Category Archives: eNews

Capital Update: May 25, 2017


PRESIDENT’S MESSAGE
Charles Rothberg, MD
May 25, 2017
Volume 17
Number 20

As End of Session Nears, Now is the Time to Act to Prevent Enactment of Disastrous Liability Expansion Bill
MSSNY is urging all physicians to take action (click here) to oppose bills moving in the Legislature that could drastically increase the cost of medical liability insurance.  There are only a few weeks left of the 2017 Legislative Session.  Next week, the Legislature will be in their home districts for Memorial Day weekend and the observance of Shavuot.  It is the perfect time to contact your legislators in their district office.

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:   

  • Expanding the Medical Liability Lawsuits (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 Medical Liability Damages (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%.
  • 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)


Please Urge Your Legislators to Enact Legislation to Permit Collective Negotiations 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 here
  • S.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 here.
  • 5675 (Hannon)/A.7671 (Rosenthal) – would require health insurers to make out of network coverage options available through the New York Health Insurance Exchange. Currently, there are no out of network coverage options in the Exchange in downstate New York, despite Exchange officials strongly encouraging the offering of these options by insurers.  The bills are in the Senate Health and Assembly Insurance Committee. Please send a letter to your legislators in support here.(DIVISION OF GOVERNMENTAL)



Physicians Should Avail Themselves of New NYSDOH Website to Enable Expedited Search of Health Plan Networks
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, and please let MSSNY know so we can let DOH officials know.  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 previously expressed concerns to the Legislature and state agency officials that inaccurate health insurer network listings may mask situations where an insurer has an inadequate physician network.

According to the DOH press release, the NYS Provider & Health Plan Look-Up will initially include information on the health care providers that participate with plans offered on the NY State of Health Marketplace, including Qualified Health Plans, the Essential Plan, Child Health Plus and Medicaid Managed Care. The tool also includes information about provider networks for other Medicaid managed care programs including Managed Long Term Care (MLTC), Health and Recovery Plans (HARPs) and Fully Integrated Dual Advantage (FIDA) Plans. The website will be regularly updated using data submitted by health plans. The website will be updated later this year to add provider network data for commercial insurance products.  (AUSTER)


Legislation About Educating Athletes About Sudden Cardiac Arrest Advances In NYS Legislature
Assembly Bill 6538/Senate Bill 3149, sponsored by Assemblymember Michael Cusick and Senator Andrew Lanza has passed the New York State Assembly and is on the Senate calendar for a vote.   This measure requires that the New York State Department of Health develop educational materials for students, their parents and guardians, regarding sudden cardiac arrest. The materials would be developed in conjunction with the Commissioner of Education, the Medical Society of the State of New York, the New York Chapter of the American Academy of Pediatrics, and the American Heart  Association.

The materials would include an explanation of sudden cardiac arrest, a description of early warning signs, and an overview of options that are presently available for screening. Sudden death in young athletes is a rare but tragic event. The possibility that young, well-trained athletes at the high school, college, or professional level could die suddenly seems incomprehensible. It is a dramatic and tragic event that devastates families and the community. Physical exertion associated with competitive sports and other physical athletic activities can exacerbate a pre-existing condition and can result in an untimely death of a student.  The State of New Jersey currently has a similar program where brochures are sent home to parents and guardians. This legislation would establish a similar program by developing brochures that could be given to parents as well as pediatricians to distribute. (CLANCY)


Special Election Results
This week, Democratic candidate Brian Benjamin won the open 30th Senate District (New York County) seat to replace Democrat Bill Perkins who won a seat on the New York City Council.   On Long Island, Democrat Christine Pellegrino defeated Republican Thomas Gargiulo in the 9th Assembly District.  Pellegrino, an elementary school teacher, filled the seat vacated by Republican Joseph Saladino to serve as Oyster Bay Town supervisor.  Pellegrino won by a margin of 58 percent of the vote over Gargiulo, who got 42 percent in a seat that historically has been a Republican seat.   (BELMONT)


CBO Release Scoring of AHCA Proposal; AMA Sends Recommendations for Improvements to US Senate
The Congressional Budget Office released a document this week noting the American Health Care Act recently passed by the US House and under consideration by the US Senate would  “reduce federal deficits by $119 billion over the coming decade but  increase the number of people who are uninsured by 23 million by 2026”.  Also this week, the American Medical Association sent a letter to US Senate Finance Committee Chair Orrin Hatch this week to provide recommendations to improve the AHCA.  The comments focused primarily on premium affordability, insurance market stabilization, and the Medicaid safety net—topics that are generally consistent with the scope of a budget reconciliation bill. Among the AMA’s recommendations:

  • Continue to Fund the cost-sharing reductions (CSRs) for 2017 and 2018.
  • Provide young adults (ages 19-30) with enhanced tax credits—e.g., $50 per month—while maintaining the current premium tax credit structure which is inversely related to income;
  • Fix the ACA’s “family glitch,” which denies premium and cost-sharing subsidies to purchase coverage on health insurance exchanges to families facing high-cost employer-sponsored insurance when one family member has access to affordable employee-only coverage, ignoring the cost of family coverage;
  • To address problems of high deductibles and cost-sharing for individuals with incomes above 250% FPL,  consider modestly funding HSAs.  Many individuals eligible for premium tax credits, but not cost-sharing subsidies, are having difficulties in affording the cost-sharing requirements in the plans they have enrolled;
  • Create demonstration projects to allow individuals eligible for cost-sharing subsidies—who forego these subsidies by enrolling in a bronze plan—to have access to a pre-funded HSA in an amount determined to be equivalent to the cost-sharing subsidy they would have received if they had enrolled in a silver plan.
  • Lower the cap on premiums for the second lowest cost silver plan for the highest incomes eligible for premium tax credits (for example, from 9.69 percent to 8.5 percent of household income), and lower premium caps for lower incomes accordingly. Lowering premiums for individuals eligible for premium tax credits would serve as a greater incentive to this population becoming and remaining insured.
  • Protecting the Medicaid Expansion, or assure that any changes to the Medicaid program must ensure that those who have benefited continue to have the ability to obtain quality, affordable coverage. (AUSTER)


CMS Delays Medicare Bundled Payment Programs Until January 2018
The Centers for Medicare & Medicaid Services (CMS) recently released a final rule that postponed until January 1, 2018 the effective date of various bundled payment programs for Medicare.  The delay is applicable to the proposed expansion of the Comprehensive Care for Joint replacement (CJR) model as well as implementation of the Advancing Care Coordination through Episode Payment Models (EPMs) and the Cardiac Rehabilitation Incentive Payment Model.   Under these “virtual bundling” programs, hospitals and physicians would continue to be paid by Medicare Part A and Part B on a fee for service basis for the care delivered.  However, there will be a retrospective assessment of the total costs of care provided under Medicare Part A and Part B to patients during their hospitalization and for 90 days after discharge. Initially, hospitals will receive bonuses if their costs fall below historical benchmarks and meet quality standards.  Beginning in 2019, hospitals will have to reimburse CMS if their costs exceed the benchmark, and could require physicians to share in the upside and downside risk. (AUSTER)


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)


NYS DOH Confirms a Case of Measles; Warns About Potential Exposure to Others
On May 23, 2017, the New York State Department of Health in a press statement confirmed that a tourist from India traveling in western New York has measles.  This tourist has visited a NYS Thruway Travel Plaza in Herkimer County, a Monroe County hotel, Niagara Falls State Park, and a Niagara Falls restaurant between May 11 and May 12, 2017, potentially exposing others to measles. Anyone who visited the following locations may have been exposed:

  • The Iroquois Travel Plaza (rest stop) between Exit 29 (Canajoharie) and Exit 29A (Little Falls) on the NYS Thruway between 8:30 p.m. – 12:30 a.m. on May 11– 12, 2017.
  • The Hampton Inn, 4873 Lake Road, Brockport, N.Y. between 12:00 a.m. – 12:00 p.m. on May 12, 2017.
  • Niagara Falls State Park, Niagara Falls, N.Y. between 11:00 a.m. – 5:00 p.m. on May 12, 2017, which includes the Maid of the Mist.
  • Swagat Fine Indian Cuisine, 24 Buffalo Avenue, Niagara Falls, N.Y. between 2:00 – 6:00 p.m. on May 12, 2017.

According to the DOH, “the times reflect the period that the infected individual was in these areas and a two-hour period after the individual left the area, as the virus remains alive in air and on surfaces for up to two hours. This explains the overlap in times. In a statement by DOH, individuals are not at risk of contracting measles if they are immune. A person is unlikely to get measles if they were born before January 1, 1957, have received two doses of the MMR (Measles, Mumps and Rubella) vaccine or have a lab test confirming immunity. Those individuals lacking immunity or not sure if they have been vaccinated, should contact their health care provider if they develop measles symptoms. Symptoms include a fever, rash, cough, conjunctivitis or runny nose. Symptoms usually appear in 10-12 days after exposure, although they may occur as late as June 2, 2017. To prevent the spread of illness, the NYSDOH is advising individuals who may have been exposed and who have symptoms consistent with measles to contact their health care provider or a local emergency department before going for care. This will help to prevent others at these facilities from being exposed to the illness. Measles is a highly contagious respiratory disease caused by a virus that is spread by direct contact with nasal or throat secretions of infected people.  Symptoms generally appear in two stages. “    (CLANCY)


Register Now for Upcoming Medical Matters 2017 CME Webinar Series
Registration is now open for “Mosquito Borne Diseases” on Wednesday, June 14, 2017 at 7:30 a.m.  Faculty for this webinar are William Valenti, MD chair of MSSNY’s Infectious Disease Committee and member of the MSSNY’s Emergency Preparedness and Disaster/Terrorism Response Committee and Elizabeth Dufort, MD medical director, Division of Epidemiology from the New York State Department of Health.  .  Registration is now available at this link.

 The educational objectives 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.  Additional information or assistance with registration may be obtained by contacting Melissa Hoffman at mhoffman@mssny.org.  Medical Matters is a series of CME webinars sponsored by MSSNY’s Committee on Emergency Preparedness and Disaster/Terrorism Response. 

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.

Can’t wait until June 14th?  Listen to MSSNY’s Zika podcast here.   (Clancy, Hoffman)


Available for Physicians & Patients – Immunization Podcasts
The importance of immunizations remains paramount!  The Medical Society of the State of New York (MSSNY) has released ten brief informational podcasts for physicians and patients to learn about vaccines.  MSSNY’s immunization podcast series addresses the importance of adult immunizations, as well as herd immunity.  This series was created by MSSNY’s Preventive Medicine and Family Health and Infectious Disease Committees.  Each of these brief podcasts offers insightful commentary about immunizations from committee members (all experts in their fields).  MSSNY’s immunization podcast series can be accessed here .

The topics discussed include

  • Hepatitis B
  • Human Papillomavirus (HPV)
  • Influenza
  • Measles, Mumps and Rubella (MMR)
  • Meningococcal Disease
  • Pneumococcal
  • Tetanus, Diphtheria and Pertussis (TD & Tdap)
  • Young Adults
  • Zoster.

Share this link with your patients: http://www.buzzsprout.com/51522

Additionally, you can contact Melissa Hoffman at mhoffman@mssny.org to request some take-away cards for your patients with links to MSSNY’s immunization podcast series.(Hoffman, 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

CLASSIFIEDS


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

May 19, 2017 – Speak Now or Forever Hold…


PRESIDENT’S MESSAGE
Charles Rothberg, MD
May 19, 2017
Volume 17
Number 19

MLMIC Insurance

Dear Colleagues:

There are some extremely important issues that affect every physician. You might want to take a minute to go to our Grassroots Action Center —it really only takes a minute—to let your opinion be known to YOUR legislator. With the legislative session expected to end June 21, MSSNY is currently advocating for various pieces of legislation so that you can assure your patients they will continue to receive timely and quality care.

  • Collective Negotiation
    In my opinion, a primary goal of having collective negotiation (under states’ rights doctrine) is to level the currently one-sided contracting playing field, which would minimize the need to actually engage in bargaining. And we have precedent in the effectiveness of this concept in surprise bill legislation whereby physicians and payers seem to come to terms, mostly without resorting to the dispute resolution process. One of MSSNY’s priority bills recently moved through the Senate Health Committee to the Finance Committee. The bill (S.3663, Hannon / A.4472, Gottfried) would allow independently practicing physicians to collectively negotiate patient care terms with market dominant health insurers under close state supervision. Its Assembly counterpart has advanced to the Assembly Ways & Means Committee. It is very important that you send a letter to your legislators so that we can inform them how important the bill is for physicians. Physicians can send a letter here.
  • Expanding Medical Liability Lawsuits (3339/S.4080)
    If we do not continue to talk about this, our adversaries will win. The Assembly bill has advanced to the Assembly floor and can be voted on at any time. It is very important that you send a letter to your legislators so that we can inform them how important the bill is for physicians. This bill 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%.  Please send a letter in opposition click here.
  • Conversion Therapy
    Legislation (A.3977/S.263) would bar mental health providers from trying to change the sexual orientation of anyone under the age of 18, something 5 states have already done.Gov. Cuomo signed an executive order in February precluding insurance companies in the state from covering conversion therapy. The DFS is issuing regulations barring New York insurers from providing coverage for conversion therapy given to an individual under the age of 18.The NYS DOH is prohibiting coverage of conversion therapy under New York’s Medicaid program.

You can call your legislator’s directly in their legislative offices in Albany to speak about the issues impacting your ability to treat patients. The bill
Senate: 518-455-2800
Assembly: 518-455-4100.

Finally, I attended the Queens County Annual Dinner this week where Dr. Carlos Zapata was inaugurated as President. I congratulate Carlos and am thrilled how quickly he has zipped up the ranks as I “mentored” him back in his medical school days.

Sincerely,
Charles Rothberg, MD
MSSNY President

Please send your comments to comments@mssny.org


Please Contact Your Legislator to Oppose One Sided Liability Expansion Bills
All physicians should contact their legislators to urge them to oppose a package of bills that moved through the Assembly Codes and Judiciary Committees this past week. Physicians can send a letter please here. These bills would drastically increase New York’s already exorbitantly high medical liability premiums when no premium increases can be tolerated.  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.

Among the bills that MSSNY is opposing include:

  • Expanding the Medical Statute of Limitations Lawsuits (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 Medical Liability Damages (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%.
  • 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.     

Contact your legislature today!
(DIVISION OF GOVERNMENTAL AFFAIRS)


A Collective Voice Matters
MSSNY will continue to push for comprehensive liability reform to preserve access to care for patients, not one-sided proposals that would further reduce access.  With the trial lawyers having their Lobby Day in Albany this week, it is important that we counteract their message.  With only a few weeks left in session, we must be active in every way.  Please call and write your legislators.  MSSNY continues to oppose legislation that would have drastic consequences on York’s health care system.  It is imperative that legislators hear directly from their physicians, family and friends.   Decisions on these issues will be based on the feedback from each and every legislator.

Here are some facts to help you with your contacts:

  • A recent analysis from the website WalletHub listed New York as the worst state in the country in which to practice medicine, in large part due to its overwhelming liability exposure as compared to other states in the country.
  • New York physicians have reached the breaking point and already face extraordinary overhead costs, declining payments from insurers, and increasing mandates from government, such as required participation in unproven value based payment systems.
  • Many New York physicians already pay extraordinary medical liability premiums to remain in practice, premiums which are among the highest in the country.   Shockingly, many New York physicians pay premiums that far exceed $100,000 and in some cases even exceed $300,000.
  • New York has by far and away the highest total of medical liability payouts and per capita payouts than any other state in the country, according to a recent study Dietrich Healthcare.  (BELMONT)


Legislation Placing E-cigarette Under the Clean Indoor Air Act Passes NYS Assembly
Assembly Bill 516, which would place electronic cigarettes under the Clean Indoor Air Act (CIAA) passed the New York State Assembly this week.  The measure, sponsored by Assemblywoman Linda Rosenthal, would prohibit 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 on as early as next week.   Additionally, 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.   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, HARRING)

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:

  • S.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 please: click here.
  • S.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 by clicking here.
  • S.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.

Moreover, legislation is likely to be introduced shortly that would help to reduce insurer-imposed administrative hassles consistent with the recently released document entitled Prior Authorization and Utilization Management Reform Principles please click here.  These principles were developed by the American Medical Association, American Hospital Association, Medical Group Management Association, American Pharmacists Association, and Arthritis Foundation along with other health and patient advocacy associations including MSSNY.
(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.  Physicians are urged to send a letter to their legislators in support of this legislation please click here.
(AUSTER)

Bill to Prohibit Mid-Year Formulary Changes Advances to Assembly Floor
After receiving unanimous support from the Assembly’s Insurance Committee, legislation (A.2317, Peoples-Stokes) has advanced to the Assembly Floor that would protect patients from unforeseen changes in prescription drug formularies during a policy year that could in turn seriously interfere with their drug therapy.  This bill would protect thousands of insured New Yorkers by preventing the imposition of higher out of pocket costs. The Medical Society of the State of New York supports enactment of this measure. Similar legislation has been introduced by Senator Sue Serino (S.5022), and has referred to the Senate Insurance Committee.
(HARRING)

Register Now for Upcoming Medical Matters 2017 CME Webinar Series
Registration is now open for Mosquito Borne Diseases” on Wednesday, June 14, 2017 at 7:30 a.m.  Faculty for this webinar are William Valenti, MD chair of MSSNY’s Infectious Disease Committee and member of the MSSNY’s Emergency Preparedness and Disaster/Terrorism Response Committee and Elizabeth Dufort, MD medical director, Division of Epidemiology from the New York State Department of Health.   Registration is now available at this link.

The educational objectives 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.  Additional information or assistance with registration may be obtained by contacting Melissa Hoffman at mhoffman@mssny.org.  Medical Matters is a series of CME webinars sponsored by MSSNY’s Committee on Emergency Preparedness and Disaster/Terrorism Response. 

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)

MSSNY & NYSDOH Presents Current Concepts in Concussion for Pediatric and Adult Patients
MSSNY’s Continuing Medical Education webinar on Current Concepts in Concussion for Pediatric and Adult Patients is available on the MSSNY CME website 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, discuss topics including identifying symptoms indicative of concussion, outlining appropriate management plans, and methods for primary and secondary prevention of concussion.

Click here  to view the webinar and fulfill the requirements to receive a certificate awarding one hour of CME. COMING SOON – Dr. John Pugh and Dr. Deborah Light discuss the topic of concussion in MSSNY’s podcast on Current Concepts in Concussion for Pediatric and Adult Patients. The podcast will soon be posted to MSSNY’s CME webpage.
(HARRING)


NYS DOH Expands HIV Testing Website
The New York State Department of Health announced the release of its newly designed New York State Expanded HIV Testing website: www.NYSEHT.org.  DOH has streamlined its site to better serve hospital and clinic administrators and New York State clinical providers.  Physicians are encouraged to visit the site and refer to it for all routine HIV testing questions and needs.  Additionally, physicians are invited to partake in a research study entitled “Usability and evaluation of the NYS Expanded HIV Testing Website” conducted by the University of Rochester and the New York State Department of Health.  The purpose of the study is to help DOH understand practicing providers’ current HIV testing practices.

DOH will use this information to address potential gaps in routine HIV testing.  This study involves an on-line survey that should take no more than three minutes to complete. To learn more about the study or complete the survey, click here If there are additional questions or need assistance to complete the survey, please email the study coordinator at:  margaret_demment@urmc.rochester.edu  Physicians will receive up to two follow-up emails about participating in this study.  If you would like to stop receiving these emails please let us know at:
margaret_demment@urmc.rochester.edu                                                            (CLANCY)

NYS DOH Conducts Buprenorphine Waiver Trainings throughout New York State
The NYS Department of Health, AIDS Institute, Office of Drug User Health, is sponsoring free buprenorphine waiver trainings for all clinical providers at various locations throughout the state.  Training will take place on Saturday, May 20th, from 8:00 a.m. to 1:00 p.m. at Champlain Valley Physicians Hospital, 75 Beekman Street, Plattsburgh, NY 12901.   Online registration please  click here   Additional information, registration, and locations please   click here.      (CLANCY)   

Join MSSNY and Support MSSNYPAC Today
MSSNY and MSSNYPAC enables physicians to pool their resources to fight the multitude of misguided proposals being pushed by many groups whose agendas are diametrically opposed to physicians and the patients they treat.   It also provides resources to help fight for needed changes in our health care system so physicians can continue to deliver the quality and timely care expected by their patients.

We thank you for your support and urge you to make sure your colleagues also join us in these efforts.  If all physicians were to join MSSNY and MSSNYPAC there is little we could not accomplish.  Please do not let your colleagues ignore the need for a strongly supported MSSNY and MSSNYPAC.
(BELMONT)

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

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

enews large

HHS notification: International Cyber Threat to Healthcare Organizations
Dear HPH Sector Colleagues,
HHS is aware of a significant cyber security issue in the UK and other international locations affecting hospitals and healthcare information systems. We are also aware that there is evidence of this attack occurring inside the United States. We are working with our partners across government and in the private sector to develop a better understanding of the threat and to provide additional information on measures to protect your systems. We advise that you continue to exercise cyber security best practices – particularly with respect to email.

Laura Wolf,
Critical Infrastructure Protection Lead
HHS-ASPR-OEM

May 12, 2017
Additional information on ransomware provided by HHS Office for Civil Rights can be found at:

Cyber Newsletters:
https://www.hhs.gov/sites/default/files/hippa-cyber-awareness-monthly-issue1.pdf
https://www.hhs.gov/sites/default/files/hipaa-cyber-awareness-monthly-issue3.pdf
https://www.hhs.gov/sites/default/files/february-2017-ocr-cyber-awareness-newsletter.pdf

Ransomware Guidance:
https://www.hhs.gov/sites/default/files/RansomwareFactSheet.pdf 

Doctors Do Dismiss Patients for Difficult or Inappropriate Behaviors
Nine out of 10 health care provider practices have “fired” a patient because of poor patient behaviors, according to research published this week in JAMA Internal Medicine. According to the researchers, the findings show that physicians are not dismissing patients because of particularly difficult or complex medical issues as insurers shift from fee-for-service reimbursement toward value-based payments. “The reasons practices are dismissing patients aren’t so much related to the things people were worrying about — that if [insurers reimburse more for] quality of care, doctors might start cherry-picking patients,” said Dr. Ann O’Malley, Mathematica Policy Research senior fellow and lead author.

Among the reasons the nearly 800 practices surveyed gave for cutting ties with a patient:

  • Violent, “disruptive,” or inappropriate behavior toward doctors or staff
  • Violation of policies related to chronic pain and controlled substances
  • Failure to show up to scheduled appointments
  • Repeated disregard of a doctor’s medical recommendations
  • Violation of bill payment policies


Agencies Warn of Faulty Blood Tests for Lead, Recommend Retesting
Some blood tests made by Magellan Diagnostics may falsely report low lead levels in children and adults, the FDA and CDC cautioned on Wednesday. The FDA is warning against using Magellan Diagnostics LeadCare analyzers with venous blood samples. The alert doesn’t apply to blood collected by finger- or heelstick.

Children currently younger than 6 years need to be retested if they had venous blood samples analyzed with any of the following Magellan products — LeadCare, LeadCare II (which is used in provider offices and clinics), LeadCare Plus, or LeadCare Ultra – and their results were 10 µg/dL or less. Pregnant and nursing women should also be retested.

