Category Archives: eNews

July 21, 2017


PRESIDENT’S MESSAGE
Charles Rothberg, MD
July 21, 2017
Volume 17
Number 28

Dear Colleagues:

The Daily Beast and other publications reported this week that the current Administration and the Department of Health and Human Services used taxpayer money—earmarked for encouraging enrollment in the ACA—on a multi-pronged public relations campaign designed to damage public opinion of Obamacare.

How is it possible that an agency tasked with overseeing the existing health care law and educating the public can instead divert taxpayer dollars to fly people dissatisfied with the ACA to DC from all over the country to produce negative videos?

The ACA website has also been redesigned. Instead of a direct link to access the sign-up portal, the site criticizes the healthcare.gov and encourages people to use private sector web brokers.
Former HHS Secretary Kathleen Sebelius told The Daily Beast: “I’m on a daily basis horrified by leaders at the Department of Health and Human Services who seem intent on taking healthcare away from the constituents they are supposed to serve. We always believed that delivering health and human services was the mission of the department. That seems to not be the mission of the current leadership.”

Governor Awards $76.3 M

Also, this week, Gov. Cuomo awarded $76.3 million (see list below)to support 27 projects that will protect and transform New York’s health care system. More dollars for healthcare is good for patients, good for physicians, and good for our communities.

Sincerely,
Charles Rothberg, MD
MSSNY President

Please send your comments to comments@mssny.org

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MSSNY Objects to UHC Policy Change re Consultation Reimbursement
In the June United Healthcare Bulletin, the plan placed a notice regarding the elimination of reimbursement for consultation codes effective October 1, 2017. UHC indicates that they are adopting a policy that was put forth by CMS for the Medicare program back in 2010. MSSNY is joining with other entities of organized medicine to voice our strong opposition to UHC regarding this egregious policy change.

ACA Repeal/Replacement Could Affect Coverage of Some 370,000 Long Islanders
Newsday (NY) (7/15) reported that nearly 370,000 people in Long Island “could see their access to health coverage directly affected by the possible repeal and replacement of the 2010 Affordable Care Act.” In a statement, Dr. Charles Rothberg, President of the Medical Society of the State of New York, said, ‘While a wholesale review of the flaws of the ACA should be undertaken, we are deeply concerned about potentially significant adverse consequences to New York’s residents and its health care system arising from proposals before the House and Senate.’” Dr. Rothberg said in an interview, “I think New York and Long Island have the potential to be devastated.”

$491 Million Awarded Statewide to Health Care Facility Transformation Program
27 Awards to Support Essential Health Care Services
This week, Governor Cuomo announced $76.3 million to support 27 projects that will protect and transform New York City’s health care system. As part of the $491 million Statewide Health Care Facility Transformation Program, this funding will improve patient care through the development of high-quality medical facilities and programs serving the inpatient, primary care, mental health, substance use disorder and long-term care needs of communities throughout New York State.

“Now, more than ever, we need to protect health care in New York and ensure the system in place is meeting the needs of current and future generations of New Yorkers,” Governor Cuomo said. “While others seek to decimate our hospitals and reduce access to quality healthcare, we are investing to help ensure a stronger, healthier New York for all.”

For more information about the 27 awarded providers, the specific funding awarded, and the details about the awarded projects, click here .



Your membership yields results and will continue to do so. When your 2017 invoice arrives, please renew. KEEP MSSNY STRONG!


AMA Update on Senate Reform Bill
While there was considerable activity in the Senate this week, plans for bringing a health system reform bill to the floor for a vote remain very fluid.  Up until this week, Majority Leader McConnell could only afford to lose two Republican votes to pass an Affordable Care Act (ACA) “repeal and replace” bill, and with the sad news that Senator John McCain’s illness may keep him away from Washington next week that number could be reduced to one.  Nevertheless, under pressure from both from President Trump and a long legislative to-do list, Senator McConnell said he will attempt to bring repeal legislation to the floor next Tuesday.

Process
Senators will be asked on Tuesday to approve a motion to open debate on the House-passed American Health Care Act, H.R. 1628.  At this point, it appears that two substitute amendments for the House-passed text are likely candidates to serve as the basis for Senate debate and amendment:

  • A revised version of the Obamacare Repeal and Reconciliation Act (ORRA), vetoed by President Obama in 2015, that eliminates mandate penalties as well as all premium subsidies and Medicaid expansion funds; or
  • The Better Care Reconciliation Act (BCRA), with modification that include additional funding for opioid addiction treatment and for market stabilization, among other changes.

It is unclear whether there are 50 votes to approve the motion to proceed, let alone for passage of either of these substitute amendments (which could be revised further before Tuesday).  To date, enough Senators have expressed opposition to proceeding to either substitute to block its consideration, though negotiations are ongoing.

Want to Get Involved? AMPAC Campaign School October 27-29
The 2017 AMPAC Campaign School will be taking place Oct. 27-29 at the AMA Office in Washington, DC. The school is targeted to AMA members, their spouses, residents, medical students and medical society staff who want to become more involved in the campaign process. Running an effective campaign can be the difference between winning and losing a race. That’s why the AMPAC Campaign School is designed to give you the skills and strategic approach you will need out on the campaign trail. The AMA  team of political experts will teach you everything you need to know to run a successful campaign or be a sought-after volunteer.

During the two and a half day in-person portion of the program under the direction of  political experts, participants will be broken into campaign staff teams to run a simulated congressional campaign using what they’ve learned from the pre-school workbook activities and videos along with the group sessions on strategy, vote targeting, social media, advertising and more.

NOTE: Faculty, materials (including the pre-school workbooks, videos and all in-person meeting materials) and all meals during the meeting are covered by AMPAC. Participants are responsible for the registration fee ($350 for AMA Members / $1000 for non-members), airfare, and hotel accommodations at the Hyatt Regency Washington on Capitol Hill (AMA has secured a room block for a discounted rate). The registration fee is waived for residents and students, however, space is limited to four slots and the AMPAC Board will review and select qualified participants from the pool of resident and student applicants.

For more information or to apply click here.


CLASSIFIEDS


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

Medical Space Available for Leasing
Currently (last 7 years) occupied by Lab Corp.
2,500 sq. ft. ADA compliant.
25-15 Steinway Street, Astoria, NY 11103
Please contact Landlord: 1-800-283-0602;
e mail: wwwevans@yahoo.com

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

Physician Opportunities



Job Posting – Chief Medical Officer – Cayuga Medical Associates

Cayuga Medical Associates (CMA), a growing multi-specialty group located in the heart of the beautiful Finger Lakes Region in Central New York, is currently seeking a Chief Medical Officer to work within the organization. This newly created senior leadership position is designed to ensure that high quality, service-oriented patient care is delivered by Cayuga Medical Associates’ physicians on a consistent basis. The Chief Medical Officer has primary responsibility for clinical issues pertaining to the delivery of patient care services, patient satisfaction, and quality at the practice level. This position will report to the President of CMA, with an administrative dyad/partnership to the Chief Operating Officer. In this role, the Chief Medical Officer will work in an administrative capacity 2 days a week, and will practice as a physician for the remaining 3 days of the workweek.

This position will require the physician to:

  • Engage in Physician recruitment, engagement and retention, in collaboration with President and Chief Operating Officer
  •  Set and communicate performance, service standards and expectations to  all providers
  •  Exercise professional clinical leadership regarding specific cases or questions of quality or compliance
  • Assist with compensation model refinements and redesign, with specific focus on quality and productivity metrics
  •  Oversee CMA’s Physician Action Council (PAC)
  •  Develop and implements physician peer review system, medical policies, and clinical programs

Qualifications for this position include:

  • Graduate from accredited medical school and appropriate residency training
  • Board certified physician in a primary care or related sub-specialty area
  •  Active NYS medical license
  •  At least 3-5 years of relevant work experience in a physician practice setting, prior experience in physician leadership role preferred
  • Strong leadership skills to develop a close, collaborative working relationship with senior leadership team, physician leaders, and practice  management staff

The Finger Lakes region of New York offers endless opportunities for outdoor adventures, as well as rich support of the arts and diverse cultural opportunities, excellent school districts, and charming villages, towns and small cities to call home.  If you are dedicated to excellence and possess a commitment to patient-centered care, please submit your CV and cover letter to cma_hr@cayugamedicalassociates.org or fax to (607) 277-1415, attention Human Resources. CMA offers a competitive pay and benefits package and is an equal opportunity employer.


Position Available for Critical Care Physician to Join Established Practice in Nassau County, Long Island, NY.
The Physician will join our existing team of Board-Eligible/Board-Certified Intensivists. This is a PT/FT position including both nocturnal and daytime responsibilities. The Physician will work with a dedicated group of highly trained mid-level practitioners, respiratory therapists and nurses to provide Critical Care at St. Francis Hospital in Roslyn, NY. St. Francis was ranked one of the top 10 hospitals in the nation for Cardiac Care and is top rated nationally in seven other adult specialties.
We are expanding our Intensivist Program and are expecting to add an Intensivist to our group.
Nassau Chest Physicians, P.C. was established in 1978 to provide state-of-the-art care to patients with pulmonary diseases on Long Island. We have expanded our practice to include 8 Intensivist/Pulmonologists and 5 pure Intensivists. Since 2006, we have assumed management of Critical Care services at St. Francis Hospital-The Heart Center in Roslyn, NY.
St. Francis Hospital is New York State’s only specialty designated cardiac center and is a nationally recognized leader in cardiology and heart surgery, ear-nose-throat, gastroenterology and GI surgery, geriatrics, neurology and neurosurgery. More cardiac procedures are performed at St. Francis than at any other hospital in New York State. The hospital is located on the North Shore of Long Island; approximately 30 minutes from Manhattan. The hospital combines unrivaled expertise in cardiovascular medicine with top-ranged nursing (AACN Magnet Award) to provide the very best in patient care.
In addition, St. Francis offers excellent Thoracic, Vascular, Oncologic, Neurosurgical, and Orthopedic Surgical Programs. We have a very active Emergency Department. The hospital offers the latest in technologies such as Therapeutic Temperature Modification, Impella, ECMO and LVAD. Our excellent and experienced medical staff supports strong medical and surgical subspecialty programs.

Aside from Certified Critical Care Nurses, many who have more than 20 years of experience and are expert at caring for this complex patient population, we have a growing pool of Intensivist mid-level practitioners who work hand in hand with our Intensivist physicians to coordinate the care of the critically ill patient, minister to them and perform procedures.

Of course, a New York License is required. J1 or H1 VISAS accepted.
Additional Salary Information: Salary and benefits are competitive and commensurate with experience. Interested applicants, send resume to: dr.sorett@nassauchest.com


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

July 14, 2017 – Last Chance to Demand VETO!


PRESIDENT’S MESSAGE
Charles Rothberg, MD
July 14, 2017
Volume 17
Number 27

Dear Colleagues:

Bad week for medicine, law and money. Last week I wrote about the NYS legislature passing an over reaching and defective expansion of medical liability (“Lavern’s Law”) that seriously burdens all providers, but at the same time leaves an unsuspecting public nearly as unprotected as before.

This week, a discredited, convicted legislative leader— perhaps best known as an opponent of liability reforms, had his corruption conviction overturned on appeal.

And, in that leader, the medical connection extends beyond medical liability. Mr. Sheldon Silver was convicted of using his office to provide public money to a medical researcher in exchange for referrals of patients (also possible plaintiffs).  Mr. Silver was in turn paid for those referrals. He did no work—an activity illegal for doctors but—perfectly legal for lawyers.

For this, Mr. Silver was convicted in 2015. But in another case in 2016, the US Supreme Court narrowed the definition of corruption sufficiently to provide the technicality to overturn Mr. Silver’s conviction.

His story of conflicts regarding the legislature, the legal profession, and the medical profession illustrates the difficulty of obtaining a legislative solution to overcome the deficiencies of our medical liability system.  And while a stunning story, there persists within the legislature a cultural barrier to the best solutions.  Last year, in New York State, medical liability payouts were $700 million.  The public deserves better for the money.

When will our elected officials finally examine the adversarial trial process, its distortions, unintended consequences, and inefficiencies in order to institute reforms that return the process to its public purpose?

Meanwhile, I urge the Governor to veto this version of Lavern’s law instead of doubling down on this outrageous charade. Now, more than ever, we need comprehensive reform.

PHYSICIANS MUST CONTINUE TO CALL GOVERNOR CUOMO AT 518-474-8390 and send a letter from here

Sincerely,
Charles Rothberg, MD
MSSNY President

Please send your comments to comments@mssny.org

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We Can Assure the Stability of MLMIC
In today’s marketplace, stability is top-of-mind for many us. And given recent reports from July 6, 2017, by the Albany Times Union and Politico, that New York State has ousted the CEO of the state’s second largest medical malpractice insurance carrier, this is unsurprising.

However, MLMIC, our trusted partner and longstanding endorsed professional liability insurer, continues to maintain a sound financial condition. And for 40+ years, MLMIC has provided exceptional coverage, an unyielding defense, strong risk management programs, and high-quality legal counsel to the physicians of the State of New York.

MSSNY and MLMIC remain unwavering in our commitment to protecting you and your practice.

Please do not hesitate to contact our offices and/or reach out to MLMIC directly at mlmic.com or (888) 412-2012 should you have any questions or need additional information.

Senate Released Revised ACA Repeal/Replace Bill; Possible Floor Consideration Next Week
This week, the Senate released a revised version of the Better Care Reconciliation Act (BCRA), a bill designed to repeal and replace much of the Affordable Care Act (ACA).  While review of the new bill is ongoing, at first glance it does not appear to remediate concerns with the earlier version of this legislation that it could potentially significantly expand the number of New Yorkers who will face higher cost-sharing.

AMA President Dr. David Barbe issued the following statement in response: “The revised bill does not address the key concerns of physicians and patients regarding proposed Medicaid cuts and inadequate subsidies that will result in millions of Americans losing health insurance coverage. The additional funding to address the opioid epidemic is a positive step, however, those suffering from substance use disorder have other health care needs that are not likely to be addressed if they lose coverage through a rollback of the Medicaid expansion. While stabilizing the individual market is an initial step, more bipartisan collaboration is needed in the months ahead to improve the delivery and financing of health care.”

According to the AMA, revised estimates by the Congressional Budget Office on the impact on spending and health insurance coverage are expected to be released on Monday.  Senate floor consideration is likely to begin on Tuesday or Wednesday.    However, Senators Rand Paul (R-KY) and Susan Collins (R-ME) have indicated they would oppose the “motion to proceed” to begin consideration of the bill, putting into question whether there will be enough votes to begin floor consideration.

Please stay alert for further updates.

Upstate Fatality in Case of Powassan Virus
Since 2000, only 24 cases of Powassan virus have been confirmed in New York.  Five of them were fatal. The most recent case was 74-year-old Charles Smith from Gansevoort. His family reported that he was bitten by a tick on April 28. He went to the doctor on May 1 and was sent home. However, by May 11, he had fever and chills and was hospitalized. He died June 6.

“Powassan is a serious illness,” said Bryon Backenson, New York State DOH’s Deputy Director of Communicable Disease Control. There is no cure for Powassan’s, which is deadly about 10-percent of the time because it affects the central nervous system in about half the cases. “You’re trying to do things to reduce swelling in the brain or reduce swelling on the lining of the brain,” explained Backenson. Symptoms of Powassan’s include headache, fever, vomiting, weakness, and confusion, loss of coordination, speech difficulty and seizures.

It can take up to four weeks for Powassan’s to be confirmed by blood and cerebrospinal fluid testing, making early treatment important when it’s suspected. “With a disease like Powassan that tick only has to be on 10 or 15 minutes before it has the potential to transmit what it’s carrying because Powassan is a virus,” warned Backenson.

Unlike Lyme disease which is a bacteria and can take up to 36 hours for infection to occur.

Without a specific treatment, the need to protect against tick bites is key. “This is a very severe illness. It’s an illness that can cause deaths, but it’s also one that’s extremely rare,” explained Backenson. (WNYT, July 12)


 

Your membership yields results and will continue to do so. When your 2017 invoice arrives, please renew. KEEP MSSNY STRONG!


FDA To Implement Stricter Education Requirements for Opioid Makers
FDA Commissioner Scott Gottlieb “announced plans Monday to require manufacturers of painkillers to provide more extensive education for physicians and other health-care professionals who prescribe the drugs.” Previously, only manufacturers of extended-released opioids, which account for ten percent of opioid prescriptions, were required to provide the training. Dr. Gottlieb said the agency would also consider legal action on any drugs that it concludes pose a larger risk than benefit. The FDA did that last month when it concluded that the painkiller Opana ER was linked to injection drug abuse. Its maker, Endo Pharmaceutical, Inc. pulled the drug from the market last week at the FDA’s request. (Wall Street Journal (7/10)

CMS Proposes Medicare Physician Payment Rule for 2018
On July 13, CMS issued a proposed rule to update the Medicare physician fee schedule for 2018.

To read the CMS press release announcing some of the key policy changes proposed in the rule, click here.

To read the entire rule, click here.

A chart listing the specialty by specialty impact of the proposed rule changes is on pp.727-728.   Specifically, the chart notes that, as a result of these proposed changes, the following specialties will see an overall +1% in allowed charges: geriatrics, hand surgery, infectious disease, physical medicine, psychiatry and radiation oncology.

The chart notes that the following specialties could see an overall -1% in permitted charges: colon and rectal surgery, emergency medicine, gastroenterology, general surgery, interventional radiology, neurosurgery, OB-GYN, pathology, radiology, thoracic surgery, and urology.

The chart also notes that the following specialties could see an overall -2% in permitted charges: cardiac surgery, cardiology, otolaryngology and vascular surgery, with a -3% projected for allergy/immunology.

MSSNY, working together with the AMA and the federation of medicine, will be reviewing the rule and will follow up with further analysis.

CMS Proposed Rule for Implementation of Diabetes Prevention Program (MDPP)
On July 13, 2017, CMS issued the Calendar Year (CY) 2018 Physician Fee Schedule (PFS) proposed rule that would make additional proposals to implement the Medicare Diabetes Prevention Program (MDPP) expanded model starting in 2018.

The MDPP expanded model was announced in early 2016, when it was determined that the Diabetes Prevention Program (DPP) model test through the Center for Medicare and Medicaid Innovation’s Health Care Innovation Awards met the statutory criteria for expansion. Through expansion of this model test, more Medicare beneficiaries will be able to access evidence-based diabetes prevention services, potentially resulting in a lowered rate of progression to type 2 diabetes, improved health, and reduced costs.

The Medicare Diabetes Prevention Program expanded model is a structured intervention with the goal of preventing progression to type 2 diabetes in individuals with an indication of pre-diabetes. The clinical intervention, the result of National Institutes of Health-funded research, consists of a minimum of 16 intensive “core” sessions of a Centers for Disease Control and Prevention (CDC) approved curriculum furnished over six months in a group-based, classroom-style setting that provides practical training in long-term dietary change, increased physical activity, and behavior change strategies for weight control.

After completing the core sessions, less intensive follow-up meetings furnished monthly will help ensure that the participants maintain healthy behaviors. The primary goal of the expanded model is at least 5 percent weight loss by participants. 

Long-Term Dietary Improvements Associated with Decreased Risk of Death
The New England Journal of Medicine reports that “long-term improvements in diet were associated with a significantly decreased risk of death,” researchers found. The study revealed that “making mostly healthier choices for 12 years could decrease someone’s risk of death during the next 12 years by 20 percent.”

NGS Claim Submission Changes
Healthcare continues to keep up with technology with the new claim submission changes issued by National Government Services (NGS). Beginning July 10, 2017 NGS will no longer be accepting claim submissions with handwriting on the CMS 1500 form (except in the specified signature boxes). As per the new alert issued on June 29th, handwritten claims received will be returned to the provider with a notice to submit a new claim in the acceptable format.

The CMS Pub. 100-04, Medicare Claims Processing Manual, Chapter 26, Section 30 notes the CMS 1500 form specifications are “required to facilitate the use of image processing technology such as Optical Character Recognition (OCR), facsimile transmission, and image storing.”

NGS currently allows for claims to be submitted online via NGSConnex. If you are currently submitting handwritten claims it is recommended to open a dialogue with your billers and consider alternatives, as many private insurance carriers look towards Medicare and Medicaid for guidance. 

Sources:
http://ow.ly/hM5E30drukU
https://www.cms.gov/Regulations-and-Guidance/Guidance/Manuals/Downloads/clm104c26.pdf
Lorna Simons CPC, Medco Consultants Inc.

Former Suffolk County President Dr. Bernard Lane Dies
MSSNY member Bernard P. Lane, MD, passed away on July 5, 2017 at the age of 79 after a long battle with cancer.  The Brooklyn native—known to friends and colleagues as Bernie—graduated from Brown University and NYU Medical School.

A founding faculty member of Stony Brook University School of Medicine, Dr. Lane contributed over 45 years of service to medical science and education including his faculty years at NYU and Stony Brook medical schools.  In addition to his duties as Professor of Pathology, Dr. Lane also served as Deputy Chairman, Interim Chair, and Director of the Electron Microscopy Laboratory.  He was the Pathology residency program director for 25 years, mentoring scores of pathologists who have gone on to positions in hospitals and academic medical centers both locally and nationally.

Dr. Lane served as President of the Stony Brook University Faculty Senate, and was the Founding Chairman of the Board of Directors of the Clinical Practice Management Plan at the University Hospital, serving in that capacity for nearly 20 years.

An active member of organized medicine, Dr. Lane was a member of MSSNY since 1986 and served as President of the Suffolk County Medical Society in 1990 and 1991.  He was Chair of the National Group on Faculty Practice of the Association of American Medical Colleges, and president of the Suffolk County Pathology Society.

Dr. Lane and his wife, Dr. Dorothy Lane (nee Spiegel), celebrated their 53rd wedding anniversary in August 2016. In addition to his wife, Dr. Lane is survived by his daughter Erika Neil, his sons Dr. Andrew Lane and Matthew Lane, his daughter-in-law Dr. Wendy Lane, and his grandchildren Zachary Lane, Jacob Lane, Rachel Neil and Justin Neil.

A graveside funeral service was held on Friday, July 7, 2017 at the Washington Memorial Park cemetery in Mount Sinai. In lieu of flowers, the family requests that donations be made in his memory to the Stony Brook Cancer Center or the American Cancer Society.


