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

Arthur Fougner MSSNY Presiident

PRESIDENT’S MESSAGE<
Arthur Fougner, MD
MSSNY President

MSSNY eNews
June 7, 2019

Vol. 22  Number 22


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

                    -Dirty Laundry by Don Henley

Colleagues:

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

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

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

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

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

Engage!

Arthur Fougner, MD
MSSNY President 

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


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

Capital Update

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

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

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

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

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

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


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

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

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

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


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

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

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

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


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

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

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

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

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


 


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

Mid-year formulary changes

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

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

Network due process

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

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

Collective negotiations

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

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


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


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

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


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

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

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

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


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

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


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


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

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

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


                                                     


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

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

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

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


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

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

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


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

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


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


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

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

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


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

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

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

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


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

Members of Jefferson County Medical Society

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


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

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

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

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

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

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


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


 

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


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

PHYSICIAN OPPORTUNITIES

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

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

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

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

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

Primary Contact: Oksana


 

 


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


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

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 


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

Arthur Fougner MSSNY Presiident

PRESIDENT’S MESSAGE<
Arthur Fougner, MD
MSSNY President

MSSNY eNews
May 31, 2019

Vol. 22  Number 21


MSSNYPAC Seal

 


Colleagues:

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

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

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

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

Funny how that works, right?

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

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

Stay tuned.

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

Bob Marley

Arthur Fougner, MD
MSSNY President 

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


MSSNY Physician Burnout Banner


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


 

Capital Update


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

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

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


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

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

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

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

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

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


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

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



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

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

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

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

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

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

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

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

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


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

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

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


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

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


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

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

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


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

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

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

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

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


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

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

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

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


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

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

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

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

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

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


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

Veterans Matters: Substance Use Disorders in Veterans

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

Faculty: Frank Dowling, MD

Educational Objectives

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

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

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

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


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

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

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


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

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

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

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

Pediatrics article


MSSNY Council Notes—May 30. 2019

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

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

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


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

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

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


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


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


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


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


Classified

RENTAL/LEASING SPACE


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


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


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


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


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


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


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

PHYSICIAN OPPORTUNITIES

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

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

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

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

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

Primary Contact: Oksana


 

 


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


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

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 


MSSNY eNews – May 24, 2019 – Memorials and Decorations

Arthur Fougner MSSNY Presiident

PRESIDENT’S MESSAGE<
Arthur Fougner, MD
MSSNY President

MSSNY eNews
May 24, 2019

Vol. 22  Number 20


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Colleagues:

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

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

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

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

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

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

Arthur Fougner, MD
MSSNY President 

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


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Capital Update


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

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

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

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


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

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

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



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

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

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

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

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

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

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


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

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

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

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

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

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


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

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

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

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


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

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

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

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


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

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

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

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

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


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

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


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

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

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


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

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

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


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

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

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

Faculty: Lt. Col Lance Allen Wang (Ret)

Educational Objectives

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

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

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

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

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


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

Veterans Matters: Substance Use Disorders in Veterans

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

Faculty: Frank Dowling, MD

Educational Objectives

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

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

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

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


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

eNews

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


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

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

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


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

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

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

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

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

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

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


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


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


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


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


 

CMS

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


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RENTAL/LEASING SPACE


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


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


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


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


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


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


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

PHYSICIAN OPPORTUNITIES

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

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

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

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

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

Primary Contact: Oksana


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


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


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

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 


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

Arthur Fougner MSSNY Presiident

PRESIDENT’S MESSAGE<
Arthur Fougner, MD
MSSNY President

MSSNY eNews
May 17, 2019

Vol. 22  Number 19


MSSNYPAC Seal

 


Colleagues:

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

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

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

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

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

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

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

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

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

Arthur Fougner, MD
MSSNY President 

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


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Capital Update

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This Week’s Podcast of MSSNY’s Legislative Priorities


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

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

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

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

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

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

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


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

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

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

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

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

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

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



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

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

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

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

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

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

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

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


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

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


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

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

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


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

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

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

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

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


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

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

Veterans Matters: Substance Use Disorders in Veterans

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

Faculty: Frank Dowling, MD

Educational Objectives

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

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

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


 

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

eNews

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

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


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

See link below about the hiring of Dr. Maybank

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


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

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

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


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


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

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

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


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

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

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

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

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


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

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

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

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


CMS

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

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

2019 CEHRT Requirements

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

Attestation Statements

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

For More Information

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


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RENTAL/LEASING SPACE


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


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


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


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


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


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


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

PHYSICIAN OPPORTUNITIES

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

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

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

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

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

Primary Contact: Oksana


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


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


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

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 


MSSNY eNews – May 10, 2019 – NY State of Fear

Arthur Fougner MSSNY Presiident

PRESIDENT’S MESSAGE<
Arthur Fougner, MD
MSSNY President

MSSNY eNews
MAy 10, 2019

Vol. 22  Number 18


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Colleagues:

Fear is the Mind Killer.”
-Bene Gesserit (from Dune by Frank Herbert)

The 21st Century is not turning out the way I expected. How it could happen that a disease once declared eradicated by the CDC in 2000, now plagues our state? With over 600 cases in NY State, there seems no end to this outbreak. Schools have been closed, families are now under quarantine. Any day, I expect to pick up the paper and learn that someone, like the Israeli flight attendant, is now in an intensive care unit somewhere on life support.

Where once NY enjoyed almost universal vaccination, today there are over 200 schools where less than two thirds of the children are immunized. This is truly disturbing.  You see, there are those who cannot be vaccinated – those infants 6 months of age or younger, those with cancer or transplants on immunosuppression therapy, patients with HIV or autoimmune disease, pregnant women, or those allergic to any of the ingredients in the vaccine. To minimize the likelihood of exposure, the rest of the community needs to be immunized. This is the concept of herd immunity. Today, our herd has been culled.

So what’s going on here? Some might point to religion. Yet there is no major religion that proscribes vaccination. Moreover, religion has been with us since the day that homo sapiens took their first steps. Religion was certainly around while measles was being eradicated through a vigorous vaccination campaign.

So what is different now?

What’s different now is the pervasive state of fear created by a relatively small group who spread the notion that the vaccines are more terrifying than the diseases they are designed to control. We all know who they are. They are powerful, they are media savvy and their influence has spread throughout all sectors of our society, promulgating the false gospel that vaccination causes such afflictions as autism. That notion, which first emerged 20 years ago, has been thoroughly discredited but facts do not deter this cult. Take the two recent Danish studies of over half a million children. These found no significant difference in autism rates between those vaccinated and those not. In fact, the vaccinated group actually had a slightly LOWER incidence of autism.

So we must take this challenge head on and protect those who cannot protect themselves. Re-establish Community Immunity. Remember the words of a former NY governor, President and victim of a now vaccine-preventable disease: “The only thing we have to fear is fear itself.”

Arthur Fougner, MD
MSSNY President 

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

Dr. Fougner and Dr. Sellers at Measles Conference

Vaccinations: Only Medical Exemptions.
MSSNY Vice President Dr. Joseph Sellers and MSSNY President Dr. Art Fougner at a press conference on Tuesday, May 8. Speaking to NYS legislators, Dr. Fougner said, “An important first step is ensuring that medical exemptions are the ONLY exemptions allowable.”


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Capital Update

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This Week’s Podcast of MSSNY’s Legislative Priorities


MSSNY Participates in Congressional Discussion on Addressing Surprise Medical Bills
MSSNY Past-President Dr. Andrew Kleinman was one of the key participants in a meeting this week in Washington DC with the US House of Representatives’ Doctors Caucus to highlight New York’s acclaimed “surprise medical bill” law as a model for Congress to follow as it develops similar legislation for the country.  Dr. Kleinman highlighted that New York’s comprehensive law protected patients and struck a balance among the concerns of physicians, hospitals and health insurers to help preserve needed on-call specialty care availability in hospital emergency departments.

He noted New York’s law not only addressed surprise out of network bills directly, but also addressed other “root causes” of  surprise medical bills, such as inadequate and inaccurate physician networks and inadequate out of network coverage. He also highlighted the expeditious and relatively inexpensive cost of New York’s independent dispute resolution system for resolving surprise out of network bills.  Dr. Kleinman was extensively involved in efforts to help develop and advance New York’s law.

Other participants in the meeting included the American Medical Association, the American Association of Neurological Surgeons, the American College of Emergency Physicians, and the Federation of American Hospitals.  Dr. Kleinman also met with key health policy staff for several other key US Senators developing legislation on this issue, including Senate Minority Charles Schumer (D-NY) and Senator Dr. William Cassidy (R-LA).    

This week, President Trump held a press conference urging action to address surprise medical bills. The AMA released a statement following the press conference agreeing with the goal to protect patients from surprise bills but raising concerns with aspects of the President’s statement.  Read the AMA statement here.

Physicians are urged to send a letter to Senators Schumer and Gillibrand, as well as their respective member of Congress here  to urge that any proposal addressing surprise medical bills be consistent with New York’s law.                      (AUSTER)


Medical Organizations, Public Health and Patient Advocacy Groups Hold Press Conference; Urge Legislators to Enact Medical Exemption
The Medical Society of the State of New York and 27 other medical organizations, public health and patient advocacy groups are urging the New York State Legislature to pass A.2371/S.2984 which ensures that medical reasons are the only exception to vaccination requirements.  MSSNY President Dr. Art Fougner, Vice-President Dr. Joseph Sellers and Assistant Treasurer Dr. Parag Mehta joined many other physicians and patient advocates this week in a press conference urging support for the legislation.  The press conference generated significant media attention. The legislation is sponsored by Assemblymember Dinowitz and Senator Hoylman and is in the Assembly and Senate Health Committees.

Following the press conference, the groups met with various members of the legislature urging their support of the measure; those meetings will continue this week.  It is important to note that many anti-vaccine advocates are expected at the Capitol next week to discuss their views with legislators.  Therefore, it is critically important that all physicians reach out o their legislators and urge passage of A.2371/S.2984.

The measure must go through the Assembly Health Committee and MSSNY’s focus has been on the following individuals:  Assemblymembers Gottfired, Abinanti, Ashby, Barron, Bichotte, Braunstein, K. Byrne, M. Byrnes, Cahall, Cymbrowitz, Dinowitz, Galed, Garbarino, Gunther, Hevesi, Jaffee, Kim, D. McDonought, Paulin, Ra, Raia, Rosenthal, Sayegh, Schimminger, Solages, P. Steck.  You can call the Asssembly at 518-455-4100 and ask to be transferred to their offices.  You may also send a letter to these legislators urging support of A.2371 and S.2984 by going to MSSNY Grassroots Action Center (GAC) here.

With the number of confirmed measles cases exceeding 700, groups are urging passage to ensure that measles – a vaccine preventable disease – does not gain a sustained foothold in New York and across the nation.

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



Collective Negotiations Bill Advances in the Assembly
Please urge your legislators to support Assemblymember Gottfried’s bill A.2393, which would help to even the playing field between physicians and insurance companies.  A letter can be sent here.

This bill was reported out of the Health committee on 4/30 and has now been reported out of the Codes committee. It currently awaits a vote in the Assembly Ways and Means Committee. If enacted into law it would allow independently practicing physicians to communicate and negotiate collectively with health care plans in limited instances (when health plans have an undue advantage negotiating the terms of contracts with health care providers). Physicians are currently unable to do so due to federal antitrust law. However, a longstanding US Supreme Court precedent enables States to permit these negotiations via the State Action Doctrine.

Passage of this legislation would help to enable physicians to negotiate in order to limit burdensome prior authorization procedures and unfair network participation rules. It also contains protections to help ensure that negotiations do not impair access to patient care by prohibiting collective slowdowns/strikes and would ensure strict oversight of these negotiations by the Department of Health.

The bill, which is also sponsored by Senator Rivera (S.3462) is currently in the Senate Health Committee.             (AVELLA)     


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

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

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

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



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Action Needed on Prior Authorization Reform Bill
Prior authorizations continue to be a major roadblock to care and cause endless hassles for physicians and their staff. The burdens caused by excessive and often unjustified prior authorization requirements take away from the time that physicians can spend with their patients and lead to far too many hours being spent on paperwork. Further, surveys continue to demonstrate that a significant number of patients have experienced adverse outcomes due to prior authorizations, either due to the time that insurance companies take to process them or because of improper or unfair denials.

Senator Breslin and Assemblymember Gottfried have introduced an “omnibus bill” (S.2847/A.3038) that would help in reducing prior authorization burdens, updating UR standards and patient protections for prescription drugs.  MSSNY has been working with several specialty societies and patient advocacy groups, including the New York Bleeding Disorders Coalition, on advocacy in support of the legislation.

The bill has picked up additional co-sponsors in both houses this year. It is currently awaiting action in the Senate Health Committee and the Assembly Insurance Committee. Please urge your Assemblymember and Senator to join on as a co-sponsor here(AVELLA)


Single Payer Hearing Scheduled for May 28 in Albany
Health Committee Chairs Senator Rivera and Assemblymember Gottfried will host a hearing on the Proposed New York Health Act on May 28, 2019 in Albany. It will be the first of a series of hearings throughout NY regarding the proposed legislation, which would create a single payor system in New York. MSSNY President Arthur Fougner, MD will be providing testimony on behalf of MSSNY.

The hearing will take place at 10am in Hearing Room A in the Legislative Office Building. Oral testimony will be limited to 10 minutes per participant. More information, including the form that must be submitted by those who wish to testify, can be found here.          (AVELLA)


Uniform Credentialing Bill on Senate Health Committee Agenda
Senate Bill S.4335, sponsored by Senator Salazar, is on the Senate Health Committee’s agenda for Tuesday, May 14. The bill would require the creation and use of uniform credentialing and re-credentialing forms for physicians and other providers to use for the purposes of applying for and being maintained on a health care plan’s network. While many insurance companies now use CAQH’s standard form, not all use it exclusively. As a result, physicians and their staff – who are already overburdened with paperwork and bureaucratic tasks – must sometimes file multiple different forms that serve the same purpose.

It would also require the creation of a standard referral form that a primary care physician may use to facilitate care for a patient from a specialist physician. Similar to the credentialing forms, health care plans may have their own referral forms that are substantially similar, but different enough so that the physician must use each plan’s form instead of a single form. A uniform referral form would alleviate further unnecessary administrative hassles that physicians face in attempting to facilitate appropriate care for their patients.

Assemblymember Gottfried’s companion bill A.3077 passed the Assembly on 3/26.        (AVELLA)


Patient Formulary Protection Bill Ready for Senate Vote
Senator Breslin’s S.2849, which would prohibit a health care plan from making prescription drug formulary changes during the contract year, is currently on the floor of the Senate. While patients are locked into an insurance plan for the contract year – and often choose their plan based on their prescription co-pays and prescription formularies – insurance companies are able to modify their formulary and often move drugs into a higher cost-sharing tier mid-contract. This legislation would ensure that patients are able to access the drugs they need without unexpected cost increases mid-year.  MSSNY has been working with several patient advocacy groups in support of this legislation.

This is the first year that the bill has advanced out of committee in the Senate. Its companion bill, which is sponsored by Assemblymember People-Stokes (A.2969), has passed the Assembly every year since 2015 and is currently in the Assembly Insurance Committee awaiting movement. Please urge your legislator to support this bill by clicking here. (AVELLA)


CMS to Require Pharma Companies to Include List Price during TV Commercials
CMS will now require TV commercials for prescription drugs covered by Medicare or Medicaid to include the list price (Wholesale Acquisition Cost) if the price is greater than or equal to $35 per month or the usual course of therapy. Currently, drug companies are only required to disclose a drug’s potential major side effects. The final rule is effective 60 days after its May 10, 2019 publication in the Federal Register (July 9, 2019).

Per HHS, the 10 most commonly advertised drugs have list prices ranging from $488 to $16,938 per month (or usual course of therapy).  HHS estimates that prescription drug spending in the United States was about $457 billion in 2015, or 16.7 percent of overall personal health care services. Further, over $4.2 billion was spent on prescription drug television advertising.

