MSSNYeNews: February 19, 2021 – Distribution of Vaccine to Community-Based Physicians

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Distribution of COVID-19 Vaccine to Community-Based Physicians

Colleagues:

In November, our state asked community-based physicians all over New York to register as vaccinators for Covid-19.  Thousands of physician practices heeded the call and stand ready, willing, and able to immunize this state’s most vulnerable patients.

We are pleased that the vaccine supply is beginning to increase, and new vaccines gain emergency use authorization, which means more of our patients can receive these critically needed vaccinations.  However, as part of this effort, it is imperative that our state and our country employ all resources available and that certainly must include our most experienced vaccinators, community-based physicians.   Our community physicians can quickly identify the most vulnerable and can reach large amounts of patients who suffer from significant co-morbidities and who cannot travel to a vaccine distribution site due to health reasons.

Equity in vaccine distribution has been prioritized by all, and community-based physicians can aid in execution.  Community-based physicians practice in a wide range of communities— urban, rural, and suburban settings; and they serve the poor, the elderly, individuals of color and those with co-morbidities.   Many of these patients do not have transportation, are in communities without mass transportation, lack the financial resources, or are simply too ill to travel.   More importantly, patients trust their physicians and are comfortable in the office setting.

So, who better than the community physician to decrease vaccine hesitancy and promote vaccination?

It is time to update the game plan on the distribution of the vaccine and get the vaccine to the people rather than having the people go to the vaccine.  Click here to urge Governor Cuomo and the NYS Legislature to take the steps necessary to ensure that community-based physicians are part of our “all hands-on-deck” effort to provide COVID -19 vaccination to their patients!

Bonnie Litvack, MD
MSSNY President


 


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Join Us for MSSNY’s Virtual Lobby Day on March 2
Please plan to put aside Tuesday, March 2 for MSSNY’s Annual Physician Advocacy Day – this time Virtual!  To register, click here.

The format will follow previous years formats, where assembled physicians and allies will hear from legislative leaders and MSSNY physician leaders in the morning (this year via Zoom) from 8 AM-11 AM, and then have virtual visits with their respective legislators in the afternoon (organized by their county medical societies).

Please take this opportunity to advocate your concerns to your legislators regarding the numerous problematic proposals that have been advanced in the proposed Executive Budget including:

  • Significantly reducing physician due process when a complaint has been filed against them to the OPMC;
  • Forcing the 17,000 physicians insured through the Excess Medical Malpractice Insurance Program to unfairly bear thousands to tens of thousands of dollars in new costs for this coverage
  • Inappropriately expanding scope of practice for various non-physicians including pharmacists and nurse practitioners;
  • Handing insurance companies enormous new powers to limit physicians providing telehealth services to their patients

As well as voicing your support for a number of Executive Budget proposals including:

  • Expanding the supply of PPE
  • Regulation of Pharmacy Benefit Managers (PBMs)
  • Reducing the interest on court judgments to bring down exorbitant liability costs

Please plan to join hundreds of colleagues from around the State on March 2! (ALI) 


Please Urge Your Legislators to Reject Huge New Costs Placed on Community Physicians for Excess Coverage
Please urge your legislators to reject an extremely ill-timed Executive Budget proposal that would foist thousands to tens of thousands of dollars of new costs on the nearly 17,000 physicians enrolled in the Excess Medical Malpractice Insurance.   You can send a letter and/or tweet them from here.

This proposal, which would for the 1st time in the program’s 35-year history require enrolled physicians to bear an extraordinary 50% of the cost of these policies, would thrust over $50 million of new costs on the backs of our community-based physicians who served on the front lines of responding to the pandemic.  For some physicians, particularly in Long Island and New York City, this could add up to tens of thousands of dollars per physician (see examples below).  This new cost imposition would hit these practices at a time when many of these practices are already facing huge losses resulting from the substantial reduction in the number of patients receiving care during the pandemic.

NEW COSTS TO BE IMPOSED ON PHYSICIANS FOR EXCESS COVERAGE BASED UPON GOVERNOR’S 50% COST BUDGET PROPOSAL

SPECIALTY Long Island Bronx, Staten Island Brooklyn, Queens Westchester, Orange, Rockland, and Manhattan
Emergency Medicine $5,653 $6,561 $6,118 $4,500
Cardiac Surgery $4,482 $5,202 $4,862 $3,567
OB-GYN $20,881 $24,235 $22,648 $16,617
Neurosurgery $35,222 $40,879 $38,202 $28,030

MSSNY has joined with 16 other specialty medical societies in a letter to the entire State Legislature that expresses our strong objection to this proposal (Click Here).  Among the key points in the letter is that a recent AMA survey reported that during the pandemic the average number of in-person visits to physician offices dropped nearly in half.   The bottom line is that the new costs this proposal would impose are simply not assumable by physicians, meaning that many physicians will face no choice but to forgo receiving this additional coverage.                                                          (AUSTER)


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MSSNY Joins Other Northeastern State Medical Societies Urging Allocation of COVID-19 Vaccine to Community Based Physicians to Immunize Their Patients
The Medical Society of the State of New York and other state medical societies joined together to urge that the Biden Administration and state governments take necessary to steps to ensure that community-based physicians can receive the COVID-19 vaccine to immunize their patients.   Joining in the statement were the: Connecticut State Medical Society, Massachusetts Medical Society, Medical Society of New Jersey, Pennsylvania Medical Society, and the Ohio State Medical Association. 

The statement says in part: “As the country moves forward into the immunization process, and as supply increases, it is vitally important that the country and the states employ all resources available and that includes the community-based physicians.   Unfortunately, so far, hospitals, chain pharmacies and mass vaccination sites have been prioritized at the expense of those who know their patients’ needs best – the community physician. These are individuals who can quickly identify the most vulnerable and can reach large amounts of patients who suffer from significant co-morbidities and cannot travel to a vaccine distribution site due to health reasons.

Community-based physicians practice in a wide range of communities such as urban, rural and suburban settings and serve the poor, the elderly, individuals of color and those with co-morbidities.   Many of these patients do not have transportation, are in communities without mass transportation, lack the financial resources or are simply too ill to travel.    Community based physicians care for thousands of patients each and can quickly identify those patients who are most at risk of getting COVID-19 or having complications due to their comorbidities.  More importantly, patients feel comfortable with their physicians, with whom they can discuss the vaccine, and address any vaccine hesitancy, and feel comfortable in the office setting.” (CLANCY, AUSTER)


Urge Your Legislators to Reject Proposal to Curtail Physician Due Process Protections
Please urge your legislators to reject an Executive Budget proposal that that would greatly curtail due process protections for physicians when a complaint has been filed with the Office of Professional Medical Conduct (OPMC), including making information public about a complaint even if no professional misconduct is found and greatly lessening the burden for imposing an interim suspension prior to the conclusion of the statutory hearing process.   You can send a letter and/or tweet to your local legislators from here.

MSSNY has joined with more than a dozen specialty medical societies in a letter to the State Legislature expressing its strong opposition to this proposal (Click Here). While New York’s physicians share the goal of assuring the State has ample power to protect the public when the conduct of a particular health care provider places patients at risk, the Commissioner already has authority to take summary action prior to the conclusion of a disciplinary hearing in the absence of a finding of misconduct.  Moreover, this proposal is stunning in light of the enormous sacrifices made by countless physicians over the last year, serving on the front lines in responding to the pandemic.

The group letter reminds the State Legislature that, while the medical community is always ready to work to address gaps in our disciplinary system to protect patient safety, this proposal is grossly unfair and over-reaching given that most complaints never result in findings of misconducts or even formal charges being filed. Of greatest concern is that information released to the public, even if there is no action ultimately taken, can remain available through “Google searches” forever, with the potential to eviscerate a physician’s professional reputation.                                         (AUSTER)


Please Contact Your Legislators to Raise Concerns with “Consolidated Billing” Legislation
Physicians are urged to contact their Assemblymembers and Senators to urge them to substantially revise A.3470- A/S.2521-A, “The Patient Medical Debt Reduction Act”. Click here to contact your legislators today!

While there are many components to this well-intended legislation, there is a seriously problematic component would prohibit a physician or other provider with any “financial or contractual relationship” with a hospital from separately billing a patient for a course or episode of treatment in the hospital. While it doesn’t appear to prohibit continued separate billing to insurance companies or other payers, a single hospital-physician bill would be required when a bill is sent to a

patient for costs not covered by the patient’s insurance, such as collection of a deductible. It would also require such consolidated bill to be sent within 7 days of a patient’s discharge from the hospital before there is any clarity as to what expenses will actually be covered by a patient’s insurance.

If this bill were to pass and this provision not amended, it would put non-employed physicians at the mercy of the hospitals where they practice since the legislation does not specify how payments to hospitals from this “single bill” would then be distributed to these physicians.  In an era when patients’ insurance policies regularly impose enormous deductibles, it would likely force even more physicians to sell their practices and become employees of hospitals in response to the helpless position many physicians would find themselves.  Other physicians may leave the state altogether.  The impact of this prohibition will fall most adversely on physicians who are on the front lines of the pandemic, many of whom are facing an enormous drop in patient volume due to a significant amount of delayed care.

The legislation recently advanced from the Assembly Health Committee to the Codes Committee and is before the Senate Health Committee.  Please let your legislators know you appreciate the intent of the legislation to minimize the financial burden on our patients but that this “single bill” component will most heavily adversely impact community physicians, and ultimately result in the loss of patient choice and exacerbate health care monopolies in our health care system.  (AUSTER)


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Governor Cuomo Announces 30-Day Budget Amendment on Recreational Marijuana
This week, Governor Cuomo announced a budget amendment on his quest to legalize recreational marijuana.  This amendment included a designation of $100 Million for the purposes of Social Equity Funding including how it will be allocated as well as refining criminal penalties related to the improper sales.   Under the Governor’s proposed amendments, qualified community-based nonprofit organizations and local governments would apply for funding to support a number of different community revitalization efforts, including, but not limited to: 

  • Job placement and skills services,
  • Adult education,
  • Mental health treatment,
  • Substance use disorder treatment,
  • Housing,
  • Financial literacy,
  • Community banking,
  • Nutrition services,
  • Services to address adverse childhood experiences,
  • Afterschool and child care services, system navigation services,
  • Legal services to address barriers to reentry, and
  • Linkages to medical care, women’s health services and other community-based supportive services

The amendment also calls for the following classification of certain criminal penalties:

  • Criminal sale in the third degree (sale to under 21 year old) will be made a class A misdemeanor
  • Criminal sale in the second degree (sale of over 16 ounces or 80 grams of concentrate) will be made a class E felony
  • Criminal sale in the first degree (sale of over 64 ounces or 320 grams of concentrate) will be made a class D felony

MSSNY continues to oppose the legalization of recreational use of marijuana and also urges that it be taken out of the NYS budget for 21-22.  Physicians are encouraged to send a letter to the Governor and to members of NY Legislature through MSSNY’s Grassroots Action Center (GAC) here. (CLANCY)


Please Oppose Proposals That Facilitate Uncoordinated Siloed Care to be Provided by Pharmacists
Please contact your legislators to urge that they oppose several components of the Executive Budget that could upend the patient-centered medical home model and threaten patient safety by greatly expanding the scope of services provided to patients by pharmacists without coordination with patient care physicians.  You can send a letter from here: Click Here.  Please let them know these proposals would greatly enhance the power of big box giants to control various aspects of patient care delivery not in coordination with but to the exclusion of community-based primary care and specialty care physicians that typically manage the care of their patients.

Specifically, these Budget proposals would 1) permit pharmacists to order various lab tests without any physician oversight and without any requirement to coordinate with the patient’s physician for follow-up care; 2) greatly expand the physician-pharmacist Collaborative Drug Therapy Program to enable pharmacists to adjust the medications provided to entire classes of patients rather than individual patients and 3) permit pharmacists the power to administer any vaccination approved by the federal Advisory Commission on Immunization Practices (ACIP), including those which may be added in the future, thereby removing the discretion of the State Legislature to make these decisions.  Some of these proposals have been rejected by the Legislature in previous Budget cycles.

All of these programs together could incentivize the development of health care silos at the expense of the patient centered medical home model we have worked so hard to develop in New York.   It would also marginalize community based primary care and specialty care physicians’ ability to continue to be able to manage their patients’ ongoing care needs.    Please urge your legislators to reject these measures as they finalize the State Budget for 2021-22.        (AUSTER)


If you or someone you know is struggling with everyday life stressors, reach out to the P2P program to be connected with a peer supporter to help!
Email: P2P@mssny.org and request that you be connected with a peer supporter. Phone: 1-844-P2P-PEER (1-844-727-7337) and request that you be connected with a peer supporter.

MSSNY now offers to physicians, residents and medical students a completely confidential and anonymous opportunity to talk with a peer about some of their life stressors. MSSNY’s Physician Wellness and Resiliency Committee launched a Peer 2 Peer (P2P) program to assist their colleagues who are need of help in dealing with work and family stressors. With the myriad of challenges we are all facing related to the pandemic, some physicians may need the support of their colleagues to help manage these stressors.

MSSNY has established a confidential helpline phone number (1-844-P2P-PEER) and an email address (p2p@mssny.org) so that physicians may be connected with a peer 24 hours a day/7 days a week. In addition to offering a trained, empathetic ear, peer supporters may provide information on specific resources that can offer further support, provide positive coping skills, or connect physicians to professionals for more focused assistance when needed.

MSSNY has nearly 50 trained peer supporters across NYS who are just a phone call away!                                       (LAUDER)                                                     


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MSSNY Podcasts Keep You Informed and Current
Don’t forget to check out MSSNY’s podcast website.  In addition to MSSNY’s weekly Update podcasts, there are numerous informative podcasts available on topics ranging from COVID-19 to emergency preparedness to vaccines.  Each podcast offers insight from medical experts on topics for which they are extensively well versed.  Go to http://www.buzzsprout.com/51522 and choose one or many to listen.                                                                    (HOFFMAN)


eNews

Troy Oechsner Named Executive VP of Medical Society of State of New York
February 17, 2021, Westbury, NY—The Medical Society of the State of New York (MSSNY) today announced that it has named Troy Oechsner as its new Executive Vice President. Oechsner is a veteran of State government who served as lead regulator of commercial health insurance at the Department of Financial Services as well as prosecutor of illegal and deceptive health care business practices with the New York State Attorney General.  Most recently, Oechsner has been a partner at the consulting firm Manatt, Phelps and Phillips.

“We are thrilled to have Troy on board at MSSNY.  He brings proven ability to effectively advocate for positive reforms that will protect the rights of doctors and their patients to affordable, accessible quality health care,” said Dr. Bonnie Litvack, MSSNY President.  “Troy has a track record of effective management and leadership, and the ability to build coalitions among a broad section of health care professionals and consumers.”

“The Medical Society has worked successfully with Troy for decades,” said Dr. Andrew Kleinman, Chair of the MSSNY Board of Trustees.  “He brings passion, knowledge and skill to the job that will help further the cause of physicians and patients.  Troy is a welcome addition to the important work of the Society.”

“As a former insurance regulator and prosecutor, I recognize the many challenges faced by both physicians and patients,” said Oechsner.  “Physicians have been leaders in the frontline battle against COVID.  I am excited and honored to join the MSSNY team in our common fight to support doctors and patients seeking improved access to quality, affordable health care, guided by the physician’s training, experience and best practices.”

During over 30 years in State government, Oechsner helped lead many actions to improve health care for physicians and consumers.  Oechsner was part of a team leading the implementation of the Affordable Care Act in New York, including the successful establishment of the state’s health insurance exchange marketplace – the New York State of Health.  Oechsner was also instrumental in drafting and negotiating New York’s landmark Surprise Balance Billing Law that protected consumers from surprise bills from out-of-network doctors with a dispute resolution system fair to physicians and insurers.

Mr. Oechsner led an investigation by the New York Attorney General’s office into improper denials of specialty care by Aetna when it failed to acknowledge appropriate referrals to specialists.  These actions resulted in a negotiated settlement with Aetna that assured fair reimbursement to the impacted physicians.  Oechsner also helped initiate the investigation of Ingenix, which ultimately produced action by then Attorney General Cuomo to stop the manipulation of physician fee data, which was inappropriately increasing patient cost-sharing responsibilities for out-of-network care.

Oechsner succeeds Philip Schuh, CPA, who is retiring from MSSNY after a 35-year career at the Medical Society.


Patient Medical Debt Bill:  Right Premise-Wrong Solution
The patient medical debt bill S2521-A (Rivera)/A3470-A (Gottfried) proposed by the New York State Legislature is well intended, seeking to ensure patients receive clear, concise, and timely bills. However, the legislation as currently written will have negative unintended consequences. This bill would prohibit a physician or other provider with any financial or contractual relationship with a hospital from separately billing the patient. This could force many physicians to sell their practices and become employees of hospitals in order to receive timely and adequate payments. 

The professional services provided by a contracted physician are often only a small component of the overall hospital services received by a patient.  Prohibiting a private physician group from separately billing a patient for services provided at a hospital puts the physician group at a distinct financial disadvantage, will increase health care costs, and ultimately reduce quality of care.

