupancy available.  Call James: 917-710-7643


For Lease – Buffalo Area Urgent Care / Primary Care Clinic
Next door to only grocery store in town: Sav-a-Lot 4+ exam rooms, X-Ray room, Lab, Offices, etc. 3300 Sq Ft. – Fully built-out facility  ADA compliant Dunkirk New York

View full listing https://reporting.loopnet.com/report/3008dc65-60b8-4476-ab01-df4ffa2bc628.

Contact geoff_jenkins@hotmail.com / (917) 825-4542

 


Upper East Side Medical Office Space for Rent Part–Time
Beautiful, newly renovated medical office on the Upper East Side between Lexington and Park Ave. Full service building with 2 entrances, conveniently located near all public transportation. Office includes 2 consult rooms, 3 exam rooms, treatment area, 2 bathrooms, kitchenette and reception area with waiting room. The office is available on a part-time basis. Please call 212-288-2278 or e-mail eastsidemedical@usa.net for further information.
Upper East Side Office lobby and receptions area



Park Avenue Office Share-3 Days Per Week
Tasteful, bright, well-maintained medical office in prestigious building on Park Avenue at 94th Street.  Large waiting room and reception area, consultation room and 2 exam rooms available 3 days per week. Room for an
assistant or clerical help 5 days per week. Please email abgmdpc@gmail.com or call 987-5000


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


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




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


 

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

  

 


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


PHYSICIAN OPPORTUNITIES

Great Career Opportunities for Clinical Physicians
The NYS Department of Corrections and Community Supervision has great career opportunities for Clinical Physicians. You must have possession of a license and current registration to practice medicine in New York State, and have two years of post-licensure medical experience.

Starting salary is $143,381 – $171,631 *(Additional $10,000 or $20,000). Benefits include comprehensive health insurance, NYS retirement system, deferred compensation plan, flexible spending plan, and paid time off.

We have openings in the following counties offering a choice of urban, suburban or rural living:

Clinton*                  Clinton Correctional Facility (sporting and recreational outlets)
Dutchess                 Fishkill and Green Haven Correctional Facilities (Hudson River Valley Beauty)
Franklin*                 Franklin and Upstate Correctional Facility (North Country, 1 hour to Montreal)
Greene*                  Greene Correctional Facility (rural charm yet only 2 hours to New York City)
Oneida                    Mohawk Correctional Facility (Cooperstown, breweries)
Sullivan                   Woodbourne Correctional Facility (mountains, outlets, casinos and entertainment)
Seneca*                  Five Points Correctional Facility (heart of wine country)
St. Lawrence           Riverview Correctional Facility (hiking, boating and museums)
Washington             Great Meadow Correctional Facility (Between Vermont & the Green Mountains)
Westchester            Bedford Hills Correctional Facility (Less than 1 Hour to NYC)

Contact: www.doccs.ny.gov or DOCCS Personnel Office at (518) 457-8132 for more information and to apply.


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


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

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 


MSSNY eNews: June 21, 2019 – A Funny Thing Happened on the Way to Legalization

Arthur Fougner MSSNY Presiident

PRESIDENT’S MESSAGE<
Arthur Fougner, MD
MSSNY President

MSSNY eNews
June 21, 2019

Vol. 22  Number 24


MSSNYPAC Seal

 


Colleagues:

As the NY State Budget was being prepared, revenue generated from the legalization of “adult use” marijuana figured prominently in Albany’s calculus.

The State Department of Health released a 96 page report which concluded that the benefits outweighed any risks of legalization. “Listening tours,” usually the sign of a done deal, were held all over NY State. While these meetings were being scheduled, then MSSNY President, Dr. Thomas Madejski of Orleans County didn’t just say no. Dr. Madejski said: “Hell, No” as he recruited physicians all over the state to testify at these meetings.

Slowly, the tide began to turn as not only MSSNY but law enforcement, substance use specialists and county health departments weighed in. Then, enter the PTAs. That did it. Marijuana was no longer a part of the budget. The legislators now worked on stand-alone bills for legalization. However, at this point, articles began to appear in the press which countered many of the arguments in favor of legalization. Visits to Emergency Departments had increased. Revenues were less than advertised. Legalization had not eliminated the black market. Big Pot was poised to supplant Big Tobacco.

Dr. Madejski’s “Just Say Know” campaign on social media soon attracted allies from other states as NJ and CT also threw up roadblocks to legalization. While the dust has not quite settled in Albany, it’s now clear that Albany’s “done deal” is indeed done.  Legal recreational pot in NY State is not happening in 2019.

Willie Nelson won’t be celebrating in Albany this year.

Horatius at the Bridge
When the goodman mends his armor,
And trims his helmet’s plume;
When the goodwife’s shuttle merrily
Goes flashing through the loom;
With weeping and with laughter
Still is the story told,
How well Horatius kept the bridge
In the brave days of old.
By Thomas Babington, Lord Macaulay

Arthur Fougner, MD
MSSNY President 

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


MLMIC Insurance Banner Ad


Podcast SymbolThis Week’s Podcast of MSSNY’s Legislative Priorities


Capital Update

Legislative Session Wrap Up; Brings Several Positive Outcomes for Physicians
The State Legislature worked through the night to wrap up its 2019 Legislative Session, one of the most memorable in recent years given the breadth of issues the Legislature decided to address following the power-shifting election which occurred last November.  Despite the many threats we faced, the Session produced several “wins” for physicians and their patients, though some adverse bills were also passed that will require MSSNY and others to request vetoes from the Governor.

Your DGA staff thanks the many physicians and county society staff who took the time to make phone calls, write letters, send tweets and personally meet with their local legislators on the myriad of issues which we prioritized our advocacy.  Moreover, we thank the numerous specialty societies we regularly partnered with to help achieve these outcomes.  Among the highlights of the last few weeks of Session:

  • Enactment of legislation supported by MSSNY which ensures that medical contraindications are the only acceptable exception to vaccine requirements;
  • Passage of legislation supported by MSSNY which significantly curtails health insurers making mid-year changes to their prescription formularies; or increasing patient cost sharing;
  • Passage of legislation supported by MSSNY which will provide extensive new regulation of Pharmaceutical Benefit Managers (PBM);
  • Passage of legislation supported by MSSNY that permits a prescriber to arrange with a pharmacist to “partially fill” a patient prescription for opioid medication;
  • Passage of legislation supported by MSSNY to reduce insurer prior authorization (PA) requirements when a PA for a related procedure has already been received;
  • Defeat of legislation opposed by MSSNY that would have legalized adult use marijuana, as well as proposals that would have significantly expanded the medical marijuana program.  Instead legislation was enacted supported by MSSNY that provides further “decriminalization” of small amounts of marijuana;
  • Defeat of every major scope of practice expansion bill opposed by MSSNY, including pushing back against aggressive efforts by podiatrists and optometrists;
  • Defeat of numerous trial lawyer backed bills opposed by MSSNY which could have greatly expanded lawsuits or damage awards against physicians, or made it much more difficult to defend a lawsuit.  It should be noted that the Legislature did pass a couple of smaller measures opposed by MSSNY and many other groups that will affect certain cases involving multiple defendants and where an adverse judgment has been reached;
  • Defeat of several bills opposed by MSSNY that would have overridden physician clinical judgment and added even more requirements on physicians prior to prescribing opioid medications to patients.

See below for a more detailed summary of these issues.                                   (DIVISION OF GOVERNMENTAL AFFAIRS) 


Physician Advocacy Urged to Prevent Congressional Attempts to Undermine New York “Surprise Bill” Law
Physicians are urged to send a letter Please click Here: to Senators Schumer and Gillibrand, as well as your local US Representative, urging your member of Congress to fight for a “surprise medical billing” law that is consistent with New York’s approach.  This week, US Senators Lamar Alexander (R-TN) and Patty Murray (D-WA) released a bill that would seriously undermine New York’s proven model and greatly diminish the ability of physicians to fairly negotiate patient care terms with market dominant health insurers.

Instead of the disastrous Alexander-Murray bill, MSSNY and many other physician advocacy organizations have praised a proposal advanced by Representative Joe Morelle (D-Rocheseter) together with Representative Dr. Phil Roe (R-TN) and Dr. Raul Ruiz (D-CA), that seeks to mirror New York’s law, which uses a “baseball arbitration” Independent Dispute Resolution (IDR) system to determine payment for out of network medical care, and uses charge data collected by an independent database as a leading benchmark to guide the IDR.

Specifically, the Alexander-Murray bill would require an insurer determined in-network based default rate for out of network surprise medical bills.  This would give enormous new powers to already market dominant insurers, and fails to recognize the insurance industry’s fault in creating this problem due to their narrow networks.  MSSNY has written to New York’s Congressional delegation praising the approach set forth by Representatives Morelle, Roe and Ruiz, and raising strong concerns with other proposals.  Specifically, New York’s letter raised concerns with the insurance industry’s own notorious history in establishing benchmarks for out of network payment, and the history of then-Attorney General Cuomo’s investigation which found that by using a flawed and conflicted database to determine reimbursement rates for out-of-network care, insurers were increasing profits at the expense of patients and physicians.

Moreover, it was noted that New York’s law struck a tenuous balance among various health care stakeholders that protected patients from surprise medical bills and assured that hospital emergency departments had access to needed on-call specialty care.

MSSNY has been working with several other state medical associations and national specialty societies in its advocacy to Congress.  Please see here for a short “Fact Sheet” developed by the Physicians Advocacy Institute that sets forth key principles for Congress to consider in this debate Please click here:  (AUSTER)



NYS Legislature Moves to Decriminalize Marijuana; Does Not Permit Legalization of Marijuana
Legislation to permit the legalization and commercial sales of recreational use marijuana did not happen this year. However, a measure to decriminalize possession of small amounts of marijuana was successful.  A.8420A/S.6579A, sponsored by Assembly Majority Leader Crystal Peoples-Stokes and Senator Jamaal T. Bailey, provides for further decriminalization of certain low level marijuana possession offenses and for expungement of the records.  Governor Cuomo has indicated that he will sign this measure.  The Medical Society had also indicated for support of the measure as it was consistent with MSSNY policy.

The legislature also did not act on legislation to expand the medical marijuana program, through a bill opposed by MSSNY that would eliminate the “serious condition” threshold for certifying a patient for medical marijuana, enable smoked versions of medical marijuana, and allow any “practitioner” who is authorized to prescribe controlled substances with the state to certify a patient for medical marijuana use.

MSSNY worked with the New York State Association of County Health Officials (NYSCHO), the PTA, the NYS Sherriff’s Association and Smart Approaches to Marijuana (SAM) in getting a unified message to the legislature about the potential impact of marijuana on young people as well as the adverse public health impacts in other states.  MSSNY also credits several members of the Legislature with bringing those concerns back to the members of their respective houses. (CLANCY, AUSTER)


Legislature Passes Bill to Curtail Mid-Year Formulary Changes by Health Plans
The Senate and Assembly gave final passage to legislation this week that would substantially limit the ability of health insurers to make changes to their prescription medication formularies during a policy year.

The legislation (A.2969, People-Stokes/S.2849, Breslin) would prohibit a health insurer from removing a prescription drug from a formulary during the patient’s policy year.  Moreover, if the plan’s drug formulary has two or more tiers of drug benefits with different deductibles, copayments or coinsurance, the plan may not move a drug to a tier with higher patient cost sharing during the policy year. It also prohibits the plan from adding new or additional formulary restrictions during the policy year.

The legislation does permit an insurer to move a prescription drug to a tier with a larger copayment, coinsurance and different deductible only if an AB-rated generic equivalent drug or interchangeable biological product is added to the formulary at the same time.  MSSNY supported this legislation and worked with several patient advocacy organizations to advocate for its passage.         (AUSTER, AVELLA)


 

NY Rx Card Banner


Pharmacy Benefit Manager Licensure and Regulation Passes Both Houses
Legislation that will require licensure for pharmacy benefit managers (PBMs) and outline their duties and responsibilities has passed both houses and awaits the governor’s signature. Senator Breslin and Assemblymember Gottfried’s bill (S.6531/A.2836A) passed the final week of session and will implement measures to provide clarity and oversight of PBMs and requires PBMs to act in the best interest of covered individuals, health plans and providers.

PBMs will be required to register with the Superintendent of Insurance and will require renewal of their license every three years. Licensure will be contingent upon meeting minimum standards established by DFS and the Commissioner of Health. PBMs will be required to address any conflicts of interest, deceptive practices, anti-competitive practices, and unfair claims practices. They will also be required to disclose plans with whom they contract and terms and conditions placed on their pharmacy networks. Per Trish Riley, the Executive Director of the National Academy for State Health Policy, New York’s policy will go the furthest in the nation toward regulating PBMs.                               (AVELLA)


Legislature Passes Bill to Reduce Certain Prior Auth Requirements to Prevent Interruption of Patient Care Services
The Assembly and Senate gave final passage this week to a measure to reduce insurer prior authorization (PA) requirements when a PA for a related procedure has already been received.  The bill, A.2880-B, Hunter/S.5328-B, Breslin, would ensure that if a physician providing a treatment to a patient for which a PA has been received determines that providing  an  additional  or related  service or procedure  is “immediately necessary as part of  such  treatment”  and  would  not  be  “medically  advisable  to  interrupt  the  provision of care to the patient” in order to obtain a PA, then the insurer shall not deny the claim, except under limited circumstances.

Specific patient scenarios this legislation is seeking to address include when a patient receiving chemotherapy needs to quickly receive treatment for related health issues, such as nausea, low platelet count or allergic reactions, without the need for the physician to ask and receive an additional PA from the insurance company.  MSSNY supported this legislation.                                (AUSTER) 


Partial-Fill Legislation Passes New York State Legislature; Bill Goes to Governor
Assembly Bill 3918 and Senate Bill 1813, Which was sponsored by Assemblymember John McDonald and Senator Gustavo Rivera would allow physicians to prescribe a controlled substance, on a partially filled basis and has passed the New York State Legislature. The measure will now go before Governor Cuomo for his consideration. Passage of this measure allows New York State to align itself with the federal law; partial fills were authorized on a federal level under the Comprehensive Addiction and Recovery Act (CARA).

This measure would allow physicians/prescribers, in consultation with their patient, to prescribe up to a 30 – day supply of a controlled substance with a notation to the pharmacist that he/she should only dispense the agreed – to amount.   Each partial filling would be dispensed and recorded in the same manner as a refilling (i.e., date refilled, amount dispensed, initials of dispensing pharmacist, etc.), and the total quantity dispensed in all partial fillings may not exceed the total quantity prescribed.

The Medical Society of the State of New York believes that this measure will now allow prescribers to help patients balance the need to relieve pain with an adequate supply of medication by only filling part of the prescription. Should they need additional pain relief; patients will be able to return to the pharmacy to fill the remaining portion of their prescription.  (CLANCY)


Maternal Mortality Board Fine-Tuned on Last Day of Session
Senator Rivera and Assemblymember Joyner passed legislation (S.6529/A.8338) to make technical changes to the maternal mortality legislation board that was passed earlier this year, & supported by MSSNY & ACOG. This bill will ensure that the board’s makeup is representative of the racial, ethnic and socioeconomic diversity of women and mothers in the state and to the extent possible, representative of areas that are medically underserved and areas with high occurrences of maternal mortality and morbidity. It also clarifies how committee members will be appointed and what information the commissioner may request from health departments and other public authorities.            (AVELLA)


Cesarean Section Mandate Fails to Pass in 2019
Legislation that would have required physicians and other health care providers to provide maternity patients with written information regarding the risks associated with Cesarean section passed the Assembly, but not the Senate. This bill, S.2888/A.318, which is sponsored by Senator Salazar and Assemblymember Paulin is opposed by MSSNY and the American College of Obstetricians and Gynecologists (ACOG).

This bill was opposed by MSSNY and ACOG for a variety of reasons, including the fact that the bill’s terminology is not consistent with accepted medical practice. Additionally, physicians already seek informed consent – this bill would interfere with the physician-patient relationship by requiring boilerplate, pre-determined written communication. This goes against the concept of patient-centered, custom provision of care that differs from patient to patient.

Further troubling to MSSNY is the recent trend in New York and across the nation to mandate discussions and/or certain actions by physicians. While these measures are well-intended, they do patients a disservice by interfering with their relationship with their doctor and often may prove to be more harmful than helpful. (AVELLA)


Legislature Rejects Liability Expansion Legislation with Huge Premium Impacts; Passes Others Affecting Cases with Multiple Defendants
Despite trial lawyers aggressively pushing the State Legislature on a litany of adverse bills in the Session’s final days, the Legislature left Albany without taking action on many of their priority bills that would have significantly driven up already excessive liability costs for physicians, hospitals and other business entities, and made it far more difficult for a physician to defend themselves in a medical liability action.  These bills included legislation that would have: exponentially expanded awardable damages in wrongful death lawsuit (S.4006/A.5612); prohibited a defendant physician’s defense counsel from interviewing a medical malpractice plaintiff’s treating physician (S.6194/A.2370); and permitted the admissibility of certain “hearsay” statements of employees in civil actions (A.7599/S.6335).

With significant objections from MSSNY, numerous specialty societies, HANYS and GNYHA, the Legislature did pass 2 bills affecting certain cases involving multiple defendants where the jury has awarded a judgment for the plaintiff, including:

  • A.2372/S.6081 – would permit a plaintiff to collect on a court judgment directly against a third party defendant that had been sued by the original defendant for contribution and indemnification.  The concern is that this type of practice could encourage those parties unable to satisfy their apportioned share of liability to dodge their responsibility, while allowing a plaintiff to target a deep-pocketed third party.
  • A.2373/S.6552 – would require a non-settling co-defendant in a tort action, where another co-defendant has settled, to choose whether to reduce his/her liability exposure by the stated settlement amount or the settling tortfeasor’s equitable share prior to a trial, instead of after a jury verdict has been reached.  The concern is that it forces the non-settling defendants to make a blind choice without knowing the ultimate outcome of the trial, with the risk that if the co-defendant makes the “wrong choice”, a plaintiff could receive a recovery above what the jury awarded.

MSSNY will be working with other groups to request that the Governor vetos these 2 bills given their likely inflationary impact on overall medical liability costs, which already are by far and away the highest in the country.                       (AUSTER)


Legislature Passes Bill to Provide Greater Clarity to Medical Record Disbursement When Physician Retires
The Senate and Assembly gave final passage this week to legislation setting forth procedures to follow when a physician or other health care practitioner decides to cease to stop providing patient care in New York State.  The goal of the legislation (A.2349/S.5367) is to address the often-asked question of where patient records should be sent when a physician or other care provider retires from medical practice or moves to another state.   Specifically, the legislation requires the practitioner, at least 30 days prior to ending their practice, to make a good faith effort to notify the practice’s “current patients” of the impending closure and of the patient’s right to request their patient information or medical records be sent to the health care provider, facility, or practitioner of their choice or returned to the patient.

The bill does not define what is considered to be a “current patient”.  The bill does, however, clarify that the provisions of the bill do not apply to situations where a physician’s practice is acquired or merged with another entity, and the physician continues to deliver care to patients.  MSSNY is continuing to review the legislation with its General Counsel and will submit comments to the Governor’s office when the bill is delivered to the Governor.                              (AUSTER)  


Opioid Measures Not Acted on By Legislature
There were several measures that related to opioid prescribing that would have imposed even more requirements on physicians prior to prescribing opioids that failed to win passage.  The bills are:

  • 8256/S.5867A, moved to the Assembly calendar but was not voted on by the full Assembly. This legislation would have amended the public health law to require health practitioners, before prescribing an opioid medication, to consider discussing with the patient and refer or prescribe alternative services such as chiropractic, massage therapy or behavioral therapy.
  • 5603/S.5150, moved to the Assembly Ways and Means Committee and to the Senate calendar but was not acted on by either house. This legislation would have amended the public health law to require that prescribers, who prescribe opioids for the first time must also co-prescribe an opioid antagonist with the prescription.
  • 7285A/S.4277A, passed the Senate but was not acted upon in the Assembly. The legislation would have amended the public health law to require health practitioners who prescribe an opioid or other Schedule II Controlled Substance to discuss with the patient the risks of being prescribed a CSII drug, other co-prescribe an opioid antagonist.