The stated intent of this rule change is to incentivize lower list prices and ensuring that beneficiaries are provided all of the information that they need to make informed decisions, minimizing their out-of-pocket costs. 47% of Americans are insured through high-deductible health plans and all seniors on Medicare Part D must pay coinsurance and often a deductible as well. The list price is also what a patient would pay if a drug is not on their insurance formulary.    (AVELLA)  


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

The number of measles cases in New York State continues to rise with approximately 665 of the 706 confirmed cases nationwide occurring in New York State (423 in New York City, 206 in Rockland, 23 in Orange, 10 in Westchester, 2 in Sullivan, 1 in Suffolk and 1 in Greene counties) as of May 1st.  MSSNY conducted a just-in-time Medical Matters webinar entitled “The Continued Public Health Threat of Measles 2018” in December, 2018.  This webinar has now been posted to the MSSNY CME website. You can also view MSSNY’s latest Medical Matters webinar entitled “What’s Your Diagnosis? Infectious Diseases” which involves a patient with a fever and a rash.  Please check these out and keep yourself informed about the growing measles outbreak throughout New York State.  You can also listen to MSSNY’s brief podcast on the Measles, Mumps and Rubella vaccine here         (HOFFMAN, CLANCY)


Be Sure to Listen to MSSNY’s Latest Podcast
MSSNY proudly announces our latest podcast entitled Military Culture: Forging an Alliance with Veteran Patients.  Dr. Frank Dowling, MSSNY Secretary, discusses the unique aspects of military culture with Marcelle Leis, CMS (Ret.) USAF/ANG and Lance Allen Want, Lt. Col. (Ret.) USA.  Listen here.                                                                   (HOFFMAN)


Registration Now Open for Medical Matters Webinar on May 15, 2019 @ 7:30am
The Medical Society of the State of New York will host its final Medical Matters webinar of 2019, The Importance of Resilience After a Disaster on May 15th @ 7:30am.  Encouraging post traumatic growth is an essential part of recovery from any type of disaster.  Learn more about how best to encourage resilience behaviors in patients.

The Importance of Resilience After a DisasterRegister here.:

When:  Wednesday, May 15 2019 at 7:30am

Faculty: Craig Katz, MD

Educational Objectives:

  • Define resilience and post traumatic growth
  • Describe how best to measure resilience and post traumatic growth
  • Explore resilience behaviors and how to encourage them in your patients

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

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


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

Veterans Matters: Substance Use Disorders in Veterans

When:  Wednesday June 5 2019 at 7:30am

Faculty: Frank Dowling, MD

Educational Objectives

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

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

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


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

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Empire, Westchester Medical Center Locked in Contract Dispute
Empire BlueCross BlueShield has notified its members that Westchester Medical Center Health Network will become out-of-network on June 1 unless the two sides reach an agreement. The health network’s contract with Empire expired April 1, but discussions have continued during a two-month “cooling off” period.

“We have a strong desire for Westchester Medical Center to be in-network, but we have to provide affordable products,” Alan Murray, Empire’s CEO, told Crain’s. “That’s a constant balance we’re challenged with.”

The hospitals affected are Westchester Medical Center and Maria Fareri Children’s Hospital in Valhalla; Bon Secours Community Hospital in Port Jervis, Orange County; Good Samaritan Hospital in Suffern, Rockland County; St. Anthony Community Hospital in Warwick, Orange County; and MidHudson Regional Hospital in Poughkeepsie, Dutchess County.

The insurer told members that Empire would cover WMCHealth facilities as in-network during emergencies, when services have been previously authorized or where another provider is not within 30 miles of a patient’s home. Crains May 7.


Mayor Unveils NYC Care Card for Uninsured; Will Hire Seven Doctors in Bronx
The city’s public hospital system is hiring seven doctors for Lincoln Hospital in the Bronx to prepare for what officials hope will be an influx of patients this summer who will take advantage of NYC Care, the de Blasio administration’s latest health program.

The city’s effort to connect people without insurance to primary care at NYC Health + Hospitals will officially start Aug. 1 in the Bronx. The mayor’s office expects 10,000 people to sign up for NYC Care within the first six months of the program. The patients will have 24/7 access to a customer-service line and hospital-based pharmacies.

The $100 million NYC Care program does not provide participants with access to medical care at any private doctor, hospital or pharmacy. It will charge sliding-scale payments based on an individual’s income and encourage people to enroll in MetroPlus if they earn too much to qualify. The card includes a member ID number, the name of an individual’s primary-care physician and a customer-service phone number.

People are eligible if they have lived in the city for at least six months and do not have an affordable insurance option or are ineligible for insurance. Of course, NYC Health + Hospitals always has welcomed any patient whether or not they have insurance. The difference is the priority of connecting uninsured patients to primary care before they go to a city emergency room with a crisis. The city will spend $25 million bringing the program to the Bronx, which also includes ramp-up costs, said City Hall spokesperson Marcy Miranda.


NY Improves Its Readiness for Health Emergencies
New York has continued to improve its readiness for health emergencies, according to the 2019 National Health Security Preparedness Index, released by the Robert Wood Johnson Foundation. The state improved its readiness in all areas between 2013 and 2018, the index found. It also bested the national average of 6.7—on a 10-point scale—scoring 6.9. Specifically, New York scored particularly well in community planning and engagement, increasing nearly 21%, to 5.8. The national average was 5.2 last year.

New York also posted its highest score in health security surveillance, 9.2, compared with a national average of 8.3. Health security surveillance is defined by the index as the ability to detect and monitor health threats and identify where they start and spread to contain them rapidly.

The state also exceeded the national average in readiness in environmental and occupational health last year at 6.7, compared with 5.9. New York’s lowest score was in health care delivery—the ability to provide care during and after emergencies—at 4.7. The national average was 4.9. The state also scored significantly below the national average in incident and information management, at 8.2, compared with 8.7. This metric is the ability to deploy people, supplies and funds to locations where they are most effective in protecting health, according to the index.

The index was originally developed by the Centers for Disease Control and Prevention. It is now funded by the Robert Wood Johnson Foundation and involves the collaboration of more than 30 organizations.


Yelp to List NYC and Long Island Maternity Care Metrics on Hospital Pages
As of May 8, Yelp started displaying information about the quality of maternity care at about 50 hospitals in New York City and Long Island through a partnership with the Northeast Business Group on Health. The Yelp pages for hospitals will indicate whether the facilities are above average, average or below average in their rates of Cesarean-section deliveries in low-risk pregnancies, newborns being fed only breast milk before discharge, the administering of an episiotomy and vaginal births among women who’ve had a previous C-section.

The data come from expectny.com, a project of the Northeast Business Group on Health, which provides maternity-care statistics from New York State and patient-safety organization Leapfrog Group. Its work was supported by a grant from the New York State Health Foundation. The ratings include a link to expectny.com where users can get more information about why it has rated hospitals on these measures. A 2017 report from researchers at the Manhattan Institute found Yelp ratings were correlated with better-quality hospitals in New York State. In the analysis, hospitals with lower rates of avoidable readmission were considered higher quality. Crains NY May 8 

“Do I Really Need An Employee Handbook? Absolutely!”
Creating an employee handbook can seem like a daunting task for an employer. Some employers have few, if any, written policies in place when they begin the process. Others may have adopted individual written policies in the past with little, if any, consideration given to how the policies can or should fit together in a handbook. Questions abound over what policies must or should be included, or over how often the handbook should be updated.

Despite such issues, there is no question that every employer should have a handbook in place.  A properly drafted employee handbook can be a critical risk management tool, communication tool and cost containment tool.  Specifically, a handbook informs employees and supervisors of the rules and policies of the workplace in a uniform way, and provides for clarity concerning expectations and standards that must be followed and adhered to by employees.  A handbook is a primary tool for placing employees on notice of an employer’s policies, expectations and benefits.

Moreover, employers can refer to provisions of an employee manual for purposes of establishing legitimate and lawful reasons for taking an adverse employment action against an employee.  Furthermore, a handbook informs the employees of their rights and benefits in a clear consistent manner and of grievance procedures to ensure that complaints are handled appropriately and effectively.  The prospect of supervisors enforcing rules consistently is enhanced by the existence of a handbook.

Finally, a properly drafted handbook can reduce the risks of litigation or provide a defense in should a lawsuit arise.  This is because its existence can show an employer’s intended consistent treatment of employees, the plaintiff-employee’s violation of the workplace rules, and that a plaintiff-employee’s claim for benefits is baseless given the express language of the handbook.

[1]Madelin T. Zwerling is an attorney at Garfunkel Wild, P.C., which she joined in 2011, and a member of the Employment Law Practice Group, which provides legal advice on a full range of employment matters.  She may be reached at mzwerling@garfunkelwild.com or (516) 393-2510.


New Rule Requires Drug Price Disclosure in TV Ads
The HHS finalized a rule on Wednesday that will require drugmakers to post the list prices of their products in TV ads. The policy applies to all drugs covered by Medicare that cost $35 or more per month or over the course of treatment. The rule takes effect 60 days after it is published in the federal register. The drug industry might challenge the rule.

“We’re moving from a system where patients are left in the dark to where patients are put in the driver’s seat,” Alex Azar, secretary of health and human services, said in a speech.

The rule makes drug companies more accountable to New York consumers, said Eric Linzer, president and CEO of the state Health Plan Association.

“While breakthrough medications provide tremendous clinical benefits to patients there’s really little understanding of how drug manufacturers establish their prices,” he said.


Severe Alcohol-Related Liver Disease Rising, Possibly Due to Binge Drinking
Severe alcohol-related liver disease is on the rise,” (which) may be due to heavy binge drinking, especially in young adults,” experts posit. For the study, investigators “turned to data from 2001 to 2016 from the National Health and Nutrition Examination Survey (NHANES).” The researchers then discovered that “while there has been little change in the rate of people developing alcoholic fatty liver disease, there appears to be an increase in those who are at greater risk of cirrhosis, liver cancer and death.” The findings of the 34,423-person study were published May 7 in a research letter in JAMA.


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RENTAL/LEASING SPACE


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


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


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


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


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


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


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

PHYSICIAN OPPORTUNITIES

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

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

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

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

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

Primary Contact: Oksana


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


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


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

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 


MSSNY eNews – May 3, 2019 – Dazzled by Ex-Bronco in Buffalo

Arthur Fougner MSSNY Presiident

PRESIDENT’S MESSAGE<
Arthur Fougner, MD
MSSNY President

MSSNY eNews
MAy 3, 2019

Vol. 22  Number 17


MSSNYPAC Seal

 


Colleagues:

“Blinded by the light
Revved up like a deuce, another Runner in the Night
Blinded by the light.”
Bruce Springsteen

It was great to be back in Buffalo for the Erie County Annual Meeting as Dr. John Gillespie turned over the reins to Dr. Kenneth Eckert III, a third generation physician. In his inaugural, Dr. Eckhert shared several quotes from his grandfather – quotes that still ring true today.

The highlight of the evening was former Denver Broncos wide receiver Vance Johnson (I know – a Bronco in Bills country?) who shared with us his life outside the lines. His was a real Wide World of Sports story – from the thrill of victory to the agony of defeat, as he sank steadily into the quagmire of substance abuse and addiction. A few words can hardly recap the emotion of the evening as the man poured out his heart to all in attendance. Suddenly, agonizing about Managed Care or Reimbursement seemed such small matters indeed.

Mr. Johnson credited the care and tough love shown by a physician Mark Twardowski, DO, for the inspiration and the guts to turn his life around. “He cared about me,” Vance shared. Today, Vance Johnson is a substance abuse counselor and motivational speaker who is truly making an impact one life at a time.

After the meeting, I shared with Vance that I had had a hip replacement and had been prescribed powerful opioids. For some reason, I was somehow not susceptible to their allure.  There but for good fortune, indeed. And we spoke about kids in sports and the influence their coaches and trainers have on them and how easily bad advice and unrealistic expectations can lead athletes to a path to self-destruction. As Mr. Vance was speaking, the realization hit like a ton of bricks that we must always strive to see the person behind the mask. For more about Vance Johnson, check out his video here.

Dr. Fougner Speaks in Buffalo

“Let’s get the collective negotiation football across the goal line,” said MSSNY President Art Fougner at the Erie County Medical Society Annual Meeting this week.

Arthur Fougner, MD
MSSNY President

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


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Capital Update

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This Week’s Podcast of MSSNY’s Legislative Priorities


Medical Organizations, Public Health and Patient Advocacy Groups Join Together to Urge Further Limits on Exemptions For Immunizations
This Monday, May 6, the Medical Society of the State of New York will join 25 other medical organizations, public health and patient advocacy groups urging the New York State Legislature to pass A.2371/S.2984 which ensures that medical reasons are the only exception to vaccination requirements.  The legislation is sponsored by Assemblymember Dinowitz and Senator Hoylman and is in the Assembly and Senate Health Committees. Following the press conference, the groups will meet with various members of the legislature urging their support of the measure.  With the number of measles cases exceeding 700 confirmed cases, all the groups are urging passage to ensure that measles, a vaccine preventable disease, does not gain a sustained foothold in New York and the nation.  The following groups have joined onto a memo in support and many representatives will be attending the press conference:

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

Schuyler Center For Analysis and Advocacy and The Children’s Agenda.

Physicians are encouraged to send a letter to their legislators urging support of A.2371 and S.2984 by going to MSSNY Grassroots Action Center (GAC). Please click here.                               (CLANCY)


Bill Requiring Physicians to Maintain Excessive Documentation of Discussion of Risks of Prescribing Opioids Moves to Senate Floor; Action Needed!
Legislation which would require physicians and health practitioners, who prescribe an opioid or other Schedule II Controlled Substance, to discuss with patients’ the risks prior to being prescribed a CSII drug, has moved to the Senate floor and can be voted on at any time.  The measure, S.4277-A, is sponsored by Senator Harckham.  There is now a companion measure, A.7285-A, sponsored by Assemblywoman Rosenthal.   Specifically the legislation would require physicians to discuss and, by extension, document that such discussions took place: a) the risks of addiction and overdose associated with opioid medications, b) the reason why the prescription is necessary, c) alternative treatments that may be available and d) the risks associated with the use of these medications. Moreover it would require the physician each year to counsel the patient on the risks of overdose and the availability of an opioid antagonist.

While the legislation is well intended, it ignores existing law essentially requiring the patient’s informed consent under the Public Health Law—which means that when a patient needs treatment, the physician must give the patient the information regarding risks to make an informed decision. Additionally, this is duplicative of requirements that currently exist under the ISTOP law, whereby, after the physician prescribes the medication, the pharmacist is required to again inform the patient about the risks of taking a controlled substance. Moreover MSSNY is concerned that such requirements will further discourage physicians from prescribing pain medications for patients who need them – already a growing concern, as well as potentially scaring patients away from taking pain medications who may truly need them.

The Medical Society is opposed to this measure and encourages physicians to send a letter to their legislator at the MSSNY Grassroots Action Center (CAC) here.
(CLANCY, AUSTER)



Collective Negotiations Bill Advances in the Assembly
Assemblymember Gottfried’s bill A.2393, which would help to even the playing field between physicians and insurance companies, has been reported out of the health committee and is now on the Assembly Codes Committee agenda for next week. This bill would allow independently practicing physicians to communicate and negotiate collectively with health care plans in limited instances (when health plans have an undue advantage negotiating the terms of contracts with health care providers). Currently physicians are unable to do so due to federal antitrust law. However, a longstanding US Supreme Court precedent enables States to permit these negotiations via the State Action Doctrine.

Passage of this legislation would help to enable physicians to negotiate to limit burdensome prior authorization procedures and unfair network participation rules. It also contains protections to help ensure that negotiations do not impair access to patient care by prohibiting collective slowdowns/strikes and would ensure strict oversight of these negotiations by the Department of Health.

The same as bill, which is sponsored by Senator Rivera (S.3462) is currently in the Senate Health Committee.

Please urge your legislator to support this bill by clicking here.
(AVELLA, AUSTER)


Senate Health Committee to Consider Legislation to Reduce MOC Hassles
Legislation is on the agenda of the Senate Health Committee for next week (S.5280, Rivera) that would prohibit health insurance companies and hospitals from requiring that their participating network and staff physicians continue to complete often unnecessarily burdensome Maintenance of Certification requirements as a condition of participation in their panels and medical staffs. The Medical Society of the State of New York supports this legislation.

The cost of updating board certification status is increasingly becoming prohibitively expensive and excessively time-consuming for many physicians. With demands on physician time greater than ever before (which is leading to a significant increase in “burnout”), many physicians find that they do not have sufficient time to prepare for ever more cumbersome specialty recertification exams. While efforts are being made by some of the national specialty boards to simplify this re-credentialing process in response to an outcry from the physician community about these excessive requirements, the needed relief is not happening quickly enough. This bill would help to ensure that continuing board certification remains aspirational for physicians, but not mandatory, by ensuring that hospitals and health insurance companies cannot impose such ongoing requirements as a condition of participation, thereby reducing one barrier to delivering medical care in New York State.

Similar legislation (A.5140, Schimminger) is in the Assembly Health Committee. (AUSTER)



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Bill to Restrict Physicians’ Defense in Medical Liability Cases Reported Out of Committee
The Assembly Codes Committee has reported Assemblymember Dinowitz’s bill A.2370 to the floor. The bill, which is opposed by MSSNY, would prohibit a physician’s defense counsel in a medical liability action from conducting an interview with the plaintiff’s treating physician.