In addition, the legislation as written fails to address further billing for applicable patient cost-sharing as required by their insurance policy (co-pay, coinsurance, deductible, etc.) after a claim has been paid by the insurance company, and how partial payments will be allocated between the multiple health care parties whose services are being billed by the hospital. The bill has the right premise but the wrong solution.  MSSNY strongly supports greater transparency and timeliness of billing for patients and is committed to working with the sponsors of this legislation to achieve these goals and to preserve the independent physician practice model and high-quality patient care. Click here to urge your legislator to oppose S2521-A (Rivera)/A3470-A (Gottfried).


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MSSNY Member Details a Scam Re His Medical License by Purported State and Federal Officials
Dear Members: Below please find a concerning message from one of our valued physician members detailing an account that took place this week and involved individuals purporting to be State and Federal officials. For the sake of honoring the integrity of this member’s account, I have shared the member’s direct message below: Here are the details of my experience yesterday that I would like to let other members be aware of. My Medical Assistant took a call yesterday morning from someone identifying himself as Albert Rossi from the State Education Department, Office of Professions, Division of Licensing Services. He said that he needed to talk to me about a problem with my NY Medical License.

When I got on the phone, he told me that I was under investigation and connected me with someone who said he was Brian Hobbs, the Chief Investigating Officer, Unit 3. I spent most of the morning and a good part of the afternoon on the phone with this person. He told me that my license was being suspended at the order of the FBI and DEA because I was the prime suspect in an investigation involving illegal drug trafficking and money laundering. At times, he would call someone that he said was an FBI Agent named Robert Johnson who then was part of a 3-way call with me.

They faxed me official looking documents that are attached to this email. [Please click here to view those documents, which have been redacted for privacy reasons]. The first one stated that my license was suspended. He then told me my options were to consult a lawyer and fight these allegations in court. If I did that, I would not be able to practice medicine until the case was resolved. The other option was that I could agree to cooperate with the investigation. Even though the evidence appeared to show that I was involved, they suspected that I was set up and my DEA and license were being used by someone else. They hoped that my cooperation would help them find the real culprit. If I agreed to cooperate, they would be able to reinstate my license within 48-72 hours. I was told that I would have to post a bond of $15,600 to have the license reinstated and this would be refunded once the case was resolved. I did sign the cooperation agreement, but then I was able to confirm with the State Education Department that there was no action against my license.

The caller ID on their call was the real number for the State Education Department. This whole scheme was well rehearsed and very convincing. They preyed on the fact that I desperately didn’t want my license suspended. They insisted that I stay on the line with them while all this was transpiring and would put me on hold while they prepared or reviewed the attached documentation, etc. They insisted that I not hang up or talk to anyone else because it could compromise the investigation. This was obviously a ploy to prevent me from getting anyone else to help me figure if this was real or a scam.
This was submitted by Aimana ElBahtity, Esq. Executive Director Erie County.


2021 E/M Coding Changes: Are You Leaving Money on the Table?

Limited to 25 Attendees
Two convenient time slots for “2021 E/M Guideline Changes

Course Description
Many physicians are still struggling when it comes to implementing these historic changes into their day-to-day workflow. Garfunkel Health Advisors is offering an interactive event on Documentation & Coding Compliance following the new E/M Coding Guidelines. 

To help ensure you get the most out of the live session, participation will be limited to 25 participants and you may submit questions in advance, specific to your practice and specialty.  

During the event we will:

• Share our knowledge and experience
• Answer your questions
• Discuss tips and best practices
• Review Time vs MDM opportunities
• Wave the caution flag in areas of potential audit risk 

Speaker:
Alicia Shickle
President, Documentation and Coding/Audit Division of
Garfunkel Health Advisors, Inc

Discounted pricing for MSSNY members:
◊ Member rate $150
◊ Non-member rate $300 

OPTION 1
Tuesday, February 23, 2021Presentation:
12:00 pm – 1:30 pm (EST)
OPTION 2
Thursday, February 25, 2021Presentation:
7:30 pm – 9:00 pm (EST)

For more information call: 516-393-2294

REGISTER HERE

Garfunkel Health Advisors, Inc.
Garfunkel Wild is pleased to announce the launch of Garfunkel Health Advisors, Inc., a healthcare consulting subsidiary providing strategic and operational advice to the healthcare industry.


Biden To Nominate Chiquita Brooks-Lasure As CMS Chief
Chiquita Brooks-LaSure, a former policy official in the Obama administration, is President Joe Biden’s pick to lead CMS, according to Politico, which cites four sources familiar with the decision. Ms. Brooks-LaSure, who previously oversaw the implementation of the ACA, was named a front-runner for the CMS administrator role in early February.

If her nomination is confirmed, Ms. Brooks-LaSure will oversee the Biden administration’s plans to expand the ACA and other healthcare policy efforts.

Ms. Brooks-LaSure, who serves as managing director of consulting firm Manatt Health, previously was deputy director for policy at CMS’ Center for Consumer Information and Insurance Oversight. She also served as director of coverage policy within HHS.


Declines in Hospital Volume Amid COVID-19
U.S. hospitals saw patient volume for CMS-defined shoppable services drop an average of 35.2 percent in the second quarter of 2020, compared to the same period in 2019, according to a new analysis from Hospital Pricing Specialists.

For the analysis, Hospital Pricing Specialists reviewed volume data on 68 current procedural terminology codes on the CMS-mandated list of shoppable services. The analysis, which sought to understand how patient volume was affected by the COVID-19 pandemic, compared volume in the second quarter of 2019 to the second quarter of 2020.

Hospital Pricing Specialists also normalized the data so only codes that were present in both time periods were analyzed.

The state that saw the steepest decline in patient volume for the CPT codes analyzed was Massachusetts, which saw volume decline by 48.5 percent from the second quarter of 2019 to the second quarter of 2020.

New Jersey: -47.9 percent
New York: -42.2 percent
Connecticut: -44.4 percent
Pennsylvania: -35.0 percent
Massachusetts: -48.5 percent


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Unique Rheumatology Practice Opportunity – Great Neck, NY
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State Medical Societies Urge Biden Administration and State Governments to Facilitate Distribution of COVID-19 Vaccine to Community-Based Physicians

For Immediate Release
February 19, 2021  

 

CONNECTICUT STATE MEDICAL SOCIETY
MASSACHUSETTS MEDICAL SOCIETY
MEDICAL SOCIETY OF NEW JERSEY
MEDICAL SOCIETY OF THE STATE OF NEW YORK
PENNSYLVANIA MEDICAL SOCIETY
OHIO STATE MEDICAL ASSOCIATION  

State Medical Societies Urge Biden Administration and State Governments to Facilitate Distribution of COVID-19 Vaccine to Community-Based Physicians

“On behalf of the tens of thousands of physicians we represent, the medical societies of Connecticut, Massachusetts, New Jersey, New York, Pennsylvania and Ohio call upon the Biden Administration and state governments to facilitate the distribution of the COVID-19 vaccine to those community-based physicians who have registered with their state systems in order for them to immunize the country’s most vulnerable patients.

As the country moves forward into the immunization process, and as supply increases, it is vitally important that the country and the states employ all resources available and that includes the community-based physicians.   Unfortunately, so far, hospitals, chain pharmacies and mass vaccination sites have been prioritized at the expense of those who know their patients’ needs best – the community physician. These are individuals who can quickly identify the most vulnerable and can reach large amounts of patients who suffer from significant co-morbidities and cannot travel to a vaccine distribution site due to health reasons.

Community-based physicians practice in a wide range of communities such as urban, rural and suburban settings and serve the poor, the elderly, individuals of color and those with co-morbidities.   Many of these patients do not have transportation, are in communities without mass transportation, lack the financial resources or are simply too ill to travel.    Community based physicians care for thousands of patients each and can quickly identify those patients who are most of risk of getting COVID-19 or having complications due to their comorbidities.  More importantly, patients feel comfortable with their physicians, with whom they can discuss the vaccine, and address any vaccine hesitancy, and feel comfortable in the office setting.

The COVID-19 pandemic is the biggest health care challenge that this country has faced in the last 100 years.   The difference compared with public health crises is the rapid advancement of science that allowed the world to develop vaccine that could very well stop this pandemic in its tracks.  The key though is to ensure that we engage all facets of the health care system and that includes the community-based physician.

It is time to change the game plan on the distribution of the vaccine and get the vaccine to the people rather than having the people go to the vaccine.   The first step in this process is for the federal government to take the necessary steps to enable community-based physicians to secure a supply of the COVID -19 vaccine and to begin to immunize those patients most at risk.”

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

 

Media Contact:
Roseann Raia

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

Troy Oechsner Named Executive VP of Medical Society  

For Immediate Release
 

Troy Oechsner Named Executive VP of Medical Society

February 17, 2021, Westbury, NY—The Medical Society of the State of New York (MSSNY) today announced that it has named Troy Oechsner as its new Executive Vice President. Oechsner is a veteran of State government who served as lead regulator of commercial health insurance at the Department of Financial Services as well as prosecutor of illegal and deceptive health care business practices with the New York State Attorney General.  Most recently, Oechsner has been a partner at the consulting firm Manatt, Phelps and Phillips.

“We are thrilled to have Troy on board at MSSNY.  He brings proven ability to effectively advocate for positive reforms that will protect the rights of doctors and their patients to affordable, accessible quality health care,” said Dr. Bonnie Litvack, MSSNY President.  “Troy has a track record of effective management and leadership, and the ability to build coalitions among a broad section of health care professionals and consumers.”

“The Medical Society has worked successfully with Troy for decades,” said Dr. Andrew Kleinman, Chair of the MSSNY Board of Trustees.  “He brings passion, knowledge and skill to the job that will help further the cause of physicians and patients.  Troy is a welcome addition to the important work of the Society.”

“As a former insurance regulator and prosecutor, I recognize the many challenges faced by both physicians and patients,” said Oechsner.  “Physicians have been leaders in the frontline battle against COVID.  I am excited and honored to join the MSSNY team in our common fight to support doctors and patients seeking improved access to quality, affordable health care, guided by the physician’s training, experience and best practices.”

During over 30 years in State government, Oechsner helped lead many actions to improve health care for physicians and consumers.  Oechsner was part of a team leading the implementation of the Affordable Care Act in New York, including the successful establishment of the state’s health insurance exchange marketplace – the New York State of Health.  Oechsner was also instrumental in drafting and negotiating New York’s landmark Surprise Balance Billing Law that protected consumers from surprise bills from out-of-network doctors with a dispute resolution system fair to physicians and insurers.

Mr. Oechsner led an investigation by the New York Attorney General’s office into improper denials of specialty care by Aetna when it failed to acknowledge appropriate referrals to specialists.  These actions resulted in a negotiated settlement with Aetna that assured fair reimbursement to the impacted physicians.  Oechsner also helped initiate the investigation of Ingenix, which ultimately produced action by then Attorney General Cuomo to stop the manipulation of physician fee data, which was inappropriately increasing patient cost-sharing responsibilities for out-of-network care.

Oechsner succeeds Philip Schuh, CPA, who is retiring from MSSNY after a 35-year career at the Medical Society.

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

Media Contact:
Roseann Raia

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

 

 

MSSNYeNews: February 17, 2021 – AMA Acknowledges Its History of Racism

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AMA Acknowledges that Founder, Dr. Nathan Davis, Allowed and Upheld Racism
Today, the American Medical Association (AMA) is taking an important step to reconcile AMA’s past by acknowledging the harms that one of their founders, Dr. Nathan Davis, had in their organization’s history that allowed and upheld racism within the medical profession.

This Viewpoint from AMA CEO James L. Madara, MD, provides important details and context for this acknowledgment including AMA’s 2008 apology, recent actions by their Board and House of Delegates, and the work underway through the AMA Center for Health Equity. By acknowledging the past, the AMA is embracing a discussion about how to begin to heal past harms.


Pfizer COVID-19 Vaccine Cuts Symptomatic Cases By 94%, Data Shows
COVID-19 infections fell by 94 percent among people who received two doses of Pfizer’s vaccine, according to a study by Clalit, the largest healthcare provider in Israel. Clalit studied symptomatic COVID-19 infections among 600,000 people who received two doses of Pfizer’s vaccine and compared them to an unvaccinated group of the same size (WSJ) reported Feb. 15. The study included 430,000 participants between ages 16 and 59 and 170,000 participants ages 60 and older, Clalit said.

The study also found that Pfizer’s vaccine reduced cases of severe illness from COVID-19 by 92 percent. (Becker’s Hospital 2/18)


Physicians See Spike in Rare Inflammatory Condition Linked to COVID-19
Physicians are reporting a significant uptick in cases of multisystem inflammatory syndrome in children, a rare inflammatory condition potentially linked to COVID-19, reports The New York Times. The condition, known as MIS-C, typically emerges several weeks after COVID-19 infection and causes symptoms like fever, inflammation and poor organ function. Physicians said these cases are not just becoming more common, but also more severe.

“We’re now getting more of these MIS-C kids, but this time, it just seems that a higher percentage of them are really critically ill,” Roberta DeBiasi, MD, chief of infectious diseases at Children’s National Hospital in Washington, D.C., told the Times. About 80 percent to 90 percent of Children’s National patients with MIS-C need intensive care, up from about half of patients in the spring, according to Dr. DeBiasi. Children’s Hospital & Medical Center in Omaha saw about two MIS-C cases per month between April and October 2020, with about 30 percent of patients needing intensive care. This jumped to 10 cases in December and another 12 in January, with about 60 percent needing ICU care.

It is unclear why cases are rising, and experts say it is too early to speculate whether virus variants are influencing these numbers. Overall, MIS-C is still a rare condition. As of Feb. 8, the CDC had confirmed 2,060 cases nationwide, including 30 deaths.


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Vaccine Will Be Available to All Americans By Late July, President Biden Says
For the first time in 2021, no state is reporting a seven-day COVID-19 case average higher than 10,000 as of Feb. 16, reports The COVID Tracking Project.

Other updates:

  1. President Joe Biden also said that every American who wants to receive a COVID-19 vaccine will be able to get one by the end of July during a town hall meeting hosted by CNN Feb. 16.
  2. The federal government will increase states’ collective vaccine allocation to 13.5 million doses each week, White House Press Secretary Jen Psaki said Feb. 16. The U.S. is also doubling its supply for pharmacies to 2 million doses weekly through a new federal program, Ms. Psaki said.
  3. Moderna expects to deliver 300 million vaccines to the U.S. government by the end of July, according to a Feb. 16 update. About 25.5 million doses of the Moderna vaccine have been administered in the U.S. thus far, according to a CDC communication with Moderna.

2021 E/M Coding Changes: Are You Leaving Money on the Table?
Limited to 25 Attendees
Two convenient time slots for “2021 E/M Guideline Changes
Course Description
Many physicians are still struggling when it comes to implementing these historic changes into their day-to-day workflow. Garfunkel Health Advisors is offering an interactive event on Documentation & Coding Compliance following the new E/M Coding Guidelines.To help ensure you get the most out of the live session, participation will be limited to 25 participants and you may submit questions in advance, specific to your practice and specialty.  During the event we will:

  • Share our knowledge and experience
    •  Answer your questions
    •  Discuss tips and best practices
    •  Review Time vs MDM opportunities
    •  Wave the caution flag in areas of potential audit risk

Speaker:
Alicia Shickle
President, Documentation and Coding/Audit Division of
Garfunkel Health Advisors, Inc

Discounted pricing for MSSNY members:
◊ Member rate $150
◊ Non-member rate $300 

OPTION 1
Tuesday, February 23, 2021 Presentation:
12:00 pm – 1:30 pm (EST)
OPTION 2
Thursday, February 25, 2021 Presentation:
7:30 pm – 9:00 pm (EST)

For more information call: 516-393-2294

REGISTER HERE

Garfunkel Health Advisors, Inc.
Garfunkel Wild is pleased to announce the launch of Garfunkel Health Advisors, Inc., a healthcare consulting subsidiary providing strategic and operational advice to the healthcare industry


43% of Patients Check a Pharmacy Comparison App for Prescription Savings
Americans are becoming increasingly curious about ways to lower their prescription drug costs, according to recent survey results released by healthcare software company CoverMyMeds.

CoverMyMeds surveyed patients, providers and pharmacists during September and October. One thousand patients, 400 providers and 328 pharmacists participated in the survey, the results of which were released Jan. 25.

