The following letter to the editor was submitted to the Washington Post on September 6, 2019.
To the Editor:
Physicians agree with the goal of legislation before Congress to protect patients from “surprise” medical bills. It is unfortunate Dr. Ezekiel (Re “No One Likes Surprise Medical Bills…”, 9/5/19) failed to recognize the need for a balanced solution. Instead, he promotes the interests of the health insurance industry.
In 2014, New York physicians worked with state regulators and patient groups to enact a law protecting patients from surprise medical bills and established a balanced approach to determine fair payment. When an insurer and physician cannot agree, the solution is decided through a low cost, simplified dispute resolution system. The arbitrator chooses the side that is more reasonable based upon a number of factors. New York’s system has discouraged unreasonable billing and encourages negotiated compromises between physicians and insurers.
Importantly, New York’s law also addressed a key factor often leading to surprise medical bills – new rules to protect against narrow insurer networks. Legislation before Congress (HR 3502-Ruiz-Roe) would emulate New York’s acclaimed system. It would take patients out of the middle while employing a simplified dispute resolution system.
We are very concerned with Congressional approaches that give insurers unilateral control to determine payment for surprise bills. It would undoubtedly be manipulated by market-dominant insurers to reduce their physician networks. Worse, it could produce shortages in hospital emergency departments, a concern New York sought to prevent.
This is a serious problem that requires a thoughtful solution—not a one-sided giveaway to the insurance industry.
Comments? firstname.lastname@example.org; @mssnytweet; @sonodoc99
Arthur Fougner, MD
Assemblyman Walter Mosley Campaign Event
New York War on E-Cigarettes Breaks Out
Local state and now federal officials have declared war on e-cigarettes amid an outbreak of respiratory illnesses tied to vaping, but with little data to go on, it’s unclear regulatory efforts will stymie the health problems that have captured the public’s attention. In New York, the health complications from vaping are associated with cannabis oil, Health Commissioner Howard Zucker said, during a press conference Monday where Gov. Andrew Cuomo called for legislation banning flavored pods. Cannabis oil, and other recreational marijuana products, remain black-market items and would not be affected by curbing the availability of over-the-counter e-cigarettes and flavored pods. (Politico New York Health Sept. 12)
NYCDOHMH: Nearly 15% of Middle School Students Used E Cigs
The New York City Health Department “revealed alarming new information Tuesday about the use of electronic cigarettes among New York adolescents and teens, and pushed the city to crack down on the device’s availability to the youth.” Last year, “about 13,000 middle school students, roughly 6.7%, reported using e-cigarettes and 29,000 students, about 14.4%, said they had tried them. Health Commissioner Dr. Oxiris Barbot said the numbers are concerning, particularly in light of recent studies that have shown that e-cig use leads to long term health problems.”
DFS: Insurance Cannot Be Canceled for Carrying a Script for Naxalone
The state’s top insurance regulator said on September 6 that it’s illegal for insurance companies to deny life, disability income or long-term care insurance to applicants based solely on whether they carry a prescription for naloxone, a drug that reverses opioid overdoses.
The updated guidance from the state Department of Financial Services comes four months after Gov. Andrew Cuomo directed an investigation into reports that nurses and other first responders were being denied life insurance because they had a prescription for the drug known by the brand name Narcan.
Many had prescriptions as a preventative measure — in case they encountered someone in the field who overdosed and needed to be revived. But the department’s investigation found that insurers’ underwriting practices and guidelines did not distinguish between circumstances where an applicant had naloxone for their own use, or when they had naloxone for encounters with other individuals at risk of overdose.
The distinction is important, at least with insurance law, because companies are prohibited from discriminating against people of the same class and of “equal expectation of life” when approving coverage and setting rates. Carrying naloxone to prevent your own overdose could be seen as an indicator of shorter life expectancy, but carrying it to protect others would not.
“In the midst of a national opioid crisis, it is common sense for our nurses and first responders who work every day to keep New Yorkers safe to carry naloxone,” Cuomo said. “Denying them insurance coverage for doing their job to save lives is unacceptable, and today we correct this discriminatory practice.”
And it’s not just medical professionals who have taken to carrying it. Family members and friends of people struggling with addiction are also increasingly seeking prescriptions for naloxone as a way to keep their loved ones safe. In some cases, a prescription is not needed if individuals request it from a pharmacist or other official who has a “standing order” to dispense it without a prescription.
In guidance published, however, Deputy Superintendent for Insurance James Regalbuto instructed any insurer who has improperly denied coverage to “immediately reach out” to the rejected applicants to provide them with an opportunity to reapply for coverage. He also instructed insurers to “correct or remove” any record or report that may have been made to a third-party consumer reporting agency regarding an improper insurance denial.
First responders who have been denied coverage should contact the Department of Financial Services via its consumer complaint website (www.dfs.ny.gov/complaint) or by phone at 212-480-6400 or toll-free at 1-800-342-3736.
