March 18, 2016 – DOH’s Exceptions to E-Prescribing

drmaldonado PRESIDENT’S  MESSAGE
 Dr. Joseph R.  Maldonado
asset.find.us.on.facebook.lgTwitter_logo_blue1

March 18,  2016
Volume 16, Number 10

Dear Colleagues:

In lieu of my weekly introduction, New York State Commissioner of Health Dr. Howard Zucker issued a very important letter on March 15th outlining “12 Exceptions” to the E-Prescribing Law that is looming over us and goes into effect in 10 days.

“This letter is to inform you of a blanket waiver with respect to the electronic prescribing requirements, pursuant to Public Health Law (PHL) § 281 and Education Law § 6810, that goes into effect on March 27, 2016, for exceptional circumstances in which electronic prescribing… Read More

Joseph Maldonado, M.D, MSc, MBA, DipEBHC
MSSNY President

Please send your comments to comments@mssny.org


MLMIC_011916_Enews_550x150


Capital_Update_Banner


Legislature Puts in One House Budget Bills; Negotiations to Begin in Earnest
The Senate and Assembly one house bills were posted over the weekend. While DGA staff continues to analyze the provisions of the bills, below are highlights of what we have read thus far.

  1. After strenuous advocacy by MSSNY and other advocacy groups, each House added $25M in their one House budget bills to restore funding for the Excess program. In addition they included language to continue the Excess program as is and to continue the Superintendent’s authority to set medical malpractice rates. Physicians should thank their elected officials for proposing to restore this funding and continue to urge restoration of this cut as the final Budget is being negotiated. Go to the this link for a letter you can send to your elected representatives.
  1. After proactive advocacy by MSSNY and other advocacy groups, both Houses articulated a desire that “funding or settlement funds be identified in  addition  to  remaining  assets  to   reimburse   hospitals, physicians and producers pro-rata for losses associated with the demise of Health  Republic  upon  completion  of  the  formal liquidation process” (Senate language). Importantly, several key legislators (Senators Hannon, Rivera, and Valesky and Assemblymembers Cahill and Walter) articulated this goal in the first meting of the Health Budget Conference Committee this week.  In addition, the Senate bill would eliminate the requirement for prior approval of health insurance premium rates and would establish a requirement that within thirty days deeming an insurer insolvent, the superintendent must apply for a liquidation order.

ALL PHYSICIANS SHOULD IMMEDIATELY GO TO THE FOLLOWING LINK TO CONTACT THEIR ELECTED REPRESENTATIVES TO URGE THE INDENTIFICATION OF A POOL OF MONIES TO REIMBURSE HEALTHCARE PROVIDERS FOR THE SERVICES RENDERED TO PATIENTS PREVIOUSLY INSURED BY HEALTH REPUBLIC.  http://cqrcengage.com/mssny/app/onestep-write-a-letter?5&engagementId=151313

  1. The Senate included the Governor’s retail clinic language which would allow publicly traded corporations to own and operate limited service clinics in retail space they own without regard for public need. The Assembly advanced language which would, importantly, not allow publicly traded corporations to own and operate retail clinics but which seeks to regulate practices that rent space in retail establishments by, among other things, requiring them to be accredited; limit the type of services which can be provided and prohibit them from delivering care to children under the age of two. The corporately owned retail clinic language remains in play.  Go to the this link to send a letter of opposition to this proposal to your legislators.
  1. After strenuous advocacy by MSSNY and other advocacy groups, neither House included any of the workers’ compensation language we opposed. While this is a very positive development, we must keep the pressure on by reaching out to your elected representatives if you haven’t yet done so by sending a letter found at this site.
  1. The Senate bill includes language to require the commissioner of health to develop an elder abuse screening tool. Physicians, PAs and NPs are permitted (not required) to use the tool to identify abuse or maltreatment of their patients. The language also calls for the establishment of an interagency clearinghouse for reported cases involving physical abuse, sexual abuse, emotional abuse, active, passive or self-neglect, financial exploitation or other hazardous situations which could jeopardize the health and wellbeing of an individual and calls for the creation of multidisciplinary teams for the purpose of investigating reports of suspected elder abuse. The proposal would also authorize a financial institution to disallow a transaction if it believes that financial exploitation of a vulnerable adult is occurring.
  1. The Senate bill included legislation strongly supported by MSSNY which would exempt low volume providers from the eRx mandate and allow prescribers invoking an exception to the mandate to make a notation in the patient’s medical record instead of calling DOH (currently required by law).  Please send in support letter here:
  1. Senate bill sets aside an additional $12M in new funding for 100 new loan forgiveness/practice support slots as part of the Doctors Across New York. The bill would reduce from five to three the number of years of service associated with the support and would allow for $40,000 in loan forgiveness/practice support each year up to $120,000 for each new recipient.
  1. Each House would restore existing ”prescriber prevails” protections in the Medicaid and Medicaid Managed Care program.
  1. Each House devotes a significant amount of new money ($26M (Senate) and $32M (Assembly)) to address substance abuse with significant money flowing for prevention and treatment services, recovery support services and recovery community centers. In addition, the Assembly would require OASAS to: develop educational materials for schools and require schools to make Substance Use Disorder (SUD) treatment referrals; develop materials for pharmacies to distribute regarding drug addiction, treatment and disposal of drugs; develop SBIRT materials; develop SUD materials for physicians for voluntary distribution to patients and require hospitals to establish policies regarding referral of individuals in need of SUD treatment.
  1. The Senate included language in its one House bill that MSSNY opposes that would allow chiropractors and physicians to partner in LLPs/LLCs.
  1. Importantly, the Senate one House repeals action taken in last year’s budget to eliminate Medicaid reimbursement for services provided to patients dually eligible for Medicaid and Medicare thereby restoring the 20% of the co-insurance. Please send a letter in support here.

The conference committees are expected to continue meeting next week.

We will keep you informed of discussions which ensue throughout the next couple of weeks.

Best Regards,
Liz. Moe, Pat and James

NYS DOH Commissioner Issues 12 Additional Exemptions to the E-Prescribing Requirment
NYS Health Commissioner Howard Zucker, MD issued a statement this week providing 12 exemptions to the e-Prescribing mandate going in effect March 27th.   In a March 16th letter, the Commissioner said that exceptional circumstances existed in which electronic prescribing cannot be performed due to limitations in software functionality.   In a letter to prescribers, the Commissioner listed the 12 additional exceptions to the e-prescribing requirement.   Those exceptions are as follows:

  • any practitioner prescribing a controlled or non-controlled substance, containing two (2) or more products, which is compounded by a pharmacist;
  • any practitioner prescribing a controlled or non-controlled substance to be compounded for the direct administration to a patient by parenteral, intravenous, intramuscular, subcutaneous or intraspinal infusion;
  • any practitioner prescribing a controlled or non-controlled substance that contains long or complicated directions;
  • any practitioner prescribing a controlled or non-controlled substance that requires a prescription to contain certain elements required by the federal Food and Drug Administration (FDA) that are not able to be accomplished with electronic prescribing;
  • any practitioner prescribing a controlled or non-controlled substance under approved protocols under expedited partner therapy, collaborative drug management or in response to a public health emergency that would allow a non-patient specific prescription;
  • any practitioner prescribing an opioid antagonist that would allow a non-patient specific prescription;
  • any practitioner prescribing a controlled or non-controlled substance under a research protocol;
  • a practitioner prescribing a controlled or non-controlled substance either through an Official New York State Prescription form or an oral prescription communicated to a pharmacist serving as a vendor of pharmaceutical services, by an agent who is a health care practitioner, for patients in nursing homes and residential health care facilities as defined in section twenty-eight hundred one of the public health law. The Assembly and Senate have passed similar legislation (A.9334/S6778)
  • a pharmacist dispensing controlled and non-controlled substance compounded prescriptions, prescriptions containing long or complicated directions, and prescriptions containing certain elements required by the FDA or any other governmental agency that are not able to be accomplished with electronic prescribing;
  • a pharmacist dispensing prescriptions issued under a research protocol, or under approved protocols for expedited partner therapy, or for collaborative drug management;
  • a pharmacist dispensing non-patient specific prescriptions, including opioid antagonists, or prescriptions issued in response to a public health emergency issued; and
  • a pharmacist serving as a vendor of pharmaceutical services dispensing a controlled or non-controlled substance through an Official New York State Prescription form or an oral prescription communicated by an agent who is a health care practitioner, for patients in nursing homes and residential health care facilities as defined in section twenty-eight hundred one of the public health law.

The the above-listed exceptional circumstances will be effective until March 26, 2017. According to an email that MSSNY received on March 17, 2016 from the NYS Bureau of Narcotics Enforcement, any use of these the exceptions does not require physicians to notify the Department of Health that they are using the exception.