CLASSIFIEDS


Medical Space Available for Leasing
Currently (last 7 years) occupied by Lab Corp.
2,500 sq. ft. ADA compliant.
25-15 Steinway Street, Astoria, NY 11103
Please contact Landlord: 1-800-283-0602;
e mail: wwwevans@yahoo.com

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

Physician Opportunities


Medical Director – Cayuga Medical Associates
Cayuga Medical Associates (CMA), a growing multispecialty group located in the heart of the beautiful Finger Lakes Region in Central New York, is currently seeking a Medical Director to work within the organization. This senior leadership position is designed to ensure that high quality, service-oriented patient care is delivered by Cayuga Medical Associates’ physicians on a consistent basis. The medical director has primary responsibility for clinical issues pertaining to the delivery of patient care services, patient satisfaction, and quality at the practice level. This position will report to the Chief Operating Officer of CMA, and will serve as an ex-officio board member. In this role, the Medical Director will work in an administrative capacity 2 days a week, and will practice as a physician for the remaining 3 days of the workweek.This position will require the physician to:

  • Engage in Physician recruitment, engagement and retention, in collaboration with Executive Director
  • Set and communicate performance, service standards and expectations to all providers
  • Exercise professional clinical leadership regarding specific cases or questions of quality or compliance
  • Assist with compensation model refinements and redesign, with specific focus on quality and productivity metrics
  • Oversee CMA’s Physician Action Council (PAC)
  • Develop and implements physician peer review system, medical policies, and clinical programs

Qualifications for this position include:

  • Graduate from accredited medical school and appropriate residency training
  • Board certified physician in a primary care or related sub-specialty area
  • Active NYS medical license

At least 3-5 years of relevant work experience in a physician practice setting, prior experience in physician leadership role preferred

vStrong leadership skills to develop a close, collaborative working relationship with senior leadership team, physician leaders, and practice management staff

The Finger Lakes region of New York offers endless opportunities for outdoor adventures, as well as rich support of the arts and diverse cultural opportunities, excellent school districts, and charming villages, towns and small cities to call home.  If you are dedicated to excellence and possess a commitment to patient-centered care, please submit your CV and cover letter to cma_hr@cayugamedicalassociates.org or fax to (607) 277-1415, attention Human Resources. CMA offers a competitive pay and benefits package and is an equal opportunity employer.


Position Available for Critical Care Physician to Join Established Practice in Nassau County, Long Island, NY.
The Physician will join our existing team of Board-Eligible/Board-Certified Intensivists. This is a PT/FT position including both nocturnal and daytime responsibilities. The Physician will work with a dedicated group of highly trained mid-level practitioners, respiratory therapists and nurses to provide Critical Care at St. Francis Hospital in Roslyn, NY. St. Francis was ranked one of the top 10 hospitals in the nation for Cardiac Care and is top rated nationally in seven other adult specialties.
We are expanding our Intensivist Program and are expecting to add an Intensivist to our group.
Nassau Chest Physicians, P.C. was established in 1978 to provide state-of-the-art care to patients with pulmonary diseases on Long Island. We have expanded our practice to include 8 Intensivist/Pulmonologists and 5 pure Intensivists. Since 2006, we have assumed management of Critical Care services at St. Francis Hospital-The Heart Center in Roslyn, NY.
St. Francis Hospital is New York State’s only specialty designated cardiac center and is a nationally recognized leader in cardiology and heart surgery, ear-nose-throat, gastroenterology and GI surgery, geriatrics, neurology and neurosurgery. More cardiac procedures are performed at St. Francis than at any other hospital in New York State. The hospital is located on the North Shore of Long Island; approximately 30 minutes from Manhattan. The hospital combines unrivaled expertise in cardiovascular medicine with top-ranged nursing (AACN Magnet Award) to provide the very best in patient care.
In addition, St. Francis offers excellent Thoracic, Vascular, Oncologic, Neurosurgical, and Orthopedic Surgical Programs. We have a very active Emergency Department. The hospital offers the latest in technologies such as Therapeutic Temperature Modification, Impella, ECMO and LVAD. Our excellent and experienced medical staff supports strong medical and surgical subspecialty programs.

Aside from Certified Critical Care Nurses, many who have more than 20 years of experience and are expert at caring for this complex patient population, we have a growing pool of Intensivist mid-level practitioners who work hand in hand with our Intensivist physicians to coordinate the care of the critically ill patient, minister to them and perform procedures.

Of course, a New York License is required. J1 or H1 VISAS accepted.
Additional Salary Information: Salary and benefits are competitive and commensurate with experience. Interested applicants, send resume to: dr.sorett@nassauchest.com


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

July 7, 2017 – PRI Oust & Urge Gov Veto


PRESIDENT’S MESSAGE
Charles Rothberg, MD
July 7, 2017
Volume 17
Number 26

Dear Colleagues:

Today’s press has reported the Department of Financial Services (DFS) findings following a yearlong audit of PRI, the second largest malpractice carrier in the state.  As a result of their findings the CEO of PRI has been ousted. The superintendent of the DFS, Maria Vullo, stated, “…, the examination determined that AFP (PRI’s management company) and its top executives, including its CEO and owner, Anthony J. Bonomo, disregarded sound actuarial principles when setting PRI’s loss reserves, and then tried to cover it up by seeking to silence outside auditors and employees who objected to this misconduct.”

The board of PRI voted yesterday to void the company’s management contract with Administrators for the Professions, a subsidiary of AJB Ventures, which Mr. Bonomo owns. The new management contract will be given to PRIMMA, LLC, and a wholly-owned subsidiary of PRI. PRIMMA will be run on an interim basis by The Princeton Partnership, a firm that specializes in turnaround and runoff management. Read more here.

More importantly, this information comes at a volatile time for New York’s malpractice industry, especially in view of the Expansion of Liability bill that will be delivered to the Governor. He needs to make a decision whether or not this is the appropriate time to sign such legislation into law. This does not appear to be the optimal time to further destabilize the climate of the malpractice industry in New York.

Expansion of Liability Bill

New York has a reputation of being a difficult place to be a doctor.  Yet the legislature in Albany has potentially made this problem far worse.  It passed a “one-sided” bill that, if enacted, will drastically increase health care costs by radically increasing the number of lawsuits that could be brought against our doctors and hospitals. But the law ignores much of the problem illustrated by the story of Lavern.

Voice your opposition here!

The bill is a hastily conceived legislative response to the sad case of Lavern Wilkinson.  Ms. Wilkinson, treated at a public hospital, was not informed of a cancerous lesion present on an x-ray.  Sometime later, when Ms. Wilkinson ‘discovered’ the cancer, it had already spread.  She was unable to sue for medical negligence owing to the short 15-month statute of limitations that applies to public hospitals like the one that treated her.  Had she been treated elsewhere in New York, with the standard 30-month statute, Lavern would have been able to sue.  Sadly, she succumbed to this cancer.

The legislature could have solved Lavern’s medical liability ‘problem’ by simply extending the shortened statute against public hospitals to 30 months (like in non-public hospitals). Instead, they unreasonably extended the statute to date of discovery (as long as 7 years from treatment) to all venues. If this law is enacted, despite the unnecessary burden on all physicians and hospitals, patients presenting to public hospitals might still find themselves unable to sue.  For example, a patient presenting to a public hospital for evaluation following a motor vehicle accident, not informed of an aneurysm on x-ray, would still be unable to sue after 15 months’ time. This bill, that would increase liability costs for physician practices by 15%, would not provide a remedy for many patients like Lavern!

We are not alone in this fight. HANYS and the Greater New York Hospital Association are equally opposed. Ken Raske, in a letter to the Governor, stated that they are “deeply disappointed with the Senate leadership—whom we have repeatedly supported—for putting this onerous, extremely damaging bill forward… At the very least, it will lead to more litigation, as parties seek to take advantage of the bill’s drafting ambiguities.” Specialty societies were against it, too.

But if there is a need to expand the time to bring lawsuits; it must be balanced with legislation to address the numerous flaws of our medical liability system that drive our excessive costs – “comprehensive” reform.  Unfortunately, the Legislature, with its hasty one-sided remedy, ignored the risk of harm to our already fragile care delivery infrastructure.

Governor Cuomo must veto this bill and instead work for comprehensive medical malpractice reform effort that address deficiencies raised by all sides – patients, lawyers and doctors. New York is already the worst state to be a doctor largely because our medical liability costs and premiums far exceed any other state.  Many other states such as California, Texas and Florida, along with the majority of others, have put reasonable controls on liability awards to preserve some stability in their health care systems.

What do our legislators not see?

Governor Cuomo must insist on fair balance by vetoing this bill and pushing for comprehensive reform instead.

Voice your opposition here!

Sincerely,
Charles Rothberg, MD
MSSNY President

Please send your comments to comments@mssny.org


Your membership yields results and will continue to do so. When your 2017 invoice arrives, please renew. KEEP MSSNY STRONG!


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Please Contact Gov. to Urge Veto to Prevent More Lawsuits and Increased Costs
All physicians are urged to contact Governor Andrew Cuomo to veto legislation (S.6800/A.8516) that would prompt significant increases in medical malpractice lawsuits and premiums at a time when no further increases can be tolerated.  Please call at (518) 474-8390, and send a letter here: Take Action

This week, MSSNY President-elect Dr. Thomas Madejski and Erie County Medical Society President Dr. Willie Underwood authored an op-ed that appeared in the Buffalo News urging the Governor to veto the bill, and press for comprehensive medical liability reform instead.  Read the op-ed here.

Introduced in the final days and passed in the final hours of the 2017 Legislative Session over the strong objections of MSSNY, the specialty societies, the hospital industry and medical liability insurers, S6800/A8516 would expand the medical liability statute of limitations for cases involving “alleged negligent failure to diagnose a malignant tumor or cancer”.   The bill would permit lawsuits 2.5 years from the “date of discovery” of such alleged negligence, up to an outside limit of 7 years from the date of the alleged negligent act.

While it is likely that a more narrowly focused bill will reduce somewhat the premium increase needed from the 15% projected increase for an earlier version of this bill, there is great ambiguity in the legislation as to which cases the 7-year limit would apply.  Moreover, the bill does not just apply to treatment that occurs after the proposed effective date of the bill but has a very significant retroactive impact, subject to numerous interpretations, for which insurance companies have not reserved premium dollars (another reason to veto the bill!).  These errors and/or ambiguities are likely the result of the bill being “rushed into print” to meet the constitutional “3-day aging” requirement before a bill can be considered by the Legislature.

Of greatest concern, the bill fails to include needed tort reforms to help bring down our already exorbitant medical liability costs.

While it is not known when the bill will be officially delivered to the Governor for his consideration, it could be sent at any time.  Please take action and urge your colleagues to do the same.

DOH Announces Additional Four-Hour Medical Marijuana Course
The New York State Department of Health announced the availability of an additional four-hour medical use of marijuana course. Practitioners who wish to register with the Department and certify their patients for the Medical Marijuana Program must complete one of the available approved courses.  The Department also streamlined the process for practitioners to register with the program. See the following press release for additional information on these enhancements to the program.

CDC: Opioid Prescribing Down Since 2010, But Varies Widely
The amount of opioids prescribed in the United States decreased each year between 2010 and 2015, according to a Vital Signs report released this week by the CDC. The amount of opioids prescribed per capita fell from a peak of 782 morphine milligram equivalents in 2010 to 640 MME in 2015, but remains about three times higher than in 1999 and varies widely by county, with some counties prescribing six times as much as others.

“This variation highlights the need for health care providers to consider evidence-based guidance when prescribing opioids,” said Deborah Dowell, M.D., chief medical officer for CDC’s Division of Unintentional Injury Prevention. Between 2010 and 2015, MME per capita decreased in half of US counties and increased in 23% of counties.

NAM Collaborative Calls for Research to Address Clinician Burnout
The National Academy of Medicine Action Collaborative on Clinician Well-Being and Resilience, whose sponsors include the AHA, yesterday issued a discussion paper calling for research to identify the organizational and health system factors that place physicians, nurses and other health care professionals at increased risk for burnout; the implications for health care outcomes; and effective interventions to improve clinician well-being.

“The U.S. health care system is rapidly changing in an effort to deliver better care, improve health, and lower costs while providing care for an aging population with high rates of chronic disease and co-morbidities,” notes the paper, whose co-authors include AHA Chief Medical Officer Jay Bhatt, D.O. “…Navigating these changes are health care professionals, whose daily work is critical to the success of health care improvement.

Unfortunately, as a result of these changes and resulting added pressures, many HCPs are burned out, a syndrome characterized by a high degree of emotional exhaustion and high depersonalization (i.e., cynicism), and a low sense of personal accomplishment from work.” On July 14, the collaborative will host its first public meeting to solicit feedback and highlight research and examples of promising approaches to promoting clinician well-being. To attend in person or via webcast, register here.

In July: Pilot for Office-Based Surgery Practitioners New Online Practice Report
To assist in the promotion of patient safety and quality of care for patients undergoing procedures in the office-based setting, the NYS Department of Health (NYS DOH) Office-Based Surgery (OBS) Program has developed a new online Practice Report. This Report will assist in providing context for the interpretation of Adverse Event information received by the NYS DOH. Public Health Law provides the NYS DOH with authority to require OBS practices to report additional data for the interpretation of adverse events.[1] Beginning in January 2018, all NYS OBS practice sites will be required to complete an annual Practice Report.

In July of 2017, the NYS DOH will conduct a pilot with OBS practices to ensure practitioners and practices are aware of the report content and are able to complete the Practice Report. They are requesting practices complete the pilot Practice Report using information from January 1 through December 31, 2016. Practices newly accredited in 2017, may provide available 2017 data. The NYS DOH has contacted OBS practices with details regarding the pilot by email.

In late Fall 2017, the NYS DOH will share feedback received from the pilot and any subsequent changes to the report. The NYS DOH is hopeful the pilot Practice Report will assist OBS practices in preparing for the first annual Practice report in January of 2018.  If you have any questions, please contact the Office-Based Surgery Program at 518-408-1219 or obs@health.ny.gov.
[1]PHL § 230-d, 4. (b);  “the department may also require licensees to report additional data such as procedural information as needed for the interpretation of adverse events”

Athenahealth: The Case for Staying Independent
Join online on Wednesday, July 12, at 2pm ET
Reserve your spot
If you think that merging your independent practice with a larger healthcare system is the only way for it to survive, this webinar is for you. On the heels of Independence Day, this free one-hour presentation takes a close look at topics such as:

  • Why it’s so overwhelming for independent practices to operate today
  • The measurable advantages independent practices have over larger systems
  • 3 case studies of once-struggling independent practices that are thriving today

Know what athenahealth knows about helping you run your practice your way.                                    REGISTER TODAY


Less Expensive Hearing Devices May Work as Well as Traditional Hearing Aids
Some over-the-counter sound amplification devices are nearly as effective as prescription hearing aids, according to a small JAMA study.

Researchers compared five personal sound amplification products with one hearing aid in 40 older adults with mild-to-moderate hearing loss. Speech understanding improved with the hearing aid and four of the amplification products. For three of the products (Sound World Solution sCS50+, Soundhawk, Etymotic BEAN), the improvement in speech understanding was within 5 percentage points of that of the hearing aid.

The authors conclude: “Results lend support to current national initiatives … requesting that the US Food and Drug Administration create a new regulatory classification for hearing devices meeting appropriate specifications to be available over the counter.”
JAMA research letter

New Web Page for Doctors Working in Small, Rural, or Underserved Areas
CMS announced the launch of a new section on the Quality Payment Program on https://qpp.cms.gov/about/small-underserved-rural-practices  dedicated to doctors and other clinicians working in small or rural practices as well as those treating patients in underserved areas. This page serves as a single point of reference to help physicians prepare for, and actively participate in, the Quality Payment Program, especially, for those of you participating under the Merit-based Incentive Payment System (MIPS) track.

Physicians can quickly locate contact information for the organizations providing assistance to practices through the Small, Underserved, and Rural Support initiative using a simple interactive map. These local, experienced, community-based organizations provide hands-on training to help thousands of small practices, especially those that practice in historically under-resourced areas including rural areas, health professional shortage areas, and medically underserved areas.

The training and education resources are available nationwide and will be provided at no cost to eligible clinicians and practices. Physicians can also review the flexibilities to help reduce the participation and reporting burden on small practices for 2017. We anticipate adding more features and information over time and will continue to keep the lines of communication open, as CMS values physician feedback in helping to improve their experience in the Quality Payment Program.


CLASSIFIEDS


Medical Space Available for Leasing
Currently (last 7 years) occupied by Lab Corp.
2,500 sq. ft. ADA compliant.
25-15 Steinway Street, Astoria, NY 11103
Please contact Landlord: 1-800-283-0602;
e mail: wwwevans@yahoo.com

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

Physician Opportunities


Medical Director – Cayuga Medical Associates
Cayuga Medical Associates (CMA), a growing multispecialty group located in the heart of the beautiful Finger Lakes Region in Central New York, is currently seeking a Medical Director to work within the organization. This senior leadership position is designed to ensure that high quality, service-oriented patient care is delivered by Cayuga Medical Associates’ physicians on a consistent basis. The medical director has primary responsibility for clinical issues pertaining to the delivery of patient care services, patient satisfaction, and quality at the practice level. This position will report to the Chief Operating Officer of CMA, and will serve as an ex-officio board member. In this role, the Medical Director will work in an administrative capacity 2 days a week, and will practice as a physician for the remaining 3 days of the workweek.This position will require the physician to:

  • Engage in Physician recruitment, engagement and retention, in collaboration with Executive Director
  • Set and communicate performance, service standards and expectations to all providers
  • Exercise professional clinical leadership regarding specific cases or questions of quality or compliance
  • Assist with compensation model refinements and redesign, with specific focus on quality and productivity metrics
  • Oversee CMA’s Physician Action Council (PAC)
  • Develop and implements physician peer review system, medical policies, and clinical programs

Qualifications for this position include:

  • Graduate from accredited medical school and appropriate residency training
  • Board certified physician in a primary care or related sub-specialty area
  • Active NYS medical license

At least 3-5 years of relevant work experience in a physician practice setting, prior experience in physician leadership role preferred

vStrong leadership skills to develop a close, collaborative working relationship with senior leadership team, physician leaders, and practice management staff

The Finger Lakes region of New York offers endless opportunities for outdoor adventures, as well as rich support of the arts and diverse cultural opportunities, excellent school districts, and charming villages, towns and small cities to call home.  If you are dedicated to excellence and possess a commitment to patient-centered care, please submit your CV and cover letter to cma_hr@cayugamedicalassociates.org or fax to (607) 277-1415, attention Human Resources. CMA offers a competitive pay and benefits package and is an equal opportunity employer.


Position Available for Critical Care Physician to Join Established Practice in Nassau County, Long Island, NY.
The Physician will join our existing team of Board-Eligible/Board-Certified Intensivists. This is a PT/FT position including both nocturnal and daytime responsibilities. The Physician will work with a dedicated group of highly trained mid-level practitioners, respiratory therapists and nurses to provide Critical Care at St. Francis Hospital in Roslyn, NY. St. Francis was ranked one of the top 10 hospitals in the nation for Cardiac Care and is top rated nationally in seven other adult specialties.
We are expanding our Intensivist Program and are expecting to add an Intensivist to our group.
Nassau Chest Physicians, P.C. was established in 1978 to provide state-of-the-art care to patients with pulmonary diseases on Long Island. We have expanded our practice to include 8 Intensivist/Pulmonologists and 5 pure Intensivists. Since 2006, we have assumed management of Critical Care services at St. Francis Hospital-The Heart Center in Roslyn, NY.
St. Francis Hospital is New York State’s only specialty designated cardiac center and is a nationally recognized leader in cardiology and heart surgery, ear-nose-throat, gastroenterology and GI surgery, geriatrics, neurology and neurosurgery. More cardiac procedures are performed at St. Francis than at any other hospital in New York State. The hospital is located on the North Shore of Long Island; approximately 30 minutes from Manhattan. The hospital combines unrivaled expertise in cardiovascular medicine with top-ranged nursing (AACN Magnet Award) to provide the very best in patient care.
In addition, St. Francis offers excellent Thoracic, Vascular, Oncologic, Neurosurgical, and Orthopedic Surgical Programs. We have a very active Emergency Department. The hospital offers the latest in technologies such as Therapeutic Temperature Modification, Impella, ECMO and LVAD. Our excellent and experienced medical staff supports strong medical and surgical subspecialty programs.

Aside from Certified Critical Care Nurses, many who have more than 20 years of experience and are expert at caring for this complex patient population, we have a growing pool of Intensivist mid-level practitioners who work hand in hand with our Intensivist physicians to coordinate the care of the critically ill patient, minister to them and perform procedures.

Of course, a New York License is required. J1 or H1 VISAS accepted.
Additional Salary Information: Salary and benefits are competitive and commensurate with experience. Interested applicants, send resume to: dr.sorett@nassauchest.com


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

Press coverage of MSSNY’s statement on Surgeon General Nominee

Health Medicine Network – 06/30/17
Trump Nominates Indiana Health Commissioner as Surgeon General
(MSSNY President Dr. Charles Rothberg, MD quoted)

USA Today – 06/30/17
Trump nominates Indiana doctor for surgeon general
(MSSNY statement included)

The Tennessean – 06/30/17
Trump nominates Indiana doctor for surgeon general

The Commercial Appeal – 06/30/17
Trump nominates Indiana doctor for surgeon general

Springfield News-Leader – 06/30/17
Trump nominates Indiana doctor for surgeon general

Democrat and Chronicle   – 06/30/17
Trump nominates Indiana doctor for surgeon general

My Northshore NOW   – 06/30/17
Trump nominates Indiana doctor for surgeon general

Lake Country NOW  – 06/30/17
Trump nominates Indiana doctor for surgeon general

The Asbury Park Press (AP)  – 06/30/17
Trump nominates Indiana doctor for surgeon general

HometownLife.com  – 06/30/17
Trump nominates Indiana doctor for surgeon general 

Courier-Journal  – 06/30/17
Trump nominates Indiana doctor for surgeon general

Central Florida Future – 06/30/17
Trump nominates Indiana doctor for surgeon general 

Post-Crescent  – 06/30/17
Trump nominates Indiana doctor for surgeon general

The Newark Advocate  – 06/30/17
Trump nominates Indiana doctor for surgeon general

WaukeshaNow  – 06/30/17
Trump nominates Indiana doctor for surgeon general

The Californian – 06/30/17
Trump nominates Indiana doctor for surgeon general

LoHud.com  – 06/30/17
Trump nominates Indiana doctor for surgeon general 

Northwest Now  – 06/30/17
Trump nominates Indiana doctor for surgeon general

Ruidoso News  – 06/30/17
Trump nominates Indiana doctor for surgeon general

The News Leader (AP) – 06/30/17
Trump nominates Indiana doctor for surgeon general

Chambersburg Public Opinion  – 06/30/17
Trump nominates Indiana doctor for surgeon general

Tallahassee Democrat  – 06/30/17
Trump nominates Indiana doctor for surgeon general

June 30, 2017 – Fix Insurance System NOT Healthcare System


PRESIDENT’S MESSAGE
Charles Rothberg, MD
June 30, 2017
Volume 17
Number 25

Dear Colleagues:

According to the Washington Post, Senate Majority Leader Mitch McConnell (R-KY) “intends to send a revised version of his health-care bill to the Congressional Budget Office today according to Capitol Hill aides and lobbyists.” This timeline points to McConnell’s attempt to hold a vote before the August recess.

We need to promote a message, by July 3, to Mitch McConnell and all the federal legislators, while they are home in their districts, that what is needed is to fix the health insurance system— not healthcare.

If we get them to rethink patient costs related to premiums, deductibles, co-insurance and/or co-payments, then affordable, usable quality healthcare can be provided to patients with medical needs.  (A $6000 deductible is not usable to most people.) Both political parties will need to work together to get this done.

To help make America greater, we must put away party politics and get health insurance reform back on track. Outrageous deductible amounts are unaffordable to working families with health care needs.  High deductibles mean high out-of-pocket cost to insureds, who (despite high premium costs) are left with paying for office visits as though they don’t have insurance.  This is not right.

For example, an individual insurance premium of $10K+ annually, whereby that individual pays $140 in co-payments for TWO specialist visits and $80 for TWO PCP visits, while the health plan pays just $20 for all FOUR visits is not right either.  Before Obamacare, this ‘feature’ of managed care was a deplorable hurdle and it still is.  It was not right then, it is not right now.  Current proposals don’t appear to address this issue at all.