  • Sixty-two percent of patients seek information from their provider about medication costs and affordability options.
  • Forty-three percent of patients said they checked a pharmacy comparison app to find cheaper medication prices, up from 28 percent the previous year.
  • More than a third of pharmacists said they saw patients use prescription price shopping tools on a daily basis. (Feb. 15 Becker’s Hospital Review)

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Northwell Sues Insurers for Denying Pandemic-Related Claims

  • New York’s largest health care provider is suing two out-of-state insurance companies for denying claims related to business-interruption insurance policies and the Covid-19 pandemic.
  • Northwell Health, home to more than 21 hospitals in the metropolitan area, is suing Boston-based Lexington Insurance Co. and Chicago-based Interstate Fire & Casualty Co. for breach of contract for their refusal to honor an “all risk” property policy.
  • In the lawsuit, filed in the Southern District of New York, Northwell contends it suffered “significant property and business-interruption losses arising out of the novel coronavirus outbreak and ongoing Covid-19 pandemic,” and the defendants “have refused to compensate Northwell for its losses.”
  • Northwell alleges that the defendants denied coverage in its entirety Oct. 30 based on a “pollution” exclusion endorsement. The health system says the defendants’ interpretation of the pollution exclusion contravenes the plain meaning of the language, and the policy contains coverage for communicable diseases, confirming that a virus can cause loss of or damage to property.
  • Northwell says both defendants have refused to pay any amount to date, with currently assessed damages listed as “hundreds of millions of dollars.” The health care provider alleges its policies with the defendants provide almost $1.3 billion in coverage, with Lexington covering 90% of the share, and Interstate covering 10%. (Crain’s Feb. 16)

The Importance of Community-Based Organizations During the Pandemic
With the COVID-19 national emergency, many people are facing unprecedented challenges. Some have lost their jobs and have lost health insurance coverage for themselves and their families. Others may be underinsured with unaffordable health coverage, or may have health insurance, but are not sure how to access the services that they need for their health problems.

With these uncertainties, Community-Based Organizations (CBOs) are key players who can help link community members to valuable resources, including how and where to obtain health insurance. CBOs also play a major role in educating community members about COVID-19 vaccines, raising awareness about the benefits of vaccination, and addressing common questions and concerns. As many communities are waiting for their turn to get the vaccine, CBOs can encourage them to take the time to consider their health insurance coverage. 

What can CBOs do now to help your community access valuable resources on the vaccine and health insurance coverage?

  • Use the NEW Community-Based Organizations COVID-19 Vaccine Toolkit. Soon the communities you serve will have access to vaccines to help protect against COVID-19. CDC has designed a toolkit to help CBOs educate communities about this important new prevention tool. This toolkit is designed for staff of organizations serving communities affected by COVID-19.
  • Share COVID-19 Vaccine information and Resources with the communities that you serve. Here’s some messaging to share with your communities through newsletters, e-mail listserv announcements or other channels:
    • You can receive the COVID-19 vaccine at no cost. People without health insurance or whose insurance does not provide coverage of the vaccine can also get the COVID-19 vaccine at no cost.
    • State governments are handling the distribution of COVID-19 vaccines. Look for updates from your state and local officials as more doses of the vaccine become available for additional priority groups.
    • Link community members to information on how to obtain health insurance or use their existing coverage:
    • Consumers can take advantage of a special enrollment period (SEP) for individuals and families to apply and enroll in the coverage they need starting February 15, 2021 through May 15, 2021. This SEP will be available to consumers in the 36 states served by Marketplaces that use gov. Read the press release here.
    • Those in states with State Based Exchanges should check their state’s exchange website to find out specific enrollment options for their state. Go to gov to find out more information or be directed to your state’s exchange.
    • See if you qualify for Medicare, Medicaid or the Children’s Health Insurance Program or check on your health benefits if you already have coverage.
    • The From Coverage to Care initiative, has resources such as the Roadmap to Better Care to help consumers understand their health coverage and connect to primary care and the preventive services that are right for them.

Questions? Please e-mail us: Partnership@cms.hhs.gov


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CMS: What Partners Need to Know Now About Health Insurance During Pandemic
As COVID-19 vaccines begin rolling out across the country, CMS is taking action to protect the health and safety of our nation’s patients and providers and keeping you updated on the latest COVID-19 resources from HHS, CDC, and CMS.

With information coming from many different sources, CMS has compiled resources and materials to help you share important and relevant information on the COVID-19 vaccine with the people that you serve. You can find these and more resources on the COVID-19 Partner Resources Page and the HHS COVID Education Campaign page. We look forward to partnering with you to promote vaccine safety and encourage our beneficiaries to get vaccinated when they have the opportunity. 


Classifieds

Classified Ads Available for:

Physicians’ search services • allied medical placements • locum tenens • practice valuation • practice brokerage • practice consulting • real estate

For help, information or to place your ad, call Christina Southard 516-488-6100 x355 • fax 516-488-2188


Two (2) Prime Commercial Spaces
Two (2) affordable office spaces available for immediate occupancy.  Located in Sheepshead Bay Brooklyn,  surrounded by multiple co-ops and private homes.  Space can be viewed at your convenience. Price negotiable. Call: Avi 212-736-3680 ext. 15


Physician & Other Healthcare Jobs. P/T & F/T
Check us out @….bit.ly/38xkgDv


Unique Rheumatology Practice Opportunity – Great Neck, NY
Partnership opportunity available at an established rheumatology practice in Great Neck, NY. Looking for a dedicated physician to join our practice or merge practices. Contact 516-972-2986 / susanrita1@msn.com for more info.


 

 

 

 

 

 

 

 

 

MSSNYeNews: February 12, 2021 – Changing of the Guard: Thank you Philip Schuh, CPA, MS, and Welcome Troy Oechsner, JD

.MSSNY’s Partnership with Premier Group Purchasing

Colleagues:

For the last 30 years, our current EVP, Philip Schuh, has served our MSSNY tirelessly and effectively earning the respect and gratitude of us all.  Mr. Schuh was deservedly awarded the AMA lifetime achievement award for medical executives in the fall of 2020. We wish him well in his retirement and thank him for his financial stewardship and his enormous contributions to our organization and our profession. On a personal note, I would like to thank him for his friendship, support, and general good humor.

After an extensive nationwide search, I am excited to announce that MSSNY has selected a new Executive Vice President, Troy Oechsner, JD.  He will be leaving his position as a partner at the law firm Manatt Phelps & Phillips, LLP to lead the MSSNY team beginning March 1, 2021.  Mr. Oechsner is a Cum Laude graduate of the State University of New York at Buffalo Law School.  He has served as the Deputy Bureau Chief of the Health Bureau of the New York State Office of Attorney General, and as Deputy Superintendent of Health Insurance for the New York State Department of Financial Services.

The MSSNY search committee found his vision for the future of MSSNY to be both aspirational and inspirational.  Some of you are already familiar with Mr. Oechsner from previous presentations at past MSSNY Lobby Days and from his prominent role in formulating New York’s landmark Surprise Medical Billing Law.

Mr. Oechsner is well known and highly respected in state health circles, including among consumer groups, elected officials, state offices and hospital associations which will be an asset to our MSSNY in building coalitions to achieve meaningful victories for physicians and patients.  His experience in managing 700 employees at the Department of Financial Services will be instrumental in oversight of the daily operations of our MSSNY and in continuing strong financial stewardship.  Mr. Oechsner plans to prioritize membership expansion and non-dues revenue.

We look forward to his leadership and welcome him to the MSSNY family.

Bonnie Litvack, MD
MSSNY President


 


Capital Update

MSSNY Weekly Podcast


MSSNY Urges Governor Cuomo to Authorize Community Based Physicians to Begin Immunizing their Patients with COVID 19 Vaccine
From the beginning of this pandemic MSSNY has said repeatedly that the state should be relying on the multifaceted health care system, including the community-based physicians as one prong in the COVID 19 vaccination effort to reach the entire patient population.  Physicians are urged to send a Grassroot Action Center letter to the Governor Cuomo and members of the NYS Legislature urging that New York State allow community-based physicians to begin to receive a supply of COVID-19 vaccine and begin immunizing patients.

These concerns have been raised in numerous articles in papers across the State including in the New York Times, Buffalo News and NY1:

Community-Based Physicians Seek More Vaccine Doses (ny1.com)
Pop-up vaccine clinics try to fill gaps, but community doctors say they can do it better | Local News | buffalonews.com
Primary Care Doctors Feel Left Out of Vaccine Rollout – The New York Times (nytimes.com)

Governor Andrew M. Cuomo announced this week that New Yorkers with comorbidities and underlying conditions are now eligible to receive the COVID19 vaccine.    Several hundred community-based physicians who have signed up to through the New York State Immunization Information System (NYSIIS) only to be told that there is no vaccine available for the community-based physician.

These individuals’ practice in a wide range of communities throughout the state.  MSSNY has raised concerns that the plan to limit immunizing these comorbid patients to a state run COVID-19 site will adversely impact the poor, individuals of color and the very population you are trying to immunize—those with co-morbidity.   Many do not have the ability to go long distances (even an hour away) to these sites due to their condition.

MSSNY has asked Department of Health and the Governor’s office for an estimated time frame for these physicians to start receiving vaccine to immunize these patients and has yet to receive a reply.  Additionally,  Governor Cuomo has also indicated that excess vaccine supply meant for hospital workers can be used to open eligibility for New Yorkers with comorbidities and underlying conditions.  The Medical Society of the State of New York has repeatedly indicated to the state Department of Health and to the Governor’s office that there continues to be community-based physicians and their office staff that remain unimmunized because hospitals either don’t have a supply or that there the regional or local hospital hub are not immunizing those physicians and/or staff that are not employed.

Physicians log on to the GAC and make your voice on COVID-19 vaccination heard.  Click here to contact the governor and your legislator today! (CLANCY)


Join Us for MSSNY’s Virtual Lobby Day on March 2
Please plan to put aside Tuesday, March 2 for MSSNY’s Annual Physician Advocacy Day – this time Virtual!  To register, click here.

The format will follow previous years formats, where assembled physicians and allies will hear from legislative leaders in the morning (this year via Zoom), and then have virtual visits with their respective legislators in the afternoon.

With the significant number of adverse proposals in this year’s State Budget submission that will drive exacerbate existing practice challenges and unquestionably drive physicians away from New York State, your participation in this program is absolutely essential.

Please plan to join hundreds of colleagues from around the State on March 2!


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Please Urge Your Legislators to Reject Huge New Costs Placed on Community Physicians for Excess Coverage
Please urge your legislators to reject an extremely unfair Executive Budget proposal that would require the nearly 17,000 physicians enrolled in the Excess Medical Malpractice Insurance program to bear 50% of the cost of these policies.   You can send a letter and/or tweet them from here: Click Here.

This proposal would thrust over $50 million of new costs on the backs of our community-based physicians who served on the front lines of responding to the pandemic.  For some physicians, particularly in Long Island and New York City, this could add up to tens of thousands of dollars per physician.

For example, an emergency physician in Queens would face a new charge of over $6,000 for this coverage; an Ob-GYN in the Bronx would face a new charge of over $24,000; and a neurosurgeon on Long Island would face a new charge of nearly $41,000.  This new cost imposition would hit these practices at a time when many of these practices are already facing huge losses resulting from the substantial reduction in the number of patients receiving care during the pandemic.

MSSNY has joined with 16 other specialty medical societies in a letter to the entire State Legislature that expresses our strong objection to this proposal (Click Here).  Among the key points in the letter is that a recent AMA survey reported that during the pandemic the average number of in-person visits to physician offices dropped nearly in half.   The bottom line is that the new costs this proposal would impose are simply not assumable by physicians, meaning that many physicians will face no choice but to forgo receiving this additional coverage.

It is important to remember that the Excess Insurance program exists because of New York’s disproportionately high medical liability insurance costs as compared to all other states.  The real solution to this problem is comprehensive medical liability reform, but in its absence this program continues to be absolutely essential.  Please contact your legislators today to oppose this new cost imposition: Click Here (AUSTER)


Urge Your Legislators to Reject Proposal to Disregard Important Physician Due Process Protections
Please urge your legislators to oppose an Executive Budget proposal that that would significantly reduce due process protections for physicians against whom a complaint has been filed with the Office of Professional Medical Conduct (OPMC), including making information public about a complaint even if no professional misconduct is found and greatly lessening the burden for imposing an interim suspension prior to the conclusion of disciplinary proceedings.   You can send a letter and/or tweet to your local legislators from here: Click Here.

MSSNY has joined with 15 other specialty medical societies in a letter to the State Legislature expressing its strong opposition to this proposal. While New York’s physicians share the goal of assuring the State has ample power to protect the public when the conduct of a particular health care provider places patients at risk, the Commissioner already has authority to take summary action prior to the conclusion of a disciplinary hearing in the absence of a finding of misconduct.  Moreover, this proposal is stunning in light of the enormous sacrifices made by many in the medical profession over the last year, serving on the front lines in responding to the pandemic.  The proposal was rejected by the Legislature last year when it was proposed in the Executive Budget and we are urging them to reject it again.

The group letter reminds the Legislature that, while the medical community is always ready to work to address gaps in our disciplinary system to protect patient safety, this proposal is far too broad given that most complaints never result in findings of misconducts or even formal charges being filed. Of greatest concern is that information released to the public, even if there is no action ultimately taken, can remain available through Google searches forever, potentially unfairly destroying a physician’s professional reputation.

Please urge your legislators to reject this grossly unfair proposal. (AUSTER)


New Yorkers With Comorbidities and Underlying Conditions Now Eligible to Get COVID 19 Vaccine—MSSNY Asks When Community Based Physicians Will Receive Vaccine
Governor Andrew M. Cuomo announced that New Yorkers with comorbidities and underlying conditions are now eligible to receive the COVID19 vaccine.    Patients must show proof of comorbidities by either a

  • Physician letter or
  • Medical Information Evidencing Comorbidity or
  • Signed Certification which will be developed by local governments.

Patients can begin to make appointments at state-run mass vaccination sites beginning February 14, with the first appointments scheduled for February 15.   They must do so by logging onto “Am I Eligible?” or by calling 1-833 NYS 4 VAX (1-833-6974829).

The full list of comorbidities and underlying conditions is available below. The list is subject to change as additional scientific evidence is published and as New York State obtains and analyzes additional state-specific data.

  • Adults of any age with the following conditions due to increased risk of moderate or severe illness or death from the virus that causes COVID-19.
  • Cancer (current or in remission, including 9/11-related cancers)
  • Chronic kidney disease
  • Pulmonary Disease, including but not limited to, COPD (chronic obstructive pulmonary disease), asthma (moderate-to-severe), pulmonary fibrosis, cystic fibrosis, and 9/11 related pulmonary diseases
  • Intellectual and Developmental Disabilities including Down Syndrome
  • Heart conditions, including but not limited to heart failure, coronary artery disease, cardiomyopathies, or hypertension (high blood pressure)
  • Immunocompromised state (weakened immune system) including but not limited to solid organ transplant or from blood or bone marrow transplant, immune deficiencies, HIV, use of corticosteroids, use of other immune weakening medicines, or other causes
  • Severe Obesity (BMI 40 kg/m2), Obesity (body mass index [BMI] of 30 kg/m2 or higher but < 40 kg/m2)
  • Pregnancy
  • Sickle cell disease or Thalassemia
  • Type 1 or 2 diabetes mellitus
  • Cerebrovascular disease (affects blood vessels and blood supply to the brain)
  • Neurologic conditions including but not limited to Alzheimer’s Disease or dementia
  • Liver disease

There has not yet been official guidance on this issued by New York State Department of Health.

The New York State Department of Health has issued a compilation guidance information of items of importance regarding the COVID-19.   This guidance is complete as of February 4, 2021 and offers information from becoming an enrolled COVID-19 immunizer to mental health resources, including information on MSSNY’s P2P program.  The guidance is HERE.
(CLANCY)


 

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Legislation to Prohibit Billing by Hospital Based Physicians Advances – Please Contact Your Legislators
Physicians are urged to contact their Assemblymembers and Senators to urge them to substantially revise A.3470-A/S.2521-A, “The Patient Medical Debt Reduction Act”. Click here to contact your legislators today!  There are many components to this legislation, but one seriously problematic component would prohibit a physician or other provider with any “financial or contractual relationship” with a hospital from separately billing a patient for a course or episode of treatment in the hospital.  While it would not appear to prohibit continued separate billing to insurance companies and other payers, a single hospital and physician bill would be required when a bill is sent to a patient for costs not covered by the patient’s insurance.  It would also require such consolidated bill to be sent within 7 days of a patient’s discharge from the hospital before there is any clarity as to what expenses will actually be covered by a patient’s insurance.

If this bill were to pass and this provision not amended, it would put non-employed physicians at the mercy of the hospitals where they practice since it is not clear how payments to hospitals from this “single bill” would then be distributed to these physicians.  In an era when patients’ insurance policies impose enormous deductibles, it would likely force even more physicians to sell their practices and become employees of hospitals in order to receive timely and adequate payments. The impact of this prohibition will fall most adversely on physicians who are on the front lines of the pandemic, many of whom are facing an enormous drop in patient volume due to a significant amount of delayed care.   This is one more factor that will drive physicians out of New York State towards other states with more favorable practice environments.