The problem with falsely low readings began as far back as 2014, the FDA said. FDA news releaseCDC health advisory

Join CMS May 22nd to Learn More re Quality Payment Participation Requirements
On Monday, May 22nd at 1:00 PM ET, CMS will host an overview webinar on the participation criteria used to determine inclusion in the Merit-based Incentive Payment System (MIPS) and Advanced Alternative Payment Models (APMs).

Webinar Details
Title: Quality Payment Program Participation Criteria Webinar
Date: Monday, May 22, 2017
Time: 2:00 PM ET

Description: During this webinar, CMS will provide an overview of:

  • MIPS participation requirements for individual clinicians and groups
  • >Participation requirements for Advanced APMs and MIPS APMs
  • A new tool that allows clinicians to check if they are included in MIPS
  • The recent participation letter sent to clinician offices

Event Registration: https://engage.vevent.com/rt/cms/index.jsp?seid=828

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. Phone lines will be available for the Q&A portion of the webinar.

Have a specific question about the Quality Payment Program? Please e-mail QPP@cms.hhs.gov
For More Information<
Visit qpp.cms.gov to learn more about the MIPS participation requirements and other information on MIPS and the Quality Payment Program. To review presentations from previous webinars, visit the Quality Payment Program Events page.

Many Americans Skipping MMR Vaccination before Traveling Abroad
Of US adults who go to travel clinics before traveling internationally, only about half of those eligible for the measles, mumps, and rubella (MMR) vaccine actually receive it, a study in the Annals of Internal Medicine finds.

Researchers studied 40,000 U.S. adults who presented to clinics for pretravel consultation. Of the 6600 who were eligible to receive the MMR vaccine based on self-reported disease and immunization history, 53% did not get vaccinated. Nearly half of the unvaccinated had refused the vaccine; most said they refused because they were not concerned about acquiring measles.

Roughly 28% of eligible patients didn’t receive the vaccine because of the provider’s decision; the vast majority of providers believed that the vaccine was not indicated.

Editorialists conclude: “If persons traveling abroad continue to underestimate the importance of pretravel MMR vaccination, our society is destined to be affected by imported cases of measles, leading to morbidity and mortality from this disease.”
Annals of Internal Medicine article

USPSTF Stance against Using Hormone Therapy to Prevent Chronic Conditions
The U.S. Preventive Services Task Force, in a draft recommendation statement, is again advising against the use of hormone therapy to prevent chronic conditions in postmenopausal women.

In particular, the task force recommends against use of combined estrogen-progestin for this purpose, and against estrogen alone in women who’ve had a hysterectomy. The grade D recommendations are in line with the group’s prior recommendations, issued in 2012 and 2005.

While the USPSTF found evidence that hormone therapy offers some benefits, including reduced risks for fracture and diabetes, it found evidence of more potential harms, including increased risks for invasive breast cancer (with estrogen-progestin only), venous thromboembolism, stroke, dementia, gallbladder disease, and urinary incontinence.

The recommendations do not apply to hormone therapy for the treatment of menopausal symptoms, such as hot flashes and night sweats.
LINK(S):
USPSTF draft recommendation statementUSPSTF grade definitions



CLASSIFIEDS


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

May 12, 2017 – In It or Can’t Win It!


PRESIDENT’S MESSAGE
Charles Rothberg. MD
May 12, 2017
Volume 17
Number 18

MLMIC Insurance

Dear Colleagues:

As you know, MSSNY has, in the past, issued a statement that expressed significant concerns about the impact to New York practices, patients and the State Budget regarding the American Health Care Act (AHCA) legislation. At the same time, MSSNY’s statement noted the need for substantial revisions to the ACA.

In order to craft a clear physician message, we must come to understand where it is that we stand on health legislation and then come to an agreement on the merits or lack of them.

Last week, we sent out a five-question survey to our MSSNY’s Legislation and Advocacy Committee regarding their opinion of the AHCA legislation. I did not cherry-pick physicians for the survey because I figured that these physicians constitute a group that is interested, engaged and well informed on physician issues in New York.

On the recent AHCA bill, exactly 50% were opposed, 20% supported it and an amazing 30% neither supported nor opposed. On the matter of the 2010 Affordable Care Act (ACA) now in place, the outcome was evenly balanced—50% answered that the ACA (not the AHCA) should be repealed and 50% opposed repeal.

Last week MSSNY joined over 20 patient advocacy organizations in a letter to New York’s Congressional delegation stating that “…the AHCA would have significant adverse consequences to millions of New Yorkers.”  The letter urged that New York’s Congressional Delegation fight to:

  • ensure uninterrupted healthcare coverage for the 850,000 New Yorkers who gained coverage under the ACA;
  • not harm New York State’s budget and not shortchange New York’s Medicaid program; and
  • protect the more than 600,000 New Yorkers who gained coverage under the essential plan.

I have been traveling all over the state since my inauguration to speak with county society members. They want to talk about this issue. The ACA certainly caused animus among us but not division. One of our physician survey-responders commented that “we should never be in the position of opposing proposed legislation. It is far better to at least remain neutral and help craft it to our liking.”

Who better to shape this than physicians?

I attended a hospital Medical Staff meeting this week, too. Hospitals are very worried about the AHCA bill. HANYS opposes the AHCA for the following reasons:

  • It would increase by 24 million the number of uninsured nationwide, placing 2.7 million New Yorkers at risk;
  • It would upend the Medicaid program, stripping hospitals and health systems of needed resources while they care for more uninsured and underinsured patients; and
  • It would weaken federal protections for New Yorkers with pre-existing conditions.

Is the ACA working? For some yes. The patients that seem to be most negatively affected by this law are those who are “too rich for Medicaid” but too poor to afford insurance.

We all must get active and come up with better ideas.  We want to engage you on this matter—Please follow us on Twitter @MSSNYRothberg.

If you need help setting up an account, call Roseann Raia at 516-488-6100 ext. 302 to assist you.

Your comments are welcome. The elected officials’ ideas are not up to snuff.

When physicians ask me what I think, I offer them my mantra. All decisions should be made after they consider how it will affect their practice, their patients, their community and their profession.

Sincerely,
Charles Rothberg, MD
MSSNY President

Please send your comments to comments@mssny.org


Please Urge Your Legislators to Enact Legislation to Address Prior Authorization Hassles and Expand Patient Choice of Physicians
With just 6 weeks left in the Legislative Session, MSSNY is strongly advocating for a number of bills 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 to consumers 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) 


Disastrous Liability Expansion Bill on Assembly Codes Committee Next Week; Contact Your Legislators to Oppose
All physicians are urged to contact their legislators to oppose legislation (A.3339) before the Assembly Codes Committee next week that would substantially lengthen New York’s medical liability statute of limitations.  Physicians can send a letter in opposition here: click here.  An actuarial analysis of substantially similar legislation indicated that enactment of this legislation could produce a medical liability premium increase of 15%, perhaps even greater, at a time when no increases can be tolerated and at a time when there is tremendous instability in our health care system.    Similar, but not identical legislation (S.4080) has been introduced in the Senate and is in the Senate Judiciary Committee.  Please let your legislators know that we need comprehensive medical liability reform, not one-sided proposals that will harm access to care!                                        (AUSTER)

US Senate Begins Review of AHCA
The United State Senate has begun its review of legislation that narrowly passed the US House of Representatives that enacts a partial repeal and significant revision of the ACA.  The Senate announced a 13-Senator working group to look at changes to the American Health Care Act (AHCA) legislation that was objected to by many patient and health care provider associations across the country and here in New York State.

MSSNY had previously issued statements that expressed significant concerns about the impact of the AHCA legislation to New York patients and the State Budget.   MSSNY recently joined with nearly two dozen patient advocacy organizations in a letter to New York’s Congressional delegation that noted that “while the Affordable Care Act (ACA) can be improved, replacing it with the AHCA would have significant adverse consequences to millions of New Yorkers”.   Instead, the letter urged that New York’s Congressional Delegation fight to: “Ensure uninterrupted healthcare coverage for the 24 million Americans, including the 850,000 New Yorkers who gained coverage under the ACA; Do not harm New York State’s budget and do not shortchange New York’s Medicaid program; and Protect the more than 600,000 New Yorkers who gained coverage under the Essential plan.”

These concerns were reiterated at a meeting this week of the Albany County Medical Society where physicians heard a presentation from Representative John Faso (R-Upper Hudson Valley), one of the key “swing” votes that led to the AHCA being passed by the House.  Rep. Faso’s detailed comments regarding his support for the legislation led to a spirited debate among physician attendees regarding the potential consequences to our health care delivery if this or similar legislation were to be enacted, as well as the potential consequences if this or similar legislation were not enacted.

As has been previously reported, the AHCA would maintain some provisions from the ACA, such as required coverage for pre-existing conditions, and requiring dependent coverage up to age 26.   It also contains components supported by MSSNY, such as significantly expanding the amount of funds that a person could direct to their Health Savings Account and delaying for several years implementation of the “Cadillac Tax” on comprehensive health insurance coverage.

However, the bill would jeopardize the availability of affordable health insurance coverage options for many in New York.   While the expanded eligibility for Medicaid (up to 138% FPL) would be available through the end of 2019, starting in 2020 such expanded coverage would only be continued for those who had such coverage prior to the end of 2019.  The AHCA would also repeal the tax credits currently provided to help cover cost-sharing amounts for coverage for individuals who earn too much to qualify for Medicaid.  Instead, tax credits of $2,000-$4,500 (depending upon age) would be provided to enable the purchase of health insurance coverage.   It should be noted that these tax credits would not be available for any health insurance policy that covers abortions (which is required in New York.)

Tax credits will be available in full to individuals earning less than $75,000 and households earning less than $150,000, but they will be capped for higher earners.  The AHCA would also completely eliminate funding for New York’s Essential Plan, which provides low-cost insurance coverage with little cost-sharing responsibilities for over 600,000 New Yorkers who make between 138% -200% FPL.  As the US Senate continues its review and revisions over the next weeks and months, please remain alert for further updates.    (AUSTER)

Anthem Calls Off Proposed Takeover of Cigna
Several media sources were reporting this afternoon that Anthem (the parent of Empire Blue Cross) is terminating its proposed merger with Cigna. The decision comes after a Delaware judge ruled Thursday that Cigna could walk away from the deal, which Anthem had tried to stop.  Two weeks ago, a federal appeals court upheld a lower-court ruling that blocked this proposed mega-merger from moving forward.

MSSNY worked together with the AMA and several other state medical associations to oppose this proposed merger.  Last fall, then-MSSNY President Dr. Malcolm Reid as well as AMA representatives testified at a public hearing hosted by the New York Department of Financial Services examining this proposed merger.  Dr. Reid’s testimony emphasized the already very difficult practice environment for physicians in New York State that has become worse in recent years, as a result of the narrowing of health insurer participating provider networks and increasing pre-authorization burdens, problems which undoubtedly would be made worse had this merger been permitted to move forward.

DFS Superintendent Maria Vullo issued a letter last August that highlighted concerns with the significant market impact the merger would have had if approved.  New York Attorney General Eric Schneiderman, joined several AGs across the country in litigation to oppose the proposed merger.

Following Anthem’s announcement, the AMA released a statement noting that:

“Today’s action marks the end of a proposed merger that the American Medical Association, courts and regulators widely condemned as a bad deal for patients and harmful to the nation’s health system. The termination of the Anthem-Cigna merger is a clear victory to preserve competition in the health insurance industry. To the detriment of patients, there is already far too little competition among insurers. Networks are already too narrow, and premiums are already too high…Today’s action concludes a successful campaign by the AMA and 17 state medical societies to stop the Anthem-Cigna merger. The AMA and its coalition of state medical societies worked tirelessly to protect patients and block both this merger and the Aetna-Humana merger.”
(AUSTER) 

Bills That Would Raise The Purchasing Age For Tobacco And Restrict E-Cigarettes Moving In The NYS Legislature
Two tobacco related pieces of legislation are advancing in the NYS Legislature and physicians are urged to contact their legislators to support both measures.  S.2543/A.516, which would include the use of electronic cigarettes or e-cigarettes under the Clean Indoor Air Act, is now on the calendar in both houses and can be voted on at any time.   S.3978/A.273, which would increase the purchasing age for tobacco products from eighteen to 21 years of age, is on the Senate Finance Committee for its consideration.   The Medical Society of the State of New York strongly supports both these measures and urges physicians to contact their legislators to vote in support for both bills.  Physicians can send a letter to their legislators by clicking on the link here                                                                  (HARRING, CLANCY) 

Please Contact Your Legislators to Reject Bill that Would Potentially Expand CRNA Scope
Physicians should continue to contact their legislators to urge defeat of legislation (A.442/S.1385), which purports to statutorily recognize the title of a nurse anesthetist, but is written in such a way that it could potentially empower CRNAs to work beyond the scope of their training and work independently of physician supervision.  The legislation was recently advanced from the Assembly Higher Education Committee to the Assembly Ways & Means Committee.  MSSNY and the New York State Society of Anesthesiologists oppose this legislation.  Physicians can send a letter here, click here.                                                                                             (AUSTER)            

Please Review DFS Q&A Regarding New Law to Give Physicians Power to Challenge Improper Step Therapy Protocols
The New York Department of Financial Services has released a detailed Q&A regarding the legislation enacted last year that provides physicians with a stronger ability to override health insurer step therapy medication protocols to better ensure that their patients will have coverage for the most appropriate medications.  To read the DFS Q&A, click here.

The new law requires health insurers to grant a physician’s override request of an insurer step therapy medication protocol if the drug required by the insurer is contraindicated for the patient, likely to be ineffective for the patient, or if the patient is stable on the medication requested by the physician.  If the physician’s request for an override of the step therapy protocol is denied, it would enable a physician to formally appeal the decision both within the plan’s existing appeal mechanism as well as taking an independent external appeal to assure the patient receives coverage for the medication needed by the patient.  MSSNY strongly supported this bill, and worked with a wide array of patient advocacy organizations and physician specialty societies to achieve enactment of this legislation.

The DFS Q&A notes that these new protections apply to any health insurance policy that was delivered, issued for delivery or renewed after January 1, 2017 (this would typically be group plans, which are approved by DFS on a “rolling” basis throughout the calendar year).   For example, if a policy is issued or renewed on March 1, 2017, it must comply with the new step therapy law.  However, for plans obtained through the individual market, which began this past January 1, the effective date for the step therapy protections will not be until January 1, 2018.  Please let us know if you have questions regarding this important new law.                                                          (AUSTER)  

New York Among Several States to Resolve Allegations Against CareCore for Alleged Improper Review of Imaging Requests
New York Attorney General Eric Schneiderman announced this week that New York was one of 20 states to reach an agreement with CareCore National LLC, an entity that reviews the medical necessity of imaging services.   According to the press release, the agreement settles allegations that CareCore instituted a scheme to “auto-approve” hundreds of radiology service requests on a daily basis, deeming those diagnostic services as reasonable and medically necessary, even though there had been no evaluation of those cases by the appropriate medical personnel. CareCore will pay the federal government $54 million, of which $18 million will go to the state Medicaid programs, including over $7.6 million to be returned to New York.    To read the AG’s press release, click here.

According to the press release, the agreement would resolve allegations that from January 1, 2005 through June 13, 2013, CareCore developed and implemented a program through which CareCore improperly approved over 200,000 prior authorization requests which CareCore initially determined could not be approved based on the information provided.   The press release also notes that the settlement resolves allegations that CareCore auto-approved the requests in an effort to keep up with the volume of preauthorization requests for diagnostic radiology services and to avoid a contractual monetary penalty per case for untimely reviews, which caused false or fraudulent claims to be submitted to and reimbursed by the State’s Medicaid program.                                                     (AUSTER)

Need to Meet Your Pain Management 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 applied 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)

Register Now For Upcoming Medical Matters 2017 CME Webinar Series
Registration is now open for the next Medical Matters webinar on Wednesday, May 7, 2017 at 7:30 a.m.  “Exercise Response to Novel Influenza Strains” will be conducted by Pat Anders, MS, MEP, Manager, Health Emergency Preparedness Exercises, New York State Department of Health, Office of Health Emergency Preparedness.  Registration is now available at this link.

The educational objectives are: 1)  Understand preparedness and response actions of public health and healthcare to a novel pandemic influenza, simulated in full-scale exercise.  2)  Describe two delineated strategies in which public health and office-based physicians would interact in a pandemic influenza.

Registration is also open for “Mosquito Borne Diseases” on Wednesday, June 14, 2017 at 7:30 a.m.  Faculty for this webinar are William Valenti, MD chair of MSSNY’s Infectious Disease Committee and member of the MSSNY’s Emergency Preparedness and Disaster/Terrorism Response Committee and Elizabeth Dufort, MD medical director, Division of Epidemiology from the New York State Department of Health.  .  Registration is now available at this link.

The educational objectives 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.  Additional information or assistance with registration may be obtained by contacting Melissa Hoffman at mhoffman@mssny.org.  Medical Matters is a series of CME webinars sponsored by MSSNY’s Committee on Emergency Preparedness and Disaster/Terrorism Response.  

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

enews large

CMS: 800,000 Clinicians Given a Pass on MACRA Requirements
According to Modern Healthcare (5/11), 806,879 clinicians will not have to comply with Merit-based Incentive Payment System reporting requirements outlined in MACRA. They will not be evaluated under MIPS in 2017. Regina McNally, VP of MSSNY Socio-Economic Division, stated that the 806,879 number includes not only physicians—but also— physician assistants, Nurse practitioners, Clinical nurse specialists, and Certified registered nurse anesthetists. She has asked CMS officials for a breakdown. “Physicians who are excluded should have received a letter from their Medicare Contractor by now. If you have not received, you are probably NOT included. If you want to verify, you can use the QPP Exemption Lookup Tool. Just type in your 10-digit NPI number,” said Ms. McNally.

The majority of physician practices were expected to use the Merit-based Incentive Payment System, known as MIPS, to comply with MACRA as opposed to alternative pay models. Under MIPS, payments would be based on a compilation of quality measures and use of electronic health records.

The exempted physicians include those with less than $30,000 in Medicare charges or fewer than 100 unique Medicare patients per year. Clinicians new to Medicare this year are also exempt this year. The agency also gave a pass to providers who have implemented a MACRA-compliant Advanced Alternative Payment Model, which is the other value-based reimbursement track doctors complying with the law can choose.

Under MIPS, physician pay will be based on success in four performance categories: quality, resource use, clinical practice improvement and “advancing care information” through use of health information technology. The advancing care criteria is based on the government’s meaningful-use program, which is used to decide whether doctors should be rewarded for using EHRs.

Medicare reimbursement for providers in 2019 will be based on how well doctors perform on these metrics this year. Under MIPS, physicians can earn a bonus or penalty of 4% of their reimbursement in 2019.

Participation Notification Letters

See a sample of the letter (zip) on the Education page of https://qpp.cms.gov/. This tool is another resource for clinicians to use to determine their status.

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

IPRO Supporting CMS Payment Program
IPRO has been awarded a special contract from the Centers for Medicare & Medicaid Services (CMS) to help physician practices in New York, Maryland, Virginia and the District of Columbia prepare for and participate in the new Quality Payment Program, established by the Medicare Access and CHIP Reauthorization Act of 2015 (MACRA). This technical assistance, authorized and funded under MACRA, brings direct support to an estimated thousands of Merit-based Incentive Payment System (MIPS) eligible clinicians in small practices with 15 or fewer clinicians, including small practices in rural locations, health professional shortage areas, and medically underserved areas across the country. 

The direct technical assistance is available immediately, free to all MIPS eligible clinicians, and will deliver support for up to a five-year period. “We’re very pleased to be able to support CMS in this effort to offer free technical assistance to thousands of physicians as they implement the new value-based Medicare payment system,” said IPRO Chief Medical Officer Clare Bradley, MD, MPH. IPRO will provide customized technical assistance to MIPS eligible clinicians, which may include, but is not limited to, the following:

  • Conveying the MIPS expectations and timelines,
  • Explaining the MIPS feedback report,
  • Creating a MIPS-score improvement plan,
  • Evaluating practice readiness for joining an Advanced Alternative Payment Model (APM),
  • Assessing and optimizing Health Information Technology,

Supporting change management and strategic planning,

  • Developing and disseminating education and training materials,
  • Enabling peer-to-peer learning and local partnerships.

For more information regarding this support service, go to www.mssny.org for contact information or to seek assistance.

CMP Medica 2017 Staff Salary Results
Looking to see if your staff salaries are in line with national bencharks? Check out our national data on key positions in medical practices broken out by years of experience. http://bit.ly/2qa6H7c

FDA: Doctors Should Get Info re Acupuncture/Chiropractic for Treating Pain
The Food and Drug Administration released proposed changes Wednesday to its blueprint on educating health care providers about treating pain http://bit.ly/2qb5hJk The guidelines now recommend that doctors get information about chiropractic care and acupuncture as therapies that might help patients avoid prescription opioids. “[Health care providers] should be knowledgeable about the range of available therapies, when they may be helpful, and when they should be used as part of a multidisciplinary approach to pain management,” the agency wrote in the proposal.

Expired EpiPens May Still Contain Effective Doses of Epinephrine
In a small study published in the Annals of Internal Medicine, researchers analyzed the contents of 31 EpiPens and 9 EpiPen Jrs that had expired in the prior 1–50 months. None had developed discoloration. Roughly 65% of the EpiPens and 56% of the EpiPen Jrs still had at least 90% of the labeled concentration of epinephrine. An EpiPen that had expired 50 months earlier still had 84% of the stated amount of epinephrine.

The authors conclude: “Although we observed declining concentrations of epinephrine over time, we expect that the dose available 50 months after expiration would still provide a beneficial pharmacologic response. Thus, we conclude that the process for establishing expiration dates for EpiPens should be revised and that, in the setting of outpatient anaphylaxis without other therapeutic alternatives, patients and caregivers should consider the potential benefits of using an expired EpiPen.”

Annals of Internal Medicine letter

Seven Rules of OSHA for Physicians
OSHA, the Occupational Safety and Health Administration is quite alive and well when it comes to enforcing its regulations against physicians. The seven rules that apply to physicians involve:

  1. Having a plan to reduce exposure to bloodborne pathogens.
  2. You must have a safety plan for exiting your office.
  3. You must have a plan for hazard communication; this involves hazardous chemicals of any kind. There must be a written list along with several other requirements.
  4. Electrical safety rules must be observed.
  5. New York does not require reporting occupational injuries and illnesses. There is a federal exemption for medical office reporting.
  6. Every practice must display an approved OSHA poster showing the employee rights to a safe working environment.
  7. For practices that use x-rays and imaging services, there are rules, such as radiation exposure badges.

Do NOT ignore the OSHA requirements as the fines may be substantial.

By Larry Kobak, Esq. If you have any questions, please contact Kern Augustine, P.C. at 1-800-445-0954 or via email at info@DrLaw.com.

Teens Drinking Less but Binge Drinking More
A report from the CDC that states that “teen drinking appears to have reached a new low.” The report indicates that “the percent of teens who reported drinking at least one drink per month dropped from 50.8 percent in 1991 to just 32.8 percent in 2015.” But, “those who reported drinking tended to also report what is considered binge drinking: 57.8 percent of teens who reported drinking said they have had five drinks in a row.”

The prevalence of binge drinking increased from 31.3% in 1991 to 31.5% in 1999, then declined significantly to 17.7% in 2015. However, in 2015, approximately one in three high school students drank alcohol during the past 30 days and one in six were binge drinkers. Most high school students who drank (57.8%) were also binge drinkers, and more than two in five binge drinkers consumed eight or more drinks in a row.