The insurance industry is to blame and that is where more focus should be. There is far too much talk about perverse ‘incentives’ and ‘payment reform’ for providers of medical services such as physicians and hospitals.  That, too, is wrong.  Insurance reform is what is needed to fix the ills in the system.

Now – Senate, House, Republican and Democrat, how do you propose do fix the system?

Sincerely,
Charles Rothberg, MD
MSSNY President

Please send your comments to comments@mssny.org


Your membership yields results and will continue to do so. When your 2017 invoice arrives, please renew. KEEP MSSNY STRONG!


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US House Passes Medical Liability Reform Bill
By a largely party line 218-210 vote the US House of Representatives passed legislation to expand patient access to care by reducing the exorbitant cost of medical liability insurance.  Among other provisions, the bill contains a provision that would limit to $250,000 the amount of non-economic damages that could be awarded in cases where the patient is enrolled in a Government-subsidized program like Medicare, Medicaid or an Exchange plan.    It would also define federal standards for attorney contingency fees, statutes of limitations, certificates of merit and prohibiting apologies from being introduced into evidence.

After the bill was passed, MSSNY President Dr. Charles Rothberg issued the following statement praising the action of the US House:

“We have long maintained that medical liability reform is an essential component of health reform.  We commend the House of Representatives for passing legislation (HR 1215) that if enacted could help to reduce some of the extraordinary costs faced by our physicians and hospitals and restore some balance to our medical liability system.

New York State was recently designated as the worst state in the country to practice medicine, in large part due to our excessive liability exposure as compared to all other states.  Indeed, physicians in New York City, Long Island and the Lower Hudson Valley pay some of the highest liability premiums in the country.  New York not only far exceeds all other states in terms of total medical liability payouts, we also spend more on a per capita than any other state in the country.

The actions of the US House of Representatives to address this huge problem stands in stark contrast to the New York State Legislature, which despite New York’s exorbitant costs, just passed legislation that would actually expand lawsuits against doctors and hospitals and impose huge new costs.  MSSNY and many other health care provider associations are urging Governor Cuomo to veto this legislation.

As efforts continue to be undertaken to fix the flaws of the Affordable Care Act, we urge that comprehensive medical liability reform be included in these efforts.”

All 9 Republican members of New York’s Congressional delegation (Collins, Donovan, Faso, Katko, King, Reed, Stefanik, Tenney and Zeldin) voted in favor of the bill.  All 18 Democrat members of New York’s Congressional delegation (Clarke, Crowley, Engel, Espaillat, Jeffries, Higgins, Lowey, C. Maloney, S.P. Maloney, Meeks, Meng, Nadler, Rice, Serrano, Slaughter, Suozzi, Tonko, and Velasquez) voted against the bill.

At this point, it is not clear what the Senate will do with this legislation.  It has been reported that some US Senators are seeking to include medical liability reform provisions within the broader health care reform debate.

Tell Governor Cuomo to Reject Medical Liability Expansion Bill and Call for Comprehensive Liability Reform
All physicians are urged to call Governor Cuomo at 518-474-8390 and send a letter here urging that he veto a so-called “cancer only” medical liability statute of limitations expansion bill (S.6800/A.8516) that passed the Legislature over the strong objections of MSSNY, the specialty societies, the hospital industry and MLMIC.  Please urge that legislation be enacted instead that provides for comprehensive medical liability reform.

This ambiguously drafted bill, introduced in the final days and passed in the final hours of the 2017 Legislative Session, would expand the medical liability statute of limitations for cases involving “alleged negligent failure to diagnose a malignant tumor or cancer”.   The bill would permit lawsuits 2.5 years from the “date of discovery” of such alleged negligence, up to an outside limit of 7 years.

While it is likely that a more narrowly focused bill will reduce somewhat the premium increase needed from the 15% projected increase for an earlier version of this bill, there is great ambiguity in the legislation as to which cases the 7-year limit would apply that will undoubtedly generate significant litigation.    Moreover, the bill does not just apply to treatment that occurs after the proposed effective date of the bill but has a very significant retroactive impact, subject to numerous interpretations, for which insurance companies have not reserved premium dollars (another reason to veto the bill!).  These errors and/or ambiguities are likely the result of the bill being “rushed into print” to meet the constitutional “3-day aging” requirement before a bill can be considered by the Legislature.

Besides the bill’s drafting errors, of greatest concern, the bill completely ignores the exorbitant medical liability costs that New York physicians already pay, which was reflected in MSSNY President Dr. Rothberg’s statement about the failings of this bill:

“New York’s physicians are extremely concerned about the ultimate impact to New Yorkers’ access to care if the statute of limitations expansion bill (S.6800/S.8516) considered by the Legislature today is ultimately signed into law.  Many New York hospitals and physicians are already struggling to keep their doors open.

New York State has already earned the dubious distinction as the absolute worst state in the country in which to practice medicine, in large part due to its overwhelming liability costs.  The bill will add significantly to these costs that have already driven physician after physician out of private practice, and in many cases driving them out of New York altogether.  It will also discourage countless others from coming here to practice.  We urge Governor Cuomo to veto this legislation and bring parties together to pass comprehensive, not one-sided, medical liability reform. New Yorkers’ access to health care is at stake.”

Again, please urge the Governor to veto this bill and encourage your colleagues to do the same! Please let the Governor know how this bill will harm patient care and exacerbate existing physician shortage issues in your community. 

MSSNY President Issues Statement Expressing Deep Concerns US Senate Health Reform Legislation, Communicates to NY Congressional Delegation
As the US Senate was deciding this week whether to begin floor debate on its proposal to repeal and revise much of the Affordable Care Act, MSSNY President Dr. Charles Rothberg issued the following statement expressing deep concerns about the legislation’s impact to New York:

“While a wholesale review of the flaws of the ACA should be undertaken, we are deeply concerned about potentially significant adverse consequences to New York’s residents and its health care system arising from proposals before the House and Senate. 

The House and Senate bills will replace the low cost coverage hundreds of thousands of New Yorkers currently have with tax credits that for many will be insufficient to purchase coverage. Patients may face huge new out of pocket costs or worse, they may not purchase any coverage at all. In addition, we also have strong concerns about the bill’s long-term impact on funding for New York’s health care system. 

We look forward to working with the members of New York’s Congressional delegation and urge that they work towards enactment of legislation that enhances rather than reduces affordable and comprehensive coverage options for our patients. We also urge that they work proactively with physicians and physician advocacy associations to ensure that proposed remedies will truly address patient care and coverage needs.”

This week, MSSNY also joined on to a letter to New York’s Congressional delegation along with over 30 other New York health care advocacy organization that noted that “By eliminating the cost-sharing reduction payments in 2020, and pegging tax credits for consumers to the very low actuarial value Bronze Plan, the Senate bill will significantly reduce funding for our state’s Essential Plan, jeopardizing coverage for 700,000 low-income New Yorkers. These changes will also lead to higher prices in our state’s individual insurance market, especially for older New Yorkers. And the bill hits providers hard by imposing cuts at the same time as the number of uninsured people seeking care will rise.”  Specifically, the letter called on New York’s Congressional delegation to:

  • Ensure uninterrupted health insurance coverage for the 24 million Americans, including the 850,000 New Yorkers, who gained coverage under the Affordable Care Act (ACA);
  • Do not harm New York State’s budget and do not shortchange New York’s Medicaid program by repealing the expansion under the ACA and profoundly restructuring it into a per capita cap program;
  • Protect the more than 700,000 New Yorkers who gained coverage under the ACA’s Essential Plan;
  • Do not harm health care consumers and providers;
  • Maintain and improve our insurance markets for individuals, families, and small employers


MSSNY/County Society Physician Leaders Participate in Regional ACA Town Hall Forums
This week MSSNY and county society physician leaders participated in forums organized by the Cuomo Administration designed to highlight concerns to the public with the legislation before the Congress that would repeal and revise much of the Affordable Care Act (ACA).  MSSNY Treasurer and Cobleskill internist/pediatrician Dr. Joseph Sellers participated at the forum in Hudson, and Erie County Medical Society President and Roswell Park urologist Dr. Willie Underwood participated at the forum in Buffalo (along with former MSSNY House of Delegates Speaker and AMA President Dr. Nancy Nielsen).

Both Dr. Sellers and Dr. Underwood noted that it was appropriate for Congress to examine and seek to fix the flaws of the ACA, given the increasing use of health plans with narrow networks and high deductibles.  However, both Dr. Sellers and Dr. Underwood noted MSSNY’s concerns “with proposals before Congress that would replace provisions that may cause New Yorkers who currently have low cost, “first dollar” coverage through the Essential Plan or expanded Medicaid to lose this coverage.  Instead they will have to purchase coverage with tax credits where they may only be able afford policies with high deductibles and other high cost sharing responsibilities.

Or worse yet, they may not purchase any coverage at all.” Moreover, both articulated to the Governor’s top health care staff at these forums the importance of including medical liability reform within ACA reform discussions, given New York’s recent designation as the worst state in the country to be a physician, in large part due to its excessive liability costs.

AG: Would Sue Federal if Provision Affecting NY Medicaid Spending Became Law
Crain’s New York Business (6/27) reports New York Attorney General Eric Schneiderman said on Tuesday that he would “sue the federal government if Senate Republicans pass their bill to repeal the Affordable Care Act.” Schneiderman said the measure unconstitutionally interfered in the governance of New York by shifting Medicaid costs from counties to the state government.

MSSNY President Charles Rothberg, MD with Jerome Adams, MD
MSSNY President Charles Rothberg, MD with Jerome Adams, MD

MSSNY Supports Dr. Jerome M. Adams’ Nomination as US Surgeon General
Indiana State Health Commissioner Jerome Adams, MD, MPH, has been nominated as Surgeon General of the US by President Donald Trump.

Trained as an anesthesiologist, Adams has been outspoken about the risks of prescription opioid painkillers and the need to address the opioid epidemic. Dr. Adams took the helm at the Indiana Health Department in October 2014. Just a month later, the first cases of what would later be recognized as a full-blown HIV outbreak were detected in the community of Austin in southeastern Indiana.

The virus was being spread primarily by intravenous drug users sharing needles to inject the prescription opioid oxymorphone. In 2015, Dr. Adams worked to persuade then Governor Michael Pence to authorize an emergency needle exchange for 30 days, although Governor Pence was morally against needle sharing.

MSSNY President Charles N. Rothberg, MD, stated, “Dr. Adams has a proven track record to make public health a priority despite political hurdles. He is reminiscent of  Dr. C. Everett Koop (US Surgeon General, 1982-1989), who was a champion of public health.  Dr. Adams is in touch with the public needs.”

Dr. Adams wrote in May 2015, “We are building a model for prevention and response should this type of outbreak happen in other communities in the US. I would like nothing better than to tell you this unprecedented HIV epidemic will never happen anywhere else. But I can’t do that.”

In July of 2016, Indiana joined the list of states with standing orders for naloxone, the antidote to revive people who overdose on opioids. Subsequently, Indiana, residents can go to registered pharmacies, nonprofit organizations, and health centers and get naloxone without needing a prescription.

In 2016, Dr. Adams gave a presentation on fighting the spread of hepatitis C and HIV at the National Rx Drug Abuse & Heroin Summit in Atlanta.  He said in his presentation, “Speak to your audience in their language. To change behavior, public health program workers need to confront ignorance and denial, conduct small pilot programs, and use successes to gain support.”

Dr. Adams earned bachelor’s degrees in biochemistry and biopsychology from the University of Maryland in 1997. He then earned a master’s degree in public health from the University of California at Berkley, and a medical degree from the Indiana University Medical School. He has been a researcher at medical schools in both the Netherlands and Zimbabwe and has worked under Nobel Prize winner Dr. Tom Cech.

Dr. Adams is married and has three children.

Click here to read press coverage of MSSNY’s support of Dr. Adams’ nomination. 

NYS Provider & Health Plan Look-Up
The New York State Department of Health, together with the NY State of Health, this week announced the launch of the NYS Provider & Health Plan Look-Up, an online tool that consumers can use to research those health insurance plans with which a physician (and other health care practitioners) participates.  It also lists practice locations for each physician.  Previously, a consumer would have to go to the website of each health insurance company to determine if a physician participated with a particular plan.

Physicians should take the opportunity to go to the website to see with which health plans they are listed to participate to determine if there are inaccuracies in their listings. The most efficient way to report an error is for the physician or someone on his or her behalf to select the  Contact Us button on the website. Then select the health plan and the reason for the contact. The issue will be routed electronically to the DOH and to the selected health plan(s) for review and follow-up.

CDC Working on New Approach for Early-Stage Lyme Disease Detection
STAT (6/28) reports that the number of Lyme disease cases is rising, and given that the current FDA-approved laboratory test does not consistently detect the disease in its early stages, the CDC is focusing on creating a new Lyme test using “metabolomics,” which measures “metabolite biosignatures” rather than the body’s immune response. The article extensively quotes CDC microbiologist Claudia Molins, who says, “We want a test that can be used within the first two weeks of infection and that does not rely on antibody production.” STAT adds that by using metabolomics, “the CDC aims to create a Lyme ‘signature’ of small molecules in the blood – an approach that, in early testing, catches a dramatically higher share of early infections.”

2018 EHR Hardship Exemption
July 1 is the deadline for avoiding the 2018 penalty imposed by the federal government’s Electronic Health Record (EHR) Incentive Program in its final year if you were not successful in reporting Meaningful Use in 2016 (the performance year for the 2018 penalty).  If you think you might not have reported sufficient data please review the following links:

Instructions
Hardship Application

The deadline for the hardship application is 11:59 PM on Saturday, July 1, 2017

Social Security Number Removal Initiative (SSNRI)
As we reported previously, beginning in April 2018, CMS will start mailing new Medicare cards with Medicare Beneficiary Identifier (MBIs) to people with Medicare. CMS is figuring out the best way to mail the cards. CMS will keep clinicians and beneficiaries posted about critical information so everyone can be ready to ask Medicare patients at the time of service if they have a new card with an MBI.

Beginning in October 2018, through the transition period, when physicians submit a claim using the patient’s valid and active Health Insurance Claim Number (HICN), NGS Medicare will return both the HICN and the MBI on every remittance advice. The MBI will be in the same place you currently get the “changed HICN.” The new MBI format is explained at the following website: https://www.cms.gov › Regulations and Guidance › EHR Incentive Programs

Important Modification on E&M Exam for Expanded Problem and Detailed Levels
The originally planned differentiation in examination requirements for Expanded Problem Focused (2-5) and Detailed (6-7) levels of service will no longer be considered mandatory for providers as of 7/1/2017. NGS developed these suggestions in response to multiple provider queries on the original levels (both EPF and Detailed at 2-7), and has received strong provider support for delineating the two levels as a means of more accurately coding a service.

We will not, however, mandate the changes as previously announced; all medical records reviewed will be subject to the original standard of 2-7 or the newly suggested levels of 2-5 and 6-7, in whatever manner is more beneficial to our providers. These suggestions apply to services coded as per the CMS 1995 Documentation Guidelines for Evaluation and Management Services; suggestions do not apply to services coded as per the CMS 1997 Documentation Guidelines for Evaluation and Management Services.

The posted NGS Evaluation & Management Documentation Training Tool reflects the 2-7 exam component standard for both coding levels, and will remain unchanged.


CLASSIFIEDS


Medical Space Available for Leasing
Currently (last 7 years) occupied by Lab Corp.
2,500 sq. ft. ADA compliant.
25-15 Steinway Street, Astoria, NY 11103
Please contact Landlord: 1-800-283-0602;
e mail: wwwevans@yahoo.com

Office Space Available within Beautiful Medical Spa in Woodbury NY
Seeking an MD that is looking to rent space in Woodbury, NY within a beautiful, state-of-the-art Medical Spa. Located in the Woodbury Common with high profile brands such as Soul Cycle, Athleta, Chop’t and more, this area is exclusive, elite and high-traffic. Rental space can include from 1 – 4 rooms with office space, shared reception and retail area. Size of area and price are negotiable. Great opportunity to share like-minded patients. ssoni@becomemedspa.com.

Manhasset Suite
Medical Suite to share- located at 1201 Northern Blvd, Manhasset. The medical space includes 4 exam rooms and consultation rooms. Direct access to office-  NO STEPS. Conveniently located between St.Francis Hospital and NS/LIJ Hospitals. For more information, please call 516-365-4616 or email RSwe777@aol.com


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

Physician Opportunities


Position Available for Critical Care Physician to Join Established Practice in Nassau County, Long Island, NY.
The Physician will join our existing team of Board-Eligible/Board-Certified Intensivists. This is a PT/FT position including both nocturnal and daytime responsibilities. The Physician will work with a dedicated group of highly trained mid-level practitioners, respiratory therapists and nurses to provide Critical Care at St. Francis Hospital in Roslyn, NY. St. Francis was ranked one of the top 10 hospitals in the nation for Cardiac Care and is top rated nationally in seven other adult specialties.
We are expanding our Intensivist Program and are expecting to add an Intensivist to our group.
Nassau Chest Physicians, P.C. was established in 1978 to provide state-of-the-art care to patients with pulmonary diseases on Long Island. We have expanded our practice to include 8 Intensivist/Pulmonologists and 5 pure Intensivists. Since 2006, we have assumed management of Critical Care services at St. Francis Hospital-The Heart Center in Roslyn, NY.
St. Francis Hospital is New York State’s only specialty designated cardiac center and is a nationally recognized leader in cardiology and heart surgery, ear-nose-throat, gastroenterology and GI surgery, geriatrics, neurology and neurosurgery. More cardiac procedures are performed at St. Francis than at any other hospital in New York State. The hospital is located on the North Shore of Long Island; approximately 30 minutes from Manhattan. The hospital combines unrivaled expertise in cardiovascular medicine with top-ranged nursing (AACN Magnet Award) to provide the very best in patient care.
In addition, St. Francis offers excellent Thoracic, Vascular, Oncologic, Neurosurgical, and Orthopedic Surgical Programs. We have a very active Emergency Department. The hospital offers the latest in technologies such as Therapeutic Temperature Modification, Impella, ECMO and LVAD. Our excellent and experienced medical staff supports strong medical and surgical subspecialty programs.

Aside from Certified Critical Care Nurses, many who have more than 20 years of experience and are expert at caring for this complex patient population, we have a growing pool of Intensivist mid-level practitioners who work hand in hand with our Intensivist physicians to coordinate the care of the critically ill patient, minister to them and perform procedures.

Of course, a New York License is required. J1 or H1 VISAS accepted.
Additional Salary Information: Salary and benefits are competitive and commensurate with experience. Interested applicants, send resume to: dr.sorett@nassauchest.com


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

June 23, 2017 – Operating in Obscurity-Wrong, Wrong, Wrong!


PRESIDENT’S MESSAGE
Charles Rothberg, MD
June 23, 2017
Volume 17
Number 24

Dear Colleagues:

On Thursday, a medical liability expansion bill, fast-tracked by a select group of New York State Republican Senators was delivered to their peers amid a totally unacceptable veil.  While quite early to deconstruct this ‘failure’ for the house of medicine, some important lessons are evident.

Healthcare is such a vital issue to the people of our nation that any legislative endeavor regarding this complicated topic deserves to be thoroughly scrutinized to assure it provides the highest standards possible prior to its enactment.

In that spirit, I must question how it is that any bill be considered if it has not been made available for public review and comment prior to its presentation on the floor of the Senate, or worse—after it has been voted into law?

To operate in obscurity is wrong. The public wants to know what doctors think. With rare exception, the public still trusts us to protect their interests—especially their health.

In that spirit, the MSSNY Council considered the manner in which the United States Senate has been crafting its ACA replacement – behind closed doors!  While the Senate did (finally) release the language of the bill just yesterday, it plans to vote as early as next week, an unreasonably short time for public—let alone expert comment.  It was the consensus of the MSSNY Council to advise Congress and the public of our desire to review and comment on health legislation, and to recommend that a similar position be taken by the American Medical Association.

Political Not Medical

I should say that at certain times, such as deliberations regarding investigations or national security, “closed door” deliberation may be appropriate. But in health care deliberations, the motive of closed-door deliberation is purely political. The result will be a political rather than a medical solution—not likely the best service to our sector or to the public we serve.

Our objections to the closed door manner of the Senate proceedings on health care is being disseminated to our entire physician membership, our patient population, and all media to advise the population-at-large of our concerns for their health and welfare—today and in the future.

Expansion of Liability Issue

Our position on the statute of limitations expansion bill that was passed on Wednesday is that it is a poor solution. We still require comprehensive laws to serve all stakeholders in the long term.

Lavern Wilkinson (of Lavern’ Law) was treated at a public hospital, a venue that enjoys a shortened 15-month statute of limitations.  The remedy for Laverne could have extended the statute for public hospitals to 30 months (like all non-public venues).  But instead, the new law unnecessarily expands liability for all physicians and all hospitals. There is major dysfunction operating here

You may recall that in 2008-2009, the New York Medicaid Redesign Team delivered 79 recommendations, including medical liability reform. Originally, MRT was to be enacted as a package up or down.  But ultimately only one provision was excluded, tort reform. The other 78 became law and the genesis of DSRIP!

Both the Senators in Washington and those in the New York legislature cross paths in their exclusion of input from the major healthcare stakeholders—physicians and hospitals.

1) We urge Governor Cuomo to veto this legislation and to then bring parties together to pass comprehensive, not one-sided medical liability reform.   

2) We urge congress to solicit, not exclude input from the local health care experts – our physicians.

Sincerely,
Charles Rothberg, MD
MSSNY President

Please send your comments to comments@mssny.org



Dear Physicians: 

As you may be aware, the State Legislature ended its formally scheduled 2017 Legislative Session late Wednesday (though it is possible for them to return to Albany on a limited basis).  Despite being besieged with numerous adverse proposals in the final weeks of Session, we are happy to report that the Session ended with MSSNY, working together with many other allies, able to assure that the scores of the adverse legislative proposals were rejected, including legislation that would have:

  • Enabled corporate-owned Retail Clinics staffed by physician extenders
  • Significantly expanded the information required to be included in the Physician Profile
  • Limited injured worker choice of physician in Workers Compensation, expanded the role of Non-Physicians under Workers Compensation, and eliminated the county medical society role in processing applications
  • Imposed burdensome new requirements on the prescribing of pain medications to patients;
  • Required urgent care  office –based surgery centers to use electronic health records
  • Expanded the scope of practice of numerous non-physicians, including podiatrists, Nurse-anesthetists, optometrists, psychologists, chiropractors, and naturopaths; and
  • Formally permitted non-physicians to perform laser hair removal with virtually no physician oversight. 

Moreover, working with many other public health groups, we scored an important public health victory by assuring that e-cigarettes are regulated similar to other tobacco products. 

However, as you will note below, we are very disappointed that the Legislature chose to pass a one-sided liability expansion bill at a time when physicians and hospitals already face exorbitant liability costs, and potentially significant cuts from Washington.  With Governor Cuomo waging on aggressive public campaign to warn the public about the threat to our health care system and New Yorkers generally if cuts arising from various proposals to repeal the ACA are enacted, please let him know that further increases in liability costs would make these health care access problems even worse. 

We thank the many of you who responded to our call throughout the Session to contact your legislators when requested. 

Sincerely,

Your MSSNY Division of Government Affairs Team

Tell Governor Cuomo to Reject Medical Liability Expansion Bill and Call for Comprehensive Liability Reform
All physicians are urged to call Governor Cuomo at 518-474-8390 and send a letter here Click Here:

urging that he veto a purported “cancer only” medical liability statute of limitations expansion bill (S.6800/A.8516) that passed the Legislature over the strong objections of MSSNY, the specialty societies, the hospital industry and MLMIC.  Please urge that instead he work towards enacting comprehensive medical liability reform.