Additionally, on March 17, 2016, Governor Cuomo issued a press statement about e-prescribing, noting that the “requirement is a key component of New York’s I-STOP initiative that is focused on helping curb the abuse of prescription medication throughout the state”.   He reminds prescribers that e-prescribing will become effective on March 27, 2016.   A copy of the Governor’s press release is here.

A copy of the Commissioner’s letter can be found here.                                (CLANCY, DEARS)

Continue to Urge your Legislators to Reduce Liability Insurance Costs, Not Raise Them!
Last week physicians and medical students from across New York State came to Albany to remind their legislators that, in light of the huge financial pressures threatening the viability of physician practices and our health care delivery system, no further liability increases can be tolerated.  Please continue to urge  your legislators (http://cqrcengage.com/mssny/app/write-a-letter?4&engagementId=105729) to oppose legislation (A.285-A, Weinstein/S.6596, DeFrancisco) that could drastically increase New York’s already exorbitantly high medical liability premiums by changing the medical liability Statute of limitations to a “Date of Discovery” rule.

MLMIC’s estimate is that this bill could increase physician liability premiums by nearly 15%!   New York physicians continue to pay liability premiums that are among the very highest in the country.  By way of example, a neurosurgeon practicing on Long Island must pay an astounding $338,252 for just one year of insurance coverage and an OB/GYN practicing in the Bronx or Staten Island must pay $186,639.   New York far surpasses all other states in terms of total medical liability payouts, per capita payments, and medical liability awards above $1 million.

MSSNY joined the Greater New York Hospital Association (GNYHA) and Healthcare Association of New York State (HANYS) in an ad in the Albany Times-Union and City & State calling for reduction in these exorbitant costs.

To make matters even worse, trial lawyers are aggressively pushing the Legislature to consider additional liability expansion bills such as legislation that would eliminate the statutory limitation on contingency fees in medical liability actions, legislation that MLMIC has estimated could have the effect of raising your premiums by over 10%.   Please tell your legislators to enact comprehensive liability reform to bring down these costs, not legislation that increases them!                                                                                                  (AUSTER, DEARS)

MSSNY Joins Many Other Group in Expressing Strong Concerns with Changes to Payment for Medicare Part B Drugs
MSSNY joined numerous patient advocacy groups, specialty societies and state medical societies in a letter to HHS, CMS and Congressional leaders expressing strong concerns with proposed changes to the methodology for paying for medications covered under Medicare Part B, such as chemotherapy and ophthalmological medications.   CMS is proposing to change the reimbursement methodology of Part B drugs from the current 6% add-on to the “Average Sales Price (ASP)” to 2.5% plus a flat fee.  CMS also proposed a second phase that would implement value-based purchasing tools similar to those employed by commercial health plans, pharmacy benefit managers, hospitals, and other entities that manage health benefits and drug utilization. 

Broad concerns with this proposal were expressed by several groups and members of Congress in a New York Times article last week.  The American Society of Clinical Oncology released a statement condemning the proposal noting that “it is inappropriate for CMS to manipulate choice of treatment for cancer patients using heavy-handed reimbursement techniques…..Physicians did not create the problem of drug pricing and its solution should not be on their backs.”  More here.

To read the CMS press release and other materials describing CMS’ proposal, click here.                                                                                                            (AUSTER)


Assembly Passes Stand-Alone Ethics Reform Bill
On Tuesday, March 15th, the Assembly passed a bill (A.9535) that was introduced by Speaker Heastie and includes over 85 assembly sponsors. The bill proposes to limit outside earned income, close the LLC loophole, place restrictions on legislator-lawyers, and prohibit ownership interests in any company with matters before the state. The bill would limit outside earned income of legislators to no greater than 40% of the annual salary of the state justices of the New York State Supreme Court. And it places restrictions on legislator-lawyers by prohibiting the sharing of legal fees between legislator-lawyers and other lawyers who are not a member of the same law firm, unless the legislator-lawyer actually performs legal work, and the fee is in proportion to the services performed.

Legislators, without a legislative ethics commission written opinion, would be prevented from earning income from ownership interests in any firm, corporation, LLC, or partnership engaged in any lobbying activity (directly or indirectly), representing litigants against the state, contracting with the state, or appearing to have matters before the state. Within 30 days of taking offices, legislators would also be required to submit records of all ownership interests in any company to the legislative ethics commission.                                              (MCPARTLON)


PTSD and TBI in Returning Veterans:  March – June Webinars
MSSNY will be holding a series of CME webinars on PTSD and TBI in returning veterans on seven dates listed below from March through June. The faculty presenters will be Frank Dowling, MD and Joshua Cohen, MD.

Course objectives:

  • Explore the two most prevalent mental disorders facing American veterans today, their causes, symptoms, and comorbidities
  • Outline treatment options including evidence-based psychotherapy and pharmacotherapy
  • Discuss barriers to treatment, including those unique to military culture, and how to overcome them
  • Outline the process of recovery and post-traumatic grow

To register for this webinar, click on a date below and fill out the registration form

Tuesday, March 22, 6-7 PM
Thursday, April 7, 6-7 PM
Tuesday, April 12, 7:30-8:30 AM
Thursday, May 5, 6-7 PM
Thursday, May 19, 7:30-8:30 AM
Thursday, June 2, 6-7 PM
Thursday, June 9, 7:30-8:30 AM                                                                                   (DEARS, ELPERIN)

298 Participants View Zika Webinar; Program Archived on MSSNY’s CME Site
Nearly 300 physicians and other healthcare providers participated in this month’s MSSNY Medical Matters program, entitled “Zika—An Evolving Story”.    The webinar was conducted by MSSNY and the New York State Department of Health and featured Dr. William Valenti, chair of MSSNY’s Infectious Disease Committee and member of the MSSNY’s Emergency Preparedness and Disaster/Terrorism Response Committee and Dr. Elizabeth Dufort,  medical director, Division of Epidemiology from the New York State Department of Health.   This program has been archived to the MSSNY CME website and physicians and other health care providers can view this program free of charge by logging into the MSSNY CME Website.

The MSSNY CME site requires new users to register, but once registered physicians and other health care providers will have a personalized training page to take them to this webinar and other course work located on the site.   New registrants to the site will create a username and password, which should be retained and be used for continued access to the site. Once registered and logged into the site, physicians will be taken to an instruction page.   Click on the tool bar menu located at the top of the page and click on “My training” to view and take the various courses.     MSSNY has over 50 programs at this site and physicians are able to earn continuing medical education credits for each course. 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 online programs have varying numbers of continuing medical education credits, but the majority of the programs are for 1.0 AMA/PRA Category 1 credit™.  Further information on all these programs may be obtained by contacting Pat Clancy at pclancy@mssny.org.
(CLANCY)

Live Seminar on Ebola at MSSNY House of Delegates; Physicians Can Also Participate by Web
The April session of Medical Matters will take place at the MSSNY House of Delegates and is entitled,

“Ebola: A Perspective from the Field”.  The program will be held on Thursday, April 14, 2016 at 2:00pm. Physicians may attend the session at the Westchester Marriott, 670 White Plains Road, Tarrytown, NY 10591 or by webinar.  Registration is limited at the Tarrytown, so physicians are encouraged to register for the live session as soon as possible.   Registration for the live session or by webinar is now open here. Click on the upcoming tab and select the program.

The program will be conducted by Dario Gonzalez, MD, FACEP, Associate Medical Director, Fire Department City of New York/Office of Medical Affairs.  Dr. Gonzalez was deployed for nine weeks by Americares to Liberia, West Africa as part of the US response to the Ebola epidemic.  The educational objective is: Offer perspective and lessons learned from an individual who treated Ebola patients firsthand.

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.

Further information or assistance in registering for any of these programs may be obtained by contacting Melissa Hoffman at mhoffman@mssny.org.
(CLANCY, HOFFMAN)

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

pschuh@mssny.org ldears@mssny.org      mauster@mssny.org  
pclancy@mssny.org jmcpartlon@mssny.org    

 

enews large


JAMA: Physicians’ EHR-Inboxes Are Overloaded
A research letter published online March 14 in JAMA Internal Medicine suggest “some physicians receive more than 100 notifications per day via electronic health record (EHR)-based inboxes, and dealing with this electronic burden requires more than an hour every day.” Researchers arrived at these conclusions after evaluating “the electronic logs of 276,207 notifications received from January 1 through June 30, 2015, by 92 physicians at three large practices (one multispecialty and two primary care practices) in Texas.

“Information overload is of emerging concern because new types of notifications and “FYI” (for your information) messages can be easily created in the EHR (vs in a paper-based system). Furthermore, the additional workload to read and process these messages remains uncompensated in an environment of reduced reimbursements for office-based care. Conversely, EHRs make it easier to measure the amount of information received. We quantified the notifications that physicians received via inboxes of commercial EHRs to estimate their burden.”