FDA Experts Warn Medical Devices Are Vulnerable to Hacking, Errors
Experts attending a meeting of the FDA’s Patient Engagement Advisory Committee on Sept. 10 warned medical devices like insulin pumps and pacemakers can be prone to hacking and errors. At least two speakers at the meeting “described how easy it was to hack their own medical devices by reverse-engineering them.” Committee members also “repeatedly said that many devices and the instructions that come with them are cumbersome and difficult to understand.” One attendee also stated that the “fact that it is impossible to predict which types of cybersecurity risks can affect a given medical device can make it more difficult for healthcare providers to have meaningful conversations about risks and benefits.” Medscape (9/12)
Health Matters for Women: Endometriosis
REGISTRATION NOW OPEN
The Medical Society of the State of New York will host a live continuing medical education (CME) webinar on women’s health topics entitled “Health Matters for Women: Endometriosis” on Friday, September 20th, 2019 from 7:30 AM to 8:30 AM.
To register for “Health Matters for Women: Endometriosis”, please click here. The faculty will be Lisa Eng, DO. The educational objectives are: 1) Review potential causes of pelvic pain and discuss how to identify endometriosis. 2) Discuss the benefits and risks as well as the efficacy and limitations of available medical therapies for long-term treatment of endometriosis. 3) Discuss implementation of individualized endometriosis treatment plans and options.
For assistance in registering or any other questions, please contact Melissa Hoffman at email@example.com or call (518) 465-8085.
The Medical Society for 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 credit TM. Physicians should claim only the credit commensurate with the extent of their participation in the activity.
CMS-1500 Resources: Video Available and Q&A Webinars Next Week
The Workers’ Compensation Board is offering new resources to assist in the transition to Form CMS-1500, which will streamline medical billing and reduce the paperwork requirements currently in the workers’ compensation system. To help you prepare, the Board has developed a training video to show health care providers, and all others who will be using Form CMS-1500, how to use the form and the required narrative reports to bill for their services to workers ‘compensation patients.
Next week, the Board is also holding two follow-up Q&A webinars so that you can get answers to any questions you may have after viewing the training video and reading the CMS-1500 FAQ’s on the Board’s website.
With that in mind, we encourage you to view the training video before attending one of the webinars. As you view the training video, take note of questions that come up so that you’ll be prepared for the Q&A webinar. This will enable you to take full advantage of both resources.
To view the training video, follow this link: CMS-1500 Training Video
The webinars will be held next week on:
- September 17, 2019
8:30 a.m. – 9:30 a.m. Register Here
- September 18, 2019
4:00 p.m. – 5:00 p.m. Register Here
Revalidate before your due date to avoid a hold on your Medicare payments and deactivation of your Medicare billing privileges.
There are several ways to find your revalidation due date:
Search by National Provider Identifier (NPI) or name.
A due date of “TBD” (to be determined) means a revalidation due date has not been assigned by CMS.
You can access the YouTube video, “How to use the CMS Medicare Revalidation Tool“
Revalidation notice mailed by National Government Services
Mailed in yellow envelope
Sign in with user ID and password.
Generally, the due date will remain with the provider/supplier throughout subsequent revalidation cycles. So you will not have to wonder about the due date the next time you need to revalidate.
NOTE: Unsolicited applications received seven months prior to the revalidation due date will be returned to the provider.
Need assistance? Providers and suppliers can register for our provider enrollment webinars by either using the following links, Part A/Part B or by visiting the NGSMedicare.com website. The webinars below can be found under the Education Tab by selecting Webinars, Teleconference and Events.
Provider Enrollment Revalidation Overview
Getting Connected to PECOS
Submitting Revalidation via PECOS Application
Submitting Revalidation via CMS-855A Paper Application for a Part A providers
Submitting Revalidation via CMS-855B Paper Application for a Part B providers
Submitting Revalidation via CMS-855I Paper Application for a Part B providers
Let’s Chat about Provider Enrollment Revalidation
PECOS: View and Manage Reassignments through Group Enrollment
You are invited to join the New York State Public Health Association and the New York State Association of County Health Officials for the “Public Health Impact of Legalizing Cannabis.” Program content will address implications for public health, cannabis policy and health equity resulting from a legalized program. As New York State considers the passage of policy to establish an adult-use cannabis program, it is imperative that public health stakeholders unite to prepare for potential implications and learn about policy, regulatory and governance aspects related to legalization.
When: 17 Oct. 2019
TIME: 8:30 AM – 4:00 PM
WHERE: Hilton Westchester
Hear from nationally-recognized experts in partnership with your colleagues in the public health sector. Throughout this meeting, there will be plenty of opportunities for networking with professionals representing local health departments; academia; clinical care settings; community-based organizations and others who value the health and safety of communities in New York. For more information and to register, please click here.
2019 AIM: Advocacy in Medicine Conference
Sunday, September 22, 2019
Venue: New York Academy of Medicine, 1216 Fifth Avenue &103rd Street, NYC
Cost : Free for medical students and health professionals with current ID; advance online registration is required. REGISTER
The second annual Advocacy in Medicine (AIM) Conference will bring together healthcare advocates and trainees from various local academic institutions interested in health advocacy for full day of talks, interactive panels, breakout sessions and networking. The conference opens with keynote speakers addressing the role of physician advocacy followed by an interactive Q&A panel discussion with physicians on advocacy, activism, and their personal career trajectories. The afternoon will be dedicated to small workgroups with the opportunity to focus on skill-building and topic-focused content.