This legislation would overturn a New York State Court of Appeals decision that affirmed a long-standing principle in our legal system that no party has a proprietary interest in a particular witness in a civil liability action.  Were this Court of Appeals decision to be overturned through legislation, it would present significant problems for a physician defendant in seeking to defend him or herself in a medical liability action by unfairly limiting the opportunity to fully examine the plaintiff’s health condition to evaluate the merit of the plaintiff’s claim.

New York already has the most burdensome liability environment for physicians in the entire nation, leading to escalating costs and driving physicians out of the state. Analyses have repeatedly stated that New York is the worst state in the country in which to be a doctor, in large part due to its overwhelming liability exposure as compared to other states. Indeed a recent report by LeverageRx showed that New York once again overwhelmingly had the highest liability costs in the country and up 11% between 2017 and 2018.  This legislation would exacerbate these already onerous costs, further drive increases in defensive medicine costs and would make worse the imbalance in our medical liability adjudication system.                                                                                    (AVELLA, AUSTER)


Patient Formulary Protection Bill Advances in Senate
Senator Breslin’s bill S.2849, which would prohibit a health care plan from making prescription drug formulary changes during the contract year, has been reported out of the Senate Insurance Committee for the first time. While patients are locked into an insurance plan for the contract year – and often choose their plan based on their prescription co-pays – insurance companies are able to modify their formulary and often move drugs into a higher cost-sharing tier mid-contract. This legislation would ensure that patients are able to access the drugs they need without unexpected cost increases mid-year.

The bill, which is sponsored by Assemblymember People-Stokes (A.2969), has passed the Assembly every year since 2015 and is currently in the Assembly Insurance Committee awaiting movement.

Please urge your legislator to support this bill by clicking here.  (AVELLA)


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

The number of measles cases in New York State continues to rise with approximately 665 of the 706 confirmed cases nationwide in New York State (423 in New York City, 206 in Rockland, 23 in Orange, 10 in Westchester, 2 in Sullivan, 1 in Suffolk and 1 in Greene counties) as of May 1st.  MSSNY conducted a just-in-time Medical Matters webinar entitled “The Continued Public Health Threat of Measles 2018” in December, 2018.  This webinar has now been posted to the MSSNY CME website. You can also view MSSNY’s latest Medical Matters webinar entitled “What’s Your Diagnosis? Infectious Diseases” which involves a patient with a fever and a rash.  Please check these out and keep yourself informed about the growing measles outbreak throughout New York State.  You can also listen to MSSNY’s brief; podcast on the Measles, Mumps and Rubella vaccine here. (HOFFMAN, CLANCY)

https://tinyurl.com/PublicHealthThreatofMeasles


Registration Now Open for Medical Matters Webinar on May 15, 2019 @ 7:30am
The Medical Society of the State of New York will host its final Medical Matters webinar of 2019, The Importance of Resilience After a Disaster on May 15th @ 7:30am.  Encouraging post traumatic growth is an essential part of recovery from any type of disaster.  Learn more about how best to encourage resilience behaviors in patients.

The Importance of Resilience After a DisasterRegister here.

When:  Wednesday, May 15 2019 at 7:30am

Faculty: Craig Katz, MD

Educational Objectives:

  • Define resilience and post traumatic growth
  • Describe how best to measure resilience and post traumatic growth
  • Explore resilience behaviors and how to encourage them in your patients

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

The Medical Society of the State of New York designates this live activity for a maximum of 1.0 AMA/PRA Category 1 credits. Physician should only claim credit commensurate with the extent HOFFMAN)


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

Veterans Matters: Substance Use Disorders in Veterans

When:  Wednesday June 5 2019 at 7:30am

Faculty: Frank Dowling, MD

Educational Objectives

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

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

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


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

eNews

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Zocdoc – The Concern About Their Directory
MSSNY continues to raise concerns on behalf of our member physicians.  Most recently, MSSNY had a conversation with the NYS AG’s office regarding the propriety of the Zocdoc new pricing arrangement.  The AG’s staff agreed with the decision of the NYS DOH indicating that the new pricing protocol does not equate to fee splitting.

We also raised concerns about Zocdoc’s directory. We know that Zocdoc lists the names of physicians who have never had an agreement or who have chosen to non-renew their agreement. These physician names appear in the Zocdoc directory. This present Zocdoc system of listing physicians without an agreement appears to steer patients to physicians with Zocdoc agreements.  This process is unacceptable. We have enlisted our General Counsel, Garfunkel Wild, to ask that Zocdoc amend their directory to include only those physicians who have a Zocdoc agreement.  As soon as we receive a response from Zocdoc, we will inform the membership.


Check Vaccination History if Born Between 1957 through 1989
The total number of U.S. measles cases reported so far in 2019 has reached the highest level in a single year since 1994, according to a CDC report released this week. CDC now is recommending that all U.S. residents check to ensure they have been adequately vaccinated against measles—particularly, individuals who were born in the years 1957 through 1989, since it is likely they were given a weaker version of the vaccine and, during those years, it was common for children to receive just one dose of the immunization. (Source: Vox,4/29)


New York Trails in Toddler Vaccination Rate
New York state ranked 43rd in the rate of children 19 months old to 35 months old who have received the full course of recommended immunizations, at 67.5% in 2017, according to data from the CDC. The U.S. average was 70.4%, and Massachusetts had the highest rate, 82.1%. The data come from the 2017 National Immunization Survey, which tracks whether children have received vaccines against 14 illnesses, such as diphtheria, hepatitis B, measles, meningitis and pneumonia.


FDA Approves First Vaccine to Prevent Dengue Disease
The US Food and Drug Administration (FDA) has approved the first vaccine to prevent dengue disease caused by all dengue virus serotypes (1, 2, 3, and 4) for people aged 9 through 16 years who have previously had laboratory-confirmed dengue infection and who live in endemic areas. The vaccine, Dengvaxia (Sanofi Pasteur), is a live, attenuated vaccine given in three injections. The initial dose is followed by two additional injections 6 and 12 months later.

“Dengue disease is the most common mosquito-borne viral disease in the world and global incidence has increased in recent decades. While there is no cure for dengue disease, [this] approval is an important step toward helping to reduce the impact of this virus in endemic regions of the United States,” Anna Abram, FDA deputy commissioner for policy, legislation, and international affairs, said in a news release. Dengue is endemic in the US territories of American Samoa, Guam, Puerto Rico, and the US Virgin Islands.


Enrollment Declines in Medicaid or Children’s Health Insurance Program
The latest CMS data show that nationally 2.2 million fewer people were enrolled in Medicaid or the Children’s Health Insurance Program from January 2018 to January 2019. CMS says the decline could stem from the improving economy, but other health experts say the drop could stem from stricter eligibility redetermination processes. The New York stats are:

Total Medicaid and CHIP Enrollment 6,527,141 1
·        Medicaid Enrollment 5,883,397
·        CHIP Enrollment 643,744
Total Medicaid Child and CHIP Enrollment 2,499,955 1

Doctors Without Borders Informational Session in NYC
On Wednesday, May 22nd, 2019 physicians are invited to join Doctors Without Borders/Médecins Sans Frontières (MSF) for a recruitment information session in New York, NY. This is your opportunity to meet our recruitment team and learn about how you can join our pool of dedicated aid workers. We’re currently recruiting a variety of positions. Recruitment Information Session Doctors Without Borders 40 Rector St 16th Floor New York, NY 10006 Wednesday, May 22nd, 2019 at 7:00 – 8:30 pm.

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Investors Sue UnitedHealth Directors: Four Things to Know
Central Laborers Pension Fund and a set of investment funds managed by Amalgamated Bank LongView sued UnitedHealth Group’s directors and former CEO in Delaware Chancery Court, according to Law360.

Four things to know:

  1. The derivative action, filed April 24, alleges 15 current or past UnitedHealth directors permitted the company to submit inflated risk adjustment claims to CMS for Medicare Advantage patients.
  2. The lawsuit accuses the directors of breaching their corporate duty, according to Law360.
  3. The lawsuit includes specific allegations against Stephen J. Hemsley, UnitedHealth Group executive chairman and former CEO. He “bore ultimate responsibility for overseeing and executing UHG’s efforts to improperly increase revenues by defrauding Medicare,” the lawsuit states, according to Law360.
  4. The pension fund and bank-managed investment funds are seeking damages on behalf of UnitedHealth for the alleged billing violations. The damages include liabilities for practices dating back roughly 13 years to 2006.becker’s hospital review Ap 30

Millennials’ Health: One-Third Have Lower Life Expectancy
One-third of millennials have a health condition that will lower their life expectancy and quality of life, according to a recent study from the Blue Cross Blue Shield Health Index published last week. The Health Index found that “millennials as a group were living at about 95% of their optimal health.”


CMS

Conscience Rule Finalized to Protect Healthcare Workers’ Religious Beliefs
The Trump administration on Thursday finalized a “conscience rule” to protect healthcare workers who refuse to perform certain services—such as abortion—due to religious beliefs.

The HHS’ Office for Civil Rights issued the 440-page final rule, which offers protections for providers, health insurers and employers that decline to provide, participate in, pay for, provide coverage of or offer referrals for services that violate their religious or moral beliefs. The rule also covers healthcare staff that “assist in the performance” of such services, including schedulers and those who prepare rooms.

The rule is meant to protect individuals and healthcare organizations in HHS-funded programs from discriminating on the basis of religion, according to Roger Severino, director of the OCR. “Finally, laws prohibiting government-funded discrimination against conscience and religious freedom will be enforced like every other civil rights law,” he said.

The OCR said that the rule largely reinforces current laws and regulations that protect a medical provider’s rights to refuse to perform certain procedures, while adding new standards that Medicare and Medicaid providers will need to follow to comply with. Under the rule, applicants for HHS funding must provide assurances and certifications that they are complying with its regulations.

“No new law is being made here,” Severino said on a call with reporters Thursday. “What is being done is the provision of enforcement tools for existing conscience and religious freedom protections in healthcare.”

If providers don’t comply with the conscience regulations, they could lose federal funding. The OCR’s Conscience and Religious Freedom Division, which the office established in 2018, will oversee complaints from providers that feel their rights have not been respected.


Open Payments Data Available for Review
Pre-publication Review and dispute for the Program Year 2018 Open Payments data publication began on April 1, 2019 and will end on May 15, 2019. The Centers for Medicare & Medicaid Services (CMS) will publish the Open Payments Program Year 2018 data and updates to the previous program years’ data in June 2019.

Physician and teaching hospital review of the data is voluntary, but strongly encouraged. Please keep in mind the following:

  • Records eligible for review and dispute: all records submitted during the submission period of the current calendar year, including newly edited, submitted, and re-attested records from previous calendar years. For detailed information refer to the Physician and Teaching Hospital Review and Dispute Tutorial
  • Disputes must be initiated by May 15, 2019 in order to be reflected in the June 2019 data publication. For more information on review and dispute timing and publication refer to the Review and Dispute Timing and Data Publication Quick Reference Guide.
  • CMS does not meditate or facilitate disputes. Physicians and teaching hospitals should work directly with reporting entities to resolve disputes.
  • Registration in the Open Payments system is required in order to participate in review and dispute activities.

Registration Details

If you have never registered with Open Payments before:

Make sure you have your National Provider Identifier (NPI) number and State License Number (SLN). Initial registration is a two-step process:

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

For users who have previously registered:  Users that have registered during previous program years do not need to re-register.


New Study on Physician Compensation

2019 Physician Compensation Report: Doximity, March 2019


Classified

RENTAL/LEASING SPACE


Bronx Physician’s Office for Sale or Lease
Fully equipped physician’s office for sale or lease. Features three exam rooms, lab room, reception area and waiting room, computer and storage rooms. Bronx location near Einstein Hospital and subway. Call 914-882 3797/ shiva381@yahoo.com


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


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


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


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


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


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

PHYSICIAN OPPORTUNITIES

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

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

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

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

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

Primary Contact: Oksana


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


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


Pediatrician BC, P/T
Seeking motivated, enthusiastic pediatrician for P/T position in solo practice in Long Island. Coverage will increase over time. Great opportunity or those seeking part time hours in an established practice. Fax resume to 516-858-2389.


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

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 


MSSNY eNews – April 26, 2019 – Standing Up for All Doctors

Arthur Fougner MSSNY Presiident

PRESIDENT’S MESSAGE<
Arthur Fougner, MD
MSSNY President

MSSNY eNews
April 26, 2019

Vol. 22  Number 16


MSSNYPAC Seal

 


Colleagues:

John Natale, MD, age 63, was a cardiothoracic and vascular surgeon who practiced in Arlington, IL. Dr. Natale says he made simple coding and billing mistakes. The government believes the doctor tried to rip off taxpayers.

In 2012, government prosecutors accused Dr. Natale of fraud for using CPT (current procedural terminology) codes that allegedly represented more complicated procedures than the surgical ones he performed.  Dr. Natale incorrectly stated that he had used a bifurcation or Y-graft in repairing an abdominal aortic aneurysm instead of a straight tube graft actually used. Government prosecutors accused Natale of fraud for using CPT codes that allegedly represented more complicated procedures than the surgical ones he performed.
                                                     

Prison Sentence


Dr. Natale served a 10-month prison sentence after being convicted in U.S. district court of two counts of making false statements in connection with surgical codes submitted between August 2002 and October 2003. He was acquitted of two counts of Medicare fraud. When he was prosecuted, the MSSNY Council discussed the case at length and Councilors were shocked at the outcome of his trial and it was generally felt that CMS was using Dr. Natale as an example to warn all physicians that erroneous coding was a serious crime.

At this year’s 213th House of Delegates, Resolution 204, “Pardon Dr. Natale,” was adopted. The resolution asks that MSSNY petition President Trump to pardon Dr. Natale, offering some solace for the loss of his career and good name. The reference committee heard testimony that Dr. Natale was convicted and served a prison sentence, based on a coding error, despite having been cleared of the original charge of Medicare fraud in the matter. The AMA and MSSNY supported the overturning of his conviction several years ago, but did not prevail. Those who testified at the reference committee hearing felt strongly that Dr. Natale has been unfairly treated.

Just last week, I received the following note from Dr. Natale:

“Happy Easter to you, Art, and God bless you and your family.
I am working with Kirkland and Ellis in Washington D.C. (the same
lawyers that wrote my amicus brief to SCOTUS). I will send this
email to them. I am hoping for the best. I will keep you informed.
Again thanks for all your support.”

Then, a few days later, I found this in my inbox:

“Dr. Fougner, You’re always a light in a never ending terrible situation.
The leadership that you and the MSSNY provided over my father’s
government targeting was a relief at some of the lowest parts of
our lives. Our fight and resolve continues due to the strength and
kindness you and the MSSNY have provided to my father, our family,
and his community of support. Please express to the MSSNY board
and community our overwhelming gratitude we feel for this very
impactful measure your board has taken. We are proceeding
with this pardon, and when we are successful it will be larger
in part to you and the MSSNY. We should never forget the
medical profession is an easy & soft target, my father’s case
gives presence to future cases that should have all practitioners
fearful for their freedom, but his pardon will have large
implications and hopefully push the judicial system to think
twice on targeting doctors. I have been blessed to have you as
a supporter through much darkness and we look forward to
meeting you and MSSNY in person when we are successful.”

Kindest regards,
Michael Natale

Very proud son of Dr. John Natale

Honestly, I think the underlying story is the real story: All we have is each other.

What matters matters.