THIS WEEK: MSSNY in the News
New York Times – 03/14/16
The End of Prescriptions as We Know Them in New York
(MSSNY President Dr. Joseph Maldonado quoted)
Also picked up in:
Times Union – 03/14/16

State rewrites medical practice
(MSSNY President, Dr. Joseph Maldonado quoted)

The Buffalo News – 03/14/16
In New York, paper prescriptions out, computers in
(MSSNY President, Dr. Joseph Maldonado quoted

 

The Oneida Daily Dispatch (AP) – 3/13/16
NY mulls legalizing doctor-assisted suicide
(MSSNY mentioned)

The Daily Freeman(AP)  03/13/16
NY Legislature mulling doctor-assisted suicide bills
(MSSNY mentioned)

The Troy Record (AP) 03/13/16
New York lawmakers eye assisted suicide law
(MSSNY mentioned)

The Saratogian (AP) – 03/13/16
New York lawmakers eye assisted suicide law
(MSSNY mentioned)

Private Officer Breaking News – 03/14/16
New York to Discard Prescription Pads, and Doctors’ Handwriting, in Digital Shift
(MSSNY President Dr. Joseph Maldonado quoted)

Utica Observer – 03/15/16
E-scripts: Is everyone ready?
(MSSNY President Dr. Joseph Maldonado quoted)

New York State Osteopathetic Medical Society – 3/15/2016
NYSOMS joins MSSNY in Powerful Day of Advocacy
(MSSNY mentioned)

Thefix.com – – 03-17/16
New York State Is Doing Away With Paper Prescriptions
(MSSNY President Dr. Joseph Maldonado quoted)

Crain’s Health Pulse – 03/18/16
As e-prescribing deadline looms, DOH issues waivers
(Elizabeth Dears, MSSNY’s senior vice president for legislative and regulatory affairs quoted)


Are You a Pre-residency IMG looking for Experience?  Are You a Physician Who Can Help?
MSSNY’s IMG Committee, through its Clearinghouse of Opportunities Program, seeks to place IMG candidates seeking externship and internship opportunities.

Contact us if you are an IMG looking for a meaningful experience to help you become familiar with the US healthcare system and help prepare you for residency training. Past participants have worked as scribes, entering notes into electronic medical records; performed chart audits for preventive care as a quality improvement measure; educated patients; coordinated with insurance and healthcare providers; helped with research and special projects, etc.

If you are looking for a way to stay connected to medical practice as you pursue residency training, or if you have a position to offer an unlicensed medical graduate, please contact Ruzanna Arsenian (rarsenian@mssny.org). Graduates should include a CV, and those with previous experience in their home countries as faculty members, practicing physicians, or researchers, should be sure to mention that.  Let us know where you are located, how far you would be able to travel, and whether or not you require a paid position or if you could accept a role as a volunteer.

Physicians who are willing to help familiarize an unlicensed medical graduate with medical practice in the US are asked to describe the role they would ask the graduate to fill and include any specific requirements in terms of hours or duties.  Please indicate if the position will include observership experience with a formal evaluation leading to a possible letter of recommendation, or will offer payment for office work performed.


Commit to Pursuing Your Leadership Potential
Join the American Association for Physician Leadership from April 13-15 in Washington, D.C. for the 2016 Spring Institute and engage with health care’s influencers to find solutions to today’s toughest challenges. Register today for leadership courses from the American Association for Physician Leadership®, formerly ACPE, and earn up to 35 CME credits.

Recommended courses:

  • Physician in Management Series (35 CME/Credits)
    Gain a solid foundation to succeed in your new leadership role.
  • Managing Physician Performance (24 CME/Credits)
    Learn to effectively hire, engage and manage physicians within your organization.
  • Election 2016 and Health Policy for Physician Leaders (11 CME/Credits)
    Get insight from health policy experts and learn how to communicate with policymakers.

Register today for leadership courses from the American Association for Physician Leadership®, formerly ACPE, and earn up to 35 CME credits.
View All Courses
Hurry! Hotel group rate expires March 28. 


Zika Virus Update from NYSDOH
New York officials announced a new plan to combat Zika on Thursday. The state of New York plans to “monitor and target a type of mosquito that officials fear could spread the Zika virus,” in addition to distributing “prevention kits to pregnant women.” Thus far the state has reported 49 cases of Zika, all from people who have recently traveled to affected areas, the AP says. Gov. Andrew Cuomo said Thursday that officials “expect that number to go up” but are unsure “how high.”

Health Advisory: Expansion of Zika Virus Testing to Pregnant Women Who Had Unprotected Sex With A Partner Who Traveled to An Area With Active Mosquito-borne Transmission of Zika Virus – March 10, 2016


NYU Med Offerings: Dietary Strategies in Cardiovascular Risk Reduction
Thursday, May 19, 2016, 12:30 PM – 5:30 PM
To Register and for more information: http://www.med.nyu.edu/cme/diet_cardiovascular
The NYU Post-Graduate Medical School designates this live activity for a maximum of 4.25 AMA PRA Category 1 Credits™. Physicians should claim only the credit commensurate with the extent of their participation in the activity. ​

The course will cover topics such as the Mediterranean Diet, the Vascular Biology of Eating, Plant Based Nutrition and explore the evidence and controversies surrounding saturated fat, cholesterol, sugar and salt.  Attendees will also be instructed in dietary assessment and dietary counseling with the latest innovations in counseling—motivation/technology. The course will also offer a unique lecture on the link between the human microbiome and cardiovascular disease.

Advances in Cardiovascular Risk Reduction
Friday, May 20, 2016, 8:30 AM – 3:45 PM
To register and for more information: http://www.med.nyu.edu/cme/cardiovascular
The NYU Post-Graduate Medical School designates this live activity for a maximum of 7.00 AMA PRA Category 1 Credits™. Physicians should claim only the credit commensurate with the extent of their participation in the activity.

This one-day course will cover state-of-the-art management of patients with cardiovascular risk factors, with a focus on prevention. This year’s program focuses on recent clinical trial results with implications in the management of cardiovascular disease risk factors, such as diabetes, hypertension and ischemia. Additional topics include new developments in PCSK9 treatments for familial hypercholesterolemia, the use of aspirin in cardiac prevention and weight loss surgery insights.


CLASSIFIED

Physician Opportunities

Family & Internal Medicine Opportunity Just 50 miles North of NYC
Top $$ AND potential partnership with large multi-specialty physicians’ group + the balance of work & personal life you have been seeking. Perfect suburban area just 50 miles north of NYC. This is a growth position with the right person moving into a partnership opportunity within two to three years. You will enjoy a salary of $175K+ as well as:
• A monthly bonus potential
• Health, Dental, Vision and prescription insurance
• 3 weeks’ paid vacation time off annually
• 6 federal Holidays off with pay
• A $2500 CME reimbursement
• A 401K plan with company match
• Company pays 75% of a single premium life insurance policy at twice your annual salary
• Paid malpractice insurance, plus paid DEA and license renewals
The ideal candidate will possess the following:
• BE/C in Family Medicine or Internal Medicine
• Active NYS license
• Current DEA #
• Experienced as well as New Grads welcome to apply
**Relocating physicians are welcome and relocation assistance will be offered to the right candidate!**
For immediate consideration and additional information on position details please contact Laura Rappleyea at 845-344-3434 or lrappleyea@hereshelp.com and send CV’s for review.

Neurologist & Pain Management Physician Needed
A growing multi-specialty group in Orange County is looking for both a Neurologist and Pain Management Physician to join their group. This position will work with the headache center Neurologist/Pain Management Specialist. All subspecialties are welcome.
The ideal candidate will possess the following:
• BE/C in Family Medicine or Internal Medicine
   • Active NYS license
   • Experienced as well as New Grads welcome to apply
   • Experience in procedures and utilizing an integrated comprehensive approach to pain management.
For immediate consideration and additional information on position details please contact Laura Rappleyea at 845-344-3434 or lrappleyea@hereshelp.com and send CV’s for review.


OB/GYN Opportunity in the Hudson Valley
Are you looking for a great work/life balance? We are looking for an OB/GYN to join the team. We are looking for a provider to provide comprehensive primary health care to a select population of essentially healthy women, participate in the care of women with complications & responsible for providing a full range of agency approved antepartum, intrapartum, postpartum, gynecological and family planning service.
The ideal candidate will possess the following:
• BE/C in Family Medicine or Internal Medicine
       • Active NYS license
       • Experienced as well as New Grads welcome to apply
For immediate consideration and additional information on position details please contact Laura Rappleyea at 845-344-3434 or lrappleyea@hereshelp.com and send CV’s for review
.


Pediatrician Opportunity in Orange County, New York
A prestigious multi-specialty physicians’ group seeks a family driven
Pediatrician to join their group.
The ideal candidate will possess the following:
• BE/C in Family Medicine or Internal Medicine
   • Active NYS license
   • Experienced as well as New Grads welcome to apply
For immediate consideration and additional information on position details please contact Laura Rappleyea at 845-344-3434 or lrappleyea@hereshelp.com and send CV’s for review. 
.