4th Annual U of Buffalo DoctHERS Symposium; A Time of Urgency: Health Care Leaders Needed
When: Saturday, September 21, 2019
Time 8:00 am – 12:00 pm
Where: The Westin Buffalo, 250 Delaware Avenue, Buffalo, NY 14202
Join us for a morning of networking, empowerment, and education about
leadership development for women in health care professions.
Cost: $25 for General Alumni and Non-Alumni Guests; free for Students/Residents
More Details: The Jacobs School of Medicine and Biomedical Sciences’ Medical Alumni Association is proud to present the 4th Annual DoctHERS Symposium, featuring keynote speaker Dr. Susan R. Bailey, President-Elect, American Medical Association. We hope you will join us for a morning of networking, information, enrichment and resources for pay, promotions and equity in the workplace and support for females in the healthcare profession. MSSNYPAC Co-Chair Rose Berkun, MD is Chair of the event.
For more information on schedule and speaker biographies, please visit www.medicine.buffalo.edu/docthersnow
Shared NYC Medical Space *Prime Flatiron Location* 17th Street and 5th Ave
Ground Floor Office with Private Street Entrance in Luxury Park Avenue Building
Rental includes: two consultation rooms, private office, private bathroom. Common waiting room, back office filing space and reception desks included. Affordable rent. Location East 60s between Park and Lexington. Easy distance to Lenox Hill Hospital and New York Cornell. Subway access within 1 block. Immediate occupancy available. Call James: 917-710-7643
Fully Renovated Office Space for Part-Time Lease in Hauppauge
Available Tuesdays/Fridays, $450 half session, $750 full session. Elegant office space, beautiful waiting room with new stone and granite reception desk, custom molding, large windows, abundant natural light, TV, and refreshment counter. Four new exam rooms and dictation room. New stainless and granite kitchenette. State-of-the-art network infrastructure meets HIPPA & PCI DSS compliance standards. Digital X-ray room with PACS in each exam room available as an option. Located in close proximity to LIE, Northern State Pkwy, and Vets Memorial Hwy. Contact us at (631) 486-8855; Please see our listing: https://www.loopnet.com/Listing/517-Route-111-Hauppauge-NY/15298633/
Office Rental 30 Central Park South
Two fully equipped exam, two certified operating, bathrooms and consultation room. Shared secretarial and waiting rooms. Elegantly decorated, central a/c, hardwood floors. Next to Park Lane and Plaza hotels. $1250 for four days a month. Available full or part-time. 212.371.0468 / firstname.lastname@example.org.
Are You Trying to Lease Your Medical Office or Sell Your Medical Practice? Trying to Sell New or Used Medical Equipment?
Clineeds, the new online platform designed for medical providers.
Great Career Opportunities for Clinical Physicians
The NYS Department of Corrections and Community Supervision has great career opportunities for Clinical Physicians. You must have possession of a license and current registration to practice medicine in New York State, and have two years of post-licensure medical experience.
Starting salary is $143,381 – $171,631 *(Additional $10,000 or $20,000). Benefits include comprehensive health insurance, NYS retirement system, deferred compensation plan, flexible spending plan, and paid time off.
We have openings in the following counties offering a choice of urban, suburban or rural living:
Clinton* Clinton Correctional Facility (sporting and recreational outlets)
Dutchess Fishkill and Green Haven Correctional Facilities (Hudson River Valley Beauty)
Franklin* Franklin and Upstate Correctional Facility (North Country, 1 hour to Montreal)
Greene* Greene Correctional Facility (rural charm yet only 2 hours to New York City)
Oneida Mohawk Correctional Facility (Cooperstown, breweries)
Sullivan Woodbourne Correctional Facility (mountains, outlets, casinos and entertainment)
Seneca* Five Points Correctional Facility (heart of wine country)
St. Lawrence Riverview Correctional Facility (hiking, boating and museums)
Washington Great Meadow Correctional Facility (Between Vermont & the Green Mountains)
Westchester Bedford Hills Correctional Facility (Less than 1 Hour to NYC)
Contact: www.doccs.ny.gov or DOCCS Personnel Office at (518) 457-8132 for more information and to apply.
Nurse, RN Utilization Review Full-Time-Westbury, NY (In-office position only)
Excellent opportunity for a RN who is seeking a position performing utilization review. We require 1-2 years recent experience in hospital and/or insurer utilization review and experience using Interqual criteria and/or MCG Guidelines. Data entry/PC skills a plus. Benefits include 401(k), paid vacation and holidays. Send resume and salary requirements to: Empire State Medical Scientific and Educational Foundation, Inc. Human Resource Department e-mail: email@example.com Fax: (1-516) 833-4760 Equal Oppty Employer M/F
CALL FOR RATES & INFO. CHRISTINA SOUTHARD: 516-488-6100 ext. 355