(CLANCY, AUSTER)


Efforts to Expand Scope of Practice Legislation Pending on Senate Calendar for a Vote
There are several bills that would have expanded the scope of practice of various professions that moved forward in the New York State Senate but failed to win approval in the Assembly. MSSNY worked together with several specialty societies to advocate on these issues.  The Medical Society had opposed the following measures:

  • 5395/A.6185, would have inappropriately expanded the scope of practice of podiatrists the following ways: by reducing certification requirements for podiatrists seeking to have advanced surgical privileges; removing the requirement that a podiatrist seeking either standard ankle surgery or advanced ankle surgery privileges be directly supervised by a podiatrist with an advanced license from the NYSED or a physician; and enabling podiatrists to treat wounds that are not contiguous with structures of the foot or ankle. This measure was approved by the Senate, but failed in the Assembly.
  • 1193, would have permitted Optometrists to prescribe oral antibiotic and other medications. The bill failed to advance out of the Higher Assembly Ed committee.
  • 5092/A.3867, would have added pharmacists to the list of licensed health care professionals authorized under public health law to perform non-invasive laboratory tests as an adjunct to their professional services, without an order from a physician. The measure advanced in the Senate, but failed to move in the Assembly.
  • 5227/A.6511A, would have allowed pharmacists to provide ALL immunizations on the Advisory Committee on Immunizations Practices (ACIP) list recommended for adults.This would more than double the number of immunizations pharmacists would be permitted to provide. The measure advanced in the Senate, but failed to move in the Assembly.
  • 4975/A.6486, would have authorized a pharmacist to administer vaccines for hepatitis A, hepatitis B, and human papillomavirus to adults via a patient or non-patient specific script. The measure advanced in the Senate, but failed to move in the Assembly.                                                                                                   (CLANCY, AUSTER)

Joint Statement Issued by DOH, Office of Children and Family Services, SED on Non-Medical Exemptions—Measles Outbreak Continues
The New York State Department of Health, the Office of Children and Family Services, and the State Education Department has issued a joint statement on the law that removed non-medical exemption from school vaccination requirements.  According to the statement, as of June 13, 2019, “there is no longer a religious exemption to the requirement that children be vaccinated against measles and other diseases to attend either a public, private or parochial school (for students in pre-kindergarten through 12th grade or child day care settings.”

For those children that have had a religious exemption to required immunizations, they must receive their first age appropriate dose in each immunization series by June 28, 2019 to attend or remain in school or child care.  A copy of the joint statement and Frequently Asked Questions about the legislation can be found at: Please click Here.

Physicians and other providers who provide immunizations to children are advised to be prepared to see an increase in children who need these vaccines and to try their best to accommodate them into their practice.  As summer and travel begins, there will be an increased demand for immunizations for both children and adults. The measles outbreak continues to grow in New York State.  There is continued ongoing transmission of measles in communities in NYS with the majority of cases in those who are unvaccinated or under- vaccinated. The New York State Department of Health has issued a June 14, 2019 health advisory that says:  Please click Here

  • Since October 1, 2018, there have been 932 cases reported in NYS: including 267 in Rockland County, 49 in Orange County, 18 in Westchester County, 8 in Sullivan County, and 588 in New York City (NYC).
  • Providers should NOT rely upon self-report of vaccination as evidence of immunity. If there is no record of vaccination or evidence of immunity (and no contraindication), the patient should be vaccinated.
  • For adults in outbreak areas, the NYSDOH recommends administration of a second dose of a measles-containing vaccine (MMR) for adults with one documented dose of a measles-containing vaccine.
  • For adults in non-outbreak areas, recommendations have not changed. One dose of a measles containing vaccine (or other presumptive evidence of immunity) is sufficient for most adults.
  • Healthcare providers need to maintain vigilance for measles and immediately report any suspect cases by telephone to the local health department (LHD) where the patient resides.                                                       (CLANCY)

A Big Thank You for Physician Advocacy Efforts!
MSSNY’s Physician Advocacy Liaison (PAL) network was instrumental in helping to achieve our numerous legislative victories, by helping us quickly respond to legislators who needed to hear the physician perspective on a number of issues. As always, thank you for the work all of you do on a daily basis, and for taking the additional time to be active in the legislative and budgetary process. There is no doubt that your efforts were a major contributor to our successes.

While another legislative session has wrapped up in Albany, MSSNY is still actively looking to expand the PAL network.  The PAL network is a vital way for elected officials to hear directly from their physicians and a way to make certain that our leaders remain committed to championing the issues that matter most to MSSNY members and their patients.

For more information on the PAL network or to sign-up, click Please click Here: (HARRING)


Measles Outbreak in New York State Continues to Spread Webinars Available at MSSNY CME Website
Did you know that 90% of the 1,044 measles cases in the United States are right here in New York?  The number of measles cases in New York State in 2019 has again seen an uptick over the past week.  943 of the 1,044 confirmed cases nationwide are in New York State. In 2019 there have been 596 confirmed cases in New York City and 323 outside of New York City (268 in Rockland; 51 in Orange; 18 in Westchester; 8 in Sullivan; 1 in Suffolk and 1 in Greene counties) confirmed cases as of June 17th.  MSSNY conducted a just-in-time Medical Matters webinar entitled “The Continued Public Health Threat of Measles 2018” in December, 2018.

This webinar has now been posted to the MSSNY CME website. You can also view MSSNY’s latest Medical Matters webinar entitled “What’s Your Diagnosis? Infectious Diseases” which involves a patient with a fever and a rash. Please check these out and keep yourself informed about the growing measles outbreak throughout New York State.  You can also listen to MSSNY’s newest podcasts on the current measles outbreak for both physicians and patients At as well as a brief podcast on the Measles, Mumps and Rubella vaccine at the same site.         (HOFFMAN, CLANCY)


Please Join Us for MSSNY’s Physicians’ Day at the Races
MSSNY’s 2nd Physicians’ Day at the Races will take place on Saturday, July 27, 2019 at the Saratoga Race Course “The Rail at the 1863 Club” in Saratoga Springs, NY.

Please join your friends and colleagues for a great event to benefit your profession.  MSSNY uses its resources and mobilizes support from elected officials who will stand and fight for us, regardless of what party they are from.  MSSNYPAC allows us to pool our resources and together, make a difference against other special interest that continues to try to undermine the delivery of quality health care.  MSSNY continues to develop new fundraising opportunities for our physicians to become more active.

Tickets:
$500/Physician
$300/Guest

Ticket price includes clubhouse admission, post parade programs, a gourmet buffet lunch at your own trackside table (11:30am-2:30pm), open bar, private viewing of the horses as they bring them from the paddock and private betting windows with a 1:00pm post time.

For more information, click Please click Here. Contact Jennifer Wilks at 518-465-8085 or jwilks@mssny.org to secure tickets.              (HARRING)                                                             


   

                                              


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

Garfunkel Ad


NYS Workers’ Comp Board to Provide Training at Regional Conferences
The New York State Workers’ Compensation Board (Board) has announced a series of three regional conferences to take place this summer in Albany, Rochester, and New York City. The half-day, afternoon sessions are open to anyone with an interest in the New York State workers’ compensation system, and will highlight important advances in workers’ comp, as well as provide Continuing Legal Education (CLE) and Continuing Medical Education (CME) courses.

The conferences come on the heels of several significant Board initiatives, including New York’s first drug formulary and revised medical fee schedules that provide higher reimbursements to health care providers who treat injured workers. Additionally, the Board is gearing up to implement a new law that takes effect on January 1, 2020, that enables more types of health care providers to be authorized to treat workers’ compensation patients. In addition to a general overview highlighting recent accomplishments, attendees can also choose other sessions to attend for a deeper dive into key topics, such as:

  • Legal update: significant case law, developments in adjudication and legislation (CLE)
  • Ethical considerations in appearing before the Board (CLE)
  • Medical marijuana in NYS workers’ compensation (CLE/CME)
  • Impairment guidelines for determining schedule loss of use (CME)
  • Understanding variances and the drug formulary (CME)
  • Combatting fraud
  • Best practices in workers’ compensation
  • Intro to workers’ compensation for new providers

The regional schedule is below:

  • Albany
    Monday, July 1
    Empire State Plaza Convention Center
    Concourse Level Albany, NY 12242
  • Rochester
    Wednesday July 31
    Hyatt Regency Rochester
    125 East Main Street
    Rochester, NY 14604
  • New York City
    Monday, August 5
    New York Marriott Downtown
    85 West Street at Albany Street
    New York, NY 10006

The cost is $50 to attend, with hardship scholarships available to those who qualify. Registration is limited and will be granted mainly on a first-come, first-served basis. However, special consideration will be given to those seeking CME/CLE credits.

For complete details and to register, visit bit.ly/WCBconference19.

More information is also available at the Board’s website at wcb.ny.gov or by emailing outreach@wcb.ny.gov.


Attention: All Physicians
Do You Know about Having to Research Exclusionary Databases of Your Managing Employees?
MSSNY has heard from several physicians and specialty societies regarding the significant burdens associated with a requirement that managed care companies are imposing on its participating physicians to check numerous databases on a monthly basis.   The Office of the Medicaid Inspector General (OMIG) checked with their Office of Counsel (OOC) and it’s their interpretation of the contract that MCOs must require their participating providers to check exclusion lists for their managing employees, not all their employees.

Network physicians are being instructed by managed care organizations to conduct routine checks of Federal and State databases. These include the Social Security Administration’s Death Master file, and the National Plan and Provider Enumeration System (NPPES), and the Excluded Parties List System (EPLS), and either the List of Excluded Individuals and Entities (LEIE) or the Medicare Excluded Database (MED), the NYS OMIG Exclusion List, and any such other databases as the Secretary may prescribe; and check the LEIE (or MED), the EPLS and NYS OMIG Exclusions List no less frequently than monthly.

The NYS DOH has stated that this is a requirement for providers seeing Medicaid patients (and receiving public dollars), whether they are in FFS or managed care. Plans are enforcing the requirement.

Are you aware of this?  Please provide your feedback to MSSNY at csouthard@mssny.org or rmcnally@mssny.org


NYS Buprenorphine Waiver Eligibility Trainings for Clinical Providers

Summer 2019

The NYSDOH AIDS Institute in partnership with various local health departments are sponsoring free Buprenorphine Waiver Eligibility Trainings for Clinical Providers. In response to opioid overdose deaths in New York State, increased access to buprenorphine treatment for Opioid Use Disorder (OUD) is urgently needed. Physicians, Nurse Practitioners, Physician Assistants and Medical Residents are highly encouraged to attend.
Under current regulations, authorized practitioners (MDs, DOs, NPs & PAs) are required to obtain a ‘waiver’ to prescribe buprenorphine. To acquire this waiver, physicians are required to complete a standardized 8-hour buprenorphine waiver training.

Nurse Practitioners (NPs) and Physician Assistants (PAs) are required to complete the 8-hour buprenorphine waiver training as well as an additional 16 hours of online training as established by the Comprehensive Addiction and Recovery Act (CARA). Residents may also take the course and apply for their waiver once they receive their DEA license. The 8-hour buprenorphine waiver training is offered in a ‘half and-half’ format [4.5 hours of in-person training followed by 3.5 hours of online training]. Upon completion of the required training, providers will meet the requirement of the DATA 2000 to apply for a waiver to prescribe buprenorphine for opioid-dependent patients. Visit PCSS for more info including how to complete of all required training online:

*For more information about waiver trainings held in NYC, email buprenorphine@health.nyc.gov


Coalition Wants Johns Hopkins to Drop Medical Debt Suits v. Low-Income Patients
A coalition of Baltimore citizens, backed by two unions, presented a letter and petition June 17 to Baltimore-based Johns Hopkins Hospital President Redonda Miller, MD, calling on the hospital to drop medical debt lawsuits against patients.

The group, called the Coalition for A Humane Hopkins, published a joint report with National Nurses United and AFL-CIO last month that found the hospital won wage garnishments or seized funds from patient bank accounts in more than 400 cases. The groups claim the hospital seized the last $100 in a patient’s bank account in at least two instances. The report also alleges this issue disproportionately affects a primarily African American and low-income zip code in Baltimore.

The coalition wants the hospital to stop filing medical debt lawsuits, drop all current medical debt lawsuits and reimburse patients billed more than allowed under charity care rules. It also wants the hospital to be more transparent about its charity care rules by increasing signage and screening patients at admission to see if they are eligible for charity care. Lastly, it wants the hospital to offer charity care to patients who are not citizens of the U.S.

However, Johns Hopkins spokesperson Kim Hoppe said the hospital does provide financial assistance and charity care information to every patient.

Ms. Hoppe provided Becker’s the following statement:

“It is always our priority to provide the best possible care to every patient who comes to us. We have an extraordinary community benefits program, and it is our policy to inform our patients about our programs for free and discounted services. For patients who choose not to pursue those options or who have a demonstrated ability to pay, we will still make every effort to reach out to them and to accommodate their schedule and needs. In those rare occasions when a patient who has the ability to pay chooses not to, we then honor our obligation as a hospital in the state of Maryland, with its unique payer model, to pursue reimbursement.” (Beckers Hospital Review June 18)


Under Financial Pressure, US Citizens Travel to Canada to Buy Insulin
Between 2012 and 2016, the cost of insulin for treating Type 1 diabetes nearly doubled, according to the nonprofit Health Care Cost Institute,” and insulin can cost hundreds of dollars per vial in the US. Now, some people are traveling to Canada to buy the treatment, where insulin can be purchased “without a prescription for a tenth of” the price. Similarly, “Republicans and Democrats have produced federal and state proposals to import drugs from Canada.” Department of Health and Human Services spokeswoman Caitlin B. Oakley wrote in an email, “President Trump and [HHS] Secretary Azar are firmly committed to getting drug prices down.” Meanwhile, many Canadians “worry that bulk [insulin] buys from the United States could cause shortages or higher prices.” Washington Post (6/16)


Drug Cos. Sue HHS over Rule Requiring Them to Include List Prices in TV Ads
An effort “by the Trump administration to shine light on the high costs of prescription drugs prompted legal resistance by three major pharmaceutical companies.” The article said, “Amgen, Eli Lilly, and Merck sued the Department of Health and Human Services in a bid to block new rules requiring that companies disclose the ‘list price’ of their drugs in television advertising.” The companies “called the rules ‘entirely unnecessary, bad for patients, and detrimental to health care,’ as well as a violation of” their “free speech rights.” The lawsuit names HHS Secretary Alex Azar as a defendant.

Azar said last month when he announced the rule, “Claiming list prices don’t matter is almost the same as claiming there is no problem with high drug costs at all – and I don’t think many American seniors or patients with serious illnesses would say that’s the case.” Azar also stated at the time, “Requiring the inclusion of drugs’ list prices in TV ads is the single most significant step any administration has taken toward a simple commitment: American patients deserve to know the prices of the health care they receive.” Washington Post (6/14)


Join CMS for a Public Webinar on Quality Measurement
CMS is pleased to invite the public to attend its upcoming webinar titled Measuring Quality to Improve Quality: Strengths and Challenges of Clinical Quality Measurement. The webinar will provide an engaging and informative overview of key concepts that go into its quality measures. Additionally, the presentation will review current CMS quality measures, explain how they are used, and how they fit into CMS’s quality goals, including the Meaningful Measures initiative.

The webinar will be offered twice in June, on Tuesday, June 25th, from 2:00-3:00pm EST (Register here) and Thursday, June 27th, from 2:00-3:00pm EST (Register here). Please register in advance if you can attend as space will be limited. We request that you please only register for events you plan to attend. We hope you can join us and look forward to your questions! For questions, please contact MMSSupport@battelle.org.


Classified

RENTAL/LEASING SPACE


Ground Floor Office with Private Street Entrance in Luxury Park Avenue Building
Rental includes: two consultation rooms, private office, private bathroom.  Common waiting room, back office filing space and reception desks included.  Affordable rent.  Location East 60s between Park and Lexington.  Easy distance to Lenox Hill Hospital and New York Cornell.  Subway access within 1 block.  Immediate occupancy available.  Call James: 917-710-7643


For Lease – Buffalo Area  Urgent Care / Primary Care Clinic
Next door to only grocery store in town: Sav-a-Lot 4+ exam rooms, X-Ray room, Lab, Offices, etc. 3300 Sq Ft. – Fully built-out facility  ADA compliant Dunkirk New York

View full listing https://reporting.loopnet.com/report/3008dc65-60b8-4476-ab01-df4ffa2bc628.

Contact geoff_jenkins@hotmail.com / (917) 825-4542


Upper East Side Medical Office Space for Rent Part–Time
Beautiful, newly renovated medical office on the Upper East Side between Lexington and Park Ave. Full service building with 2 entrances, conveniently located near all public transportation. Office includes 2 consult rooms, 3 exam rooms, treatment area, 2 bathrooms, kitchenette and reception area with waiting room. The office is available on a part-time basis. Please call 212-288-2278 or e-mail eastsidemedical@usa.net for further information.
Upper East Side Office lobby and receptions area



Park Avenue Office Share-3 Days Per Week
Tasteful, bright, well-maintained medical office in prestigious building on Park Avenue at 94th Street.  Large waiting room and reception area, consultation room and 2 exam rooms available 3 days per week. Room for an assistant or clerical help 5 days per week. Please email abgmdpc@gmail.com or call 987-5000


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

 


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



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


 

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


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

PHYSICIAN OPPORTUNITIES

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

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

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

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

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

Primary Contact: Oksana


 

 


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


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

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 


NY Eliminates Religious Exemption for Vaccinations 


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

 

For Immediate Release
June 14, 2019 

NY Eliminates Religious Exemption for Vaccinations 

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

“Yesterday, the New York State Legislature passed a measure that will assure that the only acceptable exception to New York’s vaccination requirements is when there are medical contraindications.   Governor Andrew Cuomo has already signed this measure.  The Medical Society would like to thank all the physicians who took the time to write a letter, make a phone call and take other steps to educate their legislators about the critical importance of this legislation for protecting our public health.

MSSNY would also like to thank the many patient and public health advocacy organizations who also took the time to advocate to their legislators for this needed change.

Most importantly, we thank Assemblymember Jeff Dinowitz, Senator Brad Hoylman and our MSSNY legislative staff Moe Auster and Pat Clancy, for their dogged advocacy in support of this legislation!  Their steadfastness commitment to the measure and to the public health ensures that ALL of New York State children will be protected from vaccine preventable diseases.”

# # #

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

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

 

Facebook Icon Twitter Icon

 

MSSNY eNews – June 14, 2019 – Circle of Life

Arthur Fougner MSSNY Presiident

PRESIDENT’S MESSAGE<
Arthur Fougner, MD
MSSNY President

MSSNY eNews
June 14, 2019

Vol. 22  Number 23


MSSNYPAC Seal

 


Colleagues:

Yesterday, the New York State Legislature passed a measure that will assure that the only acceptable exception to New York’s vaccination requirements is when there are medical contraindications.  Governor Andrew Cuomo has already signed this measure.  The Medical Society would like to thank all the physicians who took the time to write a letter, make a phone call and take other steps to educate their legislators about the critical importance of this legislation for protecting our public health.  MSSNY would also like to thank the many patient and public health advocacy organizations who also took the time to advocate to their legislators for this needed change.

Most importantly, we thank Assemblymember Jeff Dinowitz, Senator Brad Hoylman and our superior MSSNY legislative staff, especially Moe Auster and Pat Clancy, for their dogged advocacy in support of this legislation!  Their steadfastness commitment to the measure and to the public health ensures that ALL of New York State children will be protected from vaccine preventable diseases.

AMA Annual Meeting

Returning from the 2019 AMA Annual House of Delegates, I got in a cab, returned home, picked up my car and drove off to the Northwell Ob-Gyn Resident Graduation Party on Long Island. En route to the affair, I checked off potential topics for this week’s epistle and it dawned on me that the graduating house staff IS the topic. They are the fledglings leaving the nest and flying toward their collective future. Yet are they truly prepared for the world of copays, deductibles, contracts, prior authorizations and medical liability?

There are those in academia who feel that there will be time enough to address these concerns. I am not one of those academics. What is often missing in medical school and postgraduate medical education is advocacy. Yet there is hope for at the AMA meeting, I encountered many medical students, residents and fellows who were eager to familiarize themselves with the issues that would either soon confront them or were engulfing them now. Full of youthful exuberance, they embrace the concerns of medicine with an enthusiastic optimism unencumbered by the vicissitudes of life. Here was the opportunity for continual dialogue, continual reality check, learning the art of negotiation and compromise. And yes, sometimes we all agreed to disagree yet continue to engage.

Sadly, I noted that several health systems in our state were not represented. This is a pity for these students and young physicians are the future. Without the opportunity for mentoring by those who have walked these paths before them, they are thus free to repeat our missteps. We are the ones who must provide the GPS for their careers.

In “The Last Samurai”, Katsumoto says to Algren: “The way of the Samurai is not necessary anymore.”

Algren replies: “Necessary? What could be more necessary?”

Similarly, in these troubled times, what could be more necessary than our Medical Society? And Advocacy is our most important product.