Psychiatry Opportunity in New York’s Beautiful Hudson Valley
Our client, a prestigious multi-specialty physicians’ group who has been recognized as a Patient-Centered Medical Home by the National Committee for Quality Assurance, seeks a Psychiatrist to join their group.
The ideal candidate will possess the following:
• BE/C in Psychiatry
   • Active NYS license preferred
   • Experienced as well as New Grads welcome to apply
For immediate consideration and additional information on position details please contact Laura Rappleyea at 845-344-3434 or lrappleyea@hereshelp.com and send CV’s for review.



Join Well Established Solo Female OB/GYN Physician Practice in New York City
Quality oriented, looking for MD for long term career opportunity. New graduates welcome to apply. Affiliated with Lenox Hill Hospital. The current office has a AAAA certified operating room and an AIUM accredited ultrasound service. Looking to establish another location. Great opportunity to balance personalized practice with quality lifestyle. Please summit CV to obgynpractice130@gmail.com


Jerome I. Sager – Attorney at Law
The health care law experts representing medical professionals for more than 25 years.  See us for Professional Medical Conduct Defense, Medicaid and Medicare Fraud Cases, DEA and Controlled Substance Issues, Third party insurance issues. We can handle most legal matters. Call us for a free consultation. 212-685-2333 / 917-312-6631, jeromesager@cs.com

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

 

 

 

 

 

 

 

 

 

 

 

 

 

March 11, 2016 – Opting Out of What Is Being Sold to Us

drmaldonado PRESIDENT’S  MESSAGE
 Dr. Joseph R.  Maldonado
asset.find.us.on.facebook.lgTwitter_logo_blue1

March 11,  2016
Volume 16, Number 9

Dear Colleagues: 

Opting Out of the Pipe Dream Floated to Most Doctors

The latest mantra being floated by the purveyors of the next iteration to transform healthcare in America is Value Based Payments.  Doctors are told that they will have to adjust to a new reimbursement methodology that changes from fee for service to value based payments.  Those preaching the virtues of this new gospel aim to convince physicians that this new reimbursement methodology rewards them for what they do best.  They extol the virtues of it and label those aspects of the payment methodologies that carry the greatest financial risk, “premium” level engagement.  Surely, those touting such “premium” level methodologies cannot possibly be serious given the just published CMS outcomes for the Value Modifier Program for quality and cost effectiveness measures.  One has to ask whether the failure to attain meaningful positive improvements in physician compensation for value based services is a reflection of Bent Flyvbjerg’s notions of “optimism bias” or simply “strategic misrepresentation.”

Abysmal Misrepresentation

This year’s results indicate that only 1.5% of entities which participated in the CMS’ Value Modifier Program were able to attain a positive adjustment to their reimbursements for 2016.  The prior year’s review indicated that only 0.86% of entities were able to gain a positive adjustment for 2015.  I await the spin that there has been a 50% improvement in physician capability to garner upward adjustment in reimbursement for their stellar quality and cost effectiveness performance.  These numbers clearly show the abysmal misrepresentation that participation in these quality programs offer a real opportunity for physicians to improve their reimbursements.  Consider the investments in time, energy and monies of the 8,395 practices representing 98.5% of those eligible for the touted, but missed, upward adjustments.

The “Game” Is rigged

These dreadful results make it clear to me that participation in these value base payment schemes is a pipe dream for most physician practices.  It is the promise held out by the claw machines for prizes in game arcades.  The prizes are real.  The likelihood of grabbing the prize is low.  The game is rigged.  With no firm guaranty of physicians being made whole in the Health Republic debacle, it is perplexing to me why anyone would believe the promise of a value based payment scheme that offers anything better than the abysmal outcomes reported by the CMS Value Modifier Program in the past two years or the chances with the claw machines in the gaming arcade.

I’ve opted out of this game.  Stop the optimism bias.  Stop the strategic misrepresentation.

Joseph Maldonado, M.D, MSc, MBA, DipEBHC
MSSNY President

Please send your comments to comments@mssny.org


MLMIC_011916_Enews_550x150


Capital_Update_Banner

By All Accounts MSSNY’s Lobby Day A Success – MSSNY Thanks All Who Participated
MSSNY’s “Physician Advocacy Day” was held in Albany earlier this week on March 8th. More than 300 physicians, medical students, residents, alliance members and friends of medicine participated in the event. By all accounts, the Lobby Day was a real success! 

The March 8th program has been archived and is available for viewing here.

A full slate of legislators and top Administration officials participated including Donna Frescatore, Executive Director, NYS Health Benefit Exchange; Jason Helgerson, Medicaid Director, NYS Department of Health; Troy Oechsner, Executive Deputy Superintendent, Department of Financial Services; Senate Health Chair Kemp Hannon; Assembly Health Chair Richard Gottfried; Senate Insurance Chair James Seward; Assembly Insurance Chair Kevin Cahill.

In addition, Assembly Majority Leader Joe Morelle and Senate Majority Leader John Flanagan also addressed the physician advocates in  the morning proceedings. A brief informal luncheon in which members of each House also attended and spoke with their constituents followed the morning program.  In the afternoon participants met with their elected representatives and/or their staff to discuss the organized medicine’s priority issues.

MSSNY’s leadership including its President, Joseph Maldonado, MD, President-Elect, Malcolm Reid, MD, Vice-President, Charlie Rothberg, Immediate Past Presient, Andrew Kleinman, MD, HOD Speaker Kira Geraci-Ciardullo, MD and Legislative Committee Chair Paul Pipia, MD led discussion which ensued with the speakers on important issues including restoration of funding to the Excess program, a Guaranty Fund for failed health insurers like Health Republic, identification of funding to reimburse physicians for care provided to the now defunct Health Republic, and defeat of the retail clinic and workers compensation proposal.

MSSNY would like to thank all county medical society executive directors, the leadership of the NYS Osteopathic Medical Society, the leadership of several specialty medical societies including, in particular, ACOG and David Welch, MD for bringing more than 100 medical students, residents and aspiring High School students to participate in this event.

IMG_3272
Dr. Robert Goldberg with Touro medical students at MSSNY’s Lobby Day
IMG_3291
(left to right) Senator Kemp Hannon, Chair, Senate Health Committee; Assemblyman Kevin Cahill , Chair, Assembly Insurance Committee; Senator James Seward, Chair, Senate Insurance Committee
IMG_3384
Senate Majority Leader John Flanagan addresses physicians at MSSNY’s Lobby Day

(DIVISION OF GOVERNMENTAL AFFAIRS)


Physicians Urged to Oppose Huge Cuts To Excess Medical Liability Insurance Program
While many leaders and staff in the Assembly and Senate have indicated strong concerns with the proposal in the Executive Budget to cut funding for the Excess Medical Malpractice Insurance Program by $25 million, physicians must continue to contact their legislators to urge that they continue to fight to assure this funding is restored in the final State Budget.

The proposal would result in 55% of physicians who currently receive this additional coverage being dropped from the program.  Across much of upstate New York, only neurosurgeons, bariatric surgeons and OB-GYNs would keep this coverage.   And downstate, many primary care physicians, ophthalmologists, otolaryngologists, pathologists, dermatologists and allergists would be dropped.

The Excess Medical Liability Insurance Program provides an additional layer of $1M of coverage to physicians with hospital privileges who maintain primary coverage at the $1.3 million/$3.9 million level.  The program was created over 30 years ago as a result of the liability insurance crisis of the mid-1980’s to address concerns among physicians that their liability exposure far exceeded available coverage limitations.  Absent meaningful liability reform, with verdicts and physician liability premiums continuing to be far out of proportion compared to the rest of the country, full funding for the Excess program is absolutely essential in today’s very challenging practice environment.

At a time when the state is seeking to attract and retain physicians, this proposal deters physicians from wanting to practice in New York State for fear of putting themselves and their families in financial jeopardy for judgements and settlements exceeding the limits of their primary coverage.  Please urge your legislators to restore full funding for the program!                                                                 (AUSTER, DEARS)


Urge Your Legislators to Reduce Liability Insurance Costs, Not Raise Them!
This week, physicians and students from across New York State came to Albany to remind their legislators that, in light of the huge financial pressures threatening the viability of physician practices and our health care delivery system, no further liability increases can be tolerated.  Please join your colleagues by contacting your legislators (http://cqrcengage.com/mssny/app/write-a-letter?4&engagementId=105729) to urge that they oppose legislation (A.285-A, Weinstein/S.6596, DeFrancisco) that could drastically increase New York’s already exorbitantly high medical liability premiums by changing the medical liability Statute of limitations to a “Date of Discovery” rule.   