The legislation recently advanced from the Assembly Health Committee to the Codes Committee and is before the Senate Health Committee.  The sponsors of the legislation have indicated that they intend to make this legislation a major priority for this Legislative Session.  Please let your legislators know you appreciate the intent of the legislation to minimize the financial burden on our patients but that this “single bill” component will most heavily adversely impact community physicians, and ultimately result in the loss of patient choice and exacerbate health care monopolies in our health care system. Click here to contact your legislators today! (AUSTER)


Please Oppose Proposals That Facilitate Uncoordinated Siloed Care to be Provided by Pharmacists
Please contact your legislators to urge that they oppose several components of the Executive Budget that could upend the patient-centered medical home model and threaten patient safety by greatly expanding the scope of services provided to patients by pharmacists without coordination with patient care physicians.  You can send a letter from here: Click Here.  Please let them know these proposals would greatly enhance the power of big box giants to control various aspects of patient care delivery not in coordination with but to the exclusion of community-based primary care and specialty care physicians that typically manage the care of their patients.

Specifically, these Budget proposals would 1) permit pharmacists to order various lab tests without any physician oversight and without any requirement to coordinate with the patient’s physician for follow-up care; 2) greatly expand the physician-pharmacist Collaborative Drug Therapy Program to enable pharmacists to adjust the medications provided to entire classes of patients rather than individual patients and 3) permit pharmacists the power to administer any vaccination approved by the federal Advisory Commission on Immunization Practices (ACIP), including those which may be added in the future, thereby removing the discretion of the State Legislature to make these decisions.  Some of these proposals have been rejected by the Legislature in previous Budget cycles.

All of these programs together could incentivize the development of health care silos at the expense of the patient centered medical home model we have worked so hard to develop in New York.   It would also marginalize community based primary care and specialty care physicians’ ability to continue to be able to manage their patients’ ongoing care needs.    Please urge your legislators to reject these measures as they finalize the State Budget for 2021-22. (AUSTER)


MSSNY Continues to Raise Concerns that Executive Budget Proposal to Expand Telehealth Coverage May Actually Lessen Coverage
MSSNY continues its outreach to lawmakers to ensure patients can continue to have coverage for needed health care services via telehealth, including providing payment parity between in-person and telehealth visits. At the same time, we continue to raise concerns with a number of aspects of the Executive Budget proposal to expand Telehealth coverage, and are seeking further clarification of these provisions.

We are particularly concerned that the Executive Budget proposal did not include a measure to ensure payment parity, which is a significant issue for community physicians and the patients that they serve. A recent survey of its members by MSSNY showed that 83% had incorporated telemedicine into their practice, with nearly half saying they were treating at least 25% of their patients remotely. However, insurers’ reimbursement for audio and video Telehealth services has not kept pace with those paid for in-office visits and the gap is wide. According to the survey, less than 1/4 of health plans had set their reimbursement levels for telehealth equal to what they pay for in-office visits, with audio-only visits the least compensated.

Further, MSSNY has raised concerns that the Budget proposal may be used by the insurance industry to actually reverse the telehealth gains made over the past year. Specifically, linking coverage of telehealth services to insurers having a “so-called” adequate network, together with the proposal to permit telehealth delivery services by out of state physicians, could essentially empower insurers to limit who it will pay for telehealth services once it asserts it has an “adequate” network. It is not hard to imagine a scenario where a health plan asserts it has an adequate network through a national telehealth service provider, and then excludes coverage of telehealth service by all or some of its in-network community-based physicians. That is completely at odds with the expansive approach to telehealth coverage taken over the past year as a result of actions taken by the DFS and DOH.

MSSNY has also raised concerns that the Executive Budget proposal doesn’t expressly address payment parity in the state’s Medicaid program, which if not addressed, could create an inequity in the care that beneficiaries of Medicaid receive.

MSSNY is continuing to work with a range of other patient and provider partner organizations to address our concerns and will update members as the issue unfolds. (CARY)


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NYS DOH Commissioner Medical Grand Rounds Virtual Webcast on March 5
The New York State Health Commissioner, Howard Zucker, MD, will host his 2021-2022 Commissioner’s Medical Grand Rounds series on Friday, March 5th, virtually via webcast.   The session, entitled Caring for Patients Living with and Beyond Cancer, will bring together experts to discuss the role primary care providers play in improving the quality of life for cancer survivors.

This Grand Rounds session will help primary care providers understand the long-term impact of cancer treatment on their patients and their continuing physical- and mental-health care needs by providing access to timely and evidence-based information. Three experts in cancer survivorship will discuss how to identify and manage commonly experienced physical and psychosocial effects of cancer and its treatment, as well as best practices for coordinating survivorship care between oncology specialists and primary care providers. View the flyer here.

This virtual session will take place on Friday, March 5th from 1:00 – 3:00 pm, and will be streamed via live webcast. The session will also be archived on the NYSDOH Website. The event is free-of-charge and open to all interested providers across New York State. The link to register can be found here.  The Medical Society of the State of New York is a partner in the Commissioner Grand Rounds. (CLANCY)


MSSNY’s Peer-to-Peer is Here to Help if You or Someone You Know is Struggling with Everyday Life Stressors
Email: P2P@mssny.org and request that you be connected with a peer supporter

Phone: 1-844-P2P-PEER (1-844-727-7337) and request that you be connected with a peer supporter

The Medical Society of the State of New York now offers to physicians, residents and medical students a completely confidential and anonymous opportunity to talk with a peer about some of life stressors. MSSNY’s Physician Wellness and Resiliency Committee launched a Peer 2 Peer (P2P) program to assist their colleagues who are need of help in dealing with work and family stressors. With the advent of the COVID-19 pandemic, some of the emotional issues related to this event may also be troubling for our colleagues.

MSSNY has established a confidential helpline phone number (1-844-P2P-PEER) and an email address (p2p@mssny.org) so that physicians may be connected with a peer 24 hours a day/7 days a week. In addition to offering a trained, empathetic ear, peer supporters may provide information on specific resources that can offer further support, provide positive coping skills, or connect physicians to professionals for more focused assistance when needed. MSSNY has nearly 50 trained peer supporters across NYS who are just a phone call away! (LAUDER)


Registration Now Open
Medical Matters: COVID Vaccine Update February 17, 2021 @ 7:30 am
There is still time to register.  Learn more about the COVID-19 vaccine on February 17th @ 7:30am.  Registration is now open for the next Medical Matters webinar: COVID Vaccine Update.  The discussion will include the types of vaccine in development, distribution priorities and barriers surrounding vaccine administration.  Dr. William Valenti will serve as faculty.  Click here to register.

Educational Objectives:

  • Recognize the types of COVID-19 vaccine in development
  • Discuss priorities for vaccine distribution
  • Identify barriers to COVID-19 immunization

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

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. (HOFFMAN)


eNews

HHS: US Government Bought 200,000,000 Vaccine Doses Yesterday
The U.S. government purchased 200 million COVID-19 vaccine doses Feb. 11. HHS and the Department of Defense purchased 100 million doses of COVID-19 vaccines from both Pfizer and Moderna, bringing the total doses purchased by the government from the two companies to a total of 600 million. Each company is set to deliver 300 million doses in regular increments through the end of July 2021.


2021 E/M Coding Changes: Are You Leaving Money on the Table?

Limited to 25 Attendees
Two convenient time slots for “2021 E/M Guideline Changes

Course Description
Many physicians are still struggling when it comes to implementing these historic changes into their day-to-day workflow. Garfunkel Health Advisors is offering an interactive event on Documentation & Coding Compliance following the new E/M Coding Guidelines. 

To help ensure you get the most out of the live session, participation will be limited to 25 participants and you may submit questions in advance, specific to your practice and specialty.  

During the event we will:

• Share our knowledge and experience
• Answer your questions
• Discuss tips and best practices
• Review Time vs MDM opportunities
• Wave the caution flag in areas of potential audit risk 

Speaker:
Alicia Shickle
President, Documentation and Coding/Audit Division of
Garfunkel Health Advisors, Inc

Discounted pricing for MSSNY members:
◊ Member rate $150
◊ Non-member rate $300 

OPTION 1
Tuesday, February 23, 2021Presentation:
12:00 pm – 1:30 pm (EST)
OPTION 2
Thursday, February 25, 2021Presentation:
7:30 pm – 9:00 pm (EST)

For more information call: 516-393-2294

REGISTER HERE

Garfunkel Health Advisors, Inc.
Garfunkel Wild is pleased to announce the launch of Garfunkel Health Advisors, Inc., a healthcare consulting subsidiary providing strategic and operational advice to the healthcare industry.


20 Most Expensive Prescription Drugs in 2021
Drug prices in the U.S. are about 256 percent higher than those in other countries, according to recent research.

Below is a list of the 20 most expensive prescription drugs in the U.S., based on the official price their manufacture assigned to them, as compiled by prescription discount company GoodRx. This list excludes medications that must be administered by a healthcare practitioner.

  1. Zokinvy (Geiger Biopharmaceuticals’): $86,040
  2. Millet (Aegerion Pharmaceuticals): $74,159
  3. Mavenclad (EMD Serono): $60,371
  4. Ravicti (Horizon Therapeutics): $57,998
  5. Actimmune (Horizon Therapeutics): $55,310
  6. Oxervate (Dompé): $48,498
  7. Takhzyro (Takeda): $46,828
  8. Juxtapid (Aegerion Pharmaceuticals): $46,502
  9. Cinryze (Takeda): $45,465
    • Chenodal (Travere Therapeutics): $42,570
    • Gattex (Takeda): $41,664
    • P. Acthar (Mallinckrodt Pharmaceuticals): $39,864
    • Orladeyo (BioCryst Pharmaceuticals): $37,308
    • Tegsedi (Akcea Therapeutics): $35,638
    • Ayvakit (Blueprint Medicines): $33,568
    • Vitrakvi (Bayer Pharmaceuticals): $32,800
    • Qinlock (Decipera Pharmaceuticals): $32,000
    • Korlym (Corcept Therapeutics): $31,440
    • Cerdelga (Genzyme): $28,599
    • Idhifa (Celgene): $28,246
      (Becker’s Hospital Review, Feb. 11)


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WHO Team Shares First Details of Probe into Pandemic’s Origin: 3 Things to Know
After spending time in hospitals, markets and laboratories in Wuhan, China, the World Health Organization team investigating the origins of the novel coronavirus shared findings from their initial data during a Feb. 9 news conference. 

Three early research findings:

  1. COVID-19 may have been circulating both inside and outside of the Huanan Seafood Market in Wuhan in December 2019, suggesting it may not have been the original source of the outbreak. “The market probably was a setting where that kind of spread could have happened easily, but that’s not the whole story,” said Dr. Peter Ben Embarek, the investigation’s international team lead. Dr. Liang Wannian, Chinese team lead of the WHO study, added that while there may have been missed cases in other regions, there’s been no evidence of significant COVID-19 circulation outside of Wuhan before the December 2019 outbreak.
  2. The virus “most likely” originated in animals before spreading to humans, the scientists said, emphasizing that more targeted research is needed to confirm the hypothesis and identify the intermediary animal host.
  3. The team said it was “extremely unlikely” that the virus was leaked from a Wuhan research lab as earlier theories have suggested, adding that the group will not recommend further investigation into the hypothesis.

“In terms of understanding what happened in the early days of December 2019, did we change dramatically the picture we had beforehand? I don’t think so,” Dr. Ben Embarek said. “Did we improve our understanding? Did we add details to that story? Absolutely.”


CDC: Tight-Fitting Masks, Two Masks Best Protection Against Infectious Aerosols
Double masking or knotting and tucking a single medical procedure mask helps prevent air leakage and improve mask performance, according to the CDC’s Feb. 10 Morbidity and Mortality Weekly Report.

After performing lab experiments with dummies, the CDC found that modifying masks to tighten the fit reduced exposure to potentially infectious aerosols, including those in the size range able to transmit SARS-CoV-2, by about 95 percent.

Researchers evaluated two modifications: Layering a cloth mask over a medical procedure mask, known as double masking, and a single medical procedure mask with knotted ear loops and tucked-in sides to help get rid of any loose material. When the infected wearer (source) and receiver were both fitted with the double mask or knotted and tucked mask modifications, the cumulative exposure of the receiver was reduced by 96.4 percent and 95.9 percent for each modification, respectively.

The report also highlighted the use of solid or elastic mask fitters and a modification where a nylon cover is placed over a mask, as additional effective options to improve mask fit.

“The data in this report underscore the finding that good fit can increase overall mask efficiency,” the CDC said. “Multiple simple ways to improve fit have been demonstrated to be effective.”

To view the full report, click here.


Increased Alcohol Use Driving Uptick in Hospitalizations for Liver Disease
Hospitals nationwide have reported a spike in alcohol-related admissions for serious liver disease, reports the Los Angeles Times. At Los Angeles-based Keck Hospital of USC, admissions for alcoholic liver disease jumped 30 percent last year compared to 2019. Hospitals affiliated with Chicago-based Northwestern Medicine, Boston-based Harvard University and New York City-based Mount Sinai Health System have reported up to 50 percent increases in these admissions since March 2020, specialists at each organization told the publication.

Many liver disease specialists and psychiatrists said they believe pandemic-related stressors such as isolation and unemployment are causing more people to drink and are fueling the spike in liver disease cases. “There’s been a tremendous influx,” Haripriya Maddur, a hepatologist at Northwestern Medicine, told the Los Angeles Times, adding that many of her patients with alcoholism have relapsed during the pandemic and required hospitalization.

Dr. Maddur and other physicians have expressed concerns that the stressors leading to higher alcohol consumption will continue well after lockdowns are lifted.

“I think we’re only on the cusp of this,” Dr. Maddur said. “Quarantine is one thing, but the downturn of the economy, that’s not going away anytime soon



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Physician & Other Healthcare Jobs. P/T & F/T – Check Us Out


Unique Rheumatology Practice Opportunity – Great Neck, NY
Partnership opportunity available at an established rheumatology practice in Great Neck, NY. Looking for a dedicated physician to join our practice or merge practices. Contact 516-972-2986 / susanrita1@msn.com for more info.

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MSSNY eNews: February 10, 2021 – DOH COVID Update TOMORROW 1PM to 2PM

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Gov. Cuomo’s  COVID-19 Briefing
– Day 347
– Statewide Positivity rate 4.02%
– 176,750 Test results reported
– 136 deaths
– 7,593 Hospitalizations, down 282
– 1,423 ICU patients, up 11
– 955 Intubations, down 16

Hospitalizations by Region:
– Finger Lakes: 364 (0.03%)
– Western NY: 338 (0.02%)
– Southern Tier: 206 (0.03%)
– Mid-Hudson: 828 (0.04%)
– Central New York: 173 (0.02%)
– Mohawk Valley: 166 (0.03%)
– Capital Region: 313 (0.03%)
– NYC: 3,797 (0.04%)
– Long Island: 1,327 (0.05%)
– North Country:  81 (0.02%)

Positivity by Region:
– Finger Lakes: 2.82%
– Western NY: 4.04%
– Southern Tier: 1.15%
– Mid-Hudson: 5.28%
– Central New York: 1.85%
– Mohawk Valley: 2.88%
– Capital Region: 3.32%
– NYC: 5.08%
– Long Island: 5.29%
– North Country: 4.45%
– Manhattan: 3.21%
– Bronx: 6.74%
– Queens: 5.14%
– Staten Island: 4.85%
– Brooklyn 5.35%

Q & A
– Post holiday surge continues to decrease
– Gov. said COVID has exposed failures in public health, incompetence
in government, failed leadership, and structural racism and discrimination in
the United States
– Gov. outlined disparities in COVID experience: COVID killed Black
people at 2x the rate of White people and Hispanic people at 1.5X the rate of
white people

New Mass Vaccination Sites:
– Gov. announced federal/state partnership to open mass vaccination sites
for socially vulnerable communities in NYC and upstate
– New mass vaccination sites in Brooklyn and Queens are set to open the week
of Feb 24th and Upstate sites will follow
– These vaccination sites will receive special federal dosage allocations and will
be a joint state and federal effort

COVID Vaccine:
– 2.6 million total doses administered
– 93% of allocated first doses administered
– Vaccine supply is now week-to-week but the White House announced an
additional 5% increase in supply and 3-week allocations

Q&A
On what needs to happen to increase vaccine access in Queens:
– The mass vaccination site in Jamaica Queens will conduct 3,000 vaccinations
a day for Queens residents
On whether the state will be doing anything else to ensure that members of the
black and brown community will be prioritized at new mass vaccination sites:
– Gov. said location alone of the sites will help to prioritize certain target communities
– Gov. said the obstacle at these sites will not be access but distrust of the
vaccine within the community.


New Eli Lilly Combo Antibody Drug Approved by FDA Yesterday
A new combination antibody drug from Eli Lilly received emergency approval from the FDA Feb. 9. The authorization allows bamlanivimab and etesevimab to be administered together for the treatment of mild to moderate COVID-19 in adults and some children who are at high risk for progressing to severe COVID-19.


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NYSDOH COVID-19 Update for Physicians TOMORROW, Feb 11 from 1 PM to 2 PM
Please join the NYS Department of Health Thursday, February 11 at 1:00 PM 2:00 PM for a COVID-19 update for healthcare providers.