It’s the circle of life
And it moves us all
Through despair and hope
Through faith and love

Till we find our place
On the path unwinding

“Circle of Love,” Tim Rice, lyricist for The Lion King

Arthur Fougner, MD
MSSNY President 

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


MLMIC Insurance Banner Ad


Podcast SymbolThis Week’s Podcast of MSSNY’s Legislative Priorities

Capital Update

Legislature & Governor Pass Bill to Assure Medical Exemptions Only For Immunization
In a significant move to change public health policy, the New York State Legislature passed a measure that would assure that the only acceptable exception to New York’s vaccination requirements is when there are medical contraindications.   Governor Andrew Cuomo has already signed the bill into law.  The bill is effective immediately, and contains provisions that allow a school age child, who has begun the immunization process to attend school in Fall 2019.  The law becomes fully effective in June 2020.  The measure, A.2371A and S.2994A, was sponsored by Assemblymember Jeffery Dinowitz and Senator Brad Hoylman.  The measure, which the MSSNY strongly supported, passed the Assembly by a vote of 84-61 and the New York State Senate by 36-26.   A copy of the voting record is at click here.

MSSNY led a group of specialty societies, patient and public health advocates to ensure that there was strong support for the bill and helped to activate many physicians, nurses, parents, and other public health organizations in support of the measure.  MSSNY wishes to thank Assemblymember Dinowitz and Senator Hoylman for their dogged advocacy in support of this legislation and for their commitment to public health.   MSSNY recognizes that it will be important to educate the public about the benefits about immunization over the next several months.

There were 33 organizations that joined with the Medical Society in support of the bill:

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


All Physicians Urged to Contact Their Legislators to Prevent Huge Increases in Liability Premiums
All physicians are urged to contact their legislators to oppose bills being aggressively pushed  by trial lawyers in the Session’s final days that would drive huge increases in physicians’ and hospitals’ already outrageously high liability premiums, and make it even more difficult for physicians and hospitals to be available to deliver needed patient care.   Physicians are urged to call their local legislators and send a letter clicking here: These bills include:

  • 4006/A.5612, which would greatly expand the possible damages awardable in a wrongful death action. While estimates vary, one actuarial estimate indicated that passage of this legislation could further increase premiums by nearly 50%, which translates to tens of thousands of dollars in new costs for many physicians and could make it impossible for many physicians to stay in practice in New York.
  • 6194/A.2370, which would limit a physician’s ability to defend themselves in liability actions by prohibiting their defense counsel from conducting an interview with the plaintiff’s treating physician.
  • 6081/A.2372, which would require a non-settling co-defendant in a tort action to choose whether to reduce his/her liability exposure by the stated settlement amount or the settling tortfeasor’s equitable share prior to the first opening statement of the trial.

Medical liability payouts in New York State continue to be far out of proportion with the rest of country. A recently released report showed that New York State had far and away the highest number of cumulative medical liability payouts of any state, and that this cumulative number had increased by 11% from 2017 to 2018. Claimants in New York were awarded nearly two times more than the state with the next highest amounts, Pennsylvania, and payments in New York far exceeded states such as California and Florida. Moreover, New York had the highest per capita medical liability payment as well, averaging over $35 per New York resident, more than 20% higher than the second highest state, New Jersey.

Given the extraordinary costs of medical liability insurance that many physicians must pay, combined with the enormous changes in health care delivery and payment that is placing huge new financial pressures on physician practices and hospitals, MSSNY is urging legislators to consider long overdue needed comprehensive reforms, not stand alone pieces of legislation that will harm patient access to care.    (AUSTER)


Ad Banner for Health Connections Corp.


Efforts to Legalize Recreational Marijuana Continue as Legislature Nears End; Physician Action Urged
With momentum growing in the New York State Legislature to act on the commercialization of the recreational use of marijuana, physicians are urged to continue to contact their legislators to oppose legislation here  A.1617B/S.1527B sponsored by Assembly Majority Leader Crystal Peoples-Stokes and Senator Liz Krueger, was recently amended.  The Assembly bill is in the Assembly Codes Committee and the Senate bill is in the Senate Finance Committee.  The Medical Society of the State of New York continues to oppose the legalization of recreational/adult use marijuana and continues to work with other advocacy groups that oppose this measure. In particular, MSSNY is concerned with the adverse public health consequences that have occurred in other states that have legalized marijuana.

Additionally, the measure changes the medical use of marijuana and takes the program out of the Department of Health and under the Office of Cannabis.  The measure eliminates “serious condition” and eliminates the list of conditions for certifying patients.   It also would allow any “practitioner” who is authorized to prescribe controlled substances with the state to certify a patient for marijuana. Training requirements for the medical components under the bill have been reduced to two hours.     The measure would also authorize “smoking” as a modality of treatment in the medical component and for recreational use.   (CLANCY,AUSTER)


Opioid Measures Moving in Both Houses
There are several measures that relate to opioid prescribing that are moving forward in the New York State Legislature that would have an impact on prescribing practices for physicians.  The bills are listed below:

  • 8256/S.5867A, sponsored by Assemblymember Richard Gottfried and Senator Gustavo Rivera, has moved from the Assembly Health Committee to the Assembly Rules Committee. This legislation would amend the public health law to require health practitioners before prescribing an opioid medication to consider discussing with the patient and refer or prescribe alternative services such as chiropractic, massage therapy or behavioral therapy. The Medical Society is concerned that this legislation will create confusing requirements for prescribers that will simply deter more physicians from prescribing pain medications for those patients that truly need them.  The Medical Society of the State of New York is opposed to this measure.
  • 5603/S.5150, sponsored by Assemblymember Edward Braunstein and Senator Peter Harckham, has moved to the Assembly Ways and Means Committee and is pending in the Senate Health Committee. This legislation would amend the public health law to require require that prescribers, who prescribe opioids for the first time, also co-prescribe an opioid antagonist with the prescription. MSSNY is concerned that this legislation could potentially create fear within patients that they would be stigmatized as drug addicts.  This fear may very well carry over to the patient’s use of opioids in general – leading those patients to suffer intense pain because of the fear of “addiction”.
  • 7285A/S. 4277A, sponsored by Assemblymember Linda Rosenthal and Senator Peter Harckham, has passed the Senate and is pending in the Assembly Health Committee. This legislation would amend the public health law to require health practitioners who prescribe an opioid or other Schedule II Controlled Substance to discuss with the patient the risks of being prescribed a CSII drug. The measure ignores the principle of informed consent—which essentially means that if a patient needs treatment, the physician gives the patient the information to make an informed decision. This process of understanding the risks and benefits of treatment is known as informed consent.  Additionally, this is duplicative of requirements that currently exist under the ISTOP law, whereby, after the physician prescribes the medication, the pharmacist is required to again inform the patient about the risks of taking a controlled substance.

Physicians are urged to call their member of the New York State Assembly and Senate and to urge them to vote no on these measures. (CLANCY, AUSTER)



Physician Advocacy Needed to Support Important Health Insurance Reforms
With just one week left until the scheduled end of 2019’s legislative session it is vital to continue advocating for legislation to assure patients are more able to receive the timely quality care and medications they need. Physicians may advocate via clicking the links below or calling their legislator’s office. You can call the switchboard and ask to be directed to their office (Senate 518-455-2800, Assembly 518-455-4100). Find your legislator here.

Mid-year formulary changes – Surprisingly, current law does not restrict insurance companies from making substantial changes to their formularies mid-year. This is an egregious practice when you consider the fact that your patients choose insurance plans based on the coverage presented to them – and they generally are not able to switch plans mid-year. Senator Breslin and Assemblymember Peoples-Stokes have introduced legislation (S.2849/A.2969) that would prevent mid-year formulary changes so that patients do not experience removal of a drug or changes in tiering when there is no similarly effective option.  This bill is on the verge of becoming law as it is on the floor calendar in both houses.  However it is being fiercely opposed by health insurers.  Please urge your Assemblymember and Senator to join on as a co-sponsor and support the bill here.

Network due process – There is currently a glaring loophole in New York’s laws that allow insurance companies to terminate physicians by non-renewal without cause or recourse. While they are required to notify physicians when contracts are terminated and physicians are then afforded the opportunity for a hearing, these protections don’t extend to non-renewal. Senator Rivera and Assemblymember Lavine’s bill (S.3463/A.2835) would provide physicians with proper due process upon non-renewal and would enhance the current hearing process by allowing the subject of the hearing (the physician) to choose one of the three members of the panel.  The bill is on the floor of both Houses.

Collective negotiations – Negotiating patient care terms with insurance companies is extremely difficult given many insurers’ overwhelming market share, so we strongly support legislation introduced by Senator Rivera and Assemblymember Gottfried (S.3462/A.2393) that would allow independently physicians to collectively negotiate with insurance companies in certain situations. The bill has been reported out of the Assembly Health Committee and awaits a vote in Ways & Means. Its Senate companion is currently in in the Senate Health Committee. Please urge your Assemblymember and Senator to join on as a co-sponsor and support the bill http://tiny.cc/mssnycollectivenegotation      (AVELLA/AUSTER)


Physician Advocacy Urged to Prevent Congressional Attempts to Undermine New York “Surprise Bill” Law
With several US House and Senate leaders releasing proposals to address the issue of “surprise” out of network medical bills faced by patients, physicians are urged to send a letter (please click here) urging their member of Congress to fight for a law that is consistent with New York’s approach.  Physician advocacy is essential due to a multitude of proposals before Congress that could seriously undermine New York’s proven model and further diminish the ability of physicians to fairly negotiate patient care terms with market dominant health insurers.

Specifically, MSSNY and other physician advocacy organizations have praised a proposal advanced by Representative Joe Morelle (D-Rochester) together with Representative Dr. Phil Roe (R-TN) and Dr. Raul Ruiz (D-CA), that seeks to mirror New York’s law, which uses a “baseball arbitration” Independent Dispute Resolution (IDR) system to determine payment for out of network medical care, and uses charge data collected by an independent database as a leading benchmark to guide the IDR.  MSSNY Board of Trustees member Dr. Andrew Kleinman also recently participated in a meeting with the House Doctors Caucus to educate legislators about New York’s approach.

However, several other proposals have been advanced that would require an insurer determined in-network based default rate for out of network surprise medical bills.  This would give enormous new powers to already market dominant insurers, and fails to recognize the insurance industry’s fault in creating this problem due to their narrow networks.  MSSNY has written to New York’s Congressional delegation praising the approach set forth by Representatives Morelle, Roe and Ruiz, and raising strong concerns with other proposals.

Specifically, New York’s letter raised concerns with the insurance industry’s own notorious history in establishing benchmarks for out of network payment, and the history of then-Attorney General Cuomo’s investigation which found that by using a flawed and conflicted database to determine reimbursement rates for out-of-network care, insurers were increasing profits at the expense of patients and physicians. Moreover, it was noted that New York’s law struck a tenuous balance among various health care stakeholders that protected patients from surprise medical bills and assured that hospital emergency departments had access to needed on-call specialty care.

MSSNY has been working with several other state medical associations and national specialty societies in its advocacy to Congress.  Please see here for a short “Fact Sheet” developed by the Physicians Advocacy Institute that sets forth key principles for Congress to consider in this debate: Fact Sheet   (AUSTER)


NY Rx Card Banner


Workers Compensation Board Adopts Regulations to Implement Prescription Medication Formulary
The New York Workers’ Compensation Board (WCB) recently announced it had adopted regulations to implement a prescription drug formulary for injured workers’ medication needs.  To read the final adopted regulation, formulary and summary documents, click here.

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

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

The regulation also sets forth that new prescriptions must be prescribed pursuant to the Formulary within 6 months of the effective date of the Formulary (December 2019), and that refills and renewals must be prescribed pursuant to the

Formulary within 12 months of the effective date of the Formulary (June 2020). (AUSTER)


Please Complete NYeC Survey to Gauge Physician Hassles with EHR Implementation and Use
MSSNY, in conjunction with other physician associations, has been working with the New York e-Health Collaborative (NYeC) on ways to reduce the hassles associated with the implementation and use of electric health record (EHR) systems. To that end, they have developed a survey for physicians to complete gauging the challenges of EHR use, including connecting to and using medical information from your local Regional Health Information Organization (RHIO) to enhance patient care delivery.

Please take just a few minutes to complete the survey here. (AUSTER)                                                                   


                                                 


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

Garfunkel Ad


Zocdoc Update
Recently, MSSNY expressed concerns with Zocdoc based on physicians expressing discontent with the verbiage of “Dr. XXX has no appointments on Zocdoc right now.”  The site then lists other {Specialists} nearby.  Many physicians viewed this as Zocdoc steering patients away from their practice to practices that have an agreement with Zocdoc.  We asked Zocdoc to reconsider their language.

In an effort of cooperation and in an attempt to address our stated concerns, Zocdoc advised that they are going to adjust the language on these pages as a show of good faith to MSSNY and its members. Zocdoc asked their Product team to update the language to read as follows: “Dr. [NAME] does not participate in Zocdoc to offer online booking at this time.”  This should resolve our specific concern and MSSNY is appreciative of Zocdoc’s consideration.


Our State Fair is a Great State Fair…Don’t Miss It!
Once again the Onondaga County Medical Society will staff the Medical Society of the State of New York/New York State Society of Anesthesiologists booth at the state fair. Medical Society physician members are encouraged to volunteer to work the booth during a time slot. This is a great opportunity to perform public health outreach, and to promote your practice or organization at the NYS Fair, free of charge. Those who work at the booth will receive free admission tickets and free parking (on a limited basis). Feel free to bring handouts about your practice or other timely medical information to share with fairgoers. Please let us know if you have any ideas for exhibits, testing, etc., that you feel will be informative and help advance a positive image of the medical profession.

Contact us for available time slots remaining for the 13-day fair, which runs from Wednesday, August 21 – Monday, September 2, 2019 (Labor Day). You can work as little as two hours or the entire day if you’d like. We need only one physician-member group per time slot. This is being updated daily. Time availability is on a first-come, first-served basis Contact Patty Corasaniti at (315) 424-8118, or send email to corasaniti@oncms.org for more information.


Major City Physician Group Calls for Two-Year Extension of DSRIP Money
Dr. Ramon Tallaj, chairman of Somos Community Care, said Tuesday that the Cuomo administration should work to secure federal funding to continue the Delivery System Reform Incentive Payment program. The DSRIP program provided $7.4 billion for health care providers across the state to implement projects that would lower unnecessary trips to the hospital by 25% over five years. The program is set to end by April.

“We need to extend this for two more years. We have to find together a way to do that,” Tallaj said Tuesday after speaking at a conference hosted by Somos at the New York Academy of Medicine in Manhattan. “We need to be sure the Medicaid money is available to the state to do this transformation.”

Somos Community Care is a network of more than 2,500 physicians who care for more than 700,000 patients in New York City. It is one of 25 Performing Provider Systems, or groups of medical providers that have collaborated on projects to keep patients healthy and out of the hospital. Those projects include increasing care management and integrating medical and behavioral health care.

The money for DSRIP came from an amendment to New York’s 1115 waiver through which the federal government provided New York more than $8 billion. That allowed the state to reinvest some of the $17 billion it had saved through initiatives developed by its Medicaid Redesign Team. To secure additional funding, the state will need to a new amendment to its 1115 waiver, a labor-intensive process that will test New York’s ability to work with the Trump administration. But New York could renew some money from its DSRIP program. Certain parts of DSRIP, known as the state supplemental programs, are distributed through Medicaid managed-care plans and represented more than $1.5 billion in the first five years of the program. The state could allocate a continuation of that money in the next state budget.

Not all leaders in the health care industry think that DSRIP 2.0 is the answer to funding future collaboration among providers and social service organizations. (Crain’s Health Pulse)


NYC DOHMH Conducting Survey on Closure of Pain Clinics
The NYC Department of Health and Mental Hygiene (DOHMH) is involved in emergency preparedness planning in case of the event of a pain clinic closure or other emergency within New York City.  Pain clinic closures in other parts of New York State have led to serious public health consequences.   It is essential to have contingency plans in place in NYC to avoid abrupt interruption of treatment for patients with chronic pain, some of whom receive opioid therapy, and to assure continuity of care.  Physician response to this survey will inform DOHMH’s work and optimize all available resources to protect the health of New Yorkers.

AMA Meeting Highlights

  • AMA And Single-Payer 

The AMA remained opposed Tuesday to proposals for the U.S. to establish a single-payer health care system. At its annual House of Delegates meeting, it voted 53% to 47% against adopting an amendment to remove its formal opposition. The vote follows days of debate between leadership and a group of medical students.

  • AMA: Mature Minors Should Be Able to Provide Informed Consent for Vaccinations

Members voted to express support for “state policies that would allow minors to override their parent’s objections to vaccinations.” AMA board member S. Bobby Mukkamala, M.D., said in a news release, “The prevalence of unvaccinated pediatric patients is troubling to physicians. Many children go unvaccinated as anti-vaccine related messages and advertisements target parents with misinformation. Allowing mature minors to provide informed consent to vaccinations will ensure these patients can access this type of preventive care.”

  • AMA Delegates Vote In Favor of Ethics Council Report On Aid-In-Dying, Physician-Assisted Suicide

Members approved “a report from the AMA’s Council on Ethical and Judicial Affairs (CEJA), which was issued in response to resolutions at the 2016 and 2017 annual meetings that asked the council to ‘study the issue of aid-in-dying with consideration of data collected from the states that currently authorize aid-in-dying, and input from some of the physicians who have provided medical aid-in-dying to qualified patients.’” In the report, “the council had noted that arguments for and against participating in aid-in-dying or physician-assisted suicide were ‘fundamentally unchanged’ since the council’s earlier report on the issue in 1991.” The report also said, “In the council’s view, despite its negative connotations, the term ‘physician-assisted suicide’ describes the practice with the greatest precision.”


Dr. Underwood, Urologist from Buffalo, Elected to AMA Board of Trustees

Dr. Underwood

Willie Underwood, III, M.D., M.Sc., M.P.H., a urologist based in Buffalo was elected to the AMA’s to its Board of Trustees. Dr. Underwood has been an active leader in organized medicine for many years; he has chaired the AMA Council on Legislation and the AMA Resident and Fellow Section, served as president of the Erie County New York Medical Society, and he is an AMA Delegate from the American Urological Association (AUA).

Dr. Underwood is a board-certified urologic surgeon specializing in prostate cancer who has been practicing in the state of New York for the past 11 years. He oversees research focusing on methods to improve early detection and treatment of prostate cancer. In all his advocacy work he is proudest of getting prostate cancer early detection legislation successfully passed in Michigan and Maryland. Dr. Underwood earned his M.D. and M.Sc. from SUNY Upstate Medical University and his M.P.H. from the University of Michigan.


Physician Wellness Committee: 2016 Survey Has Sparked More Attention
Michael Privitera MD, Co-Chair of MSSNY’s Committee for Physician Wellness and Resilience, announced that another publication has come out of the MSSNY Burnout survey we did in the fall of 2016 in collaboration with Federation of State Medical Boards. “Physician Burnout and Mental Health Care Barriers when Reporting on Applications” has been accepted in Journal of Legal Medicine. It expounds upon how asking physicians questions on their state license applications and renewals about previous mental health care is such a large deterrent for physicians getting the care they need and how this backfires in efforts to protect the public.

Dr. Privitera stated, “I am particularly pleased about taking these issues seriously on a national level. There is the terrible perfect storm of an endless list of increasing expectations on physicians and medical students without any single agency overseeing the total expectations of the job. This scenario is then mixed with a culture of silence and endurance prevalent in medical culture that makes them less likely to be aware of how impossible the job has become. It’s not a fair fight  like other challenges in which they have prevailed, so it is important to try to recognize this and  reach out to get help.”


CMS

NGS Medicare Part B Claims Update

Top Reasons for Returning Claims

  • Item 1a Insured ID Number – blank or not valid format
  • Item 21 Diagnosis – No diagnosis code report
  • Item 24b Place of Service – No place of service reported
  • Item 32 – Service Facility location – Blank
  • Item 33a Missing NPI – missing or invalid format reported

JK Timeliness Jan Feb Mar Apr May
JK Claims 977 829 814 2,681 1,627

MIPS 2019: Not Too Late to Avert Future Medicare Pay Penalties
MIPS-eligible physicians who don’t report data may be subject to a 7% Medicare pay penalty in 2021. AMA resources offer help to avoid that outcome

Eligible physicians who fail to report data under Medicare’s 2019 Quality Payment Program (QPP) will be subject to a 7% penalty in 2021. That penalty will rise to 9% the following year.

To avoid such penalties, physicians need to score a minimum of 30 points in this year’s iteration of the QPP’s Merit-based Incentive Payment System (MIPS). The AMA’s expert resources outline what’s new this year under MIPS and how you can avoid potential future pay cuts.

The AMA offers extensive resources to help physicians understand MIPS, including:

Those physicians seeking a positive payment adjustment to their Medicare rates (potentially up to 7%) should have already started collecting data for the MIPS Quality performance category as of Jan. 1. Physicians, however, looking to avoid penalties and receive a neutral Medicare pay adjustment can still do so by collecting 90 days’ worth of data relevant to the MIPS Promoting Interoperability (PI) and Improvement Activities (IA) categories. The latest date to begin collecting data is Oct. 1.