MLMIC’s estimate is that this bill could increase physician liability premiums by nearly 15%!   New York physicians continue to pay liability premiums that are among the very highest in the country.  By way of example, a neurosurgeon practicing on Long Island must pay an astounding $338,252 for just one year of insurance coverage and an OB/GYN practicing in the Bronx or Staten Island must pay $186,639.   New York far surpasses all other states in terms of total medical liability payouts, per capita payments, and medical liability awards above $1 million.

MSSNY has joined the Greater New York Hospital Association (GNYHA) and Healthcare Association of New York State (HANYS) in an ad in the Albany Times-Union and City & State calling for reduction in these exorbitant costs.

To make matters even worse, trial lawyers are aggressively pushing the Legislature to consider additional liability expansion bills such as legislation that would eliminate the statutory limitation on contingency fees in medical liability actions, legislation that MLMIC has estimated could have the effect of raising your premiums by over 10%.   Please tell your legislators to enact comprehensive liability reform to bring down these costs, not legislation that increases them!
(AUSTER, DEARS)
 


Physicians Urged to Contact Their Representatives to Urge Defeat of the Retail Clinic Proposal
Physicians are urged to contact their elected representatives to urge rejection of the retail clinic proposal included in the Governor’s budget which would  permit public corporations to own and operate retail clinics, or “limited service clinics”, throughout New York State. Go to the following link to send a letter to your legislators.

While various versions of this legislation exist, each seeks to allow publicly traded corporations to establish health clinics without need for certificate of need for review—for the first time in New York State. By permitting this practice, NYS will infringe upon the independence of medical decision-making and the integrity of the doctor-patient relationship. Furthermore, corporately owned and operated retail clinics will open the floodgates to conflicts of interest posed to exist as retail clinics directly profit from the very prescriptions they write, and treatments they recommend—all under the very same roof.

At a time when we in NYS are working hard to ensure and expand primary care and medical home capacity, retail clinics threaten the very viability of primary care physician’s practices. Contact your legislator today, and urge them to oppose the expansion of Retail Clinics in New York State.
(McPARTLON, DEARS)
 


Urge the Inclusion of Monies to Pay Health Republic Claims in the State Budget
This week numerous key legislative leaders articulated their awareness that failure to pay outstanding Health Republic claims will have a seriously destabilizing impact on regional health care delivery systems across the State.  Therefore, as the Assembly, Senate and Governor’s office begin in-depth negotiations on the State Budget, it is imperative that physicians continue to contact their legislators to urge that a Guarantee Fund or other allocation of monies be included in the State Budget to assure these claims are paid.  To send a letter, click here.

So far, 35 Assemblymembers have joined Assembly Health Committee Chair Richard Gottfried and Assemblyman Charles Lavine (D-Nassau County) in co-sponsoring legislation (A.9311) to establish a Guarantee Fund to help to assure the payment of the hundreds of millions that Health Republic owes physicians and hospitals across New York State, as well as to protect consumers and health care providers from future health plan insolvencies.  To view the list of co-sponsors, click here.

Identical legislation (S.6667, Valesky, also with several co-sponsors – see here) has been introduced in the State Senate.

You must remind your legislators that, with physicians facing so many other challenges in seeking to keep their doors open to deliver patient care, including high liability costs, expensive electronic medical record equipment, employee costs, insurance companies dropping physicians from their networks and declining payments from insurers, failure to assure payment for these claims would have serious negative consequences for patient care and employment in your community.
(AUSTER, DEARS)


Payment of Health Republic Claims, Restoring Excess Insurance Cuts, Listed as Priorties of Senate Democratic Conference
The New York State Senate Democratic Conference this week released a 17-page letter outlining its Budget priorities as the Assembly and Senate Majority conferences were planning to advance its own suggested modifications to the Governor’s proposed Budget.  Of note, Senate Democratic Leader Andrea Stewart-Cousins’ letter to Senate Majority Leader Flanagan included the following items consistent with MSSNY’s Budget advocacy:

  • Restoring the $25 million cut to the Excess Medical Malpractice Insurance Program, and extending the program for 3 years;
  • Establish a Health Care Guarantee Fund “to reimburse providers for uncompensated care as a result of the collapse of health insurance companies such as Health Republic”;
  • Rejecting the proposed Workers Compensation reforms;
  • Rejecting the proposal to permit the establishment of limited service (retail) clinics;
  • Rejecting the proposal to eliminate “prescriber prevails” in fee for service Medicaid and Medicaid managed care.
    (AUSTER, DEARS)


Physicians Must Continue to Let Their Legislators Know of Concerns With Adverse Workers’ Compensation Budget Proposal
While leaders and staff in both the Assembly and Senate have articulated significant concerns with the sweeping Workers Compensation reform proposals contained in the Executive Budget, all physicians must continue to contact their local legislators to urge that these proposals be rejected as in-depth negotiations towards a final Budget commence.

MSSNY staff continues to meet with key legislative leaders and staff to voice its very serious concerns with Budget proposals that would:

  • Expands the list of non-physicians who can treat and be paid directly for care to injured workers without any clarity as to how these non-physicians will coordinate care delivery when specialized care is needed;
  • Expand the circumstances when a physician or other health care provider can have their authorization removed and empowers the Board to impose significant fines on a physician or any other Board-authorized health care provider for violating a Workers Compensation rule;
  • Remove the authority of county medical societies to recommend physicians to serve as treating providers or independent medical examiners under Workers Compensation.
  • Reduce choice for injured workers by expanding the circumstances when an injured worker must seek care within a PPO network;
  • Remove the requirement for a referral by a physician for an injured worker as a pre-condition to receive psychological care; and
  • Remove the ability of professional associations, such as MSSNY, to recommend arbitrators to resolve medical fee disputes between health care providers and carriers.

Working closely with MSSNY, county medical society leaders from across the State have been writing to, and meeting with, their local Senators and Assemblymembers to request that these proposals be jettisoned from the Budget. Moreover, many of these proposals are being opposed by other stakeholders, including the NYS AFL-CIO, the NYS Trial Lawyers Association, the Injured Workers Bar Association and the New York Insurance Association.
(AUSTER, DEARS)                                                                             

Legislation to Make Changes to the ERx Law to Exempt Low Volume Prescribers Passes NYS Senate; Amendments Introduced in The Assembly
Legislation (S.6779, Hannon) which would completely exempt low volume prescribers from the e-prescribing mandate passed the Senate this week. Amendments were made to the Assembly counterpart (A.9335, Gottfried) to clarify that when a low volume prescriber terminates his/her low volume status because they intend to issue more than twenty five prescriptions in a year the validity of the first twenty five prescriptions remain intact.  The amendments also make clear that a provider who certifies to the Department that he/she is a low volume prescriber must make a notation in the patient’s medical record that the reason a paper script was issued is that the prescriber is certified as low volume. This will obviate the need to contact the Department each time he/she issues a paper script.

MSSNY is aware that physicians who are low volume prescribers (those who write less than 25 prescriptions a year) are receiving waivers from the mandate; but those waivers are only good for one year requiring low volume physicians to reapply each year. This measure would eliminate the need for them to re-apply for a waiver each year.

The bill would also amend the eRx law by eliminating existing provisions which require prescribers who invoke one or more of the exemptions to the eRx mandate to contact the department when they exercise an exemption. Instead, the bill would require a prescriber to make a notation in the patient’s record that the exercise of the exemption was utilized.

It is anticipated that the Senate will recall and amend S.6779 to incorporate the amendments thereby making it the same as the Assembly version and will re-pass it as soon as possible.                       (DEARS, AUSTER) 


Legislation to Enable Nurses in LTC Facilities to Act as Agent for the Physician Passes NYS Senate
Legislation (A.9334, Gottfried/S.6778, Hannon), supported by MSSNY, passed the Senate this week and was advanced to the floor of the Assembly. Specifically this proposal would allow prescriptions for non-controlled substances for nursing home residents to be made orally rather than electronically.  For decades, nurses, acting as the agent to the physician, have been authorized to take oral orders from the physician for non-controlled medications through the nursing home medication administration system to deliver medications to residents safely and without delay. In this long-standing system, the physician then routinely signs the oral orders within 48 hours.

Physicians are not physically present in nursing homes 24 hours a day. Nurses serve a vital role ensuring proper medication administration in nursing homes. This bill is necessary to assure that physicians’ orders are timely filled to protect the health and well-being for each resident in a safe and secure method.
(DEARS, AUSTER)


CMS Proposes Huge Changes to Payment for Medicare Part B Drugs; Prompts Negative Reaction From Physician Groups and Pharma
This week CMS proposed testing a new model for covering drugs under Medicare Part B, such as chemotherapy medications, which immediately prompted concerns from several groups and members of Congress, as was noted in the New York Times.  CMS is proposing to change the reimbursement methodology of Part B drugs from the current 6% add-on to the “Average Sales Price (ASP)” to 2.5% plus a flat fee.  CMS also proposed a second phase that would implement value-based purchasing tools similar to those employed by commercial health plans, pharmacy benefit managers, hospitals, and other entities that manage health benefits and drug utilization.