Arthur Fougner, MD
MSSNY President

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

 


MLMIC Banner


Capital Update

Public Health and Patient Advocacy Groups Join Together to Urge Further limits on Exemptions For Immunizations
This week, the Medical Society of the State of New York, the American Academy of Pediatrics, NYSAAP, Chapter 1,2,3, the New York Chapter American College of Physicians Services, Inc.,  the New York Academy of Family Physicians and the NYS Association of County Health Officials met to work together to help enact A. 2371/S. 2984 which ensures that medical reasons are the only exception to vaccination requirements.  The legislation is sponsored by Assemblymember Jeffrey Dinowitz and Senator Brad Hoylman and is the Assembly and Senate Health Committees.  Also joining MSSNY in supporting this measure are Nurses Who Vaccinate and the Kimberly Coffey Foundation.  This week the number of measles cases rose to 695—and have exceeded the entire number of cases from 2018.   According to the CDC  “the high number of cases in 2019 is primarily the result of a few large outbreaks – one in Washington State and two large outbreaks in New York that started in late 2018. The outbreaks in New York City and New York State are among the largest and longest lasting since measles elimination in 2000.  The longer these outbreaks continue, the greater the chance measles will again get a sustained foothold in the United States.”  Physicians are encouraged to send a letter to their legislators urging support of Assembly Bill 2371 and Senate Bill 2984 by going to MSSNY Grassroots Action Center (GAC) Please Click Here   (CLANCY)

 

Bill Requiring Physicians to Discuss Risks of Prescribing Opioids on Senate Health Committee
Legislation which would require physicians and health practitioners who prescribe an opioid or other Schedule II Controlled Substance to discuss with patients’ the risks prior to being prescribed a CSII drug, is on the Senate Health Committee for action this Tuesday 4/30.  The measure, S. 4277, is sponsored by Senator Peter B. Harckham.  There is currently no Assembly same as. While the legistlation is well intended, it ignores the principle of informed consent—which essentially means that when a patient needs treatment, the physician gives the patient the information to make an informed decision. Additionally, this is duplicative of requirements that currently exist under the ISTOP law, whereby, after the physician prescribes the medication, the pharmacist is required to again inform the patient about the risks of taking a controlled substance. Moreover MSSNY is concerned that such requirements will further disincentive physicians from prescribing pain medications for patients who need them – already a growing concern. The Medical Society is opposed to this measure and encourages physicians to contact members of the Senate Health Committee to express their opposition.  Committee members are:  Senator Gustavo Rivera, Chair, Senators:  Patrick Gallivan, Robert Antonacci, Brian Benjamin, Alessandra Biaggi, David Carlucci, Brad Hoylman, Chris Jacobs, Todd Kaminsky, Betty Little, Jen Metzger, Velmanette Montgomery, Patty Ritchie, Julia Salazar, Toby Stavisky.  Members of the Senate can be reached at 518-455-2800.  (CLANCY)


CDC Advises Against Misapplication of the Guideline for Prescribing Opioids for Chronic Pain
The Center for Disease Control and Prevention (CDC) this week in a statement said that the authors of the 2016 CDC Guideline for Prescribing Opioids for Chronic Pain (Guideline) advise against misapplication of the guideline that can risk patient health and safety. The statement said, in part, that the “CDC commends efforts by healthcare providers and systems, quality improvement organizations, payers, and states to improve opioid prescribing and reduce opioid misuse and overdose. However, some policies and practices that cite the guideline are inconsistent with, and go beyond, its recommendations.  In the NEJM commentary, the authors outline examples of misapplication of the guideline, and highlight advice from the Guideline that is sometimes overlooked but is critical for safe and effective implementation of the recommendations.  The full text of CDC release of “CDC Advises Against Misapplication of the Guideline for Prescribing Opioids for Chronic Pain,” is available by Clicking Here.

The American Medical Association (AMA)’s Opioid Task Force Chair, Patrice Harris, MD, MA and President-Elect of the AMA, issued a statement that said in part, that “the CDC’s clarification underscores that patients with acute or chronic pain can benefit from taking prescription opioid analgesics at doses that may be greater than the guidelines or thresholds put forward by federal agencies, state governments, health insurance companies, pharmacy chains, pharmacy benefit managers and other advisory or regulatory bodies.”  A copy of that statement can be found here.

Last year, as part of the New York State budget, a provision was included that required a treatment plan for those on opioid therapy expected to last more than 90 days.  There was a recent letter that NYS Department of Health Bureau of Narcotics sent to physicians who prescribed controlled substances.  This letter stated that the treatment plan must follow generally accepted national professional or governmental guidelines, and shall include (but is not limited to) the documentation and discussion of the following clinical criteria within the medical record:

  • goals for pain management and functional improvement based on diagnosis, and a discussion on how opioid therapy would be tapered to lower dosages or tapered and discontinued if benefits do not outweigh risks;
  • an evaluation of risk factors for opioid-related harms.
  • Such documentation and discussion of the above clinical criteria shall be done, at a minimum, on an annual basis.

The letter then goes on to note: “For an example of a generally accepted national governmental guideline for prescribing opioids for chronic pain from the Centers for Disease Control and Prevention (CDC), visit by Clicking Here

The CDC clarification says that the guideline does not support abrupt tapering or sudden discontinuation of opioids, nor does it suggest discontinuation of opioids already prescribed at higher dosages.       (CLANCY)     

 



Advocating to Improve Insurance Regulations – Take Action Now!
As we progress toward the end of session, it is vital that physicians let legislators know how they feel about a variety of insurance-related legislative measures that would impact physicians and their patients ‘ability to have coverage for the care they need. The following three bills would improve the way that insurance companies operate to allow for better and timelier treatment of patients in New York. Please take action by contacting your legislators and asking them to support these bills.

  • Collective negotiations: Negotiating with insurance companies is extremely difficult, especially when monolithic payers control a huge portion (or all) of the market in which you practice. The fact that Physicians are barred from advocating together with their colleagues is unfair, so we strongly support legislation introduced by Senator Rivera and Assemblymember Gottfried (S.3462/A.2393) that would allow physicians to collectively negotiate with insurance companies in certain situations. The bill is currently on the Assembly Health Committee’s agenda for Tuesday, 4/30 and is in the Senate Health Committee. Please urge your Assemblymember and Senator to join on as a co-sponsor  Here 
  • Mid-year formulary changes: Surprisingly, current law does not restrict insurance companies from making substantial changes to their prescription formularies mid-year. This is an egregious practice when you consider the fact that patients choose insurance plans based on the coverage presented to them – and they generally are not able to switch plans mid-year. Senator Breslin and Assemblymember Peoples-Stokes have introduced legislation (S.2849/A.2969) that would prevent mid-year formulary changes so that patients do not experience removal of a drug or changes in tiering. The bill is currently on the Senate Insurance Committee’s agenda for Monday, 4/29 and is in the Assembly Insurance Committee. Please urge your Assemblymember and Senator to join on as a co-sponsor  Here:
  • Prior authorizations: Prior authorizations continue to be a major roadblock to care and cause endless hassles for you and your staff. The burdens caused by excessive and often unjustified prior authorization requirements take away from the time that Physicians can spend with thei patients and lead to far too many hours being spent on paperwork. Senator Breslin and Assemblymember Gottfried have introduced an “omnibus bill” (S.2847/A.3038) that would help in reducing prior auth burdens, updating UR standards and patient protections for prescription drugs. The bill is currently in the Senate Health Committee and the Assembly Insurance Committee. Please urge your Assemblymember and Senator to join on as a co-sponsor Here   (AVELLA, AUSTER)


Advocacy Continues to be Needed Urging a “Go Slow” Approach on Legalizing Recreational Marijuana Use
While a proposal to legalize “recreational” or “adult use” marijuana was removed from consideration from the recently enacted State Budget, it remains under strong consideration on a “stand-alone” basis by the State Legislature with 8 weeks left to go in the 2019 Legislative Session. MSSNY continues to work with Parent-Teacher associations, school administration officials, county health officials, substance abuse providers, law enforcement and Smart Approaches to Marijuana (SAM) to raise concerns with these proposals.  MSSNY remains supportive of efforts to remove the threat of criminal sanction for marijuana use to address concerns related to selective enforcement of these laws, but remains very concerned regarding various adverse public health effects that have arisen in other states that have legalized recreational marijuana use.  Physicians are urged to continue to send a letter to their legislators urging a “go slow” approach Here     (AUSTER, CLANCY)                     


SED Grants Extension on Use of School Health Forms
The State Education Department (SED) has notified school districts that it has again delayed implementation of a new NYS School Health Examination Form.   In an April 16, 2019 letter to school superintendents and principals, SED instructed that schools accept any physician examination form from students for the 2019-2020 school year, regardless of the form used.  The Medical Society of the State of New York and the American Academy of Pediatrics, Chapters I, II, III, have been working with the SED and health officials on revisions to the school health form.   The new form was required by Commissioner’s Regulation 136.3 which became effective on July 1, 2018.   Physicians throughout the state have indicated that the new form was not compatible with the various electronic health record systems in use by physicians.  MSSNY, AAP and SED have been working collaboratively to make the form compatible to EHR.   A copy of SED’s letter to the school superintendents and principals can be found Here   (CLANCY)

 



NY Rx Card Banner


Workers Compensation Board Issues Updated Regulations to Implement Prescription Medication Formulary
The New York Workers’ Compensation Board (WCB) recently announced its 3rd revision of proposed regulations to implement a prescription drug formulary for injured workers’ medication needs.  To read the latest draft regulation, proposed formulary and summary documents, Click Here.

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

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

The proposed regulation also sets forth that new prescriptions must be prescribed pursuant to the Formulary within 6 months of the effective date of the Formulary, and that refills and renewals must be prescribed pursuant to the Formulary within 12 months of the effective date of the Formulary.

Comments will be accepted by the WCB on the revised proposal until May 17.  (AUSTER)


Coalition of State Medical Societies Responds to CMS Report Describing Physician Participation In Medicare MIPS/APM Programs
This week MSSNY joined on to a letter to the Center for Medicare and Medicaid Services (CMS) along with 7 other state medical societies raising concerns with aspects of a CMS report (Click Here:) released in late March summarizing the results of physician and other care provider participation in the Medicare Quality Payment Program for 2017, effecting 2019 Medicare payments.

As reported in last week’s MSSNY e-news, according to CMS, a total of 1,057,824 “clinicians” were eligible for MIPS in 2017, of which 95% participated in the program and avoided a negative payment adjustment by receiving at least 3 points as their MIPS final score.    Physicians had a 94.2% overall participation rate, and non-physician clinicians had a 97.5% participation rate.  The report also noted that 81% of clinicians practicing in small practices participated with MIPS, and 94% of those practicing in a rural area participated with MIPS.

The medical societies’ letter raised concerns that the report failed to provide greater specificity as to the state by state results of small practice participation, as well as creating misimpressions by including within its definition of “participation” those practices unable to submit data due to being a designated disaster.  The report also raises concerns that “while the number of our states’ clinicians who did not participate appears relatively low, the fact that 15,238 of our clinicians would prefer to sit out of the QPP in 2017 and suffer a 4% payment penalty this year rather than hassle with participation is significant to us and bad for medicine”.  Moreover, because some of the mitigating factors no longer exist, the societies noted that “we foresee future outcomes in our states in which potentially thousands more receive the payment penalty. We believe there is an urgent need for CMS to prioritize QPP improvements to ensure broad physician participation.”

Other highlights of the CMS report include:

  • Of the over 1,000,000 clinicians that participated in QPP, 54% received their final score based on participation as part of a group; 12% of received their final score based on individual participation; and 34%  received final scores based on participating in the QPP through an Advanced Payment Model (APM).
  • Bonuses: 71% overall received positive adjustments ranging from +0.28% to +1.88%; 22% received bonuses of up to +0.2%; and 2% received no positive or negative adjustment.
  • Of the over 340,000 clinicians who participated in the APM track, the overwhelming majority participated via the Medicare Shared Savings Program (as an Accountable Care Organization).
  • Of those who successfully participated, 74.3% reported data for a full 12 months, and another 24.9% reported data for 90 days to 12 months.  With regard to small practices, 44.5% reported for the full 12 months, and 53.9% reported data for 90 days to 12 months.
  • The most frequent quality measures reported were: 1) controlling high blood pressure 2) screening for tobacco use and cessation 3) Breast Cancer screening 4) pneumococcal vaccine and 5) encouraging use of aspirin or other anti-platelet
  • The most frequent Quality Improvement measures reported were 1) Having 24/7 access to a patient’s medical record 2) Use of decision support and standardized treatment protocols 3) Patient Centered Medical Home attestation 4) Engaging with patients through patient portal and 5) Collection of data and follow up regarding patient experience.      (AUSTER)


Measles Outbreak in New York State Continues to Spread
Webinar Available at MSSNY CME Website
The measles outbreak in New York State continues to spread with approximately 622 (390 in New York City, and 200 in Rockland, 20 in Orange, 10 in Westchester and 2 in Sullivan counties) confirmed cases as of April 24.  MSSNY conducted a just-in-time Medical Matters webinar entitled “The Continued Public Health Threat of Measles 2018” in December, 2018.  This webinar has now been posted to the MSSNY CME website. Please check it out and keep yourself informed about the growing measles outbreak throughout New York State.  You can also listen to MSSNY’s brief podcast on the Measles, Mumps and Rubella vaccine Here(HOFFMAN, CLANCY)


Registration Now Open for Veterans Matters CME Webinar on April 30th
Register now for MSSNY’s next Veterans Matters webinar on April 30th at 7:30am. This webinar is entitled Suicide in Veterans.  Register for this program Here .
Veterans Matters: Suicide in Veterans
When: Thursday April 30, 2019 at 7:30am – Register Here
Faculty: Jack McIntyre, MD
Educational Objectives:

Address the causes and warning signs of suicide and suicidal behavior among veterans
Explore evidence-based diagnostic, intervention and treatment options
Identify barriers to identification and treatment in military culture and methods to overcome them

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

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

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


Registration Now Open for Medical Matters Webinar on May 15, 2019 @ 7:30am
The Importance of Resilience After a DisasterRegister here:

The Medical Society of the State of New York will host its final Medical Matters webinar of 2019, The Importance of Resilience After a Disaster on May 15th @ 7:30am.  Encouraging post traumatic growth is an essential part of recovery from any type of disaster.  Learn more about how best to encourage resilience behaviors in patients.

Faculty: Craig Katz, MD

Educational Objectives:

Define resilience and post traumatic growth

Describe how best to measure resilience and post traumatic growth

Explore resilience behaviors and how to encourage them in your patients

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

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

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


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

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

eNews

NYC DOHMH Issue Health Advisory on Measles
The New York City Department of Health and Mental Hygiene (DOHMH) released a health advisory related to the current measles outbreak which now totals almost 400. While most cases have been in the Orthodox Jewish communities of Williamsburg, a small number have occurred outside of this area. The advisory includes recommendations about vaccinations and proof of immunity, and provides specific guidance for individuals residing in the four zip codes in Williamsburg impacted by the Order of the Commissioner.

The Medical Society of the State of New York has created a just-in-time Medical Matters online course entitled “The Continued Public Health Threat of Measles 2018”.  This free CME program is on the MSSNY CME website. If you are new to the website, please follow the steps to create an account.  For those who have been on the site, please log in to your account.  Please contact Melissa Hoffman at mhoffman@mssny.org if there are any questions about the CME site.  

 

Rockland County Renews State Of Emergency Despite Court Order
Rockland County renewed its state of emergency order, despite it being struck down by a judge earlier this month, as the state’s worst measles outbreak in a generation continues, officials said Thursday afternoon. Under the renewed state of emergency, which is extended to May 25, 16 schools are forbidden from allowing students to attend class until they are vaccinated or provide a legal exemption. The order affects 331 students, according to county officials. Rockland County has 200 reported cases of measles as of April 25, up from 186 last week, and brings New York’s total to more than 600 reported cases.

The county’s numbers make up about 29 percent of the country’s measles cases, despite Rockland County representing 0.1 percent of the population, according to the state of emergency order.

 

NY Primary Care Doctors in PCMH Rose by 35% from 2018-2018
The number of primary care providers in New York State adopting a high-performing, health care delivery model known as the patient-centered medical home (PCMH) rose by more than 35 percent between May 2017 and May 2018, a dramatic increase in the rate of growth over prior years, according to a United Hospital Fund report released on April 18. Over the past eight years the number of clinicians working in PCMH practices has increased at an average rate of roughly 15 percent a year, from 3,400 clinicians in 2011 to more than 9,000 at the end of May 2018. The recent growth coincides with the Delivery System Reform Incentive Payment (DSRIP) program, the state’s Medicaid reform initiative, in which all or most of a patient’s health care needs are coordinated through a primary care physician. The report, Patient-Centered Medical Homes in New York, 2018 Update: Drivers of Growth and Challenges for the Future, is part of a series UHF has produced since 2011 tracking the adoption of the PCMH model across New York State. New York State continues to lead the nation in the adoption of the medical home model, accounting for 15 percent of the nation’s NCQA-recognized PCMH clinicians.

PCMH is a patient-centric model of care that strengthens relationships between patients and their clinical teams, focusing on improving the health of the population served by the practice. It is especially valuable for treating people with multiple chronic conditions, who generate a disproportionate share of U.S. health care costs.

Primary care practices that have adopted the PCMH model are also struggling with a rapidly changing, and challenging health care landscape. The emergence of, telemedicine, convenient care (e.g., retail clinics and urgent care centers), and concierge medicine, among other innovations, threatens to make it more difficult for PCMH practices to thrive. The report offers suggestions that could make medical homes better able to compete, including: improving access by expanding hours; focusing on prevention and health education; helping patients negotiate the health system during and after acute episodes and hospitalization; and helping patients with multiple chronic diseases better manage their conditions.


MSSNYPAC Welcomes New Co-Chairs And Members

With the transition of Dr. Joseph R. Sellers, MD into the role of MSSNY Vice President, Dr. Arthur Fougner, MSSNY President, has seated two new Co-Chairs with the appointment of Dr. Thomas T Lee, MD, Neurosurgeon of Westchester County and Dr. Rose Berkun, MD Anesthesiologist of Erie County.  Each Chair brings their own strengths, vast experience in fundraising, astute political awareness, and great love for their profession.   Additional appointments to the MSSNYPAC Executive Committee are: Dr. Malcolm Reid, MD, MPP Physical Medicine & Rehabilitation of New York County, Dr. Inderpal Chhabra, MD Internal Medicine of Nassau County, Dr. Michael A. Pisacano, MD, Ophthalmologist of Bronx County, Janine L. Fogarty, MD Radiologist of Monroe County, Yongsoo Joo as Medical Student Representative.  See the full committee list.