The bill, introduced in the final days and passed in the final hours of the 2017 Legislative Session, would expand the medical liability statute of limitations for cases involving “alleged negligent failure to diagnose a malignant tumor or cancer”.   The bill would permit lawsuits 2.5 years from the “date of discovery” of such alleged negligence, up to an outside limit of 7 years.

While it is likely that a more narrowly focused bill will reduce the premium increase needed for this legislation (if signed) from the 15% projected to be needed for an earlier version of this bill, there is great ambiguity in the language that could generate significant litigation as to which cases it would apply.    Moreover, the bill does not just apply to cases that may arise in the future but has a retroactive impact. The ambiguities are likely the result of the bill being “rushed into print” late Sunday night to meet the constitutional “3-day aging” requirement before a bill can be considered by the Legislature, as the Legislature was planning to adjourn its 2017 Session Wednesday.

The bill passed the State Senate by a 56-6 vote (those voting no included Senators Hannon, Klein, Murphy, Ortt, O’Mara, and Valesky) and the Assembly by a 112-27 vote (to see how your Assembly member voted, Click Here:

In response to the passage, Dr. Rothberg issued the following statement (Click Here) expressing MSSNY’s great concerns with proposals to expand liability when are in desperate cost decreases:

“New York’s physicians are extremely concerned about the ultimate impact to New Yorkers’ access to care if the statute of limitations expansion bill (S.6800/S.8516) considered by the Legislature today is ultimately signed into law.  Many New York hospitals and physicians are already struggling to keep their doors open.

New York State has already earned the dubious distinction as the absolute worst state in the country in which to practice medicine, in large part due to its overwhelming liability costs.  The bill will add significantly to these costs that have already driven physician after physician out of private practice, and in many cases driving them out of New York altogether.  It will also discourage countless others from coming here to practice.  We urge Governor Cuomo to veto this legislation and bring parties together to pass comprehensive, not one-sided, medical liability reform. New Yorkers’ access to health care is at stake.”

  • Rothberg’s concerns here noted in both the Daily News and Crains Health Pulse.

We thank all of you who took the time to contact their legislators over the last several days to oppose these and the myriad of other liability expansion bills that were also being aggressively pushed by the Trial Bar in the Session’s final days (for example, the attorney contingency fee limit removal was also under serious consideration but was defeated: Click Here.

Again, please urge the Governor to veto the bill and encourage your colleagues to do the same! Please let the Governor how patient access to care will be harmed if this bill were to be enacted.   (DIVISION OF GOVERNMENTAL AFFAIRS) 

New York State Legislature Approves Bill Banning E-Cigarettes From Bars, Restaurants
The New York State Legislature has approved A. 516A/S. 2543A expanding the state’s Clean Indoor Air Act so that it now bans e-cigarettes from bars and restaurants.  Assembly member Linda Rosenthal and Senator Kemp Hannon were the sponsors of the measure.  The Medical Society of the State of New York strongly supported this measure and worked with other health organizations on the bill’s passage.  Governor Andrew Cuomo, who proposed the measure in his budget earlier this year, is expected to sign the bill.        (CLANCY)

Legislature Does Not Take Up Retail Clinic Legislation
The Legislature ended its regularly scheduled session Wednesday night without taking action on legislation strongly opposed by MSSNY (A.958, Paulin) that would permit corporate-owned retail clinics, which would have veered New York away from its long history of opposition to corporately owned care delivery.    Big box store interests were aggressively pursuing this legislation.  The bill advanced from the Assembly Health Committee to the Assembly Codes Committee earlier this year, but moved no further. This legislation was also opposed by the New York State Nurses Association.
(AUSTER)                 


Your membership yields results and will continue to do so. When your 2017 invoice arrives, please renew. KEEP MSSNY STRONG!


Anti-Physician Workers Compensation “Reform” Proposals Not Taken Up
The Legislature left Albany without taking action on legislation (A.8387, Pretlow and S.6349, Alcantara)   that could have significantly impaired injured workers access to care from WC-authorized physicians including giving greater discretion to the Board to penalize physicians, expanding the scope of numerous non-physicians to treat injured workers without requiring coordination with a physician, and limiting the ability of your county medical society to assist physicians in completing applications to become WC-authorized.

Moreover, MSSNY expressed concerns that the bill does nothing to address the myriad of administrative hassles that physicians have experienced with the Workers Compensation system that have forced many physicians to leave the program.  Similar legislation was considered during negotiations of the State Budget, but was ultimately rejected.   Discussions on this topic are likely to continue over into next year.
(AUSTER, BELMONT)

Legislature Does Not Take Up Bill to Empower Non-Physicians to Perform Laser Hair Removal
The Legislature left Albany without taking action on legislation (S.6088-A, Savino/A.7977-A, Paulin) to expressly permit estheticians and others to perform laser hair removal with only minimal physician oversight.  The bill, strongly opposed by MSSNY and other specialty societies, had advanced from the Senate Consumer Protection to the Rules Committee, but moved no further. 

MSSNY has adopted policy that vigorously opposes certification of non-physicians (including non-medical personnel) to perform laser and intense pulsed light source skin enhancement procedures.   That is because lasers have the potential to cause painful burns and permanent scarring if not used properly.  With laser hair removal largely unregulated in New York, legislation to provide strong physician oversight of this process would be appropriate.   However, the only physician oversight this legislation would have required is a once per year audit of policies and procedures.
(AUSTER)

Legislature Rejects Scope of Practice Changes
Working together with the affected specialty societies MSSNY was successful in convincing the legislature to reject various bills that would have expanded the scope of practice for various professions.  These bills include:

  • Certification of Certified Registered Nurse Anesthetists (CRNAs)

A.442 (Paulin) / S.1385 (Gallivan) – This measure would provide for the certification by the education department of certified registered nurse anesthetists (CRNAs).  Because this bill fails to define a scope of practice we had conserns that it could have given the Education Dept authority to enable independent practice for CRNA’s.

  • Broadens scope of practice of dentistry

A.4543 (Morelle) / S.3551 (Golden) – This measure would permit dentists to perform a wide range of medical surgical procedures involving the oral and maxillofacial area. This bill would expand the current scope of practice for dentist which is currently limited to the oral and maxillofacial area relating to restoring and maintaining dental health.

  • Podiatric Scope of Practice

A.1880 (Pretlow) – This bill would expand the scope of practice of podiatrists to allow podiatrists to “diagnose, treat, operate or prescribe for cutaneous conditions of the ankle to the level of the distal tibial tuberocity” (knee).

  • Allows PA’s to Operate Fluoroscopy Imaging Technology

A.4716 (Gottfried) -This bill would allow physician assistants (PAs) who have completed a training program approved by the Department of Education to operate fluoroscopy imaging technology as part of a diagnostic or treatment procedure.      

  • Psychologists Prescribing

A.2851(Mcdonald) / S.4498 (Lanza) – would permit Psychologists to prescribe medications
(BELMONT)

Assembly and Senate Pass Legislation Designed to Regulate Biosimilar Substitutions
The Assembly and Senate passed legislation (S.4788-A/A.7509-A) this week that would establish rules regarding the substitution of interchangeable biological products.  While New York State law regulates the substitution by pharmacists of generic drugs for their branded counterparts, the existing law has not been updated to set forth the circumstances under which a biologic products can be substituted with a FDA approved interchangeable biologic.  Importantly, it would prohibit a pharmacist from substituting an interchangeable biological product (as defined by the FDA) prescribed by a physician if the physician affirmatively requests that the product be dispensed as written.

If the physician does not specify that the biological medication should be dispensed as written, then the pharmacist may substitute an interchangeable biological product but only if the pharmacist provides notice to the physician within 5 days of the substitution.  It would also establish a 5-year sunset on these provisions.
(AUSTER)

New York State Legislature Approves Bill Allowing Medical Marijuana For Treatment Of PTSD
The New York State Senate approved legislation A.7006/S.5629, sponsored by Assembly member Richard Gottfried and Senator Diane J. Savino, that allows medical marijuana to be used to treat post-traumatic stress disorder [PTSD].  The Assembly had passed the bill in May.  The measure now heads to Gov. Andrew M. Cuomo for signature.  The Medical Society of the State of New York opposes the use of marijuana in treatment for PTSD.  Furthermore, MSSNY has expressed concerns about the law due to possible federal prosecution of physicians.
(CLANCY)  

Public Health Issues
Sepsis Awareness Program –   The New York State Legislature has passed a bill which would establish a sepsis awareness, prevention and education program to educate students, parents and school personnel about sepsis awareness on sepsis has passed the state Assembly.

This measure, A. 6053/S.4971, sponsored by Assemblywoman Catherine Nolan and Senator Carl Marcellino, also amends New York State’s amends Public Health Law to require that information on  sepsis  be part of course work in infection control practices already taken by all healthcare providers and would require that this coursework be completed on or before July 1, 2022. 

Raise the Age for Tobacco Purchase—S.3978/A.273, which would increase the purchasing age for tobacco products from eighteen to 21 years of age remained in the Assembly Codes Committee and the Senate Finance Committee.   MSSNY continues to support this measure. 

Three Day Limitation on Pain Medication— There was no action taken on A. 7741/S.6246, sponsored by Assemblyman John McDonald and Senator Kemp Hannon, which would have limited the initial prescription of a Schedule II or III for the alleviation of acute pain from a seven-day supply to a three-day supply for someone suffering from acute pain.  Most importantly, patients throughout New York State who are suffering acute pain, such as acute postoperative pain; acute back or chest pain; acute pain related to an injury, post-herpetic neuralgia, or acute pain related to disease or condition, could be significantly impacted. The Medical Society of the State of New York continues to strongly oppose this measure.

Conversion Therapy—A.3977/S.263, sponsored by Assemblywoman Deborah Glick and Senator Brad Hoylman, would prohibit mental health professionals from engaging in sexual orientation change efforts with a patient under the age of eighteen years and expands the definition of professional misconduct with respect to mental health professionals.   The measure had passed the New York State Assembly, but remained in the in the Senate’s Mental Health and Development Disabilities Committee.    (CLANCY)  

Bill Passes to Prohibit Medical Record Charges When Needed to Support a Patient’s Government Benefit Application
The Senate and Assembly passed legislation (S.6078, Valesky/A.7842, Gottfried) that would prohibit health care providers and entities from charging patients for copies of medical records when such records are needed “for the purpose of supporting an application, claim or appeal for any government benefit or program”.

The purpose of the legislation is to respond to numerous complaints lodged by patients where they were charged for medical records necessary to assist applications and appeals for government programs assisting lower income patients such as Social Security Disability Insurance (SSDI) and the Supplemental Nutritional Assistance Program (SNAP), despite provisions in existing law that prohibit charging a fee for medical records where a patient is unable to pay.

MSSNY had expressed concerns that the terminology “any government benefit or program” was too broad, and suggested that the bill be amended to identify specifically those low-income government benefit programs to which this fee prohibition should apply.  However, that change was not made.                                                                                                              (AUSTER)

US Senate Releases Its Own Health Care Reform Proposal
The US Senate this week released its own proposal to repeal substantial portions of the Affordable Care Act, entitled the “Better Care Reconciliation Act of 2017”, with a vote possibly before the July 4 recess.

While the framework of the legislation mirrors the American Health Care Act (AHCA) passed in May by the US House of Representatives, there are some important differences, including with respect to the length of time for the existing Medicaid expansion to be phased out, as well as the distribution of the tax credits to be provided to subsidize the cost of health insurance coverage.

The bill would continue the current tax credit structure provided under the ACA through 2019.  Beginning in 2020, advanceable refundable tax credits would be available for those with incomes up to 350% FPL, down from the existing 400% FPL.  It would not base the size of the tax credit on a person’s age, as was proposed in the House’s AHCA bill.  The benchmark for determining the subsidy would be based on 58% of a health insurance plan’s actuarial value.

Similar to the House’s AHCA legislation, it would contain provisions supported by MSSNY to eliminate the current limitations on a person’s contribution to their HSA, as well as delaying until 2026 enforcement of the “Cadillac Tax” on comprehensive health insurance coverage.

However, of significant concern, it would repeal existing cost-sharing subsidies similar to the AHCA.  That would have the effect of repealing funding for New York’s Essential Plan, which provides low out -of-pocket cost coverage for over 600,000 New Yorkers who make between 138-200% FPL.  It would also phase out from 2021-2024 the existing option to have Medicaid cover individuals who make unto 138% FPL.

Moreover, the bill also contains the “Faso-Collins amendment” contained in the AHCA that would shift $2.3 billion in county Medicaid costs to New York State, which could result in additional cuts or an expansion of risk-based payments in Medicaid to make up the difference.

Next week, Governor Cuomo will host a series of regional forums across New York State to discuss the potential impact of these proposals on New York’s health care system and its citizens. MSSNY Treasurer and Cobleskill Internist/Pediatrician Dr. Joseph Sellers will participate at the forum on Monday, June 26 in Hudson.  The Governor issued a statement on Thursday expressing great concerns with the US Senate’s proposal. MSSNY working together with the AMA and state medical societies across the country are continuing their review of this proposal and will follow up with more detailed information about this proposal and whether the Senate will be able to pass it.
(AUSTER)

CMS Proposes Simplifications to the MIPS Program to Ease Physician Compliance
This week CMS proposed a revised rule implementing the Medicare Quality Payment Program (QPP) as required under MACRA.  According to a summary provided by the AMA, CMS is proposing a number of policies to help small practices,  including a significant expansion of the “low-volume” exemption  threshold to $90,000 (up from $30,000) or less in Medicare Part B allowed charges OR 200 or fewer Medicare Part B patients (up from 100 patients).

CMS estimates that, under this proposed rule, more than 94% of eligible clinicians would earn either a positive or neutral payment adjustment.

In addition to increasing the low volume exemptions, other highlights articulated by the AMA include:

Additional accommodations for small practices

  • Creates virtual groups to assist small practices;
  • Adds 5 bonus points to the final MIPS scores for practices of 15 or fewer clinicians; and
  • Adds a hardship exception from the Advancing Care Information (previously Meaningful Use) category for practices of 15 or fewer clinicians.

Advancing Care Information Category

  • Allows the use of 2014 edition certified electronic health records technology (CEHRT) past 2017 – CMS will not mandate that physicians update their EHRs in 2018;
  • Permits physicians to continue to report on Modified Stage 2 measures in 2018 instead of new Stage 3 measures.

Quality Category

  • Increases the quality performance category weight to 60% in 2018 (due to the Cost category weight remaining at zero in 2018);
  • No additional cross-cutting measure requirements added in 2018;

Cost Category

  • CMS proposes a zero weight for costs again in the 2018 performance/2020 payment year, which would rise to 30% for 2019/2021.
  • Physicians will receive information on how they would have scored under the two current value-based modifier measures (total costs per beneficiary and spending from 3 days before to 30 days after hospital admission)

Improvement Activities (IAs)

  • CMS continues to allow physicians to report on IAs through simple attestation;
  • The proposed rule creates stability in program requirements by not changing the number of IAs physicians must report; and
  • It also develops additional IAs, including adding two activities related to diabetes prevention programs, and clarifies existing IAs to be inclusive of additional activities.
    For more information, Click Here.
    (AUSTER)


DOH Attestation Process for Pain Management CME Must Be Completed by July 1, 2017! One WEEK LEFT!
The New York State Department of Health has announced the attestation process for prescribers required to complete Pain Management CME. Prescribers must attest to the completion of the pain management, palliative care and addiction course work or training by July 1, 2017, and again every three years thereafter. The prescriber should only attest after completion of at least three hours of course work or training covering all eight topics.

A prescriber with a Health Commerce System (HCS) account will attest online using the Narcotic Education Attestation Tracker (NEAT) application.  Complete the steps to access the NEAT (Narcotic Education Attestation Tracker) application in the NYS Health Commerce System (HCS):

  1. Log into the HCS
  2. Under “My Content” click on “All Applications”
  3. Click on “N”
  4. Scroll down to NEAT (Narcotic Education Attestation Tracker) and double click to open the application. You may also click on the “+” sign to add this application under “My Applications” on the left side of the Home screen.

Complete the steps to ATTEST to the completion of the education requirement.   A full set of instructions can be found here.

Prescribers that do not have access to a computer can request a paper attestation form by calling the Bureau of Narcotic Enforcement (BNE) toll-free at 1-866-811-7957. They may then complete the form and return it by mail to the address provided in the form. The Bureau of Narcotic Enforcement has also released a Frequently Asked Questions (FAQs) on the prescriber mandate.   A copy of the FAQs can be found here. 

In certain limited circumstances, the New York State Department of Health may grant an exemption to the required course work or training to an individual prescriber who clearly demonstrates to the department that there is no need to complete such training.  Exemptions will be granted only in very limited circumstances, and not solely on the basis of

Economic hardship, technological limitations, prescribing volume, practice area, specialty, or board certification.

Prescribers may apply for an exemption through the Health Commerce System. Further information may be obtained by contacting BNE at 1-866-811-7957 or narcotic@health.ny.gov.  (CLANCY)

Physicians Have One Week To Meet the  Pain Management Mandatory Education By July 1, 2017
The Medical Society of the State of New York Pain Management, Palliative Care and Addiction modules are now available on-line here.  These modules are being offered free of charge to all MSSNY members.  Physicians who are new users to the MSSNY CME site will be required to register as a new user.

As a new user, physicians and non-physicians will be required to enter fields that include: position; name (the name should be what you want to appear on the CME certificate); email  address; and then create a password.  MSSNY members who encounter a payment page or have difficulty registering, please email cme@mssny.org for technical support.  Directions for creating a new account/or logging in can be found here.   Non-MSSNY physicians will be charged $50 per module. 

The MSSNY CME is a new site and while many MSSNY members have an account with mssny.org a MSSNY member may not necessary have an account with cme.mssny.org   If in doubt, try to create an account and if it tells you that the email address is unavailable or in use,  an account exists.   Passwords can be reset if you don’t know it. 

Physicians who have previously had an account at the MSSNY CME site will need to log into the site using their email and password. The MSSNY CME site provides the ability for physicians and other prescribers to view the archived webinar at their leisure, take the required test, and download their certificate. The online program covers all eight topics required in the New York State statute. MSSNY developed the program with the NYS Office of Alcoholism and Substance Abuse Services (OASAS).  MSSNY is listed as an accrediting organization by the NYS DOH Bureau of Narcotic Enforcement.   Information on the three CME modules is available here.  Additional information or technical support may be obtained by contacting cme@mssny.org.
(CLANCY)

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

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Council Notes from June 22, 2017

  • Discussion of the effects in the near future of hospitals and physicians regarding the expansion of liability law
  • MSSNY Council Don Moy advised physicians that they should keep medical records dating back 10 years
  • MLMIC reported that the Berkshire Hathaway deal was moving forward without problems
  • MSSNY won two contested elections at the AMA –Dr. Robert Goldberg , DO, AMA Council on Medical Education; Jerry Cohen MD was reelected to the AMA Council on Constitution and Bylaws;and Meena Davaluri, MD was elected to the Resident slot on the Council on Medical Service. MSSNY now has seats on all AMA Councils that provide guidance on the policies being adopted. AMA Delegation Chair Dr. John Kennedy thanked the 38 delegates and alternates who came to the AMA Annual Meeting in Chicago.
  • Joe Sellers, MD, PAC Chairman said “too many doctors remain on the sidelines with fewer giving even more support” to the PAC. He said that “Doctor to Doctor” solicitation is the most effective was to recruit new PAC members and that the PAC would be happy to meet with small groups throughout the state in an effort to increase PAC membership.
  • Donald Moy, Lawrence Kobak and Thomas Gallo from Kern Augustine will be serving as MSSNY General Counsel.
  • MSSNY Task Force on Physician Stress and Burnout Chair Michael Privitera, MD, made recommendations on the Task Force’s findings for further research collaboration for data analysis
  • Parag Mehta, MD, Commissioner of Membership, presented a resolution about alternate types of memberships for Nonaffiliated Groups of Physicians

Anthem: Minor Conditions No Longer Covered in ED as of July 1
Anthem recently announced that as of July 1, it will no longer cover emergency department visits for most instances of minor conditions that could “safely [be] treated in less acute facilities.” Jay Moore, CMO for Anthem Blue Cross Blue Shield (BCBS) Missouri, said the policy has long been part of coverage contracts, but it has not always been enforced.

A spokeswoman for the insurer, Said its goal was to control costs by steering patients away from expensive ER services and toward doctor offices or urgent care clinics when those are more appropriate settings for treatment. She said the policy wouldn’t apply when the patient is 14 or younger, an urgent care clinic isn’t located within 15 miles, or the visit occurs on a Sunday or holiday. She said it’s aimed at manifestly minor ailments — “If you had cold symptoms; if you have a sore throat. Symptoms of potentially more serious conditions, such as chest pains, could be seen at the ER even if they turn out to be indigestion.” (CBS News & LA Times)

Buffalo Health Centers: ACA Will “Strip People of Their Health Insurance”
The Buffalo (NY) News (6/21) reports that “leaders of Kaleida Health, Erie County Medical Center and the University at Buffalo issued a joint statement this week warning that the bill, known as the American Health Care Act, ‘will ultimately make health care more expensive for patients, doctors and hospitals’” or “strip people of their health insurance, ‘either through prohibitively high premiums for people with pre-existing conditions, elimination of the Medicaid safety net or forcing patients into severely underfunded high-risk pools.’”

The group also said that two key areas of western New York’s economic recovery are medical education and biomedical research, to which “potential cutbacks that stem from the legislation will pose a challenge.”


MSSNY Members Only: Unpaid Claims
We Can Help!
In 2016, MSSNY’s Ombudsman Program was successful in recovering $89,815.79 for physicians who had reached a stalemate regarding unpaid claims. From January to June of 2017, the program recovered $121,441.68 for our members who availed them of the Ombudsman service.If you are a member in good standing, this service is available to you for FREE!For further information, call 516-4886100 ext. 334 or 332.



AMA: New Video Shows Physicians How to Avoid Medicare Payment Penalties
The AMA and the M are looking to help physicians avoid a negative Medicare payment adjustment in 2019—an effort that may be particularly relevant to physicians who have not previously participated in Medicare reporting programs, and/or physicians in smaller practices. The AMA has designated the week starting June 26, 2017 as Pick Your Pace Week, and will broadly disseminate simple instructions on how to report “one patient, one measure, no penalty.” The new materials, available on the AMA website, include:

  • A short video: One patient, one measure, no penalty: How to avoid a Medicare payment penalty with basic reporting.
  • A sample CMS-1500 claim form
  • Links to quality measures on the CMS website

A link to the CMS MIPS eligibility tool

Important Notice Regarding Handwriting on Claims Submitted to Medicare
Beginning 7/1/2017, NGS will return to the provider any paper claim submitted with handwriting on the face of the claim that is not a signature field, (i.e., Items 12, 13, or 31). A notice will be attached to the front of the returned claim and you will need to submit a new claim.

The Centers for Medicare & Medicaid Services (CMS) Internet-Only Manual (IOM) Publication 100-04, Medicare Claims Processing Manual, Chapter 26, Section 30, “Printing Standards and Print File Specifications Form CMS-1500” (700 KB) contains the printing specifications for the CMS-1500 claim form. These printing specifications do not provide instructions to submit handwritten claims. Please use this CMS IOM reference to ensure you are completing paper claims correctly.