The American Society of Clinical Oncology released a statement condemning the proposal noting that “it is inappropriate for CMS to manipulate choice of treatment for cancer patients using heavy-handed reimbursement techniques…..Physicians did not create the problem of drug pricing and its solution should not be on their backs.”

To read the CMS press release and other materials describing CMS’ proposal, click here.                                                                                                             (AUSTER)

Clinical Update for Primary Care Providers on Pre-Exposure Prophylaxis (Prep)
The New York State (NYS) Department of Health AIDS Institute Clinical Education Initiative (CEI) and Mount Sinai Institute for Advanced Medicine will be offering an educational program on the Treatment for Hepatitis C: New Tests, New Drugs & New Recommendations on Thursday, March 31, 2016, 9:00am – 12:00pm at St. Mary’s Healthcare, Amsterdam – Carondelet Pavilion Auditorium, 380 Guy Park Ave, Amsterdam, New York 12010. 

RegistrationOn-line registration is required as space will be limited.

This free event will focus on the current epidemiological trends, updates on prevention and care best practices, and NYSDOH guidance on HIV & HCV, as well as therapeutic regimens and monitoring plans.

This event is open to New York State clinical providers, such as physicians, physician assistants, nurses, nurse practitioners, and pharmacists.  The New York State (NYS) Department of Health AIDS Institute Clinical Education Initiative (CEI) is designed to enhance the capacity of New York’s diverse health care workforce to deliver clinical services to improve health outcomes related to HIV, sexually transmitted diseases (STDs) and hepatitis C (HCV). The aims of the CEI are fourfold:

  • provide progressive HIV, HCV and STD education to clinicians;
  • disseminate AIDS Institute clinical practice guidelines;
  • expand the base of providers able to diagnose and care for HIV, HCV and STD patients; and
  • foster partnerships between community-based providers and HIV, HCV and STD specialists.

Mount Sinai serves as The HIV/HCV Center and provides free education and training for medical providers in NYS. Clinicians are updated on the latest NYS guidelines to enhance the capacity to deliver clinical services to improve health outcomes related to HIV/HCV.  Further information is available by contacting Robert Walsh at 212-636-1315 or at rwalsh@chpnet.org.
(CLANCY) 


Learn about MOLST  and eMOLST Dr. Pat Bomba VP and Medical Director, Geriatrics, Excellus BlueCross Blue Shield

When: Tuesday, March 15, 2016 @  12:30-1:30 PM

WHAT:

  • Learn about the MOLST and eMOLST form and how it should be used with patients.
  • Describe how the NYS eMOLST: Improves Quality & Patient Safety and Reduces Harm
  • Learn about the 8 step MOLST protocol and how it can be used effectively
  • Describe how eMOLST aligns with move toward Value Based Payment

Additional information can be found here.

To register for this CME webinar:  Click here and fill out registration form.

For additional information, contact Miriam Hardin at: mhardin@mssny.org or (518) 465-8085

Accreditation Statement: 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.

Disclosure Statement: The Medical Society of The State of New York relies upon planners and faculty participants in its CME activities to provide educational information that is objective and free of bias. In this spirit and in accordance with the guidelines of MSSNY and the ACCME, all speakers and planners for CME activities must disclose any relevant financial relationships with commercial interests whose products, devices or services may be discussed in the content of a CME activity, that might be perceived as a real or apparent conflict of interest.

Any discussion of investigational or unlabeled uses of a product will be identified.


MSSNY to Conduct Medical Matters Webinar on Zika Virus on March 16, April Session on Ebola
The Medical Society, in conjunction with the New York State Department of Health will conduct a Medical Matters webinar on the  “Zika Virus: An Evolving Story” on March 16th at 7:30 a.m.   Registration for this program is now open.  Click on the upcoming tab and select the programs.

The educational objectives for this program are: 1) Describe the epidemiology of Zika Virus infection;

2) Understand the modes of transmission; 3) Understand how to advise patients; and 4) Learn methods for prevention of infection.  William Valenti, MD, chair of MSSNY’s Infectious Disease Committee, and Elizabeth Dufort, MD,  Medical Director, Division of Epidemiology from the New York State Department of Health will conduct this presentation.

The April session of Medical Matters will take place at the MSSNY House of Delegates and is entitled, “Ebola: A Perspective from the Field”.  The program will be conducted by Dario Gonzalez, MD, FACEP. Associate Medical Director,  Fire Department City of New York/Office of Medical Affairs.  Dr. Gonzalez was deployed for nine weeks by Americares to Liberia, West Africa as part of the US response to the Ebola epidemic.  The program will be held on Thursday, April 14, 2016 at 2:00pm. Physicians may attend the session at the Westchester Marriott, 670 White Plains Road, Tarrytown, NY 10591 or by webinar.  Registration is now open. Click on the upcoming tab and select the program.

The educational objective is: Offer perspective and lessons learned from an individual who treated Ebola patients firsthand.

The May session will be “Radiological Emergencies”, this session will be held on May 18, 2016 at 7:30 AM. (Please note that this session was originally scheduled for March 16, 2016) Faculty for this session will be Cham Dallas, PhD.  Dr. Dallas is a professor in the Department of Health Policy and Management at the College of Public Health, University of Georgia.  He is also the Director of the Institute for Disaster Management at the University of Georgia and a Board Member of the National Disaster Life Support Foundation (NDLSF).  Dr. Dallas has a national/international reputation in toxicology and emergency preparedness and response, including over 30 years of experience.

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.

Further information or assistance in registering for any of these programs may be obtained by contacting Melissa Hoffman at mhoffman@mssny.org.
(CLANCY, HOFFMAN) 


MSSNY’s Opioid Webinars are Now Available Through Its CME Online Site
The Medical Society has archived its opioid webinar series on its continuing medical education website at http://cme.mssny.org/   The webinars that are currently on the site are:  Webinar 1 Pain Management at the Crossroads:  A Tale of Two Public Health Problems and Webinar 2   Rational Opioid Prescribing:  Is this Possible for Chronic Pain?  Physicians and other prescribers can earn up to one hour of continuing medical credits by viewing this webinar and completing the test.    The reminder of the webinars will be placed on line in the very near future. 

The MSSNY CME site requires new users to register, but once registered physicians and other health care providers will have a personalized training page to take the webinars and other course work located on the site.   New registrants to the site will create a username and password, which should be retained and be used for continued access to the site. Once registered and logged into the site, physicians will be taken to an instruction page.   Click on the tool bar menu located at the top of the page and click on “My training” to view and take the various courses.     MSSNY has over 50 programs at this site and physicians are able to earn continuing medical education credits for each course. 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 online program has various programs with the number of continuing medical education credits, but the majority of the programs are for 1.0 AMA/PRA Category 1 credit™.  Further information on all these programs may be obtained by contacting Pat Clancy at pclancy@mssny.org.                  (CLANCY) 


PTSD And TBI in Returning Veterans:  March – June Webinars
MSSNY will be holding a series of CME webinars on PTSD and TBI in returning veterans on seven dates listed below from March through June. The faculty presenters will be Frank Dowling, MD and Joshua Cohen, MD.

Course objectives:

  • Explore the two most prevalent mental disorders facing American veterans today, their causes, symptoms, and comorbidities
  • Outline treatment options including evidence-based psychotherapy and pharmacotherapy
  • Discuss barriers to treatment, including those unique to military culture, and how to overcome them
  • Outline the process of recovery and post-traumatic grow

To register for this webinar, click on a date below and fill out the registration form.

Tuesday, March 22, 6-7 PM
Thursday, April 7, 6-7 PM
Tuesday, April 12, 7:30-8:30 AM
Thursday, May 5, 6-7 PM
Thursday, May 19, 7:30-8:30 AM
Thursday, June 2, 6-7 PM
Thursday, June 9, 7:30-8:30 AM
(ELPERIN, DEARS)

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 ldears@mssny.org      mauster@mssny.org  
pclancy@mssny.org jmcpartlon@mssny.org    

 

 


enews large

Council Notes

At the March 8 meeting in Albany, Council approved the following items:

  • MSSNY should seek supplemental funding sources other than Medicare funding to increase the number of residency training positions in New York State, and should take the lead in bringing together the various parties to devise a supplemental funding source to meet the medical educational and workforce needs of New York State. This should involve State officials responsible for health and medical education, leaders of academic medical centers, and businesses that are thriving economically and that benefit from the work of the medical profession. Medicare should not bear major responsibility for GME funding. Strong arguments can be made that health insurers, pharmaceutical companies and device manufacturers should also contribute to the cost of graduate medical education.
  • The MSSNY president may decide if a non-MSSNY physician group (such as the Out-of-Network Preservation Work Group) warrants creation of its own special committee within MSSNY. Each President-Elect of MSSNY shall continue to analyze on an annual basis MSSNY’s committee structure with an intention to eliminate any committee not felt to be contributing directly to MSSNY’s mission, and combining committees wherever possible to reduce duplication, confusion and cost.  MSSNY may sign on to letters with non-MSSNY groups when consistent with existing MSSNY policy and at the discretion of the President.