Join CMS for a Public Webinar on Quality Measurement
CMS is pleased to invite the public to attend its upcoming webinar titled Measuring Quality to Improve Quality: Strengths and Challenges of Clinical Quality Measurement. The webinar will provide an engaging and informative overview of key concepts that go into its quality measures. Additionally, the presentation will review current CMS quality measures, explain how they are used, and how they fit into CMS’s quality goals, including the Meaningful Measures initiative. The webinar will be offered twice in June, on Tuesday, June 25th, from 2:00-3:00pm EST (Register here) and Thursday, June 27th, from 2:00-3:00pm EST (Register here). Please register in advance if you can attend as space will be limited. We request that you please only register for events you plan to attend. We hope you can join us and look forward to your questions! For questions, please contact MMSSupport@battelle.org.


Classified

RENTAL/LEASING SPACE


For Lease – Buffalo Area  Urgent Care / Primary Care Clinic
Next door to only grocery store in town: Sav-a-Lot 4+ exam rooms, X-Ray room, Lab, Offices, etc. 3300 Sq Ft. – Fully built-out facility  ADA compliant Dunkirk New York

View full listing https://reporting.loopnet.com/report/3008dc65-60b8-4476-ab01-df4ffa2bc628.

Contact geoff_jenkins@hotmail.com / (917) 825-4542


Upper East Side Medical Office Space for Rent Part–Time
Beautiful, newly renovated medical office on the Upper East Side between Lexington and Park Ave. Full service building with 2 entrances, conveniently located near all public transportation. Office includes 2 consult rooms, 3 exam rooms, treatment area, 2 bathrooms, kitchenette and reception area with waiting room. The office is available on a part-time basis. Please call 212-288-2278 or e-mail eastsidemedical@usa.net for further information.
Upper East Side Office lobby and receptions area



Park Avenue Office Share-3 Days Per Week
Tasteful, bright, well-maintained medical office in prestigious building on Park Avenue at 94th Street.  Large waiting room and reception area, consultation room and 2 exam rooms available 3 days per week. Room for an assistant or clerical help 5 days per week. Please email abgmdpc@gmail.com or call 987-5000


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

 


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



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


 

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


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

PHYSICIAN OPPORTUNITIES

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

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

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

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

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

Primary Contact: Oksana


 

 


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


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

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 


MSSNYeNews – June 7, 2019 – Get With It! Engage in the Present!

Arthur Fougner MSSNY Presiident

PRESIDENT’S MESSAGE<
Arthur Fougner, MD
MSSNY President

MSSNY eNews
June 7, 2019

Vol. 22  Number 22


MSSNYPAC Seal

 


I make my living off the evening news
Just give me something-something I can use
People love it when you lose,
They love dirty laundry  

                    -Dirty Laundry by Don Henley

Colleagues:

As you are probably aware, I spend a considerable amount of time on Twitter. Despite the often intimidating noise to signal ratio, I have found it a useful source of info and breaking news, as well as an opportunity to bring our message to a wider audience. Apparently, Thomas Jefferson University recognized the importance of combatting the rising tide of health misinformation or, dare I say it, fake news. Doctors, meet Austin Chiang MD MPH. Dr. Chiang is the Chief Medical Social Media Executive for Thomas Jefferson Health. With 20,000 Instagram followers, his mission is to combat misinformation with information. Recent events regarding vaccinations demonstrate that this situation requires more than an “Army of One” or a “Few Good Men/Women.”

I recognize that as professionals, we are loathe to expose our reputations or careers to the hordes of internet orcs who would drag us off to a virtual Mount Doom. However, this is the arena that beckons and for the sake of our patients, we must engage. Since my chosen theater of engagement is Twitter, I’ll happily assist you. First, sign up here. Then you put sonodoc99 in the “search twitter” bar and type @sonodoc99. When you see Bones McCoy (my mentor), just click on my name and then hit Follow.

Similarly, do the same with @mssnytweet (MSSNY’s official Twitter handle). Now you are off and running. I would suggest just dipping your toes in the water and lurking to get your bearings. If you see a Tweet by Yours Truly or MSSNY, just click on Retweet and the message will be sent out again. Our organization has about 20,000 members. If only ¼ of the members both followed MSSNY and our leaders, we all would grow in relative influence. Moreover, retweeting our message amplifies the message so that too grows in influence. It’s the old Dallas Cowboy Cheerleader ad come to life – you tell two friends and they tell two friends and so on and so on and so on. If you still have questions, follow @DrDanChoi too. He’ll help you with Instagram as well.

Our message is strong but it often cannot be heard amongst the din of the crowded lounge during happy hour. With a critical mass, we can extend our reach to places we’ve never imagined.

The truth may not be out there yet, but it will be.

Engage!

Arthur Fougner, MD
MSSNY President 

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


MLMIC Insurance Banner Ad


Podcast SymbolThis Week’s Podcast of MSSNY’s Legislative Priorities

Capital Update

NYS Has 889 Confirmed Measles Cases—Physicians Urged to Call Legislators to Demand Action on this Public Health Epidemic
The number of measles cases in New York State has again seen an uptick over the past week with 889 confirmed cases out of the 1,000 plus confirmed nationwide. Physicians throughout the state are encouraged to call their legislators and urge action on a bill that would allow only medical exemptions for immunizations.  The measure, A.2371/S.2994A, is in the Assembly & Senate Health Committees.   The Medical Society of the State of New York has joined 29 other medical organizations, patient advocacy groups and public health organizations, meeting with members of the Legislature to advocate for passage of this measure. MSSNY has participated in several press conferences with the sponsors of this legislation, including one this week organized by the March of Dimes.

Advocates against mandatory vaccinations continue to call and meet with legislators and were in Albany again this week.  It is vitally important that physicians call or send messages to their legislators urging action on this measure.  You can help by following these steps:

  • Physicians are strongly urged to contact members of the Assembly Health Committee. Please call 518-455-4100 and ask for the following Assemblymembers: Gottfried, Schimminger, Galef, Dinowitz, Cahill, Paulin, Cymbrowitz, Gunther, L. Rosenthal, Hevesi, Jaffee, Steck, Abinanti, Braunstein, Kim, Solages, Bichotte, Barron, Sayegh, Raia, McDonough, Ra, Garbarino, Byrne, Byrnes and Ashby.  Tell them that you support passage of A.2371/S.2994, which ensures that the only allowable exemption to vaccination will be for medical reasons.
  • Please send a letter to your legislator via the MSSNY Grassroots Action Center (GAC).  Please click here!
  • Physicians are encouraged to call their Senator and Assemblymember’s office to voice support for this legislation. There is strength in numbers! Please click here.

The Medical Society of the State of New York’s memo in support of A.2371/S.2994A can be found here and a copy of the memo produced by physician and public health organizations and parent and patient advocacy groups is available here. 

Governor Andrew Cuomo has publicly stated that he will sign the bill if it comes to his desk.  The question is whether there will be enough votes in support in the New York State Assembly Health Committee and on the Assembly Floor.

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


Act Now to Prevent Unsustainable Increases in Liability Premiums
There are currently a handful of bills being advanced that would have the effect of significantly increasing already outrageously high medical liability insurance premiums and further erode patient access to needed care. Physicians are encouraged to reach out to their elected officials to let them know how harmful these bills would be for patient care continuity by clicking here.    

  • 4006/A.5612 would greatly expand the possible damages in a wrongful death action which would have the effect of greatly expanding liability insurance premiums. While estimates vary, one actuarial estimate indicated that passage of this legislation could further increase premiums by nearly 50%, which translates to tens of thousands of dollars in new costs for many physicians and could make it impossible for many physicians to stay in practice.
  • 6194/A.2370 would limit a physician’s ability to defend themselves in liability actions by prohibiting their defense counsel from conducting an interview with the plaintiff’s treating physician. This would depart from a long-standing judicial concept that no party has a proprietary interest in a witness, and would further tip the scales of New York’s already one-sided malpractice adjudication system.
  • 6081/A.2372 would require a non-settling co-defendant in a tort action to choose whether to reduce his/her liability exposure by the stated settlement amount or the settling tortfeasor’s equitable share prior to the first opening statement of the trial. It is likely that this bill would enable a plaintiff to be unjustly enriched by collecting more than the jury ultimately determined the non-settling defendants’ equitable share to be if the settling defendant settles for an amount that exceeds their equitable share of the award.

Medical liability payouts and premiums in New York State continue to be considerably out of proportion with the rest of country. A recently released report showed that New York State had far and away the highest number of cumulative medical liability payouts of any state, and that this cumulative number had increased by 11% from 2017 to 2018. Claimants in New York were awarded nearly two times more than the state with the next highest amounts, Pennsylvania, and payments in New York far exceeded states such as California and Florida. Moreover, demonstrating once again why New York has been designated the worst state in the country to be a doctor, New York had the highest per capita medical liability payment as well, averaging over $35 per New York resident, more than 20% higher than the second highest state, New Jersey.

Given the extraordinary costs of medical liability insurance that many physicians must already pay, combined with the enormous changes in health care delivery and payment that is placing huge new financial pressures on physician practices and hospitals, MSSNY is urging legislators to reject these bills, as it could drive many physicians out of New York State.  Instead we urge that comprehensive liability reform be enacted.                (AVELLA)


Ad Banner for Health Connections Corp.


Efforts to Legalize Recreational Marijuana Continue As Legislature Nears End; Physician Action Urged
Physicians are urged to continue to contact their legislators to oppose legislation and commercialization of recreational use of marijuana. In the remaining days of the legislative session, advocates on both sides of legalizing the recreational/adult-use of marijuana in New York held joint press conference espousing their view on whether the New York State Legislature should pass the bill.

MSSNY joined Smart Alternatives to Marijuana (SAM), the New York State PTA, the Sheriff’s Association, school superintendents and the New York State Association of County Health Officials (NYSACHO) in opposing passage of the legislation.  A.1617A/S.1527A, sponsored by Assembly Majority Leader Crystal Peoples-Stokes and Senator Liz Krueger, was recently amended and would create the “marijuana regulation and taxation act”.  The Assembly bill is in the Assembly Codes Committee and the Senate bill is in the Senate Finance Committee.

The Medical Society of the State of New York continues to oppose the legalization of recreational/adult use marijuana and continues to work with other advocacy groups that oppose this measure. In particular MSSNY is concerned with the adverse public health consequences that have occurred in other states that have legalized marijuana.  Also pending in both houses is A.7467/S.5657, sponsored by Assemblymember Richard Gottfried and Senator Diane Savino, which would greatly expand New York State’s medical program for certifying patients for the use of marijuana.

The bill eliminates “serious condition” and replaces it with “condition” and further expands the list of conditions eligible for certification.  The measure also expands the list of practitioners who can certify the patient for the use of marijuana and would authorize “smoking” as a modality of treatment.   The bill is pending in the Assembly Codes Committee and the Senate Health Committee.  Physicians throughout New York State are urged to send a letter through MSSNY Grassroots  Action Center opposing legalization of marijuana here.     (CLANCY, AUSTER)


Opioid Prescribing in NYS Down by 37.5% Over Five Year Period
Opioid prescribing by New York State physicians has decreased 37.5% percent between 2013-2018 and opioid prescriptions also decreased by 11.2% from 2017 to 2018 according to data recently released by the IQVIA, Danbury, CT,  a data collection firm within the healthcare industry. The data is available here.

Additionally, the American Medical Association (AMA) has released its 2019 Opioid Progress Report—the third year that the AMA has reported on actions that physicians have taken to help end the nation’s opioid epidemic. The report shows significant decreases in opioid prescribing as well as increases in PDMP use and naloxone prescriptions. In addition to the national data, the AMA also released state-level data for opioid prescribing and PDMP use. New York State physicians and other users of the prescription monitoring program logged 23,931,571 inquiries in 2018, a 42% increase since 2014.

The Medical Society of the State of New York is a member of the AMA Task Force on Opioids which put together the report.   While more can be done to address our opioid abuse epidemic, the report highlights the progress that has been made.  The topline findings from the report are as follows:

  • Nationally, opioid prescriptions decreased 33 percent between 2013-2018 from 251.8M to 168.8M;
  • PDMP use increased to 462M since 2014 (up from 61.4M in 2014);
  • More than 700,000 physicians and other health care professionals completed CME and related trainings or accessed other resources focused on opioid prescribing, pain management, screening for substance use disorders and other areas;
  • Naloxone prescriptions increased to nearly 600,000 in 2018—a 338 percent increase from 2016;
  • More than 66,000 physicians and other health care professionals now have a federal waiver to prescribe buprenorphine in-office for the treatment of opioid use disorder—an increase of more than 28,000 since 2016.

Many states have also taken action to remove prior authorization and other barriers to evidence-based treatment for an opioid use disorder and the AMA has proudly supported those efforts.   New York State is at the forefront by removing the prior authorization for Medicated Assistance Treatment (MAT).  MSSNY strongly supported this measure during the 2019-20 New York State budget process.   (CLANCY)


 


Physician Advocacy Needed in End of Session Push for Insurance Reforms
There are two weeks left until the scheduled end of 2019’s legislative session and in these waning days it is vital to continue advocating for the insurance related bills to assure patients are more able to receive the timely quality care they need. Physicians are urged to help advocate for the advancement of these reforms by conducting outreach to the appropriate legislators to emphasize how important these bills are. Physicians may advocate via clicking the links below or calling their legislator’s office. You can call the switchboard and ask to be directed to their office (Senate – 518-455-2800, Assembly – 518-455-4100). Find your legislator here.

Mid-year formulary changes

Surprisingly, current law does not restrict insurance companies from making substantial changes to their formularies mid-year. This is an egregious practice when you consider the fact that your patients choose insurance plans based on the coverage presented to them – and they generally are not able to switch plans mid-year. Senator Breslin and Assemblymember Peoples-Stokes have introduced legislation (S.2849/A.2969) that would prevent mid-year formulary changes so that patients do not experience removal of a drug or changes in tiering when there is no similarly effective option.

This bill is on the verge of becoming law as it is on the floor calendar in both houses (for the first time in the Senate).  However it is being fiercely opposed by health insurers.  Please urge your Assemblymember and Senator to join on as a co-sponsor and support the bill here. 

Network due process

There is currently a glaring loophole in New York’s laws that allow insurance companies to terminate physicians by non-renewal without cause or recourse. While they are required to notify physicians when contracts are terminated and physicians are then afforded the opportunity for a hearing, these protections don’t extend to non-renewal. Senator Rivera and Assemblymember Lavine’s bill (S.3463/A.2835) would provide physicians with proper due process upon non-renewal and would enhance the current hearing process by allowing the subject of the hearing (the physician) to choose one of the three members of the panel.

The bill is currently eligible for a vote in both the full Senate and Assembly.

Collective negotiations

Negotiating with insurance companies is extremely difficult, especially when monolithic payers control a huge portion (or all) of the market that you practice in. The fact that you are barred from banding together with your colleagues is unfair, so we strongly support legislation introduced by Senator Rivera and Assemblymember Gottfried (S.3462/A.2393) that would allow physicians to collectively negotiate with insurance companies in certain situations. Insurance companies will surely be out fighting against this and so we must ensure grassroots support for this provision that would put you on more even footing with insurers.

The bill has been reported out of the Assembly Health Committee and awaits a vote in Ways & Means. Its Senate companion is currently in the Senate Health Committee. Please urge your Assemblymember and Senator to join on as a co-sponsor and support the bill here.                                    (AVELLA/AUSTER)


Physician Advocacy Results in Scope of Practice Expansion Bills Being Pulled from Committee Agenda
Thank you to the many physicians who responded to our grassroots call to action earlier this week to oppose bills that were on the Assembly Higher Education Committee agenda and would have inappropriately expanded the scope of practice for podiatrists (A.6185) and optometrists (A.1193-A).  With your grassroots assistance, MSSNY worked closely with specialty societies representing Orthopedic Surgery, Radiology and Ophthalmology, lobbying members of the Committee, with the result that the bills were taken off the Committee agenda due to insufficient support by Assemblymembers on the Committee.  However, it is still possible these bills could still return before the end of Session.  Physicians are urged to continue to contact their legislators to express their opposition to these bills.  518-455-4100.    (AUSTER)


NY Rx Card Banner


MSSNY Joins Public Health Advocates Urging Passage of Bill to Ban Use of Flavored E-liquids
The Medical Society of the State of New York joined with the American Cancer Society, the American Heart Association, Parents Against Vaping e-cigarettes (PAVe) and other advocates to urge that the New York State Legislature to pass A.47/S.248 which would ban flavored e-liquids for use in e-cigarettes.  PAVe, a grassroots organization founded by parents that seeks to educate parents about the dangers of e-cigarettes and an advocate for the health and safety of young people, joined the bill’s sponsors Assemblywoman Linda Rosenthal and Senator Brad Hoylman in urging the bill’s passage before the close of session.  At a press conference held this week, young people talked to the press about their or their friend’s nicotine addiction stemming from vaping flavored e-cigarettes.  They indicated that they had thought that e-cigarettes were harmless and that all they were inhaling was “flavored” water.  They have since learned that one e-cigarette can contain as much nicotine as 20 cigarettes.

Tobacco companies have a long history of using creative tactics to draw in adolescents and young adults to begin smoking and are now using flavoring to entice young people to begin using e-cigarettes in New York State, the use of electronic cigarette is on the rise-especially among adolescents and young adults.  E-cigarette use poses a significant health risk to young people by increasing the possibility of addiction and long-term harm to brain development and respiratory health. E-cigarette liquid containing nicotine and most are now flavored.  The Medical Society supports this measure.  The bill is currently in the Assembly Codes Committee and is on the floor of the Senate awaiting a vote.                               (CLANCY)


Physician Advocacy Urged to Prevent Congressional Attempts to Undermine New York “Surprise Bill” Law
With several US House and Senate leaders releasing bi-partisan proposals to address the issue of “surprise” out of network medical bills faced by patients that could undermine New York’s acclaimed law, physicians are urged to send a letter (please click here) urging their member of Congress to fight for a law that is consistent with New York’s approach.  Physician advocacy is essential due to a variety of proposals before Congress that would undermine New York’s proven model and further diminish the ability of physicians to negotiate patient care terms with market dominant health insurers.

Recently, Representative Joe Morelle (D-Rochester) joined with Representative Dr. Phil Roe (R-TN) and Dr. Raul Ruiz (D-CA) in releasing a summary of a proposal that seeks to mirror New York’s law, which uses a “baseball arbitration” Independent Dispute Resolution (IDR) system to determine payment for out of network medical care, and uses charge data collected by an independent database as a leading benchmark to guide the IDR.  MSSNY Board of Trustees member Dr. Andrew Kleinman also recently participated in a meeting with the House Doctors Caucus to educate legislators about New York’s approach.

However, several proposals have been advanced that would either require an insurer determined in-network based default rate for out-of-network surprise medical bills, or would create a baseball arbitration system that uses an insurer determined in-network rate as a benchmark.  MSSNY has written to New York’s Congressional delegation praising the approach set forth by Representatives Morelle, Roe and Ruiz, and raising strong concerns with the other proposals.

Specifically, New York’s letter raised concerns with the insurance industry’s own notorious history of establishing benchmarks for out of network payment, and the history of then-Attorney General Cuomo’s investigation which found that by using a flawed and conflicted database to determine reimbursement rates for out-of-network care, insurers were increasing profits at the expense of patients and physicians.   Moreover, it was noted that New York’s law struck a tenuous balance among various health care stakeholders that protected patients from surprise medical bills and ensured that patients receiving care in hospital emergency departments had greater access to needed on-call specialty physician care.    (AUSTER)


Please Complete NYeC Survey to Gauge Physician Hassles with EHR Implementation and Use
MSSNY, in conjunction with other physician associations, has been working with the New York e-Health Collaborative (NYeC) on ways to reduce the hassles associated with the implementation and use of electric health record (EHR) systems.   To that end, they have developed a survey for physicians to complete that will gauge the challenges of EHR use, including connecting to and using medical information from your local Regional Health Information Organization (RHIO) to enhance patient care delivery.

Please take just a few minutes to complete the survey here:                                 (AUSTER)


Commissioner’s Medical Grand Rounds On June 13th On Vaccine Hesitancy
New York State Department of Health Commissioner Howard A. Zucker, MD, JD, will conduct a Commissioner’s Medical Grand Rounds on “Vaccine Hesitancy: An Evolving Public Health Threat” on Thursday, June 13 from 9-11 a.m.  The location of the grand rounds will be: Annenberg Building, Room 13-01, Ichan School of Medicine at Mount Sinai, 1468 Madison Avenue, New York, NY 10029.  For registration information please view the flyer here. There are also continuing medical education credits that are being offered for this program.      (CLANCY)


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

The number of measles cases in New York State has again seen an uptick over the past week.  832 of the 981 nationwide cases confirmed in 2019 are in New York State. Year-to-date as of June 6th there have been 509 confirmed cases in New York City and 323 outside of New York City (259 in Rockland; 38 in Orange; 18 in Westchester; 6 in Sullivan; 1 in Suffolk and 1 in Greene counties).  MSSNY conducted a just-in-time Medical Matters webinar entitled “The Continued Public Health Threat of Measles 2018” in December, 2018.  This webinar has now been posted to the MSSNY CME website.