Open Payments Physician and Dispute Period Ends Next Week
Physicians and teaching hospitals have until May 15, 2017 to review data reported by drug and medical device makers about them and, if necessary, dispute the payments before the data is made public on June 30, 2017.

To review and dispute data, physicians and teaching hospitals must register in the Open Payments system.

If You Have Never Registered In Open Payments Before:

Make sure you have your National Provider Identifier (NPI) number, Drug Enforcement Agency (DEA) number, and State license number (SLN).  Initial registration is a two-step process and should only take about 30 minutes:

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

Please remember to select the role of “Applicable Manufacturer/GPO, Physician, or Teaching Hospital”, when registering in EIDM. If any other role is requested, no access to the Open Payments System will be granted. For any additional information on registering in EIDM, refer to the Open Payments System Quick Reference Guide Enterprise Identity Management System (EIDM) Registration here.

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

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

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

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

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

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

Learn more about the review and dispute process by accessing the educational materials available on the Resources page of the Open Payments website.



CLASSIFIEDS



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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

May 5, 2017 – Many Object to ACA Repeal


PRESIDENT’S MESSAGE
Charles Rothberg. MD
May 5, 2017
Volume 17
Number 17

MLMIC Insurance

Dear Colleagues:

This week, I traveled to Rochester to speak to the Monroe County Medical Society.

Although I had prepared a speech—mercifully, I cut it short. The physicians were very eager to talk about the AHCA bill and what it meant to medicine and their practices. I told them that I had been interviewed recently by Crain’s Health Pulse and they mistitled the article, “State Doctors’ Group Stays Neutral on AHCA.”

Doctors are NOT neutral on this topic. However, we are divided.

It is unfortunate that the newest health bill would have the effect of watering down existing protections for pre-existing conditions as the means to reduce premiums.  As to our physician community, any state or national health care legislation should provide better solutions that are less burdensome on our profession, our patients and their health outcomes. Let us not be divided on these essentials.

Moe Auster, VP of MSSNY Legislative and Regulatory Affairs, has provided us with an overview how the ACA affects New York.

House of Representatives Approves ACA Repeal Legislation Objected to by Many
By a 217-213 vote, the US House of Representatives passed an amended version of the American Health Care Act (AHCA) that was objected to by many patient and health care provider associations across the country and here in New York State.  Several media outlets have reported that the prospects for passage in the Senate are uncertain, as several GOP Senators have expressed concerns with various provisions.

MSSNY Issued Concerns

MSSNY had previously issued statements that expressed significant concerns about the impact to New York patients and the State Budget as a result of this legislation. Last week, MSSNY joined with nearly two dozen patient advocacy organizations in a letter to New York’s Congressional delegation that noted that “while the Affordable Care Act (ACA) can be improved, replacing it with the AHCA would have significant adverse consequences to millions of New Yorkers”  Instead, the letter urged that New York’s Congressional Delegation fight to: “Ensure uninterrupted healthcare coverage for the 24 million Americans, including the 850,000 New Yorkers who gained coverage under the ACA; Do not harm New York State’s budget and do not shortchange New York’s Medicaid program; and Protect the more than 600,000 New Yorkers who gained coverage under the Essential plan.”

AMA President Dr. Andrew Gurman issued a statement expressing great concerns with the bill that passed the House:

“The bill passed by the House … will result in millions of Americans losing access to quality, affordable health insurance and those with pre-existing health conditions face the possibility of going back to the time when insurers could charge them premiums that made access to coverage out of the question. Action is needed, however, to improve the current health care insurance system … while preserving the safety net for vulnerable populations.”

As has been previously reported, the AHCA would maintain some provisions from the ACA, such as required coverage for pre-existing conditions, and requiring dependent coverage up to age 26.   It also contains components supported by MSSNY, such as significantly expanding the amount of funds that a person could direct to their Health Savings Account and delaying for several years implementation of the “Cadillac Tax” on comprehensive health insurance coverage.

Bill Would Jeopardize Available Options

However, the bill would jeopardize the availability of affordable health insurance coverage options for many in New York. While the expanded eligibility for Medicaid (up to 138% FPL) would be available through the end of 2019, starting in 2020 such expanded coverage would only be continued for those who had such coverage prior to the end of 2019.  The AHCA would also repeal the tax credits currently provided to help cover cost-sharing amounts for coverage for individuals who earn too much to qualify for Medicaid.  Instead, tax credits of $2,000-$4,500 (depending upon age) would be provided to enable the purchase of health insurance coverage.   Tax credits will be available in full to individuals earning less than $75,000 and households earning less than $150,000, but they will be capped for higher earners.  The AHCA would also completely eliminate funding for New York’s Essential Plan, which provides low-cost insurance coverage with little cost-sharing responsibilities for over 600,000 New Yorkers who make between 138% -200% FPL.

How They Voted

All 18 Democrats in New York’s Congressional delegation opposed the bill, as did Republicans Dan Donovan (Staten Island) and John Katko (Syracuse).  New York Republicans supporting the bill include Chris Collins (Western New York), John Faso (Hudson Valley), Peter King (Nassau County), Tom Reed (Southern Tier), Elise Stefanik (Northern New York), Claudia Tenney (Mohawk Valley), and Lee Zeldin (Suffolk County).

Sincerely,
Charles Rothberg, MD
MSSNY President

Please send your comments to comments@mssny.org




House of Representatives Approves Partial ACA Repeal Legislation Objected to by Many Patient Advocacy Organizations
By a 217-213 vote, the US House of Representatives passed an amended version of the American Health Care Act (AHCA) that was objected to by many patient and health care provider associations across the country and here in New York State.  Several media outlets have reported that the prospects for passage in the Senate are uncertain, as several GOP Senators have expressed concerns with various provisions.

MSSNY had previously issued statements that expressed significant concerns about the impact to New York patients and the State Budget as a result of this legislation. Last week, MSSNY joined with nearly two dozen patient advocacy organizations in a letter to New York’s Congressional delegation that noted that “while the Affordable Care Act (ACA) can be improved, replacing it with the AHCA would have significant adverse consequences to millions of New Yorkers”  Instead, the letter urged that New York’s Congressional Delegation fight to: “Ensure uninterrupted healthcare coverage for the 24 million Americans, including the 850,000 New Yorkers who gained coverage under the ACA; Do not harm New York State’s budget and do not shortchange New York’s Medicaid program; and Protect the more than 600,000 New Yorkers who gained coverage under the Essential plan.”

AMA President Dr. Andrew Gurman issued the following statement expressing great concerns with the bill that passed the House:

The bill passed by the House today will result in millions of Americans losing access to quality, affordable health insurance and those with pre-existing health conditions face the possibility of going back to the time when insurers could charge them premiums that made access to coverage out of the question. Action is needed, however, to improve the current health care insurance system. The AMA urges the Senate and the Administration to work with physician, patient, hospital and other provider groups to craft bipartisan solutions so all American families can access affordable and meaningful coverage, while preserving the safety net for vulnerable populations.

As has been previously reported, the AHCA would maintain some provisions from the ACA, such as required, availability of coverage for those with  pre-existing conditions, and requiring dependent coverage up to age 26.   It also contains components supported by MSSNY, such as significantly expanding the amount of funds that a person could direct to their Health Savings Account and delaying for several years implementation of the “Cadillac Tax” on comprehensive health insurance coverage. However, the bill would jeopardize the availability of affordable health insurance coverage options for many in New York.

While the expanded eligibility for Medicaid (up to 138% FPL) would be available through the end of 2019, starting in 2020 such expanded coverage would only be continued for those who had such coverage prior to the end of 2019.  The AHCA would also repeal the tax credits currently provided to help cover cost-sharing amounts for coverage for individuals who earn too much to qualify for Medicaid.  Instead, tax credits of $2,000-$4,500 (depending upon age) would be provided to enable the purchase of health insurance coverage.

Tax credits will be available in full to individuals earning less than $75,000 and households earning less than $150,000, but they will be capped for higher earners.  The AHCA would also completely eliminate funding for New York’s Essential Plan, which provides low-cost insurance coverage with little cost-sharing responsibilities for over 600,000 New Yorkers who make between 138% -200% FPL. All 18 Democrats in New York’s Congressional delegation opposed the bill, as did Republicans Dan Donovan (Staten Island) and John Katko (Syracuse).  New York Republicans supporting the bill include Chris Collins (Western New York), John Faso (Hudson Valley), Peter King (Nassau County), Tom Reed (Southern Tier), Elise Stefanik (Northern New York), Claudia Tenney (Mohawk Valley), and Lee Zeldin (Suffolk County).
(AUSTER)                               


Bills That Would Raise The Purchasing Age For Tobacco And Restrict E-Cigarettes Moving In The NYS Legislature
Two tobacco related pieces of legislation are advancing in the NYS Legislature and physicians are urged to contact their legislators to support both measures.  S.2543/A.516, which would include the use of electronic cigarettes or e-cigarettes under the Clean Indoor Air Act, is now on the calendar in both houses and can be voted on at any time.   S.3978/A.273, which would increase the purchasing age for tobacco products from eighteen to 21 years of age, is in the Senate Finance Committee.

The Medical Society of the State of New York strongly supports both these measures and urges physicians to contact their legislators to vote in support for both bills.  Physicians can send a letter to their legislators by clicking on the link: here.                                                                                                                       (HARRING, CLANCY)

Collective Negotiation Bill Advances – Get Active and Contact Your Legislators
With the legislative session expected to end June 21st.MSSNY is currently advocating for various pieces of legislation to better enable physicians to be able to continue to assure their patient are able to receive timely and quality care.  This week, one of MSSNY’s priority bills just moved through the Senate Health Committee to the Finance Committee. The bill (S.3663, Hannon / A.4472, Gottfried ) would allow independently practicing physicians to collectively negotiate patient care terms with market dominant health insurers under close state supervision.

Its Assembly counterpart has advanced to the Assembly Ways & Means Committee. It is very important that you send a letter to your legislators so that we can inform our legislators how important the bill is for physicians. Physicians can send a letter  here. The Legislature is scheduled for a three day session next week, covering Monday through Wednesday. You can call your legislator’s directly in their legislative offices in Albany to speak about the issues impacting your ability to treat patients including this issue.

Senate- 518-455-2800
Assembly- 518-455-4100
(BELMONT)


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


Please Contact Your Legislators to Reject CRNA Scope Expansion Bill
Physicians are urged to contact their legislators to urge defeat of legislation (A.442/S.1385) which purports to statutorily recognize the title of a nurse anesthetist, but would potentially empower CRNAs to work beyond the scope of their training and work independently of physician supervision.  The legislation was advanced from the Assembly Higher Education Committee to the Assembly Ways & Means Committee this week.  MSSNY and the New York State Society of Anesthesiologists oppose this legislation.  Physicians can send a letter  here.
(AUSTER) 

IPRO CME Webinar on MAPPP App
Alex C Spyropoulos, MD, FACP, FCCP, FRCPC and Jessica Cohen, MD will serve as faculty for an IPRO CME webinar entitled “Management of Anticoagulation in the Peri-Procedural Period (MAPPP) App:  Overview, Instructions and Case Studies.”  The webinar will be held on Friday, 5/12/17, 11-12am ET.  Registration is required.  The registration and webinar connection information can also be found under “Event” at this link:  http://mappp.ipro.org.

Program flyer may be accessed here.

This activity has been planned and implemented in accordance with the accreditation requirements and policies of the Accreditation Council for Continuing Medical Education (ACCME) through the joint providership of The Medical Society of the State of New York (MSSNY) and IPRO.  MSSNY is accredited by ACCME to provide continuing medical education for physicians.

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

For more information contact: Anne Myrka, IPRO Director, Drug Safety (518) 320-3591 anne.myrka@area-i.hcqis.org. (HARDIN)

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.

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 applied 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)

Rep. Crowley Re-Introduces Bi-Partisan Resident Physician Reduction Shortage Act
House Democratic Caucus Chair Joseph Crowley (D-Queens) and Representative Ryan Costello (R-Pennsylvania) announced this week the reintroduction of legislation to increase the current cap on the number of Medicare-supported training slots for doctors, to help meet the growing demands for physicians as our nation faces a looming doctor shortage.

The legislation would increase the number of Medicare-supported hospital residency positions by 15,000 (3,000 slots per year, over five years), bringing the total number of slots available to 105,000 and opening up significant new opportunities for future physicians and for the teaching hospitals that train them.  The press release noted that the U.S. is expected to face a shortage of up to 104,900 physicians by 2030, including shortages in both primary and specialty care, according to the Association of American Medical Colleges.  MSSNY has policy, adopted at its 2011 House of Delegates, calling for elimination of the cap on the number of Medicare funded residency programs.  This legislation would go a long way towards addressing the goals of this resolution. Rep. Crowley noted in the press release: “A doctor shortage is something we just can’t ignore.

This is a nationwide problem and the path to ensuring all Americans have access to high-quality, well-trained physicians is through the strengthening of GME programs.” Rep. Costello noted in the press release “A strong physician workforce is vital to ensuring all Americans have timely access to essential and quality healthcare.  This legislation would allow Congress to address concerns about physician shortages by providing teaching hospitals with the necessary resources to support increased residency openings.”        (AUSTER)

Register Now For Upcoming Medical Matters 2017 CME Webinar Series
Registration is now open for the next Medical Matters webinar on Wednesday, May 7, 2017 at 7:30 a.m.  “Exercise Response to Novel Influenza Strains” will be conducted by Pat Anders, MS, MEP, Manager, Health Emergency Preparedness Exercises, New York State Department of Health, Office of Health Emergency Preparedness.  Registration is now available at this link. The educational objectives are: 1)  Understand preparedness and response actions of public health and healthcare to a novel pandemic influenza, simulated in full-scale exercise.  2)  Describe two delineated strategies in which public health and office-based physicians would interact in a pandemic influenza.  Registration is also open for Mosquito Borne Diseases” on Wednesday, June 14, 2017 at 7:30 a.m.  Faculty for this webinar are William Valenti, MD chair of MSSNY’s Infectious Disease Committee and member of the MSSNY’s Emergency Preparedness and Disaster/Terrorism Response Committee and Elizabeth Dufort, MD medical director, Division of Epidemiology from the New York State Department of Health.  Registration is now available at this link.

The educational objectives 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.  Additional information or assistance with registration may be obtained by contacting Melissa Hoffman at mhoffman@mssny.org.  Medical Matters is a series of CME webinars sponsored by MSSNY’s Committee on Emergency Preparedness and Disaster/Terrorism Response.  

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

enews large


More than 6,000 New York Organ Donors Signed Up in One Week
Gov. Andrew Cuomo announced that 6,326 people enrolled in the New York State Donate Life Registry in the week ending April 27th.

Cuomo signed legislation last year requiring the health department to add the organ donation component to its health insurance application.

Anyone 16 or older completing an application, renewing a plan, or making a life status change is now asked if they would like to be added to the Donate Life Registry.

Organ donors also enroll at the websites for the Department of Health, the Department of Motor Vehicles, the Board of Elections, and when applying for the NYC Identification Card.

HCS Will Discontinue Access for Computers Running Windows XP and Internet Explorer9 (IE9)
The Health Commerce System (HCS) will be discontinuing access for computers running Windows XP and Microsoft Internet Explorer 9 (IE9) and older web browsers as they pose a security risk to HCS applications.  Windows XP users must upgrade their operating system and IE9 users must upgrade their browser by June 1, 2017 to continue using the HCS, as the HCS will block connections from computers running Windows XP and IE9 browser and older.

  • What:  The HCS will discontinue access for PCs using Windows XP and Microsoft IE9 and older web browsers. Upon implementation of this change, any computer running Windows XP or IE9 or older will not be able to connect to or open https://commerce.health.state.ny.us.
  • When:  This change is scheduled for June 1, 2017.
  • Why:  Due to NYS application and data security requirements, HCS access will be discontinued for unsecured IE9 and older web browsers and Windows XP operating system on June 1, 2017.
  • What is at stake:  Inability to access the HCS will affect your ability to: comply with New York State Public Health and Education laws; access critical information and data; and receive HCS technical support.

Specifically, you will not be allowed access to the following applications:

  • Patient narcotic histories (i-STOP/PMP);
  • E-Prescribing waivers;
  • Your Physician Profile;
  • The New York State Immunization Information System;
  • Environmental Health EHCitrix Platform;
  • Evacuation of Facilities in Disasters System (eFINDS);
  • The Health Electronic Response Data System (HERDS); and
  • Other mission-critical applications.

What to do next:  If you are using Windows XP or IE9, you must upgrade your PC to a modern, secure operating system as soon as possible, and upgrade your IE9 or older web browser.  It is suggested you perform the following actions to upgrade your PC and browser:

1.      OPERATING SYSTEM: To upgrade to a current Windows operating system please visit http://www.microsoft.com to determine if your computer can be upgraded.  To upgrade, follow the instructions on the Microsoft website. Please note that Windows 10 users will still need to use Microsoft Internet Explorer 11 or Google Chrome as most HCS applications do not yet support the Microsoft Edge browser, which is the default browser for Microsoft 10.

2.      BROWSER: If you are not sure which Internet browser you are using, please visit http://whatsmybrowser.org to determine your browser and version.

On the Windows platform, the HCS currently supports Microsoft Internet Explorer and Google Chrome, and offers partial support for Mozilla Firefox. You may download the latest version of these browsers from the following links:

Microsoft Internet Explorer:
http://windows.microsoft.com/en-us/internet-explorer/download-ie
Google Chrome:
https://www.google.com/chrome/browser/desktop/
Mozilla Firefox:
https://www.mozilla.org/en-US/firefox/new/

User of MacOS, OSX, Windows 7, Windows 8, or Windows 10 and users of Google Chrome, Microsoft Internet Explorer 10 or newer, or Safari on the Mac platform, are not affected by this change.Please contact hcsxpeol@health.ny.gov for questions or assistance.

NRMP 2017 Main Residency Match Report: Record-High 31,554 Positions Filled
The National Resident Matching Program® (NRMP®) has released the Results and Data Book for the 2017 Main Residency Match®, the system through which U.S. and international medical school students and graduates obtain residency positions in United States teaching institutions. The Match included a record-high 43,157 registered applicants and 31,757 positions. When the matching algorithm was processed 30,478 positions were filled, and of the 1,177 positions offered through the Match Week Supplemental Offer and Acceptance Program® (SOAP®), 1,076 were filled. Only 203 positions remained unfilled at the conclusion of SOAP, resulting in an overall fill rate of 99.4 percent. 

Other Highlights

  • Although the number of Match registrants was the most ever, the increase was due primarily to growth in U.S. allopathic medical school seniors (increase of 362) and students/graduates of U.S. osteopathic medical schools (increase of 722).
  • The number of U.S. citizen and non-U.S. citizen international medical school students and graduates (IMGs) who submitted program choices declined; however, their match rates of 54.8% and 52.4% respectively were the highest in more than a decade.
  • In the six years since implementation of the All In Policy in 2013, the primary care specialties of Internal Medicine, Family Medicine, and Pediatrics have added a combined 2,900 positions, a 25.8 percent increase.
  • Since 2012, the number of U.S. allopathic seniors matching to Family Medicine has increased every year from 1,322 to 1,513.

The Results and Data Book is widely recognized as the most comprehensive data and analysis resource about the Main Residency Match. The report documents matches by specialty and applicant type, applicant preferred specialty, trends in specialty competitiveness, and positions per active applicant.

View and download the report Match by the Numbers

Poll: Lowering Prescription Drug Costs a High Priority for Many Americans
Six in 10 Americans identify lowering the cost of prescription drugs as a “top priority” for President Trump and Congress when it comes to health care, according to a recent poll by the Kaiser Family Foundation. When asked about specific proposals to hold down drug costs, a majority of adults support allowing the federal government to negotiate with drug companies to lower prices for Medicare beneficiaries (92%); making it easier for generic drugs to come to market (87%); requiring drug companies to release information on how they set prices (86%); limiting what drug companies can charge for certain high-cost drugs (78%); allowing Americans to buy drugs imported from Canada (72%); and creating an independent group to oversee drug pricing (72%).

US Health Officials Concerned That Puerto Rico Not Reporting All Zika Cases
Health officials claim that Puerto Rico is downplaying the extent of its Zika problem and have struggled to get a grasp on the issue because of a protracted dispute with health officials in the territory, according to a document obtained by STAT.

The rift was so contentious that, at one point, health leaders in Puerto Rico refused to meet with their counterparts from the CDC. The multipage document suggests that the dispute has obscured the extent of the territory’s problem for more than half a year.

The focus of the dispute centers on Puerto Rico’s handling of a surveillance system set up to track pregnant women and identify infants and fetuses with Zika-related birth defects — and concerns that officials there are undercounting cases. The registry is called ZAPSS (the Zika Active Pregnancy Surveillance System) and the CDC awarded Puerto Rico’s Department of Health $9.5 million in grants to establish and operate it on the island.

New York RX Card Can Help Patients with Prescription Costs
With healthcare costs rising, many of your patients need assistance. The New York Rx Card can help with those prescription costs and is a free program available to all New York residents. There are no eligibility requirements or forms to fill out. Tell your patients to simply take the card into the pharmacy to get savings of up to 75% on prescription medications for their whole family. New York Rx Card is a proud supporter of Children’s Miracle Network. A donation will be made to your local CMN hospital each time a prescription is processed through the New York Rx Card. Your patients can find and print their FREE card here!

CMS is Accepting Measure Submissions for the Advancing Care Information Performance Category until June 30
There’s still time to submit measures for the Advancing Care Information performance category of the Merit-based Incentive Payment System (MIPS). The Centers for Medicare and Medicaid Services (CMS) Annual Call for Measures and Activities ends June 30, 2017.

CMS encourages providers to identify and submit measures for the MIPS Advancing Care Information performance category. To be considered, proposals must include specific criteria including, but not limited to, measure description, measure type and numerator and denominator descriptions.

CMS requests that stakeholders consider outcome-based measures, patient safety measures, and measures are cross cutting which use certified EHR technology to support the improvement activities and quality performance categories of MIPS.

How to Submit

Please use the Advancing Care Information Submission Form to propose measures for inclusion, and send the form to CMSCallforMeasuresACI@ketchum.com. 

For More Information

To learn more about the process for submitting measures, please visit the Call for Measures webpage, and review the Call for Measures and Activities fact sheet.

Applications(RFA) for Doctors Across New York Ambulatory Care Training Program
The New York State Department of Health’s Office of Primary Care and Health Systems Management (OPCHSM), Center for Health Care Policy and Resource Development, Division of Workforce Transformation, has issued a Request for Applications (RFA) for Doctors Across New York Ambulatory Care Training Program.  Information is available on the Department website at:  www.health.ny.gov/funding/ and the RFA is available on the New York State Grants Gateway at:  Doctors Across New York Ambulatory Care Training Program.To apply, eligible applicants must submit applications via the Grants Gateway.  The link to the site is as follows:  https://grantsgateway.ny.gov.

Written questions must be submitted to GME@health.ny.gov by May 22nd 2017 and they should note in the subject line: “DANY Ambulatory Care RFA Question”.  Questions, answers and updates will be posted on or about June 1st 2017. Proposals are due via the Grants Gateway by June 22nd 2017 by 4:00 PM EST.