State Awards $112.3 to Long Island Hospitals
The state has awarded $112.3 million to Long Island hospitals and clinics for projects ranging from repairs at Nassau University Medical Center to building an emergency department in East Hampton.

The 16 grants, part of $1.5 billion statewide announced March 4, are intended to help health care providers involved in New York’s Delivery System Reform Incentive Program, or DSRIP.

Under the program, up to $6.42 billion will go to safety-net or public hospitals and their community collaborators statewide if they cut avoidable hospital use among Medicaid recipients by 25 percent by the end of 2019. To do that, hospitals and community organizations must work together to improve access and coordination of patients’ care. These grants — an addition to the $6.42 billion — are meant to assist with that.

REMINDER:  All Prescriptions Must Be Sent Electronically Beginning March 27th
Tell your patients NOW that you will NOT be issuing papers scripts as of March 27. With the e-prescribing mandate quickly approaching, we at MSSNY are concerned about the lack of preparedness expressed by New York doctors.  Our recent survey showed that more than 40% of responding physicians are not yet prepared to meet the e-prescribing mandate.
We DO NOT expect an extension of the deadline, and urge you to ACT NOW to ensure you are compliant with the law.


From Socio-Med: 38,000 Doctors Will Have to Revalidate with CMS
I have been told that NGS Medicare is required by CMS to initiate the REVALIDATION process for 38,000 NYS practitioners. Please be on the LOOK OUT for a yellow envelope.  The official letter will be mailed from National Government Services in a yellow envelope: J6/JK Provider Enrollment Sample Yellow Envelope

If you rely on Medicare payments, you do not want your cash flow disrupted.  Please be sure that you and your staff are aware of the vital mailing.  In addition, please share this information with your colleagues, especially those who might not use email. The yellow envelope for NGS Medicare should not be overlooked.


Expansion to Include Pregnant Women with Sex Partner Who Traveled To a Country with Zika Virus Transmission
On March 9, the NYSDOH was directed by Gov. Cuomo to expand free Zika virus testing to pregnant women who engaged in unprotected sex with a partner who had recently traveled to a country where Zika is present.  Meanwhile, the city is ramping up its efforts in preparation for mosquito season to protect against transmission of the virus in New York. Health Commissioner Mary Bassett said the city is increasing the number of mosquito traps around the city by 20% to 50%.

To date, NYSDOH’s Wadsworth Center has conducted tests on samples from more than 1,400 patients and 40 have been found to be positive. With the exception of the one possible case of sexual transmission, all of the infected patients have been returning travelers from countries where Zika virus is ongoing.

NYSDOH also already offers testing to pregnant women who themselves have traveled to an area with ongoing Zika virus transmission during their pregnancy, as well as to non-pregnant women, men or children who developed symptoms of Zika virus within 4 weeks of travel to an area with active Zika virus transmission.


CDC: NYS has High Rate of Childhood Flu Vaccination
The New York State DOH is being honored, for the second year in a row, by the CDC for having high rates of childhood influenza vaccine coverage. During the 2014-15 flu season, 67 percent of New York children (outside of NYC) 6 months to 17 years of age received the flu vaccine, well above the national average of 59 percent. Childhood influenza vaccination coverage rates in other states ranged from 45.3 percent to 78.6 percent.


CMS Mulling New Payment Models For Some Medicare Part D Prescription Drugs
On March 8, Medicare proposed new models to determine the best “ways to pay for drugs administered in a doctor’s office, including many cancer treatments.” Dr. Patrick Conway, acting principal deputy administrator and chief medical officer of CMS, explained that the Federal government will not decide which drugs physicians can prescribe, but the objective “is to address financial incentives in the current payment system that can encourage the use of a more expensive drug, when a cheaper medication is just as effective.” According to Conway, “‘Perverse incentives’ in the current rules do not benefit patients or Medicare.”

The NY Times http://nyti.ms/1P46uDU reports CMS plans to “test new ways to pay for prescription drugs in an effort to slow the growth of Medicare spending on medicines while encouraging doctors to choose the most effective treatments for their patients.” Dr. Conway said the government was not infringing on the discretion or authority of doctors. “Physicians and clinicians will make the prescribing decisions,” he said. “Nothing limits the ability of physicians to prescribe the most appropriate medications.” Data indicate CMS “spent $20 billion last year under Part B of Medicare for prescription drugs administered in doctors’ offices and hospital outpatient departments.” 


The Age of Compliance and the Impact on Your Healthcare Revenue Cycle
The arrival of the Consumer Financial Protection Bureau (CFPB) and associated increased legislation in the area of Healthcare Debt Collection has made the job of Healthcare Revenue Cycle Professionals more challenging than ever before.

Listen as IC System’s Vice President of Healthcare discusses these issues in detail, and shares tips and tactics to help insure that your Healthcare Business Office stays efficient, effective and compliant.

Please click on this link  to register for the LIVE presentation.


Pediatrics Group Issues New Recommendations to Screen for Poverty
The American Academy of Pediatrics has issued a policy statement at  http://bit.ly/1p89Tfv recommending that “with nearly half of American children living in poverty or close to that line, pediatricians need to broach another health-related matter with mom or dad: Are you having trouble making ends meet?”

THE AAP announced the “new recommendations to screen for poverty in a bid to reduce its health effects.” In its policy statement, “the group highlights what it calls the ‘lifelong hardship’ faced by kids who grow up in poverty.”


Ithaca Mayor Wants to Create Heroin Injection Sites to Stop Overdoses
In a more than 1,450-word article, the Washington Post reports Svante Myrick, the mayor of Ithaca, New York, is pushing to create “supervised injection sites where addicts can use” heroin “under the watch of medical professionals” who are available to administer naloxone if overdoses occur. While Myrick will struggle to convince state and Federal officials, the Post states his “proposal nonetheless marks the latest departure from the zero-tolerance orthodoxy that has for years governed the drug war.” The article explains that success stories in Germany, Switzerland, the Netherlands, and Canada “sold Myrick on the idea.”


CLASSIFIED

Physician Opportunities

Family & Internal Medicine Opportunity Just 50 miles North of NYC
Top $$ AND potential partnership with large multi-specialty physicians’ group + the balance of work & personal life you have been seeking. Perfect suburban area just 50 miles north of NYC. This is a growth position with the right person moving into a partnership opportunity within two to three years. You will enjoy a salary of $175K+ as well as:
• A monthly bonus potential
• Health, Dental, Vision and prescription insurance
• 3 weeks’ paid vacation time off annually
• 6 federal Holidays off with pay
• A $2500 CME reimbursement
• A 401K plan with company match
• Company pays 75% of a single premium life insurance policy at twice your annual salary
• Paid malpractice insurance, plus paid DEA and license renewals
The ideal candidate will possess the following:
• BE/C in Family Medicine or Internal Medicine
• Active NYS license
• Current DEA #
• Experienced as well as New Grads welcome to apply
**Relocating physicians are welcome and relocation assistance will be offered to the right candidate!**
For immediate consideration and additional information on position details please contact Laura Rappleyea at 845-344-3434 or lrappleyea@hereshelp.com and send CV’s for review.

Neurologist & Pain Management Physician Needed
A growing multi-specialty group in Orange County is looking for both a Neurologist and Pain Management Physician to join their group. This position will work with the headache center Neurologist/Pain Management Specialist. All subspecialties are welcome.
The ideal candidate will possess the following:
• BE/C in Family Medicine or Internal Medicine
   • Active NYS license
   • Experienced as well as New Grads welcome to apply
   • Experience in procedures and utilizing an integrated comprehensive approach to pain management.
For immediate consideration and additional information on position details please contact Laura Rappleyea at 845-344-3434 or lrappleyea@hereshelp.com and send CV’s for review.


OB/GYN Opportunity in the Hudson Valley
Are you looking for a great work/life balance? We are looking for an OB/GYN to join the team. We are looking for a provider to provide comprehensive primary health care to a select population of essentially healthy women, participate in the care of women with complications & responsible for providing a full range of agency approved antepartum, intrapartum, postpartum, gynecological and family planning service.
The ideal candidate will possess the following:
• BE/C in Family Medicine or Internal Medicine
       • Active NYS license
       • Experienced as well as New Grads welcome to apply
For immediate consideration and additional information on position details please contact Laura Rappleyea at 845-344-3434 or lrappleyea@hereshelp.com and send CV’s for review
.


Pediatrician Opportunity in Orange County, New York
A prestigious multi-specialty physicians’ group seeks a family driven
Pediatrician to join their group.
The ideal candidate will possess the following:
• BE/C in Family Medicine or Internal Medicine
   • Active NYS license
   • Experienced as well as New Grads welcome to apply
For immediate consideration and additional information on position details please contact Laura Rappleyea at 845-344-3434 or lrappleyea@hereshelp.com and send CV’s for review. 
.