You can also view MSSNY’s latest Medical Matters webinar entitled “What’s Your Diagnosis? Infectious Diseases” which involves a patient with a fever and a rash. Please check these out and keep yourself informed about the growing measles outbreak throughout New York State.  You can also listen to MSSNY’s brief podcast on the Measles, Mumps and Rubella vaccine here.                                                                                                               (HOFFMAN, CLANCY)


                                                     


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

eNews

Garfunkel Ad


Medicaid Illegally Paid for NY Sex Offenders’ Erectile Dysfunction Drugs
New York’s publicly funded Medicaid program paid more than $63,000 for erectile dysfunction drugs and other sexual treatments for 47 sex offenders, despite laws banning such expenses. The figures come from an audit released Wednesday by state Comptroller Thomas DiNapoli and first reported by The Associated Press. A state audit revealed that the New York Medicaid system made $993,000 in payments for erectile dysfunction drugs, providing 47 state sex offenders with sexual treatments. While Medicaid will cover such drugs used to treat certain diagnoses, state auditors argued that the cases did not warrant the prescriptions.

Health officials deny the charges, saying auditors “either ignored the law or the facts which undermines any value that can be associated with its findings. State and federal laws prohibit payments for sexual treatments for any Medicaid recipient. Yet auditors found that the state approved such treatments between 2012 and 2018. DiNapoli urged immediate changes to ensure the state isn’t misusing taxpayer money.

“There are clear rules about what conditions Medicaid will cover when it comes to erectile dysfunction drugs. And paying for sex offenders who’ve committed terrible crimes to get these drugs should never be lost in the bureaucratic administration of this program,” DiNapoli said. “Nearly two decades ago this office identified this problem, which led to national and state changes. While the state Department of Health immediately followed up to make corrections during the course of our audit, our auditors found that the problem persisted and needed to be fixed.”


VA Expands Veterans’ Access to Private Physicians
The New York Times (6/5) reports that on Thursday, the Department of Veterans Affairs will start “allowing a broad swath of its nine million enrollees to seek medical care outside of traditional VA hospitals, the biggest shift in the American health care system since the passage of” the ACA. Although “department officials say they are ready, veterans groups and lawmakers on Capitol Hill have expressed concerns about the VA, which has been dogged by problems with its computer systems for years.”

The groups are concerned “the department is not fully prepared to begin its new policy, which Congress adopted last year to streamline and expand the way veterans get care.” The article says “veterans facing a wait of 30 days or more for an appointment at their closest VA health care center could seek private care,” but “under the new policy, that waiting time would be reduced to 20 days, with the goal of 14 days by 2020.”

With respect to “specialty care, they can see private doctors at VA expense if they have to wait longer than 28 days or drive more than an hour to see a VA provider.” Prior to this update, “veterans who had to drive more than 40 miles or wait longer than 30 days could choose to see a private doctor paid for by the VA.”


Physician Wellness and Resilience Committee Sparks Article in Legal Journal
Dr. Michael Privitera, Co-Chair of MSSNY Physician Wellness and Resilience Committee announced that another publication has come out of the MSSNY Burnout survey we did in the fall of 2016 in collaboration with Federation of State Medical Boards. “Physician Burnout and Mental Health Care Barriers when Reporting on Applications” has been accepted in Journal of Legal Medicine.

It expounds upon how asking physicians questions on their state license applications and renewals about previous mental health care is such a large deterrent for physicians getting the care they need and how this backfires in efforts to protect the public. Other MSSNY Co-Authors were Fouad Attalah, Caroline Gomez-DiCesare, Frank Dowling and Arthur Hengerer.


A Spike in Emergency Department Prices: 135% from 2008 to 2017
The average price of an emergency department (ED) visit rose by 135% from 2008 to 2017, leaving patients on the hook for a larger share of the cost, according to a new report from the Health Care Cost Institute. The report also found that ED providers were billing for complex care more often in 2017 when compared with 2008.


Average Cost of Emergency Room in 2017 Is $1389: Up 176% over Last Decade
The nonprofit Health Care Cost Institute (HCCI) examined insurance claims for a decade’s worth of hospital emergency room bills, analyzing millions of insurance claims for people under the age of 65 who get health insurance through an employer.

HCCI found that hospital emergency rooms not only substantially increased prices for care from 2008 through 2017. The hospitals and doctors also billed for more complex care, which allows them to collect more lucrative fees from consumers, employers and private insurers.

The average emergency room visit cost $1,389 in 2017, up 176% over the decade. That is the cost of entry for emergency care; it does not include extra charges such as blood tests, IVs, drugs or other treatments.


CVS to Open 1,500 HealthHub Stores by the End of 2021
After success with its pilot sites in Houston, CVS Health plans to open 1,500 HealthHub stores by the end of 2021, the pharmacy retail giant announced June 4. HealthHubs are CVS’  redesigned health-focused concept stores that have space dedicated to helping customers manage such chronic conditions as diabetes, hypertension and asthma. Each store features an expanded health clinic with a lab for blood testing and health screenings as well as wellness rooms equipped to handle yoga classes and seminars. The stores also have more shelf space for health-focused products, such as medical equipment and supplies for diabetes care and sleep apnea.

CVS opened its first three HealthHub location in Houston. It plans to open more HealthHubs in Houston, Atlanta, Philadelphia, southern New Jersey and Tampa, Fla., this year.

The goal is to have 1,500 of the health-focused stores operating by the end of 2021.

Read the full announcement here. Becker’s Hospital Review Jun 5


Jefferson County Elects New Officers
The Medical Society of Jefferson County met on Tuesday, May 21. The meeting information is below and pictures are attached. On May 21, the Medical Society of Jefferson County hosted a Member Appreciation and New Member Welcome event. Members enjoyed a social gathering in Green Street at the Ramada Inn, Watertown, before adjourning to the Renaissance Room for a light buffet where Dr. Thomas Madejski, Immediate Past President of the Medical Society of the State of New York, led a discussion on current issues of concern to physicians.

Members of Jefferson County Medical Society

Josiree Ochotorena MD, Secretary/Treasurer, MSJC; David O. Van Eenenaam MD, Director, MSJC; Thomas Madejski MD, Immediate Past President of MSSNY; Robert Kimball MD, President, MSJC; Elizabeth Sinclair- Cady (MLMIC), and Howard Huang MD, Director, MSJC & Counselor to the 5th-6th Districts.


AMGA Survey: Physician Benefit Packages Haven’t Changed Much Since 2014
The core discretionary benefits for physicians remained largely unchanged from 2014 to 2018, according to the latest provider benefits survey from medical trade group AMGA. The survey — conducted by AMGA’s subsidiary, AMGA Consulting — also showed that the number of part-time primary care providers who are eligible for employer benefits is increasing.

For instance, in 2018, the most common combination of retirement plans reported by respondents was a 403(b) with a 457(b) plan, which was consistent with the AMGA’s 2014 benefits survey.

The 2014 and 2018 surveys also found that most employers offered some type of life insurance coverage, and that most group physicians become eligible for life insurance the first of the month after their hire date. To compare provider benefits of health systems, researchers examined data from 83 healthcare organizations across 34 states. The research included 2018 benefits package information from AMGA’s 2018 Medical Group Compensation and Productivity survey. AMGA also used a supplemental survey to gain additional information from respondents.

Overall, benefits survey found that core physician benefits, such as retirement plans, medical insurance, income protection, time off, and professional development, remained largely unchanged from 2014 to 2018, said AMGA.

Additionally, 89 percent of the 2018 survey respondents indicated they offer continuing medical education benefits for providers. Also, more than half of the 64 organizations that provided information on provider time-off benefits last year reported more than the typical six holidays guaranteed off, including New Year’s Day, Memorial Day, Independence Day, Labor Day, Thanksgiving Day and Christmas Day.

“The healthcare industry is currently experiencing a physician shortage, especially in primary care,” said Elizabeth Siemsen, AMGA Consulting director, in a news release. “The expanded offerings and lowered FTE [full-time-equivalent] thresholds we saw in this survey indicate short-staffed organizations are looking to fill employment gaps with part-time physicians and are using employee benefits as a way to attract talent.” (Beckers Hospital Review May 29).


Classified

RENTAL/LEASING SPACE


Park Avenue Office Share-3 Days Per Week
Tasteful, bright, well-maintained  medical office in prestigious building on Park Avenue at 94th Street.  Large waiting room and reception area, consultation room and 2 exam rooms available 3 days per week. Room for an assistant or clerical help 5 days per week. Please email abgmdpc@gmail.com or call 987-5000

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

 


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


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


 

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


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

PHYSICIAN OPPORTUNITIES

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

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

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

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

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

Primary Contact: Oksana


 

 


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


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

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 


MSSNY eNews – May 31, 2019 – WHO YOU GONNA CALL? MSSNY!

Arthur Fougner MSSNY Presiident

PRESIDENT’S MESSAGE<
Arthur Fougner, MD
MSSNY President

MSSNY eNews
May 31, 2019

Vol. 22  Number 21


MSSNYPAC Seal

 


Colleagues:

We get asked all the time: “Why MSSNY”? Or perhaps, “What does MSSNY do for me?” For two Bronx physicians, that answer is resoundingly clear— “MSSNY saved our practice.”

Two Bronx doctors received notification from their largest carrier that because of an issue with their Maintenance of Certification (this will be the subject of a future piece), they were about to be dropped from participation. These physicians do not practice in the trendy Hamptons or on the tony Upper West Side. They do primary care for patients of modest means and, I must say, do it well.

So they reached out to us with a cry for help. Right away, our in-house ombudsman Regina McNally contacted the carrier for more information. We also suggested they reach out to Bronx State Senator Gustavo Rivera who now chairs the Health Committee about the problem. We also did the same.

Lo and behold, the physicians received a follow-up letter from the carrier apologizing for a “mistake,” assuring them that they would remain an integral part of their network.

Funny how that works, right?

So the next time anyone asks “Why MSSNY?,” invite them to pull up a chair and tell them the story of the two Bronx physicians.

As a postscript, the following week, I met up with Sen. Rivera at an event and he told me that after speaking with those same doctors, he was introducing legislation on this whole “MOC business.”

Stay tuned.

Get up, Stand up. Stand up for your right.
Get up, Stand up. Don’t give up the fight.

Bob Marley

Arthur Fougner, MD
MSSNY President 

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


MSSNY Physician Burnout Banner


Podcast SymbolThis Week’s Podcast of MSSNY’s Legislative Priorities


 

Capital Update


Wrongful Death Bill Reported Out of Judiciary Committees
All physicians are urged to contact their legislators to oppose a bill that would cause enormous increases in medical liability premiums by expanding damages awarded in wrongful death actions. Senator Hoylman and Assemblyman Weinstein’s S.4006/A.5612, which was reported out of the Senate and Assembly Judiciary Committees on Thursday,  which will now be considered in the Senate Finance and Assembly Codes committees, would expand the possible award in a wrongful death action to include compensation for grief or anguish, the loss of love and companionship, loss of services and support and the loss of nurture and guidance.

Current law allows the family and/or estate of a decedent to sue for both economic damages and for pain and suffering that the decedent may have experienced prior to death. They also may sue for economic loss incurred due to the death. This bill would greatly expand the permissible compensation and would likely lead to drastic increases in already outrageously high liability insurance premiums.  An Actuarial estimate released by the NY Lawsuit Reform Alliance indicated that passage of this legislation could increase premiums by nearly 50%!!

With New York consistently being ranked as the worst state in the country in which to practice medicine, in large part due to its overwhelming liability exposure as compared to other states in the country, passage of this legislation would likely exacerbate these issues, making the practice environment even worse. Physicians are urged to contact their legislators and let them know how harmful this bill would be by going here.  (AVELLA) 


NYS Has 845 Confirmed Measles Cases—Physicians Urged to Call Legislators to Demand Action on this Public Health Epidemic
As of May 24, 2019, there are 940 confirmed cases of measles nationally—with 845 of them here in New York State.   Physicians throughout the state are encouraged to call their legislators and urge action on a bill that would allow only medical exemptions for immunizations.  The measure, A.2371/S.2994A, is in the Assembly & Senate Health Committees.   The Medical Society of the State of New York has joined 29 other medical organizations, patient advocacy groups and public health organizations, meeting with members of the Legislature to advocate for passage of this measure.

Advocates against mandatory vaccinations continue to call and meet with legislators and were in Albany again this week.  It is vitally important that physicians call or send messages to their legislators urging action on this measure.  You can help by following these steps:

  • Physicians are strongly urged to contact members of the Assembly Health Committee. Please call at 518-455-4100 and ask for the following Assemblymembers: Gottfried, Schimminger, Galef, Dinowitz, Cahill, Paulin, Cymbrowitz, Gunther, L. Rosenthal, Hevesi, Jaffee, Steck, Abinanti, Braunstein, Kim, Solages, Bichotte, Barron, Sayegh,Raia, McDonough, Ra, Garbarino, Byrne, Byrnes, Ashby.  Tell them that you support passage of A.2371/S.2994, which would repeal the religious exemption, ensuring that the only allowable exemption to vaccination will be for medical reasons.
  • Please send a letter to your legislator via the MSSNY Grassroots Action Center (GAC).  Please click here !
  • Physicians are encouraged to work with their local county medical society to schedule a local legislative meeting with your with local legislators! Please call your State Senator and Assembly Member’s office to voice your support of this legislation. There is strength in numbers! Please click here

The Medical Society of the State of New York’s Memo in support of A.2371/S.2994A can be found here and a copy of the memo produced by physician and public health organizations and parent and patient advocacy groups’ memo is available here.

Senate Majority Leader Andrea Stewart-Cousins has indicated that she has enough votes to pass this measure in the Senate and Governor Andrew Cuomo has publicly stated that he will sign the bill if it comes to his desk.  The question is whether there will be enough votes in support in the New York State Assembly Health Committee.

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


Rural Health Care Hearing Highlights Roots of Rural Access Issues
On Friday the Assembly Health Committee held a hearing to discuss issues surrounding access to care in rural communities. The committee heard testimony from a wide array of individuals, including those representing physicians, hospitals, home care organizations and other providers. The theme was consistent as those testifying spoke to the need to increase reimbursement to rural areas.

Dr. Chris Kjolhede, a pediatrician from Cooperstown and MSSNY delegate, testified on behalf of MSSNY and addressed the variety of issues challenging communities in rural areas. These include the need for more adequate reimbursement for services provided to Medicaid members; enhanced ability to incentivize physicians to practice in rural areas through increased funding for programs like Doctors Across New York (DANY); innovation through a carefully planned and quality-controlled telemedicine system; understanding how social determinants of health impact communities in order to craft localized solutions; and supporting evidence-based public health measures. Dr. Kjolhede and others also stressed the strong willingness on the behalf of physicians and other stakeholders to work together to improve access to quality care in rural areas.   (AVELLA)



Physician Advocacy Needed in End of Session Push for Insurance Reforms
With only three weeks remaining until the scheduled end of session, strong advocacy is needed on a variety of insurance related bills that MSSNY is supporting in order to bring about positive reforms to the health insurance system in New York. Physicians are urged to help advocate for the advancement of these reforms and emphasize how important these bills are. 

Collective negotiationsNegotiating with insurance companies is extremely difficult, especially when monolithic payers control a huge portion (or all) of the market that you practice in. The fact that you are barred from banding together with your colleagues is unfair, so MSSNY strongly supports legislation introduced by Senator Rivera and Assemblymember Gottfried (S.3462/A.2393) that would allow physicians to collectively negotiate patient care terms with insurance companies such as prior authorizations and network participation rules. Insurance companies have been fighting against this fiercely so we must ensure strong grassroots support for this legislation that would put physicians on more even footing with insurers.

The bill has been reported out of the Assembly Health and Codes Committees and awaits a vote in Ways & Means. Its Senate companion is currently in in the Senate Health Committee. Please urge your Assemblymember and Senator to join on as a co-sponsor and support the bill click here. 

Mid-year formulary changesSurprisingly, current law does not restrict insurance companies from making substantial changes to their formularies mid-year. This is an egregious practice when you consider the fact that your patients choose insurance plans based on the coverage presented to them – and they generally are not able to switch plans mid-year. Senator Breslin and Assemblymember Peoples-Stokes have introduced legislation (S.2849/A.2969) that would prevent mid-year formulary changes so that patients do not experience removal of a drug or changes in tiering when there is no similarly effective option.

The bill is currently on the Senate calendar eligible for a vote and has been reported out of the Assembly Insurance Committee; it currently awaits a vote in the Assembly Codes Committee. Please urge your Assemblymember and Senator to join on as a co-sponsor and support the bill click here.

Prior authorizationsPrior authorizations continue to be a major roadblock to care and cause endless hassles for you and your staff. The burdens caused by excessive and often unjustified prior authorization requirements take away from the time that you should be spending with your patients and lead to far too many hours being spent on paperwork. Senator Breslin and Assemblymember Gottfried have introduced an “omnibus bill” (S.2847/A.3038) that would help physicians in a variety of ways, including reducing prior authorization burdens, updating UR standards and patient protections for prescription drug coverage continuity.

The bill is has been reported out of the Senate Insurance Committee and is on the floor calendar eligible for a vote. Its Assembly companion awaits consideration in the insurance committee. Please urge your Assemblymember and Senator to join on as a co-sponsor and support the bill click here.

Network due processThere is currently a glaring loophole in New York’s laws that allow insurance companies to terminate physicians from their networks by non-renewal without cause or recourse. While they are required to notify physicians when contracts are terminated and physicians are then afforded the opportunity for a hearing, these protections don’t extend to non-renewal. Senator Rivera’s and Assemblymember Lavine’s bill (S.3463/A.2835) would provide physicians with proper due process upon non-renewal and would enhance the current hearing process by allowing the subject of the hearing (the physician) to choose one of the three members of the panel.

The bill is currently eligible for a vote on the Senate Floor. It was recently reported out of the Assembly Codes Committee and will be eligible for a vote in the Assembly next week.  (AVELLA)


MSSNY Testifies at Single Payor Hearing
MSSNY President Dr. Art Fougner testified at a 13-hour long Assembly-Senate hearing this week (click here) examining legislation (S.3577, Rivera/A.5248, Gottfried) that would create a single payor system in New York State.  Dr. Fougner’s testimony praised the sponsors for their efforts to ensure New Yorkers have coverage for the care they need, as well as the efforts to revise the legislation to address concerns that physicians have raised with the legislation.   These improvements include provisions to reduce prior authorization requirements and additional mechanisms to help physicians more fairly negotiate with a monolithic bureaucratic structure.  MSSNY has a long-standing position in opposition to a single payor insurance system, though many physicians across the State have expressed support for such a system.

Dr. Fougner noted that while there are aspects of such a system that are appealing, such as the potential for administrative simplification, MSSNY remains concerned that the good intentions of the sponsors of this proposal may not be how the NY Health system will ultimately operate, particularly when they must respond to situations where anticipated tax revenues do not meet spending projections. He also noted that continued promotion and expansion of the varied programs to provide health insurance coverage for New York’s uninsured and underinsured is MSSNY’s preferred approach.

There will be more hearings on this issue later in the year.   (AUSTER)


Efforts to Legalize Recreational Marijuana Continue as Legislature Nears End
Advocates for legalizing the recreational/adult-use of marijuana in New York are strongly pressing members of the New York State Legislature to pass legislation.   A. 1617A/ S 1527A, sponsored by Assembly Majority Leader Crystal Peoples-Stokes and Senator Liz Krueger, which was recently amended, would create the “marijuana regulation and taxation act”.   The amended bill would expunge lower level marijuana convictions reduce the amount of marijuana that can be possessed to three ounces, and tax marijuana at a higher level.  Additionally, the new bill calls for the state to train police to recognize impaired drivers and establishes an Office of Cannabis Management which would oversee the growth, sale and distribution of hemp and medical marijuana as well as recreational/adult-use marijuana.  The Assembly bill is in the Assembly Codes Committee and the Senate bill is in the Senate Finance Committee.  The Medical Society of the State of New York continues to oppose the legalization of recreational marijuana and continues to work with other advocacy groups that oppose this measure.