Physician Foundation “Practice of Medicine” Series in Health Affairs May Issue
The Physicians Foundation, of which MSSNY is a Charter Member, is proudly sponsoring a new Health Affairs series, “The Practice of Medicine.” The second study of the series, “The Medicare Access and CHIP Reauthorization Act and the Corporate Transformation of American Medicine,” was published this week in the Health Affairs May issue. The full article is attached and available to read through http://bit.ly/2p1RwtL ifyou have a Health Affairs subscription.



CLASSIFIEDS


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


Luxurious Medical Office Space to Share in Manhattan
Spacious and modern wellness office suite off 5th avenue, near grand central, and all major subway lines. Newly renovated space catering to the needs of various health practitioners and their clients (vision, chiropractors, acupuncturists, psychologists, nutritionists, etc.) 13 foot ceilings throughout. Two spacious waiting areas, elegantly furnished. Two bathrooms en suite. Fully equipped kitchen/pantry area. Two elevators. Free coffee/tea station, hot/cold water cooler, free mail sorting services. Windowed offices starting from $2,800. Utilities, cleanings and high speed internet. Call: 570-499-5851 / email: columbuslaservision@gmail.com


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

April 28, 2017 – Success Requires Action!


PRESIDENT’S MESSAGE
Dr. Charles Rothberg
April 28, 2017
Volume 17
Number 16

MLMIC Insurance

Dear Colleagues:

In my view, success for physicians is well within MSSNY’s grasp. But that success won’t come easy.  And success will not result from inaction.  Nor will it result from being too risk averse.

  • We’ll need to work to advocate on behalf our doctors to provide legislative relief, regulatory relief, and administrative simplification.
  • We’ll need to advocate for them and help them to more effectively represent themselves in an ever changing practice environment – more often in the role of employee in a changing workforce.

I am well aware that I have just a one-year term to implement some ideas that I believe are critical going forward.  I intend to build upon the strong foundation provided by my predecessor, Dr. Malcolm Reid, and I expect to provide a bridge to the leadership of president elect Dr. Tom Madejski.  I introduce Three Pillars that make up my platform:

  • Wellness
  • Disparities
  • Engagement

Wellness
The term “burnout” has become so overused that it risks losing much of its meaning. We learned at a CME program at this year’s HOD and through our Task Force report that it is institutional factors that contribute to ‘burnout’— NOT defective doctors.  Yes, they are exhausted— from the hamster wheel of insurance authorizations, rejections and unfair remuneration for work that has been signed, sealed and delivered.  What is MSSNY doing to alleviate the problem?

MSSNY is currently working on early intervention programs. We must change our focus from intervention to one that places greater emphasis on prevention. We should refer to “Physician Wellness” which is suggestive of the remedy, rather than “burnout,” which refers solely to the symptom.

Engagement
If we want to survive as a viable society, we must engage NOT ONLY our members, but also non-members, students, health care stakeholders, and the press. If we do not engage, we undermine our own authority. The balance is tricky. When the press asks us for statements, we have to speak decisively, thoughtfully, unambiguously and without timidity. To do so we need to have strong policy positions and abundant discourse on which to rely.  We need to engage by means of all kinds of media – conventional, social media, face to face.  Please do not groan when I sincerely encourage you to sign up for twitter. You might enjoy it! Follow me @MSSNYRothberg and MSSNY@mssnytweet.

Engagement for MSSNY will involve much more than compelling policy, advocacy and effective messaging. It must involve enrichment as well.  However, expanding existing programs such as our CME, our advocacy, newsletters, and especially programs modeled on our successful leadership seminars which engaged over 100 physicians in programs both downstate and in central New York.

Disparities
We have developed an overly narrow view of disparities – a narrow view that I believe we have outgrown.  Going forward, our solutions must extend beyond just the ethnic. The future must include ALL contributors to adverse health outcomes— gender, LGBTQ, geography, poverty, age and even physician diversity. We need to look beyond how we traditionally view diversity. There are lots of people out there who don’t want to fit a mold. But they do want to feel free to be themselves. They look to us for understanding, not necessarily for advice.

As we are coming to understand, patients with gender identity issues have hated going to the doctor, any doctor. They were afraid, because they thought they might be judged. The people who have been outliers have stepped forward and we should walk beside them and learn how to better treat them in our offices. The objective of the three pillars I have outlined is to chart a path to the future. Other stakeholders are certainly positioning themselves to fill any voids – WE SEE HOW THAT IS WORKING OUT!  We must not allow voids, and where they exist, WE must fill them.

Now that we know better, we must listen better; then we will do better.

Addendum
A matter that was discussed at the House that is receiving some attention is our decision to develop an unbiased survey through the Bioethics Committee regarding MSSNY’s members’ attitude towards aid-to-the-dying. For now, our policy remains that “physicians should not assist in suicide.”

Results of this survey will be conveyed to the 2018 House of Delegates.

Sincerely,
Charles Rothberg, MD
MSSNY President

Please send your comments to comments@mssny.org



Appeals Court Blocks Proposed Anthem-Cigna Merger
In a landmark victory for patients and physicians, a federal appeals court upheld the lower-court ruling that blocked the proposed mega-merger between health insurance giants Cigna and Anthem (the parent of Empire Blue Cross/Blue Shield).   MSSNY worked together with the AMA and several other state medical associations to oppose this proposed merger.  Last fall, then-MSSNY President Dr. Malcolm Reid testified at a public hearing hosted by the New York Department of Financial Services examining this proposed merger.

Dr. Reid’s testimony emphasized the already very difficult practice environment for physicians in New York State that has become worse in recent years, in part the result of the narrowing of health insurer participating provider networks and increasing pre-authorization burdens, problems which undoubtedly would be made worse had this merger been permitted to move forward.  Indeed, DFS Superintendent Maria Vullo issued a letter that highlighted concerns with the significant market impact the merger would have had if approved.

New York Attorney General Eric Schneiderman, who had joined several AGs across the country in litigation to oppose the proposed merger, issued a statement praising the Appeal’s court’s ruling:

“Today’s decision is a win for consumers in New York and across the country.  We are very pleased that the Court of Appeals agreed with the District Court’s finding that this merger would violate antitrust laws by substantially lessening competition in commercial health insurance markets, likely leading to increased health insurance premiums and reduced quality and innovation.  I again thank my federal and state partners for their work to protect patients and ensure that competition in the health insurance industry remains vibrant across the country.”

To read more click here.                                                                                                      (AUSTER)

Last Weeks of Legislative Session Present Opportunities and Challenges
The legislature returned to session this past Monday after two weeks off following the passage of the state budget.  The last scheduled session day is June 21st. Issues for state lawmakers to address in the remaining weeks of session could include New York City Mayoral control, ethics reform and various MSSNY supported/opposed bills detailed below.   Stay tuned for future emails and go to MSSNY’s website for updates when actions are needed on our priority legislation.

One bill supported by MSSNY, S.3943 (Hannon), was moved through the Senate Health committee this week and has passed the Assembly (see related article).  This bill 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.

MSSNY is also working together with several specialty societies to reduce administrative hassles by advancing legislation that would enact several components of the AMA’s Prior Authorization Principles (click here), including:

  • Assuring that a practitioner of the same or similar specialty review health care pre-authorization request on behalf of a health plan before treatment is denied;
  • Require health plan utilization review criteria to be evidence-based and peer reviewed ;
  • Reduce the time frame for reviewing prior authorization requests from 3 business days to 48 hours (and to 24 hours for urgent situations)
  • Assure that a prior authorization, once given, is enduring for the duration of the medication or treatment.
  • Prohibit mid-year prescription formulary changes; and
  • Assure that once a prior authorization is given, it cannot be withdrawn if eligibility is confirmed on the day of the service.

Among the Many Other Bills MSSNY is fighting to achieve:

  • Collective Negotiations (4472, Gottfried /S.3663,Hannon) – would allow independently practicing physicians to collectively negotiate patient care terms with market dominant health insurers under close state supervision.  To send a letter to your legislators click here.
  • Changes Definition of Clinical Peer Reviewer (2539,Gottfried) – Would assure that a physician of the same or similar specialty review health care recommendations on behalf of a health plan before treatment recommendations are denied
  • Improving the Medical Liability Landscape in New York State (4913, Schimminger) – would implement a number of important reforms to the medical liability adjudication system to reduce the exorbitant cost of medical liability insurance.
  • Protecting the Peer-Review Process (2460 Gottfried / S.3661 Hannon) – Would extend the confidentiality provisions relating to discovery of testimony to apply to statements made by any person in attendance at peer-review committee that is a party to an action the subject matter of which was reviewed at such meeting.
  • Raising the purchase age of tobacco products to 21 and regulate e-cigarettes under the Clean Indoor Air Act.

Among the many Bills MSSNY is opposing:

  • Expanding the Medical Liability Lawsuits (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%.  Please send a letter in opposition click here.
  • Expansion of Medical Liability Damages (411/A.1386) – 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%.
  • Prohibiting Ex-Parte Interviews of Plaintiff’s Treating Physician (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.
  • Retail Clinics (A958) – would permit corporate owned “retail clinics” in big box stores
  • Certification of Certified Registered Nurse Anesthetists (CRNAs) (A.442/S.1385) – would provide for the certification by the education department of certified registered nurse anesthetists (CRNAs).  This bill fails to define a scope of practice consistent with existing New York State standards.  Under NYS Health Code (10 NYCRR 700.2), CRNAs are already required to register with the NYS Education Department and are prohibited from practicing nurse anesthesia without meeting specific education and testing requirements.
  • Podiatric scope of practice (1880/ S.4734) – 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).(DIVISION OF GOVERNMENTAL AFFAIRS)

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


Legislation to Repeal Significant Portions of the ACA Could Be Back Before Congress; MSSNY Joins Several Other Organizations to Express Concerns
Multiple media outlets reported this week that the members of House Freedom Caucus agreed to support the American Health Care Act (AHCA) if it incorporated amendments that would permit states to modify specific ACA requirements, including age rating bands, essential health benefits, and continuous coverage incentives.  The amendment was the result of ongoing discussions between Representative Tom MacArthur (R-NJ), co-Chair of the centrist “Tuesday Group” and the House Freedom Caucus.

The AHCA was pulled from Congressional consideration in late March because it had insufficient “yes” votes, including lack of support from the Freedom Caucus.  However, as of this writing it is not known whether this amendment to the AHCA legislation will now produce a majority to support the legislation, or whether it could also pass the US Senate.

This week, MSSNY joined with nearly two dozen patient advocacy organizations in a letter to New York’s Congressional delegation that noted that “while the Affordable Care Act (ACA) can be improved, replacing it with the AHCA would have significant adverse consequences to millions of New Yorkers”  Instead, the letter urged that New York’s Congressional Delegation fight to: “Ensure uninterrupted healthcare coverage for the 24 million Americans, including the 850,000 New Yorkers who gained coverage under the ACA; Do not harm New York State’s budget and do not shortchange New York’s Medicaid program; and Protect the more than 600,000 New Yorkers who gained coverage under the Essential plan.”

The AMA sent a letter to Congressional leaders noting that “Nothing in the MacArthur amendment remedies the shortcomings of the underlying bill” and that the AMA remains “deeply concerned that the AHCA would result in millions of Americans losing their current health insurance coverage”.  It is urging physicians to send a letter in opposition to their legislators here: click here.

As has been previously reported, the AHCA would keep some of the popular provisions from the ACA, such as required coverage for pre-existing conditions, and requiring dependent coverage up to age 26.   It would also significantly expand the amount of funds that a person could direct to their Health Savings Account and delay for several years implementation of the “Cadillac Tax” on comprehensive health insurance coverage.

However, it would substantially revise ACA rules that facilitated various subsidized coverage programs for those who make up to 400% FPL ($94,000 for a family of 4).  While the expanded eligibility for Medicaid (up to 138% FPL) would be available through the end of 2019, starting in 2020, such expanded coverage would only be continued for those who had such coverage prior to the end of 2019.  The AHCA would also repeal the tax credits currently provided to help cover cost-sharing amounts for coverage for individuals who earn too much to qualify for Medicaid.  Instead, tax credits of $2,000-$4,500 (depending upon age) would be provided to enable the purchase of health insurance coverage.

Tax credits will be available in full to individuals earning less than $75,000 and households earning less than $150,000, but they will be capped for higher earners.  It appears as if the AHCA would also completely eliminate funding for New York’s Essential Plan, which provides low-cost insurance coverage with little cost-sharing responsibilities for those who make between 138% -200% FPL.

The bill would also repeal several other notable ACA provisions, including the requirement for all individuals to have health insurance coverage, the large employer coverage mandate, the provision to impose a “tanning” tax and a provision that limits the tax deductible treatment for health insurers of executive income that exceeds $500,000.

Please remain alert for further updates.
(AUSTER)

MSSNY Supports Legislation That Would Raise The Purchasing Age For Tobacco And Restrict E-Cigarettes
The New York State Senate Health Committee advanced two smoking related pieces of legislation this week.  S.3978/A.273 would increase the purchasing age for tobacco products from eighteen to 21 years of age and S.2543/A.516 would include the use of electronic cigarettes or e-cigarettes under the Clean Indoor Air Act.  The Medical Society of the State of New York strongly supports both these measures.  In its statement of support, MSSNY indicated that the best way to reduce the number of people who are addicted to tobacco is to prevent them from starting to smoke.  Addiction to tobacco products occurs relatively quickly once someone begins to smoke.  Once someone becomes addicted to tobacco it is very difficult to quit.  Data suggest the earlier the onset of smoking, the more severe the addiction is likely to be and 90% of all smokers begin before age 20.  Each day, 6,000 children under 18 years of age smoke their first cigarette.

Children most often try their first cigarette with a friend or peer who already smokes.  This bill aims at reducing the number of people who smoke by raising the age requirement to 21. E-cigarettes are not currently defined as a “tobacco product” under the New York S tax law, retailers that sell e-cigarettes do not need a tobacco registration from the Department of Taxation and Finance.

This opens a loophole for retailers to sell e-cigarettes, even if they are not registered and do not sell traditional tobacco products.  Since there is no registration requirement, there is no way for the Department of Health’s Enforcement Unit to know that they are selling e-cigarettes or conduct compliance checks to ensure that they are not selling to minors. This bill will further require that they register if they sell e-cigarettes. The Medical Society of the State of New York strongly supports both these measures and urges physicians to contact their legislators and urge their support for both bills.  Physicians can send a letter to their legislators by clicking on the link: click here.
(HARRING, CLANCY)                                                 

Legislation Advances to Assure Peer Review Prior to Health Plan Contract Non-Renewal
Legislation (S.3943, Hannon) to assure that a physician has a right to a hearing before their clinical peers before their participation contract with a health insurance company can be non-renewed was reported unanimously from the Senate Health Committee to the Senate floor this week.

MSSNY supports this legislation.  Identical legislation (A.2704, Lavine) recently passed the Assembly.  The purpose of the bill is to address a gap in current law that prohibits a health insurance company from terminating a physician’s contract with a health plan without a written explanation of the reasons for the proposed contract termination and an opportunity for a hearing before clinical peers, but does not apply those rights to situations where the physician’s contract is not renewed.

There have been instances in the last few years where certain health insurance companies have dropped significant numbers of physicians from their networks without providing any recourse to these physicians to challenge these non-renewals.  This legislation would provide important protections to better assure the continuity of the physician-patient treatment relationship.  Physicians can send a letter to their Senator in support of this legislation here (click here).
(AUSTER)

MSSNY Joins Other Advocacy Organizations to Continue Federal Support for Subsidized Health Insurance Coverage for those below 250% FPL
MSSNY joined several other health care, patient and employer organizations in a press statement (Click here ) this week that encouraged Congress and President Trump to ensure continued funding for health insurance cost-sharing reductions (CSRs) currently provided under the Affordable Care Act, as Congress was negotiating a continuing Budget resolution to prevent a government shutdown.

In particular, the press release highlighted that more than 700,000 New Yorkers benefit from these CSR funds, including those who are enrolled in the State’s Essential Plan (for those earn less than 200% of the FPL), as well as those who earn between 200-250% FPL who receive health insurance coverage through New York’s Health Insurance Exchange.   These subsidized health insurance coverage options could be lost if these CSR subsidies were not continued.  It was reported in several media outlets on Wednesday that the new administration intends to continue to make these subsidy payments (click here)
(AUSTER)

Register Now For Upcoming Medical Matters 2017 CME Webinar Series
Registration is now open for the next Medical Matters webinar on Wednesday, May 7, 2017 at 7:30 a.m.  “Exercise Response to Novel Influenza Strains” will be conducted by Pat Anders, MS, MEP, Manager, Health Emergency Preparedness Exercises, New York State Department of Health, Office of Health Emergency Preparedness.  Registration is now available at this link.

The educational objectives are: 1)  Understand preparedness and response actions of public health and healthcare to a novel pandemic influenza, simulated in full-scale exercise.  2)  Describe two delineated strategies in which public health and office-based physicians would interact in a pandemic influenza.  Additional information or assistance with registration may be obtained by contacting Melissa Hoffman at mhoffman@mssny.org.  

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

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) 

NYS DOH Announce Free Buprenorphine Training Across New York State
The NYSDOH AIDS Institute announces a Free Buprenorphine Waiver Training for Clinical Providers in various locations throughout the state.  Attached are flyers with further information, including location, online registration and pre-requisite training.  The NYSDOH trainings will be in Monticello (May 6th) click here , Plattsburgh (May 20th) click here, Ithaca (June 3rd)  click here. 

The New York City Department of Health and Mental Hygiene conducts free buprenorphine waiver trainings as well throughout all five boroughs.  For further information, please contact them at buprenorphine@health.nyc.gov. For more information about all upcoming MAT trainings, please visit www.pcssmat.org/mat-basics/mat-waiver-training/.  Should you have any questions, please do not hesitate to contact the department at 1-800-692-8528 or buprenorphine@health.ny.gov. Space is limited to 40 individuals and will fill up so please register fast!
(CLANCY)

LAST CHANCE TO REGISTER:  Please Join our Running/Walking Team for the CDPHP Workforce Team Challenge
Please join us on May 18th!  MSSNY will be a premium sponsor of the 2017 CDPHP Workforce Team Challenge, a 3.5-mile race for runners and walkers, taking place in Albany on May 18, 2017.  MSSNY members and alliance members are highly encouraged to join with us to participate, either as a runner or a walker.

MSSNY’s sponsorship of the event is part of an ongoing effort to have a visible presence at health-related public events.    As a premium sponsor, MSSNY’s logo will be featured on the official race t-shirt, and MSSNY will be recognized during the race announcements.  In addition, MSSNY will have an exhibit table on Empire State Plaza.

Registration for this event closes May 1, 2017, OR when the cap of 10,000 registrants is reached.  As of today, Friday, April 28, 2017, at 10:00 AM, 9,200 people had already registered.  Please do not wait! 

The race begins at 6:25 PM, at Empire State Plaza, and features a scenic route that traverses Albany’s Washington Park.  The popular event always attracts great crowd support and on-course entertainment.  Sawyer Fredericks, winner of the eighth season of The Voice, will be singing the National Anthem.

Instructions and registration link are available  here.  Please choose “Medical Society of the State of New York” from the team drop-down list.  Registration is $24, and a portion of the registration fees go to this year’s “Charities of Choice,” Boys and Girls Club of Albany and Vanderheyden.   A flyer may be accessed here.  For more information, please contact Miriam Hardin (mhardin@mssny.org).   (HARDIN)

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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Clinicians: MIPS Participation Status Letter
CMS is reviewing claims and letting practices know which clinicians need to take part in the Merit-based Incentive Payment System (MIPS), an important part of the new Quality Payment Program (QPP). In late April through May, you will get a letter from your Medicare Administrative Contractor that processes Medicare Part B claims, providing the participation status of each MIPS clinician associated with your Taxpayer Identification Number (TIN).

Clinicians should participate in MIPS in the 2017 transition year if they:

  • Bill more than $30,000 in Medicare Part B allowed charges a year and
  • Provide care for more than 100 Part B-enrolled Medicare beneficiaries a year

QPP intends to shift reimbursement from the volume of services provided toward a payment system that rewards clinicians for their overall work in delivering the best care for patients. It replaces the Sustainable Growth Rate formula and streamlines the “Legacy Programs” – Physician Quality Reporting System, the Value-based Payment Modifier, and the Medicare Electronic Health Records Incentive Program. During this first year of the program, CMS is committed to working with you to streamline the process as much as possible. Our goal is to further reduce burdensome requirements so that you can deliver the best possible care to patients. Learn more about the Quality Payment Program.

A MSSNY House United Can Never Be Defeated
One of the important messages that came out of the MSSNY’s Annual House of Delegate’s meeting was the powerful force we can play in the legislative process when physicians are united.  While physicians may have differing views on key health issues, it was again demonstrated that respectful dialogue and discussions lead to a productive MSSNY agenda.  The House of Delegate’s meeting has concluded but a lot of work still has to be done.  Various speakers highlighted the importance of contacting your legislators and the role of MSSNYPAC.   We have a lot of work ahead, but if all physicians engage in advocacy and the political process, there is much we can accomplish.  Please join us in these efforts.
(Belmont)

Upcoming Veterans Health Care Conference in LI: CME for Primary Care Physicians
MSSNY, the New York State Psychiatric Association, and the National Association of Social Workers New York State Chapter are hosting a two-day conference on Long Island on Friday, May 5 and Saturday, May 6, 2017 at the Clarion Hotel & Conference Center, located at 3845 E Veterans Memorial Hwy, Ronkonkoma, NY 11779.

The conference will consist of interactive seminars and panel discussions focusing on the current and evolving healthcare needs of veterans.The training section is fully subscribed. However, physicians can still attend the conference.,/span>

There is no cost, but separate registration is required for both the trainings and conference. The presentation is part of Veterans Mental Health Training Initiative, which is supported by a grant provided by the New York State Legislature and administered through the New York State Office of Mental Health. The Medical Society of the State of New York is accredited by the Accreditation Council for Continuing Medical Education (ACCME) to provide continuing medical education for physicians.

The Medical Society of the State of New York designates each 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

Further information or for assistance in registering for these programs, contact Greg Elperin at gelperin@mssny.org

MLMIC Releases New Risk Management CME Program
As part of MLMIC’s ongoing commitment to help physicians and other healthcare practitioners improve the quality of patient care and reduce potential liability exposure in their practices, a new online risk management CME program, Proactive Risk Management Follow-Up Program VII (Follow-Up VII), has been developed for its policyholders and is now available at policyholders’ secure login at MLMIC.com.

The topics covered in this program include:

  • the benefits as well as the associated liability risks of using electronic health records (EHRs) in the office practice
  • the proper use of EHR features and the use of EHR data in litigation
  • the key factors considered by plaintiffs’ attorneys when evaluating a potential malpractice claim
  • the areas of risk commonly identified in high exposure liability cases
  • follow-up procedures in the office practice and the liability risks of patient noncompliance
  • recent trends in pediatric claims and the main areas of liability risk in the treatment of pediatric patients

In addition to its educational value, physicians can earn CME credits, ABIM and ABP MOC credits (if appropriate), the applicable premium credit (5%, VAP or ECPIP) and eligibility to participate in the NYS excess medical malpractice insurance program (Section 18 professional liability coverage).  To view the program now, click here to log in.

Should you have any questions regarding this program, please do not hesitate to contact MLMIC’s Risk Management Department at (212) 576-9601, from 9 a.m. – 4:45 p.m., Monday through Friday.