To accommodate the large number of participants, find our webinar streaming via YouTube Live (and available for viewing immediately thereafter) on the NYSDOH COVID website for providers:

Audio number and code: 844-512-2950 Access code 6474981#

Recipients: All Prescribers
For questions: Please send an e-mail to bcdc@health.ny.gov, a s notify01 is a non-monitored mailbox.


Coalition of Hospitals, Insurers, Employers Call for ACA Expansion
Eight groups representing hospitals, physicians, insurers and employers called on Congress to support proposals to expand the ACA, according to a joint statement released Feb. 10. The coalition includes:

  • America’s Health Insurance Plans
  • American Academy of Family Physicians
  • American Benefits Council
  • American Hospital Association
  • American Medical Association
  • Blue Cross Blue Shield Association
  • Federation of American Hospitals
  • S. Chamber of Commerce

The groups outlined several proposals it wants the federal government to implement. They include the expansion of ACA subsidies, the reintroduction of a three-year, 100 percent federal funding match for states that expand Medicaid and increased federal funding for insurance outreach and enrollment programs. Current proposals under a $1.9 trillion COVID-19 relief bill already target increasing subsidies for Americans who buy their health insurance from the ACA marketplace.

“While we sometimes disagree on important issues in healthcare, we are in total agreement that Americans deserve a stable healthcare market that provides access to high-quality care and affordable coverage for all,” the coalition said in the joint statement.


MSSNY, #ThisIsOurShot to Encourage Vaccination & Decrease Vaccine Hesitancy
#ThisIsOurShot is a grassroots social media campaign to encourage vaccination and decrease vaccine hesitancy among patients. If you have photos of yourself receiving the COVID-19 vaccine, please share them with us so we can post them on social media. Photos can be emailed to rraia@mssny.org or post your photos to your personal accounts, hashtag #ThisIsOurShot and tag us so we can like and share. Don’t forget, please follow us on Twitter @mssnytweet and Instagram @mssnygram.  


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Onondaga County Health Dept. Recruiting Physician for Medical Director
The Onondaga County Health Department is a nationally accredited health department located in Central New York. The department is recruiting a full-time Medical Director. The position involves responsibility for the medical oversight and administrative direction provided to medically related health programs including Communicable Disease Control, Environmental Health, Healthy Families, Lead Poisoning Prevention, Cancer Services, Public Health Preparedness, and Employee Health. Reports to the Commissioner of Health.

QUALIFICATIONS

Must be proficient in public health, epidemiology, and infectious diseases. MD degree from a medical school or equivalent professional degree recognized by the New York State Education Department. Board-certified or board-eligible. Possession of a current license to practice medicine in the State of New York.

SALARY AND BENEFITS

The salary for the position is $175,500 with scheduled annual increases and a competitive benefits package including: Medical, dental, and vision coverage; Annual vacation, sick, personal leave, and paid holidays; No-cost long term disability; Flexible Spending Accounts;

  • New York State Retirement/Pension and Deferred Compensation Program

TO APPLY

  • Please submit a cover letter detailing qualifications meeting the above requirements and a resume to CathyClark@ongov.net and CynthiaClift@ongov.net by February 19, 2021.

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Classifieds

Classified Ads Available for:

Physicians’ search services • allied medical placements • locum tenens • practice valuation • practice brokerage • practice consulting • real estate

For help, information or to place your ad, call Christina Southard 516-488-6100 x355 • fax 516-488-2188


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Physician & Other Healthcare Jobs. P/T & F/T
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Unique Rheumatology Practice Opportunity – Great Neck, NY
Partnership opportunity available at an established rheumatology practice in Great Neck, NY. Looking for a dedicated physician to join our practice or merge practices. Contact 516-972-2986 / susanrita1@msn.com for more info.


 

 

 

 

 

 

 

 

 

MSSNYeNews: February 5, 2021 – Stressing about Increased Physician Stress


.MSSNY’s Partnership with Premier Group Purchasing

Colleagues:

Yesterday, the New York Times published an article titled A Parallel Pandemic Hits Health Care Workers: Trauma and Exhaustion.

Physician demoralization was a problem long before COVID-19, but the pandemic has significantly exacerbated the issue taking it from a problem to an acute crisis that must be addressed.  The nationwide shortage of PPE, public and even political disregard for mask-wearing and social distancing, added home responsibilities for our children’s academic/remote learning needs, stress over remotely caring for aging parents, guilt over inadvertently infecting loved ones, death and acute and chronic illness enveloping our families and our practices are just some of the emotional and physical burdens that are crushing our collective psyche as we work long hours, often for less pay.

In January, our MSSNY convened a meeting on physician wellness with the goal of bringing together those committed to the endeavor so we could pool resources, share ideas, and break down silos.  The meeting included representatives from MSSNY, NYSDOH, Northwell Health, Bassett Healthcare, Catholic Health Services of LI, NYACP, GNYHA, NYSAFP and HANYS.  We heard about novel approaches to physician engagement through affinity groups, recharge rooms to decrease stress and increase mindfulness, and statewide seminars. MSSNY shared information about our Peer-to-Peer program which provides physicians, residents, and medical students the opportunity to talk with a peer about their life stressors.

We explained that this is a confidential discussion with a peer supporter who is trained to share experiences, listen without judgment, and validate feelings as well as offer further support, provide positive coping skills, or connect physicians to professionals for more focused assistance (P2P@MSSNY.org 1-844-P2P-PEER).  We also shared updates on the Practice Transformation Initiative which is a 5-step process aimed at providing guidance to health system leaders on how to create conditions where joy, purpose, and meaning are possible for physicians and care teams by finding strategies to optimize practice efficiencies, reduce burn out, and improve physician well-being.

The NY Times article was spot on and I hope it has been read and digested by not only all of us but also our Governor and our legislators. We will be sharing it with the entire Legislature. For us, it validates our feelings and lets us know we are not alone in our experiences.  For our elected officials this should be a wake-up call and should be kept in mind in the current budget cycle and the current legislative cycle. With a Medscape survey reporting that two-thirds of American doctors are grappling with intense burnout during the pandemic, our NYS budget should include increased funding for the Committee on Physician Health (CPH)—not the unfathomable and potentially dangerous 20% cut that is currently proposed. The proposed “OPMC Modernization” should be struck.  Removing physicians’ due process rights will only add to moral injury and burn out.

In the Medscape survey, 2/3 of respondents reported a drop in income and 1/4 reported that they had left the practice of medicine. Our State can’t afford to lose any more physicians to early retirement, career changes or suicide.  This is not the time to impose increased financial burdens on physicians by requiring them to pay 50% of the excess malpractice fund. Don’t Balance the Budget on the Backs of Physicians. This fund exists due to the long-standing dysfunctional malpractice adjudication system in NYS and our state’s failure to address the root problem by enacting malpractice reform.

The NY Times article raises the question of whether our government has done enough. We need a commitment from our elected officials that they will stand with MSSNY and promote policies and laws that support physician wellness and resilience and oppose those that add to demoralization and endanger the health and well being of our physician hero workforce.

Please make it a point to join with us in our Annual Physician Advocacy Day on March 2 – this year virtual – to help ensure your state legislators make this commitment.  This is the link to register.

Bonnie Litvack, MD
MSSNY President


Notes from Governor Cuomo’s Briefing:

COVID:

– Day 342
– Statewide Positivity rate 4.31%
– 203,627 Test results reported
– 153 deaths
– 7,937 Hospitalizations, down 30
– 1,516 ICU patients, up 10
– 1,000 Intubations, up 14
– Lowest daily positivity rate since Nov. 28th
– Lowest daily hospitalization rate since Jan 1st

Hospitalizations by Region:
– Finger Lakes: 483 (0.04%)
– Western NY:  377 (0.03%)
– Southern Tier: 232 (0.04%)
– Mid-Hudson: 919 (0.04%)
– Central New York: 182 (0.02%)
– Mohawk Valley:  199 (0.04%)
– Capital Region: 374 (0.03%)
– NYC: 3,598 (0.04%)
– Long Island:  1,382 (0.05%)
– North Country: 91(0.02%)

Positivity by Region:

– Finger Lakes: 3.30%
– Western NY: 4.69%
– Southern Tier: 1.68%
– Mid-Hudson: 5.54%
– Central New York: 2.82%
– Mohawk Valley: 3.63%
– Capital Region: 3.92%
– NYC: 5.08%
– Long Island: 5.56%
– North Country: 5.36%

– Manhattan: 3.36%
– Bronx: 6.67%
– Queens: 5.15%
– Staten Island: %
– Brooklyn 5.37%

– Gov. said NYS needs support from the federal government in order to
rebuild and recover economically

COVID Vaccine:

– 2,237,678 total doses administered
– 99.02% of allocated first doses administered
– Vaccine supply is now week-to-week
– Gov. said Vaccine hesitancy is a major obstacle stemming from concern about
side effects and distrust of the healthcare system
– 39% of New Yorkers are hesitant to take the vaccine
– Gov. described differentials by race in acceptance of vaccine within eligible groups
– Gov. said two challenges in reaching the Black community include access and acceptance
– NYS is making efforts to add mass vaccination sites in high positivity areas in Black
and Latino communities and committing to more outreach
– Yankee Stadium vaccine site opening today for Bronx residents

– 75% of hospital workers vaccinated but there are still uneven levels of vaccinations
among hospitals
– Gov. said hospitals have one more week to vaccinate their last workers
– Gov. said the state is reallocating the majority of the 1a subgroup allocation to local
health departments to vaccinate people with comorbidities beginning February 15th.
– NYS is working with the CDC to establish a comorbidities list for eligibility
– Gov. said FDA and CDC recommends not to use second dose allocations as first doses
– Johnson and Johnson filed for emergency use authorization

COVID- Variants:

– 15 new variants of interest in NYS
– 59 total UK strain cases in NYS
– UK strain is up to 70% more transmittable

UK Strain Cases by County:

– Niagara County: 1 Case
– Allegany County: 1 Case
– Tompkins County: 4 Cases
– NYC: 18 Cases
– Nassau County: 8 Cases
– Suffolk: 6 Cases
– Westchester: 4 Cases
– Ulster County: 1 Case
– Onondoga County: 1 Case
– Jefferson County: 1 Case
– Essex County: 1 Case
– Warren County: 6 Cases
– Saratoga County: 7 Cases



Capital Update


MSSNY Weekly Podcast


Join Us for MSSNY’s Virtual Lobby Day on March 2
Please plan to put aside Tuesday, March 2 for MSSNY’s Annual Physician Advocacy Day – this time Virtual!  To register, click here: Webinar Registration

The format will follow previous years formats, where assembled physicians and allies will hear from legislative leaders and MSSNY physician leaders in the morning (this year via Zoom) from 8 AM-11 AM, and then have virtual visits with their respective legislators in the afternoon (organized by their county medical societies).

With the Governor and the State Legislature needing to create tens of billions of savings to the state budget, any number of healthcare programs of interest to physicians could be on the table, not to mention concerns with the numerous problematic proposals that have already been advanced in the proposed Executive Budget including:

  • Significantly reducing physician due process when a complaint has been filed against them to the OPMC;
  • Forcing the 17,000 physicians insured through the Excess Medical Malpractice Insurance Program to bear 50% of these policies, resulting in the imposition of thousands of dollars of new costs;
  • Inappropriately expanding scope of practice for various non-physicians including pharmacists and nurse practitioners;
  • Handing insurance companies enormous new powers to limit physicians providing telehealth services to their patients

As well as voicing your support for a number of proposals including:

  • Expanding the supply of PPE
  • Regulation of Pharmacy Benefit Managers(PBMs)
  • Reducing the interest on court judgments to bring down exorbitant liability costs

Please plan to join hundreds of colleagues from around the State on March 2!


New York Times Story Captures Depth of Physicians’ Struggles During COVID While 2021 Executive Budget Proposal Fails to Address Provider Needs
A New York Times article this week (Click Here) detailed the significant impact on the medical profession in New York and across the country as a result of the pandemic.   The article notes that, since March, 3,373 healthcare workers have died from COVID19, with physicians among the top three health professions impacted and a number of studies suggest that medical professionals made up 10-20% of the deaths in the early days of the pandemic. Moreover, New York State leads the nation in deaths among healthcare professionals [1] [2]

The article notes a recent survey by Medscape which showed that 2/3 of American physicians are grappling with intense burnout from the ongoing crisis, and dramatic drops in income, with many considering early retirement, or leaving the field altogether. A quarter of respondents said their experiences with COVID had led them to exit the medical field and another survey found that 8% of physicians in the United States had closed their doors since the start of the crisis, which translates into 16,000 fewer private practices of community physicians and an inevitable decline in the quality of care.[3] [4]

Instead of proposals to help confront these challenges and protect patient access to care, physicians practicing in New York are facing significant additional challenges from the litany of adverse proposals in proposed Executive budget for FY 2022, which includes a proposal for a restructuring of the state Excess Medical Malpractice Program to require physicians to bear 50% of the cost for their medical malpractice insurance. For many physicians this equates to thousands, or tens of thousands, of dollars of new costs at a time when patient visits & revenues have dropped dramatically.

The Budget proposal also includes an unreasonable bypass of due process for physicians through the Office of Professional Medical Conduct (OPMC), a misguided expansion of Telehealth coverage that may actually harm physician practices, and huge cuts in the funding for the Committee for Physicians’ Health (CPH), among others.  The CPH program is designed to assist physicians who may be struggling with mental health issues, including stress.   An American Medical Association study on the mental health impacts and COVID-19 has shown that 52% of physicians are stressed and over 16% feel “burnout” since the pandemic began.

MSSNY is urging that all of these misguided proposals be rejected as the Legislature finalizes its State Budget for 2021-22.

To help physicians in confronting the events of the last year, last July, the Medical Society of the State of New York launched the Peer 2 Peer (P2P) program.   This program offers physicians, residents and medical students an opportunity to talk with a peer about some of life stressors.  MSSNY’s program is to assist their colleagues who are need of help in dealing with work and family stressor and with the advent of the COVID-19 pandemic, some of the emotional issues related to this event have been difficult to overcome.   Physicians, residents and students can reach out 24/7 to either 1-844-P2P-PEER (1-844-727-7337) or by email at p2p@mssny.org  to be connected to a peer.
(CARY, CLANCY)


Please Urge Your Legislators to Oppose Huge New Costs for Excess Liability Insurance
Please urge your legislators to reject an enormously adverse Executive Budget proposal that would require the over 16,000 physicians enrolled in the Excess Medical Malpractice Insurance program to bear 50% of the cost of these policies.   You can send a letter and/or tweet them from here.

This incredibly short-sighted proposal would thrust over $50 million of new costs on the backs of our community-based physicians who served on the front lines of responding to the pandemic.  For some physicians, particularly in Long Island and New York City, this could add up to tens of thousands of dollars per physician.  This new cost imposition would hit these practices at a time when many of these practices are already facing huge losses resulting from the substantial reduction in the number of patients receiving care during the pandemic.

MSSNY has joined with 16 other specialty medical societies in a letter to the entire State Legislature that expresses our strong objection to this proposal (Click Here).  Among the key points in the letter is that a recent AMA survey reported that during the pandemic the average number of in-person visits to physician offices dropped nearly in half.  As a result, physicians averaged a 32% drop in revenue since February, with about one in five doctors seeing revenue drop by 50% or more, while nearly 1/3 saw a 25%-49% decrease.

The bottom line is that the new costs this proposal would impose are simply not assumable by physicians, meaning that many physicians will face no choice but to forgo receiving this additional coverage.

[1] Click Here
[2] Click Here
[3] Click Here
[4] Click Here

It is important to remember that the Excess Insurance program exists because of New York’s disproportionately high medical liability insurance costs as compared to all other states.  The real solution to this problem is comprehensive medical liability reform, but in its absence, this program is absolutely essential to provide needed assurance to physicians that they will not risk losing everything they have worked for every time they treat a patient.  Please contact your legislators today to oppose this new cost imposition: Click Here. (AUSTER                                                                              


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Urge Your Senators and Assemblymembers to Reject Proposal to Disregard Important Physician Due Process Protections
Please urge your legislators to oppose an Executive Budget proposal that that would significantly reduce due process protections for physicians against whom a complaint has been filed with the Office of Professional Medical Conduct (OPMC), including making information public about a complaint even if no professional misconduct is found and greatly lessening the burden for imposing an interim suspension prior to the conclusion of disciplinary proceedings.   You can send a letter and/or tweet to your local legislators from here: Click Here.

MSSNY has joined with 15 other specialty medical societies in a letter to the State Legislature expressing its strong opposition to this proposal (Click Here). While New York’s physicians share the goal of assuring the State has ample power to protect the public when the conduct of a particular health care provider places patients at risk, the Commissioner already has authority to take summary action prior to the conclusion of a disciplinary hearing in the absence of a finding of misconduct.  Moreover, this proposal is stunning in light of the enormous sacrifices made by many in the medical profession over the last year, serving on the front lines in responding to the pandemic.  The proposal was rejected by the Legislature last year when it was proposed in the Executive Budget and we are urging them to reject it again.