Also pending in both houses is A.7467/S.5657, sponsored by Assemblymember Richard Gottfried and Senator Diane Savino, which would greatly expand New York State’s medical program for certifying patients for the use of marijuana.   The bill eliminates “serious condition” and replaces it with “condition” and further expands the list of condition eligible for certification.  The measure also expands the list of practitioners who can certify the patient for the use of marijuana and would authorize “smoking” as a modality of treatment.   The bill is pending in the Assembly Codes Committee and the Senate Health Committee.   (CLANCY, AUSTER)


Bill to Assess Ways to Improve Physician Loan Repayment Program Passes Both Houses
Senator Rivera and Assemblymember Gottfried’s S.4269/A.5425 has passed both the Senate and Assembly and will be sent to the Governor for signature. The bill, which was supported by MSSNY, will require an assessment of the impact of requiring individual applicants for grants from the Doctors Across New York physician loan repayment and physician practice support programs to use the New York State Grants Gateway.

Doctors Across New York (DANY) is a successful recruitment and retention tool that helps attract physicians to underserved areas across New York. This is achieved by offering loan forgiveness and practice start-up financial support from the state. This year, the application has been moved from the Department of Health to the New York Grants Gateway. The process to obtain a grants gateway account and the method via which applicants access the RFA is more rigorous and difficult than the previous process and there is some fear that this will reduce the number of physicians that are able to take advantage of this program.  MSSNY has been working with the NY Chapter of ACP in advocating for this legislation.

The workgroup established by this legislation will gather information on the results of the new application process and will work to ensure that the number of applicants is not negatively impacted by the increased administrative steps needed to apply.       (AVELLA)


Varying Proposals to Address Surprise Medical Bills Contain Positive and Concerning Elements
With several US House and Senate leaders releasing bi-partisan proposals to address the issue of “surprise” patient out of network medical bills that could undermine New York’s acclaimed law, physicians are urged to send a letter (please click here) urging their member of Congress to fight for a law that is consistent with New York’s approach, and to oppose legislation that would undermine New York’s proven model.

Importantly, last week Representative Joe Morelle (D-NY) together with Representative Dr. Phil Roe (R-TN) and Dr. Raul Ruiz (D-CA) released a proposal that seeks to mirror New York’s law, which uses a “baseball arbitration” Independent Dispute Resolution (IDR) system to determine payments for out of network medical care, and uses charge data collected by an independently controlled database as a leading benchmark to guide the IDR.  MSSNY Board of Trustees member Dr. Andrew Kleinman also recently participated in a meeting with the House Doctors Caucus to educate legislators about New York’s approach.

However, several proposals have been advanced that would either require an insurer determined in-network based default rate for out of network surprise medical bills, or create a baseball arbitration system that uses an insurer determined in-network rate as a benchmark.   MSSNY has written to New York’s Congressional delegation praising the approach set forth by Representatives Morelle, Roe and Ruiz, and raising strong concerns with other proposals.

Specifically, New York’s letter raised concerns with the insurance industry’s own notorious history establishing benchmarks for out of network payment, and the history of then-Attorney General Cuomo’s investigation which found that by using a flawed and conflicted database to determine reimbursement rates for out-of-network care, insurers were increasing profits at the expense of patients and physicians.   Moreover, it was noted that New York’s law struck a tenuous balance among various health care stakeholders that protected patients from surprise medical bills and assured that hospital emergency departments had access to needed on-call specialty care.

With so much interest in this issue, there will be likely be Congressional action this year, so physician grassroots advocacy is essential.  (AUSTER)


Expansion of Scope of Practice Legislation Pending on Senate Calendar For A Vote
There are several bills that are now on the Senate Calendar and ready for a vote that would expand the scope of practice for many providers.  The Medical Society opposes the following measures:

  • 5395/A.6185, which is sponsored by Senator Robert Jackson and Assemblymember Gary Pretlow, would inappropriately expand the scope of practice of podiatrists the following ways: by reducing certification requirements for podiatrists seeking to have advanced surgical privileges; Removing the requirement that a podiatrist seeking either standard ankle surgery or advanced ankle surgery privileges be directly supervised by a podiatrist with an advanced license from the NYSED or a physician; and enabling podiatrists to treat wounds that are not contiguous with structures of the foot or ankle.
  • 5092/A.3867, sponsored by Senate Health Chair Gustavo Rivera and Assemblymember John McDonald. This would add pharmacists to the list of licensed health care professionals authorized under public health law to perform non-invasive laboratory tests as an adjunct to their professional services, without an order from a physician to provide such services.
  • 5227/A.6511A, sponsored by Senator Rachel May and Assemblymember Amy Paulin. The bill would allow pharmacists to provide ALL immunizations on the Advisory Committee on Immunizations Practices (ACIP) list recommended for adults, this would more than double the number of immunizations pharmacists would be permitted to provide.
  • 4975/A.6486, sponsored by Senator Neil Breslin and Assemblymember John McDonald, would authorize a pharmacist to administer vaccines for hepatitis A, hepatitis B, and human papillomavirus

to adults via a patient or non-patient specific script.

Please urge your legislators to oppose these measures.  Assembly 518-455-4100, and Senate 518-455-2800.    (CLANCY, AUSTER)     


AMA Opioid Task Force Issued 2019 Report
The AMA Opioid Task Force this week issued an updated report containing recommendations focusing on tangible actions that can help to end the opioid epidemic. In 2014-15, the Task Force issued six recommendations focused on ways in which physicians could take specific actions to help reverse the nation’s opioid epidemic. While there has been   demonstrated progress in each of these areas, it is clear that much more work remains, and policymakers have an increasing role to play. The new recommendations:

  1. Remove prior authorization, step therapy and other inappropriate administrative burdens or barriers that delay or deny care for FDA-approved medications used as part of medication-assisted treatment for opioid use disorder.
  2. Support assessment, referral and treatment for co-occurring mental health disorders as well as enforce state and federal laws that require insurance parity for mental health and substance use disorders.
  3. Remove administrative and other barriers to comprehensive, multimodal, multidisciplinary pain care and rehabilitation programs.
  4. Support maternal and child health by increasing access to evidence-based treatment, preserving families, and ensuring that policies are non-punitive.
  5. Support reforms in the civil and criminal justice system that help ensure access to high quality, evidence-based care for opioid use disorder, including medication-assisted treatment.

The task force consists of American Medical Association, American Osteopathic Association, and 25 specialty and state medical societies as well as the American Dental Association.   The Medical Society of the State of New York is a member of the task force.    The original task force recommendations, issued in 2015, focused on actions that physicians could take to help end the epidemic and are now regularly being followed by New York physicians:

  • Register for and use the state prescription drug monitoring program;
  • Enhance education and training on effective, evidence-based treatment;
  • Support comprehensive care for patients in pain and those with a substance use disorder;
  • Remove stigma. Patients with pain and with a substance use disorder deserve comprehensive care and compassion, not judgment;
  • Expand access to naloxone in the community and through co-prescribing; and
  • Encourage safe storage and disposal of opioids and all medications. (CLANCY)

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

The number of measles cases in New York State in 2019 has again seen an uptick over the past week.  806 of the 940 confirmed cases nationwide are in New York State. In 2019 there have been 493 confirmed cases in New York City and 313 outside of New York City (254 in Rockland; 37 in Orange; 17 in Westchester; 3 in Sullivan; 1 in Suffolk and 1 in Greene counties) confirmed cases as of May 30th.  MSSNY conducted a just-in-time Medical Matters webinar entitled “The Continued Public Health Threat of Measles 2018” in December, 2018.  This webinar has now been posted to the MSSNY CME website. https://cme.mssny.org/ . You can also view MSSNY’s latest Medical Matters webinar entitled “What’s Your Diagnosis? Infectious Diseases” which involves a patient with a fever and a rash. Please check these out and keep yourself informed about the growing measles outbreak throughout New York State.  You can also listen to MSSNY’s brief podcast on the Measles, Mumps and Rubella vaccine here.          (HOFFMAN, CLANCY)


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

Veterans Matters: Substance Use Disorders in Veterans

When:  Wednesday June 5 2019 at 7:30am – Register here

Faculty: Frank Dowling, MD

Educational Objectives

  1. Define Substance Use Disorders (SUDs), symptoms, warning signs, comorbidities
  2. Explore evidence-based intervention and treatment options for SUDs among veterans
  3. Identify barriers to diagnosis and treatment and methods to overcome them

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

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

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


NY Rx Card Banner                                                     


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

eNews

Garfunkel Ad


SURVEY: What are Your Challenges with EHR?
MSSNY, in conjunction with other physician associations, has been working with the New York e-Health Collaborative (NYeC) on ways to reduce the hassles associated with the implementation and use of electric health record (EHR) systems.

To that end, they have developed a survey for physicians to complete gauging the challenges of EHR use, including connecting to and using medical information from your local Regional Health Information Organization (RHIO) to enhance patient care delivery.

Please take just a few minutes to complete the survey here.


Opioids Prescribed in 1 of 6 ED Visits by Young People
One in six emergency department visits by adolescents and young adults resulted in an opioid prescription, according to a Pediatrics study.

Using 2005 to 2015 data from two national health surveys, researchers examined 47,000 visits to emergency departments and 31,000 visits to outpatient clinics among patients aged 13 to 22. Among the findings:

  • Nearly 15% of emergency department visits and 3% of clinic visits resulted in an opioid prescription.
  • Opioid prescriptions in the ED decreased slightly over time.
  • The prescribing rate surpassed 40% for dental problems in all ages and clavicle fracture in adolescents.

A commentator writes: “This study’s findings reflect many of the unique attributes of health care use by young adults. … Young adults seek care for acute conditions and injuries, chronic conditions, and reproductive care and receive a greater proportion of their care at emergency departments than any age group except for the elderly.”

Pediatrics article


MSSNY Council Notes—May 30. 2019

  • MLMIC has filed for a no rate increase and a “claims free” discount with DFS. The decision is expected at the end of June. MLMIC will let MSSNY know immediately when the decision is made and we will inform membership.
  • MLMIC has contributed $50,000 to MSSNY’s Physician Wellness Committee, which is chaired by Dr. Charles Rothberg.
  • On behalf of MSSNYPAC, Dr. Thomas Lee reported very successful fundraising events in Erie County and Staten Island, and encouraged each county in New York to develop a local fundraising effort to bring new members into MSSNYPAC. Contact Jennifer Wilks at jwilks@mssnypac.org or 518.465.8085 to get started.
  • The Medical, Educational and Scientific Foundation of New York (MESF) will run a final Physician Leadership Seminar June 21-22 at the Hyatt Regency in Hauppauge on Long Island. Contact Tom Donohue at tdonoghue@mssny.org for more info.
  • 40 MSSNY Delegates and Alternates will attend the annual AMA meeting June 8-12 in Chicago.
  • Hayden S. Wool, a partner with Garfunkel Wild, presented “Key Considerations in Informing Ancillary Services through a Group.” He provided an overview of the key regulatory compliance issues related to patient referrals and the performance of ancillary services by Group Practice. The presentation focused on an overview of physician consolidation/service expansion; structural changes; and regulatory compliance issues.
  • Onondaga County Medical Society hired Erika Barry as their new executive director.

Westchester Medical Center Locked in Contract Dispute
Empire BlueCross BlueShield has notified its members that Westchester Medical Center Health Network will become out-of-network on June 1 unless the two sides reach an agreement. The health network’s contract with Empire expired April 1, but discussions have continued during a two-month “cooling off” period. “We have a strong desire for Westchester Medical Center to be in-network, but we have to provide affordable products,” Alan Murray, Empire’s CEO, told Crain’s. “That’s a constant balance we’re challenged with.”

The insurer sent a letter describing the potential network changes to members last month; it was obtained this week by The Journal News. The hospitals affected are Westchester Medical Center and Maria Fareri Children’s Hospital in Valhalla; Bon Secours Community Hospital in Port Jervis, Orange County; Good Samaritan Hospital in Suffern, Rockland County; St. Anthony Community Hospital in Warwick, Orange County; and MidHudson Regional Hospital in Poughkeepsie, Dutchess County. The insurer told members that Empire would cover WMCHealth facilities as in-network during emergencies, when services have been previously authorized or where another provider is not within 30 miles of a patient’s home. (Crain’s Health Pulse)


Some Measles Patients Are Asked Not to Travel by Air
Five states, including New York, have advised people who may have measles that public health officials could stop them from boarding airplanes, the Washington Post reports.

State officials can request that the CDC put measles patients on a Do Not Board List that could prevent them from getting on aircraft. All eight people given the warnings by officials in New York, California, Illinois, Oklahoma and Washington State canceled their flights.

The CDC reported 971 cases of measles in the United States so far this year, the highest number in over a quarter-century an increase of 91 cases in the past week. CDC Director Robert Redfield pleaded with hesitant parents to vaccinate their children, reiterating that measles and other vaccines are safe and do not cause autism. Maine and New Mexico have joined the list of 26 states that have confirmed measles. https://www.cdc.gov/measles/travelers.html; CDC measles outbreak surveillance;  NEJM Journal Watch Infectious Diseases coverage of U.S. measles outbreak in 2019


Growing Number of Cancer Patients Are Using Electronic Cigarettes
Findings published in a research letter in JAMA Oncology report that “research shows a growing number of cancer patients are using electronic cigarettes.” Investigators found that “e-cigarette use by cancer patients rose from 8.5% in 2014 to nearly 11% in 2017.” The data indicated that “among patients younger than 50, the rate of use rose from 23% in 2014 to 27% in 2017.”


CDC: Decline of Diagnosed Diabetes in US, Yet Overall Numbers High
Even though “rates of diagnosed diabetes in the United States may finally be declining…overall numbers remain high,” Stephen R. Benoit, MD, and colleagues from the Division of Diabetes Translation, Centers for Disease Control and Prevention (CDC) concluded after analyzing “data for an almost 40-year period (1980-2017) from the National Health Interview Survey.” The findings were published online in BMJ Open Diabetes Research and Care. https://drc.bmj.com/content/7/1/e000657


Weed Killer May Be Linked to Liver Disease, Study Suggests
An article published online in Clinical Gastroenterology and Hepatology reported that research suggests “the popular weed killer Roundup might be linked to liver disease.” Researchers found that “a group of patients suffering from liver disease had elevated urine levels of glyphosate, the primary weed-killing ingredient in Roundup.” Lead researcher Paul Mills said, “We found those patients who had more severe disease had higher levels of [glyphosate] excretion, which means they had higher levels of exposure, presumably through their diet.”


Dr. Madejski Debates Legalization of Recreational Marijuana
Immediate Past President Dr. Tom Madejski debates recreational marijuana with author, screenwriter, former editor-in-chief/Publisher at High Times and convicted drug smuggler Richard Stratton on the podcast Morano Whenever. Highlights of the debate will also air this Sunday morning on AM 970 THE ANSWER, which is broadcast in the New York metropolitan area.


Classified

RENTAL/LEASING SPACE


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


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


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


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


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


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


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

PHYSICIAN OPPORTUNITIES

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

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

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

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

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

Primary Contact: Oksana


 

 


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


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

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 


MSSNY eNews – May 24, 2019 – Memorials and Decorations

Arthur Fougner MSSNY Presiident

PRESIDENT’S MESSAGE<
Arthur Fougner, MD
MSSNY President

MSSNY eNews
May 24, 2019

Vol. 22  Number 20


MSSNYPAC Seal

 


Colleagues:

This is Memorial Day weekend. We celebrate the unofficial beginning of summer with barbecues, sitting in traffic en route to newly opened pools and beaches, or perhaps strolling in lower Manhattan for the Fleet Week celebration. Maybe you take care of that long delayed yard work and sit on the back porch, sipping lemonade or something stronger, enjoying the weather. But really, is this what Memorial Day is about?

Memorial Day began as separate remembrances in 1866 in both the North and the South. In the town of Waterloo, NY, a ceremony was held to honor the local veterans. (This was later recognized by President Lyndon Johnson as the birthplace of Memorial Day.) In 1868, Gen. Logan declared May 30 Decoration Day for the official placing of florals on the graves of the Union War Dead. As America entered World War I, Decoration Day became today’s Memorial Day to honor those who died in all America’s wars.

One of the earliest of those was a physician. Gen. Joseph Warren was a Boston physician who once saved a young John Quincy Adams finger from amputation. A prominent member of the Sons of Liberty, Warren had enlisted Paul Revere and William Dawes to take that famous ride. Though a General, he chose to fight with the enlisted men who stood their ground on Breed’s Hill (Yes, the Battle of Bunker Hill was actually fought on Breed’s Hill.) Dr. Warren gave his all for what would become our United States in the British troops final assault.

We should also remember one of our own – Dr. Ralph Schlossman. Although he did not die in battle, he served our country honorably and was perhaps the first US physician to fly jets. Dr. Schlossman’s cause was and remains our cause – the good of all patients and their doctors.

So as you enjoy that last hot dog, perhaps washing it down with an adult beverage or two, do remember those who served and gave their all for their cause – us.

The torch; be yours to hold it high.
If ye break faith with us who die
We shall not sleep, though poppies grow
In Flanders fields.  – John McCrae, Flanders Fields

Arthur Fougner, MD
MSSNY President 

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


MLMIC Ad Banner


Capital Update


Physician Action Needed to Help Stop Measles Outbreak, NYS Has 810 Confirmed Cases!
There are 810 confirmed measles cases in New York State and the number continues to grow.  The Medical Society of the State of New York continues to advocate for passage of legislation that would allow only medical exemptions for immunizations.  The measure, A.2371/S.2994A, is in the Assembly & Senate Health Committees.   MSSNY, along with 28 other medical organizations, patient advocacy groups and public health organizations, have been meeting with members of the Legislature to advocate for passage of this measure. The Medical Society of the State of New York’s Memo in support of A.2371/S.2994A can be found here and a copy of the memo  produced by physician and public health organizations, and parent and patient advocacy groups memo is available here.

Physicians are strongly urged to contact members of the Assembly Health Committee.  Please call them at 518-455-4100 and ask for the following Assemblymembers: Gottfried, Schimminger, Galef, Dinowitz, Cahill, Paulin, Cymbrowitz, Gunther, L. Rosenthal, Hevesi, Jaffee, Steck, Abinanti, Braunstein, Kim, Solages, Bichotte, Barron, Sayegh,Raia, McDonough, Ra, Garbarino, Byrne, Byrnes,Ashby.  Tell them that you support passage of A.2371/S.2994, which would repeal the religious exemption, ensuring that the only allowable exemptions to vaccination will be for medical reasons.  Additionally, please send a letter via the MSSNY Grassroots Action Center (GAC) to your legislator!   Please click here..

Physicians are also encouraged to work with local county medical society to schedule a legislative meeting within your area with! Or call your State Senator and Assembly Member’s office to voice your support of this legislation.     There is strength in numbers! Please look them up here: Please click here

MSSNY President Arthur Fougner, MD and M. Monica Sweeney, MD, a member of the MSSNY’s Committee on Infectious Disease and Health Disparities participated in a press conference this week with the bill sponsors, calling upon the NY State Legislature to pass this vital bill.  Joining the Medical Society in support of repealing religious exemptions are the following groups:  American Academy of Pediatrics, NYS District II, Chapters 1, 2 & 3, American Nurses Association – New York (ANA-NY),  Associated Medical Schools of New York, Autism Science Foundation, Citizen Committee for Children of New York, Inc., Children’s Defense Fund-New York, Erie County Department of Health, Ithaca Is Immunized, Kimberly Coffey Foundation, Nurses Who Vaccinate, March of Dimes, Meningitis B Action Project,  Nurse Practitioner Association New York State, New York American College of Emergency Physicians, New York State Society of Dermatology and Dermatologic Surgery, NY Chapter American College of Physicians, NYS Academy of Family Physicians, NYS Association of County Health Officials (NYSACHO), NY Occupational and Environmental Medical Association (NYOEMA), NY State Neurological Society, NY State Neurosurgical Society, NYS Ophthalmological Society, NYS Society of Otolaryngology-Head and Neck Surgery, NYS Public Health Association, New York State Society of Anesthesiologists, Inc., The New York State Radiological Society, Schuyler Center For Analysis and Advocacy, The Children’s Agenda, Tompkins County Department of Health.      (CLANCY)


Wrongful Death Bill on Senate Judiciary Agenda
A bill to authorize additional compensation in wrongful death actions will be considered in the Senate Judiciary Committee on Thursday. Senator Hoylman and Assemblyman Weinstein’s S.4006/A.5612 would expand the possible award in a wrongful death action to include compensation for grief or anguish, the loss of love and companionship, loss of services and support and the loss of nurture and guidance.

Current law allows the family and/or estate of a decedent to sue for both economic damages and for pain and suffering that the decedent may have experienced prior to death. They also may sue for economic loss incurred due to the death. This bill would greatly expand the permissible compensation and would likely lead to drastic increases in already outrageously high liability insurance premiums. Actuarial estimates have indicated that passage of this legislation could increase premiums by over 50%.