41.6% of Heart Attack Patients Not Taking Meds after Two Years
study in JAMA Cardiology analyzed data on 29,932 Medicare patients ages 66 to 75 who had been hospitalized for a heart attack from 2007 through 2012 and had filled a prescription for either Lipitor or Crestor.

At six months after their discharge from the hospital, 58.9 percent of them were still taking the medicine with high adherence rates. By two years, only 41.6 percent were taking it as directed; many were taking lower dosages than prescribed, and nearly one in five had stopped taking the medicine completely.

The senior author, Dr. Robert S. Rosenson, a professor of medicine at the Icahn School of Medicine at Mt. Sinai, said that failing to take the medicine properly results in greater risk for heart attack, stroke and unstable angina.

“Health care providers have an obligation to educate the patient,” he said. “We need to stress the evidence that supports the therapy. People who continue the medicine have progressively fewer adverse outcomes over time. Once you have a heart attack, this is prevention for the rest of your life.”


MSSNYPAC – The Political Voice of New York’s Physicians
MSSNYPAC Medical Society of New York
More than 100 MSSNYPAC-supporting physicians participated in our Physician Advocacy Roundtable held in Westchester last Friday during MSSNY’s annual House of Delegates meeting.  Senator Terrence Murphy, Assemblyman Andrew Raia, Nassau-Suffolk Hospital Council Chair Kevin Dahill and AMA Trustee Barbara McAneny, MD discussed the importance of physician participation in the development of health care policies affecting the communities we serve, such as implications of a potential ACA repeal, and response to the opioid and heroin addiction epidemic.  To support our work, please join MSSNYPAC at www.mssnypac.org/contributeMSSNYPAC is a force for change in healthcare delivery. 

Malaria May Be More Common In US Than Previously Reported, Study Suggests
The New York Times (4/25) reports in “Global Health” that malaria may be more common in the US than previously reported, according to a new study published in The American Journal of Tropical Medicine and Hygiene. After analyzing hospital discharge records in the Agency for Healthcare Research and Quality’s National Inpatient Sample, researchers concluded there were at least 2,100 cases of malaria each year in the US between 2000 and 2014. The article also points out that the Centers for Disease Control and Prevention estimates that there are around 1,500 to 2,000 cases of malaria each year.

Illegal Cancer Treatments: FDA Warning – Fraudulent Claims of Diagnosis, Treatment, Prevention or Cure
FDA issued warning letters addressed to 14 U.S.-based companies illegally selling more than 65 products that fraudulently claim to prevent, diagnose, treat or cure cancer.

It is a violation of the Federal Food, Drug and Cosmetic Act to market and sell products that claim to prevent, diagnose, treat, mitigate or cure diseases without first demonstrating to the FDA that they are safe and effective for their labeled uses. The illegally sold products cited in the warning letters include a variety of product types, such as pills, topical creams, ointments, oils, drops, syrups, teas and diagnostics (such as thermography devices).

They include products marketed for use by humans or pets that make illegal, unproven claims regarding preventing, reversing or curing cancer, killing/inhibiting cancer cells or tumors, or other similar anti-cancer claims. See the list of illegally sold cancer treatments.

The products are marketed and sold without FDA approval, most commonly on websites and social media platforms. Healthcare professionals and patients are encouraged to report adverse events or side effects related to the use of these products to the FDA’s MedWatch Safety Information and Adverse Event Reporting Program:

  • Complete and submit the report Online: www.fda.gov/MedWatch/report
  • Download form or call 1-800-332-1088 to request a reporting form, then complete and return to the address on the pre-addressed form, or submit by fax to 1-800-FDA-0178 


Do You Want to Comment on Role of Physician-Owned Hospitals?The Fiscal Year (FY) 2018 Hospital Inpatient Prospective Payment System proposed rule released by the Centers for Medicare and Medicaid Services (CMS) on April 14 asks the public to comment on the appropriate role of physician-owned hospitals in the nation’s health care delivery system.  Specifically, the proposed regulation asks about the impact that CMS regulations and the statutory restrictions on these facilities have had on health care delivery and on Medicare beneficiaries.

While there have been longstanding restrictions on physician hospital ownership under the Stark self-referral regulations, these restrictions were tightened with passage of the Affordable Care Act (ACA), which essentially banned the construction of new facilities and placed restrictions on the expansion of already existing physician-owned hospitals.

Representative Sam Johnson (R-TX) recently re-introduced H.R. 1156, the “Patient Access to Higher Quality Health Care Act of 2017,” which would repeal the ACA limits on physician-owned hospitals and allow these facilities to remain competitive.  The legislation is supported by the American Medical Association.

Physician-owned hospitals provide high-quality care and contribute to a competitive health care marketplace.  If allowed to compete on a level playing field, they may play an important role in enhanced care coordination as well as new health care delivery models.

Physicians are encouraged to submit comments to CMS electronically, following the instructions under the “comment now” button, before 5:00 pm ET on June 13, 2017. 

Doctors’ Visas: Bronx Lebanon Filed 213 Applications in 2016
Bronx-Lebanon Hospital Center filed 213 applications for H-1B visas in 2016, second only to Michigan’s William Beaumont Hospital, according to a study published in JAMA last week and reported on by Kaiser Health News. Employers in New York, Michigan and Illinois submitted the most H-1B applications for foreign physicians, causing concern amid President Donald Trump’s call for a review of the visa program. The H-1B visa program allows employers to hire highly skilled professionals from abroad to fill employment gaps in the U.S., typically in high-tech, science, engineering and math jobs. But hospitals use the program as well, often to recruit doctors to serve in rural or underserved urban areas. The number of visas is capped at 85,000 annually.

Review Your Open Payments Data Before it Becomes Available to the Public
CMS will publish the Open Payments Program Year 2016 data and updates to the 2013, 2014, and 2015 program years on June 30, 2017.
Review and dispute for the Program Year 2016 Open Payments data publication began on Saturday, April 1, 2017 and will last until May 15, 2017. Physicians and teaching hospitals must initiate their disputes during this 45-day review period in order for any disputes to be addressed before the June 30th publication.
Physician and teaching hospital review of the data is voluntary, but strongly encouraged. While the opportunity for physicians and teaching hospitals to dispute any data associated with them expires at the end of the calendar year in which the record is published, the disputes must be initiated during this 45-day review and dispute period, ending on May 15th, in order to be reflected in the June 30th publication.

If you have never registered with Open Payments before:
Make sure you have your National Provider Identifier (NPI) number, and State License Number (SLN). Initial registration is a two-step process and should take approximately 30 minutes:

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

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

For users that registered last year but have been inactive for more than 60 days:
The EIDM locks accounts if there is no activity for 60 days or more. To unlock an account, go to the CMS Enterprise Portal, enter your user ID and correctly answer all challenge questions; you’ll then be prompted to enter a new password.

For users that registered last year but have been inactive for more than 180 days:
The EIDM deactivates accounts if there is no activity for 180 days or more. To reinstate an account that has been deactivated, contact the Open Payments Help Desk.

For more information about the registration process, visit the physician and teaching hospital registration page on the Open Payments website.

Submit questions to the Help Desk via email at openpayments@cms.hhs.gov or by calling 1-855-326-8366, Monday through Friday, from 8:30 a.m. to 7:30 p.m. (ET), excluding Federal holidays.



CLASSIFIEDS


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


Luxurious Medical Office Space to Share in Manhattan
Spacious and modern wellness office suite off 5th avenue, near grand central, and all major subway lines. Newly renovated space catering to the needs of various health practitioners and their clients (vision, chiropractors, acupuncturists, psychologists, nutritionists, etc.) 13 foot ceilings throughout. Two spacious waiting areas, elegantly furnished. Two bathrooms en suite. Fully equipped kitchen/pantry area. Two elevators. Free coffee/tea station, hot/cold water cooler, free mail sorting services. Windowed offices starting from $2,800. Utilities, cleanings and high speed internet. Call: 570-499-5851 / email: columbuslaservision@gmail.com


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

April 14, 2017 – Budget’s High Points for Us

Dr. Reid - MSSNY President
PRESIDENT’S MESSAGE
Dr. Malcolm Reid
April 14, 2017
Volume 17
Number 15

MLMIC Insurance

Dear Colleagues:

The New York State Legislature completed passage of a $153 Billion State Budget 9 days after the State due date of April 1, and after several weeks of “round the clock” negotiations on an extraordinary number of difficult issues including raising the age of criminal responsibility, ride-sharing, education funding, emergency Budgetary powers, a Medicaid prescription drug price cap and Workers Compensation reform.  While the Legislature passed a two-month Budget extender, this final Budget deal overrides that legislation.

Thanks to strong advocacy by MSSNY physician leaders, MSSNY member physicians, county medical societies, and the many specialty societies with whom MSSNY works closely, the final Budget enacted DID NOT contain several objectionable provisions that had been opposed by MSSNY.  The final Budget:

  • Deleted a proposal opposed by MSSNY that would have required a physician to receive a “tax clearance” as a pre-condition of receiving Excess Medical Liability Insurance coverage, while assuring that the more than 20,000 physicians who currently receive Excess coverage continue to receive such coverage;
  • Deleted a proposal opposed by MSSNY that would have expanded burdensome prior authorization requirements by repealing statutory provisions that assure that the prescriber has the final say for all prescriptions for fee for service Medicaid patients as well for several drug classes for patients covered through Medicaid managed care;
  • Deleted a proposal opposed by MSSNY that would have permitted pharmacists to enter into “comprehensive medication management protocols” with nurse practitioners to manage, adjust and change the medications of patients with a chronic disease or who have not met clinical goals of therapy;
  • Deleted a proposal opposed by MSSNY to create a Regulatory Modernization Team that could have empowered state agencies to override existing scope of practice laws without legislative approval;
  • Substantially revised provisions to permit Medicaid to sanction or remove a health care practitioner who violates a statutory limit on opioid prescribing, by assuring that a prescriber has appropriate due process protections before a sanction is imposed.
  • Continues necessary funding for MSSNY’s Committee for Physician’s Health and MSSNY’s Veterans Mental Health Care educational program;
  • Deleted several problematic elements that had been under serious consideration to be included in Workers’ Compensation Reform package enacted as part of the Budget, including provisions that would have:
    • Limited injured worker choice of treating physician by expanding the required use of Workers Compensation PPOs;
    • Removed the authority of county medical societies to recommend physicians to be approved to be WC-authorized providers or IMEs;
    • Expanded the penalties that the Board could impose on WC-authorized physicians;
    • Expanded the list of authorized health care providers in Workers Compensation, without any requirement for several of these providers to collaborate with a physician.

It should be noted that the final package includes a number of notable reforms that will have a significant long-term impact on New York’s Workers Compensation system including provisions that will:

  • Implement new impairment guidelines by year end 2017 after “consultation with  representatives of labor, business, medical providers, insurance carriers, and  self-insured employers”;
  • Create a prescription drug formulary by year end 2017 which “shall  include  a tiered list of high-quality, cost-effective medications that are pre-approved to be  prescribed  and  dispensed,  as well as additional non-preferred drugs that can be prescribed with prior approval”.
  • Create a workgroup in 2018 to review the criteria for those who provide Independent Medical Exams (IMEs);
  • Expedite the timeframe for Workers Compensation coverage disputes to be resolved; and
  • Grant additional powers to the Workers Compensation Board to impose “performance standards” on Workers Compensation carriers.

MSSNY’s Division of Governmental Affairs

Please send your comments to comments@mssny.org


enews large



MLMIC Hosting Physician Meetings throughout State to Discuss Strategies
MLMIC will be hosting Healthcare Law Review programs for physicians at 11 different locations in the state during May and June. This program will provide:

  • Overview of the recent case law developments that impact the provision of healthcare
  • Strategies to safeguard the privacy of a patient’s medical information.
  • Strategies to protect Quality Assurance materials from discovery in a lawsuit
  • Steps that a physician should take to clarify his/her role as a consulting physician to improve patient care and reduce potential liability exposure
  • Review the information that the physician must disclose to the patient to establish true informed consent.

Click here to open the brochure regarding the 2017 Network Meetings. If you are interested in attending, please feel free to contact Ms. Diane Allen, MLMIC’s Risk Management Coordinator at 518-786-2741 or email: dallen@mlmic.com.

Registration Now Open for CME Webinar on Concussion in Pediatric and Adult Population
MSSNY will hold a Continuing Medical Education (CME) webinar on the “Current Concepts in Concussion for Pediatric & Adult Patients” on Wednesday, April 19, 2017 at 1 p.m. for all physicians and other health care providers.  Registration for the webinar is now open HERE A copy of the flyer can be found HERE

Faculty for the course will be John Anthony Pugh, MD, PhD, assistant professor of Neurology at Albany Medical Center (AMC), and Deborah Ilana Light, MD, primary care sports medicine and associate program director for the Sports Medicine Fellowship at Albany Medical Center.  Educational objectives are: 1) Identify signs and symptoms indicative of concussion as well as red flags that indicate alternate or more severe pathology; 2) Outline an appropriate management plan for a patient presenting with concussion including a return to “normal life” protocol; 3) Describe methods for the primary and secondary prevention of concussion; 4) Identify patients who would benefit from referral to a concussion specialist.

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

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

USPSTF Releases Draft Guidelines on PSA Testing
The US Preventive Services Task Force (USPSTF) “has dropped its controversial opposition to routine screening for prostate cancer, and now says that men between the ages of 55 and 69 should discuss the test’s potential benefits and harms with their physicians “and make decisions based on their own ‘values and preferences.’” The group said in proposed new guidelines on April 11, “The decision about whether to be screened for prostate cancer should be an individual one.” The task force “continues to recommend that men 70 and older forgo screening altogether.”

The USPSTF’s 2012 advice against screening said there was little evidence that PSA screening was reducing deaths. Since that time, “PSA screening rates have declined by as much as 10%, and now less than one-third of US men get the tests.” Meanwhile, fewer men are being diagnosed with early-stage disease, when it is more treatable, while more are being diagnosed with more aggressive harder-to-treat cancer.

The draft prostate cancer recommendations announced online in JAMA, are open for public comment until May 8.


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



Physicians Still Disagree as to When to Recommend Mammograms
Research indicates “primary-care physicians and gynecologists continue recommending breast cancer screening for younger and older women despite changes to breast cancer screening guidelines.” Researchers found that “trust in different guidelines and a physician’s specialization affect their screening recommendations.” The findings were published in JAMA Internal Medicine http://bit.ly/2ojV8Ju. The US Preventive Services Task Force recommends biennial mammograms starting at 50 for all women.”

DFS: Insurers to Provide Coverage for Visits that Result in Marijuana Certification
New York State Department of Financial Services sent a letter issued on April 12, 2017 to remind insurers authorized in New York State that they must provide coverage for office visits for covered services, including those that result in medical marijuana certification, as long as the office visit wasn’t solely for the purpose of medical marijuana certification. 

Upcoming Veterans Health Care Training Program on Long Island: Includes CME Training for Primary Care Physicians
MSSNY, the New York State Psychiatric Association, and the National Association of Social Workers – New York State Chapter are hosting a two day conference on Long Island on Friday, May 5 and Saturday, May 6, 2017 at the Clarion Hotel & Conference Center, located at 3845 E Veterans Memorial Hwy, Ronkonkoma, NY 11779.

The conference will consist of interactive seminars and panel discussions focusing on the current and evolving healthcare needs of veterans. MSSNY will be conducting three CME accredited trainings for primary physicians and specialists, covering PTSD and TBI in returning veterans, suicide among returning veterans, and substance use disorders among returning veterans.

There is no cost, but separate registration is required for both the trainings and conference.

Click here to view a detailed schedule and register for the Veterans’ Mental Health Training Initiative

To register for each CME program, click on the program name below

PTSD and TBI in Returning Veterans
Friday, May 5, 1:15 p.m.
Faculty Presenter: Thomas Madjeski, MD
The educational Objectives for the PTSD program are:

1) Describe the symptoms of PTSD and TBI.
2) Describe the treatment modalities of PTSD and TBI.
3) Describe military culture & how to overcome unique barriers to treatment intrinsic to military culture 

Suicide among Returning Veterans
Friday, May 5, 2:30 p.m.
Faculty Presenter: Frank Dowling, MD
The educational Objectives for the Suicide program are:

1) Address the causes and warning signs of suicide and suicidal behavior among veterans.
2) Explore the best evidence-based diagnostic and treatment options available including psychotherapy and pharmacotherapy.
3) Identify barriers in military culture to identification and treatment and how to overcome them.

Substance Use Disorders Among Returning Veterans
Saturday, May 6, 10:45 a.m.
Faculty Presenter: Adolph Meyer, MD
The educational objectives for the Substance Use Disorders program are:

1) Explain substance use disorders (SUDs), symptoms, warning signs, comorbidities
2) Explore treatment options for veterans including evidence-based practices in psychotherapy and pharmacotherapy
3) Identify barriers to identification and treatment, including those unique to military culture, and how to overcome them

The presentation is part of Veterans Mental Health Training Initiative, which is supported by a grant provided by the New York State Legislature and administered through the New York State Office of Mental Health.

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

Further information or for assistance in registering for these programs, contact Greg Elperin at gelperin@mssny.org.

Trans-Fat Ban Linked to Reduction in New York’s CVD Admissions
Banning the use of trans-fatty acids in some New York counties coincided with a decline in admission rates for cardiovascular disease, JAMA Cardiology reports.

Researchers compared admission rates for the composite of myocardial infarction and stroke between New York counties implementing the ban in its eateries versus those that did not. The restricting counties showed an additional 6% drop in admissions relative to non-restricting counties after adjustment for an already-declining trend across the state. The difference became significant 3 years after implementation of the bans and benefitted men and women equally.

Of note, in 2015, the FDA mandated that food manufacturers remove partially hydrogenated oils from their products by mid-2018.

JAMA Cardiology article

Dietary & Lifestyle Strategies in Cardiovascular Risk Reduction – Half Day!

Friday, May 12, 2017, 8:00 AM – 1:30 PM

To Register and for more information, click here.

  • Diet and lifestyle are crucial components in the development and progression of cardiovascular disease (CVD), but are underemphasized in the educational training of most health care providers. This course will review the evidence for diet and cardiovascular disease including recent guidelines, analyses and controversies while providing practical counseling advice for assessing and implementing change to patients’ diets and lifestyle patterns. The evidence for dietary supplements will be reviewed as well as the evidence for exercise and how to appropriately and safely prescribe an exercise regimen for the prevention and treatment of cardiovascular disease. Attendees will learn specific time- efficient strategies to assess patients’ diet, use technology and motivational strategies for greater patient engagement and convey basic dietary advice within the time constraints of an office visit.

The NYU Post-Graduate Medical School designates this live activity for a maximum of 5.00 AMA PRA Category 1 Credits™. Physicians should claim only the credit commensurate with the extent of their participation in the activity. ​



CLASSIFIEDS


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Luxurious Medical Office Space to Share in Manhattan
Spacious and modern wellness office suite off 5th avenue, near grand central, and all major subway lines. Newly renovated space catering to the needs of various health practitioners and their clients (vision, chiropractors, acupuncturists, psychologists, nutritionists, etc.) 13 foot ceilings throughout. Two spacious waiting areas, elegantly furnished. Two bathrooms en suite. Fully equipped kitchen/pantry area. Two elevators. Free coffee/tea station, hot/cold water cooler, free mail sorting services. Windowed offices starting from $2,800. Utilities, cleanings and high speed internet. Call: 570-499-5851 / email: columbuslaservision@gmail.com


Physician Opportunities

Internist Needed Mon.-Fri. for Psychiatric Inpt in Queens
Internist needed for Full time general medical care of psychiatric inpatients.  Creedmoor Psychiatric Center is in Queens, and convenient to NYC, Nassau/Suffolk and near major transportation.  We are a small well organized Medical Department looking for another member.  Our physicians enjoy their work- life balance. Please contact: alan.diner@omh.ny.gov or call 718-264-4046

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

Council Meeting – April 23, 2017

AGENDA
Council Meeting
Sunday, April 23, 2017
Westchester Marriott, Tarrytown, NY

A.          Call to Order and Roll Call

B.          APPROVAL of the Council Minutes of March 7, 2017

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

        1. President’s Report
          Please welcome our MSSNY Officers, Councilors, Trustees, County Execs, MSSNY Staff and the following new MSSNY Councilors:

          Janine Fogarty, MD
          – Monroe County Medical Society Councilor

          Justin Fuehrer, DO
          – Resident & Fellow Section Councilor

          Pratistha Koirala
          – Medical Student Section Councilor

          Bonnie Litvack, MD
          – Organized Medical Staff Section Councilor

          a.  APPROVAL – 2017/2018 Meeting Schedule
          b. APPROVAL – 2017/2018 Committee Appointments

        2. Board of Trustees Report
          – No report – Board meets after Council

D.           Commissioners (All Committee & Sub-Committee
                Informational Reports/Minutes  
(No reports submitted)

E.           Reports of Officers (Verbal Reports)

        1. Office of the President
          Charles Rothberg, MD
        2. Office of the President-Elect
          Thomas J. Madejski, MD, FACP
        3. Office of the Vice President
          Arthur C. Fougner, MD
        4. Office of the Treasurer
          Joseph R. Sellers, MD, FAAP, FACP
          Financial Statement for the period January 1, 2017 March 31, 2017
        5. Office of the Secretary
          Frank G. Dowling, MD
        6. Office of the Speaker
          Kira A. Geraci-Ciardullo, MD, MPH

F. Reports of Councilors (Informational)
1.    Nassau County Report    
2.    Kings/Richmond Report 
3.    Seventh District Branch Report               
4.    Suffolk County Report                   
5.    Fifth District Branch Report 
6.    Sixth District Branch Report
 7.    Ninth District Branch Report
8.    Manhattan/Bronx Report                   

G.  Report of the Executive Vice President

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

H.  Other Information/Announcements

  1.      Final version of the penalty sign-on letter
  2.     AMA/MSSNY Sign On Letter – 3 Hour CME Program

 I.  Adjournment

 

April 7, 2017 – Take Required 3-Hour Opioid Course Now! Click Here

Dr. Reid - MSSNY President
PRESIDENT’S MESSAGE
Dr. Malcolm Reid
April 7, 2017
Volume 17
Number 14

MLMIC Insurance

Dear Colleagues:

New York State requires every prescriber, who has a DEA license, to take a three (3) hour continuing medical education (CME) program in Pain Management, Palliative Care and Addiction medicine by July 1, 2017 and every three years after that.

The Medical Society of the State of New York has developed an online program that meets New York State’s coursework requirements.   The on-line course is now available at cme.mssny.org

The MSSNY course includes the eight (8) statutory topics:

  • New York State and federal requirements for prescribing controlled substances
  • Pain Management
  • Appropriate prescribing
  • Managing acute pain
  • Palliative medicine
  • Prevention, screening and signs of addiction
  • Responses to abuse and addiction
  • End of life care

MSSNY’s CME program was developed in conjunction with the NYS Office for Alcoholism and Substance Abuse Service.   The NYS Department of Health’s Bureau of Narcotic Enforcement lists the Medical Society of the State of New York as an accredited provider for this coursework.

In 2014, the American Medical Association , the Medical Society of the State of New York and more than 25 states, specialty and other health care associations joined together to create a task force to help reduce the nation’s burden from prescription opioids and heroin.   We believe that a comprehensive public health approach is needed to address prescription opioid-related harm and the growing heroin epidemic.   This is an issue of high importance to the profession. This interest is reflected by the fact that nearly every state has considered—and enacted—multiple pieces of legislation to address this problem.