The group letter reminds the Legislature that, while the medical community is always ready to work to address gaps in our disciplinary system to protect patient safety, this proposal is far too broad.  Most complaints to OPMC of alleged misconduct do not become actual findings of misconduct. Indeed, most complaints to OPMC do not even get so far as advancing to a formal Investigation Committee review.  According to the 2018 OPMC Annual report, while over 9,000 complaints were received by OPMC, and 8,782 complaints closed, only 210 cases resulted in the filing of actual charges. This is 2% of filed complaints that ended in actual charges.  Of greatest concern is that information released to the public, even if there is no action ultimately taken, can remain available through Google searches forever, potentially unfairly destroying a physician’s professional reputation.

Please urge your legislators to reject this grossly unfair proposal. (AUSTER)


Please Oppose Proposals That Facilitate Uncoordinated Siloed Care to be Provided by Pharmacists
Please contact your legislators to urge that they oppose several components of the Executive Budget that could upend the patient-centered medical home model and threaten patient safety by greatly expanding the scope of services provided to patients by pharmacists without coordination with patient care physicians.  You can send a letter from here: Click Here.  Please let them know these proposals would greatly enhance the power of corporate giants such as CVS and Walmart to control various aspects of patient care delivery not in coordination with but to the exclusion of community-based primary care and specialty care physicians that typically manage the care of their patients.

Specifically, these Budget proposals would 1) permit pharmacists to order various lab tests without any physician oversight and without any requirement to coordinate with the patient’s physician for follow-up care; 2) greatly expand the physician-pharmacist Collaborative Drug Therapy Program to enable pharmacists to adjust the medications provided to entire classes of patients rather than individual patients and 3) permit pharmacists the power to administer any vaccination approved by the federal Advisory Commission on Immunization Practices (ACIP), including those which may be added in the future, thereby removing the discretion of the State Legislature to make these decisions.  Some of these proposals have been rejected by the Legislature in previous Budget cycles.

All of these programs together could incentivize the development of health care silos at the expense of the patient-centered medical home model we have worked so hard to develop in New York.   It would also marginalize community-based primary care and specialty care physicians’ ability to continue to be able to manage their patients’ ongoing care needs.    Please urge your legislators to reject these measures as they finalize the State Budget for 2021-22. (AUSTER)


 

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AMA to Conduct Webinar on Mental Health and Substance Use Disorder Parity on Feb. 9
Click Here on February 9, 2021 at 2:00 PM ET on mental health and substance use disorder parity. Experts from the American Psychiatric Association, The Kennedy Forum, the Commonwealth of Pennsylvania and State of Illinois will discuss state and federal laws, including model legislation and actions taken to better enforce state parity laws.

The AMA has also developed a resource new resource that focuses on positive efforts being taken in states to help increase access to evidence-based treatment for substance use disorders, help patients with pain and support broad harm reduction efforts.  That resource can be found at: Click here

Further information on Ending the Opioid Epidemic can be found at the AMA’s microsite dedicated to ending the epidemic.          (CLANCY)


Medical Society of the State of New York (MSSNY) Teams Up With Specialty Societies to Raise Concerns with Executive Proposal to Expand Access Telehealth Coverage                                                                                                One of MSSNY’s top issues for the 2021 legislative session is securing policies to continue to expand access and coverage for Telehealth services for all New Yorkers. However, MSSNY has serious concerns about the plan included in the Executive Budget proposal for FY 2022 and teamed up recently with many of the state’s specialty societies in a letter to lawmakers expressing our concerns. To read the letter: Click Here

Among the medical societies’ primary concerns is the proposal does not include provisions to ensure providers receive payment for video, and audio-only Telehealth visits, that is on par with payments for in-office appointments. The groups’ letter also flagged the need to ensure that New York community-based physicians are not excluded from health plans’ network of physicians that provide Telehealth services and that all Telehealth policies included in private commercial insurance plans apply to public health insurance plans like Medicaid and the state health insurance Marketplace.

Prior to the onset of the COVID19 crisis, some physicians across the state had integrated Telemedicine into their practices, but the pandemic forced physicians, and other health care providers, to quickly increase their capacity to provide care remotely. A May 2020 MSSNY survey showed that 83% of the physician respondents had incorporated telemedicine into their practice, with nearly half the respondents noting that they were treating at least 25% of their patients remotely. Moreover, telehealth claim lines increased 2,938 percent nationally from November 2019 to November 2020, rising from 0.20 percent of medical claim lines in November 2019 to 6.01 percent in November 2020, according to new data announced this week from FAIR Health’s Click Here   (CARY)


Registration Now Open
Medical Matters: COVID Vaccine Update February 17, 2021 @ 7:30am
Learn more about the COVID-19 vaccine on February 17th @ 7:30am.  Registration is now open for the next Medical Matters webinar: COVID Vaccine Update.  The discussion will include the types of vaccine in development, distribution priorities and barriers surrounding vaccine administration.  Dr. William Valenti will serve as faculty.  Click here to register.

Educational Objectives:

  • Recognize the types of COVID-19 vaccine in development;
  • Discuss priorities for vaccine distribution; and
  • Identify barriers to COVID-19 immunization

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

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.       (HOFFMAN)


 

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MSSNY Podcasts Keep You Informed and Current
The MSSNY podcast website has reached a new milestone, 7,500 listens!  In addition to MSSNY’s weekly Update podcasts, there are numerous informative podcasts available on topics ranging from COVID-19 to emergency preparedness to vaccines.  Each podcast offers insight from medical experts on topics they are extensively well versed on.  Go here and choose one or many to listen to.       (HOFFMAN)     


 

eNews
Superbowl Advice from Dr. Fauci: “Lay Low and Cool It”
Dr. Anthony Fauci said families should not hold house parties but instead limit Super Bowl celebrations to those who live in their household. “As difficult as that is, at least this time around, just lay low and cool it,” he said on ABC’s Good Morning America. (Feb. 4)

Majority of COVID-19 Infected Have Antibodies for More than Six Months
Majority of people previously infected with COVID have high level of antibodies for at least six months, study indicates reports that almost all people “previously infected with COVID-19 have high levels of antibodies for at least six months that are likely to protect them from reinfection with the disease, results of a major U.K. study. Scientists “said the study, which measured levels of previous COVID-19 infection in populations across Britain, as well as how long antibodies persisted in those infected, should provide some reassurance that swift cases of reinfection will be rare.”


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Some Physicians Stop Testing For COVID-19, Citing Low Reimbursements
The New York Times (2/3 ) reports, “Across the country, some doctors are seeing reimbursement rates so low” for COVID-19 testing “that they do not cover the cost of the test supplies, jeopardizing access to a tool experts see as crucial to stopping the virus’s spread.” The Times adds, “Across the country, multiple doctors identified UnitedHealthcare and certain state Medicaid plans as the ones that routinely pay test rates that do not cover
the cost of supplies.”


Community-Based Physicians Seek More Vaccine Doses
The Medical Society of New York on Wednesday urged state officials to send more vaccine doses to community-based doctors so they can begin to immunize their patients.

The push from the organization comes as New York has opened pop-up sites for vaccine distribution as well as mass distribution sites at public colleges and university campuses and is opening a site at Yankee Stadium in the Bronx on Friday.

This week, Gov. Andrew Cuomo announced expanded eligibility to include restaurant workers, people in developmentally disabled facilities, and taxi drivers. Those doses will be administered through local public health departments.

The Medical Society in a statement said its members would be able to ensure communities of color are not left out of vaccine distribution, an increasingly key concern for health officials in New York. At the same time, doctors are already familiar with administering flu shots and have the ability to track who has received a shot through patient databases.

“MSSNY has long advocated for physician involvement as a COVID-19 immunizer, and many community-based private practices have already signed up to do so,” said Dr. Bonnie Litvack, the group’s president. “These individuals practice in a wide range of communities, including those that serve the Black/Brown/LatinX/Asian patient population and in the rural, urban, and suburban communities.”

Cuomo has said New York has the capacity to administer more doses than it currently receives each week from the federal government. In addition to the pop-up locations and mass distribution sites, the state has identified thousands of distribution locations for vaccine administration, including doctor’s offices and pharmacies.

But demand is outrunning supply in many areas of the state.

“We hear every day from physicians who are asking when they will be getting vaccines,” Litvack said. “Patients are requesting immunization from their physician rather than going to a POD or a pharmacy where they believe they risk greater exposure to COVID-19. Many of these physicians care for the state’s most vulnerable— seniors, those with significant co-morbidities, individuals of color, and those who speak different languages.” (Spectrum 1 NY News, Feb. 4)

Tenet Must Pay Whistleblowing Cardiologists $10M, Court Rules
Dallas-based Tenet Healthcare must pay two cardiologists who filed a False Claims Act lawsuit $10 million and reinstate their medical staff privileges for one year, a Michigan federal court ruled Feb. 1, according to Bloomberg Law.

In December, Amir Kaki, MD, and Mahir Elder, MD, who were fired from their leadership positions at Tenet’s Detroit Medical Center in October 2018, were awarded $10.6 million. The arbitration award also included reinstatement of their medical staff privileges.
The physicians, who originally brought suit in 2019 alleging violations of the False Claims Act, claimed they were ousted from their leadership positions for reporting problems affecting patient care. The court ordered the parties to arbitrate the federal claims, and the arbitrator found that Tenet acted with malice when the physicians were fired from their leadership positions and later had their staff privileges revoked, according to the Detroit Free Press.

Tenet, Detroit Medical Center, and the other named defendants tried to get the arbitrator’s award vacated in federal court. The defendants brought three main challenges to the award, and the court stated that only one — whether the arbitrator exceeded her powers — was a legitimate potential ground for vacating the award. Arthur Tarnow, a district judge for the Eastern District of Michigan, ultimately concluded that the defendants’ arguments were without merit.

The defendants are appealing the court’s order to the U.S. Court of Appeals for the Sixth Circuit. (Becker’s ‘Hospital Review, Law and Regulator Issues, Feb. 3)


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Oxford Finds COVID-19 Shot 76% Effective for 3 Months After Single Dose
Oxford University and AstraZeneca’s COVID-19 vaccine showed in a study it had 76% efficacy against symptomatic infection for three months after a single dose, which increased if the second shot is delayed, backing Britain’s vaccine rollout policy.
The findings of the paper, published ahead of peer-review by Preprints with The Lancet, supported Britain’s decision to extend the interval between initial and booster doses of the shot to 12 weeks, Oxford said on Tuesday.

However, the new study did not address concerns about a lack of data on efficacy among the oldest, whom the British government have given highest priority in its vaccine rollout.
Andrew Pollard, Chief Investigator of the Oxford Vaccine Trial, said the data showed the 12-week interval between doses was “the optimal approach to roll out, and reassures us that people are protected from 22 days after a single dose”.

Britain has decided to vaccinate as many people as possible as quickly as possible by lengthening the amount of time between initial shots and booster shots to tackle the COVID-19 pandemic.

AstraZeneca’s research chief has said 8-12 weeks between doses seems to be the “sweet spot” for efficacy, contrasting with U.S. drugmaker Pfizer, which has warned that the vaccine it has developed with Germany’s BioNTech was not trialled with such an interval.
The results for the AstraZeneca/Oxford vaccine, gathered from trials in Britain, Brazil, and South Africa, showed that immune responses were boosted with a longer interval to the second dose among participants aged 18 to 55 years.

“Vaccine efficacy after a single standard dose of vaccine from day 22 to day 90 post vaccination was 76%, and modeled analysis indicated that protection did not wane during this initial 3-month period,” Oxford academics said in the preprint.

The paper said that vaccine efficacy was 82.4% with 12 or more weeks to the second dose, compared to 54.9% for those where the booster was given under 6 weeks after the first dose.

The longest interval between doses for those aged 56 and over was between 6-8 weeks, so there was no data for the efficacy of a 12-week dosing gap in that cohort.
Europe’s medicine regulator has flagged that there is not enough data to determine how well the vaccine will work in people aged over 55, but Britain has expressed confidence the vaccine works in all age groups.

The study said that no-one out of the 12,408 people vaccinated with a single dose of the vaccine was hospitalized with COVID-19 from 22 days after immunization.
Oxford also said data seemed to suggest the vaccine reduced transmission of infections, with a 67% reduction in positive swabs among those vaccinated in the British arm of the trial.

SOURCE: https://bit.ly/3apMSyt Preprints with The Lancet, online February 1, 2021.


NY Supreme Court Rules in Favor of Empire Center for Nursing Home Info
The Empire Center today won a court ruling requiring the prompt release of full coronavirus death tolls in New York nursing homes. The decision by state Supreme Court Justice Kimberly O’Connor requires the Health Department to provide the requested records within five business days and compensate the Empire Center and its legal counsel for their litigation expenses. The center was represented in the case by the Government Justice Center.

The Empire Center requested the records under the Freedom of Information Law on Aug. 3. The Health Department had postponed responding three times, mostly recently until March 22—a delay of more than seven months.

Justice O’Connor addressed the delays in her ruling: “DOH does not, in the Court’s opinion, offer an adequate explanation as to why it has not responded to that request within its estimated time period or to date… The Court is not persuaded that the respondent’s estimated date for responding to Empire Center’s FOIL request is reasonable under the circumstances of the request.”

The state has been collecting comprehensive infection and mortality data from nursing homes throughout the pandemic but sharing only a partial death toll with the public. Its reports exclude residents who were transferred to hospitals before dying, a practice used by no other state.

Last week, in response to a critical report on nursing homes from the state attorney general’s office, Health Commissioner Howard Zucker revealed that almost 4,000 nursing home residents had succumbed to COVID-19 in hospitals, boosting the total nursing home toll to almost 13,000.

That one-day total represents a tiny fraction of the data the Department is now obliged to release, which would include the number of deaths in each facility on each day since the start of the pandemic.

For more background on Empire Center vs. New York State Department of Health, go to empirecenter.org/nursinghomes.


Study: Biggest Spreaders of Coronavirus in U.S. are Adults Aged 20 to 49,
reports that research “suggests that the biggest spreaders of coronavirus in the U.S. are adults aged 20 to 49.” CNN adds, “Children accounted for very little spread, the researchers said, as did older adults.” Investigators came to this conclusion after using “cell phone location data covering more than 10 million people and publicly available information on the spread of the virus to calculate which age groups were most responsible for the spread of the virus across most of the U.S.” The study was published in Science.

Top 10 Preventable Medication Errors from Last Year
Prescribing extended-release opioids to patients who are not educated about the addictive drugs’ effects was the top preventable medication error in 2020, according to the Institute for Safe Medication Practices.
The Institute for Safe Medication Practices on Jan. 27 released its list of the top 10 medication errors from 2020, selecting errors and hazards that have not only been consistently reported, but also can be avoided or minimized through operational improvements.
The 10 preventable medication errors:
1. Prescribing, dispensing, and administering extended-release opioids to patients who are opioid-naïve.
2. Not using smart infusion pumps with dose error reduction systems in perioperative settings
3. Oxytocin errors
4. Hazards resulting from infusion pumps being positioned outside of COVID-19 patients’ rooms
5. COVID-19 vaccine errors
6. Use of the “syringe pull-back” verification method during pharmacy sterile compounding
7. Combining or manipulating commercially available sterile products outside a pharmacy
8. Medication loss in the tubing when administering small-volume infusions with a primary administration set
9. Intraspinal injection errors with tranexamic acid

10. Use of error-prone abbreviations, symbols, or dose designations


Physician & Other Healthcare Jobs. P/T & F/T – Check Us Out


Unique Rheumatology Practice Opportunity – Great Neck, NY
Partnership opportunity available at an established rheumatology practice in Great Neck, NY. Looking for a dedicated physician to join our practice or merge practices. Contact 516-972-2986 / susanrita1@msn.com for more info.

 

 

 

 

 

 

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MSSNYeNews: February 3, 2021 – Frustrating Ordeal for Community Doc Seeking COVID Shot

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Gov. Cuomo’s  COVID-19 Update for February 3, 2021:

  • 8,082 Patient Hospitalizations Statewide
  • 1,522 Patients in the ICU; 1,003 Intubated
  • Statewide Positivity Rate is 4.68%
  • 7-Day Average Positivity Rate Has Declined for 26 Consecutive Days
  • 160 COVID-19 Deaths in New York State Yesterday

Today’s data is summarized briefly below:

  • Test Results Reported – 126,489
  • Total Positive – 5,925
  • Percent Positive – 4.68%
  • 7-Day Average Percent Positive – 4.86% (lowest since 12/4)
  • Patient Hospitalization – 8,082 (+15)
  • Net Change Patient Hospitalization Past Week – -689
  • Patients Newly Admitted – 680
  • Hospital Counties – 57
  • Number ICU – 1,522 (+19)
  • Number ICU with Intubation – 1,003 (-1)
  • Total Discharges – 129,378 (+489)
  • Deaths – 160
  • Total Deaths – 35,631
Post Holiday COVID Graph

The rate of increase in statewide COVID hospitalizations has
slowed considerably (2/1)


More Women Are Becoming Physicians; Four Other Workforce Insights
The U.S. physician workforce has gained women and older members since 2007, according to a new data report released by the Association of American Medical Colleges.