With New York consistently being ranked as the worst state in the country in which to practice medicine, in large part due to its overwhelming liability exposure as compared to other states in the country, passage of this legislation would likely exacerbate these issues, making the practice environment even worse. Physicians are urged to contact their legislators and let them know how harmful this bill would be by going here. (AVELLA)



Advocating to Reduce Health Insurer Hassles – Take Action Now!
As we progress toward the end of session, it is vital that physicians let legislators know how they feel about a variety of insurance-related legislative measures that would impact physicians and their patients’ relationships with insurance companies. The following three bills would help patients to be able to receive timelier treatment with greater choice of physician.  Please take action by contacting your legislators and asking them to support these bills. 

Collective negotiations – Negotiating with insurance companies is extremely difficult, especially when monolithic payers control a huge portion (or all) of the market that you practice in. The fact that you are barred from banding together with your colleagues is unfair, so we strongly support legislation introduced by Senator Rivera and Assemblymember Gottfried (S.3462/A.2393) that would allow physicians to collectively negotiate patient care terms with insurance companies in certain situations.

The bill is currently in the Assembly Ways and Means Committee and in the Senate Health Committee. Please urge your Assemblymember and Senator to join on as a co-sponsor please click here

Mid-year formulary changes – Surprisingly, current law does not restrict insurance companies from making substantial changes to their formularies mid-year. This is an egregious practice when you consider the fact that your patients choose insurance plans based on the coverage presented to them – and they generally are not able to switch plans mid-year. Senator Breslin and Assemblymember Peoples-Stokes have introduced legislation (S.2849/A.2969) that would prevent mid-year formulary changes so that patients do not experience removal of a drug or changes in tiering when there is no similarly effective option.

The bill is on the Senate floor, and advanced this week from the Assembly Insurance Committee to Codes Committee.  Please urge your Assemblymember and Senator to join on as a co-sponsor please click here

Prior authorizations – Prior authorizations continue to be a major roadblock to care and cause endless hassles for you and your staff. The burdens caused by excessive and often unjustified prior authorization requirements take away from the time that physicians can spend with their patients and lead to far too many hours being spent on paperwork. Senator Breslin and Assemblymember Gottfried have introduced an “omnibus bill” (S.2847/A.3038) that would reduce the hassles in a variety of ways, including updating UR standards and reducing the need for repeat prior authorizations.

The bill is advanced from the Senate Health Committee to the Senate floor this week, and is in the Assembly Insurance Committee. Please urge your Assemblymember andSenator to join on as a co-sponsor please click here (Avella, Auster)


Varying Proposals to Address Surprise Medical Bills Contain Positive and Concerning Elements
US House and Senate leaders have each released bi-partisan proposals this week to address the issue of “surprise” out of network medical bills received by patients.    While the House and Senate proposals have some similarities to New York’s law, there are also important differences which raise serious concerns.  Physicians are urged to send a letter from here (please click here) urging their member of Congress to fight for a law that is consistent with New York’s approach, and to oppose legislation that would undermine New York’s proven model.

The American Medical Association testified this week at a hearing of the House Ways and Means Committee examining this issue.  Moreover, Representative Joe Morelle (D-NY) together with Representative Van Taylor (R-TX) and Raul Ruiz (D-CA) released a summary of a proposal that seeks to mirror New York’s law, though the actual legislative text has not been released yet.

Last week, a bipartisan working group led by Dr. William Cassidy (R-LA) released a proposal that attempts to address several issues that cause patients to have surprise bills in the first instance, including increasing insurer transparency of patient cost-sharing requirements, of networks for the varying plans offered by a particular insurer, and annual reporting to HHS of the out of network services it has paid in the previous year.  Moreover, for “surprise” medical bills, it preserves state approaches to addressing surprise bills for patients insured in state-regulated plans.

With regard to ERISA regulated plans, it recommends using New York’s “baseball” arbitration approach, but of great concern, the IDR benchmark would be “commercially reasonable rates (which must be based on in-network rates and not charges) for that geographic area” This approach could greatly undermine New York’s law and eliminate any incentive for a health insurer to negotiate fairly with a physician.  To read more, click here: please click here.

Another proposal, from House Energy & Commerce Chair Frank Pallone (D-NJ) and Ranking Member Greg Walden (R-OR) would also prohibit balance billing for all emergency services and patients would only be held responsible for the amount they would have paid in-network.  It also preserves a state’s ability to determine their own payment standards for plans regulated by the state.   But of great concern, it would establish a minimum payment standard set at the median contracted (in-network) rate for the service in the geographic area the service was delivered. Again, this approach could greatly undermine New York’s law and eliminate any incentive for a health insurer to negotiate fairly with a physician. To read more, click here: please click here.

MSSNY has written to the New York Congressional delegation to raise concerns with the Cassidy and Pallone proposals, as well as to highlight approaches such as the Morelle-Ruiz-Taylor proposal that would mirror New York’s law for ERISA plans. Again, physicians are urged to send a letter to their members of Congress urging that they follow NY’s approach.   (AUSTER)                                                   


NY Rx Card Banner


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

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

While this legislation is well intended, it ignores existing Public Health Law that essentially requires the patient’s informed consent. This means that when a patient needs treatment, their physician must give them information regarding risks so that they can make an informed decision. Additionally, this is duplicative of requirements that currently exist under other laws mandating that after a physician prescribes the medication, the pharmacist is required to again inform the patient about the risks of taking a controlled substance.

Moreover, for their patients who are on opioid medications longer than 90 days, physicians are required to have a written treatment plan that includes discussing with patients the risks of these medications and possible alternatives to these medications.  MSSNY is also concerned that such requirements will further discourage physicians from prescribing pain medications for patients who need them – already a growing concern – and could potentially scare patients who truly need pain medication away from taking this medication. (CLANCY, AUSTER)


MSSNY Raises Substantial Concerns with Legislation to Expand List of Conditions for Medical Marijuana Program and Allows Smoking of Marijuana
Assembly Bill A7467, sponsored by Assemblymember Richard Gottfried, has moved from the Assembly Health Committee to the Codes Committee.  This measure would greatly expand New York State medical program for certifying patients for use of marijuana. The bill would expand the medical program for use of marijuana by eliminating “serious condition” and its definition of debilitating or condition to just “condition” and further expands the list of conditions.

Conditions currently eligible include: cancer,  positive  status  for  human  immunodeficiency virus or acquired immune deficiency syndrome, amyotrophic lateral sclerosis,  Parkinson’s  disease,  multiple  sclerosis, damage to the nervous tissue of the spinal cord  with  objective  neurological  indication  of intractable  spasticity,  epilepsy, inflammatory bowel disease, neuropathies, Huntington’s disease, post-traumatic stress disorder,  pain  that degrades health and functional capability where the use of medical marijuana is  an  alternative  to  opioid  use,  substance  use  disorder.  The bill would add Alzheimer’s, muscular dystrophy, dystonia, rheumatoid arthritis, autism or any other conditions to the list of conditions that the practitioner may certify.

There is a lack of scientific study regarding the use of marijuana to treat many of these conditions and using marijuana has the potential to exacerbate certain medical conditions.  This legislation would also authorize the “smoking” of marijuana as a modality for treatment.   Furthermore, the list of individuals who can certify the patient for use of marijuana would be expanded to include dentists and podiatrists.   It requires that the practitioner undergo a two hour course as determined by the commissioner of health. The Medical Society of the State of New York is opposed to this measure as we have serious concerns about government legitimizing in statute that a particular treatment is suitable without an appropriate level of scientific review.

This is yet another reason why MSSNY supports rescheduling of marijuana at federal level so that necessary research can be done.  While there is increasing evidence that shows marijuana may be a beneficial treatment for some conditions, there are also significant personal and public health risks related to its use.  The measure also encompasses many of the concepts contained in the 2019-20 Executive Budget proposals to legalize recreational marijuana.   This legislation is an attempt to further expand the use of marijuana under the guise of a “medical” program.  Senator Diane Savino is carrying the bill S. 5657 in the Senate and that bill is currently in the Senate Health Committee.      (CLANCY)


Senate Health Committee Approves Allowing Pharmacists to Use CLIA-Waived Tests; Bill On the Senate Calendar For A Vote

  1. 5092/ A. 3867, sponsored by Senate Health Chair Gustavo Rivera and Assemblymember John McDonald, has moved from the Senate Health Committee to the Senate Floor. The measure would add pharmacists to the list of licensed health care professionals authorized under public health law to perform non-invasive laboratory tests as an adjunct to their professional services. The Medical Society of the State of New York is opposed to this measure. This measure runs contrary to the continuum of integrated care that has become essential and is expected in today’s medical practice and would lead to siloed care. The present system recognizes that CLIA-waived testing of patients by pharmacists must occur under an established protocol and the supervision of a physician who can help to interpret the test results, provide needed context and most importantly set forth a care plan for the patient.   MSSNY has serious concerns that this legislation is a back-door attempt to allow for the establishment of retail clinics within pharmacies.  Additionally, there is absolutely no demonstrated need for not continuing the present system of how a CLIA-waived test is conducted in the pharmacy.  Having physician oversight of this process is an important step in protecting the continuum of health care. (CLANCY, AUSTER)

Bill to Expand Pharmacists Immunization Authority on Senate Calendar
A bill to allow pharmacists to administer all vaccines to adults is on the New York State Senate Calendar awaiting a vote.  Sponsored by Senator Rachel May and Assemblymember Amy Paulin, S. 5227/A. 6511-A would allow pharmacists to provide ALL immunizations on the Advisory Committee on Immunizations Practices (ACIP) list recommended for adults.  This bill significantly expands on legislation enacted in 2008 and 2012 which provided pharmacists only very limited ability to administer vaccinations to adults.

The bill would lift the sunset provision enacted in the 2012 legislation and make permanent the pharmacist’s authority to administer vaccinations to adults.  This law would expand a pharmacists’ current authority to provide seven vaccines to 16 vaccines that are on the ACIP schedule. Many of these immunizations are given as a series with specific time parameters, and calling back a patient within a physician’s office, where contact information available, is at times difficult.  Calling back an individual to a pharmacy to get the additional immunizations may be beyond the capability of that pharmacy.

More importantly, this legislation prevents a review by the NY Legislature as to whether pharmacists should be performing any additional immunizations that may be recommended by ACIP in the future as ACIP reviews newer vaccines.    The measure is currently pending in the Assembly Higher Education Committee.  The Medical Society opposes this bill and urges physicians to call their legislator regarding this measure.   (CLANCY)


Partial Fill Legislation on Senate Health Committee
Senate Bill S1813, sponsored by Senator Gustavo Rivera, is on the Senate Health Committee next week.   This measure allows a prescriber to issue a prescription to a patient for a Controlled Substance II, III or IV that can be filled partially.  It also allows them to prescribe up to a 30-day supply of Controlled Schedule II, III, and IV with a notation to the pharmacist that he/she should only dispense the agreed to amount. Each partial filling would be dispensed and recorded in the same manner as a refilling (i.e., date refilled, amount dispensed, initials of dispensing pharmacist, etc.).

The total quantity dispensed in all partial fillings may not exceed the total quantity prescribed. Partial fills of prescriptions for Controlled Substance II are allowable under federal law but are currently prohibited in New York State. Its companion measure, Assembly Bill 3918, sponsored by Assemblymember John McDonald, has passed the NYS Assembly.  The Medical Society of the State of New York supports this measure.    (CLANCY)


AMA Urges Delay in Marijuana Legalization Efforts
With the New York State Legislature still actively considering legislation to legalize “recreational” or “adult use” marijuana, the American Medical Association this week sent letters to Governor Cuomo, Senate Majority Leader Stewart-Cousins and Assembly Speaker Heastie urging New York State “to delay initiating the legalization of cannabis for recreational (non-medicinal) use until further research is completed on the public health, medical, economic and social consequences of its use.”

Specifically, the AMA letters raised concerns regarding “the effect of recreational cannabis legalization on public health, as well as the impact of its use particularly in high-risk populations such as youth, pregnant women and women who are breastfeeding.”  The letter also noted that “Early data from jurisdictions that have legalized cannabis demonstrate concerns particularly around unintentional pediatric exposures resulting in increased calls to poison control centers and emergency department visits, as well as an increase in traffic deaths due to cannabis-related impaired driving.”  The AMA also raised concerns that “experiences with other legal drugs (i.e., alcohol and tobacco) suggest that for-profit corporations will attempt to weaken regulations intended to protect health in order to maximize profits—resulting in significant public health harms.”

Recognizing that the State Legislature is also looking at proposals to expand the medical marijuana program for various health conditions without adequate scientific justification, the letter noted that importance of facilitating ongoing research to assure health care providers and legislators make informed decisions.  Specifically, the letter noted “the AMA believes that scientifically valid and well-controlled clinical trials conducted under federal investigational new drug applications are necessary to assess the safety and effectiveness of all new drugs, including potential cannabis products for medical use. The AMA supports efforts to ease current barriers to research by encouraging valid scientific and clinical research, expanding sources of research-grade cannabis and facilitating the commercial production of FDA-approved cannabinoid-based drugs.”  (AUSTER, CLANCY)


MSSNY and Specialties Oppose Change to Podiatric Scope of Practice
MSSNY working together with the New York State Society of Orthopedic Surgeons (NYSSOS) and other specialty societies are opposing legislation (S.5395, Jackson) that would inappropriately expand the scope of podiatrists.  The legislation advanced this week from the Senate Higher Education Committee to the Senate floor, with several Senators, including Senators Amedore, Breslin, LaValle and Robach voting without recommendation.  While purporting to be a “technical” correction of the podiatry scope statute, there are several substantive and concerning changes this legislation would make including:

  • Reducing certification requirements for podiatrists seeking to have advanced surgical privileges
  • Removing the requirement that a podiatrist seeking either standard ankle surgery or advanced ankle surgery privileges be directly supervised by a podiatrist with an advanced license from the NYSED or a physician; and
  • Would enable the treatment of wounds that are not contiguous with structures of the foot or ankle

Identical legislation (A.6185, Pretlow) remains in the Assembly Higher Education Committee.  Physicians are urged to contact their legislators to express their opposition to this proposed scope change.                                                         (AUSTER)


Veterans Matters: Military Culture: Everything Physicians Need to Know About Veterans as Patients Live Seminar in Saratoga

When: Tuesday May 28 2019 at 6:45pm (Reception at 6:00pm)

Where: Jacob & Anthony’s « 38 High Rock Road « Saratoga, NY  12866

Faculty: Lt. Col Lance Allen Wang (Ret)

Educational Objectives

  1. Describe the unique aspects of military culture and how they impact patients who are veterans
  2. Explain the Dwyer Peer-to-Peer program as a resource to assist veteran patients re-acclimating from a group to an individual mentality
  3. Review and identify resources to improve physician’s ability to fully treat veterans who are transitioning back into civilian life

For more information, contact Gregory Pinto, MD at Gregory685@aol.com or call (518) 587-0772 ext. 12

* Note: There is no charge for MSSNY members and their spouses, but there will be a $40.00 dinner charge for non-MSSNY members

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.


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

Veterans Matters: Substance Use Disorders in Veterans

When:  Wednesday June 5 2019 at 7:30am – Register here

Faculty: Frank Dowling, MD

Educational Objectives

  1. Define Substance Use Disorders (SUDs), symptoms, warning signs, comorbidities
  2. Explore evidence-based intervention and treatment options for SUDs among veterans
  3. Identify barriers to diagnosis and treatment and methods to overcome them

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

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

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


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

eNews

Garfunkel Ad


Bloomberg Editorial Board: A Wise Pause on Marijuana Legalization
Bloomberg’s Editorial Board wrote a strong opinion (5/19) on the slick road to marijuana legalization pointing out the downsides in Colorado—spiking of emergency room visits and rise of fatal car accidents. MSSNY’s Immediate Past President, Dr. Tom Madejski, has led the charge to have marijuana moved from Schedule I to Schedule II so it can receive funded research on its negative and positive effects. The piece asks for more research on the long and short term effects of marijuana before rushing to legalize it.


New Yorkers Spend Less on Health Care than Other Americans
New York families with employer-sponsored coverage had the second-lowest annual spending on health insurance premiums and out-of-pocket costs among workers in the 50 states and the District of Columbia, according to a new analysis from the Commonwealth Fund.

The median New York family with a job-based plan spent a combined $2,320 on premiums and out-of-pocket costs. The median in the nation was $3,700. The data come from the two most recent editions of the Current Population Survey, which is produced by the U.S. Census Bureau. The analysis covers information reported based on insurance costs in 2016 and 2017. When isolating premiums and out-of-pocket costs, the median New York family contributed $1,300 to their plan’s premiums and spent $500 on out-of-pocket costs, such as copays and deductible payments. That compares with $2,200 and $800, respectively, nationwide. There were also a smaller percentage of families in New York for whom premium contributions represented at least 10% of household income—9.6% compared with 11.6% nationally.

The data present a vastly different picture from a December analysis by the Commonwealth Fund of employers’ benefit plans. That report noted that employer-sponsored plans in New York had some of the highest premiums in the country and fast-growing deductibles.


NY Nursing Homes’ Report Cards Average 3.19 of 5.0
The scores of New York’s nursing homes dipped to an average of 3.19 out of 5 stars in the federal government’s latest Nursing Home Compare report card, down from 3.33 in January.

However, the national average dropped even further, from 3.35 stars to 3.06. New York’s standing improved from 31st to 27th among the 50 states.

The New York City area, with 300 nursing homes rated, had the best regional average at 3.82. The 31 rated homes in the North Country had the lowest regional average at 2.16.

New York’s middling statewide performance comes in spite of high costs. The median price of a semi-private room, at $141,000 per year, was the fifth highest in the country, according to a 2018 survey by the long-term insurance firm Genworth.

The state’s per capita spending on nursing homes was 29 percent above the national average in 2014, according to National Health Expenditures data.

The state’s nursing home industry gets much better grades, as a group, than its hospitals – which collectively ranked 50th out of 50 states in the most recent Hospital Compare report card.

Individual nursing homes can be searched by state, city and ZIP code at Center for Medicare & Medicaid Services’ Nursing Home Compare website. (NY Torch Public Policy)


NYFD Backing Bill Allowing Insurance Reimbursement for Medical Services
The four largest groups representing New York firefighting organizations presented their case to state lawmakers on Monday in favor of a bill, S.3685/A.1778 that would allow fire departments to be paid for medical services by insurers. Currently, “firefighters are prohibited from charging patients for medical care provided through emergency and ambulance services,” which “differs from private ambulance companies and volunteer ambulance corps, which are able to bill patients’ insurers.” The legislation “has met resistance from insurers.” Crain’s New York Business (subscription only) (5/21)


Nassau County Medical Society to Hold Annual Meeting on May 29
Nassau County Medical Society will hold its annual membership meeting at the Westbury Manor on May 29th.  The evening will honor members who have been in the practice of medicine for fifty years and will include presentations on Legal Services: Member Benefits by Jay Silverman, Esq. and An Overview of the NYS Sexual Harassment Law by Nicole Della Ragione, Esq.  Registration and dinner begin at 6:30 pm. Click here for more informationTo reserve a seat, email chris.nassaumed@gmail.com.


CPC® CERTIFICATION PREP COURSE
BECOME A PROFESSIONAL CODING EXPERT (CPC®)
August 10th – December 7th 2019 | 9am – 5:30pm
Exam Date: December 14th, 2019 | 9am -3pm | Book Check at 8am
Includes One Year AAPC Membership (New Enrollments Only)
& Coding Books! REGISTER TODAY


Study: 5.2% of New Cancer Cases in Adults May be Attributable to Poor Diet
Researchers analyzed data from the National Health and Nutrition Examination Survey and concluded that “an estimated 80,110 new cancer cases among adults 20 and older in the United States in 2015 were attributable simply to eating a poor diet.” The study’s first author, Dr. Fang Fang Zhang of Tufts University, said, “This is equivalent to about 5.2% of all invasive cancer cases newly diagnosed among US adults in 2015,” which “is comparable to the proportion of cancer burden attributable to alcohol.” The findings were published in JNCI Cancer Spectrum. https://academic.oup.com/jncics/advance-article/doi/10.1093/jncics/pkz034/5492023


 

CMS

QPP Tip of the Month: Navigating the QPP
With annual updates to the Quality Payment Program (QPP), and especially for the Merit-based Incentive Payment System (MIPS) pathway, it can be difficult for physician practices to track year-to-year changes and integrate them into their MIPS planning. PAI’s MACRA QPP Resource Center has several resources that can help you navigate the QPP for 2019:


Classified

RENTAL/LEASING SPACE


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


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


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


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


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


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


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

PHYSICIAN OPPORTUNITIES

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

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

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

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

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

Primary Contact: Oksana


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


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


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

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 


MSSNY eNews – May 14, 2019 – When Anti-Vaxers Attack

Arthur Fougner MSSNY Presiident

PRESIDENT’S MESSAGE<
Arthur Fougner, MD
MSSNY President

MSSNY eNews
May 17, 2019

Vol. 22  Number 19


MSSNYPAC Seal

 


Colleagues:

“If you can trust yourself when all men doubt you,
But make allowance for their doubting too:
If you can wait and not be tired by waiting,
Or, being lied about, don’t deal in lies”
If by Rudyard Kipling

This past Tuesday, the circus came to Albany. Led by Ringmaster RFK Jr., this troupe of not so merry pranksters dropped some anti-science fake knowledge on the capital, stating emphatically that measles is a benign disease and that vaccines are the product of Big Pharma and Big Medicine to hold our citizens hostage by the minions of big government. Mr. Kennedy is so far off the deep end that his own family members have publicly distanced themselves from his position.