We understand this may require some substantial changes to your office practices and we at NGS have two alternatives to handwritten paper claims that would be of little cost to your practice:

NGSConnex is our web-based self-service portal, free of charge, and available through Internet access. You can login to NGSConnex and submit claims to us. In addition to claims submission, NGSConnex has other useful functions like verifying Medicare entitlement, submitting appeals on claims, and viewing and downloading your remittance advice. Take this opportunity to get started on NGSConnex today!

Electronic claim submission and other transactions submitted electronically process considerably faster than paper submission. The Electronic Data Interchange (EDI) page on our website, explains how to enroll and what capabilities your office needs to be able to submit electronic claims.

$7M in Overpayments on Electronic Submissions; Recovery Attempt Expected
In the attachment please find the latest report from the Dept. of Health and Human Services, Office of the Inspector General, regarding their recently completed analysis of the Electronic Health Record Incentive Program. The report basically outlines their approach in reviewing the program through which participants received billions in incentive payments for adoption of electronic health records.

They are now asserting that upwards of $729,424,395 (amount reached through extrapolation) of those payments could have been made in situations that did not actually meet the necessary requirements of the program. Therefore, you should be aware that a recovery attempt might be undertaken to get back some of those funds previously paid out to early adopters.  More information here.

Only 25% of Youth with Opioid Use Disorder Receive Buprenorphine or Naltrexone
According to a JAMA Pediatrics study, only 25% of youth with opioid use disorder receive buprenorphine or naltrexone. Guidelines from the American Academy of Pediatrics recommend that clinicians consider offering pharmacotherapy to adolescents with opioid use disorder. Using a health insurance database, researchers tracked the treatment of youth aged 13 to 25 who were diagnosed with opioid use disorder between 2001 and 2014.

The proportion of patients with opioid use disorder who received buprenorphine or naltrexone increased from 3% in 2002 to 32% in 2009, but by 2014 it had fallen to 28%. Meanwhile, prevalence of opioid use disorder in this age group rose more than fivefold.

The authors and editorialists both note that few pediatricians have the necessary waiver to prescribe buprenorphine. “These findings suggest that provision of [buprenorphine and naltrexone] is not keeping up with the growing need for these treatments among youth.”

Physicians Invited to Meaningful Use MIPS Webinar
Physicians are invited to CAPG Educational Series 2017 webinar with CMS, Advancing Care Information: How to Implement the New Meaningful Use Component of MIPS, on July 7. Space is filling quickly, so please make sure to reserve your place – register now! CMS will provide an overview of the substantive changes to the program from meaningful use to ACI. Additionally, CMS will answer audience questions on the specific ACI component of the Quality Payment Program.

CAPG will have its members cover key implementation steps for physicians and physician organizations starting on this important transition. Our members will tell the audience about the rationale behind their strategy and any implications this will have on their organization.

Please visit our Educational Series web page to learn more and register here for July’s webinar.

Register: CMS Webinar on Proposed Rule for Year 2 of the Quality Payment
Join CMS Webinar on Proposed Rule for Year 2 of the Quality Payment Program

On Monday, June 26 at 1:00 p.m. ET, the Centers for Medicare & Medicaid Services (CMS) will host an overview webinar on the Medicare Quality Payment Program Year 2 proposed rule.

Join the webinar to hear CMS policy experts provide an overview of proposed participation requirements for the second year of the Quality Payment Program.

Webinar Details:

  • Title: Medicare Quality Payment Program Year 2 Proposed Rule Overview
  • Date: Monday, June 26
  • Time: 1:00 – 2:30 p.m. ET
  • Registration page, click here.

Please note:

  • Space for this webinar is limited. Register now to secure your spot. After you register, you will receive a follow-up e-mail with step-by-step instructions about how to log-in to the webinar.
  • The audio portion of this webinar will be broadcast through the web. You can listen to the presentation through your computer speakers. If you cannot hear audio through your computer speakers, please contact CMSQualityTeam@ketchum.com.
  • There will be a Q&A session if time allows. However, CMS must protect the rulemaking process and comply with the Administrative Procedure Act. Participants are invited to share initial comments or questions, but only comments formally submitted through the process outlined by the Federal Register will be taken into consideration by CMS. See the proposed rule for information on how to submit a comment.


CLASSIFIEDS


Office Space Available within Beautiful Medical Spa in Woodbury NY
Seeking an MD that is looking to rent space in Woodbury, NY within a beautiful, state-of-the-art Medical Spa. Located in the Woodbury Common with high profile brands such as Soul Cycle, Athleta, Chop’t and more, this area is exclusive, elite and high-traffic. Rental space can include from 1 – 4 rooms with office space, shared reception and retail area. Size of area and price are negotiable. Great opportunity to share like-minded patients. ssoni@becomemedspa.com.


Manhasset Suite
Medical Suite to share- located at 1201 Northern Blvd, Manhasset. The medical space includes 4 exam rooms and consultation rooms. Direct access to office-  NO STEPS. Conveniently located between St.Francis Hospital and NS/LIJ Hospitals. For more information, please call 516-365-4616 or email RSwe777@aol.com


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

Physician Opportunities


Position Available for Critical Care Physician to Join Established Practice in Nassau County, Long Island, NY.
The Physician will join our existing team of Board-Eligible/Board-Certified Intensivists. This is a PT/FT position including both nocturnal and daytime responsibilities. The Physician will work with a dedicated group of highly trained mid-level practitioners, respiratory therapists and nurses to provide Critical Care at St. Francis Hospital in Roslyn, NY. St. Francis was ranked one of the top 10 hospitals in the nation for Cardiac Care and is top rated nationally in seven other adult specialties.
We are expanding our Intensivist Program and are expecting to add an Intensivist to our group.
Nassau Chest Physicians, P.C. was established in 1978 to provide state-of-the-art care to patients with pulmonary diseases on Long Island. We have expanded our practice to include 8 Intensivist/Pulmonologists and 5 pure Intensivists. Since 2006, we have assumed management of Critical Care services at St. Francis Hospital-The Heart Center in Roslyn, NY.
St. Francis Hospital is New York State’s only specialty designated cardiac center and is a nationally recognized leader in cardiology and heart surgery, ear-nose-throat, gastroenterology and GI surgery, geriatrics, neurology and neurosurgery. More cardiac procedures are performed at St. Francis than at any other hospital in New York State. The hospital is located on the North Shore of Long Island; approximately 30 minutes from Manhattan. The hospital combines unrivaled expertise in cardiovascular medicine with top-ranged nursing (AACN Magnet Award) to provide the very best in patient care.
In addition, St. Francis offers excellent Thoracic, Vascular, Oncologic, Neurosurgical, and Orthopedic Surgical Programs. We have a very active Emergency Department. The hospital offers the latest in technologies such as Therapeutic Temperature Modification, Impella, ECMO and LVAD. Our excellent and experienced medical staff supports strong medical and surgical subspecialty programs.

Aside from Certified Critical Care Nurses, many who have more than 20 years of experience and are expert at caring for this complex patient population, we have a growing pool of Intensivist mid-level practitioners who work hand in hand with our Intensivist physicians to coordinate the care of the critically ill patient, minister to them and perform procedures.

Of course, a New York License is required. J1 or H1 VISAS accepted.
Additional Salary Information: Salary and benefits are competitive and commensurate with experience. Interested applicants, send resume to: dr.sorett@nassauchest.com


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

June 16, 2017 WIN, WIN for MSSNY at AMA


PRESIDENT’S MESSAGE
Charles Rothberg, MD
June 16, 2017
Volume 17
Number 23

Dear Colleagues:

The MSSNY delegation to the annual meeting of the American Medical Association has just returned from Chicago. Our efforts on behalf of our MSSNY members are important to maintaining a presence in ongoing federal and state affairs focused on medicine. Our team of 38 delegates and alternate delegates is led by John Kennedy, MD of Schenectady.

In addition to exhaustive days dealing with more than 200 reports and resolutions, there has been a major effort to assure that New York is well represented on the AMA Councils, which provide guidance on the policies being adopted. To this end, Robert Goldberg, DO was elected to the AMA Council on Medical Education. Bob’s background as Dean at Touro in NYC makes him particularly well suited to this four-year post. Tom Donoghue, once again, worked his magic to elect another MSSNY candidate to victory in a very tough race.

In addition, Jerry Cohen, MD was re-elected to the AMA Council on Constitution and Bylaws; Meena Davaluri, MD was elected to the Resident slot on the Council on Medical Service. She will be working alongside Tom Madejski, MD who already holds a seat on that important Council.

New York is also represented by MSSNY HOD Speaker Kira Geraci, MD who is an elected member of the AMA Council on Science and Public Health and Jacqueline Bello, MD who was re-elected to her seat on the Council on Medical Education. Finally, our delegation works closely with Willy Underwood MD, a MSSNY member and urologist at Roswell Park who holds a seat on the Council on Long Range Planning and Development.

MSSNY was also well-represented on the Reference Committees by Corliss Varnum, MD who chaired the Reference Committee on Public Health and Rose Berkun, MD who worked on the Reference Committee on Medical Practice.

Chicago is truly a great city but, candidly, our MSSNY Delegation does not get to see much of it. Our New York caucus usually begins at 7am and each delegation member has specific assignments to explain New York’s position at reference committee hearings and to represent our viewpoint to colleagues in other states. Usually our position prevails.

At a time when health care issues are “front and center” in Washington, it is critical that we effectively participate in helping steer the national discussion. This we do through our continued participation with the American Medical Association. As our groups, hospitals and private practices push for RVU production and taking time away from work becomes more difficult, we all owe a special thanks to our AMA team leader John Kennedy, MD and the MSSNY delegates and alternates who work on AMA issues on our behalf.

Thanks to MSSNY staffers Laurie Mayer and Michael Reyes for their hard work before, during and after the meeting.

Sincerely,
Charles Rothberg, MD
MSSNY President

Please send your comments to comments@mssny.org



Physicians Urged to Continue to Oppose Liability Expansion Bills
We need physicians to continue to contact click here their legislators to oppose several bills poised to move in the Legislature that could drastically increase the cost of medical liability insurance at a time when no increases can be tolerated. Even if you are employed by a health system, enactment of any of these bills could prompt serious cuts to your system.  These bills include:

  • Eliminating Contingency Fee Limits (S.6738/A8644) – Would remove the long-standing statutory limits on attorney contingency fees, which would undoubtedly lead to much more litigation, higher awards in medical liability actions, and potentially taking away from an award to an injured plaintiff. Actuaries have predicted that this bill could increase your liability premiums by over 10%
  • Lengthening the Medical Liability Statute of Limitations (A.3339/S.4080) – Would substantially lengthen the statute of limitations for medical malpractice actions by making it subject to a “date of discovery” of the alleged malpractice.  If enacted this bill could increase your liability premiums by 15%.
  • Expansion of Wrongful Death Actions (A.1386/ S.411) – Would greatly expand the categories of damages which a plaintiff may recover in a wrongful death action.  Actuarial studies have predicted that this bill could increase liability premiums by over 50%.; and
  • Prohibiting Ex-Parte Interviews of Plaintiff’s Treating Physician (S.243/A.1404) – would prohibit a physician’s defense counsel in a medical liability action from conducting an interview with the plaintiff’s treating physician. This bill would present significant issues for physicians in a medical liability action by limiting the opportunity to fully examine the plaintiff’s health condition to evaluate the merit of the plaintiff’s claim.

Please let your legislators know that the timing of these bills could not be worse. We now have multiple malpractice insurance companies operating in New York State that appear to be in serious financial jeopardy which can ill-afford to absorb the substantial costs of a brand new cause of action. Moreover there is a tremendous uncertainty in the NY healthcare delivery system as a result of legislation before Congress that could profoundly restructure Medicaid spending, and trigger huge cuts to our healthcare system. 

We thank the many physicians who have taken the time to respond to MSSNY’s “Call to Action”, but far more contacts are needed. MSSNY has been working closely with hospital associations and specialty societies to demonstrate our shared concerns regarding the serious adverse consequences to our healthcare system were any of such one-sided bills to be adopted, including placing advertisements in publications such as City & State and Politico-NY click here.
(DIVISION OF GOVERNMENTAL AFFAIRS)

Senate Passes Opioid Package; Discussions Continue Regarding Legislation To Combat Opioid Crisis
The New York State Senate passed a series of bills to address the state’s opioid epidemic and the package focuses on enforcement to hold drug dealers more accountable, regulates many synthetic opioids, and calls for expansion of treatment programs.   Many of the bills put forth in the Senate package do not have an Assembly sponsor.   It is anticipated that Governor Cuomo will also introduce an omnibus bill addressing the opioid crisis that will include greater access to treatment.   In the Senate package there are two bills that concern MSSNY.  The first bill, S. 5949 would require a physician to obtain written consent from a minor’s parent or legal guardian prior to prescribing opioids.

MSSNY is concerned that the bill does not take into account other sections of law, such as Public Health Law 2504, which define the circumstances when a minor may make health care decisions for themselves. The second bill, S.5670, would require that the prescriber provide counseling prior to issuing a Schedule II opioid prescription.  The Medical Society believes that patient education that would be required by this legislation is already being accomplished by the requirement enacted last year to have pharmacists provide education to patients at the time of filling the prescription.   Therefore, MSSNY believes that this legislation is unnecessary and duplicates efforts. To view the Senate package, click here. As the Legislature enters the final weeks, there are on-going discussions about legislation to address the opioid crisis.
(DIVISION OF GOVERNMENTAL AFFAIRS)           

Passage of Bill to Place E-cigarettes under the Clean Indoor Air Act Pending in Both Houses
Legislation, to place e-cigarettes under the Clean Indoor Air Act (CIAA) was recently amended to include the term “vape” and is on the floor in both houses.   Assembly Bill 516A/S.2543A,  sponsored by Assemblywoman Linda Rosenthal and by Senator Kemp Hannon, would apply the same protection for e-cigarettes that currently exist for tobacco products.  Concurrently, there is also legislation that would Raise the Age for Tobacco Purchase before the NYS Legislature. S.3978/A. 273, would increase the purchasing age for tobacco products from eighteen to 21 years of age.  It is now in the Assembly Codes Committee and is pending in the Senate Finance Committee.   MSSNY supports both these measures. In the final days of the legislative session, physicians are urged to send a letter in support of both these measures from MSSNY Grassroots Action Center (GAC) or can call their Senator at 518-488-2800. To send a letter, please click here.
(CLANCY)

Physicians Urged to Support Legislation Requiring Annual Report On Compliance with MH/SUD Federal and State Parity Laws
Physicians are urged contact their legislators to urge passage S.1156-A/A.3694-A which would authorize the superintendent of Department of Financial Services and the Commissioner of Health to expand the information and data that health insurers and health plans are required to submit to include additional information and data necessary to evaluate performance with respect to the implementation of New York State and Federal Mental Health and Substance Use Disorder (MH/SUD) parity laws.

Sponsored by Senator Robert Ortt and Assemblywoman Aileen Gunther, the legislation would require that the information collected be analyzed and used for the preparation of a parity compliance report in the “Consumer Guide to Health Insurers” issued annually by Department of Financial Services, in consultation with the Department of Health. While federal and state parity laws have been on the books for approximately a decade, there continues to be examples of disparate and unequal treatment of MH/SUD in a number of areas including among others utilization reviews, prior authorizations, medical necessity and network adequacy. The enactment of this legislation is imperative for continuing efforts to achieve full implementation of the parity laws and holding insurers and health plans accountable.   Physicians are urged to send a letter by clicking here
(AUSTER, CLANCY)


Your membership yields results and will continue to do so. When your 2017 invoice arrives, please renew. KEEP MSSNY STRONG!


NYS Assembly Will Consider Tanning Ban
Next week, the New York Assembly is expected to consider and vote on A. 7218A/S5585A which would remove the procedures to grant 17-18 year olds access to tanning booth and would prohibit anyone 18 years or younger from using a tanning booth.  This bill is on the calendar in the Assembly and is still pending in the Senate Health Committee.   The measure is sponsored by Assemblywoman Ellen Jaffe and Senator Phil Boyle.  MSSNY supports this measure.(CLANCY)

Physicians Urged to Oppose Retail Clinic Legislation
As the Legislature enters its final few days, big box store interests are aggressively pursuing legislation strongly opposed by MSSNY (A.958, Paulin) that would permit corporate-owned retail clinics, which would veer New York away from its long history of opposition to corporately owned care delivery. Earlier this year, the bill advanced from the Assembly Health Committee to the Assembly Codes Committee despite opposition from several members of the Committee.   Physicians are urged to send a letter in opposition click here.
(AUSTER) 

Legislation Moving to Continue to Permit Limited Antitrust Immunity for Healthcare Collaboratives
Legislation (S.5342, Hannon/A.7748, Gottfried) passed the Senate this week that would extend through 2020 the authority of the Commissioner of Health to approve a Certificate of Public Advantage (COPA) that enables various health care providers to join in collaborative arrangements that otherwise may be prevented by federal and state antitrust laws. The bill has also advanced to the Assembly floor.

COPAs are designed to facilitate the ability of health care providers to engage in arrangements such as (but not limited to) mergers and clinical integration agreements that promote improvements in access to care and quality of care. The original law was enacted in 2011, but expired at the end of 2016.  In order for a group of health care providers to be awarded a COPA, the application must be reviewed by both the Department of Health and New York Attorney General. If it is approved, the arrangement is subject to ongoing State supervision.  So far, three entities have applied for receiving a COPA designation.  To read more, click here.
(AUSTER)

Please Oppose Workers Compensation Proposals to Expand Role of Non-Physicians and Remove County Society Assistance
As the Legislature enters its final days of the 2017 Session, legislation (A.8387, Pretlow and S.6349, Alcantara) remains under discussion that could significantly impair injured workers access to care from WC-authorized physicians including giving greater discretion to the Board to penalize physicians, expanding the scope of numerous non-physicians to treat injured workers without requiring coordination with a physician, and limiting the ability of your county medical society to assist physicians in completing applications to become WC-authorized.

Moreover, the bill does nothing to address the myriad of administrative hassles that physicians have experienced with the Workers Compensation system that have forced many physicians to leave the program. Similar legislation was considered during negotiations of the State Budget, but was ultimately rejected. Please contact your legislators to oppose these bills by sending a letter click here.
(AUSTER, BELMONT) 

Legislation to Expand Collaborative Drug Therapy Management Protocols Delayed
MSSNY shared our strong concerns on legislation, S.4296 sponsored by Senator LaValle, that would greatly expand existing law to allow pharmacists to enter into collaborative drug therapy management (CDTM) protocols with physicians or nurse practitioners to manage, adjust or change the medications of patients.  When the bill popped up on a senate committee agenda, MSSNY worked with the senate sponsor to delay passing the bill to work on our concerns.  If structured properly, these programs can be helpful to managing the treatment of a patient.  The current collaborative drug therapy law was originally established with a “sunset date” in 2015, and was extended by the State Legislature to continue until 2018.

However, this proposal goes well beyond this demonstration program to allow nurse practitioners to participate in the program and would allow up to fifteen community-practice sites where pharmacists and physicians or nurse practitioners may propose to enter into collaborative arrangements. Currently, only physicians are currently permitted to enter into such protocols within the hospital.

We are concerned that there has been no demonstration within a specific care setting in New York, such as in a hospital, that nurse practitioners have the sufficient pharmacology background to successfully work with pharmacists on managing patient medications on a large scale basis as is contemplated in this proposal.  By contrast, physician-pharmacist CDTM protocols were studied extensively following the enactment of New York’s law, which led to the Legislature extending the existing program in 2015.  As such, it would be premature to now add nurse practitioners.
(BELMONT)

Physicians Must Take Pain Management Mandatory Education By July 1, 2017, Just Two Weeks Away!
The Medical Society of the State of New York Pain Management, Palliative Care and Addiction modules are now available on-line here.   These modules are being offered free of charge to all MSSNY members.  Physicians who are new users to the MSSNY CME site will be required to register as a new user. As a new user, physicians and non-physicians will be required to enter fields that include: position; name (the name should be what you want to appear on the CME certificate); email address; and then create a password.  MSSNY members who encounter a payment page or have difficulty registering, please email cme@mssny.org for technical support.  Directions for creating a new account/or logging in can be found here.   Non-MSSNY physicians will be charged $50 per module. 

The MSSNY CME is a new site and while many MSSNY members have an account with mssny.org a MSSNY member may not necessary have an account with cme.mssny.org   If in doubt, try to create an account and if it tells you that the email address is unavailable or in use,  an account exists.   Passwords can be reset if you don’t know it.  Physicians who have previously had an account at the MSSNY CME site will need to log into the site using their email and password.

The MSSNY CME site provides the ability for physicians and other prescribers to view the archived webinar at their leisure, take the required test, and download their certificate. The online program covers all eight topics required in the New York State statute. MSSNY developed the program with the NYS Office of Alcoholism and Substance Abuse Services (OASAS).  MSSNY is listed as an accrediting organization by the NYS DOH Bureau of Narcotic Enforcement.   Information on the three CME modules is available here.  Additional information or technical support may be obtained by contacting cme@mssny.org.
(CLANCY)

DOH Attestation Process for Pain Management CME Must Be Completed by July 1, 2017! Just 2 Weeks Away!
The New York State Department of Health has announced the attestation process for prescribers required to complete Pain Management CME. Prescribers must attest to the completion of the pain management, palliative care and addiction course work or training by July 1, 2017, and again every three years thereafter. The prescriber should only attest after completion of at least three hours of course work or training covering all eight topics. A prescriber with a Health Commerce System (HCS) account will attest online using the Narcotic Education Attestation Tracker (NEAT) application.  Complete the steps to access the NEAT (Narcotic Education Attestation Tracker) application in the NYS Health Commerce System (HCS):

  1. Log into the HCS
  2. Under “My Content” click on “All Applications”
  3. Click on “N”
  4. Scroll down to NEAT (Narcotic Education Attestation Tracker) and double click to open the application. You may also click on the “+” sign to add this application under “My Applications” on the left side of the Home screen.

Complete the steps to ATTEST to the completion of the education requirement.   A full set of instructions can be found here.

Prescribers that do not have access to a computer can request a paper attestation form by calling the Bureau of Narcotic Enforcement (BNE) toll-free at 1-866-811-7957. They may then complete the form and return it by mail to the address provided in the form. The Bureau of Narcotic Enforcement has also released a Frequently Asked Questions (FAQs) on the prescriber mandate.   A copy of the FAQs can be found here. 

In certain limited circumstances, the New York State Department of Health may grant an exemption to the required course work or training to an individual prescriber who clearly demonstrates to the department that there is no need to complete such training.  Exemptions will be granted only in very limited circumstances, and not solely on the basis of economic hardship, technological limitations, prescribing volume, practice area, specialty, or board certification.  Prescribers may apply for an exemption through the Health Commerce System. Further information may be obtained by contacting BNE at 1-866-811-7957 or narcotic@health.ny.gov.
(CLANCY)

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

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

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NYU Langone: Lawsuit Goes Up Against 1199 SEIU
NYU Langone Medical Center has pitted itself against the state’s largest health care union, 1199 SEIU, four of its chief hospital competitors and a collective-bargaining unit that represents 109 nonprofit hospitals and nursing homes.