More than 16,000 patients annually suffer an unintentional overdose and death from opioid analgesics, and more than 8,000 deaths occur annually from heroin overdoses.  MSSNY’s course discusses the safe and effective prescribing practices; approaches to treating pain, ways to respond to abuse and treatment and how to prevent, screen and recognize the signs of addiction.

We urge you to take the MSSNY 3 Hour CME program on Pain Management, Palliative Care and Addiction and join your colleagues in helping to combat the opioid epidemic.

Sincerely,

Malcolm Reid, MD, MPP
MSSNY President

Patrice Harris, MD
Chair, AMA Board of Trustees
Chair, AMA Task Force to Reduce
Opioid Abuse

Please send your comments to comments@mssny.org



Final Budget Deal Remains Elusive – Legislature and Governor Enact 2-Month Budget Extender
A final budget deal has remained elusive in Albany.  As of this writing, many major items, including raising the age of criminal responsibility, affordable housing tax credits in New York City and funding for schools remain unfinished. The adage in Albany is “nothing is decided until everything is decided.”

On Monday, the State Legislature enacted a two month “bare bones” budget extender, until May 31, after “round the clock” weekend negotiations at the State Capitol failed to produce a State Budget agreement. The State Budget was due April 1, and the budget extender was necessary to fund state operations. The Budget extender bill included several substantive health policy issues. New York became the first state to cap the growth of prescription drug spending in its Medicaid program.  The bill also included $2.5 Billion in funding for a Clean Water Infrastructure Initiative.

Importantly, the Budget extender included language that extended authority for the Excess Medical Malpractice Insurance program from July 1, 2017 through June 30, 2018 without the language opposed by MSSNY that would have required a physician to receive a “tax clearance” as a pre-condition of receiving Excess coverage.  The historical funding ($127.4 million) contained in the Executive Budget proposal and agreed to by the Senate and Assembly (in its respective one-House Budgets) was included in a separate bill that passed both houses.

Many other items that MSSNY advocated against were not included in any agreed upon budget bills yet.  These proposals include:

  • A proposal opposed by MSSNY contained in the Executive Budget that would permit pharmacists to enter into “comprehensive medication management protocols” with nurse practitioners to manage, adjust and change the medications of patients with a chronic disease or who have not met clinical goals of therapy. Both the Assembly and Senate rejected this proposal in their respective one-House Budgets adopted last month.
  • A proposal opposed by MSSNY contained in the Executive Budget that would repeal “Prescriber prevails” protections in fee for service Medicaid and for several drug classes in Medicaid managed care.  Both the Assembly and Senate rejected this proposal in their respective one-House Budgets.
  • A proposal opposed by MSSNY contained in the Executive Budget to create a Regulatory Modernization Team.  The Assembly rejected the proposal in its one-House Budget, while the Senate included language to greatly narrow its focus and powers.
  • A proposal supported by MSSNY in the Executive Budget to regulate PBMs.
  • A proposal supported by MSSNY in the Executive Budget to regulate and tax e-cigarettes.
    (DIVISION OF GOVERNMENTAL AFFAIRS)


Workers’ Compensation – Reform Provisions Likely to Be Included in State Budget
MSSNY Governmental Affairs staff has been engaged in discussions with the Assembly and Senate to urge that numerous problematic proposals to reform the Workers Compensation system be rejected.   These damaging proposals would limit patient choice of their treating physician, give greater discretion to the Board to impose financial penalties on WC-authorized physicians, and limit the ability of county medical societies to assist local physicians in completing applications to become WC-authorized.

Moreover, there are proposals to expand the use of non-physicians in Workers’ Compensation without sufficient physician collaboration.  MSSNY has argued that such provisions would drive physicians away from the program, and would not reduce premium costs.  Instead, we have urged that there should be efforts to reduce administrative hassles in the Workers Compensation program.

MSSNY thanks the many physicians and county medical society leaders who contacted their legislators to oppose these measures.

Other issues under consideration include a prescription formulary, expanded requirements for “Independent Medical Examiners (IME), revising the impairment guidelines and expediting hearings.

Without lawmakers passing a final budget bill — what is known as the “big ugly” in Albany, all issues still hang in the balance.  Final agreements are still in flux as budget negotiations between the Legislature and Governor continue as they work towards a three-way agreement for a final budget.   Please check MSSNY’s website and next week’s edition of “Capital Update” for additional budget updates.
(DIVISION OF GOVERNMENTAL AFFAIRS)

Federal Health Care Discussions Continue
In an interview with the New York Times, President Trump indicated that the White House is still working on health care reform and that it remains a continuing negotiation.  There have been other reports that a new proposal being pushed by the Freedom Caucus would give states the option to opt out of provisions that require insurers to cover a standard, minimum package of benefits, known as the essential health benefits and do away with the requirement that insurance companies charge the same price to everyone who is the same age, a provision called community rating.

Instead there are proposals to add to the AHCA legislation before Congress $15 billion to subsidize “high risk” pools.  Some moderate Republicans have already expressed concern stating they want to preserve the provisions of the Affordable Care Act, which bars insurers from denying coverage to people with pre-existing medical conditions.
(BELMONT)

MSSNY Joins AMA and Federation of Medicine in Urging CMS to Create Hardship Waivers for 2016 Reporting Obligations
MSSNY joined nearly 90 other state medical and national specialty associations in a letter initiated by the AMA urging that CMS create “hardship waivers” for physicians to prevent imposition of Medicare payment penalties for failing to satisfactorily complete participation of the Meaningful Use (MU) and PQRS programs in 2016.

As many physicians are aware, failing to have satisfactorily complied with the cumbersome MU and PQRS programs in 2016 could result in penalties that will produce significant cuts to a physician’s Medicare payments in 2018.  2016 was the last year for physicians to have to comply with the old MU, PQRS and Value Based Modifier (VBM) programs, as the new Medicare Merit-Based Incentive Payment System (MIPS) takes effect this year and will impact Medicare physician payments in 2019.

Specifically, the AMA-medical societies’ letter to CMS notes that the societies are “grateful the agency recognized there were a number of challenges with the requirements of MU, PQRS, and VM. Consequently, we urge the Administration to take a series of steps to address these same challenges in MU, PQRS, and VM prior to their replacement by MACRA and minimize the penalties assessed for physicians who tried to participate in these programs. Clearly this would send a strong message to the physician community about the extensive regulations with which physicians have been dealing and the Administration’s commitment to reduce the burden”.

Specifically, the letter requested that CMS:

  • create a hardship exemption that would allow physicians who successfully reported on any number of PQRS measures in 2016 to avoid the 2% penalty in 2018; and
  • protect physicians from additional penalties of up to 4% under the VBM Program, urging that any physician who avoided the PQRS penalty in 2018 should be exempt from any VBM penalties as well.   (AUSTER)

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



MSSNY Joins Patient Advocacy Organizations to Oppose Proposals to Cut Part B Medication Reimbursement
MSSNY has once again joined nearly 200 patient and physician advocacy groups across the country in a letter here sent to the Medicare Payment Advisory Commission (MedPAC) expressing strong concerns with a proposal under MedPAC consideration to reduce reimbursements for medications provided by physicians to patients under Medicare Part B.  Similar proposals to reduce Part B medication reimbursement were advanced by CMS last year, but were pulled back due to substantial opposition from many members of the US Congress as well as many patient and physician advocacy organizations including MSSNY.

The letter notes that “the recommendations MedPAC is proposing could accelerate the problem in ways that make care more difficult to obtain, potentially forcing changes to treatment plans that are working well for patients.   Currently, Medicare Part B offers beneficiaries broad access to infused therapies, allowing patients and their doctors to decide which treatments are best.”

The letter further notes its specific concerns with the MedPAC proposals, including that:

  • Some providers, particularly those in small or rural practices would be unable to provide certain medicines if reimbursements are reduced or blended through consolidated billing codes.
  • Patient safety could be harmed if proposals to blend coding and reimbursement for biologics or therapeutically similar treatments go forward because it will be more difficult to track and attribute adverse events.
  • Proposals to blend coding and reimbursement for Part B medicines or establish arbitrary reimbursement caps through an inflation limit could stifle innovation in the next generation of Part B treatments, including biosimilars, which are expected to generate savings for beneficiaries and the Medicare program.
  • the MedPAC proposal to create a new “Drug Value Program” leaves a number of critical questions unanswered, and as proposed could harm patient access by imposing new restrictions on Part B therapies. (AUSTER)


Register Now for Veterans’ Mental Health CME Seminars at the MSSNY House of Delegates
The Medical Society of the State of New York will hold two Continuing Medical Education (CME) seminars on veterans’ mental health as part of the MSSNY House of Delegates on Thursday, April 20, 2017 from 1-3 p.m. Entitled, “PTSD and TBI in Returning Veterans” and “Suicide Among Returning Veterans.”  The programs will be held at the Grand Ballroom D&E of the Westchester Marriott, 670 White Plains Road, Tarrytown, NY.  The programs are open to MSSNY delegates and physicians throughout the area free of charge.

Pre-registration is required and physicians may register for both programs at:

PTSD and TBI: https://mssny.webex.com/mssny/k2/j.php?MTID=tbdb5295479d5ee1865aab56f91a2ca59

Suicide: https://mssny.webex.com/mssny/k2/j.php?MTID=tcd75a710181bbd6dd4034a6625500151

Faculty for the CME programs are Frank Dowling, MD and Thomas Madjeski, MD.

PTSD and TBI

Thursday, April 20, 1 pm
Faculty Presenter: Thomas Madjeski, MD
The educational Objectives for the PTSD program are:

1) Describe the symptoms of PTSD and TBI.
2) Describe the treatment modalities of PTSD and TBI.
3) Describe military culture & how to overcome unique barriers to treatment intrinsic to military culture

Suicide

Thursday, April 20, 2 pm
Faculty Presenter: Frank Dowling, MD
The educational Objectives for the Suicide program are:

1) Address the causes and warning signs of suicide and suicidal behavior among veterans.
2) Explore the best evidence-based diagnostic and treatment options available including psychotherapy and pharmacotherapy.
3) Identify barriers in military culture to identification and treatment and how to overcome them.

Veterans Matters is a CME series made possible through a grant from the New York State Office of Mental Health.

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

The Medical Society of the State of New York designates each 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.
(ELPERIN, CLANCY)

Registration Now Open for CME Webinar on Concussion in Pediatric and Adult Population
The Medical Society of the State of New York will hold a Continuing Medical Education (CME) webinar on the “Current Concepts in Concussion for Pediatric & Adult Patients” on Wednesday, April 19, 2017 at 1 p.m. for all physicians and other health care providers.  Registration for the webinar is now open HERE.

A copy of the flyer can be found HERE.

Faculty for the course will be John Anthony Pugh, MD, PhD, assistant professor of Neurology at Albany Medical Center (AMC), and Deborah Ilana Light, MD, primary care sports medicine and associate program director for the Sports Medicine Fellowship at Albany Medical Center.  Educational objectives are: 1) Identify signs and symptoms indicative of concussion as well as red flags that indicate alternate or more severe pathology; 2) Outline an appropriate management plan for a patient presenting with concussion including a return to “normal life” protocol; 3) Describe methods for the primary and secondary prevention of concussion; 4) Identify patients who would benefit from referral to a concussion specialist. 

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

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

Task Force Releases New Recommendation To Promote Safe Storage And Disposal Of Medications
The AMA Task Force to Reduce Opioid Abuse released new recommendations urging physicians to make increased efforts to raise awareness about safe storage and disposal of expired, unwanted or unused medications. The recommendations emphasize three steps for physicians to take:

  1. Talk to your patients and educate them about safe use of prescription opioids to help prevent misuse and diversion;
  2. Remind patients that medications should be stored out of reach of children and in a safe place; and
  3. Urge patients to safely dispose of expired, unwanted and unused medications.

The Task Force also pointed to several resources that physicians and patients can use to search for drug disposal locations.  The Medical Society of the State of New York is a member of the AMA’s Task Force.

For more information, and to download a copy of the new Task Force recommendation, visit www.ama-assn.org/opioids-disposal
(CLANCY)

Nominations Sought:  2016 Bernstein Award
The Medical Society of the State of New York is accepting nominations for the 2016 Albion O. Bernstein, MD Award.  This prestigious award is given to:  “the physician, surgeon or scientist who shall have made the most widely beneficial discovery or developed the most useful method in medicine, surgery or in the prevention of disease in the twelve months prior to December, 2016.”

This award was endowed by the late Morris J. Bernstein in memory of his son, a physician who died in an accident while answering a hospital call in November, 1940.   The $2,000 award will be presented to the recipient during a MSSNY Council Meeting.  Nominations must be submitted on an official application form and must include the nominator’s narrative description of the significance of the candidate’s achievements as well as the candidate’s curriculum vitae, including a list of publications or other contributions.   To request an application, please contact: 

Committee on Continuing Medical Education
 Miriam Hardin, PhD, Manager, Continuing Medical Education
Medical Society of the State of New York
99 Washington Avenue, Suite 408
Albany, NY 12210
518-465-8085
mhardin@mssny.org

DEADLINE FOR NOMINATIONS:  May 31, 2017                                          (HARDIN)


CDPHP Workforce Team Challenge Running Event.  Please Join Us!
MSSNY will be a premium sponsor of the 2017 CDPHP Workforce Team Challenge, a 3.5-mile race for runners and walkers, taking place in Albany on May 18, 2017.  MSSNY’s sponsorship of the event is part of an ongoing effort to have a visible presence at health-related public events.  The CDPHP Workforce Team Challenge, which caps participation at 10,000 registrants, is known for reaching capacity each year.  Many Capital District health-related organizations participate annually.  As a premium sponsor, MSSNY’s logo will be featured on the official race t-shirt, and MSSNY will be recognized during the race announcements.  In addition, MSSNY will have an exhibit table on Empire State Plaza.

The race begins at 6:25 PM, at Empire State Plaza, and features a scenic route that traverses Albany’s Washington Park.  The popular event always attracts great crowd support and on-course entertainment.  Sawyer Fredericks, winner of the eighth season of The Voice, will be singing the National Anthem.

Instructions and registration link are available here.  MSSNY members and alliance members are highly encouraged to participate on our team, either as a runner or a walker.  Please choose “Medical Society of the State of New York” from the team drop-down list.  Registration is $24, and a portion of the registration fees go to this year’s “Charities of Choice,” Boys and Girls Club of Albany and Vanderheyden.   Registration deadline is May 1, 2017. A flyer may be accessed here.  For more information, please contact Miriam Hardin (mhardin@mssny.org).                                                                                                (HARDIN)

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

enews large


Pain Management, Palliative Care and Addiction Online Program Now 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

DOH Announces Attestation Process for Mandatory Prescribers
The New York State Department of Health has announced the attestation process for prescribers. 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 here.
  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 applied 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.

Dr. Bill Valenti Publishes Book on NY’s Early AIDS Epidemic at drbillvalenti.com
          All Proceeds Go to Trillium Health End the Epidemic Fund
Bill Valenti, MD, has dedicated his life and career to ending the HIV/AIDS epidemic and rightfully earned his reputation as a medical maverick and pioneer in HIV prevention, research and policy.

A Clinical Associate Professor of Medicine (Infectious Diseases) at the University of Rochester  School of Medicine, Dr Valenti has authored more than 150 peer-reviewed articles, book chapters, and scientific abstracts on HIV medical care, infectious diseases, and healthcare epidemiology and infection control. In the early 1980s, he would see AIDS patients in his office in the evening, after the staff left.

Dr. Valenti has served the first chair of MSSNY AIDS Advisory Panel (now the Infectious Disease Committee) since the early 90s.  The MSSNY Advisory Panel was one of the first formal committees nationwide to begin a medical discussion of this epidemic. Dr. Valenti has devoted countless hours to educating his peers for MSSNY .

From the prologue: By 1986, there were 10,000 cases of AIDS reported in the U.S. The fatality rate was 75 percent. That same year, Jackie Nudd, executive director of AIDS Rochester, and I went to Auburn State Prison to do an educational program for prison staff. Almost 200 cases had been reported in New York State prisons by that time. Condoms weren’t allowed, so we couldn’t talk about sex in prisons. We promoted HIV testing, but testing was complicated in the corrections system, and it would be another year before AZT would be available. They served us lunch for our efforts. It’s true what they say about prison food.

Medscape Physician Salary Survey: North Dakota Physicians Earn Most!
The nation’s physicians earned an average of $294,000 a year, according to Medscape’s 2017 compensation survey. Orthopedists continued to be the best paid, with an average salary of $489,000, while family physicians and pediatricians stayed on the bottom rungs with average salaries of $209,999 and $202,000, respectively.

Despite higher costs in big cities, doctors in rural areas earned the most. According to the survey, physicians in North Dakota were the best paid, with an average income of $361,000. “It’s a supply-and-demand issue,” said Dr. Michael Smith, medical director and chief medical editor for WebMD/Medscape.

Most physicians saw their pay rise from the previous year. Plastic surgeons fared the best, with a 24% increase to $354,500, while pediatricians saw their pay decline by 1%. Both primary care docs (45%) and specialists (33%) thought they should earn more, and almost 20% said they’re working longer hours for less money. But most doctors said they wouldn’t trade in their stethoscopes. Nearly 8 out of 10 (77%) said they’d choose a medical career again, compared with just 64% last year.

Medscape surveyed 19,200 physicians in 26 specialty areas between Dec. 20, 2016, and March 7, 2017.

First LGBTQ Center to Open in Downtown Brooklyn
The Callen-Lorde Community Health Center has signed a 20-year lease in Brooklyn that will allow it to expand its health services to the LGBTQ community in 2019. The 25,000 square foot space at 40 Flatbush Avenue Extension in downtown Brooklyn will be the organization’s first health center in the borough. Currently, about 30% of its patients travel from Brooklyn to their clinics in the Bronx and Manhattan, said Wendy Stark, executive director of Callen-Lorde.

“LGBTQ communities are in dire need of competent health care services, and we see proof of that every day in the numbers of callers we have,” she said. “We’ve expanded our capacity to the outer limits.”

For example, the Bronx clinic, which opened in July 2016, currently has a waiting list for appointments stretching until early summer, she said. (Crains)


New York AG Joins Whistleblower Lawsuit against AstraZeneca
On March 31, New York Attorney General Eric Schneiderman joined a whistleblower lawsuit against AstraZeneca’s MedImmune unit that accuses the company of creating “baby leads” for sales of its Synagis treatment for severe respiratory illness in premature infants. The lawsuit claims MedImmune gathered “private information from patient logbooks” and shared it with a specialty pharmacy Trinity Homecare, which then contacted the babies’ families or physicians “regardless of patient need or if the current physician sought a prescription.”

In its complaint that intervened in a whistleblowing nurse’s 2009 lawsuit, Attorney General Eric Schneiderman said that MedImmune’s sales representatives paid kickbacks to Trinity Homecare LLC from 2007 to 2011 by passing along “baby leads.” STAT (4/4)

MAC Satisfaction Indicator (MSI) – JK Now Available!
Evaluate Our Services in 10 Minutes!
The MAC Satisfaction Indicator (MSI) is the best way to share your opinions of our service directly with the Centers for Medicare & Medicaid Services (CMS). This survey should only take 10 minutes of your time and helps us understand how we can better serve you. To take the survey, click on the URL below:

Jurisdiction K providers may access the survey at 2017 Jurisdiction K MSI Survey

We found your 2016 feedback helpful, and we made improvements to our services. You can read about some of the changes in an article titled, “Feedback-Based Improvements from the 2016 MSI Survey“, which can be found on the NGSMedicare.com website under News & Alerts. Thank you for your feedback.

Register Now for Merit-based Incentive Payment System (MIPS) Group Web Interface and CAHPS Reporting
Groups Must Register to Utilize the CMS Web Interface and/or CAHPS for MIPS Survey by June 30, 2017. Groups participating in the Merit-based Incentive Payment System (MIPS) track of the Quality Payment Program are not required to register, except for groups that intend to utilize the CMS Web Interface and/or administer the Consumer Assessment of Healthcare Providers and Systems (CAHPS) for MIPS survey. To register, please visit the Quality Payment Program website.
The registration period is from April 1, 2017 through June 30, 2017.

Under MIPS, a group is defined as a single Taxpayer Identification Number (TIN) with two or more eligible clinicians (including at least one MIPS eligible clinician), as identified by their National Provider Identifiers (NPI), who have reassigned their billing rights to the TIN. Eligible clinicians who participate as a group will be assessed at a group level across all four MIPS performance categories. The group will receive one payment adjustment for the group’s performance.

Note: Groups that participate in a Shared Savings Program ACO are not required to register or report; the Shared Savings Program ACO is required to report quality measures on behalf of participating eligible clinicians for purposes of MIPS.

For 2017, only groups of 25 or more eligible clinicians that have registered can report via the CMS Web Interface. Groups that participate in MIPS through qualified registry, qualified clinical data registry, or electronic health record data submission mechanisms do not need to register. For 2017, only groups of 2 or more eligible clinicians that have registered can participate in the CAHPS for MIPS survey.

As a courtesy, CMS automatically registered groups for the CMS Web Interface for the 2017 performance period that previously registered for group reporting under the Physician Quality Reporting System (PQRS) via the Group Practice Reporting Option (GPRO) Web Interface. If you need to remove your registration for Web Interface submission because your group now has fewer than 25 eligible clinicians, you should cancel your registration. If your group wants to administer the CAHPS for MIPS survey, your group will need to make an election via the registration system.

The registration period for groups who choose Web Interface or CAHPS for MIPS Survey as their data submission method is April 1 June 30, 2017.

Note: For individual or group participation, registration is not required for any other submission method.

How to Register

To register, visit Quality Payment Program website. You will need a valid Enterprise Identity Management (EIDM) account with a Physician Value � Physician Quality Reporting System (PV-PQRS) role in order to register.

EIDM Account Information

Open a New Account: To create or modify an EIDM account, review the Guide for Obtaining a New EIDM Account.

Reactivate an Account: To reactivate or confirm the status of an account, contact the Quality Payment Program at 1-866-288-8292 (TTY: 1-877-715-6222) or qpp@cms.hhs.gov, Monday-Friday 8:00am-8:00pm EST and provide the group name and TIN.

Use a Current Account:To request a role to access the Physician Quality and Value Programs application in the CMS Enterprise Portal, review the Guide for Obtaining a Physician Quality and Value Programs Role for an Existing EIDM User. 

CMS Quality Measure Public Comment Announcement: Quality Measure Development and Maintenance for CMS Programs Serving Medicare-Medicaid Enrollees and Medicaid-Only Enrollees
Mathematica Policy Research is seeking public comment on a measure specification and justification for a quality measure called Healthy Days in the Community that is currently under development and testing for potential use by the Centers for Medicare & Medicaid Services (CMS) and State Medicaid agencies.  This is a measure of the average number of days within a year that dual eligible beneficiaries are alive and residing in the community without utilizing acute or post-acute health care services.

A memo listing questions on which we request public comment, as well as the measure information form (MIF) and measure justification forms (MJF), are available in a zip file in the Download section on this web page: https://www.cms.gov/Medicare/Quality-Initiatives-Patient-Assessment-Instruments/MMS/CallforPublicComment.html

The public comment period runs from March 27, 2017 to April 14, 2017.  If you wish to comment on these measures, please submit your comments by close of business April 14, 2017 to MedicaidQualMeasures@mathematica-mpr.com.