Apparently, the only one missing was Theodoric of York. However, there’s nothing funny about this bunch. They have attacked mothers, like Jill Promoli, whose children succumbed to vaccine-preventable illnesses.

They attack physicians online – doctors, like Dr. Todd Wolynn, who’ve posted strong arguments for public health and vaccination. They post fake derogatory reviews on the online rating sites.

Much like the pod-created mob from Invasion of the Body Snatchers, they have even attacked state legislators.

They are clearly formidable opposition, so how do we protect our patients and the public health?

One way is by increasing vaccination through legislation. One bill before the Assembly is A2371 which would ensure that only well-defined medical exemptions to vaccines would be acceptable. On Monday, I called all the members of the Assembly Health Committee. With sufficient votes, this bill would get out of committee and onto the floor and most likely be passed.

Below, in the first item in Capital Update there are three steps to take to secure the passage of this legislation.

Oh and one last thing – Here’s another Kennedy on vaccines. 

Arthur Fougner, MD
MSSNY President 

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


MLMIC Ad Banner


Capital Update

Podcast Symbol

This Week’s Podcast of MSSNY’s Legislative Priorities


Physician Action Needed to Help Stop Measles Outbreak
In recognition of the measles epidemic expanding in New York State and across the nation, the Medical Society of the State of New York has been advocating for passage of legislation that would allow only medical exemptions for immunizations.  The measure, A.2371/S.2994, is in the Assembly & Senate Health Committees.

MSSNY President Arthur Fougner, MD will participate in a press conference next week at which he will call upon the NY State Legislature to ensure that the only exemption from immunizations is based on a medical reason.  MSSNY, along with 28 other medical organizations, patient advocacy groups and public health organizations, have been meeting with members of the Legislature to advocate for passage of this measure.

The Medical Society of the State of New York’s Memo in support of A.2371/S.2994 can be found here and a copy of the physician and public health organizations, and parent and patient advocacy memo is available here.

Your help is needed now!   There are action steps that you can do to move the legislation forward:

  • Please call the following members of the Assembly Health Committee and tell them that you support passage of A.2371/S.2994, which would repeal the religious exemption, ensuring that the only allowable exemptions to vaccination will be for medical reasons.  There is an Albany and local office number listed:
  • Send a letter via the MSSNY Grassroots Action Center (GAC) to your          legislator!
  • Work with your local county medical society and schedule a meeting within your area with your legislator! Or call your State Senator and Assembly Member’s office to voice your support of this legislation. There is strength in numbers!
  • Please look them up here.

Joining the Medical Society in support of medical exemptions only are the following groups:

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


Varying Proposals to Address Surprise Medical Bills Contain Positive and Concerning Elements
US House and Senate leaders each released bi-partisan proposals this week to address the issue of “surprise” out of network medical bills received by patients.  Last week, past MSSNY President Dr. Andrew Kleinman had meetings in DC with the House Doctors Caucus, key health policy staff for several US Senators, and Senator Charles Schumer to share New York’s experience with its acclaimed surprise bill law.

While the House and Senate proposals share some similarities with New York’s law, there are also important differences that raise serious concerns.  MSSNY President Doctor Art Fougner made the following statement raising such concerns. Read that statement here.    Physicians are urged to send a letter from here urging their member of Congress to fight for a law that is consistent with New York’s approach.

The first proposal, developed by a bipartisan working group led by Dr. William Cassidy (R-LA), attempts to address several issues that cause patients to receive surprise bills in the first instance, including increasing insurer transparency of patient cost-sharing requirements and of networks for the varying plans offered by a particular insurer and annual reporting to HHS of the out of network services it has paid in the previous year.  Moreover, for “surprise” medical bills, it preserves state approaches to addressing surprise bills for patients insured in state-regulated plans.

With regard to ERISA regulated plans, it recommends using New York’s “baseball” arbitration approach. However, the IDR benchmark would be “commercially reasonable rates (which must be based on in-network rates and not charges) for that geographic area”, a greatly concerning prospect. This approach could greatly undermine New York’s law and eliminate any incentive for a health insurer to negotiate fairly with a physician.  To read more, click here.

The second proposal, from House Energy & Commerce Chair Frank Pallone (D-NJ) and Ranking Member Greg Walden (R-OR) would also prohibit balance billing for all emergency services; patients would only be held responsible for the amount they would have paid in-network.  It also preserves a state’s ability to determine their own payment standards for plans regulated by the state.

But of great concern, it would establish a minimum payment standard set at the median contracted (in-network) rate for the service in the geographic area in which the service was delivered. Again, this approach could greatly undermine New York’s law, potentially diminishing hospital ED on-call specialty care availability and eliminate any incentive for a health insurer to negotiate fairly with a physician. To read more, click here.

The American Medical Association will be testifying at a hearing of the House Ways & Means Committee next Tuesday, May 21 on this issue.    (AUSTER)



Progressing Toward Insurance Reform: Your Action is Needed!
MSSNY members and staff are working with members of the legislature to advance a measure that would help physicians negotiate fairer contracts with insurance companies. The bill, which is carried by Senator Rivera (S.3462) and Assemblymember Gottfried (A.2393) would allow independently practicing physicians to communicate and negotiate collectively with health care plans in limited instances (when health plans have an undue advantage negotiating the terms of contracts with health care providers).

The bill is currently in the Senate Health Committee and Assembly Ways & Means Committee. Physicians are strongly encouraged to advocate for this bill by contacting their legislators and members of the health committees via phone or via email/letter. To take action, click here.

There are also a handful of other insurance related bills supported by MSSNY that are working their way through the legislature and physicians are encouraged to reach out to their legislators to voice their support for these bills. In order to locate your local legislator, click here.

  • 2849/A.2969 would prevent mid-year formulary changes by insurance companies, helping to ensure that patients are able to access the drugs they need without unexpected cost increases mid-year. It has advanced out of the Senate Insurance committee for the first time this year and has passed the Assembly ever year since 2015. Please urge your legislator to support this bill by clicking here.
  • 2847/A.3038 would implement a variety of prior authorization reforms, including reducing the time that insurance companies have to process prior authorizations, ensuring that authorizations are valid for the duration of treatment, and requiring peer-reviewed criteria for decision-making. The bill is scheduled for a vote next week in the Senate Health Committee and is awaiting action in the Assembly Insurance Committee. Please urge your legislator to support this bill by clicking here.
  • 3463/A2835, which would assure due process protections for physicians whose contracts with insurers are non-renewed. The bill is on the Senate floor and in the Assembly Codes Committee.
  • 4335/A.3077 would require insurance companies to utilize uniform credentialing referral forms to streamline processes and cut down on unnecessary and duplicative paperwork for physicians and their staff. The bill has passed the Assembly and will be eligible for a vote in the Senate next week. (AVELLA/AUSTER)

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

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

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

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


NY Rx Card Banner


Partial Fill Legislation Passes NYS Assembly; Awaits Action in Senate Health Committee
Assembly Bill 3918, sponsored by Assemblymember John McDonald, has passed the NYS Assembly.   This measure allows a prescriber to issue a prescription to a patient for a Controlled Substance II, III or IV that can be filled partially.  It also allows them to prescribe up to a 30-day supply of Controlled Schedule II, III, and IV with a notation to the pharmacist that he/she should only dispense the agreed to amount. Each partial filling would be dispensed and recorded in the same manner as a refilling (i.e., date refilled, amount dispensed, initials of dispensing pharmacist, etc.).

The total quantity dispensed in all partial fillings may not exceed the total quantity prescribed. Partial fills of prescriptions for Controlled Substance II are allowable under federal law but are currently prohibited in New York State. Its companion measure, Senate Bill S.1813 is sponsored by Senator Rivera and is in the Senate Health Committee. The Medical Society of the State of New York supports this measure.          (CLANCY)


Legislation to Require Those Over 16 to be Restrained in Back Seat Passes NYS Senate; Vote Pending in Assembly

A measure that would require everyone to buckle up in the rear seat has passed in the Senate and is on the Assembly Calendar for a vote.  The bill, S.4336/A.6163, is sponsored by Senator Carlucci and Assemblymember Mosley.  The MSSNY House of Delegates recently unanimously adopted policy urging that seat belts be required in both front and rear seats.  One of the safest choices drivers and passengers can make is to buckle up and 89.6% of drivers and passengers did so in 2018, saving 14,955 lives.

According to the Insurance Institute for Highway Safety adult rear-row occupants were less likely to use seat belts, with just 70 percent of those age 20 to 54 and 86 percent of those 55 and older using restraints. Per IHS, adult rear seat passengers are at greater risk for chest injuries and traumatic brain injuries than front seat passengers.  MSSNY recently participated in a press conference with the bill’s sponsors in support of this measure. (CLANCY)


Congress Passes Package of Prescription Drug Reforms Supported by AMA
On Thursday, the US House of Representatives passed a package of legislation that includes bills aimed at increasing transparency and expanding competition in the pharmaceutical drug sector. The bills, which are supported by the American Medical Association, seek to achieve the following:

  • Penalize drug manufacturers that withhold samples from their generic rivals, potentially promoting competition by facilitating the timely entry of lower-cost generic and biosimilars.
  • Ban “pay-for-delay” agreements where manufacturers pay each other to delay market entry, potentially removing incentives for generics and biosimilars to delay coming to market.
  • Discourage “parking” of the 180-day exclusivity period by the first generic applicant, potentially allowing quicker market entry for additional generics.                                                                                              (AVELLA)

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

The number of measles cases in New York State continues to rise with approximately 772 of the 829 cases confirmed in the U.S. as of May 1st occurring in New York State (495 in New York City, 225 in Rockland, 31 in Orange, 17 in Westchester and 2 in Sullivan; 1 in Suffolk and 1 in Greene counties).  MSSNY conducted a just-in-time Medical Matters webinar entitled “The Continued Public Health Threat of Measles 2018” in December, 2018.

This webinar has now been posted to the MSSNY CME website. You can also view MSSNY’s latest Medical Matters webinar entitled “What’s Your Diagnosis? Infectious Diseases” which involves a patient with a fever and a rash. Please check these out and keep yourself informed about the growing measles outbreak throughout New York State.  You can also listen to MSSNY’s brief podcast on the Measles, Mumps and Rubella vaccine here.              (HOFFMAN, CLANCY)


Registration Now Open for Veterans Matters CME Webinar on June 5th

Register now for MSSNY’s next Veterans Matters webinar. This webinar is entitled Substance Use Disorders in Veterans.  Register below for this program.

Veterans Matters: Substance Use Disorders in Veterans

When:  Wednesday June 5 2019 at 7:30am – Register here

Faculty: Frank Dowling, MD

Educational Objectives

  1. Define Substance Use Disorders (SUDs), symptoms, warning signs, comorbidities
  2. Explore evidence-based intervention and treatment options for SUDs among veterans
  3. Identify barriers to diagnosis and treatment and methods to overcome them

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

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


 

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

eNews

Garfunkel Ad


MSSNY Seeking Information re NYS Physicians Having Difficulties with Walmart on Prescribing Practices
MSSNY is interested in hearing from physicians who may have received a letter from Walmart in regards to the prescribing practices for controlled substance.   Walmart, Walgreens, and CVS pharmacies have implemented the CDC Guidelines for Prescribing Opioids for Chronic Pain as corporate policy.  MSSNY has learned that Walmart has sent letters to physicians throughout the country about their prescribing practices.   In the letters, Walmart indicated that it will no longer be accepting physicians’ prescriptions for Controlled Substances II-V after Walmart’s review of a physician’s prescribing practice.

MSSNY is extremely concerned about corporate policies that could result in refusal to fill prescriptions above certain doses and to refuse to fill prescriptions from certain physicians based on the corporation’s arbitrary definitions of questionable prescribing patterns.  MSSNY is aware that a few NYS physicians have received this letter and several physicians have been told by Walmart that it will not honor any prescription for Controlled Substance II-V.   MSSNY has brought this matter to the attention of the NYS DOH Bureau of Narcotics and is awaiting further information from them.   Any physician who may have received this letter, please contact Pat Clancy, Sr. Vice President, Public Health and Education/Managing Director, at pclancy@mssny.org or by phone at 518-465-8085.


AMA Hires 1st Chief Equity Officer; Push Came from MSSNY Disparities Committee
The AMA announced the hiring of Aletha Maybank, M.D., M.P.H., as its first ever chief health equity officer. Dr. Maybank joins the AMA after serving as deputy commissioner and founding director of the Center for Heath Equity within New York City’s Public Health Department. Prior to being deputy commissioner, Dr. Maybank was an assistant commissioner at the NYC Health Department 2009-2014. Dr. Frank Dowling commented, “The development of this new center started with a MSSNY resolution from the Healthcare Disparities Committee, then to the AMA HOD two years ago. Erick Eiting and Malcolm Reid were members of the Task Force that issued a report last year calling for the development of a center to address health inequities. It seems that Dr. Maybank may be meeting with the LGBTQ AC at the June AMA Meeting. I hope we will hear more about Dr. Maybank and the plans for the development of this center.”

See link below about the hiring of Dr. Maybank

https://www.ama-assn.org/press-center/press-releases/ama-announces-first-chief-health-equity-officer


AAP and AAFP: New Guidance for Sports Physicals
Several medical groups, including the American Academy of Pediatrics and the American Academy of Family Physicians, have released new guidance on conducting a pre-participation physical evaluation, also known as the sports physical. The update includes new information on seeing female and transgender athletes, as well as evaluating a student’s mental health. Clinicians can address subjects like bullying, drug and alcohol use, and birth control during the sports physical.

The groups recommend doing the evaluation as part of the child’s regular health screening visit.

AAP news release; Background: NEJM Journal Watch Pediatrics and Adolescent Medicine coverage of cardiac screening of adolescent soccer players


Planned Parenthood Offering Transgender Hormone Therapy at Two FL Clinics
The AP (5/15) reports Planned Parenthood is “now offering hormone therapy and other services for transgender patients in Florida, starting with two health centers in Miami this week,” with “plans to expand statewide within the year.” Planned Parenthood Florida President Lillian Tamayo said, “We were hearing from our allies and witnessing the kind of barriers that transgender people experience trying to secure healthcare and that is from just walking into a health facility and being treated with judgment and discrimination.” They have plans to extend offering statewide.


Walmart Worried That CT/MRI Errors Lead to Too Many Employee Surgeries
Walmart Inc. is worried that too many of its workers are having health conditions misdiagnosed, leading to unnecessary surgery and wasted health spending. The issue crystallized for Walmart officials when they discovered about half of the company’s workers who went to the Mayo Clinic and other specialized hospitals for back surgery in the past few years turned out not to need those operations. They were either misdiagnosed by their doctor or needed only non-surgical treatment.

A key issue: Their diagnostic imaging, such as CT scans and MRIs, had high error rates, said Lisa Woods, senior director of benefits design for Walmart. So the company, whose health plans cover 1.1 million U.S. employees and dependents, has recommended since March that workers use one of 800 imaging centers identified as providing high-quality care. That list was developed for Walmart by Covera Health, a New York City-based health analytics company that uses data to help spot facilities likely to provide accurate imaging for a wide variety of conditions, from cancer to torn knee ligaments.

Although Walmart and other large employers in recent years have been steering workers to medical centers with proven track records for specific procedures such as transplants, the retail giant is believed to be the first to prod workers to use specific imaging providers Kaiser Health News, May 15.


New York Rx Card Helps Patients Fill Their Prescriptions
Prescription drugs can be a significant cost for you, your employees, and your patients.  Here are some numbers to bear in mind:

  • Pharmaceuticals account for about 22 percent of the cost of insurance premiums.
  • Prices for popular brand name drugs rose 208 percent from 2008-2016.
  • Buyers are spending over $450 billion annually to treat conditions such as high blood pressure, high cholesterol, diabetes, hepatitis C, multiple sclerosis and several cancers.
  • 40 percent of people couldn’t manage payments and asked their doctor or pharmacist for a cheaper alternative.

New York Rx Card can help relieve the “sticker shock” your patient’s feel each time they pay for a prescription.  New York Rx Card is an Rx savings program you can offer to your patients and save up to 75 percent off the retail price.

This Rx savings program was launched to help uninsured and underinsured residents afford their prescription medications. New York Rx Card can be used by patients that have health insurance coverage with no prescription benefits, which is common in many health savings accounts (HSA) and high deductible health plans. The Rx savings program can also be used by individuals who have prescription coverage but are taking medications not covered by their insurance.

Any physicians who are interested in ordering free cards for their clinic/hospital can email Chez Ciccone, Program Director, at fciccone@nyrxcard.com or 800-931-2297.


NY and 43 States Sue 20 Generic Drug Manufacturers Alleging Price Fixing
Attorney General Letitia James joined 43 states led by Connecticut Attorney General William Tong in announcing a lawsuit against Teva Pharmaceuticals and 19 of the nation’s largest generic drug manufacturers alleging a broad conspiracy to artificially inflate and manipulate prices, reduce competition, and unreasonably restrain trade for more than 100 different generic drugs. The drugs at issue account for billions of dollars of sales in the United States.  The States allege that the Defendants’ conduct artificially increased prices to health insurers, taxpayer-funded healthcare programs like Medicare and Medicaid, and individuals who paid and continue to pay inflated prices for their prescription drugs.

The complaint alleges that Teva, Sandoz, Mylan, Pfizer and 16 other generic drug manufacturers engaged in a broad, coordinated and systematic conspiracy to fix prices, allocate markets, and rig bids for more than 100 different generic drugs. The drugs span all types, including tablets, capsules, suspensions, creams, gels, and ointments; and classes, including statins, ace inhibitors, beta blockers, antibiotics, anti-depressants, contraceptives, non-steroidal anti-inflammatory drugs. They treat a range of diseases and conditions from basic infections to diabetes, cancer, epilepsy, multiple sclerosis, HIV, ADHD, and more. In some instances, the coordinated price increases were over 1,000 percent.

The complaint lays out an interconnected web of industry executives where these competitors who met with each other during industry dinners, lunches, cocktail parties, golf outings and communicated via frequent telephone calls, emails, and text messages sowing the seeds for their illegal agreements. Throughout the complaint, defendants are described as using terms like “fair share,” “playing nice in the sandbox,” and “responsible competitor” to describe how they unlawfully discouraged competition, raised prices, and enforced an ingrained culture of collusion.

The lawsuit, filed in the United States District Court for the District of Connecticut, seeks damages, civil penalties, and equitable relief to restore competition to the generic drug market.  “The evidence shows a multi-year, multi-faceted conspiracy to enrich pharmaceutical companies at the expense of consumers,” said Attorney General Letitia James. “The scope of the conspiracy is breathtaking, affecting generic drugs that people rely on every day to treat acute and chronic conditions, like diabetes and arthritis.  The blatant anticompetitive conduct alleged in the complaint harmed consumers’ health and well-being in multiple way and we intend to hold the wrongdoers accountable.”


CMS

2015 Edition CEHRT Required in Program Year 2019 for All Promoting Interoperability Program Participants
Beginning this year, all Promoting Interoperability Programs participants must use 2015 Edition certified electronic health record technology (CEHRT) to avoid a downward Medicare payment adjustment.

We believe these up-to-date standards and functions of 2015 Edition CEHRT will better support interoperable exchange of health information and improve clinical workflows.

2019 CEHRT Requirements

  • The 2015 Edition CEHRT did not need to be in place by January 1, 2019, but must be used for the entire EHR reporting period of any continuous, self-selected 90-day period.
  • The 2015 Edition CEHRT functionality must be in place by the first day of the EHR reporting period and the product must be certified to the 2015 Edition criteria by the last day of the EHR reporting period.

Attestation Statements

In addition to using the 2015 Edition CEHRT, participants must attest to certain statements to demonstrate that they have not knowingly and willfully taken action to limit or restrict the compatibility or interoperability of their CEHRT. These statements are referred to as the “prevention of information blocking attestation.” For more details on information blocking, review this fact sheet.

For More Information

To learn more about 2015 Edition CEHRT requirements, review this fact sheet. Additional information on 2019 program requirements can be found on the Promoting Interoperability Programs website.


Classified

RENTAL/LEASING SPACE


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


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


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


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


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


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


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

PHYSICIAN OPPORTUNITIES

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

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

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

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

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

Primary Contact: Oksana


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


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


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

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 


1 2 3 22