The report, released Feb. 2, is based on 2019 data from the American Medical Association, U.S. Census Bureau and GME Track, a resident database and tracking system.

Five insights on the nation’s physician workforce from the report:

  1. Women represented 28.3 percent of the physician workforce in 2007 compared to 36.3 percent in 2019.
  2. Specialties with the highest percentages of women in 2019 were pediatrics (64.3 percent) and obstetrics and gynecology (58.9 percent).
  3. Nearly 45 percent of active physicians were age 55 or older in 2019, up from 44.1 percent in 2017 and 37.6 percent in 2007.
  4. The percentage of active physicians in sports medicine grew by 55.3 percent, from 1,865 to 2,897, between 2014 and 2019.
  5. Specialties with the largest numbers of first-year Accreditation Council for Graduate Medical Education residents and fellows in 2019 were internal medicine (10,379), family medicine/general practice (4,456), and pediatrics (2,993).

Access the full report here


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Your Voice Makes a Difference and Together, Physicians Are a Force for Change!
Pending Alert: Physicians are urged to let their legislators know of their objection to an extremely concerning proposal contained in the Governor’s proposed 2021-22 Budget that would require the nearly 17,000 physicians currently enrolled in the Excess Medical Malpractice Insurance program to bear 50% of the cost of these policies.

This incredibly short-sighted proposal would thrust over $50 million of new costs on the backs of community-based physicians at a time when many have seen historic drops in patient visits and revenue.  Moreover, these new costs would be imposed on the thousands of physicians who have been on the “front lines” of responding to the coronavirus outbreak. Please let your legislators know of your objection to this proposal and ask them to fully fund this program. Click here to contact your legislators today!


Frustrating Ordeal for Community Doc Seeking COVID Shot
The COVID-19 vaccine waits for no one. That’s exactly what Julie Kupersmith, MD, a community physician in Westchester County north of New York City, has discovered.

Kupersmith, a plastic surgeon, is among those supposedly included in New York’s first priority group for vaccination, but she has been unable to get a shot, she told MedPage Today.

For weeks, she has phoned and emailed nearby hospitals as well as her local and state health departments, to no avail, she said. As she hears of hospital-based physicians, nurses, and administrative employees who have already received their second dose of the vaccine, she said she has no idea when she’ll be able to get her first.

New York has since opened up vaccination to adults age 65 and up and other frontline workers. And like other states, it’s experiencing a shortage of doses.

Health departments continue to refer Kupersmith to the state’s online portal for scheduling vaccination appointments, she said. However, the only open time slots she has been able to find through the portal are hundreds of miles away.

As of Monday, the nearest appointment available was 413 miles north of Westchester County at Plattsburgh International Airport.

Though Kupersmith said she is taking all of the safety precautions in caring for patients, she said she is concerned for her health, and what would happen if she fell ill and had to close her practice for an extended period of time. She said community physicians are often undervalued.

At the beginning of last month, as community physicians became eligible to receive the vaccine, Bonnie Litvack, MD, president of the Medical Society of the State of New York, said in a statement that the organization was fielding hundreds of emails and phone calls from providers asking where they should go to get immunized.

Litvack told MedPage Today on Monday that those concerns have largely eased, and most of its physician members and their staff have been able to get at least a first dose of the vaccine.

However, she said there are likely instances where community physicians haven’t been able to be inoculated, given limited shipments of doses. Some physicians have had to travel hours to get the vaccine.

“It’s really supply and demand here,” Litvack said. “We’ve got high demand and limited supply.”

A survey conducted by the medical society late last year found that nearly 80% of New York’s community and hospital-based physicians planned to take the COVID-19 vaccine once it became available. Only 7.5% of respondents indicated they would not.

Litvack said she believes that, as additional vaccines enter the mix, community physicians will be able to obtain doses to help vaccinate other individuals. She said she is encouraged that some 70% of healthcare workers in the state have at least gotten the first dose.

Erin Silk, a spokeswoman for the state health department, said in an email that the agency “continue[s] to do everything we can to get as many New Yorkers vaccinated as quickly as possible.”

Kupersmith said she doesn’t know if receiving the vaccine would be a game-changer for her and other community physicians who may be struggling to do so. Another primary concern is that reliable access to COVID-19 testing and personal protective equipment is still elusive for smaller practices at this stage of the pandemic.

However, “it would definitely make me feel more comfortable,” she said. (MedPage Today, Feb.3) 


 

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Study: COVID-19 Survivors Experience More Intense Side Effects from Vaccine
A new study released Monday may explain why people who were previously infected with COVID-19 experience “unexpectedly intense reactions to the first shot of a vaccine.” Researchers found COVID-19 survivors “had far higher antibody levels after both the first and second doses of the vaccine,” and reported physical side effects more frequently. “Based on these results, the researchers say, people who have had Covid-19 may need only one shot.” The findings were posted on medRxiv.


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Physicians’ search services • allied medical placements • locum tenens • practice valuation • practice brokerage • practice consulting • real estate

For help, information or to place your ad, call Christina Southard 516-488-6100 x355 • fax 516-488-2188


Physician & Other Healthcare Jobs. P/T & F/T
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Partnership opportunity available at an established rheumatology practice in Great Neck, NY. Looking for a dedicated physician to join our practice or merge practices. Contact 516-972-2986 / susanrita1@msn.com for more info.


 

 

 

 

 

 

 

 

 

It’s Time for COVID-19 Vaccines to be Distributed to Community-Based Physicians

For Immediate Release
February 3, 2021

 

It’s Time for COVID-19 Vaccines to be Distributed to
Community-Based Physicians
 

Statement Attributable to:
Bonnie Litvack, MD
President, Medical Society of the State of New York

“Yesterday’s announcement of the additional supply of COVID-19 vaccines to pharmacies and to New York State is welcome news in the effort to ensure that all New Yorkers are vaccinated. However, the Medical Society of the State of New York continues to urge that more doses be made available and distributed to community-based practicing physicians so they can begin to immunize their patients.

“MSSNY has long advocated for physician involvement as a COVID-19 immunizer, and many community-based private practices have already signed up to do so. These individuals practice in a wide range of communities, including those that serve the Black/Brown/LatinX/Asian patient population and in the rural, urban, and suburban communities. We hear every day from physicians who are asking when they will be getting vaccines. Patients are requesting immunization from their physician rather than going to a POD or a pharmacy where they believe they risk greater exposure to COVID-19. Many of these physicians care for the state’s most vulnerable— seniors, those with significant co-morbidities, individuals of color, and those who speak different languages.

“Additionally, we appreciate that Governor Cuomo has placed great emphasis on ensuring that communities of color are vaccinated. MSSNY’s Health Disparities Committee has recommended to the state that data be collected that includes racial, ethnic, and geographical information on who has been immunized. We believe that this will give the state and all COVID-19 immunizers a comprehensive review of which populations need to be targeted to ensure equity.

“Community-based physicians provide immunizations on a daily basis and have experience in providing flu clinics. Perhaps most importantly, they would be able to check their patient database and immediately identify patients who are eligible to receive the vaccine. We are making great strides in getting people immunized, but barriers remain. While we understand the significant challenges regarding the limited supply, we urge that more vaccinations also be made available for distribution to community-based physicians to help ensure their patients can be vaccinated and help stem this pandemic.”

# # #

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


Media Contact:
Roseann Raia

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

 

MSSNY eNews: January 29, 2021 – Health Insurance Payment Delays


.MSSNY’s Partnership with Premier Group Purchasing

Colleagues:

Over the past year, MSSNY has been made aware of an alarming trend with regard to some health insurers in our area. Physician practices provide necessary care to patients and file claims with the appropriate insurer.  The claims are then routed to the Health Insurer’s utilization review entity who requests that the physician’s office submit medical records.  The physician office submits the requested records and the utilization review company then denies the claim(s) as missing patient medical records.  The medical practice subsequently sends additional records to the location indicated in the request, often to be told when calling for a status update that the address used is incorrect.

MSSNY has taken a number of steps to resolve this issue. MSSNY has reached out directly to the Health Insurance companies involved and has spoken with Medical Directors and other health Insurance company staff. However, our MSSNY members continue to experience the same issues and recently the number of parent companies employing these unfair tactics has expanded.  Therefore, MSSNY conducted a recent statewide survey (take the survey here) to ascertain the scope of the problem. Our survey results show that the problem is ongoing and not isolated.

As direct discussions with the Health Insurance companies have not yielded the desired discontinuation of these unfair and in many cases illegal payment delays, MSSNY has escalated our advocacy and has sought assistance from the NYS Department of Financial Services (DFS).  DFS has regulatory authority over NYS regulated health plans/insurers and DFS has assigned an investigator to review these claims.

If you are experiencing these issues in your practice, please file a complaint/inquiry with DFS File a Complaint | Department of Financial Services (ny.gov). It is very important to include copies of all supporting documentation and all correspondence with the insurance entity.  DFS will work with individual providers to accept global complaint submissions as needed.  Also, please remember to send a copy of the DFS file number to Rmcnally@mssny.org, along with your practice name so that MSSNY can ensure that the DFS investigator has access to the aggregate of physician grievances.

We have heard that some physicians are concerned about filing a complaint with DFS due to concerns of retaliation by Health Insurance Companies.  Please note, NYS Law prohibits any retaliatory action against a physician for advocating in good faith on behalf of patients.

While physician offices have struggled to keep their doors open during the pandemic due to rising practice costs including PPE and decreased revenue due to seeing less patients, health insurers have seen record profits as less patients access care, making the current health insurance delay tactics unconscionable and intolerable. New York State has a strict Prompt Payment law.

Claims submitted electronically must be paid, denied or additional information requested within 30 days of submission (45 days for claims submitted by paper).  The law also provides that, if additional information has been requested, the claims should be either paid in part or denied in 30 days from the date the records were received. If managed care companies are violating the State’s Prompt Payment Law, there are financial consequences, and they should and will be held accountable.

Brief Update on Vaccines

Good news:

  • 96% of the 1st vaccine dosages received by NYS have been administered.
  • The Biden Administration will be increasing weekly allocations to NYS by 16% for the next three weeks.
  • All nursing home residents have been offered the vaccine with 72% vaccinated to date.
  • Healthcare Worker vaccination rates range from 62% in Western New York to 82% in Central New York.

Continued concerns:

  • Vaccine demand continues to far outstrip supply. At the current rate of vaccine availability, it will take 21 weeks to vaccinate the 7 million currently eligible 1b group.
  • Only 44% of nursing home staff has been vaccinated to date with all expected to be offered the vaccine by February 7. MSSNY has expressed concern and offered help to increase the number of nursing home staff vaccinations to > 70%.
  • Many physician offices have still not received any supply of vaccine and many patients are saying they are only willing to receive the vaccine from their physician. MSSNY has communicated this to DOH and the Governor’s office.

MSSNY has been in constant communication with the NYS Department of Health and the Governor’s office about vaccination administration and distribution.  We have been transmitting all your comments, concerns and frustrations and have been working with DOH and the Governor to continually improve the process and clear the bottlenecks.  The latest department updates can be found here.

Bonnie Litvack, MD
MSSNY President



Capital Update

MSSNY Weekly Podcast


Join Us for MSSNY’s Virtual Lobby Day on March 2
Please plan to put aside Tuesday, March 2 for MSSNY’s Annual Physician Advocacy Day – this time Virtual!  To register, click here: Webinar Registration – Zoom

The format will follow previous years formats, where assembled physicians and allies will hear from legislative leaders and MSSNY physician leaders in the morning (this year via Zoom) from 8 AM-11 AM, and then have virtual visits with their respective legislators in the afternoon (organized by their county medical societies).

With the Governor and the State Legislature needing to create tens of billions of savings to the state budget, any number of healthcare programs of interest to physicians could be on the table, not to mention concerns with the numerous problematic proposals that have already been advanced in the proposed Executive Budget, such as:

  • Significantly reducing physician due process when a complaint has been filed against them to the OPMC;
  • Forcing the 17,000 physicians insured through the Excess Medical Malpractice Insurance Program to bear 50% of the cost of these policies;
  • Inappropriately expanding scope of practice for various non-physicians including pharmacists and nurse practitioners;
  • Handing insurance companies enormous new powers to limit physicians providing telehealth services to their patients

As well as voicing your support for a number of proposals including:

  • Expanding the supply of PPE;
  • Regulation of Pharmacy Benefit Managers (PBMs);
  • Reducing the interest on court judgments to bring down exorbitant liability costs

Please plan to join hundreds of colleagues from around the State on March 2!       (ALI)


Please Urge Your Legislators to Oppose Balancing State Budget on Backs of Community Physicians
MSSNY has joined with 16 other specialty medical societies in a letter to the entire State Legislature that expresses our strong objection to a proposal contained in the Governor’s proposed State Budget (Part K of the Health/Mental Hygiene Article 7 bill) that would require the over 16,000 physicians enrolled in the Excess Medical Malpractice Insurance program to bear 50% of the cost of these policies.   Please urge your legislators to reject this proposal by sending a letter to them and/or a tweet from here.

This incredibly short-sighted proposal would thrust over $50 million of new costs on the backs of our community-based physicians who served on the front lines of responding to the pandemic.  For some physicians, particularly in Long Island and New York City, this could add up to tens of thousands of dollars per physician.  This new cost imposition would hit these practices at a time when many of these practices are already facing huge losses as a result of a substantial reduction in the number of patients receiving care during the pandemic.

A recent AMA survey reported that during the pandemic the average number of in-person visits to physician offices dropped nearly in half.  As a result, physicians averaged a 32% drop in revenue since February, with about one in five doctors seeing revenue drop by 50% or more, while nearly 1/3 saw a 25%-49% decrease.

It is important to remember that the Excess Insurance program exists because of New York’s disproportionately high medical liability insurance costs as compared to all other states.  The real solution to this problem is comprehensive medical liability reform, but in its absence, this program is absolutely essential to provide needed assurance to physicians that they will not risk losing everything they have worked for every time they treat a patient.  Please contact your legislators today to oppose this new cost imposition: contact here. (AUSTER)


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Urge Your NYS Legislators to Reject Proposal to Disregard Important Physician Due Process Protections
MSSNY has joined with 15 other specialty medical societies in a letter to the State Legislature expressing its strong opposition to an Executive Budget proposal (Part Q of the Health/Mental Hygiene Art. 7 bill) that would significantly reduce due process protections for physicians against whom a complaint has been filed with the Office of Professional Medical Conduct (OPMC), including making information public about a complaint even if no professional misconduct is found and greatly lessening the burden for imposing an interim suspension prior to the conclusion of disciplinary proceedings.

While New York’s physicians share the goal of assuring the State has ample power to protect the public when the conduct of a particular health care provider places patients at risk, the Commissioner already has authority to take summary action prior to the conclusion of a disciplinary hearing in the absence of a finding of misconduct.

You can assist us in these efforts by sending a letter and tweet in opposition to your local legislators click here.

The letter reminds the Legislature that, while the medical community is always ready to work to address gaps in our disciplinary system to protect patient safety, this proposal is far too broad.  Most complaints to OPMC of alleged misconduct do not become actual findings of misconduct. Indeed, most complaints to OPMC do not even get so far as advancing to a formal Investigation Committee review.  According to the 2018 OPMC Annual report, while over 9,000 complaints were received by OPMC, and 8,782 complaints closed, only 210 cases resulted in the filing of actual charges. This is 2% of filed complaints that ended in actual charges.  Of greatest concern is that information released to the public, even if there is no action ultimately taken, can remain available through Google searches forever, potentially unfairly destroying a physician’s professional reputation.

Please contact your legislators to urge that this measure be rejected as to the Legislature works to finalize a State Budget for the 2021-22 Fiscal Year.              (AUSTER)


Town Hall with Senator Rivera on COVID-19 Vaccine on Feb. 4, 2021
The Medical Society of the State of New York and the “Let’s Get Immunized New York” campaign is participating in a Town Hall with Senator Gustavo Rivera on Thursday, February 4 at 6:30 PM.

Panelists are:

Senator Gustavo Rivera
Lorraine Braithwaite-Harte, NYS NAACP
Bethsy Morales-Reid, Hispanic Federation
Dr. Sumir Sahgal, Essen Health Care and member of the Bronx County Medical Society
Dr. Barry S. Zingman, Clinical Director, Infectious Diseases, Moses Division, Montefiore Medical Center
Dr. Jane Ahn, Chief Medical Officer at Union Community Health Center.