CLASSIFIEDS


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


Luxurious Medical Office Space to Share in Manhattan
Spacious and modern wellness office suite off 5th avenue, near grand central, and all major subway lines. Newly renovated space catering to the needs of various health practitioners and their clients (vision, chiropractors, acupuncturists, psychologists, nutritionists, etc.) 13 foot ceilings throughout. Two spacious waiting areas, elegantly furnished. Two bathrooms en suite. Fully equipped kitchen/pantry area. Two elevators. Free coffee/tea station, hot/cold water cooler, free mail sorting services. Windowed offices starting from $2,800. Utilities, cleanings and high speed internet. Call: 570-499-5851 / email: columbuslaservision@gmail.com



Prime NYC Space for Rent
Prime Midtown Manhattan space two blocks away from Grand Central Station
next to Park Ave. 3100 RSF with nine windows in a professional building filled with MDs and DDSs. $59/RSF please inquire at wnyllc@aol.com


Physician Opportunities

Internist Needed Mon.-Fri. for Psychiatric Inpt in Queens
Internist needed for Full time general medical care of psychiatric inpatients.  Creedmoor Psychiatric Center is in Queens, and convenient to NYC, Nassau/Suffolk and near major transportation.  We are a small well organized Medical Department looking for another member.  Our physicians enjoy their work- life balance. Please contact: alan.diner@omh.ny.gov or call 718-264-4046

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

March 31, 2017 – Are You a Happy Physician?

Dr. Reid - MSSNY President
PRESIDENT’S MESSAGE
Dr. Malcolm Reid
March 31, 2017
Volume 17
Number 13


MLMIC Insurance

Dear Colleagues:

Yesterday was National Physicians Day and I hope you took a minute to think about how fortunate we are to be living out a teenage dream.

According to a 2012 Bureau of Labor Statistics study, being a doctor is still in the Top 15 careers that kids aspire to. We may be behind astronauts and rock stars in the glamour area, but you can only go to the moon once and unless you are Chuck Berry or Mick Jagger, most rock musicians quietly age out of their careers. Unlike most professions, most of us can practice for as long as we want and still feel vital to our patients. When physicians complain to me about the profession, I feel empathy for them. However, I feel compelled to ask them, “What would you rather be doing? What is better than healing people?”

Most of my colleagues know that I have a lifelong, time-consuming hobby—trains. Over a period of many years, I have built a replica of a city with all of its charms and dangers. However, I try to bring that same passion for my hobby to my “real job.” Every day is a new challenge —new patients, returning patients (“all roads lead to rehab”); in addition, this year I am head of the medical staff at my hospital, which is another major commitment. MSSNY EVP, Phil Schuh (another hardworking fellow) recently asked me how I find the time to fulfill my commitments. I told him the truth— this is one of the best years in my professional career. Yes, I get up early and go to bed late, just like most of you do. I do the most important things first and other matters seem to fall into place. Yes, I have a good support staff and I have a very supportive wife and children. That helps a lot.

Recently, Physician Burnout has become a big topic. Shortly, MSSNY  will have a library of resources on their website on burnout.  If you are feeling exhausted, unfulfilled and cynical, you will be able to read through the sections and if you see yourself in the descriptions, please seek help. We need all of our physicians working at the top of their game.

My good wishes for a happy Doctor’s Day are a day late (Friday is Enews day!). In an ideal world, every day for us should be a good day. Do I practice in an environment of ridiculous documentation requirements, time-consuming prior authorizations, CMS requirements and yes, some challenging patients? Yes, I do.

We have all overcome tremendous obstacles to become physicians and live out our dream.

Every day is a challenge—that is what I look forward to.

I hope you do, too.

Please send your comments to comments@mssny.org



Legislature and Governor Work to Finalize State Budget; Your Action Needed!
As of this writing, the State Legislature and Governor were going to be working into the weekend to finalize a State Budget that is due April 1.  Delaying final agreement were outstanding disputes regarding a number of policy areas, including: raising the age of criminal responsibility; ride-sharing, funding for schools; and college tuition assistance.

Of particular concern to MSSNY are workers’ compensation reform proposals under serious discussions under the guise of reducing business WC premium costs that would harm injured workers access to care from WC-authorized physicians.  Physicians are urged to send a letter to their legislators by clicking here.

These damaging proposals would limit patient choice of their treating physician, give greater discretion to the Board to impose financial penalties on WC-authorized physicians, and limit the ability of county medical societies to assist local physicians in completing applications to become WC-authorized.  Moreover, there are proposals to expand the use of non-physicians in Workers Compensation.  MSSNY has strongly urged the Legislature to reject these measures, as they would not help to reduce premium costs, and would simply drive more and more physicians away from the program.  Instead, the Legislature should focus on measures that would address the many administrative hassles associated with Workers Compensation that has driven many physicians away from the program.

Some of the other important Budget items under discussion for which MSSNY continues to engage with legislators include:

  • A proposal opposed by MSSNY contained in the Executive Budget proposal that would require a physician to receive a “tax clearance” as a pre-condition of receiving Excess medical malpractice insurance coverage.  Both the Assembly and Senate rejected this proposal in their respective one-House Budgets adopted earlier this month;
  • A proposal opposed by MSSNY contained in the Executive Budget that would permit pharmacists to enter into “comprehensive medication management protocols” with nurse practitioners to manage, adjust and change the medications of patients with a chronic disease or who have not met clinical goals of therapy. Both the Assembly and Senate rejected this proposal in their respective one-House Budgets adopted earlier this month.
  • A proposal opposed by MSSNY contained in the Executive Budget that would repeal “Prescriber prevails” protections in fee for service Medicaid and for several drug classes in Medicaid managed care.  Both the Assembly and Senate rejected this proposal in their respective one-House Budgets.
  • A proposal opposed by MSSNY contained in the Executive Budget to create a Regulatory Modernization Team.  The Assembly rejected the proposal in its one-House Budget, while the Senate included language to establish a workgroup but narrowed the scope, deleting the topic included in the Executive Budget proposal of revising “scope of practice” laws and deleting provisions that would give power to various agency commissioners to implement demonstration programs without the need for legislative approval.
  • A proposal supported by MSSNY contained in the Executive Budget proposal to require the registration of PBMs and to disclose financial incentives to the State.
  • A proposal supported by MSSNY included in the Executive Budget proposal to regulate vapor products under the “Clean Indoor Air” Act and to tax these products. (DIVISION OF GOVERNMENTAL AFFAIRS)


Assembly Codes Committee to Consider Physician Collective Negotiation Legislation
The Assembly Codes Committee will be considering legislation (A.4472, Gottfried) next week strongly supported by MSSNY to permit independently practicing physicians to collectively negotiate patient care contract terms with health insurance companies under close state supervision.  The bill, which has 60 Assembly co-sponsors, was recently advanced from the Assembly Health Committee to the Codes Committee by a 21-3 vote.    The bill would help physicians to negotiate on behalf of their patients to reduce the myriad of administrative hassles that stand in the way of patients receiving the treatment and medications they need, as well as better ensuring that health insurers have comprehensive physician networks.  Substantially similar legislation has been introduced by Senate Health Committee Chair Kemp Hannon (S.3663).  
(
AUSTER, BELMONT)

Assembly Passes Network Due-Process and Uniform Credentialing Bills
The New York State Assembly passed two managed care reform bills this week supported by MSSNY.

The first bill (A.2704 Lavine) would require health insurers to provide physicians with necessary due-process protections where health insurers seek to terminate a physician from its network by failing to renew the physician’s contract.   This legislation is in part a response to recent examples of health insurance companies dropping scores of physicians from their networks.  While current law prohibits a health insurer from terminating a physician’s contract without appropriate peer review of such termination, these protections do not apply to situations involving the non-renewal of a physician’s contract.    Identical legislation (S.3943) has been introduced by Senate Health Committee Chair Kemp Hannon.   The second bill (A.2389, Gottfried) that passed the Assembly this week would ease the administrative hassles of physicians and their staff by requiring all health insurers to use the same credentialing and re-credentialing forms.  MSSNY thanks the sponsors for advancing these important bills.    (AUSTER)

President’s Commission on Combating Drug Addiction and the Opioid Crisis Established by Executive Order
President Donald Trump has established the Commission on Combating Drug Addiction and the Opioid Crisis by executive order.   The commission’s goal is “to study the scope and effectiveness of the federal response to drug addiction and the opioid crisis” and issue recommendations to improve the response.  Specific areas for commission action include:  (1) identifying and describing existing federal funding to combat drug addiction and the opioid crisis; (2) identifying and reporting on addiction prevention best practices, including education of providers, evaluation of prescription practices and use of state prescription drug monitoring programs; (3) assessing drug addiction treatment services and overdose reversal and identifying underserved areas; (4) issuing recommendations to improve federal programs to prevent and treat drug addiction; and (5) making recommendations to the president to improve the federal response to drug addiction and the opioid crisis.  Interim recommendations are due within 90 days and a final report is due by October 1, 2017.  The commission is chaired by New Jersey Governor Chris Christie (R) and includes representatives of federal agencies, including the Departments of Justice, Education, Veterans Affairs, Health and Human Services, the Drug Enforcement Administration, the Office of National Drug Control Policy, and experts and private citizens affected by drug addiction and the opioid crisis. Since 2014, the Medical Society of the State of New York has been a key member of the AMA’s Task Force to Reduce Opioid Use and its goal is to help reduce the nation’s burden from prescription opioids and heroin. (CLANCY)


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


Registration Now Open for CME Webinar on Concussion in Pediatric and Adult Population
The Medical Society of the State of New York will hold a Continuing Medical Education (CME) webinar on the “Current Concepts in Concussion for Pediatric & Adult Patients” on Wednesday, April 19, 2017 at 1 p.m. for all physicians and other health care providers.  Registration for the webinar is now open HERE

A copy of the flyer can be found HERE

Faculty for the course will be John Anthony Pugh, MD, PhD, assistant professor of Neurology at Albany Medical Center (AMC), and Deborah Ilana Light, MD, primary care sports medicine and associate program director for the Sports Medicine Fellowship at Albany Medical Center.  Educational objectives are: 1) Identify signs and symptoms indicative of concussion as well as red flags that indicate alternate or more severe pathology; 2) Outline an appropriate management plan for a patient presenting with concussion including a return to “normal life” protocol; 3) Describe methods for the primary and secondary prevention of concussion; 4) Identify patients who would benefit from referral to a concussion specialist.

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

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


MSSNY Participates in HCA Technology Committee Conference
MSSNY took part in a recent meeting of the Technology Committee of the Home Care Association of New York State (HCA) to discuss technology innovations including the implementation of cyber security and mobile technology that would enhance care collaboration, communication, and patient engagement across the care continuum. It was noted that with the support from the Centers for Medicare & Medicaid Services, the New York State Department of Health has launched the Data Exchange Incentive Program (DEIP) to increase HIE adoption across the state.  In addition this program will help defray costs for an organization when connecting to their local RHIO. (HARRING)


REGISTER NOW for Veterans’ Mental Health CME Seminars at the MSSNY House of Delegates
The Medical Society of the State of New York will hold two Continuing Medical Education (CME) seminars on veterans’ mental health as part of the MSSNY House of Delegates on Thursday, April 20, 2017 from 1-3 p.m. Entitled, “PTSD and TBI in Returning Veterans” and “Suicide Among Returning Veterans” the programs will be held at the Grand Ballroom D&E of the Westchester Marriott, 670 White Plains Rd, Tarrytown, NY.  The programs are open to MSSNY delegates and physicians throughout the area free of charge.

Pre-registration is required and physicians may register for both programs at:

PTSD and TBI: https://mssny.webex.com/mssny/k2/j.php?MTID=tbdb5295479d5ee1865aab56f91a2ca59

Suicide: https://mssny.webex.com/mssny/k2/j.php?MTID=tcd75a710181bbd6dd4034a6625500151

Faculty for the CME programs are Frank Dowling, MD and Thomas Madjeski, MD.

 PTSD and TBI
Thursday, April 20, 1 p.m.
Faculty Presenter: Thomas Madjeski, MD
The educational Objectives for the PTSD program are:
1) Describe the symptoms of PTSD and TBI.
2) Describe the treatment modalities of PTSD and TBI.
3) Describe military culture & how to overcome unique barriers to treatment intrinsic to military culture

Suicide
Thursday, April 20, 2 p.m.
Faculty Presenter: Frank Dowling, MD
The educational Objectives for the Suicide program are:
1) Address the causes and warning signs of suicide and suicidal behavior among veterans.
2) Explore the best evidence-based diagnostic and treatment options available including psychotherapy and pharmacotherapy.
3) Identify barriers in military culture to identification and treatment and how to overcome them.

Veterans Matters is a CME series made possible through a grant from the New York State Office of Mental Health.

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

The Medical Society of the State of New York designates each 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.  (ELPERIN, CLANCY)

CDPHP Workforce Team Challenge Running Event May 18th – Please Join Us!
MSSNY will be a premium sponsor of the 2017 CDPHP Workforce Team Challenge, a 3.5-mile race for runners and walkers, taking place in Albany on May 18, 2017.  MSSNY’s sponsorship of the event is part of an ongoing effort to have a visible presence at health-related public events.  The CDPHP Workforce Team Challenge, which caps participation at 10,000 registrants, is known for reaching capacity each year.  Many Capital District health-related organizations participate annually.  As a premium sponsor, MSSNY’s logo will be featured on the official race t-shirt, and MSSNY will be recognized during the race announcements.  In addition, MSSNY will have an exhibit table on Empire State Plaza.

The race begins at 6:25 PM, at Empire State Plaza, and features a scenic route that traverses Albany’s Washington Park.  The popular event always attracts great crowd support and on-course entertainment.  Sawyer Fredericks, winner of the eighth season of The Voice, will be singing the National Anthem.

Instructions and registration link are available HERE MSSNY members and alliance members are highly encouraged to participate, either as a runner or a walker.  Please choose “Medical Society of the State of New York” from the team drop-down list.  Registration is $24, and a portion of the registration fees go to this year’s “Charities of Choice,” Boys and Girls Club of Albany and Vanderheyden.   Registration deadline is May 1, 2017. A flyer may be accessed HERE.  For more information, please contact Miriam Hardin (mhardin@mssny.org).  (HARDIN)

MACRA Physician Educational Webinar on April 20
The American Medical Association is hosting an educational program for physicians to receive an update regarding the implementation of the new Medicare Merit Based Incentive Payment System (MIPS) on Thursday, April 20 from 7:00 – 8:30 PM.  To register for the webinar, click here(AUSTER)

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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Saratoga County Is Number One for Overall Health of Residents in NY
The Robert Wood Johnson Foundation collaborated with the University of Wisconsin Population Health Institute to publish the information online at www.countyhealthrankings.org The rankings are designed to help counties gauge the overall health of residents. Saratoga County tops the 2017 rankings for New York. Rockland County just north of New York City is No. 2; No. 3. Is Nassau County on Long Island; and Westchester rounds out the Top 5.

Ranking No. 62 and last is the Bronx.

The rankings are based on such factors as high school graduation rates, access to healthy foods and rates of obesity.


MLMIC’s Risk Management Conference for Physicians on April 20 at HOD
In partnership with MSSNY and the 2017 MSSNY House of Delegates, Medical Liability Mutual Insurance Company (MLMIC) will be hosting its first House of Delegates Risk Management Conference on Thursday, April 20, 2017 at 9:30 a.m. at the Westchester Marriott in Tarrytown, NY.  Attendance at this complimentary educational event will enable physicians to earn AMA PRA Category 1 Credits™.

In this program, a renowned attorney from Fager Amsler Keller & Schoppmann, LLP, specializing in healthcare law will address recent legislative, regulatory and malpractice case law developments that impact the provision of healthcare.

The program will also feature risk management advice on electronic health records (EHRs) and their associated liability risks.  A highly regarded malpractice defense attorney and a physician expert and MLMIC Risk Management Consultant will discuss a number of topics, including the legal pitfalls of EHRs and the proper use of EHR features such as templates, the copy and paste function, and auto-population.  Recommendations will be provided to help improve medical and legal documentation and reduce potential liability exposures.

All NYS physicians are welcome to attend.  Pre-registration is required and space is limited. Register Today at: https://www.mlmic.com/rm-conference-registration/


Support Your Young Colleagues at MSSNY’s 12th Annual Poster Symposium
Seventy enthusiastic young residents and medical students will present their posters at MSSNY’s 12th Poster Symposium on April 21, from 2:00 to 4:00 pm at the House of Delegates. If you are at the HOD, please take a few minutes to come to the Garden Terrace to see their work. Your interest will mean a lot, and there will be plenty of knowledge to share.


Survey Says: You Have to See Pharma Ads Three Times to “Ensure Recall!”
SSCG Media Group –a leading pharma-focused strategic media planning and agency network – revealed findings from its MAP MD survey of physicians regarding their preferences on advertising and other content they access each professional day.

A key finding, the Rule of Three, is that physicians require three views of a given pharma ad to ensure recall. Specifically, nearly half (47%) of physicians reported that after seeing a pharma ad an average of three times, they feel aware of the information. Further, after the third view of the same ad regardless of where it is see, 37 percent would read some of the ad and 13 percent would read the full ad. It is important to keep in mind that it may take numerous exposures of an ad before a physician actually “views” the ad, validating the need for purchasing multiple impressions based on your brand’s digital media objectives.

The results further revealed numerous insights with respect to physician preferences regarding digital advertising and other content:

  • Messaging – When it comes to physicians’ expectations of pharma advertising message content, nearly 60 percent reported they are most likely to engage with an ad that discusses efficacy. Ads that discuss products with a new indication or are new to market are favored by 54 percent of physicians, while over 40 percent expressed high interest in ads focusing on new study data and dosing and titration.
  • Call to Action (Digital) – Eighty-five percent of physicians reported clicking on ads to see more information about a given product. “Learn More” is the most likely call to action (39%) that would result in a click, followed by “Find out More” (33%). “Click Here” was the least popular call to action with just under 15 percent.

SSCG Media Group surveyed approximately 2,100 physicians across 15 specialties.


Letter to Ed: MSSNY Should Assess Members’ Attitudes Re Medical Aid in Dying and Their Preferred Policy Position Would Help Inform MSSNY’s AMA Delegation

In June of 2016, the AMA House of Delegates approved a resolution submitted by the Oregon Medical Association to “study medical aid in dying as an end-of-life option” and report back with a “recommendation regarding the AMA taking a neutral stance on physician ‘aid in dying’.” Since that time, the AMA’s Council on Ethical and Judicial Affairs (CEJA) has been reviewing data and gathering input.

Every section, specialty and state society component of the AMA has the opportunity and responsibility to represent its members on this important public policy debate. Six states and the District of Columbia currently authorize medical aid in dying. Similar bills have been introduced in 22 states, including New York.

Lawmakers look to physicians for guidance when considering legislation that affects the practice of medicine. Historically, MSSNY has upheld the AMA’s opposition to “assisted suicide.” But, over the past two decades the rapid growth in legalizing medical aid in dying has led physicians to rethink former assumptions. To date, after reviewing the accrued experiential data and surveying their members, four state medical societies have withdrawn opposition to medical aid in dying in favor of neutrality: the Oregon Medical Association, the California Medical Association, the Colorado Medical Society, and the Maryland State Medical Society.

A 2016 Medscape Ethics Report found support for “physician-assisted dying” among doctors at 57% (up from 46% in 2010) and declining opposition (29% down from 41% in 2010). These rates are confirmed by independent surveys from state societies in Colorado and Maryland that found support among physicians at 56% and 58% respectively. In New York State, a 2015 survey showed 71 % endorsement for physician aid in dying among the public.

At the AMA Interim meeting last November, the CEJA held an open forum and the AMA presented an educational forum on medical aid in dying where members of the Council listened to a wide range of opinions on the matter. Another forum is expected at the Annual Meeting in Chicago this year. How will MSSNY delegates to the AMA represent us?

I propose that MSSNY survey our members concurrently with the AMA’s policy re-evaluation process in order to provide input as the AMA undertakes its review. As the second-largest component of the AMA, it seems inappropriate for MSSNY not to have documentation of its members’ evolving sentiments. A survey that assesses members’ attitudes toward medical aid in dying and their preferred policy position (in favor, opposed, or neutral) would help inform MSSNY’s AMA delegation and  demonstrate the healthcare leadership MSSNY assumes in representation. MSSNY should not rely on the nine-member Council nor the views of colleagues from other states to make policy changes affecting the practice of medicine solely in our state.

Robert Milch, FACS
Life Member
Medical Society of the County of Erie


 Consumer Assessment CAHPS for Merit-based Incentive Payment System (MIPS) Survey Vendor Application Submission Period Opens
CMS is now accepting CAHPS for MIPS survey vendor applications through April 30, 2017. In the Quality Payment Program, the CAHPS for MIPS survey is an optional quality measure that groups participating in MIPS can elect to administer. It would count, in the quality performance category, as a patient experience measure. Additionally, a MIPS eligible clinician may also be awarded points under the improvement activities performance category for administering the survey.

The CAHPS for MIPS survey may only be administered by CMS-approved survey vendors. If you are interested in becoming a CMS-approved CAHPS for MIPS survey vendor, you need to review the minimum business requirements and confirm that your organization meets these requirements, then submit a completed application for consideration. Applications will be processed as they are received and a list of conditionally approved CAHPS for MIPS survey vendors will be publicly available. Conditionally approved vendors (vendors’ and subcontractors’ key staff) must participate in a webinar-based training and pass an assessment at the end of the training session to become CMS-approved CAHPS for MIPS survey vendors.

For more information on the application process and to access the necessary documents, please visit the CAHPS for MIPS survey page on cms.gov. More information on the Quality Payment Program can also be found at qpp.cms.gov.


Open Door Forum:ABN, Form CMS-R-131 Renewal
The Advance Beneficiary Notice of Non-coverage (ABN), Form CMS-R-131, and form instructions have been approved by the Office of Management and Budget (OMB) for renewal. While there are no changes to the form itself, providers should take note of the newly incorporated expiration date. The effective date for use of this ABN form is 60 days from this announcement.  More information on the ABN and the ABN form instructions can be found at: FFS ABN – Centers for Medicare & Medicaid Services

CLASSIFIEDS

Luxurious Medical Office Space to Share in Manhattan
Spacious and modern wellness office suite off 5th avenue, near grand central, and all major subway lines. Newly renovated space catering to the needs of various health practitioners and their clients (vision, chiropractors, acupuncturists, psychologists, nutritionists, etc.) 13 foot ceilings throughout. Two spacious waiting areas, elegantly furnished. Two bathrooms en suite. Fully equipped kitchen/pantry area. Two elevators. Free coffee/tea station, hot/cold water cooler, free mail sorting services. Windowed offices starting from $2,800. Utilities, cleanings and high speed internet. Call: 570-499-5851 / email: columbuslaservision@gmail.com



Prime NYC Space for Rent
Prime Midtown Manhattan space two blocks away from Grand Central Station
next to Park Ave. 3100 RSF with nine windows in a professional building filled with MDs and DDSs. $59/RSF please inquire at wnyllc@aol.com



Elegant Plastic Surgery Office (Upper East Side Manhattan)
Very large and classy office to share. Located in the ground floor of a 25′ x 100′ carriage house opposite the 66th Street Armory with large consult room, 2+ treatment/exam rooms, large waiting room, business office, storage. See video of office — you won’t believe it: www.youtube.com/watch?v=Uli8Cck_eRA   $5000/month incl utilities. no brokers. Call Doctor Fischman at (212) 472–3300.Jeffrey R. Fischman, M.D.  110 E 66th Street.