All leaders of MSSNYPAC extend their deep gratitude to the hundreds of MSSNYPAC donors in New York State who continue to support the great work MSSNYPAC has helped New York physicians to achieve on behalf of our patients.  MSSNYPAC is a powerful tool essential to amplify the voice of physicians, helping to expand the opportunities for meaningful dialogue with key health care policymakers, and build strong relationships that last.

Become a supporter today www.mssnypac.org/contribute Thank you.


Garfunkel Ad


NYState of Health Providing Grants for Multi-Specialty Groups to Use Open Notes
NYSHealth has supported the spread of OpenNotes in hospital systems throughout New York State, providing patients with access to the visit notes written by their doctors, nurses, or other clinicians. Now, they are eager to spread the program to other health care settings, such as multispecialty group practices and federally qualified health centers. Through a new Request for Proposals, we will provide grants of up to $100,000 in support of the adoption or spread of OpenNotes in non-hospital settings. Proposals are due Thursday, May 2nd.


Pediatrics:
Telemedicine Tied to More Antibiotics for Kids
Telemedicine may be leading to the overprescribing of antibiotics to sniffling children, a new study suggests. The study was published Monday in the journal Pediatrics. Children with cold symptoms seen via telemedicine visits were far more likely to be prescribed antibiotics than those who went to a doctor’s office or clinic, researchers found. And a higher proportion of those prescriptions disregarded medical guidelines, raising the risk they could cause side effects or contribute to the rise of antibiotic-resistant germs.

“I understand the desire for care that’s more convenient and timely,” said the study’s lead author, Dr. Kristin Ray of the University of Pittsburgh. “But we want to make sure that we don’t sacrifice quality or safety or effectiveness in the process.” Ray and her colleagues looked at more than 340,000 insured children who had acute respiratory illness medical visits in 2015 and 2016.

Children received prescriptions for antibiotics more than half the time during telemedicine visits, compared with 42% at urgent care clinics and 31% at doctors’ offices.

The researchers also found that in looking at telemedicine doctors’ decisions about whether to prescribe or not prescribe antibiotics, 4 out of 10 failed to meet medical guidelines on matching treatment to diagnosis. That mainly had to do with doctors prescribing bacteria-fighting drugs to treat viral illnesses, such as colds and flus, that are unaffected by antibiotics. In comparison, 3 out of 10 urgent care clinic decisions were inappropriate, and about 2 out of 10 doctors’ office decisions were. The researchers also found telemedicine physicians appeared to be ignoring other guidelines. For example, doctors are supposed to take a throat swab and run a lab test before diagnosing strep throat. But that rarely happened in telemedicine visits, Ray said.

A large recent study on antibiotic prescribing patterns for adults found little difference between telemedicine and office visits. But there has been little study of the issue in children. The American Academy of Pediatrics, which publishes the journal, encourages parents not to use such direct-to-consumer programs. Academy officials say limited physical examinations and lack of access to patient records can harm care. (AP)


Federal Judge Will Enjoin Family-Planning Physician Gag Rule
U.S. District Judge Michael J. McShane said yesterday that he plans to issue a temporary injunction against the Trump administration’s gag rule dictating what physicians can and cannot say about family planning to their patients in the Title X program. The AMA is the lead plaintiff in the lawsuit to stop the rule, which was set to take effect May 3.


Erie County: NFL Champ Vance Johnson Keynote “How a Doctor Saved My Life

Wednesday, May 1@ Shea’s Seneca

Erie County Medical Society’s 198th Annual Meeting and Installation of Officers will feature Vance Johnson, retired NFL wide receiver Superbowl Champion, as keynote speaker, to tell  “How A Doctor Saved My Life” will be held Wednesday, May 1, 2019 at 5:45 PM – location is The Historic Shea’s Seneca, 2188 Seneca St., Buffalo. Tickets are available at $110 per person – contact Emily McMullen at 716-852-1810.


Services for Dr. Anthony Santomauro on Saturday, May 11 in Amherst, NY
Services for retired surgeon Anthony Santomauro, a MSSNY member since 1963, will be held on Saturday, May 11, 2019 at 10:00 AM at the University at Buffalo Newman Center, 495 Skinnersville Road, Amherst, NY 14228.

CMS

Open Payments Data Available for Review
Pre-publication Review and dispute for the Program Year 2018 Open Payments data publication began on April 1, 2019 and will end on May 15, 2019. The Centers for Medicare & Medicaid Services (CMS) will publish the Open Payments Program Year 2018 data and updates to the previous program years’ data in June 2019.

Physician and teaching hospital review of the data is voluntary, but strongly encouraged. Please keep in mind the following:

  • Records eligible for review and dispute: all records submitted during the submission period of the current calendar year, including newly edited, submitted, and re-attested records from previous calendar years. For detailed information refer to the Physician and Teaching Hospital Review and Dispute Tutorial
  • Disputes must be initiated by May 15, 2019 in order to be reflected in the June 2019 data publication. For more information on review and dispute timing and publication refer to the Review and Dispute Timing and Data Publication Quick Reference Guide.
  • CMS does not meditate or facilitate disputes. Physicians and teaching hospitals should work directly with reporting entities to resolve disputes.
  • Registration in the Open Payments system is required in order to participate in review and dispute activities.

Registration Details
If you have never registered with Open Payments before:

Make sure you have your National Provider Identifier (NPI) number and State License Number (SLN). Initial registration is a two-step process:

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

For users who have previously registered:  Users that have registered during previous program years do not need to re-register.

Please note:  If the account has not been accessed within the last 60 days the account will have been locked due to inactivity. To unlock an account go to the CMS Enterprise Portal, enter your user ID and correctly answer all challenge questions to gain access to your account. You will be prompted to create a new password.

If the account has not been accessed for 180 days or more, the account will be deactivated. To reinstate the account contact the Open Payments Help Desk at 1-855-326-8366; (TTY line: 1-844-649-2766) 

For more information about the registration process, visit the physician and teaching hospital registration page on the Open Payments website. Need help or have questions? Contact the Open Payments Help Desk at openpayments@cms.hhs.gov or call 1-855-326-8366 (TTY Line: 1-844-649-2766). The Help Desk is available Monday through Friday, from 8:30 a.m. to 7:30 p.m. (ET).


Join Primary Care First Model Options Informational Sessions
CMSInnovation Center recently announced the CMS Primary Cares Initiative that will provide primary care practices and other providers with five new payment model options, two of which are under the Primary Care First path.

The Primary Care First payment model options will test whether financial risk and performance-based payments that reward primary care practitioners and other clinicians for easily-understood, actionable outcomes will reduce total Medicare expenditures, preserve, or enhance quality of care, and improve patient health outcomes. Primary Care First also includes a payment model option that provides higher payments to practices that specialize in care for high need patients, including those with complex, chronic needs and seriously ill populations (SIP).

Please attend one of our upcoming informational sessions to learn more about Primary Care First. During the one-hour event, you’ll hear from senior leaders and the team behind Primary Care First about the model aims, requirements, benefits of participation, and application next steps.

For your convenience, we will offer multiple informational sessions. Session information and registration links are included below:

Informational Session 1: Tuesday, April 30th at 12 PM EDT
Register to attend

Informational Session 2: Tuesday, April 30th at 3 PM EDT
Register to attend

Informational Session 3: Thursday, May 16th at 12 PM EDT
Register to attend

Informational Session 4: Thursday, May 16th at 3 PM EDT
Register to attend

Feel free to forward this invitation to colleagues who may be interested in learning more about the Primary Care First Model. Reference materials will also be available for download during the event.

For additional information about Primary Care First, please visit the model website at https://innovation.cms.gov/initiatives/primary-care-first-model-options/.

 


Classified

RENTAL/LEASING SPACE


Bronx Physician’s Office for Sale or Lease
Fully equipped physician’s office for sale or lease. Features three exam rooms, lab room, reception area and waiting room, computer and storage rooms. Bronx location near Einstein Hospital and subway. Call 914-882 3797/ shiva381@yahoo.com


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


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


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


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


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


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

PHYSICIAN OPPORTUNITIES

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

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

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

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

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

Primary Contact: Oksana


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


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


Pediatrician BC, P/T
Seeking motivated, enthusiastic pediatrician for P/T position in solo practice in Long Island. Coverage will increase over time. Great opportunity or those seeking part time hours in an established practice. Fax resume to 516-858-2389.



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

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 


MSSNY eNews – April 19, 2019 – Empowering Physicians Once Again

Arthur Fougner MSSNY Presiident

 

PRESIDENT’S MESSAGE
Arthur Fougner, MD
MSSNY President

MSSNY eNews
April 19, 2019
Vol. 22  Number 15


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Colleagues:

When Gerald Ford took the oath of office, he offered that he was a Ford not a Lincoln. Heck, I’m a Fougner, not a Madejski.

I just hope I’m not an Edsel!

In the early 1980s while a young attending at North Central Bronx Hospital, Dr. George Kleiner decided they needed someone with ultrasound skills for his department and was kind enough to get me going. Fast forward to 1986 and I was now offering my services to private patients in the community, including many patients from other OB-GYNs. One physician then told me that the reason that he did not refer was that he somehow felt his patients would be so impressed that they’d leave his practice for mine. Ridiculous right? But I thought about it long and hard and decided to get a life and no longer respond to the 3AM hospital calls. I delivered my last baby in 1992 and consider myself ahead of the unfortunate trend of OB’s abandoning obstetrics for “gynecology only” practice which is collateral damage on the med-mal front.

Forces Against Us

And the front it is. For many years, there has been a War on Doctors. While there have been few pitched battles, there has been the daily toll of minor skirmishes. About ten years ago, I likened the forces confronting medicine to Cerberus, the Hound of Hades, who stood guard over the Greek Underworld. As often is the case, I was wrong. Today, that beast has morphed into an ugly, multi-headed Hydra. Yes, we still battle Trial Lawyers, Government Regulators and Insurers, but there are also Health Policy Wonks, Administrators of all sorts, Pharma and PBMs, EHRs, and— yes— even our own Boards confront us over Certification.

In Christopher Nolan’s 2005 movie “Batman Begins,” the martial arts expert who schools Bruce Wayne and remarks that “Criminals thrive on the indulgence of society’s goodwill.” Folks, today EVERYONE thrives on the indulgence of Doctors’ goodwill. Medicine is known as a learned profession yet its practitioners have so little say in the manner in which they practice their profession. We’re a Doctors’ Organization. Without doctors, what will our patients do? 

On every flight, the attendant runs a drill. The rule is that the fit place their oxygen masks on first before attending to others. Otherwise, no one is fit. Physicians, we need to learn to care for ourselves first. If something is not good for doctors, how can it be good for patients?

Our largesse is killing us. And it shows. Whatever you choose to name it, Burnout, Abuse, Moral Injury, Disillusionment, it’s real and it is killing doctors. Suicide among physicians is double that of the general public.

Fourth Pillar

Two years ago, Dr. Charles Rothberg introduced Three Pillars – Wellness, Diversity, and Engagement.

This year, I propose a fourth – EMPOWERMENT!

The good book tells us that the Father’s House has many mansions. Well, the House of Medicine has many silos. We have specialty societies, ethnic societies, alumni societies, staff societies. We have employed physicians and independent physicians. All too easily, our differences morph into opposition. Others see this … and they use it against us. Divide and conquer – Specialty vs. Specialty, Specialty vs Primary Care, Ethnic vs Ethnic, Upstate vs Downstate, Independent vs Employed, Health System vs Health System. Our differences ultimately lead to division, disillusionment and defeat.

The good book tells us that the Father’s House has many mansions. Well, the House of Medicine has many silos. We have specialty societies, ethnic societies, alumni societies, staff societies. We have employed physicians and independent physicians. All too easily, our differences morph into opposition. Others see this … and they use it against us. Divide and conquer – Specialty vs. Specialty, Specialty vs Primary Care, Ethnic vs Ethnic, Upstate vs Downstate, Independent vs Employed, Health System vs Health System. Our differences ultimately lead to division, disillusionment and defeat.

Solidarity is the key to Empowerment. Doctors everywhere, tear down these silos!

Physician Wellness is today’s buzzword. And kudos to the Northwell Health System for showing a private screening of the film “Do No Harm,” a powerful expose on the forces that can drive intelligent, talented physicians to despair—sometimes— even suicide. In fact, Dr. Ira Nash, head of Northwell’s Physician Partners, was able to intervene in a physician’s cry for help in response to the email announcing the film. Many resources are available for doctors in need. But in NY State, a physician’s plaintive cry can lead to an OPMC investigation! Our Society is negotiating with OPMC to institute a system similar to the POPPA program available for police officers in need. If all NY’s physicians to cry out in unison, this would certainly happen.

Make it so! The path to wellness runs through empowerment!

Getting Onboard

We need all physicians to get onboard. So what’s holding up engagement? The inertia of past frustrations stands in the way of the enthusiasm of winning. The silos remain intact. I get this all the time: “But what have you done for ME lately?”

Engagement without a sense of Empowerment is an exercise in futility. Defeatism is a tough nut to crack. While there are articles bemoaning the End of the Doctors’ Lounge, know that there are new Doctors’ Lounges every day called Social Media. Here our younger colleagues can show us the way because we need all the help we can get!  If the truth is out there, then let’s mobilize our younger physicians to spread the word.

Start small. Pick issues where most agree and roll with it! When folks get in the habit of working together successfully, the feeling perpetuates itself, making the harder stuff easier.

We’re the ones who managed to pass Gross Anatomy.

We can do this! This is not about me, it’s about everyone. E pluribus unum!

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

Arthur Fougner, MD
MSSNY President


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eNews

Resolution Highlights: MSSNY’s 2019 House of Delegates
Nuisance Prior Authorizations
Medication prior authorizations must have a sound clinical justification, including, but not limited to, promotion of adherence to guidelines, promotion of generic alternatives, prevention of adverse reactions, and be available upon request from the Pharmacy Benefit Manager. MSSNY will advocate with the NYS Department of Health and NYS Department of Financial Services to prevent health insurers from imposing prior authorizations without appropriate clinical justification. MSSNY will advocate to the NYSDOH to instruct Medicaid managed care contractors to approve prior authorizations for a minimum of one year. 

Single Payer
MSSNY reaffirmed its opposition to the concept of single payer. MSSNY will continue to consider the feasibility of other payment methodologies including single payer and will also continue to work collaboratively with physicians who both support and oppose such proposals in order to assess the strengths and weaknesses of such proposals. MSSNY will continue to advocate that physicians are ensured direct input and ongoing involvement on all aspects of any single payer system or other system that may be considered by the New York State Legislature or United States Congress. 

Mental Health Services for Medical Students
MSSNY will encourage Medical Schools in New York State to provide confidential in-house mental health services at no cost to students, without billing health insurance, and set up programs to educate both students and staff about burnout, depression and suicide and bring this resolution to the AMA. MSSNY will encourage Medical Schools in New York State to offer, affordable, confidential off-site counseling. 

Continuing Certification of Medical Competence
MSSNY will adopt the position that verifiable demonstration of currency and competence in medical practice should include as an acceptable alternative to continuing board certification by the appropriate medical specialty board(s) the following: written attestation of good professional standing in the appropriate community(s) of practice by a minimum of two peers also in good standing in the same community; satisfactory completion of a minimum of 50 hours every two years of CME experiences related to the specialty(s) of medicine in which one currently practices, in accordance with the current practices of the appropriate medical specialty(s); and validated self-assessment of current cognitive knowledge following no fewer than 20 hours every two years from the above cited CME experiences. 

Advancing Gender Equity in Medicine
MSSNY will promote pay structures based on objective, gender-neutral criteria; promote educational programs to empower physicians of all genders to negotiate equitable compensation; advocate for training to identify and mitigate implicit bias in compensation decision making for those in positions to determine salary and bonuses; collect and analyze comprehensive demographic data and produce a report on gender equity within MSSNY with recommendations to support ongoing gender equity efforts. 

MSSNY Policy on Gender Equity in Medicine
MSSNY will support institutional, departmental and practice policies that promote transparency in defining the criteria for initial and subsequent physician compensation; advocate for pay structures based on objective, gender-neutral criteria; encourage a specified approach, sufficient to identify gender disparity to oversight of compensation models and create an awareness campaign to inform physicians about their rights under the Lilly Ledbetter Fair Pay Act and Equal Pay Act.