In a lawsuit filed yesterday in Manhattan at the U.S. District Court for the Southern District of New York, NYU Langone alleges that 1199 SEIU and the League of Voluntary Hospitals and Homes of New York have forced it to make about $25 million in additional payments to the 1199 Benefit Fund for Health and Human Service Employees since it withdrew from the League on March 28, 2016. The payments cover medical, dental and disability benefits.

Other defendants in the lawsuit are Montefiore Medical Center, Mount Sinai Hospital, New York-Presbyterian Hospital and Northwell Health’s Long Island Jewish Medical Center.

The medical center said in the lawsuit that the League’s actions violated federal antitrust law. After the withdrawal, the League no longer represented NYU Langone in negotiations with the union, but the health system was still bound by a 2014 agreement concerning wages and benefits and required to pay dues, according to the complaint.

In August 2016, 1199 recalculated the rate NYU Langone was required to contribute to the Benefit Fund, using the methodology for non-League members, which were typically nursing homes and other non-hospital health care providers. The contribution rate for these employers was lower but had no cap, which resulted in much higher contributions for an employer with higher-paid employees like NYU Langone.

The lawsuit argues that the penalties harm competition in the New York City hospital market. NYU Langone is paying $25 million in extra benefit contributions it could otherwise spend on technology and new facilities that help it attract patients and spur its competitors to make investments, according to the complaint. (Crains, 6/16)

Dr. William Spencer Kicks Off Meningitis B Awareness Week at Press Conference
MSSNY’s William Spencer, MD addressed a June 12 press conference to kick off Meningitis B Awareness Week. MSSNY hosted the press conference in its Westbury offices in partnership with the Kimberly Coffey Foundation to urge parents to vaccinate their children to prevent Meningitis B, a potentially deadly, but preventable disease.

Both the New York State Senate and the New York Assembly recently declared June 12-16 Meningitis B Awareness Week. “The importance of vaccines begins in infancy and continues right through adulthood and MSSNY is committed to ensuring that all individuals receive immunizations,” said Dr. Spencer, a Pediatric Otolaryngologist and Suffolk County Legislator (18th District). “In 2015, MSSNY helped to successfully advocate for a law that required children entering 7th and 12th grades in all public and private schools in New York State be fully vaccinated against meningococcal disease types A, C, W and Y in order to attend school. The law does not require immunization of the Serogroup B meningococcal vaccine, but this vaccine is available for teens and young adults.”

Teen Girls: Fastest Rising Number of Torn Ligament Procedures
Jama Pediatrics reports a growing number of US athletes are getting operations to repair torn knee ligaments in a recently published in JAMA Pediatrics http://bit.ly/2ro9RlM The article suggests that  injury rates are “highest and rising fastest among teen girls.” The research on “private insurance data for 148 million US residents found that overall, the average annual” anterior cruciate ligament (ACL) “surgery rate climbed 22 percent from 2002 to 2014, when it reached 75 procedures for every 100,000 people.” But, “for teen girls…the average annual knee surgery rate rose by 59 percent during the study period to 269 procedures for every 100,000 people.” 

Five Ways for Physicians to Get Ready for New Medicare Cards
Medicare is taking steps to remove Social Security numbers from Medicare cards. Through this initiative the Centers for Medicare & Medicaid Services (CMS) will prevent fraud, fight identity theft and protect essential program funding and the private healthcare and financial information of our Medicare beneficiaries.

CMS will issue new Medicare cards with a new unique, randomly-assigned number called a Medicare Beneficiary Identifier (MBI) to replace the existing Social Security-based Health Insurance Claim Number (HICN) both on the cards and in various CMS systems we use now.   CMS will start mailing new cards to people with Medicare benefits in April 2018. All Medicare cards will be replaced by April 2019.

Based on feedback from healthcare professionals, practice managers and other stakeholders, CMS is developing capabilities whereby doctors will be able to look up the new MBI through a secure tool at the point of service. To make this change easier, there is a 21-month transition period where all healthcare providers will be able to use either the MBI or the HICN for billing purposes.

Therefore, even though your systems will need to be able to accept the new MBI format by April 2018, you can continue to bill and file healthcare claims using a patient’s HICN during the transition period. We encourage you to work with your billing vendor to make sure that your system will be updated to reflect these changes as well.

Beginning in April 2018, Medicare patients will come to your office with new cards in hand. CMS is committed to giving you information you need to help your office get ready for new Medicare cards and MBIs.

Here are 5 steps you can take today to help your office or healthcare facility get ready:

  1. Go to the CMS provider website and sign-up for the weekly MLN Connects® newsletter.
  2. Attend quarterly calls to get more information. We’ll let you know when calls are scheduled in the MLN Connects newsletter.
  3. Verify all of your Medicare patients’ addresses. If the addresses you have on file are different than the Medicare address you get on electronic eligibility transactions, ask your patients to contact Social Security and update their Medicare records.
  4. Work with us to help your Medicare patients adjust to their new Medicare card. When available later this fall, you can display helpful information about the new Medicare cards. Hang posters about the change in your offices to help us spread the word.
  5. Test your system changes and work with your billing office staff to be sure your office is ready to use the new MBI format.


Important Modification on E&M Exam Expectations for Expanded Problem Focused and Detailed Levels of E&M
The originally planned differentiation in examination requirements for Expanded Problem Focused (2-5) and Detailed (6-7) levels of service will no longer be considered mandatory for providers as of 7/1/2017. NGS developed  these suggestions in response to multiple provider queries on the original levels (both EPF and Detailed at 2-7), and has received strong provider support for delineating the two levels as a means of more accurately coding a service.

We will not, however, mandate the changes as previously announced; all medical records reviewed will be subject to the original standard of 2-7 or the newly suggested levels of 2-5 and 6-7, in whatever manner is more beneficial to our providers. These suggestions apply to services coded as per the CMS 1995 Documentation Guidelines for Evaluation and Management Services; suggestions do not apply to services coded as per the CMS 1997 Documentation Guidelines for Evaluation and Management Services.

The posted NGS Evaluation & Management Documentation Training Tool reflects the 2-7 exam component standard for both coding levels, and will remain unchanged.

EmblemHealth Backlog Update
There will be delays for a short period of time in processing claims and responding to inquiries. EmblemHealth has hired additional staff to work on backlogs. As required by statute, claims processed past the prompt pay time frame will be paid applicable interest. You should see marked improvement within 60-90 days.  We apologize for this inconvenience.

One of the efficiency measures EmblemHealth has put in place is a change to the radiopharmaceutical claims process. Notification letters were sent to affected providers on February 28, 2017. Starting with claims for dates of service on or after June 1, 2017, you will no longer need to send an invoice for your GHI PPO/EPO claims to be paid when billing radiopharmaceutical codes. This change should allow your new claims to process faster and accurately.  If your staff is not already sending in these claims electronically, they will now be able to do so.

For radiopharmaceuticals, defined by Health Common Procedure Coding System (HCPCS) codes below,

EmblemHealth will pay health care professionals at Average Sales Pricing (ASP) plus 15%. If ASP pricing is not available, then the reimbursement rate is Average Wholesale Pricing (AWP) minus 15%:

  • A9500-A9700
  • A4641-A4647
  • Q9949-Q9969

If you have questions, please contact EmblemHealth’s Provider Call Center at 1-866-447-9717.


CMS Accepts Future Measures/Activities for 3 MIPS Categories until June 30
The Centers for Medicare & Medicaid Services� (CMS) Annual Call for Measures and Activities for the Merit-based Incentive Payment System (MIPS) track of the Quality Payment Program (QPP) is open until June 30, 2017.

CMS encourages clinicians, measure stewards, organizations, and other stakeholders to identify and submit measures and activities to be considered for the Quality, Advancing Care Information, and Improvement Activities performance categories of MIPS in future years.

Submission Details

Measures and activities should be relevant, reliable, and valid at the individual clinician level. To be considered, proposals must include measure specifications, related research, and background.

A final list of measures and activities for MIPS clinicians will be published in the Federal Register no later than November 1 of the year prior to the first day of the performance period. Please note that some Advancing Care Information measures finalized in the 2018 final rule may not take effect until 2020, depending on the functionalities and workflow changes needed for implementation.

For More Information Remember to review the Annual Call for Measures and Activities fact sheet to learn more and understand the process for submitting measures and activities for the MIPS performance categories. Please direct any questions on measure and activity submissions to the QPP Service Center at QPP@cms.hhs.gov.


CLASSIFIEDS


Office Space Available within Beautiful Medical Spa in Woodbury NY
Seeking an MD that is looking to rent space in Woodbury, NY within a beautiful, state-of-the-art Medical Spa. Located in the Woodbury Common with high profile brands such as Soul Cycle, Athleta, Chop’t and more, this area is exclusive, elite and high-traffic. Rental space can include from 1 – 4 rooms with office space, shared reception and retail area. Size of area and price are negotiable. Great opportunity to share like-minded patients. ssoni@becomemedspa.com.

Manhasset Suite
Medical Suite to share- located at 1201 Northern Blvd, Manhasset. The medical space includes 4 exam rooms and consultation rooms. Direct access to office-  NO STEPS. Conveniently located between St.Francis Hospital and NS/LIJ Hospitals. For more information, please call 516-365-4616 or email RSwe777@aol.com

Medical Practice for Sale in Upscale Westchester Community
Successful well established (1984) and actively growing Internal Medicine/ Primary Care Practice conveniently located only 45 minutes from midtown Manhattan. Great Opportunity for established physician to expand his patient base or for entrepreneurial new graduate.  Lease assignable with option to renew.

Facilities / Business Details

Well known Professional Building with convenient free parking; ground/first floor location, handicap accessible. Contemporary office recently built and painted. Two large exam rooms; one consultation room/doctor’s office, lab, spacious receptionist area and large waiting room. As an independent practice, it provides an extremely appealing option for the patient that does not want to go to a huge impersonal multi-specialty group. Approximately 80% commercial payers; 20% Medicare. Doctor retiring but willing to stay on to introduce new physician to patients and assist in transition.

Asking Price: 
$175,000

Contact: rpcdb51@yahoo.com


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

Physician Opportunities


Position Available for Critical Care Physician to Join Established Practice in Nassau County, Long Island, NY.
The Physician will join our existing team of Board-Eligible/Board-Certified Intensivists. This is a PT/FT position including both nocturnal and daytime responsibilities. The Physician will work with a dedicated group of highly trained mid-level practitioners, respiratory therapists and nurses to provide Critical Care at St. Francis Hospital in Roslyn, NY. St. Francis was ranked one of the top 10 hospitals in the nation for Cardiac Care and is top rated nationally in seven other adult specialties.
We are expanding our Intensivist Program and are expecting to add an Intensivist to our group.
Nassau Chest Physicians, P.C. was established in 1978 to provide state-of-the-art care to patients with pulmonary diseases on Long Island. We have expanded our practice to include 8 Intensivist/Pulmonologists and 5 pure Intensivists. Since 2006, we have assumed management of Critical Care services at St. Francis Hospital-The Heart Center in Roslyn, NY.
St. Francis Hospital is New York State’s only specialty designated cardiac center and is a nationally recognized leader in cardiology and heart surgery, ear-nose-throat, gastroenterology and GI surgery, geriatrics, neurology and neurosurgery. More cardiac procedures are performed at St. Francis than at any other hospital in New York State. The hospital is located on the North Shore of Long Island; approximately 30 minutes from Manhattan. The hospital combines unrivaled expertise in cardiovascular medicine with top-ranged nursing (AACN Magnet Award) to provide the very best in patient care.
In addition, St. Francis offers excellent Thoracic, Vascular, Oncologic, Neurosurgical, and Orthopedic Surgical Programs. We have a very active Emergency Department. The hospital offers the latest in technologies such as Therapeutic Temperature Modification, Impella, ECMO and LVAD. Our excellent and experienced medical staff supports strong medical and surgical subspecialty programs.

Aside from Certified Critical Care Nurses, many who have more than 20 years of experience and are expert at caring for this complex patient population, we have a growing pool of Intensivist mid-level practitioners who work hand in hand with our Intensivist physicians to coordinate the care of the critically ill patient, minister to them and perform procedures.

Of course, a New York License is required. J1 or H1 VISAS accepted.
Additional Salary Information: Salary and benefits are competitive and commensurate with experience. Interested applicants, send resume to: dr.sorett@nassauchest.com


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

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

June 9, 2017 – Lavern’s Law Down to the Wire


PRESIDENT’S MESSAGE
Charles Rothberg, MD
June 9, 2017
Volume 17
Number 22

Dear Colleagues:

Thank you for answering our call.

Earlier this week, we sent out an urgent alert requesting physicians to contact their legislators to oppose several bills moving through the Legislature that could trigger drastic increases in medical liability insurance costs.  These include bills to change the nature of “wrongful death” awards and to greatly lengthen the medical liability statute of limitations to make it a “date of discovery” rule.

Of particular concern was an editorial in the Daily News this past Monday supporting changes to the Statute of Limitations that would likely trigger an immediate 15% increase in our liability premiums.  If you are employed, it would likely prompt significant cutbacks in your health system and/or other new financial pressures.

We immediately wrote to the paper to express our strong dismay that it would endorse a completely one-sided piece of legislation to greatly expand liability exposure, at a time when no new costs could be tolerated by our health care system.

We highlighted that physicians in New York City and Long Island already pay liability premiums that are among the highest in the country. And that New York has far more medical liability payouts than any other state, far exceeding states such as California, Florida and Texas, both cumulatively and per person.

We also noted the significant financial challenges facing some of the medical malpractice insurance companies operating in New York, as well potentially huge cuts our health care system could face in the years ahead as a result of proposals before Congress to repeal much of the ACA.

While well over 1,000 physicians answered out call to contact their legislators to oppose these adverse bills, many more contacts are needed.  If you have yet not called or written, please do so now here.

There are only two weeks left in the Legislative Session, a time when anything can happen.

Please let your legislators know how patient access to needed care could be harmed if physicians and hospitals would have to absorb enormous new overhead costs.

Please urge them to fight for comprehensive medical liability reform, instead of one-sided proposals.

Please do not wait to make these contacts.

Sincerely,
Charles Rothberg, MD
MSSNY President

Please send your comments to comments@mssny.org




Physicians Urged to Continue to Oppose Liability Expansion Bills
Physicians are urged to continue to contact their legislators (here) to oppose bills moving in the Legislature that could drastically increase the cost of medical liability insurance at a time when no increases can be tolerated.  We thank the many physicians who took the time this week to respond to MSSNY’s “Call to Action”, but more contacts are needed.  MSSNY has been working closely with hospital associations and specialty societies to demonstrate our shared concerns regarding the serious adverse consequences to our healthcare system were any of such one-sided bills to be adopted, including placing advertisements in “inside the Beltway” publications such as City & State and Politico-NY.

The timing of these bills could not be worse.  We now have multiple malpractice insurance companies operating in New York State that appear to be in serious financial jeopardy which can ill-afford to absorb the substantial costs of a brand new cause of action. Moreover there is a great uncertainty in the NY healthcare delivery system as a result of legislation before Congress that could profoundly restructure Medicaid spending.    Please urge you elected officials to oppose the following bills, all of which are before the full Assembly and can be voted on at any time:

Lengthening the Medical Liability Statute of Limitations (A.3339/S.4080) – would substantially lengthen the statute of limitations for medical malpractice actions and lead to enormous increases in the cost of liability insurance for physicians and hospitals.  If enacted this bill could increase your liability premiums by 15%.  

Expansion of Wrongful Death Actions (A.1386/ S.411) – would greatly expand the categories of damages which a plaintiff may recover in a wrongful death action.  Actuarial studies have predicted that this bill could increase liability premiums by over 50%. 

Direct Actions Against a Third Party Defendant (A.1500 / S. 412) – would permit a plaintiff to bypass the defendant he or she sued to collect a judgment from a third party defendant who or which had been sued by the defendant for contribution or indemnification as a result of the underlying action.  

Prohibiting Ex-Parte Interviews of Plaintiff’s Treating Physician (S.243/A.1404) – would prohibit a physician’s defense counsel in a medical liability action from conducting an interview with the plaintiff’s treating physician. This bill would present significant issues for physicians in a medical liability action by limiting the opportunity to fully examine the plaintiff’s health condition to evaluate the merit of the plaintiff’s claim.                                                   (DIVISION OF GOVERMENTAL AFFAIRS)

Governor Cuomo Announces Action to Protect New Yorkers’ Insurance Coverage Should ACA Be Repealed
Governor Cuomo announced earlier this week actions to be taken by the New York Department of Financial Services (DFS) and Department of Health (DOH) designed to protect New Yorkers from issues that could arise were legislation to be enacted by Congress that would repeal many of the protections contained within the Affordable Care Act (ACA).  Among the steps announced included:

  • Directing DFS to promulgate new emergency regulations mandating that health insurance companies do not discriminate against New Yorkers with preexisting conditions or based on age or gender, in addition to safeguarding the 10 categories of “Essential Benefits” guaranteed by the ACA;
  • Directing DOH to prohibit all insurers who withdraw from offering Qualified Health Plans on the State Health Insurance Exchange from future participation in any program that interacts with the Exchange, including Medicaid, Child Health Plus, and the Essential Plan; and
  • Finalizing regulations that will ensure that contraceptive drugs and devices are covered by commercial health insurance policies without co-pays, coinsurance, or deductibles

MSSNY President Dr. Charles Rothberg issued the following statement praising the Governor for taking this action to better ensure comprehensive protections for patients:  “We applaud Governor Cuomo for taking action to assure that New Yorkers are able to maintain comprehensive health insurance benefits were the ACA to be repealed by Congress.

However, such coverage could become an illusory benefit based upon provisions in the AHCA legislation that would have the effect of replacing existing “first dollar” coverage with tax credits.  The proposed tax credits would provide nowhere near the same level of coverage as is currently available.  We call on New York’s Congressional delegation to assure that any health reform package enacted in Washington expands, rather than reduces, New Yorkers’ access to comprehensive health insurance options.”  Dr. Rothberg’s comments were picked up in several AP articles (here and here) across the State, as well as Crains Health Pulse.
(AUSTER)

Physicians Urged to Oppose Retail Clinic Legislation
As the Legislature enters its final days, big box store interests are aggressively pursuing legislation strongly opposed by MSSNY (A.958, Paulin) that would permit corporate-owned retail clinics, which would veer New York away from its long history of opposition to corporately owned care delivery.  Earlier this year, the bill advanced from the Assembly Health Committee to the Assembly Codes Committee despite opposition from several members of the Committee.  The bill has not been officially introduced in the Senate, but versions have passed the Senate in previous sessions.  Physicians are urged to send a letter in opposition here.
(AUSTER)


Your membership yields results and will continue to do so. When your 2017 invoice arrives, please renew. KEEP MSSNY STRONG!



Public Health Issues Pending in Final Days of the NYS Legislature
There are several public health legislative issues that physicians should be aware of in the final days of the NYS Legislative Session.   These include:

Placement E-cigarettes under the Clean Indoor Air Act— Assembly Bill 516, which would place electronic cigarettes under the Clean Indoor Air Act (CIAA) has passed the New York State Assembly.   The measure, sponsored by Assemblywoman Linda Rosenthal, would prevent the use of electronic cigarettes in public places and certain outdoor areas.   Its companion measure, S. 2543, sponsored by Senator Kemp Hannon, is on the calendar in the NYS Senate and can be voted at any time.

Raise the Age for Tobacco Purchase— S.3978/A.273, which would increase the purchasing age for tobacco products from eighteen to 21 years of age is in the Assembly Health Committee and the Senate Finance Committee.   MSSNY supports both these measures. Physicians are urged to send a letter in support of both these measures from MSSNY Grassroots Action Center (GAC) or can call their Senator at 518-488-2800. To send a letter, please click here.

Tanning Ban— A. 7218A/S5585A sponsored by Assemblywoman Ellen Jaffe and Senator Phil Boyle has moved out of the Assembly Health Committee to the Assembly Codes Committee.   This bill would remove the procedures to grant 17-18 year olds access to tanning booth and would prohibit anyone 18 years or younger from using a tanning both.   MSSNY supports this measure.  The bill is in the Senate Health Committee.

Three Day Limitation on Pain Medication— A. 7741/S.6246, sponsored by Assemblyman John McDonald and Senator Kemp Hannon would limiting the initial prescription of a Schedule II or III for the alleviation of acute pain from a seven-day supply to a three-day supply.  While the bill is still in the Assembly and Senate Health Committee, there is talk about an “opioid package” being enacted during the last days of session  The limitation proposed is not based on any clinical evidence that shows limiting medication is effective.  Most importantly, patients throughout New York State who are suffering acute pain, such as acute postoperative pain; acute back or chest pain; acute pain related to an injury, post-herpetic neuralgia, or acute pain related to disease or condition, could be significantly impacted. The Medical Society of the State of New York is strongly opposed to this measure.

Bill to Allow Parents to Sign A Religious Exemption for Immunization– A. 8123a/S.6141, sponsored by Assemblymember Richard Gottfried and Senator Martin Golden would expand the ability of parents to claim a “religious” exemption to avoid immunizing their children.  This bill has recently been amended and is the Education Committee of both houses.   Advocates for this measure are urging that this measure be brought to the floor.   New York State currently has religious exemption legislation and a functional regulatory structure.  Families who have true religious issues with immunization, can, and do meet the tenets of their religious beliefs within the context of current law.  This measure, however, would provide for huge expansion of this exemption by permitting parents to ask for this exemption without clearly stating the decision basis for such an exemption. Parent need only state that they are opposed to immunization for “religious” reasons.  MSSNY is strongly opposed to this measure and will work with other health organizations in opposition to this measure. 

Conversion Therapy—A.3977/S.263, sponsored by Assemblywoman Deborah Glick and Senator Brad Hoylman, would prohibit mental health professionals from engaging in sexual orientation change efforts with a patient under the age of eighteen years and expands the definition of professional misconduct with respect to mental health professionals.   The measure has passed the New York State Assembly and is in the Senate’s Mental Health and Development Disabilities Committee.   The Medical Society and the New York State Psychiatric Association are working together to secure passage of this measure.   Physicians are encouraged to go to the MSSNY Grassroots  Action Center (GAC) to send a letter to their Senator by clicking here

 Sepsis Awareness Program – A bill which would establish a sepsis awareness, prevention and education program to educate students, parents and school personnel about sepsis awareness on sepsis has passed the state Assembly.   This measure, A. 6053/S.4971, sponsored by Assemblywoman Catherine Nolan and Senator Carl Marcellino, would also amend New York State’s existing infection control CME requirement for health care professionals to require the inclusion of information regarding the  detection of  the signs  and  symptoms  of  sepsis  and would require that this coursework be completed before July 1, 2022.            
(CLANCY)

Please Call Your Legislators to Oppose Legislation to Further Empower Non-Physicians to Perform Laser Hair Removal
Legislation (S.6088, Savino/A.7977, Paulin) to expressly permit estheticians and others to perform laser hair removal with only minimal physician oversight advanced from the Senate Consumer Protection to the Rules Committee this week.  MSSNY along with other specialty societies have expressed their strong opposition to this legislation.

MSSNY has adopted policy that vigorously opposes certification of non-physicians (including non-medical personnel) to perform laser and intense pulsed light source skin enhancement procedures.   That is because lasers have the potential to cause painful burns and permanent scarring if not used properly.  MSSNY’s memo to the Legislature noted a 2013 article in the Journal of the American Medical Association that showed that, despite the fact that approximately only 1/3 of laser hair removal procedures are performed by non-physicians, 75.5% of hair removal lawsuits from 2004 to 2012 were performed by non-physicians, and that from 2008 to 2012, this percentage increased to 85.7%.