Physician Opportunities

Internist Needed Mon.-Fri. for Psychiatric Inpt in Queens
Internist needed for Full time general medical care of psychiatric inpatients.  Creedmoor Psychiatric Center is in Queens, and convenient to NYC, Nassau/Suffolk and near major transportation.  We are a small well organized Medical Department looking for another member.  Our physicians enjoy their work- life balance. Please contact: alan.diner@omh.ny.gov or call 718-264-4046

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.



A Private Multidisciplinary Medical Group is seeking an Internal Medicine/Family Medicine Physician in Manhattan
A well-established Manhattan based private multidisciplinary medical group is seeking to hire an Internal Medicine/Family Medicine Physician. This is a great opportunity to start your own practice in a modern office in midtown Manhattan. Attractive base salary plus comprehensive benefits package offered (Malpractice, 3 weeks paid vacation, 1 week CME, CME allowance, paid health insurance, etc).If you are a solo practitioner in private practice looking to join a private group practice, we will work with you to make the transition seamless. Please email your CV to tsrgexpress@gmail.com. No recruiters please.

A Private Multidisciplinary Medical Group is seeking a Podiatrist in Manhattan
A well-established Manhattan based private multidisciplinary medical group is seeking to hire a Podiatrist. This is a great opportunity to start your own practice in a modern office in midtown Manhattan. Attractive base salary plus comprehensive benefits package offered (Malpractice, 3 weeks paid vacation, 1 week CME, CME allowance, paid health insurance, etc).If you are a solo practitioner in private practice looking to join a private group practice, we will work with you to make the transition seamless. Please email your CV to tsrgexpress@gmail.com. No recruiters please.

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

March 24, 2017 – GOP Cancels Healthcare Vote

Dr. Reid - MSSNY President
PRESIDENT’S MESSAGE
Dr. Malcolm Reid
March 24, 2017
Volume 17
Number 12


Breaking News: House Republican leaders abruptly pulled a rewrite of the nation’s health-care system from consideration on Friday

MLMIC Insurance

Dear Colleagues:

This week, as Congress was feverishly debating whether to take up legislation that would change much of the Affordable Care Act (ACA), the MSSNY Executive Committee issued a statement highlighting both the positive and negative aspects of the proposed American Health Care Act (AHCA).

As a diverse group, our MSSNY members have a wide array of perspectives regarding whether they believe the ACA has been a success or a failure.  As a society that represents physicians of every region, of every specialty, and of every type of practice setting, extensive debate is to be expected.  The ACA was the most significant health care law enacted in our generation.  Regardless of our personal viewpoints on the ACA, most physicians would likely agree, that it is important that our policymakers address problems such as the narrow networks and use of high deductible plans that have clearly accelerated since the ACA went into effect.

In this regard, our statement acknowledged some of the positive aspects of the legislation before Congress, including ideas adopted at the MSSNY House of Delegates such as:

  • expanded use of Health Savings Accounts to provide health insurance coverage; and
  • preventing implementation of a tax on comprehensive health insurance coverage, also known as the “Cadillac Tax”, which would disincentivize employers from offering plans that limit patient cost-sharing.

At the same time, our statement expresses significant concerns regarding the impact that this bill may have for many of our patients who currently receive coverage through the “Essential Plan,” or expanded Medicaid.  The provisions of the AHCA under consideration  may cause patients to face  far greater out of pocket costs for plans that may not be as generous as what they are currently receiving under the ACA.  In fact, many patients may choose simply not to buy health insurance coverage at all.

That is a serious problem with this proposed legislation, which we hope can be addressed as Congress continues to debate how best to fix the ACA.  We also hope it is an opportunity to look at other issues that we believe impact upon health insurance costs, such as the excessive liability exposure faced by physicians, as well as the extraordinary market power held by the health insurance industry, not only in New York but also throughout much of our country.

For too long, debate over the ACA has been dominated by those who either want to completely eliminate it, or those who have been reluctant to change any aspect of it. In my opinion, neither side is correct.

It is my hope that the debate currently before Congress is the first step, not the last step, towards making necessary changes to improve the availability of affordable and comprehensive coverage options for our patients. For the benefit of our patients, let’s continue this conversation.

Please send your comments to comments@mssny.org




Final Stretch of NY Budget Negotiations
It comes down to just a few days.

Budget negotiations have entered their final stages as Governor Cuomo and legislative leaders iron out the details of a final State budget agreement. It is expected that “round the clock” talks will continue through the weekend and into early next week.  The final budget is due by April 1st. While the NYS Senate and NYS Assembly’s “one-House” budgets rejected several Executive Budget provisions that had been opposed by MSSNY, these provisions could still end up in the final enacted budget.

It is critical that you contact your legislators to ensure that they hold strong and to urge that they:

Critical items also under discussion in the final days of Budget negotiations include Workers Compensation reform, as well as proposals advanced by the Governor (and supported by MSSNY) that would directly regulate Pharmaceutical Benefit Managers, and regulate e-cigarettes under the “Clean Indoor Air” Act. To View a chart listing all of the Budget proposals in which MSSNY is engaging, please click here.   (Belmont)

Lacking Votes to Pass, ACA Repeal Bill Pulled From Consideration on House Floor
After a substantial floor debate on Friday afternoon, leaders of the US House of Representatives pulled from consideration the American  Health Care Act (AHCA), legislation to repeal and revise many aspects of the Affordable Care Act (ACA).  The bill was pulled from consideration when it appeared that there would not be enough votes for the bill to pass the House.

On Thursday, MSSNY President Dr. Malcolm Reid issued a statement developed by MSSNY’s Executive Committee shared with the New York Congressional delegation noting the need to fix the flaws of the ACA, and that the legislation had some beneficial provisions.  However, the statement also highlighted the concerns with provisions in the AHCA “that may cause New Yorkers who currently have low cost, ‘first dollar’ coverage to instead purchase coverage with high deductibles and other high cost sharing responsibilities.  Moreover, the statement noted our concerns regarding the “long-term impact of the AHCA on New York State’s Budget finances”.

As has been previously reported, several health care and patient advocacy organizations, including the AMA, AARP, the American Cancer Society, the Greater New York Hospital Association and the Healthcare Association of New York State (HANYS) had expressed strong concerns with the proposal.  Governor Cuomo also has issued several statements opposing the AHCA by highlighting the district by district financial impact on hospitals and nursing homes if the bill were to be enacted.

The proposal would have kept some of the popular provisions from the ACA, including required coverage for pre-existing conditions, prohibiting annual and lifetime limits, and requiring dependent coverage up to age 26.   It would also significantly expand the amount of funds that a person could direct to their Health Savings Account.

At the same time, the bill would have substantially revised ACA rules that facilitated various subsidized coverage programs for those who make up to 400% FPL ($94,000 for a family of 4).  While the expanded eligibility for Medicaid (up to 138% FPL) would be available through the end of 2019, starting in 2020 such expanded coverage would only be continued for those who had such coverage prior to the end of 2019.  The AHCA would also repeal the tax credits currently provided to help cover cost-sharing amounts for coverage for individuals who earn too much to qualify for Medicaid.

Instead, tax credits of $2,000-$4,500 (depending upon age) would be provided to enable the purchase of health insurance coverage.   Tax credits will be available in full to individuals earning less than $75,000 and households earning less than $150,000, but they will be capped for higher earners.  It appears as if the AHCA would have also completely eliminated funding for New York’s Essential Plan, which provides low-cost health insurance coverage with little cost-sharing responsibilities for over 600,000 New Yorkers who make between 138% and 200% of the FPL.

The bill would have repealed several other notable ACA provisions, including the requirement for all individuals to have health insurance coverage, the large employer coverage mandate, the provision to impose a “tanning” tax and a provision that limits the tax deductible treatment for health insurers of executive income that exceeds $500,000.

As of this writing, it is unclear how the legislation will be revised to garner majority support.  Please remain alert for further updates.        (AUSTER)


Increase in Cases of Hepatitis A among Men Who Have Sex with Men Reported in NYC
The New York City Health Department has noted an increase in hepatitis A cases among men who have sex with men (MSM) who did not report international travel.  There have been five cases of hepatitis A among unvaccinated MSM since January 1, 2017 and three of the five patients were hospitalized and all patients have recovered.   Since 1996, the Advisory Committee on Immunization Practices (ACIP) has recommended that all MSM receive two doses of hepatitis A vaccine; the second dose should be administered 6-12 months after the first dose.   The New York City Department of Health has issued Alert #6 and has sent a letter to all providers in the New York City region.   A copy of the letter can be found here.         (CLANCY)


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


SAVE THE DATE for Veterans’ Mental Health Training Initiative: CME Programs and Panel Discussions
The Medical Society of the State of New York, along with the New York State Psychiatric Association and the National Association of Social Workers will hold a two-day Veterans’ Mental Health Training Initiative: Addressing the Unspoken Needs of Veterans.

This two-day event will be held on Friday, May 5 (1-4:30 p.m.) and Saturday May 6 (8:30 a.m.-3 p.m.) at the Clarion Hotel and Conference Center, 3845 E Veterans Memorial Hwy, Ronkonkoma, NY.  Physicians are urged to reserve the dates for participation in this weekend.  Reservation links will be forthcoming for the entire conference.

The program will include three continuing medical education (CME) seminars on PTSD and TBI, Substance Use Disorders, and Suicide as well as panel discussions on the Dwyer Peer to Peer Program, Diversity among Veterans, and veteran-driven case studies.

Faculty for the CME programs includes Frank Dowling, MD, Thomas Madjeski, MD, and Adolph Meyer, MD. Physicians can register for all or part of the three CME programs. Just click on the program name listed below.

PTSD and TBI
Friday, May 5, 1:15 p.m.
Faculty Presenter: Thomas Madjeski, MD
The educational Objectives for the PTSD program are:

1)  Describe the symptoms of PTSD and TBI.

2)  Describe the treatment modalities of PTSD and TBI.

3)  Describe military culture & how to overcome unique barriers                 to treatment intrinsic to military culture

Suicide
Friday, May 5, 2:30 p.m.
Faculty Presenter: Frank Dowling, MD
The educational Objectives for the Suicide program are:

1)   Address the causes and warning signs of suicide and suicidal                  behavior among veterans.

2) Explore the best evidence-based diagnostic and treatment                       options available including psychotherapy and
pharmacotherapy.

3)  Identify barriers in military culture to identification and                             treatment and how to overcome them.

Substance Use Disorders
Saturday, 10:45 a.m.
Faculty Presenter: Adolph Meyer, MD
The educational objectives for the Substance Use Disorders program are:

1)  Explain substance use disorders (SUDs), symptoms, warning                   signs, comorbidities

2)  Explore treatment options for veterans including evidence-                      based practices in psychotherapy and pharmacotherapy

3)  Identify barriers to identification and treatment, including                        those unique to military culture, and how to overcome them

Veterans Matters is a CME series made possible through a grant from the New York State Office of Mental Health.

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

The Medical Society of the State of New York designates each 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.  (ELPERIN)


MSSNY to Hold CME Webinar on Concussion in Pediatric and Adult Population on April 19th; Registration Now Open
The Medical Society of the State of New York will hold a Continuing Medical Education (CME) webinar on the “Current Concepts in Concussion for Pediatric & Adult Patients” on Wednesday, April 19, 2017 at 1 p.m. for all physicians and other health care providers.  Registration for the webinar is now open HERE.

Faculty for the course will be John Anthony Pugh, MD, PhD, assistant professor of Neurology at Albany Medical Center (AMC), and Deborah Ilana Light, MD, primary care sports medicine and associate program director for the Sports Medicine Fellowship at Albany Medical Center.  Educational objectives are: 1) Identify signs and symptoms indicative of concussion as well as red flags that indicate alternate or more severe pathology; 2) Outline an appropriate management plan for a patient presenting with concussion including a return to “normal life” protocol; 3) Describe methods for the primary and secondary prevention of concussion; 4) Identify patients who would benefit from referral to a concussion specialist.

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

The Medical Society of the State of New York designates this live activity for a maximum of 1.0 AMA/PRA Category 1 credits™. Physicians should claim only the credit commensurate with the extent of their participation in the activity.  (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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AG: Three Heart Monitor-Related Apps Are Not Medical Devices nor FDA Approved
Today, Attorney General Eric T. Schneiderman announced settlements with three popular health-related applications sold in Apple’s App Store and Google Play regarding misleading claims and irresponsible privacy practices. The settlement follows a year-long investigation of mobile health applications and requires the implicated companies and developers to amend deceptive statements about their apps and modify their privacy policies to better protect consumers, while also making clear that their apps are not medical devices and are not approved by the U.S Food and Drug Administration. The Attorney General today announces settlements with the following app developers:

  • Cardiio, an American company that sells Cardiio, an app downloaded hundreds of thousands of times that claims to measure heart rate. The developer had not tested its accuracy with users who had engaged in vigorous exercise, despite marketing the app for that purpose. The developer also misleadingly implied that the app was endorsed by MIT.
  • Runtastic, an Austria-based company that sells Runtastic, an app that purports to measure heart rate and cardiovascular performance under stress. Yet the developer failed to test its accuracy with users who had engaged in vigorous exercise, despite marketing the app for that purpose to the 1 million people who downloaded it.
  • Matis, an Israel-based company that sells My Baby’s Beat, an app downloaded hundreds of thousands of times, which Matis previously claimed could turn any smartphone into a fetal heart monitor, despite the fact that it has never been approved by the FDA. Although Matis exhorted consumers to use My Baby’s Beat rather than a fetal heart monitor or Doppler, it never conducted, for example, a comparison to a fetal heart monitor, Doppler, or any other device that had been scientifically proven to amplify the sound of a fetal heartbeat.

Additionally, the developers now post clear and prominent disclaimers informing consumers that the apps are not medical devices and are not approved by the FDA.


 MLMIC’s Risk Management Conference for Physicians on April 20 at HOD
In partnership with MSSNY and the 2017 MSSNY House of Delegates, Medical Liability Mutual Insurance Company (MLMIC) will be hosting its first House of Delegates Risk Management Conference on Thursday, April 20, 2017 at 9:30 a.m. at the Westchester Marriott in Tarrytown, NY.  Attendance at this complimentary educational event will enable physicians to earn AMA PRA Category 1 Credits™.

In this program, a renowned attorney from Fager Amsler Keller & Schoppmann, LLP, specializing in healthcare law will address recent legislative, regulatory and malpractice case law developments that impact the provision of healthcare.

The program will also feature risk management advice on electronic health records (EHRs) and their associated liability risks.  A highly regarded malpractice defense attorney and a physician expert and MLMIC Risk Management Consultant will discuss a number of topics, including the legal pitfalls of EHRs and the proper use of EHR features such as templates, the copy and paste function, and auto-population.  Recommendations will be provided to help improve medical and legal documentation and reduce potential liability exposures.

All NYS physicians are welcome to attend.  Pre-registration is required and space is limited. Register Today 


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.


Weekly Charting Tip: Fair Market Value v. Commercial Reasonableness
In order to comply with three different federal laws, it is very important that you document the fair market value (FMV) and commercial reasonableness of the “arrangement” at issue. Fair Market Value is “the value in arm’s length transactions, consistent with the general market value”. In other words, if I were a stranger, and I wanted a similarly situated arrangement, what would it be worth? There are professional people who actually will prepare a FMV report for you. This is the safest way of doing it. What do rents go for in the same area for a similar amount of space? You can factor in closeness to public transportation, parking lots and the like. Commercial reasonableness encompasses both the series and payment for them. Is it reasonable to pay a neurologist say $300,000 for the 40 hours a week you are offering? That depends on the location and what is expected of the neurologist. Areas with many neurologists tend to offer less. Rural areas may offer more. Think supply and demand. If a deal is too good to be true, it probably is!

–Larry Kobak, Esq., LKobak@DrLaw.com

If you have any questions, please contact Kern Augustine, P.C. at 1-800-445-0954 or via email at info@DrLaw.com.


BECOME A LEADER IN HEALTH PROFESSION EDUCATION. ATTEND AN EVENT TO GET MORE INFORMATION ABOUT THIS DYNAMIC PROGRAM AT HOFSTRA UNIVERSITY
Hofstra University’s Master of Science in Health Professions Pedagogy and Leadership
is a program designed to prepare clinicians who provide care to patients with an expanded role as an educator for students, residents, externs and fellows and to advance in leadership roles in their field. The focus of the program is on advancing teaching, leadership and research skills applicable to established healthcare educational environments. All health professionals and administrators interested in teaching in their clinical fields of expertise, overseeing educational programs, or preparing for leadership roles can benefit from this program, which is offered in a hybrid, executive format.

Attend one of the following to learn more information about this dynamic MS program:

ONLINE WEBINAR
Tuesday, April 18, 2017 @ 5:30pm
Register

IN PERSON
Monday, April 24, 2017 @ 5:30pm
Center for Learning and Innovation (CLI)
1979 Marcus Avenue Suite #101
Lake Success, NY 11042
Register

In addition, you may contact Dr. Alice Fornari, Program Director, at Alice.Fornari@hofstra.edu for more information.


Pediatrics: Calls to Poison Control-60% re Kids Under Five; 30% Are Teenagers
A study published in Pediatrics  indicates that “from January 2000 until December 2015, about 188,000 calls were placed to poison control centers regarding pediatric and teenage exposure to opioids.” The data indicated “sixty percent of the children exposed to opioids were younger than 5, while teenagers accounted for 30 percent.”

A companion paper in Pediatrics  reports a strong link between prescribed opioids and their recreational use.” The study indicated that “teens who abused opioids were often prescribed the drugs at some point by a physician.”


Match Day Madness!
The Upstate Medical University Class of 2017 presents 2017 Matchin’, a parody of 24k Magic, in celebration of their Match Day! https://www.youtube.com/watch?v=sk6AyP4u2f0


CDC: Four Countries Added to Interim Travel Guidance
The CDC is working with other public health officials to monitor for ongoing spread of Zika virus‎. On March 10, 2017 CDC posted a Zika virus travel notice for Angola, Guinea-Bissau, Maldives and Solomon Islands. CDC has issued travel notices (level 2, “practice enhanced precautions”) for people traveling to destinations with Zika. For a full list of affected countries/regions, visit http://wwwnc.cdc.gov/travel/page/zika-travel-information.

To help pregnant women and others identify areas of Zika risk, CDC published a new interactive World Map of Areas with Zika Risk that allows people to search for location-specific Zika information and travel recommendations. CDC also published an interactive “Know Your Zika Risk” tool that offers tailored risk and prevention messages based on information provided by travelers.  In addition, CDC’s Zika testing recommendations for pregnant women have been aligned with these three risk categories, as depicted in a new map for healthcare providers to use for evaluating and caring for pregnant women possibly exposed to an area with Zika risk.

CDC update
From January 1, 2015 to March 15, 2017, there have been 5,139 Zika virus disease cases reported in the US. Of these cases:

  • 4,842 cases were in travelers returning from affected areas
  • 222 cases acquired through presumed local mosquito-borne transmission in Florida (N=216) and Texas (N=6)
  • 75 cases acquired through other routes, including sexual transmission (N=45), congenital infection (N=28), laboratory transmission (N=1), and person-to-person through an unknown route (N=1).

Meanwhile there were 1,534 pregnant women with any laboratory evidence of possible Zika virus infection in the US as of February 21, 2017.


Join Nassau County for Dinner and CME Program on “Frontiers in Cellular Therapy”
The Nassau Academy of Medicine and the Nassau County Medical Society Joint Membership Meeting will be held on TUESDAY, MARCH 28, 2017 at the WESTBURY MANOR, 1100 Jericho Turnpike, Westbury. Complimentary Dinner Meeting for NCMS / NAM Members. Non-members and their staff may attend at $25 per person. Seating is limited. REGISTRATION is at 6:30PM; dinner and meeting at 7:00PM.  PRE-REGISTER NOW – Send E-Mail Response To: NASSAUMED@GMAIL.COM The CME Program, “NEW FRONTIERS in CELLULAR THERAPY” will be presented by Patricia Shi, MD, MS, Medical Director, Therapeutic Apheresis and Cellular Therapy Collection Service, New York Blood Center

Educational Objective:  At the end of this CME activity, participants should be able to; distinguish between the various types of cellular therapies being investigated; understand the potential risks, benefits, and unknowns of such therapies and become familiarized with ethical concerns and questions raised by the advance of cellular therapy. 

Accreditation Statement: This activity has been planned and implemented in accordance with the Essential Areas and Policies of the Medical Society of the State of New York (MSSNY) through the joint providership of the Suffolk Academy of Medicine and the Nassau Academy of Medicine. The Suffolk Academy of Medicine is accredited by MSSNY to provide Continuing Medical Education for physicians. The Suffolk Academy of Medicine designates this live educational activity for a maximum of 1 AMA PRA Category 1 Credit. Physicians should claim



CLASSIFIEDS


Prime NYC Space for Rent
Prime Midtown Manhattan space two blocks away from Grand Central Station
next to Park Ave. 3100 RSF with nine windows in a professional building filled with MDs and DDSs. $59/RSF please inquire at wnyllc@aol.com



Elegant Plastic Surgery Office (Upper East Side Manhattan)
Very large and classy office to share. Located in the ground floor of a 25′ x 100′ carriage house opposite the 66th Street Armory with large consult room, 2+ treatment/exam rooms, large waiting room, business office, storage. See video of office — you won’t believe it: www.youtube.com/watch?v=Uli8Cck_eRA   $5000/month incl utilities. no brokers. Call Doctor Fischman at (212) 472–3300.Jeffrey R. Fischman, M.D.  110 E 66th Street.

Physician Opportunities

Internist Needed Mon.-Fri. for Psychiatric Inpt in Queens
Internist needed for Full time general medical care of psychiatric inpatients.  Creedmoor Psychiatric Center is in Queens, and convenient to NYC, Nassau/Suffolk and near major transportation.  We are a small well organized Medical Department looking for another member.  Our physicians enjoy their work- life balance. Please contact: alan.diner@omh.ny.gov or call 718-264-4046

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


A Private Multidisciplinary Medical Group is seeking an Internal Medicine/Family Medicine Physician in Manhattan
A well-established Manhattan based private multidisciplinary medical group is seeking to hire an Internal Medicine/Family Medicine Physician. This is a great opportunity to start your own practice in a modern office in midtown Manhattan. Attractive base salary plus comprehensive benefits package offered (Malpractice, 3 weeks paid vacation, 1 week CME, CME allowance, paid health insurance, etc).If you are a solo practitioner in private practice looking to join a private group practice, we will work with you to make the transition seamless. Please email your CV to tsrgexpress@gmail.com. No recruiters please.

A Private Multidisciplinary Medical Group is seeking a Podiatrist in Manhattan
A well-established Manhattan based private multidisciplinary medical group is seeking to hire a Podiatrist. This is a great opportunity to start your own practice in a modern office in midtown Manhattan. Attractive base salary plus comprehensive benefits package offered (Malpractice, 3 weeks paid vacation, 1 week CME, CME allowance, paid health insurance, etc).If you are a solo practitioner in private practice looking to join a private group practice, we will work with you to make the transition seamless. Please email your CV to tsrgexpress@gmail.com. No recruiters please.

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