Right for Gamete Preservation Therapies
MSSNY will officially recognize fertility preservation services as an option for the members of the New York transgender and non-binary community who wish to preserve future fertility through gamete preservation prior to undergoing gender affirming medical or surgical therapies and will officially support the right of transgender or non-binary individuals to seek gamete preservation therapies. 

Increased Accessibility of Emergency Epinephrine for Anaphylactic Response
MSSNY will support legislative action to bring about training on and accessibility to emergency epinephrine in areas deemed to be high risk, including but not limited to those focused on children and food service, such as childcare facilities, schools, school buses, food-service areas and restaurants. 

Physician Credentialing Improvement
MSSNY will advocate for regulation or legislation asserting that a physician who has submitted a completed application for credentialing, until which time that application is accepted or rejected, may bill for services under the general supervision of a physician who is already credentialed by that plan. This shall be applied to all insurance plans, including state sponsored plans such as worker’s compensation. 

Reducing Physician Barriers to Mental Health Care
MSSNY will promote the work of its Physician Wellness and Resilience Committee and the survey on physicians’ stressors that are faced on a daily basis.  MSSNY will design educational resources and continuing medical educational programs on physician wellness and resiliency and will explore the possibility of establishing a physician, resident and medical student wellness program. 

Laser Hair Removal
MSSNY will advocate that laser hair removal only be performed by an appropriately trained and educated individual under physician supervision and will encourage provision of public education regarding the risks of laser use for aesthetic services. 

Financial Penalties and Clinical Decision-Making
MSSNY opposes the practice of a payer utilizing statistical targets to determine the cost-effectiveness of a therapeutic choice and opposes the practice of a payer imposing financial penalties upon individual imposing financial penalties upon individual physicians and/or associated physicians based upon use of statistical targets without fist considering the clinical factors unique to each patient’s claim. 

Benzodiazepine and Opioid Warning
MSSNY will raise the awareness of its members of the increased use of illicit sedative/opioid combinations leading to addiction and overdose death and will bring this resolution to the AMA so that it may warn members and patients about this public health problem. 

Promoting Addiction Medicine during a Time of Crisis
MSSNY will endorse and support the incorporation of addiction medicine science to medical student education and residency training and will send the resolution to AMA, Liaison Committee on Medical Education, Commission on Osteopathic College Accreditation, American Osteopathic Association, and Accreditation Council of Graduate Medical Education.

The following two resolutions were referred to Council for further study:

  • Urgent Care in the Doctor’s Office
    This resolution asks that MSSNY seek payment reform to ensure site neutrality such that urgent, same-day services provided outside of usual business hours or for emergency care are paid equivalently regardless of the site of service.
  • Shortage of Specialists in Workers’ Compensation System
    This resolution asks that MSSNY work with the Workers’ Comp Board, and, if necessary, the legislature to promulgate new regulations or laws that are necessary to increase voluntary participation of necessary specialists and subspecialists in locations and in specialties where there is a shortage of qualified providers and work with specialty societies that represent the specialties that are in short supply in the Workers’ Comp system to develop a joint strategy, including review of the current inadequate payment structure, to resolve this public health problem.

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Office-Based Surgery Mandated Reporting Update
The NYS Department of Health has sent Office-based Surgery (OBS) practices a letter indicating that it was not moving forward in 2019 with a proposed requirement for OBS practices to report information to DOH regarding the numbers of each type of procedure performed in their OBS practices.

MSSNY, working together with the NYS Society of Plastic Surgeons and NY Chapter of the American College of Physicians, had indicated its support for the goals of the proposed reporting requirements to provide necessary context to assess the frequency/lack of frequency of certain adverse events reported to DOH.  However, given the potential complexity this presented for some practices, MSSNY, NYSSPS and ACP also suggested alternatives to this reporting requirement such as having DOH request such cumulative procedural information from the accrediting entities from which OBS practices are required to receive accreditation.

Instead, the DOH will be placing additional efforts to ensure all OBS physician practices are complying with the New York law that requires all adverse events arising in an OBS setting to be reported to the DOH patient safety center within three business days of the adverse event.  NYS Public Health Law Section 230-d defines an “Adverse event” as a “(i) patient death within 30 days;  (ii) unplanned  transfer  to  a hospital or emergency department visit within 72 hours of office-based surgery for  reasons  related  to  the   office-based  surgery encounter; (iii) unscheduled hospital admission or assignment to observation services,  within 72 hours of the office-based surgery, for longer than 24 hours; or (iv) any other serious or life-threatening event”.

MSSNY looks forward to partnering with the DOH to educate and ensure physicians in complete compliance with these adverse event reporting requirements.


MSSNYPAC Congratulates and Thanks Joseph R. Sellers, Md for His Leadership
We would like to thank Dr. Joseph R. Sellers, MD of Schoharie County for his dedicated and steadfast leadership of MSSNYPAC from April 2010 until April 2019. He has skillfully steered MSSNYPAC through challenging changes in the medical practice landscape and we are confident he will do the same as he continues to progress through MSSNY leadership. Dr. Sellers has been elected to serve as Vice President of MSSNY and is on track to become President of MSSNY in 2021.

On behalf of the MSSNYPAC members and Executive Committee, we thank you for your many years of selfless service to the profession of medicine. Your professionalism in advocacy on behalf of the patients, physicians and medical community as a whole, both in New York State and nationally, has been exemplary. We extend our sincere and heartfelt gratitude and honor your service. We appreciate the foundation that you have laid for our future success and the example that you have set for our future PAC leaders and members. We wish you the best of luck in your endeavors and look forward to your continued service to MSSNY.


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Mount Sinai Medical School to Cap Debt at $75K for Students with Financial Need
The Icahn School of Medicine at Mount Sinai will begin capping debt at $75,000 for students with a demonstrated financial need during the next academic year, making it the latest institution to address the massive debt burden that often accompanies medical education.

Students who qualify will take out no more than $18,750 per year in loans to cover costs such as tuition, housing, food and books.

The initiative follows NYU School of Medicine’s decision to offer free tuition for all medical students and a move by Columbia University’s Vagelos College of Physician and Surgeons in 2017 to offer scholarships that cover 100% of students’ financial needs.

Mount Sinai’s strategy is unique in that it applies not just to tuition but to living expenses. Tuition for the current academic year is nearly $53,000, but the school estimates the cost of attendance, which includes expenses such as rent and health insurance, will run students an additional $25,000 to $35,000 a year. Three-quarters of medical students nationwide finance their education with some debt, and the median amount for the class of 2018 was $194,000, according to the Association of American Medical Colleges.

“The program won’t benefit all students. It will award money based on a student’s expected family contribution, which is determined through federal and private financial aid applications. A first-year student with an expected family contribution of $79,000, which is above the cost of attendance, wouldn’t receive any aid, for example.

The news was shared with students via email Wednesday and wasn’t met with unanimous praise. One student, who doesn’t expect to qualify but will graduate with about $200,000 in debt, said it was “honestly a little bit of a disappointment” because many middle-class students won’t be eligible.

The program does not, as some do, compel students to enter specialties such as family medicine and pediatrics or to work in underserved areas. Crains Health Plus Ap 11.


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New York Leads All States in Malpractice Payouts
Medical malpractice claims against New York health care
professionals paid out $685.3 million last year, over $300 million more than in the second-highest state, Pennsylvania.

New York’s cases paid $35.07 in malpractice payouts per capita, which was also the highest nationwide, according to data from online insurance broker LeverageRx. The payments were 11% higher than during the previous year.

New York’s medical community has for years pointed to the high rate of malpractice claims as creating a hostile environment for doctors here. Consumer-finance website WalletHub named New York the worst state to practice in as a physician, which has led the Medical Society of the State of New York to call for tort reform.


Northwell Enters Management Agreement with Nassau County Med Center
Northwell Health has received state approval to form a management services agreement with Nassau University Medical Center and create a five-year strategic plan for the hospital.

Winnie Mack, Northwell’s senior vice president of operations, will run the hospital as president and chief executive of NuHealth, the public corporation that operates the facility. She will be working on behalf of True North Healthcare Consulting but will report to NuHealth’s board.

The board has agreed to a three-year strategic advisory services agreement with Northwell, which will have its leaders assess the hospital’s needs and make recommendations.

Nassau University Medical Center is a safety-net provider for the county, and more than half of its patients either are uninsured or pay through Medicaid, which provides lower reimbursement than other forms of insurance. Northwell said the deal would be similar to its work advising One Brooklyn Health System, the three-hospital network that enlisted Northwell’s consulting arm to produce a strategic plan. That comparison is notable in that Northwell has acted as an adviser, not an acquirer, for the Brooklyn facilities, which rely on significant state subsidies. The announcement said NuHealth and Northwell will keep separate governance structures. Crains Health Plus Ap11.


Physicians Day at the Races 2019 – Secure Your Tickets Today!
Join your colleagues for MSSNYPAC’s Physicians Day at the Races on Saturday, July 27, 2019 at Saratoga Race Track in Saratoga Springs, NY. All physicians, including non-members of MSSNY are welcome to support this state-wide fellowship event for MSSNYPAC while supporting a great cause that strengthens our profession. Tickets are $500/physician and $300/guest. Visit www.mssnypac.org/events for details or to download an invitation. Ticket or sponsorship inquiries can be directed to Jennifer Wilks at 518-465-8085.


Measles Update: Recent Measles Outbreak in Brooklyn and Queens
As of April 15, 2019, there have been 329 confirmed cases of measles in Brooklyn and Queens since October. Most of these cases have involved members of the Orthodox Jewish community.

The initial child with measles was unvaccinated and acquired measles on a visit to Israel, where a large outbreak of the disease is occurring. Since then, there have been additional people from Brooklyn and Queens who were unvaccinated and acquired measles while in Israel. People who did not travel were also infected in Brooklyn or Rockland County.

Vaccination Requirement in Brooklyn

On April 9, the Health Commissioner ordered (PDF) every adult and child who lives, works or resides in the following ZIP codes and has not received the measles, mumps and rubella (MMR) vaccine to be vaccinated:

  • 11205
  • 11206
  • 11211
  • 11249

People who demonstrate they are immune from measles have a medical condition that prevents them from receiving the vaccine will not need to get vaccinated.

If the Health Department identifies a person with measles or an unvaccinated child exposed to measles in one of the above ZIP codes, that individual or their parent or guardian could be fined $1,000. (NYCDOHMH)


Potential Risks of Direct-to-Consumer Pediatric Telemedicine Visits
Children were more likely to receive antibiotics for acute respiratory infections via DTC telemedicine visit versus in-person urgent care or primary care visit.

Commercial companies now offer acute pediatric care via direct-to-consumer (DTC) telemedicine visits with physicians who are outside of the child’s medical home. The American Academy of Pediatrics and American Telemedicine Association have cautioned that because such care lacks continuity and access to the child’s past medical history, it could lead to lower quality of care, especially in nonverbal children.

To test this hypothesis, researchers used commercial health plan claims data to compare children’s receipt of antibiotics for acute respiratory infection from 4600 DTC telemedicine visits, 38,400 urgent care visits, and 485,200 primary care pediatrician (PCP) visits. Patients were newborn to age 17 years. Children with chronic conditions that could affect antibiotic management decisions were excluded. Groups were matched on patient demographics, insurance, medical complexity, and diagnosis category.

Children seen via DTC telemedicine visit were more likely to receive antibiotics (52%) compared with those seen in urgent care (42%) or by PCPs (31%) and less likely to receive guideline-concordant care regarding antibiotic management (59% vs. 67% for urgent care and 78% for PCP; P<0.001 for both comparisons). Lower guideline concordance in DTC telemedicine was primarily attributable to inappropriate antibiotic prescribing for viral infections. (Pediatrics 2019 Apr 8 Gerber JS).


Garfunkel Ad


SED Grants Extension on Use of School Health Forms
The State Education Department (SED) has notified school districts that it has again delayed implementation of a new NYS School Health Examination Form. In an April 16, 2019 letter to school superintendents and principals, SED instructed that school accept any physician examination form from students for the 2019-2020 school year, regardless of the form used. MSSNY and the American Academy of Pediatrics, Chapters I, II, III, have been working with the SED and health officials on revisions to the school health form. The new form was required by Commissioner’s Regulation 136.3 which became effective on July 1, 2018. Physicians throughout the state have indicated that the new form was not compatible to electronic health record. MSSNY, AAP and SED have been working collaboratively to make the form compatible to EHR. A copy of SED’s letter to the school superintendents and principals can be found here.


UnitedHealth posts $3.5B profit in Q1
UnitedHealth Group recorded strong financial results in the first quarter of fiscal year 2019, ending the period with a $3.5 billion profit. The company recorded revenues of $60.3 billion for the three months ended March 31, up 9.3 percent from $55.2 billion reported in the same period a year earlier. Revenue gains were led by growth across its UnitedHealthcare Medicare and Retirement, OptumRx, and OptumHealth lines. The company’s health insurance arm, UnitedHealthcare, added 880,000 members in the past year.

This helped increase the unit’s first-quarter revenues by $3.4 billion to $48.9 billion.
UnitedHealth’s Optum unit continued to be a significant source of revenue growth for the company. Optum’s revenue climbed by 11.7 percent year over year to $26.4 billion in the first quarter of this year, up from $23.6 billion recorded in the same quarter a year prior.
Overall, UnitedHealth saw its operating expenses increase year over year to $55.5 billion in the first quarter of this year, up 8.5 percent year over year from $51.1 billion.
UnitedHealth ended the first quarter with net earnings attributable to shareholders of $3.5 billion, up 22 percent from a profit of $2.8 billion reported in the first quarter of 2018. (Beckers Hospital Review)


CMS

Physicians Advocacy Institute Comments on CMS Releases QPP Year 1 Report
On March 20, CMS released the 2017 QPP Reporting Experience Report with an appendix providing an overview of the participation results from the first year of the QPP. PAI does not believe the report comprehensively reflects the experience of QPP participation, which is of great concern. For example, the report does not reflect the disproportionate number of small and rural practices who received a penalty under MIPS (details below), which underscores PAI’s ongoing concern about the burden placed on these practices that often results in a shift into employed status. In response, PAI is working to develop a thoughtful response to policymakers highlighting our concerns and providing recommendations to improve the report to accurately and fully capture the 2017 QPP experience. Additionally, PAI wants to ensure a report portraying an incomplete picture of QPP participation is not utilized to make adjustments to the program in future rulemaking. A few of CMS’ key findings are shared below in addition to initial observations from PAI.

CMS’ Key Findings

  • Ninety-five percent of all eligible clinicians participated in MIPS and avoided a negative payment adjustment
  • Ninety-three percent of those who participated in MIPS earned a positive payment adjustment
  • Fifty-four percent of eligible clinicians participated as a group, 12 percent as individuals, and 34 percent through MIPS APMs
  • A majority of eligible clinicians opted to report data for 90 days or longer
  • MIPS eligible clinicians who were in small or rural practices had participation rates of 81 and 94 percent, respectively

PAI’s Observations

  • Ninety-nine percent of individual participants submitted their quality measures data using claims emphasizing the importance of retaining this submission mechanism for small practices
  • Seventy-one percent of eligible clinicians received a positive adjustment with the additional adjustment for exceptional performance; however, the range for the overall payment adjustment for this group was low at 0.28-1.88 percent, indicating the marginal reward for participation in the program
  • It appears that the participation rate includes eligible clinicians who actively participated as well as those who did not submit any data but were deemed as meeting the minimum threshold for avoiding a negative payment adjustment (i.e. automatically received three points as their final score) due to the 2017 Extreme and Uncontrollable Circumstances Policy
  • About 83 percent of negative payment adjustments were collected from individual and small practices (15 or fewer eligible clinicians), indicating how the positive payment adjustments are mostly being funded off the backs of those in individual and small practices who may be disadvantaged and face barriers to successful participation in MIPS

Only 37 percent of eligible clinicians participated in the Promoting Interoperability (formerly ACI) category which requires use of Certified Electronic Health Records (CEHRT), indicating the continued challenges and barriers with CEHRT requirements.