Senator Rivera’s office has provided the following sign-up link which provides the event details, and directs participants to the Facebook Livestream or to register via Zoom.  bit.ly/RiveraVaccineTownHall

To register for the event directly via Zoom, please click here:  bit.ly/RiveraVaccineZoom Participants can also follow along at “Let’s Get Immunized NY” on Facebook and Twitter which is promoting the Town Hall and which is regularly sharing vaccine-related information and FAQs. Beyond social media promotion, questions can be submitted in advance at this sign-up link: bit.ly/RiveraVaccineTownHall. The Town Hall will also be live-streamed on Senator Rivera’s Facebook and Spanish closed captioning will be available for those joining via zoom.   (CLANCY)


Please Oppose Proposals That Facilitate Uncoordinated Siloed Care to be Provided by Pharmacists
Please contact your legislators to urge that they oppose several components of the Executive Budget that could upend the patient-centered medical home model and threaten patient safety by greatly expanding the scope of services provided to patients by pharmacists without coordination with patient care physicians.  You can send a letter from here: Send letter.  Please let them know these proposals would greatly enhance the power of corporate giants such as CVS and Walmart to control various aspects of patient care delivery not in coordination with community-based primary care and specialty care physicians that typically manage the care of their patients, but instead marginalizing their involvement.

Specifically, these Budget proposals would 1) permit pharmacists to order various lab tests without any physician oversight and without any requirement to coordinate with the patient’s physician for follow-up care; 2) greatly expand the physician-pharmacist Collaborative Drug Therapy Program to enable pharmacists to adjust the medications provided to entire classes of patients rather than individual patients and 3) permit pharmacists the power to administer any vaccination approved by the federal Advisory Commission on Immunization Practices (ACIP), including those which may be added in the future.  Some of these proposals have been rejected by the Legislature in previous Budget cycles.

All of these programs together could incentivize the development of health care silos at the expense of the patient centered medical home model we have worked so hard to develop in New York.   It would also marginalize community based primary care and specialty care physicians’ ability to continue to be able to manage their patients’ ongoing care needs.

Please urge your legislators to reject these measures as they finalize the State Budget for 2021-22.       (AUSTER)


 

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Physicians Raise Concerns that Executive Budget Proposal to Expand Telehealth Coverage May Actually Lessen Coverage
MSSNY is advocating together with several specialty societies to ensure patients can continue to have coverage for receiving needed health care services via telehealth, including providing payment parity between in-person and telehealth visits.  At the same time, we have raised concerns with a number of aspects of the Executive Budget proposal to expand Telehealth coverage and are seeking further clarification of these provisions.

We are particularly concerned that the Executive Budget proposal did not include a measure to ensure payment parity, which is a significant issue for community physicians and the patients that they serve. A recent survey of its members by MSSNY showed that 83% had incorporated telemedicine into their practice, with nearly half saying they were treating at least 25% of their patients remotely. However, insurers’ reimbursement for audio and video Telehealth services has not kept pace with those paid for in-office visits and the gap is wide. According to the survey, less than 1/4 of health plans had set their reimbursement levels for telehealth equal to what they pay for in-office visits, with audio-only visits the least compensated.

We are further concerned that the Budget proposal could be used by the insurance industry to actually reverse the telehealth gains we have made over the past year.  By linking coverage of telehealth services to insurers having a “so-called” adequate network together with the proposal to permit telehealth delivery services by out of state physicians, this could essentially empower insurers to limit who it will pay for telehealth services once it asserts it has an “adequate” network.

It is not hard to imagine a scenario where a health plan asserts it has an adequate network through a national telehealth service provider, and then excludes coverage of telehealth service by all or some of its in-network community-based physicians.  That is completely at odds with the expansive approach to telehealth coverage taken over the past year as a result of actions taken by the DFS and DOH.

MSSNY is also concerned that the Executive Budget proposal doesn’t expressly address payment parity in the state’s Medicaid program, which if not addressed, could create an inequity in the care that beneficiaries of Medicaid receive.

 MSSNY is continuing to work with a range of other patient and provider partner organizations to address our concerns and will update members as the issue unfolds.    (CARY)


MSSNY Opposes Measure To Legalize Adult Use Recreational Marijuana
MSSNY continues to oppose the Executive Budget proposal to authorize the sale of adult use or recreational use marijuana and to create an Office of Cannabis Management to regulate both the medical and adult-use of marijuana.  The governor has estimated that this proposal would generate more than $350 million in tax revenue—however, that revenue is not anticipated to be generated for several years.   The Medical Society of the State of New York has repeatedly expressed its opposition to the legalization of recreational marijuana because of the public harms that have occurred in other states that have legalized the sale of recreational use marijuana.

MSSNY continues to work with numerous public health advocacy organizations in opposing this measure such as the New York State Association of County Health Officials (NYSACHO), the New York State Sheriffs Association, the Mental Health Association of New York State, the NYS PTA, and Smart Approaches to Marijuana (SAM).  MSSNY believes that with the COVID-19 pandemic, this measure, if enacted would create an even greater stress on New York State’s public health system.  Physicians are encouraged to send a letter to their legislator and may do so by using the letter located at the MSSNY Grassroots Action Center here.            (CLANCY)   


MSSNY Opposes Repeal of Prescriber Prevails In Medicaid Fee for Service and Managed Care
MSSNY has joined with several specialty societies in a letter to the Legislature to express its opposition to an Executive Budget proposal to repeal the authority of physicians, and other qualified prescribers, to make the final determination about the medication prescribed to beneficiaries of New York’s Medicaid Fee-for-Service and Medicaid Managed Care programs, commonly referred to as “prescriber prevails.” The proposal is also ill-timed given the COVID-19 pandemic and the transition of the Medicaid pharmacy benefit from managed care back to fee-for-service as a result of a provision included in the final 2020-21 NYS budget.

Repealing this important patient protection not only jeopardizes patient care, but also undercuts the steps that New York has already taken to reduce unnecessary and avoidable hospitalizations, which have been trending downwards in the last several years. A key component in sustaining and accelerating such a trend is guaranteeing that individuals are able to obtain the medications prescribed by their physician to treat their disease.

The joint letter raises concerns that any projected savings based on the repeal of “prescriber prevails” in Medicaid Fee-For-Service and Managed Care would be dwarfed by the health care complications likely to arise as a result of individuals not having access to the most effective medications needed to remain healthy. For many conditions, finding the most effective treatment is not easy, making it even more important that once a treatment has been proven effective, patients continue to have unfettered access to that drug.

MSSNY is continuing to work in collaboration with a host of other provider and patient groups on this issue and will update its members as discussions with the Governor and legislature move forward.                                           (CARY)


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Registration Now Open
February 5, 2021 @ 7:30am Physician Wellness/Medical Matters COVID-19 & Mental Health of Physicians and Other Healthcare Providers

Click here to register

The COVID-19 pandemic has had a significant impact on the Mental health of physicians and other healthcare providers.  Learn more on February 5th at 7:30 am.  Dr. Craig Katz will serve as faculty.

Educational Objectives are:

  • Examine the mental health risks posed by COVID-19 for physicians;
  • Review the possible range of psychological and psychiatric responses to the pandemic; and
  • Discuss principles and interventions for helping ourselves, our families, and our colleagues

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

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. 


Registration Now Open
Medical Matters: COVID Vaccine Update February 17, 2021 @ 7:30am

Registration is now open for the next Medical Matters webinar: COVID Vaccine Update.  Learn more about the COVID-19 vaccine on February 17th @ 7:30am.  The discussion will include the types of vaccine in development, distribution priorities and barriers surrounding vaccine administration.  Dr. William Valenti will serve as faculty.

Click here to register

Educational Objectives:

  • Recognize the types of COVID-19 vaccine in development;
  • Discuss priorities for vaccine distribution; and
  • Identify barriers to COVID-19 immunization

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

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.      

eNews

Gov. Cuomo’s Jan. 28 Briefing

  • Total COVID hospitalizations fell to 8,520. 
  • Of the 250,668 tests reported yesterday, 13,398, or 5.34 percent were positive.
  • There were 1,584 patients in ICU yesterday, up 26 from the previous day. Of them, 1,024 are intubated.
  • Sadly, we lost 162 New Yorkers to the virus.

Workers’ Compensation and COVID-19
When a worker contracts COVID-19, it may be unclear to a medical provider (even one authorized to treat workers’ compensation claimants) whether it is work related. As discussed in greater detail below, it is possible for cases to be ‘established’ as compensable without having a medical report from an authorized provider indicating that the COVID-19 was work related.

The Workers’ Compensation Board published materials to provide basic information about COVID claims. The information is aggregated at: http://www.wcb.ny.gov/covid-19/

WCB Information Related To Novel Coronavirus (COVID-19) COVID-19 & Workers’ Compensation Video (October 2020) Letter From Chair Rodriguez to Carriers and Payers of Workers’ Comp: Speeding up the resolution process for COVID-19 claims (September 2020)

Among the documents are: a Q&A document, explaining how the Board evaluates claims; a bulletin by the Board’s Medical Director; letters from the Chair; and a video about COVID claims. We strongly encourage you to review the information as needed.

Regarding the role of the medical provider, let’s discuss the need for a medical report in the course of a COVID-19 claim in three phases: compensability, ongoing medical treatment, and ongoing lost time awards. Please see this letter from the Board to MSSNY which will provide additional insight.



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Response to NYT Jan. 22 Article “Filing Suit for Wrongful Life
I am compelled to react to Paula Span’s article Filing Suit for ‘Wrongful Life’ published in the new Old Age section of the New York Times on 1/22/2021 from several lens. Without conducting a thorough review of the medical records, I cannot comment on the specific merits of the case. However, I can clarify the differences between advance directives and MOLST and offer NYSeMOLSTregistry.com as a risk management tool to prevent similar future litigation in NY.

As a board-certified geriatrician, trained, licensed and practicing in New York for more than forty years, the emergence of litigation for providing unwanted life-sustaining treatment is no surprise. For decades, all life-sustaining treatment was provided, as death viewed as failure could potentially result in a lawsuit. I anticipate more litigation as baby boomers are avid consumers of health information, recognize faults in our health care delivery system, are proactive setting expectations with their physician, NP, or PA, and serve as their own self advocates.

Every American has a right to accept and/or refuse treatment, including life-sustaining treatment. The right does not end when a patient loses the capacity to make medical decisions. These rights are a result of the Patient Self Determination Act (PSDA), a federal law, passed in 1990 and instituted on December 1, 1991. Compliance with PSDA is mandatory.

Advance directives are legal documents that identify future care preferences. Each state has different laws, regulations, and state-specific advance directive documents to ensure this right. The New York Health Care Proxy (HCP) ensures a health care agent (HCA) may make decisions for the patient determined to lack capacity. In the absence of a HCP, the decision falls to a surrogate identified in Family Health Care Decisions Act (FHCDA). Both HCAs and surrogates are required to make decisions according to the patient’s known wishes or best interests. While living wills provide “clear and convincing evidence” and are recognized under case law, they cannot be followed in an emergency and are difficult to interpret in the acute care setting due to the coexistence of a terminal illness and potentially reversible acute illness.

MOLST is a set of medical orders that defines life-sustaining treatment the patient wants to receive or avoid now. It is created after a thoughtful discussion between the patient (or HCA or surrogate) with a physician, NP or PA. Medical orders must be followed by all health care professionals in all settings. NY created the MOLST program twenty years ago and is a founding member of National POLST.

Each state has different laws that govern the legal requirements for making end-of-life decisions, different portable forms, and years of experience. NY’s public health laws (PHL) integrate the ethical framework for making such decisions and provide broad patient and provider protections under HCP law and FHCDA, as well as the process outlined §SCPA 1750-b for individuals with intellectual and developmental disabilities who lack capacity. The NY DOH MOLST Checklists and OPWDD Checklist outline the law. Physicians, NPs, PAs, and health systems must be compliant.

As a knowledgeable baby boomer physician, I know my rights. I will speak with my physician when I am appropriate for a thoughtful MOLST discussion and include my health care agent and family virtually. I will insist my physician 1) complete my MOLST in NYSeMOLSTregistry.com explaining eMOLST is a risk management tool, and 2) include my personal statement in the ‘Other Instructions’ section of the MOLST form, “If my MOLST orders are not followed, my attorney will sue for battery, pain and suffering, and make sure the insurance company does not pay for unwanted treatment.”

Patricia A. Bomba, MD, MACP, FRCP
NY MOLST and eMOLST Program Director, 2001-present
(Note: Dr. Bomba is a longtime MSSNY member)


Social Distancing Rates in the U.S. Fell Drastically as the Pandemic Continued
Social distancing rates in the U.S. fell drastically as the pandemic continued according to a study published Jan. 22 in JAMANetwork. Researchers analyzed survey responses from 7,705 participants completed between April 1 and Nov. 24, 2020. All U.S. regions experienced decreases in COVID-19 mitigation efforts from early April to late November, with adherence in the final survey week significantly lower in the Midwest than all other regions. Protective behaviors that had the largest reported decreases included having no close contact with non-household members and avoiding eating at restaurants. Read more here.


Five Stats on Physician Burnout In 2021: 42% Feeling Burned Out
For the report, Medscape surveyed 12,339 physicians in more than 29 specialties from Aug. 30 to Nov. 5, 2020.

Five report findings:

  1. Sixty-nine percent of physicians said they were somewhat or very happy in 2020 before the pandemic started. This figure fell to 49 percent during the pandemic.
  2. While female physicians have historically reported higher rates of burnout than their male peers, this gap grew in 2020. Fifty-one percent of women said they were burnt out, compared to 36 percent of men.
  3. Critical care physicians had the highest rates of burnout among all specialties, at 51 percent. In 2019, urologists reported the highest burnout rates.
  4. Seventy-nine percent of physicians said their burnout began before the COVID-19 pandemic.
  5. The three most common contributing factors to burnout that physicians cited were too many bureaucratic tasks (58 percent); spending too many hours at work (37 percent); and lack of response from leaders or colleagues (37 percent).

To view the full report, click here.


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Center for Healthcare Workforce: Racial Composition of New York NPS
A recent study conducted by CHWS examined the racial/ethnic composition of New York’s nurse practitioner (NP) workforce. Researchers examined key demographic, educational, and practice characteristics of the state’s active NPs.

Statewide, Hispanic NPs are underrepresented in the state’s NP workforce, while the percentage of Black NPs is close to the percentage of Blacks in the state’s population.

On the regional level, CHWS staff found that Hispanic NPs were underrepresented in most regions of the state when compared to the Hispanic population in those regions. New York City saw the largest disparity between Hispanic NPs (8%) and the local Hispanic population (29%). On the other hand, in the North Country region, Hispanic NPs nearly mirrored their presence in the regional population.

Black NPs were also underrepresented in many regions of the state, with the greatest disparities between Black NPs and the regional Black population observed in the Western New York, Finger Lakes, and Central New York regions.

Other key findings include:

NPs younger than 50 tended to be more racially and ethnically diverse.

Black and Hispanic NPs complete their NP training at older ages compared to all other NPs.

Nearly half of Black NPs work in primary care health professional shortage areas (HPSAs).

Read our latest research brief to learn more about the key findings!


US Reports 1st Cases of South Africa Variant: 7 things to Know
South Carolina officials have confirmed two cases of the coronavirus variant first identified in South Africa, the first known cases in the U.S.

Seven things to know:

  1. The infected individuals live in different counties, the South Carolina Department of Health and Environmental Control said Jan. 28. Neither individual had a recent history of travel, suggesting community spread of the variant, known as B.1.351.
  2. The variant is believed to be highly transmissible and shares some mutations with the U.K. variant, B.1.1.7.
  3. “At this time, we have no evidence that infections by this variant cause more severe disease. Like the U.K. and Brazilian variants, preliminary data suggests this variant may spread more easily and quickly than other variants,” the CDC said Jan. 28.
  4. COVID-19 vaccines appear to be less effective against the variant, according to three new studies cited by The Wall Street Journal.
  5. Moderna is developing a new form of its COVID-19 vaccine that could be used as a booster shot to specifically target the South Africa variant.
  6. new study indicates that the South Africa variant evades antibody treatment. The study, published Jan. 26 on the pre-print server bioRxiv, has yet to be peer-reviewed.
  7. President Joe Biden implemented a new travel ban for South Africa Jan. 25.

HHS to Allow Retired Nurses, Physicians to Give COVID-19 Shots
Jeff Zients, the new White House COVID-19 response coordinator, said during a news briefing that HHS will amend the Public Readiness and Preparedness Act to allow retired physicians and nurses to administer shots, according to the Journal. The rules will also be amended to allow licensed physicians and nurses to administer shots across state lines.

The decision to allow retired physicians and nurses to administer COVID-19 shots is in addition to other efforts related to vaccine distribution. Acting CMS Administrator Andy Slavitt said Jan. 27 that the White House is considering ways to produce shots by use of the Defense Production Act. Mr. Slavitt has also said the federal government would increase vaccine supply to states by 16 percent each week for the next three weeks. (Becker’s Hospital Review, Jan 28)


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Physician & Other Healthcare Jobs. P/T & F/T – Check Us Out


Unique Rheumatology Practice Opportunity – Great Neck, NY
Partnership opportunity available at an established rheumatology practice in Great Neck, NY. Looking for a dedicated physician to join our practice or merge practices. Contact 516-972-2986 / susanrita1@msn.com for more info.

 

 

 

 

 

 

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