With laser hair removal largely unregulated in New York, legislation to provide strong physician oversight of this process is essential.   However, the only physician oversight this legislation would require is a once per year audit of policies and procedures.

Please call your legislators to oppose this bill.  Senate 518-455-2800.  Assembly 518-455-4100.
(AUSTER)

Please Take a Moment to Review Your Online Health Plan Participation Information Available Through New DOH Website
As previously reported, the New York State Department of Health, together with the NY State of Health, has announced the launch of the NYS Provider & Health Plan Look-Up, an online tool that consumers can use to look up the health insurance plans with which a physician participates. It also lists practice locations for each physician.  Previously, a consumer would have to go to the website of each health insurance company to determine if a physician participated with a particular plan.  Moreover, physicians seeking to assure the accuracy of the participation information about themselves made publicly available by a health insurance company would have to go to the website of each insurance company.

Physicians should take the opportunity to go to the website to see with which health plans they are listed to participate to determine if there are inaccuracies in their listings. According to a recent MSSNY survey, over 50% of responding physicians indicated that they were inappropriately listed as a participating provider on a health insurer’s website.  MSSNY has argued that these inaccurate listings could result in a situation where an inadequate physician network appears to be more comprehensive, and thereby able to meet state requirements for network adequacy.

So far we have heard from several physicians who have indicated that some of the information posted on this site is inaccurate.  DOH has advised that the most efficient way to report an error is for the physician or someone on his or her behalf to select the “Contact Us” button on the website (https://pndslookup.health.ny.gov/contact), and complete the electronic form.  The issue will be routed electronically to the DOH and to the selected health plan(s) for review and follow-up.

Again, your involvement is essential in MSSNY’s efforts to ensure health insurance plans truly have comprehensive health insurer networks.                                                                                                             (AUSTER)

Support Legislation to Repeal Arbitrary Limits on Compensation Arrangements with Billing Vendors
The New York State Senate passed legislation this week supported by MSSNY that would  the eliminate the “one of a kind” New York law that prohibits health care practitioners from entering into contracts with practice management companies that use percentage-based billing arrangements.

At the April MSSNY House of Delegates meeting, a resolution was adopted calling on MSSNY to “work for repeal of the New York State law barring percentage-based payment arrangements between physicians and their billing agents” and, to “oppose efforts by state government officials to demand refunds from physicians based upon allegations that claims were submitted to Medicaid using percentage-based arrangements between physicians and their billing agents”.  This legislation would accomplish one of the goals of this resolution.  Identical legislation (A.193, Buchwald) has been introduced in the Assembly and referred to the Health Committee.  Physicians are urged to send a letter to their legislators in support of this legislation here.
(AUSTER)

MSSNY Joins Many Others Advocacy Groups to Oppose Harmful Medicare Part B Reimbursement Cuts
MSSNY joined nearly 300 other physician and patient advocacy associations across the country in a letter to HHS Secretary Dr. Tom Price to express strong concerns with proposals recommended by the Medicare Payment Advisory Commission (MedPAC) and Center for Medicare and Medicaid Innovation (CMMI) to reduce reimbursement for medications covered by Medicare Part B.  These medications are primarily provided to patients in physician offices.  The recommendation is similar to a proposal that was advanced by CMS last year.

The letter noted the appreciation for the leading role that Dr. Price played “last year to raise awareness of the harmful impact that the Obama Administration’s Part B Drug Payment Model experiment would have had on physicians and patients. This model is problematic for many reasons, including pushing mandatory, disruptive, and near-nationwide policy changes under the guise of a ‘demonstration’ that could have significantly hurt the sickest and most vulnerable patients.”  Furthermore, the letter noted concerns that, if Medicare Part B drug reimbursements were to be cut, “patients would be left with fewer locations where they could receive care, resulting in less access and higher costs”, as well as forcing patients to “require traveling a longer distance to receive care and would result in higher out of pocket costs, particularly in rural communities.”
(AUSTER)

Physicians Must Take Pain Management Mandatory Education By July 1,2017!  Just 3 Weeks Away!
The Medical Society of the State of New York Pain Management, Palliative Care and Addiction modules are now available on-line here. 

These modules are being offered free of charge to all MSSNY members.  Physicians who are new users to the MSSNY CME site will be required to register as a new user.  As a new user, physicians and non-physicians will be required to enter fields that include: position; name (the name should be what you want to appear on the CME certificate); email address; and then create a password.  MSSNY members who encounter a payment page or have difficulty registering, please email cme@mssny.org for technical support.  Directions for creating a new account/or logging in can be found here.   Non-MSSNY physicians will be charged $50 per module. 

The MSSNY CME is a new site and while many MSSNY members have an account with mssny.org a MSSNY member may not necessary have an account with cme.mssny.org   If in doubt, try to create an account and if it tells you that the email address is unavailable or in use,  an account exists.   Passwords can be reset if you don’t know it.  Physicians who have previously had an account at the MSSNY CME site will need to log into the site using their email and password.

The MSSNY CME site provides the ability for physicians and other prescribers to view the archived webinar at their leisure, take the required test, and download their certificate. The online program covers all eight topics required in the New York State statute. MSSNY developed the program with the NYS Office of Alcoholism and Substance Abuse Services (OASAS).  MSSNY is listed as an accrediting organization by the NYS DOH Bureau of Narcotic Enforcement.   Information on the three CME modules is available here.  Additional information or technical support may be obtained by contacting cme@mssny.org                                                  (CLANCY)      

DOH Attestation Process for Pain Management CME Must Be Completed by July 1, 2017! Just 3 Weeks Away!
The New York State Department of Health has announced the attestation process for prescribers required to complete Pain Management CME. Prescribers must attest to the completion of the pain management, palliative care and addiction course work or training by July 1, 2017, and again every three years thereafter. The prescriber should only attest after completion of at least three hours of course work or training covering all eight topics.

A prescriber with a Health Commerce System (HCS) account will attest online using the Narcotic Education Attestation Tracker (NEAT) application.  Complete the steps to access the NEAT (Narcotic Education Attestation Tracker) application in the NYS Health Commerce System (HCS):

  1. Log into the HCS
  2. Under “My Content” click on “All Applications”
  3. Click on “N”
  4. Scroll down to NEAT (Narcotic Education Attestation Tracker) and double click to open the application. You may also click on the “+” sign to add this application under “My Applications” on the left side of the Home screen.

Complete the steps to ATTEST to the completion of the education requirement.   A full set of instructions can be found here.

Prescribers that do not have access to a computer can request a paper attestation form by calling the Bureau of Narcotic Enforcement (BNE) toll-free at 1-866-811-7957. They may then complete the form and return it by mail to the address provided in the form. The Bureau of Narcotic Enforcement has also released a Frequently Asked Questions (FAQs) on the prescriber mandate.   A copy of the FAQs can be found here. 

In certain limited circumstances, the New York State Department of Health may grant an exemption to the required course work or training to an individual prescriber who clearly demonstrates to the department that there is no need to complete such training.

Exemptions will be granted only in very limited circumstances, and not solely on the basis of economic hardship, technological limitations, prescribing volume, practice area, specialty, or board certification.  Prescribers may apply for an exemption through the Health Commerce System. Further information may be obtained by contacting BNE at 1-866-811-7957 or narcotic@health.ny.gov.           (CLANCY)

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

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

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PAI Launches Free MACRA QPP Physician Education Initiative
The Physicians Advocacy Institute (PAI), of which MSSNY is a Charter Member, has developed educational resources to help physician practices succeed under the Medicare Quality Payment Program (QPP), enacted as part of the MACRA law of 2015. This valuable information is for MEMBERS ONLY.

PAI is sharing this comprehensive array of resources free of charge to help any physician practice, regardless of its level of readiness or knowledge, assess its preparedness and determine the best approach to succeed under the MACRA QPP payment rules.

PAI collaborated with Healthsperien, a Washington D.C.-based health care consulting firm, to develop the resources, which are housed on the PAI website.

The resources include: Twenty-four stand-alone issue briefs – providing a comprehensive, detailed understanding of the program, including MIPS/APM tracks, reporting mechanisms and much more, including:

  • A “10-Step Guide” to Navigating the QPP for physicians with little understanding of the program
  • A searchable online FAQ resource with detailed answers to questions shared by Work Group members from your state associations
  • Five taped webinars and accompanying slide decks that allow physicians to learn more about specific aspects of the program

To access these resources and for more information about PAI, please visit the MSSNY website at www.mssny.org

Mount Sinai Residents Resist Signing New Contract without a Raise
Resident physicians at Mount Sinai St. Luke’s and Mount Sinai West have been locked in contract negotiations with their employer since October. They’re demanding a raise they say Mount Sinai has refused to put on the table. Instead, the health system has offered residents a one-time bonus of $850 during the three-year contract period, according to the Committee of Interns and Residents SEIU, the union representing the residents.Resident salaries at Mount Sinai are based on how many years they’ve been in their program.

They range from $62,682 for a first-year resident to about $80,000 for someone in their seventh year, according to CIR SEIU. New York-Presbyterian and NYU Langone pay residents similar starting salaries, while Northwell Health pays $68,500 to start, according to figures the union provided. (Crains 6/8)

Insurers Seek 16.6% Rate Hike in Individual Market in 2018
UnitedHealthcare is looking for the biggest premium rate hike in the downstate area in 2018, with a requested increase of 38.5% in the individual market. Overall, New York insurers are requesting an average rate increase of 16.6% in the individual market, and 11.5% in the small group market, according to the summary of rate requests the Department of Financial Services posted online Wednesday evening.
In the individual market, EmblemHealth is seeking a rate increase of 24.9%, Care Connect is seeking a 29.7% increase and Oscar is asking for an 11.1% hike.

Prepare Your Practice for Medicare’s Quality Payment Program (QPP) with CMS-Funded Technical Resources Webinar on June 15th at 5pm for NY Clinicians & Staff
CMS will be hosting a webinar on June 15th to provide an overview of some of the upcoming deadlines practices are facing to avoid payment adjustments under QPP and other CMS payment programs, and to provide an overview of the CMS-funded technical assistance available to assist them in successfully participating in QPP and in transforming their practices.

As you know, those practices that are successful can receive significantly higher reimbursement from CMS in the future, but many clinicians still have questions and concerns about this program, and are unsure where to go for help.

Please join our webinar on June 15th at 5pm.  We will be joined by CMS grantees and contractors that are funded to assist clinicians with QPP, and we will be sharing information about other available resources. The link for the webinar and dial-in information will be emailed to those who register a few days before the call.

Improvements to the Medicare Claims Appeal Process and Statistical Sampling
When: Thursday, June 29, 2017

Time:   1:00pm to 3:00pm EST

Target Audience: All Medicare Fee-For-Service providers

To register or for more information, visit MLN Connects Event Registration

A question and answer session follows the presentation.

Are you aware of recent regulatory changes to the Medicare claims appeal process? During this call, CMS and the Office of Medicare Hearings and Appeals (OMHA) discuss the HHS Medicare Appeals Final Rule, published on January 17, 2017. Learn about changes intended to streamline the administrative appeal processes, reduce the backlog of pending appeals, and increase consistency in decision making across appeal levels.

For an overview of the Final Rule, see the HHS fact sheet. Did you know that certain appeals pending at OMHA may be eligible for more efficient adjudication through statistical sampling? Learn about the expansion of this program based on feedback from the pilot phase and how your participation may advance the adjudication of your appeals.

June Workshop at MET Museum! Medicine at The Met: The Art of Seeing
​How can art help you enhance visual diagnostic skills, increase your capacity for presence and give you the the tools to communicate more effectively? Join us for ArtMed inSight’s Medicine at the MET: The Art of Seeing at the MET Museum on June 23, 2017 from 6 to 8.30 pm and June 24, 2017 from 5 to 7.30 pm. For more information and to register go to: http://artmedinsight.org/?page_id=606

Fair Health Features Fee Estimator on Local Healthcare Pricing
When making strategic decisions about pricing in the context of their local markets, providers in individual or small-group practices often are working in the dark. The FH Fee Estimator® is an affordable, easy-to-use online tool that sheds light on actual local market-level fees, procedure by procedure—and helps to inform decisions critical to a provider practice.

An FH Fee Estimator license provides access to current, reliable and independent fee-for-service charge data by specialty and geozip area—the same trusted benchmarks that payors nationwide frequently consult when establishing out-of-network fee schedules. (Geozips generally track to the first three digits of a zip code or groups of three-digit zip codes.)

Physicians and their practice managers have access to benchmark data for dentistry and over 40 clinical medical specialties, based on claims data from 493 geographic areas across the United States, updated twice a year. Access is provided to charge benchmarks from the 50th to 95th percentile for each procedure code/geographic area combination. Medicare facility and non-facility professional fees also are provided.

With just a few keystrokes, users select the specialties and geozips they are interested in, complete a payment and check-out process and then download their data or work with it online. Equipped with this data, providers and practice managers can:

  • Review and design fee schedules;
  • Evaluate network participation and inform negotiations with payors;
  • Investigate practice expansion to new geographic areas;
  • Project revenue associated with the purchase or lease of new equipment; and
  • Compare their own fees to regional market data and Medicare fees and much more.

For more information about the FH Fee Estimator-mail at info@fairhealth.org or call us at 855-301-3247, Monday through Friday, 9 am to 6 pm ET.


CLASSIFIEDS


Office Space Available within Beautiful Medical Spa in Woodbury NY
Seeking an MD that is looking to rent space in Woodbury, NY within a beautiful, state-of-the-art Medical Spa. Located in the Woodbury Common with high profile brands such as Soul Cycle, Athleta, Chop’t and more, this area is exclusive, elite and high-traffic. Rental space can include from 1 – 4 rooms with office space, shared reception and retail area. Size of area and price are negotiable. Great opportunity to share like-minded patients. ssonia@becomemedspa.com.

Manhasset Suite
Medical Suite to share- located at 1201 Northern Blvd, Manhasset. The medical space includes 4 exam rooms and consultation rooms. Direct access to office-  NO STEPS. Conveniently located between St.Francis Hospital and NS/LIJ Hospitals. For more information, please call 516-365-4616 or email RSwe777@aol.com

Medical Practice for Sale in Upscale Westchester Community
Successful well established (1984) and actively growing Internal Medicine/ Primary Care Practice conveniently located only 45 minutes from midtown Manhattan. Great Opportunity for established physician to expand his patient base or for entrepreneurial new graduate.  Lease assignable with option to renew.

Facilities / Business Details

Well known Professional Building with convenient free parking; ground/first floor location, handicap accessible. Contemporary office recently built and painted. Two large exam rooms; one consultation room/doctor’s office, lab, spacious receptionist area and large waiting room. As an independent practice, it provides an extremely appealing option for the patient that does not want to go to a huge impersonal multi-specialty group. Approximately 80% commercial payers; 20% Medicare. Doctor retiring but willing to stay on to introduce new physician to patients and assist in transition.

Asking Price: 
$175,000

Contact: rpcdb51@yahoo.com


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

Physician Opportunities


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


Ophthalmologist Part Time
Ophthalmologist needed to work at multiple nursing homes in all 5 boros except Staten Island. Part time or full-time position available.  Generous salary and incentives.Ttech provided. Opportunity to perform surgery, but not required. Please email cv to privacyssw@gmail.com


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

Positions with the Office of School Health (OSH) combine clinical skills and public health training. OSH focuses on child health, asthma prevention, obesity and nutrition, vision screening, dental care, mental health, reproductive health, and childhood disability. We collaborate with various city and community based agencies to provide social and academic services to address the needs of all New York City school children, especially those facing the most significant social, economic, and health challenges.

The Office of School Health is currently undergoing expansion. There is an immediate need for physicians with an expertise in pediatric, adolescent, or family medicine, with the capacity to utilize primary care skills set through a public health lens. OSH is also  interested in public health and preventive medicine graduates with programmatic, analytic, and social medicine skills.

The NYC DOHMH is reaching out to identify candidates for this recruitment. We are enlisting your help to nominate medical professionals who are committed to contributing their talents to improve health and academic outcomes in our schools. Please consider applying for these positions or passing these opportunities on to talented physicians among your own personal networks.

Attached are the American Academy of Pediatrics position statements on the role of the School Physician as well as the job description and recruitment flyers:

  • Adolescent School Health Physician, Family and Child Health/SH Reproductive/City Medical Specialist, Level: 01/Part-time/Flexible Work Schedule (20-35 hrs/week) To learn more about this position & apply, please submit your resume & cover letter to:https://a127-jobs.nyc.gov/ In the Job ID search bar enter: Job ID: 277208
  • Field Doctor, Bureau of School Health/SH Medical (pre-K-8 Programs or High School) City Medical Specialist, Level: 01/Part-time/Flexible Work Schedule (20-35 hrs/week) To learn more about this position & apply, please submit your resume & cover letter to:https://a127-jobs.nyc.gov/ In the Job ID search bar enter: Job ID: 265869
  • Supervising Medical Doctor,Bureau of School Health/SH Reproductive Health, City Medical Specialist, Level: 02/Part-time (35 hrs/week) To learn more about this position & apply, please submit your resume & cover letter to: https://a127-jobs.nyc.gov/ Job ID:  277026

Please list in your cover letter how you heard about this position (including name of the professional association, website, or individual who referred you). If you have questions, please contact Caroline Volel, MD, MPH at OSH@health.nyc.gov.


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

June 2, 2017 – VW Does EHR?


PRESIDENT’S MESSAGE
Charles Rothberg, MD
June 2, 2017
Volume 17
Number 21

Dear Colleagues:

This week, when the news broke about eClinicalWorks’ misdeeds, the phrase that immediately came to mind was “Volkswagen Does Electronic Health Records.”

The real story is EHR vendor eClinicalWorks has agreed to pay $155 million to resolve a False Claims Act lawsuit that alleged it gave customers kickbacks for publicly promoting its products. The fine stemmed from a whistleblower suit alleging that it falsely obtained certification for meeting certain criteria as part of the meaningful use EHR reimbursement program.

EClinicalWorks disputes the charges but said it settled anyway to avoid the “cost and uncertainty inherent in protracted litigation.”  Really?

This sounds fishy to me. Why would someone pay out a $155 million fine if they were not guilty? This outcome is an outrage. If a physician attempted such a scam, they would not be fined. They would go directly to jail and would never be able to reclaim their medical license.

The DOJ alleges that eClinicalWorks opted to add the 16 drug codes necessary for certification into its software rather than enable the product to access those from a complete database; failed to accurately record user actions with audit log functionality; did not always accurately record diagnostic imaging orders or conduct drug-drug interaction checks; and, finally, eClinicalWorks did not satisfy data portability requirements designed to enable doctors to transfer patient data over to other vendor’s EHRs.

“As a result of these and other deficiencies in its software, ECW caused the submission of false claims for federal incentive payments based on the use of ECW’s software,” the Vermont DOJ said.

Why do we try to privatize when firms are self-serving and do not hold public trust with sanctity? All they have to do is pay a fine when accused of willful wrongdoing.

By the way, the lawsuit was originally filed by whistleblower Brendan Delaney, who at the time was a software technician at the New York City Division of Health Care Access and Improvement. He will receive approximately $30 million as part of the resolution.

The vendor accepted terms in a 5-year settlement agreement that the Office of the Inspector General called innovative.  “eClinicalWorks must allow customers to obtain updated versions of their software free of charge and to give customers the option to have eClinicalWorks transfer their data to another EHR software provider without penalties or service charges,” the notice said. “eClinicalWorks must also retain an Independent Review Organization to review eClinicalWorks arrangements with healthcare providers to ensure compliance with the Anti-Kickback Statute.”

“This resolution demonstrates that EHR companies will not succeed in flouting the certification requirements,” said Acting U.S. Attorney for the District of Vermont Eugenia Cowles.

I think one already did succeed.

Sincerely,
Charles Rothberg, MD
MSSNY President

Please send your comments to comments@mssny.org


Crunch Time as the End of the Legislative Session Nears
The legislature will return to Albany next week.  With only three weeks left of session, we need to remain active in the legislative process.  The end of session usually brings a lot of negotiations and deals on various bills and regularly includes surprises. While it’s hard for us to predict the unpredictable, there are ways to get involved and tip the odds in our favor.  As we monitor bill introductions and meet with every legislator, our physicians must keep up on the most up- to-date information and important material to boost our efforts.  Our grassroots action network click here is filled with informational materials and ways to contact your legislators.  Please call, write and meet with your legislators before the end of session which is scheduled for June 21st.
(BELMONT)

Physicians Urged to Continue to Oppose Liability Expansion Bills
All physicians are urged to continue to contact their legislators (click here) to oppose bills moving in the Legislature that could drastically increase the cost of medical liability insurance at a time when no increases can be tolerated.  MSSNY has been working closely with hospital associations and specialty societies to demonstrate the health care community’s  shared concerns regarding the serious adverse consequences to our healthcare system were any of such one-sided bills to be adopted.

The timing of these bills could not be worse.  We now have multiple malpractice insurance companies operating in New York State that appear to be in serious financial jeopardy which can ill-afford to absorb the substantial costs of a brand new cause of action. Moreover there is a great uncertainty in the NY healthcare delivery system as a result of legislation before Congress that could profoundly restructure Medicaid spending.    Please urge you elected officials to oppose the following bills:

  • Lengthening the Medical Liability Statute of Limitations (3339/S.4080) – would substantially lengthen the statute of limitations for medical malpractice actions and lead to enormous increases in the cost of liability insurance for physicians and hospitals.  If enacted this bill could increase your liability premiums by 15%.  This bill is on the Assembly floor and can be voted on at any time.
  • Expansion of Wrongful Death Actions (A.1386/ S.411) – would greatly expand the categories of damages which a plaintiff may recover in a wrongful death action.  Actuarial studies have predicted that this bill could increase liability premiums by over 50%.  This bill is on the Assembly Codes Committee next week.
  • Direct Actions Against a Third Party Defendant (A.1500 / S. 412) – would permit a plaintiff to bypass the defendant he or she sued to collect a judgment from a third party defendant who or which had been sued by the defendant for contribution or indemnification as a result of the underlying action.
  • Prohibiting Ex-Parte Interviews of Plaintiff’s Treating Physician (S.243/A.1404) – would prohibit a physician’s defense counsel in a medical liability action from conducting an interview with the plaintiff’s treating physician. This bill would present significant issues for physicians in a medical liability action by limiting the opportunity to fully examine the plaintiff’s health condition to evaluate the merit of the plaintiff’s claim.
    (DIVISION OF GOVERNMENTAL AFFAIRS)


Please Urge Your Legislators to Enact Legislation to Address Prior Authorization Hassles and Expand Patient Choice of Physicians
With just a few weeks left in the Legislative Session, physicians are urged to contact their legislators to ask them to support legislation strongly supported by MSSNY to address prior authorization hassles imposed by health insurance companies, increase coverage for patients, and to limit the ability of health insurers to narrow their networks.  These bills include:

  • 3943 (Hannon)/A.2704 (Lavine) – would provide physicians and other health care practitioners with necessary due process protections where health insurers seek to terminate a physician from its network by failing to renew the physician’s contract.  The bill has passed the Assembly and was recently reported to the Senate floor. Please send a letter in support click here.
  • 3663 (Hannon)/A.4472 (Gottfried) – would permit independently practicing physicians to collectively negotiate patient care terms with market dominant health insurers under close state supervision. In addition to the ability to push back against exorbitant administrative hassles imposed by insurers, it would also help to protect physicians to have a stronger option to remain in independent practice. The bills have advanced to the Senate Finance Committee, and the Assembly Ways and Means Committee.  Please send a letter to your legislators in support click here.
  • 5675 (Hannon)/A.7671 (Rosenthal) – would require health insurers to make out of network coverage options available through the New York Health Insurance Exchange. Currently, there are no out of network coverage options in the Exchange in downstate New York, despite Exchange officials strongly encouraging the offering of these options by insurers.  The bills are in the Senate Health and Assembly Insurance Committee. Please send a letter to your legislators in support click here.    (DIVISION OF GOVERNMENTAL AFFAIRS)

Your membership yields results and will continue to do so. When your 2017 invoice arrives, please renew. KEEP MSSNY STRONG!