CMS New Report: 94% Overall Physician Participation in Medicare MIPS/APM
In late March, the Center for Medicare and Medicaid Services (CMS) released a report (https://qpp-cm-prod-content.s3.amazonaws.com/uploads/491/2017%20QPP%20Experience%20Report.pdf) summarizing the results of physician and other care provider participation in the Medicare Quality Payment Program for 2017, effecting 2019 Medicare payments.  Among the highlights of the report:

  • According to the report, a total of 1,057,824 “clinicians” were eligible for MIPS in 2017, of which 95% participated in the program and avoided a negative payment adjustment by receiving at least 3 points as their MIPS final score. This exceeded the CMS established goal of having 90% of MIPS eligible clinicians participate during the 2017 performance year. Physicians had a 94.2% participation rate, and non-physician clinicians had a 97.5% participation rate.
  • Of the over 1,000,000 clinicians that participated in QPP, 54% received their final score based on participation as part of a group; 12% of received their final score based on individual participation; and 34% received final scores based on participating in the QPP through an Advanced Payment Model (APM).
  • Bonuses: 71% overall received positive adjustments ranging from +0.28% to +1.88%; 22% received bonuses of up to +0.2%; and 2% received no positive or negative adjustment.
  • 81% of clinicians practicing in small practices participated with MIPS, and 94% of those practicing in a rural area participated with MIPS.
  • Of the over 340,000 clinicians who participated in the APM track, the overwhelming majority participated via the Medicare Shared Savings Program (as an Accountable Care Organization).
  • Of those who successfully participated, 74.3% reported data for a full 12 months, and another 24.9% reported data for 90 days to 12 months. With regard to small practices, 44.5% reported for the full 12 months, and 53.9% reported data for 90 days to 12 months.
  • The most frequent quality measures reported were: 1) controlling high blood pressure 2) screening for tobacco use and cessation 3) Breast Cancer screening 4) pneumococcal vaccine and 5) encouraging use of aspirin or other anti-platelet
  • The most frequent Quality Improvement measures reported were 1) Having 24/7 access to a patient’s medical record 2) Use of decision support and standardized treatment protocols 3) Patient Centered Medical Home attestation 4) Engaging with patients through patient portal and 5) Collection of data and follow up regarding patient experience.

Here is a chart detailing specialty by specialty participation in the QPP program in New York:

MIPS/APM PARTICIPATION LEVELS – NEW YORK – 2017

Specialty MIPS/APM Participation
Addiction Medicine 87.5%
Allergy/Immunology 91.28%
Anesthesiology 93.14%
Cardiac Surgery 93.65%
Cardiology 91.91%
Colorectal Surgery 93.57%
Critical Care Intensivists 97.37%
Dermatology 85.73%
Diagnostic Radiology 94.45%
Emergency Medicine 97.83%
Endocrinology 93.78%
Family Practice 93.91%
Gastroenterology 92.6%
General Surgery 94.32%
Geriatric Medicine 96.23%
Gynecology/Oncology 96.43%
Hand Surgery 92.68%
Hematology 97.06%
Hematology/Oncology 95.05%
Hospitalist 100%
Infectious Disease 92.6%
Internal Medicine 92.63%
Interventional Cardiology 95.51%
Interventional Pain Management 83.16%
Interventional Radiology 95.21%
Medical Oncology 96.42%
Nephrology 91.87%
Neurology 91.95%
Neurosurgery 94.66%
Nuclear Medicine 94.92%
OB-GYN 96.41%
Ophthalmology 91.14%
Orthopedic surgery 92.46%
Otolaryngology 92.43%
Pain Management 83.78%
Pathology 93.16%
Pediatric Medicine 99.32%
Physical Medicine and Rehabilitation 87.26%
Plastic and Reconstructive Surgery 90.26%
Psychiatry 93.7%
Pulmonary Disease 91.54%
Radiation Oncology 97.37%
Rheumatology 95.03%
Surgical Oncology 95.56%
Thoracic Surgery 96.37%
Urology 91.6%
Vascular Surgery 94.21%

Webinars

MSSNY CME Webinar Health Matters for Women Registration Now Open
The Medical Society of the State of New York is proud to announce a live continuing medical education (CME) webinar on a women’s health topic entitled “Health Matters for Women: Endometriosis” on Tuesday, April 23rd, 2019 from 7:30 AM to 8:30 AM for all physicians and other health care providers. Registration for the webinar is now open.

Health Matters for Women: Endometriosis.  Register here.

When:  Tuesday, April 23rd at 7:30am
Faculty: Lisa Eng, DO

Educational Objectives:

Review potential causes of pelvic pain and discuss how to identify endometriosis

Discuss the benefits and risks as well as the efficacy and limitations of available medical therapies for long-term treatment of endometriosis

Discuss implementation of individualized endometriosis treatment plans and options

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

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


Classified

RENTAL/LEASING SPACE


Bronx Physician’s Office for Sale or Lease
Fully equipped physician’s office for sale or lease. Features three exam rooms, lab room, reception area and waiting room, computer and storage rooms. Bronx location near Einstein Hospital and subway. Call 914-882 3797/ shiva381@yahoo.com


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


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


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


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


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


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

PHYSICIAN OPPORTUNITIES

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


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


Pediatrician BC, P/T
Seeking motivated, enthusiastic pediatrician for P/T position in solo practice in Long Island. Coverage will increase over time. Great opportunity or those seeking part time hours in an established practice. Fax resume to 516-858-2389.



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

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 


MSSNYeNews – April 5, 2019 – Non-Stop Flight

Thomas J. Madejski, MD MSSNY President
PRESIDENT’S MESSAGE
Thomas J. Madejski, MD
MSSNY President


MSSNY eNews
April 5, 2019
Volume 22  Number 14

MSSNYPAC Seal

 


Colleagues:

I like to joke with my kids about there being good news and bad news when we discuss certain topics.  The bad news from my standpoint is that this will be my last MSSNY Enews communication to you as President of MSSNY.  I didn’t expect to enjoy writing the weekly column as much as I have. (I’m cognizant that the end is very good news for some of you as well.  My three fans can continue to see my occasional healthcare rhapsodizing at @TomMadejski).  The good news is that MSSNY will be well led by our incoming President, Dr. Art Fougner.  Art and I have become friends over many years and I look forward to his leadership over the next year and in the future.

The end of a term naturally is accompanied by reflection on what did, and what didn’t happen during your time at the helm.  Today, I want to relate some behind the scenes activity that I think is important for MSSNY and our members moving forward.

The President of MSSNY is the executive of the organization and works on a daily basis with our Executive Vice President, Mr. Phil Schuh, and our excellent MSSNY staff.   Coming into the Presidency, I’ve always felt that one of the challenges for any volunteer organization is the potential for staff to drive activity more than the members.   We have great staff that executes our plan well, but I think more direct involvement by the officers helps us to hone our message and activity and, with our staff’s valuable input, gets us closer to where we want to go as a membership organization. We began every week with a management call with the Office of the President  (current prez, Immediate Past prez, Prez-elect, VP and Chairman of the Board) and our MSSNY Division heads to review and plan strategies weekly, as well as create a tactical planning guide for periodic review. I am very thankful to my fellow officers, Dr. Litvak, Dr. Fougner, Dr. Rothberg and Dr. Hughes for their excellent counsel and assistance in carrying out my Presidential duties.  I also wish to thank and acknowledge our excellent MSSNY staff who continue to perform at the highest level, and always strive to provide great service to our members. 

Membership

MSSNY has had a major increase in membership over the last year due to the activity of our leaders and staff, prior to this year.  Coming into the Presidency, I felt it was important we review our value proposition to new members and work with our County Societies to integrate efforts in marketing to additional new individual members and groups.  Nothing moves as quickly as I would like, but I’m thankful to Dr. Robert Hughes and the Board of Directors for their help in moving forward on this issue.  We have a team of staff and physician officers presently vetting options and I look forward to implementation over the next year.

Our Communications department had a successful year in expanding our media footprint.  The MSSNY Daily, and MSSNY Enews is now available to your healthcare teammates.  We want to continue to grow our media presence and your help sharing these communications helps to expand our message.

MSSNY Communications and Advocacy staff were very effective in helping our leaders engage other non- physician groups.  Single Payer, Marijuana, and Collective Negotiation issues helped us to expand our influence outside of the merits related to advocacy around the issue itself.  We have a great relationship with a number of other professional societies.  I was very pleased to have increased involvement in coordinating advocacy with our other professional societies.  I particularly want to salute NYACP, NYSSAM, NYSSA, ACOG, NYSOMS (Osteopathy), NYSOS (Ophthalmologists), NYSSOS (Orthopedic Surgeons), NYSSPS (Plastic Surgery), and NYSDS (Dermatology) for participating in our CME activities for Advocacy Day and walking the halls of the Leg buildings arm-in-arm with MSSNY.  Together, We REALLY Are Stronger!

I’m very thankful for the activity of my MSSNY Committee Chairs and members.  They have spent countless hours creating, and sometimes reviewing MSSNY policies on short notice. All of our Committees have done excellent work.  I want to thank Dr. Robert Goldberg and Dr. Jay Weiss who were instrumental in negotiating a substantial Workers Compensation fee increase; and our Bioethics Committee, Diversity, and Addiction Committees that reviewed our marijuana policy over the last year.

Physician-Assisted Suicide

Physician-assisted suicide remains a contentious issue for our profession.  I caught some heat for advocating our MSSNY policy during Assembly hearings last Spring. In an attempt to bring us closer together on this challenging issue, I established a Task Force on End of Life Care.  The Task Force has made substantial progress over the last year and will provide an interim report to the HOD next week. Understandably, this is a critical topic and they will continue their work to completion.  I am very thankful to Dr. John Maese for his excellent leadership of the Task Force.  We anticipate a final report to be available by the end of 2019.

The MSSNY Physician Wellness and Resilience Committee made substantial progress this year.  We have great programming available and are in the process of securing additional funding to make the programming more widely available.  We have restructured the internal management of the program to facilitate that.  We continue to work toward creation of a MSSSNY Peer to Peer Mentoring Service, not only for MSSNY members but for all New York physicians.

Thanks to all who provided feedback throughout the year.  I’m grateful for the thoughtful comments and tried to acknowledge and respond to as many as possible.  Please continue to reach out with your thoughts on issues affecting your practice and patients.

Finally, I want to thank each of you for your activities on behalf of your patients— both the care you provide to them individually, and your understanding of the importance of MSSNY membership to enhance your ability to care for your patients. Help us to be more effective by becoming more active in your County Medical Society, joining our MSSNY PAL program and joining MSSNYPAC. Your personal actions through membership are critical to providing the best care to your patients and providing stewardship to our learned profession.  

Ubi caritas, Deus ibi est.

Excelsior!

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

Thomas J. Madejski, MD
MSSNY President


MLMIC Insurance Banner


Capital Update

Legislature Finalizes $175 Billion Budget; Several Positive Items for Physicians
Overnight Sunday into Monday morning, the New York State Legislature completed passage of a $175.5 Billion Budget for the 2019-2020 Fiscal Year.  The State Budget contained a number of positive items for physicians and their patients in terms of new proposals adopted, and adverse proposals defeated.  We thank the many physician leaders and county society staff who took the time to meet, send letters and make phone calls to their local legislators on these issues.

Some of these positive outcomes include:

  • Rejection of the proposed approximate $80/patient Medicaid cut for deductibles for patients covered by Medicare and Medicaid that had been strongly opposed by MSSNY.  This action prevents the imposition of potentially tens of thousands of dollars in cuts to physicians who treat many such “dual eligible” patients as part of their practice.
  • Rejection of a proposed measure opposed by MSSNY that would have placed new prior authorization on physicians prescribing medications to their patients covered by Medicaid.
  • A proposal to legalize recreational or “adult use” marijuana was not included in the final Budget, though discussions on this issue will continue for the remainder of the Legislative Session.
  • Funding for the Excess Medical Malpractice Insurance Program was continued at its historical level, as well as continuation of the authority of the DFS Superintendent to set medical liability premium rates.
  • Comprehensive reforms to better ensure insurance coverage parity for mental health conditions (MHC) substance use disorders (SUD) and Autism Spectrum Disorder (ASD):
      • Prohibits prior authorization for formulary forms of prescribed medications for treatment of SUD.
      • Provides coverage for ALL MHCs, SUDs, and ASDs as each is defined in the most recent edition of the Diagnostic and Statistical Manual of Mental Disorders (DSM) or the most recent edition of another generally recognized independent standard of current medical practice such as the International Classification of Diseases (ICD).
      • Prohibiting preauthorization and concurrent utilization review of SUD services during the initial 28 days of treatment;
      • Medical necessity criteria with respect to benefits for MHCs/SUDs and ASDs shall be made available to patients and their physicians (and other health care providers) upon request.

Perhaps one of the most significant provisions of this section is an expanded “Anti-retaliatory” measure that prohibits a health insurer from taking “any adverse action, including but not limited to refusing to renew or execute a contract or agreement with a health care provider as retaliation against a health care provider for filing a complaint, making a report or commenting to an appropriate governmental body regarding policies or practices of such insurer… “ 

  • Greater oversight on pharmacy benefit managers (PBMs) in their dealings with Medicaid Managed Care plans including imposing new disclosure requirements and limits on PBM fees.
  • Health Insurance policies for groups with 100 or more full-time employees will be required to cover at least three cycles of in vitro fertilization,
  • A new 20% tax on the sale of “vapor products” to be used in e-cigarettes, e-cigars and vaping pens, and requiring sellers of such products to register with the NYS Tax Department.
  • A new $150,000 grant for MSSNY’s Veterans Mental Health Training Initiative physician educational programming.
  • Continued funding of $990,000 for MSSNY’s Committee for Physician’s Health
  • A re-appropriation of $100,000 to MSSNY to continue its educational programming for physician’s regarding women’s health issues.
  • While not specifically in the State Budget, the Legislature passed legislation supported by MSSNY that would raise the tobaco and e-cigarette purchase age from 18 to 21. (see separate article)

Other Budget Provisions of Note Include: 

Opioid Tax – The final Budget contained a $100 million tax on opioid manufacturers and distributors.  Last week, MSSNY, the NYS Academy of Family Physicians and the NY Chapter of the American College of Emergency Physicians joined patients, pharmacists and several legislators raising concerns with the possibility of the cost being passed on to pharmacies, hospitals and patients. 

Medicaid Cuts – The proposed 0.8% across-the-board cut in Medicaid payments was not included in the final Budget, however, there is language that provides authority to the state to reduce Medicaid payments during the fiscal year (up to $190 million across the board) in the event of an unexpected drop in revenue such as federal cuts.  MSSNY will continue to monitor the potential implementation of this provision. 

Health Insurance Exchange – The Budget codified the New York State of Health into law, including its structure for providing health insurance products at the bronze, silver, gold and platinum levels, as well as appealing health plan formulary restrictions.  It also sets forth in statute the 10 essential benefits that Exchange plans had been required to cover and provides greater assurance of no prohibitions on coverage for pre-existing conditions.

Workers’ Compensation  – With a new medical fee schedule that begin Monday, April 1 that provides long-overdue increases to physicians treating their patients covered by Workers’ Compensation (WC), the Legislature and Governor agreed to a WC package that would expand the types of practitioners who can treat and be reimbursed for treating injured worker patients while at the same time seeking to reduce some of the carrier-imposed barriers to injured workers receiving needed medical care and treatment.

The bill would expressly permit injured workers to receive treatment by Nurse Practitioners (NPs), Social Workers, Physician Assistants (PAs), acupuncturists, Physical Therapists (PTs) and Occupational Therapists (OTs) acting within their statutory defined scopes of practice.  For example, this means that a NP will no longer need to be employed by a physician to provide care to an injured worker.

MSSNY raised concerns during negotiations regarding the lack of an express requirement for some of these professionals to coordinate with a specialized physician for the care of injured workers.  However, that concern was not fully addressed.  We note that the bill would prohibit these newly listed health care professionals from performing Independent Medical Examinations.  It would also specify that Acupuncture, PT and OT care could only be provided pursuant to a referral from a physician, podiatrist or NP, and that the report of a PA, PT, OT or acupuncturist could not be used as evidence to determine that a particular injury or illness is work-related.

Importantly, the bill also contains provisions designed to reduce delays in injured workers receiving needed treatment, and physicians being paid for delivering this care:

  • Specify that the purpose of the pre-authorized procedures list maintained by the WCB is for “expediting authorization of treatment of injured workers” and “shall not prohibit varied treatment when the treating provider demonstrates the appropriateness and medical necessity of such treatment.”
  • Expressly prohibiting an employer, carrier, or third-party administrator from attempting to interfere with the selection by the  injured  employee  of an authorized medical provider;
  • Eliminating the 3-arbitrator panels for review of disputed medical bills, so that every dispute would only need to be reviewed by a single arbitrator in the same profession as the professional bringing the dispute (the arbitrator can continue to be a physician recommended by MSSNY).

Moreover, unlike some previous versions, the budget provision preserves the historical role of the county medical societies to provide peer review of physician applications to participate in the Workers’ Compensation program.

The new provisions will take effect January 1, 2020.  There will likely be follow up communications from the WCB regarding how these provisions will be implemented.

Staff is continuing its review of the thousands of pages of Budget documents and will provide further updates on these and ERNMENTAL AFFAIRS)


Post-Budget Call to Action: Make Sure Your Voice is Heard on Needed Insurance Reforms
With the State Budget now passed physicians are urged to contact their legislators in support of bills to address the hassles they and their patients face with insurance companies. Post-budget, legislative activity will begin to build steam, culminating in a flurry of bills being passed at the end of session. That’s why it is vital that you join the fight and make your voice heard about the issues affecting your ability to advocate on behalf of your patients.  Among these important measures include:

Collective negotiationsNegotiating with insurance companies regarding patient care terms is extremely difficult, especially when monolithic payers control a huge portion of the market in which you practice. The fact that you are barred from banding together with your colleagues is unfair, so MSSNY strongly supports legislation introduced by Senator Rivera and Assemblymember Gottfried (S.3462/A.2393) that would allow independently practicing physicians to collectively negotiate with insurance companies under close state supervision.  Please urge your Assemblymember and Senator to join on as a co-sponsor here.

Prior authorizationsThe burdens caused by excessive and often repeated prior authorization requirements take away from the time that physicians can spend with their patients and lead to far too many hours being spent on paperwork. A just-released American Medical Association (AMA) survey reported that 91% of responding physicians said that the prior authorization process delays patient access to necessary care; with more than ¼ of the respondents indicating that a PA process led to a serious adverse event. Moreover, 86% said that burdens associated with prior authorization were “high or extremely high”; and 88% reported that these PA requirements had increased in the last 5 years.   Senator Breslin and Assemblymember Gottfried have introduced legislation (S.2847A.3038) to reduce these burdens, including by reducing the insurer time frame for reviewing prior authorization requests, and by limiting when an insurer can withdraw or repeat a previously granted pre-authorization.    Please urge your Assemblymember and Senator to join on as a co-sponsor here.

Mid-year formulary changesSurprisingly, current law does not restrict insurance companies from making changes to their formularies mid-year. This is particularly egregious because some patients choose insurance plans based on the prescription medication formulary coverage and provisions. Senator Breslin and Assembly Majority Leader Peoples-Stokes have introduced legislation (S.2849/A.2969) that would prevent mid-year formulary changes so that patients do not experience removal of a drug or changes in tiering when there is no similarly effective option.

Please urge your Assemblymember and Senator to join on as a co-sponsor here.
(AVELLA, AUSTER)


MSSNY House of Delegates Banner


Senate Passes Bill to Increase Purchase Age for Cigarettes and E-Cigarettes; Bill Now Goes to Governor
The NYS Senate has approved legislation that would increase the purchase age for tobacco products from 18 to 21 years of age.  The measure, S. 2833/A.558, sponsored by Senator Diane Savino and Assemblywoman Linda Rosenthal, has already passed the NYS Assembly.  The bill now goes to Governor Andrew Cuomo for his signature.   It is anticipated that the governor will sign this measure. The Medical Society of the State of New York supports this measure and issued a public statement praising the Legislature for this action which you can read here.          (CLANCY)


Urge Congress to Create Sensible Surprise Billing Law, Looking to New York as a Model
Physicians are urged to contact Senators Schumer and Gillibrand as well as their respective member of Congress to urge that they assure that any legislation addressing “surprise” out of network medical bills be consistent with New York’s innovative law, including making self-insured plans covered under a similar approach.  You can send a letter here.

Surprise out of network bills care in a hospital have been the focus of much attention as of late, with the Congressional Committee on Education & Labor holding a hearing this week on this issue. MSSNY has been working with the AMA and other state medical associations in support of efforts to remove patients from the middle of these “surprise” bill disputes while at the same time assuring physicians are paid fairly for these services.   However, some of the rhetoric has unfairly cast a disproportionate share of the blame on physicians, rather than on those insurance companies which are failing to offer fair contracts to some physicians. During the April 2nd hearing, some testifiers made inflammatory comments regarding physicians charging prices that are “largely made up” and suggested limiting payment for such for out-of-network services to grossly inadequate insurer-determined or Medicare rates.  Such an approach could have significant adverse consequences for the ability of hospitals to have sufficient on-call specialty care in their emergency departments, and greatly limit the ability of physicians to fight for fair contracts with health insurers.

New York’s law establishes a fair balance among health insurers, hospital and physicians, not only in deciding how these bills are paid, but also in addressing a number of other factors which lead to surprise bills.  To that end, MSSNY has written to the New York Congressional delegation, urging that any legislation to be considered is consistent with New York’s comprehensive law on the subject enacted in 2014 (see MSSNY’s letter here).

New York’s law stands as a model for other states that are looking at this issue. We believe that any federal action on the topic should be consistent with New York’s surprise billing law which has been lauded as an equitable and sensible solution.

Please take a minute to write to your elected officials expressing your support for New York’s system and urging Congress to use it as a template for federal legislation. You can do so by going here(AVELLA, AUSTER)


                                        Women Matters HOD Seminar


Office-Based Surgery Mandated Reporting Update
The NYS Department of Health has sent Office-based Surgery (OBS) practices a letter indicating that it was not moving forward in 2019 with a proposed requirement for OBS practices to report information to DOH regarding the numbers of each type of procedure performed in their OBS practices.

MSSNY working together with the NYS Society of Plastic Surgeons and NY Chapter of the American College of Physicians had indicated its support for the goals of the proposed reporting requirements to provide necessary context to assess the frequency/lack of frequency of certain adverse events reported to DOH.  However, given the potential complexity this presented for some practices, MSSNY, NYSSPS and ACP also suggested alternatives to this reporting requirement such as having DOH request such cumulative procedural information from the accrediting entities from which OBS practices are required to receive accreditation.

Instead, the DOH will be placing additional efforts to ensure all OBS physician practices are complying with the New York law that requires all adverse events arising in an OBS setting to be reported to the DOH patient safety center within three business days of the adverse event.  NYS Public Health Law Section 230-d defines an “Adverse event” as a “(i) patient death within 30 days;  (ii) unplanned  transfer  to  a hospital or emergency department visit within 72 hours of office-based surgery for  reasons  related  to  the   office-based  surgery encounter; (iii) unscheduled hospital admission or assignment to observation services,  within 72 hours of the office-based surgery, for longer than 24 hours; or (iv) any other serious or life-threatening event”.

MSSNY looks forward to partnering with the DOH to educate and ensure physicians are in complete compliance with these adverse event reporting requirements.   (AUSTER)


CME at MSSNY 2019 House of Delegates
MSSNY is proudly offering the following CME seminars at the 2019 House of Delegates in Tarrytown on Thursday April 11th and Friday April 12th: 

Thursday April 11th 1:00-2:00pm:

Medical Matters: What’s Your Diagnosis? Infectious Diseases
Register here.
Faculty: William Valenti, MD

Educational Objectives:

Identify the modes of transmission of infectious agents

Discuss presumptive treatment of infectious diseases in advance of diagnostic testing results

Describe two scenarios and review questions and answers 

Thursday April 11th 2:00-3:00pm:

Veterans Matters: The Special Mental Health Needs of Women Veterans
Register here.
Faculty: Malene Ingram, MD, Lt. Col. US Army Reserves

Educational Objectives:

Review how the increased role of women in the military has impacted their mental health

Describe mental health concerns unique to women veterans and how to identify and treat them

Identify the barriers that women veterans face in getting the specific care they need 

Friday April 12th 1:00-2:00pm

Health Matters for Women: Myalgic Encephalomyelitis and Fibromyalgia
Register here.
Faculty: Florence Shum, DO

Educational Objectives:

Review potential causes of chronic diffused pain and fatigue

Discuss how to accurately diagnose Fibromyalgia and Myalgic Encephalomyelitis

Discuss treatment options for Fibromyalgia and Myalgic Encephalomyelitis

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

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

Friday April 12th 2:00-4:00pm

Improving Maternal Mortality Trends in New York State – Seminar and Panel Discussion – Register here.
Faculty: Linda Clark, MD, Lisa Eng, MD, Kenyani Davis, MD & Lauren Tobias, Director, Division of Family Health, NYS DOH

Educational Objectives:

Review maternal mortality trends in NYS

Examine racial disparities around maternal morbidity and mortality

Identify potential practice models to improve patient outcomes

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

The Medical Society of the State of New York designates this live activity for a maximum of 2.0 AMA/PRA Category 1 credits™. Physician should only claim credit commensurate with the extent of their participation in the activity.


HOD Banner for Seminar


Measles Outbreak in New York State Continues: Measles Educational Programs Available Online at MSSNY CME Website
The measles outbreak in New York State continues to be one of the worst in recent history.  There have been extreme measures taken in Rockland County where, according to the New York Times, only an estimated 72.9% of the population is vaccinated.  Since October of 2018, there have been 153 confirmed measles cases in Rockland County and 259 in New York City.  MSSNY conducted a just-in-time Medical Matters webinar entitled “The Continued Public Health Threat of Measles 2018” in December.  This webinar is available at the MSSNY CME website.  Also be sure to check out The Importance of Herd Immunity, another Medical Matters program that is pertinent to the current measles outbreak.  Please check it out and keep yourself informed about the ongoing measles outbreak in New York State.  You can also have patients listen to MSSNY’s brief podcast on the Measles, Mumps and Rubella vaccine here. (HOFFMAN)                                                                                                                                                                                              


Registration Now Open for Medical Matters Webinar
Be sure to register for the next Medical Matters interactive webinar, What’s Your Diagnosis? Infectious Diseases.  This program will include interactive components for participants.  You will be asked to answer questions about a case and discussion will follow.  Find out if you’re fully prepared to diagnose and treat an infectious disease. 

Medical Matters: What’s Your Diagnosis? Infectious Diseases
Register here.

When:  Wednesday, April 17th at 7:30am
Faculty: William Valenti, MD

Educational Objectives:

Identify the modes of transmission of infectious agents

Discuss presumptive treatment of infectious diseases in advance of diagnostic testing results

Describe two scenarios and review questions and answers

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

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


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MSSNY CME Webinar Health Matters for Women Registration Now Open
The Medical Society of the State of New York is proud to announce a live continuing medical education (CME) webinar on a women’s health topic entitled “Health Matters for Women: Endometriosis” on Tuesday, April 23rd, 2019 from 7:30 AM to 8:30 AM for all physicians and other health care providers. Registration for the webinar is now open.

Health Matters for Women: Endometriosis – Register here.
When:  Tuesday, April 23rd at 7:30am

Faculty: Lisa Eng, DO

Educational Objectives:

Review potential causes of pelvic pain and discuss how to identify endometriosis

Discuss the benefits and risks as well as the efficacy and limitations of available medical therapies for long-term treatment of endometriosis

Discuss implementation of individualized endometriosis treatment plans and options

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

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


 

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

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

eNews

New York Sues Six Opioid Manufacturers, Four Distributors, and Sackler Family
The New York AG Letitia James is suing six opioid manufacturers, the Sackler family and four prescription drug distributors in a massive legal fight against the pharma industry accused of fueling the opioid crisis. The amended lawsuit accuses the 11 defendants of using false and deceptive marketing practices to create the “opioid epidemic that has ravaged New York.” The Attorney General called the amended complaint the country’s most comprehensive lawsuit aimed at addressing the ever-growing problem of opioid addiction, according to The New York Law Journal.

The complaint names the defendants as the Sackler family; Purdue Pharma; Janssen Pharmaceuticals a subsidiary of Johnson & Johnson; Mallinckrodt; Endo Health Solutions; Teva Pharmaceuticals; Allergan Finance; McKesson Corp.; Cardinal Health; AmerisourceBergen; and Rochester Drug Cooperative. “Defendants caused this disaster together,” the lawsuit states. (Becker’s Hospital Review) 

Where VA Hospitals Lead and Lag in New York State
A recent study comparing Veterans Affairs (VA) and non-VA hospitals across the nation found that VA hospitals provided the best care in most regions for at least 9 of 15 quality measures. But how do they compare in New York State? Many of the nearly 800,000 veterans in New York State do not live near a VA hospital, and nearly half of veterans in the State prefer to get their care from outside the VA.

A new NYSHealth data snapshot examines levels of performance on various quality measures for each of the 10 VA hospitals in New York State. The measures span four domains of care: patient satisfaction, patient safety, health outcomes, and the timeliness and effectiveness of care.

VA hospitals and community-based hospitals perform similarly on most measures in this snapshot—and with a few exceptions, VA hospitals do not consistently out- or under-perform relative to community-based hospitals. These mixed results underscore the value of veterans having options to choose from both VA and community-based care.


Garfunkel Ad


Growing Open Notes Across New York State
The New York State Health Foundation (NYSHealth) is pleased to launch a Request for Proposals (RFP) to support federally qualified health centers (FQHCs), multispecialty group practices, hospital-affiliated physician groups, independent physician practices, and other health care settings across New York State in adopting or spreading OpenNotes.

OpenNotes is a national effort to give patients access to the visit notes written by their doctors, nurses, or other clinicians. Established in 2010, OpenNotes creates partnerships toward better health and health care by giving everyone on the medical team, including the patient, access to the same information. When patients have access to their own visit notes written by health care providers, they better remember what was discussed during the visit; feel more in control of their care; are more likely to take medications as prescribed; and can share notes with their caregivers.

This RFP is open to FQHCs and other non-hospital health care settings in New York State. Awards of up to $100,000 will be granted per organization. Proposals will be due on May 2, 2019.

Read details on the RFP and apply.


NY Has Second-Highest Percentage of Insurance Claims for Retail Clinics
Crain’s New York Business (4/2) reports, “New York had the second-highest percentage of insurance claims for retail clinics nationwide, according to a new white paper from the nonprofit Fair Health.” The article notes that the state’s “prohibition on the corporate practice of medicine” limits retail clinics in the state, and as an alternative, “for-profit companies such as CVS and Walgreens lease space to medical practices within their stores.”


AMA, Unitedhealthcare Propose Billing Codes for Nonmedical Health Needs
The AMA and UnitedHealth care are supporting the development of 23 billing codes related to social determinants of health. The healthcare system lacks a consistent, organized way to capture such nonmedical needs as food, housing and access to transportation, and incorporate them into individual care plans, executives of both organizations said. But through their collaboration, UnitedHealthcare has created — and the AMA has endorsed — ICD-10 codes related to these needs, according to Forbes. “By combining traditional medical data with self-reported [social determinants of health] data, the codes trigger referrals to social and government services to address an individual’s unique needs, connecting them directly to local and national resources in their communities,” UnitedHealthcare and the AMA said. One proposed ICD-10 code, for example, would help a dialysis patient who needs transportation, according to Forbes.

The proposal for ICD-10 codes for social determinants of health was reportedly submitted to the ICD-10 Coordination and Maintenance Committee, which includes members from the CDC and CMS. According to an AMA report, the codes, if approved by CMS, would apply to the fiscal year that begins Oct. 1, 2020. (Becker’s Hospital Review, April 2)


Online Drug Vendors Shifting Physician-Patient Relation in Absence of Regs
The New York Times (4/2) reports the growing popularity of websites such as Roman and Hers have made “obtaining lifestyle drugs for sexual health, hair loss and anxiety nearly as easy as ordering dinner online,” but are changing how patients interact with their healthcare providers. The websites allow people to “self-diagnose and select the drug they want” with the supervision of a physician who “assesses their choice, with no in-person consultation.” In response, physicians, regulators, and legal experts are warning that the companies “operate in a regulatory vacuum that could increase public health risks.” The Times adds that some companies are working to enhance their oversight by seeking expert advice, including from former Surgeon General Dr. Joycelyn Elders; however, in some cases, companies make claims about treatments that are at odds with FDA regulations.


Capping Insulin Costs
Express Scripts, a pharmacy benefit manager owned by health insurer Cigna, announced on April 4, that it will offer its clients an option to cap enrollees’ monthly out-of-pocket costs for insulin at $25. The announcement comes amid increased scrutiny of rising insulin prices and costs for patients. (Wall Street Journal, 4/3)


CMS finalizes Medicare Advantage, Part D payment policies: Four Things to Know
On April 1, CMS issued a final rule to update 2020 payment policies for Medicare Advantage and Part D prescription drug plans.

Four things to know:
1. Under the rule, Medicare Advantage health plans will see a 2.53 percent pay raise in 2020.
2. In addition, chronically ill patients with Medicare Advantage can receive coverage for products and services aimed at addressing social determinants of health.

  1. This includes meal delivery, transportation for nonmedical needs like grocery shopping and home environment services.
  2. For example, CMS said Medicare Advantage patients with asthma could receive coverage for air cleaners and carpet shampooing to address irritants that could cause asthma attacks. A patient with diabetes could receive coverage for transportation to a physician’s appointment or other services like a nutritionist.

For the full fact sheet, click here.


Classified

RENTAL/LEASING SPACE


Bronx Physician’s Office for Sale or Lease
Physician’s running office fully equipped for sale or lease. Effective immediately, retiring, Bronx, near Einstein Hospital, near subway. Call 914-882 3797 / shiva381@yahoo.com


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


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


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


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


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


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

PHYSICIAN OPPORTUNITIES

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


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


Pediatrician BC, P/T
Seeking motivated, enthusiastic pediatrician for P/T position in solo practice in Long Island. Coverage will increase over time. Great opportunity or those seeking part time hours in an established practice. Fax resume to 516-858-2389.



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

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 


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