Support Legislation to Repeal Arbitrary Limits on Compensation Arrangements with Billing Vendors
At the April MSSNY House of Delegates meeting, a resolution was adopted calling on MSSNY to “work for repeal of the New York State law barring percentage-based payment arrangements between physicians and their billing agents” and, to “oppose efforts by state government officials to demand refunds from physicians based upon allegations that claims were submitted to Medicaid using percentage-based arrangements between physicians and their billing agents”.  Legislation (A.193, Buchwald/S.2247, Hannon) has been introduced that would accomplish one of the goals of the resolution by eliminating the “one of a kind” New York law that prohibits health care practitioners from entering into contracts with practice management companies that use percentage-based billing arrangements.  The legislation has advanced from the Senate Health Committee to the Senate floor, and in the Assembly has been referred to the Health Committee.  Physicians are urged to send a letter to their legislators in support of this legislation click here.
(AUSTER)


Physicians Can Still Participate in NYS Meaningful Use Program Under Medicaid
The NYS Department of Health has sent out a notice that the deadline to register and report for Meaningful Use in the New York State Medicaid Electronic Health Records (EHR) Program is September 15, 2017.  This will be the last opportunity for physicians and other eligible professionals to join the program. Incentive payments to Eligible Professionals (EPs) are disbursed over the course of six participation years. EPs may receive up to $21,250 for the first participation year and $8,500 for each remaining participation year.   To participate in the EHR Incentive Program, you must have a certified EHR system, be enrolled as a fee-for-service New York Medicaid provider, and be registered with CMS.   Further information and to register may be obtained here.

MSSNY is seeking information from the DOH regarding the number of physicians participating in the Medicaid EHR program as well as the reasons why some physicians started in the program but did not continue.  
(CLANCY)


Need to Meet Your Pain Management CME Requirement?  MSSNY Pain Management, Palliative Care and Addiction Online Program Available
The Medical Society of the State of New York Pain Management, Palliative Care and Addiction modules are now available on-line here.

These modules are being offered free of charge to all MSSNY members.  Physicians who are new users to the MSSNY CME site will be required to register as a new user.  As a new user, physicians and non-physicians will be required to enter fields that include: position; name (the name should be what you want to appear on the CME certificate); email address; and then create a password.  MSSNY members who encounter a payment page or have difficulty registering, please email cme@mssny.org for technical support.  Directions for creating a new account/or logging in can be found here.   Non-MSSNY physicians will be charged $50 per module.

The MSSNY CME is a new site and while many MSSNY members have an account with mssny.org a MSSNY member may not necessary have an account with cme.mssny.org   If in doubt, try to create an account and if it tells you that the email address is unavailable or in use,  an account exists.   Passwords can be reset if you don’t know it.  Physicians who have previously had an account at the MSSNY CME site will need to log into the site using their email and password. The MSSNY CME site provides the ability for physicians and other prescribers to view the archived webinar at their leisure, take the required test, and download their certificate.

The online program covers all eight topics required in the New York State statute. MSSNY developed the program with the NYS Office of Alcoholism and Substance Abuse Services (OASAS).  MSSNY is listed as an accrediting organization by the NYS DOH Bureau of Narcotic Enforcement.   Information on the three CME modules is available here.  Additional information or technical support may be obtained by contacting cme@mssny.org .
(CLANCY)

 DOH Attestation Process for Pain Management CME Must Be Completed by July 1, 2017
The New York State Department of Health has announced the attestation process for prescribers required to complete Pain Management CME. Prescribers must attest to the completion of the pain management, palliative care and addiction course work or training by July 1, 2017, and again every three years thereafter. The prescriber should only attest after completion of at least three hours of course work or training covering all eight topics. A prescriber with a Health Commerce System (HCS) account will attest online using the Narcotic Education Attestation Tracker (NEAT) application.  Complete the steps to access the NEAT (Narcotic Education Attestation Tracker) application in the NYS Health Commerce System (HCS):

  1. Log into the HCS
  2. Under “My Content” click on “All Applications”
  3. Click on “N”
  4. Scroll down to NEAT (Narcotic Education Attestation Tracker) and double click to open the application. You may also click on the “+” sign to add this application under “My Applications” on the left side of the Home screen.

Complete the steps to ATTEST to the completion of the education requirement.   A full set of instructions can be found here.

Prescribers that do not have access to a computer can request a paper attestation form by calling the Bureau of Narcotic Enforcement (BNE) toll-free at 1-866-811-7957. They may then complete the form and return it by mail to the address provided in the form. The Bureau of Narcotic Enforcement has also released a Frequently Asked Questions (FAQs) on the prescriber mandate.   A copy of the FAQs can be found here.

In certain limited circumstances, the New York State Department of Health may grant an exemption to the required course work or training to an individual prescriber who clearly demonstrates to the department that there is no need to complete such training.  Exemptions will be granted only in very limited circumstances, and not solely on the basis of economic hardship, technological limitations, prescribing volume, practice area, specialty, or board certification.  Prescribers may apply for an exemption through the Health Commerce System. Further information may be obtained by contacting BNE at 1-866-811-7957 or narcotic@health.ny.gov.             (CLANCY)

MSSNY & NYSDOH Podcast: Current Concepts in Concussion for Pediatric and Adult Patients
MSSNY’s Continuing Medical Education pre-recorded podcast on Current Concepts in Concussion for Pediatric and Adult Patients is now available on the MSSNY CME webpage for your participation. Listen in on a discussion between Dr. John Pugh, assistant professor of Neurology at Albany Medical Center and Dr. Deborah Light, Director of the Sports Medicine Fellowship at Albany Medical Center while they share their expertise on topics including identifying symptoms indicative of concussion, outlining appropriate management plans, and methods for primary and secondary prevention of concussion.  Click here to listen to the podcast and fulfill the requirements to receive a certificate awarding 1 hour of CME.                                                                                           (HARRING)


Paid Family Leave Benefits Begin in 2018; Payroll Deductions Begin in July 2017
All physician employers should be aware that, beginning January 1, 2018, their employees who have worked for 26 or more consecutive weeks (or part-time for at least 175 days) will be eligible for Paid Family Leave (PFL), as a result of legislation enacted last year as part of the 2016-17 State Budget. Employees will be eligible to receive up to 8 weeks of paid leave in 2018, with this amount going up to ten weeks in 2019 and 12 weeks in 2021.   Premiums for the PFL program are fully funded through employee payroll contributions.

Employees are eligible for PFL benefits for a) maternity or paternity leave for birth of a child, b) caring for a close relative with a serious health condition or c) when a spouse, child, domestic partner or parent of the employee is on active duty or has been notified of an impending call or order of active duty.

Employers may begin to withhold the weekly employee contribution beginning July 1, 2017, for the coverage that begins on January 1, 2018.

For more information from New York State about this new program: click here.  For additional online summaries about this new law, you can review (click here) and (click here).                                                             (AUSTER)

Encourage your patients to listen to MSSNY’s podcast: “What Patients Need to Know About Zika”
The Medical Society of the State of New York has produced an audio podcast entitled “What Patients Need to Know About Zika”.  This audio podcast is available to individuals free of charge and provides New York State patients with important information on the Zika virus.  Individuals may listen to the podcast here:

Developed by MSSNY’s Committee on Emergency Preparedness and Disaster/Terrorism Response, the podcast has Dr. William Valenti, an infectious disease specialist, and Dr. Elizabeth Dufort, medical director, Division of Epidemiology, NYS Department of Health, discussing the Zika virus.  Topics covered in the podcast include general information about Zika, symptoms and treatment; sexual transmission; pregnancy risks; travel to countries where the virus is prevalent and prevention steps.

MSSNY Committee on Emergency Preparedness and Disaster/Terrorism Response has been developing educational programming on emergency preparedness for physicians and the health care community since 2001.  Partnering with the New York State Department of Health, MSSNY has conducted various educational webinars and online programs on topics ranging from Zika virus to pandemic flu.   Arthur Cooper, MD, MS is chair of the committee and Lorraine Giordano, MD is vice chair.   Physicians’ education is available on the MSSNY CME site at:  http://cme.mssny.org/

Additionally, MSSNY has also developed for physicians and health care providers an audio podcast discusses the epidemiology of Zika virus. It also provides information on disease transmittal, diagnosis and the measures that the New York State Department of Health has taken to guide and protect all New Yorkers.   This podcast is available here.
(HOFFMAN, CLANCY)


Register Now For The Next Medical Matters 2017 CME Webinar
The next “Medical Matters 2017” webinar is entitled “Mosquito Borne Diseases”.  On June 14, 2017, at 7:30am, MSSNY will present an update on Zika virus along with several other prominent mosquito-borne diseases.  Please register here.

William Valenti, MD, chair of MSSNY’s Infectious Disease Committee, and Elizabeth Dufort, MD, Medical Director, Division of Epidemiology from the New York State Department of Health will conduct this presentation.

The educational objectives for this live webinar are: 1) Identify the most prominent mosquito borne diseases, including chikungunya, dengue, West Nile virus, yellow fever and zika.  2)  Describe the epidemiology of mosquito borne diseases.  3)  Review modes of transmission and methods of prevention of infection.

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

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

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

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New Medicare Cards Will No Longer Contain Social Security Numbers
CMS is readying a fraud prevention initiative that removes Social Security numbers from Medicare cards to help combat identity theft, and safeguard taxpayer dollars. The new cards will use a unique, randomly-assigned number called a Medicare Beneficiary Identifier (MBI), to replace the Social Security-based Health Insurance Claim Number (HICN) currently used on the Medicare card. CMS will begin mailing new cards in April 2018 and will meet the congressional deadline for replacing all Medicare cards by April 2019.

Health care professionals and beneficiaries will both be able to use secure look up tools that will support quick access to MBIs when they need them. There will also be a 21-month transition period where providers will be able to use either the MBI or the HICN further easing the transition.

CMS will assign all Medicare beneficiaries a new, unique MBI number which will contain a combination of numbers and uppercase letters. Issuance of the new MBI will not change the benefits a Medicare beneficiary receives.

CMS has a website dedicated to the Social Security Removal Initiative (SSNRI) where providers can find the latest information and sign-up for newsletters. CMS is also planning regular calls as a way to share updates and answer provider questions before and after new cards are mailed beginning in April 2018.

For more information, please visit here.


New Powerful Mobile ePrescribing App Available to MSSNY Members

The Medical Society of the State of New York (MSSNY) has partnered with DrFirst to offer MSSNY members a free one-year license of DrFirst’s  new mobile e-prescribing app, iPrescribe®.Optimized for mobile experiences on small screens, iPrescribe brings you the full power of e-prescribing in an intuitive interface that allows you to e-prescribe from anywhere.

  • Faster e-prescribing
    Prescribe legend drugs and controlled substances with just a few taps on your phone.
  • Smarter e-prescribing
    Access patients’ health insurance formulary and co-pay costs as you e-prescribe.
  • Safer e-prescribing
    Receive clinical alerts and consult the most robust medication history available in the industry.
  • Better e-prescribing
    Exchange secure messages with patients and your care team.

Sign up here by July 31st to receive a one-year free trial for iPrescribe. Enter MSSNY when prompted for a promo code. As part of this special offer for MSSNY members, DrFirst is waiving all costs associated with ID proofing and the cost of obtaining the two-factor authentication token required for controlled substance prescribing (EPCS). As an additional courtesy to MSSNY members, DrFirst will also facilitate the upload of patient data into the app.
To learn more about this limited-time offer visit our iPrescribe page.


NYS DOH Launches “Provider & Health Plan Look Up:” Check ASAP for Errors
The New York State Department of Health, together with the NY State of Health, this week announced the launch of the NYS Provider & Health Plan Look-Up, an online tool that consumers can use to research those health insurance plans with which a physician (and other health care practitioners) participates. It also lists practice locations for each physician.  Previously, a consumer would have to go to the website of each health insurance company to determine if a physician participated with a particular plan. 
Physicians should take the opportunity to go to the website to see with which health plans they are listed to participate to determine if there are inaccuracies in their listings.

According to a recent MSSNY survey, over 50% of responding physicians indicated that they were inappropriately listed as a participating provider on a health insurer’s website.  One physicians who contacted us reported that he as listed as having 167 practice locations! The most efficient way to report an error is for the physician or someone on his or her behalf to select the Contact Us button on the website. Then select the health plan and the reason for the contact. The issue will be routed electronically to the DOH and to the selected health plan(s) for review and follow-up.

This newly created DOH website is strictly limited to those physicians who have contracts to participate in a health plan’s network. If you participate in ONLY traditional fee for service Medicare/Medicaid or only in academia, this website is not for you! If you cannot locate your name on your initial search, please be sure to enter the county where you practice.

NY’s Medical Marijuana Program: Free Webinar June 20th, 2017 12-1pm
What all healthcare providers should know!

Please join the Garfunkel Wild law firm for a complimentary webinar and hear from two former high-ranking New York Department of Health (NYDOH) attorneys James E. Dering, former NYSDOH General Counsel and Sandra M. Jensen, former NYSDOH Acting Director of Bureau of House Counsel, both of whom who were involved with the implementation of the Medical Marijuana program.

With the growth and expansion of New York’s Medical Marijuana Program, its highly regulated nature, and recent changes to the program’s regulations, it is important for all healthcare providers to have an understanding of how the program works and its restrictions. This is important not only for practitioners who are considering registering with the program but those already registered so that they are aware of restrictions and rules on resident or patient use – – including new regulations with provisions specific to hospitals. Space is limited. Register here:


More Deaths from Alzheimer’s and More Occurring at HomeU.S. death rates from Alzheimer’s disease rose by about 55 percent between 1999 and 2014—with a growing percentage of such deaths occurring at home, according to a CDC report released last week. CDC said Alzheimer’s is the sixth leading cause of death in the United States, accounting for 3.6 percent of all deaths in 2014.

Medicaid Questions

    1. How do I reactivate Medicaid billing? Should I if I’m not doing Medicaid billing? 

Visit https://www.emedny.org/info/ProviderEnrollment/ If you are going to write scripts for a traditional fee-for-service Medicaid recipient or refer them for labs or x-rays, you need to have a Medicaid fee-for-service provider number so that you can Order & Refer.  Please understand that the pharmacy, lab, radiologist, etc. lists your number on their claim submission to Medicaid to show that their service was Ordered or Referred by you.  If your number is not active/valid, they will not get paid.

  1.    Do I need it for all of my Medicaid managed care billing?
    With Medicaid Managed Care (MMC), you are enrolled/contracted with a specific MMC plan(s).  Based on your enrollment/contract with that plan, you would have the plan’s active provider number.  So this would not affect those contract(s)/plan(s).


New Quality Payment Program Resources Available – and New Site Look
CMS has recently revamped the look of the Quality Payment Program website, and also posted new resources to help clinicians successfully participate in the first year of the Quality Payment Program.CMS encourages clinicians to visit the website to review the following new resources:

Note: Final approval of these organizations is dependent on satisfactory completion of CMS training and submission of a Quality Assurance Plan. A final list of the CAHPS for MIPS Survey vendors approved by CMS to administer the 2017 survey will be made publicly available this summer.

  • Medicare Shared Savings Program and Quality Payment Program Fact Sheet: Explains how the Shared Savings Program and the Quality Payment Program align reporting requirements for participating Accountable Care Organizations (ACOs) and MIPS clinicians, and how certain tracks in Shared Savings Program ACOs meet Advanced Alternative Payment Model (APM) criteria under the Quality Payment Program.
  • MIPS APM Fact Sheet: Provides an overview of a specific type of APM, called a “MIPS APM,” and the special APM scoring standard used for those in MIPS APMs.


CMA Hosting June 15 5PM Webinar to Avoid Payment Adjustments under QPP
CMS will be hosting a webinar on June 15th at 5pm to provide an overview of some of the upcoming deadlines practices are facing to avoid payment adjustments under QPP and other CMS payment programs, and to provide an overview of the CMS-funded technical assistance available to assist them in successfully participating in QPP and in transforming their practices.  As you know, those practices that are successful can receive significantly higher reimbursement from CMS in the future, but many clinicians still have questions and concerns about this program, and are unsure where to go for help.

The webinar will include CMS grantees and contractors that are funded to assist clinicians with QPP, and we will be sharing information about other available resources. The link for the webinar and dial-in information will be emailed to those who register a few days before the call.

https://www.eventbrite.com/e/macra-quality-payment-program-deadlines-and-resources-in-new-york-tickets-35012449178

For More Information

To get the latest information, visit the Quality Payment Program website. The Quality Payment Program Service Center can also be reached at 1-866-288-8292 (TTY 1-877-715- 6222), available Monday through Friday, 8:00 AM-8:00 PM ET or via email at QPP@cms.hhs.gov.

What is the Status of the New CMS Primary Care Payment Initiative?
Last summer, the CMS announced a new initiative intended to improve payment for primary care. The program, called “Comprehensive Primary Care Plus” (“CPC+”), was begun in 14 regions, including 11 whole states. In this area, it included all of New Jersey,
the North Hudson Valley in New York
and the Greater Philadelphia area in Pennsylvania.

These areas were selected on the basis of density and interest shown by providers and payers. Under CPC+, providers are to be paid a monthly fee for primary care visits.
The new markets to be added include the Greater Buffalo Region in New York, encompassing Erie and Niagara Counties
, as well as Louisiana, Nebraska and North Dakota. No reasons have been given for the apparent lack of interest in this initiative, which resulted in it being rolled out in fewer new markets than anticipated. The four new markets for the initiative, to begin in January, 2018.

The initiative is intended to improve outcomes and lower costs. The initiative has two tracks – under track one, providers receive a monthly fee for specific services, in addition to fee-for-service payments. Under track two, providers will receive an upfront monthly care management fee and reduced fee for service payments.

This is intended to allow providers to offer care outside of traditional face to face encounters. Depending upon the volume of patients, providers could potentially earn an additional $100,000 to $250,000 per year under the model. The model was supposed to launch in up to 20 regions, but CMS saw less interest than was expected, and this pattern has held when the program was recently expanded.

CMS does have a number of events coming up that might be of interest; dates, times and registration information can be found here: https://innovation.cms.gov/Files/x/cpcplus-calendarevents.pdf

CMS also has two short videos that provide helpful information about the model:

CMS has stated that if any of the organizations would like to talk directly about the model, they would be happy to set up some time.  Please let me know if you would like to arrange a meeting/talk with some CMS subject matter experts. I, Regina McNally, can reached by email at rmcnally@mssny.org or call me 516-488-6100 ext. 332.

Weekly Charting Tip:

What can be the cause of a False Claim Act being filed against you by the Federal Government?

  • Up-coding procedures
  • Unbundling procedures
  • Filing multiple claims for the same procedure
  • Billing for medically unnecessary procedures
  • Violating the Anti-Kickback Statute
  • Putting down the incorrect place where the service was rendered
  • Putting down the incorrect health care provider that claimed to have rendered the services
  • Oh yes, and a disgruntled former employee to call the government so that he or she can claim a piece of the action!

Be forewarned.

Until next week, Larry Kobak, Partner, Kern Augustine, PC questions, please contact Kern Augustine, P.C. at 1-800-445-0954 or via email at info@DrLaw.com.



CLASSIFIEDS


Manhasset Suite
Medical Suite to share- located at 1201 Northern Blvd, Manhasset. The medical space includes 4 exam rooms and consultation rooms. Direct access to office-  NO STEPS. Conveniently located between St.Francis Hospital and NS/LIJ Hospitals. For more information, please call 516-365-4616 or email RSwe777@aol.com

Medical Practice for Sale in Upscale Westchester Community
Successful well established (1984) and actively growing Internal Medicine/ Primary Care Practice conveniently located only 45 minutes from midtown Manhattan. Great Opportunity for established physician to expand his patient base or for entrepreneurial new graduate.  Lease assignable with option to renew.

Facilities / Business Details

Well known Professional Building with convenient free parking; ground/first floor location, handicap accessible. Contemporary office recently built and painted. Two large exam rooms; one consultation room/doctor’s office, lab, spacious receptionist area and large waiting room. As an independent practice, it provides an extremely appealing option for the patient that does not want to go to a huge impersonal multi-specialty group. Approximately 80% commercial payers; 20% Medicare. Doctor retiring but willing to stay on to introduce new physician to patients and assist in transition.

Asking Price: 
$175,000

Contact: rpcdb51@yahoo.com


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

Physician Opportunities


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


Ophthalmologist Part Time
Ophthalmologist needed to work at multiple nursing homes in all 5 boros except Staten Island. Part time or full-time position available.  Generous salary and incentives.Ttech provided. Opportunity to perform surgery, but not required. Please email cv to privacyssw@gmail.com


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

Positions with the Office of School Health (OSH) combine clinical skills and public health training. OSH focuses on child health, asthma prevention, obesity and nutrition, vision screening, dental care, mental health, reproductive health, and childhood disability. We collaborate with various city and community based agencies to provide social and academic services to address the needs of all New York City school children, especially those facing the most significant social, economic, and health challenges.

The Office of School Health is currently undergoing expansion. There is an immediate need for physicians with an expertise in pediatric, adolescent, or family medicine, with the capacity to utilize primary care skills set through a public health lens. OSH is also  interested in public health and preventive medicine graduates with programmatic, analytic, and social medicine skills.

The NYC DOHMH is reaching out to identify candidates for this recruitment. We are enlisting your help to nominate medical professionals who are committed to contributing their talents to improve health and academic outcomes in our schools. Please consider applying for these positions or passing these opportunities on to talented physicians among your own personal networks.

Attached are the American Academy of Pediatrics position statements on the role of the School Physician as well as the job description and recruitment flyers:

  • Adolescent School Health Physician, Family and Child Health/SH Reproductive/City Medical Specialist, Level: 01/Part-time/Flexible Work Schedule (20-35 hrs/week) To learn more about this position & apply, please submit your resume & cover letter to:https://a127-jobs.nyc.gov/ In the Job ID search bar enter: Job ID: 277208
  • Field Doctor, Bureau of School Health/SH Medical (pre-K-8 Programs or High School) City Medical Specialist, Level: 01/Part-time/Flexible Work Schedule (20-35 hrs/week) To learn more about this position & apply, please submit your resume & cover letter to:https://a127-jobs.nyc.gov/ In the Job ID search bar enter: Job ID: 265869
  • Supervising Medical Doctor,Bureau of School Health/SH Reproductive Health, City Medical Specialist, Level: 02/Part-time (35 hrs/week) To learn more about this position & apply, please submit your resume & cover letter to: https://a127-jobs.nyc.gov/ Job ID:  277026

Please list in your cover letter how you heard about this position (including name of the professional association, website, or individual who referred you). If you have questions, please contact Caroline Volel, MD, MPH at OSH@health.nyc.gov.


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