Psychiatry Opportunity in New York’s Beautiful Hudson Valley
Our client, a prestigious multi-specialty physicians’ group who has been recognized as a Patient-Centered Medical Home by the National Committee for Quality Assurance, seeks a Psychiatrist to join their group.
The ideal candidate will possess the following:
• BE/C in Psychiatry
   • Active NYS license preferred
   • Experienced as well as New Grads welcome to apply
For immediate consideration and additional information on position details please contact Laura Rappleyea at 845-344-3434 or lrappleyea@hereshelp.com and send CV’s for review.



Join Well Established Solo Female OB/GYN Physician Practice in New York City
Quality oriented, looking for MD for long term career opportunity. New graduates welcome to apply. Affiliated with Lenox Hill Hospital. The current office has a AAAA certified operating room and an AIUM accredited ultrasound service. Looking to establish another location. Great opportunity to balance personalized practice with quality lifestyle. Please summit CV to obgynpractice130@gmail.com


Want to Sublease Your Clinic Space or Rent Space to Expand Your Practice? List with Clineeds 
Clineeds is an online platform designed to help physicians find and sublease clinic space. Listing is completely FREE! Sign up today at http://clineeds.com/signup We take care of the rest!


Jerome I. Sager – Attorney at Law
The health care law experts representing medical professionals for more than 25 years.  See us for Professional Medical Conduct Defense, Medicaid and Medicare Fraud Cases, DEA and Controlled Substance Issues, Third party insurance issues. We can handle most legal matters. Call us for a free consultation. 212-685-2333 / 917-312-6631, jeromesager@cs.com

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

 

 

 

 

 

 

 

 

 

 

 

 

 

March 4, 2016 – Physicians Shaping the Discourse

drmaldonado PRESIDENT’S  MESSAGE
 Dr. Joseph R.  Maldonado
asset.find.us.on.facebook.lgTwitter_logo_blue1

March 4,  2016
Volume 16, Number 9

Dear Colleagues:

This is the key issue that you should drive home with your legislator on Tuesday: Click Here.

Joseph Maldonado, M.D, MSc, MBA, DipEBHC
MSSNY President

Please send your comments to comments@mssny.org


MLMIC_011916_Enews_550x150


Capital_Update_Banner

MSSNY Lobby Day Scheduled For March 8th – Physicians Urged to Attend and Wear Your White Lab Coats
MSSNY’s “Physician Advocacy Day” will be held on March 8th in the Lewis Swyer Theatre in the Egg located at the Empire State Plaza in Albany, New York.  If you plan to attend, please register here.

A full slate of legislators and top Administration officials will attend and dialogue with Advocacy Day participants including:

  • Donna Frescatore, Executive Director, NYS Health Benefit Exchange;
  • Jason Helgerson, Medicaid Director, NYS Department of Health;
  • Troy Oechsner, Executive Deputy Superintendent, Department of Financial Services;
  • Legislative Panel: Senate Health Chair Kemp Hannon; Assembly Health Chair Richard Gottfried; Senate Insurance Chair James Seward; Assembly Insurance Chair Kevin Cahill.

In addition, Assembly Majority Leader Joe Morelle and Senate Majority Leader John Flanagan have also agreed to attend the morning proceedings. A brief informal luncheon to which members of each House are invited to speak with their constituents will follow the morning program.   County Medical Societies will be scheduling appointments for physicians to meet with their elected representatives.

For those unable to attend in person, this event will be webcast LIVE. You can access the webcast by going to the following link: http://totalwebcasting.com/live/mssny

PHYSICIANS ARE ENCOURAGED TO IMMEDIATELY REGISTER THROUGH THE LINK BELOW TO ATTEND THE MARCH 8TH LOBBY DAY IN ALBANY. http://goo.gl/forms/Mw7CX8JfzL
(DIVISION OF GOVERNMENTAL AFFAIRS)


Senate Health Committee Chair, Senator Kemp Hannon will be Guest for Fireside Chat With MSSNY President Dr. Joseph Maldonado.
On March 7th, the evening before MSSNY’s Lobby Day, Joseph Maldonado, Jr., MD, MSc, MBA, will conduct a “fireside chat” with Senator Kemp Hannon, Chairman of the Senate Health Committee.

This is a relaxed and fluid format in which Dr. Maldonado and Senator Hannon can discuss issues of concern to the medical community (network adequacy, action taken by Emblem Health to narrow its network,  the collapse of Health Republic, etc). Physicians are invited to be physically present at this event in the DGA offices located at Ste 408, One Commerce Building, in Albany or can engage in real time by submitting their questions during the LIVE webcast of the event through this link.

The program will run for one hour from 5:30-6:30PM on March 7th.  To register to attend the event, click onto the this link.  
(DIVISION OF GOVERNMENTAL AFFAIRS)
 


Physicians Urged To Oppose Huge Cuts to Excess Medical Liability Insurance Program
Physicians are urged to continue to contact their legislators to object to a provision in the Executive Budget that would cause more than half of physicians to lose their Excess Medical Malpractice Insurance coverage.     

Specifically, the proposal would cut funding for the Excess program by $25 million, which would result in 55% of physicians who currently receive this additional coverage being dropped from the program.  Across much of upstate New York, only neurosurgeons, bariatric surgeons and OB-GYNs would keep this coverage.  That means that in the Capital District, in Northern New York, in Central New York, in western New York and in the Southern Tier every family physician, internist, pediatrician, ophthalmologist, emergency room physician, vascular surgeon, cardiologist, radiologist, pathologist, otolaryngologist, dermatologist and allergist would be automatically dropped.  And downstate, many primary care physicians, ophthalmologists, otolaryngologists, pathologists, dermatologists and allergists would be dropped.

The Excess Medical Liability Insurance Program provides an additional layer of $1M of coverage to physicians with hospital privileges who maintain primary coverage at the $1.3 million/$3.9 million level.  The program was created over 30 years ago as a result of the liability insurance crisis of the mid-1980’s to address concerns among physicians that their liability exposure far exceeded available coverage limitations.  Absent meaningful liability reform, with verdicts and physician liability premiums continuing to be far out of proportion compared to the rest of the country, full funding for the Excess program is absolutely essential in today’s very challenging practice environment.

At a time when the state is seeking to attract and retain physicians, this proposal deters physicians from wanting to practice in New York State for fear of putting themselves and their families in financial jeopardy for judgments and settlements exceeding the limits of their primary coverage.  Please urge your legislators to restore full funding for the program!                                                                       (AUSTER, DEARS) 

Urge Your Legislators to Reduce Liability Insurance Costs, Not Raise Them!
All physicians must continue to contact their legislators to urge that they oppose legislation (A.285-A, Weinstein/S.6596, DeFrancisco) that could drastically increase New York’s already exorbitantly high medical liability premiums by changing the medical liability Statute of limitations to a “Date of Discovery” rule.

You need to tell your legislators that no liability increases can be tolerated.  MLMIC’s estimate is that this bill could increase physician liability premiums by nearly 15%!   New York physicians continue to pay liability premiums that are among the very highest in the country.  By way of example, a neurosurgeon practicing on Long Island must pay an astounding $338,252 for just one year of insurance coverage and an OB/GYN practicing in the Bronx or Staten Island must pay $186,639.   New York far surpasses all other states in terms of total medical liability payouts, per capita payments, and medical liability awards above $1 million.

Last week, MSSNY joined the Greater New York Hospital Association (GNYHA) and Healthcare Association of New York State (HANYS) in an ad in the Albany Times-Union calling for reduction in these exorbitant costs.

To make matters even worse, trial lawyers are aggressively pushing the Legislature to consider additional liability expansion bills such as legislation that would eliminate the statutory limitation on contingency fees in medical liability actions, legislation that MLMIC has estimated could have the effect of raising your premiums by over 10%.   Please tell your legislators to enact comprehensive liability reform to bring down these costs, not legislation that increases them!                                                                                                       (AUSTER, DEARS)


Nearly 30 Assemblymembers Affirm Support for Health Republic Guarantee Fund Legislation (S.6667/A.9311)
27 Assemblymembers have joined Assembly Health Committee Chair Richard Gottfried and Assemblyman Charles Lavine (D-Nassau County) in introducing legislation (A.9311) to establish a Guarantee Fund to help to assure the payment of the hundreds of millions that Health Republic owes physicians and hospitals across New York State, as well as to protect consumers and health care providers from future health plan insolvencies.  To view the list of co-sponsors, click here.

Identical legislation (S.6667, Valesky, also with several co-sponsors (see here) has been introduced in the State Senate.  Right now, New York is the only state in the country that does not have such a Guarantee Fund.

With the health insurance industry in strong opposition to this proposal, it is imperative that you urge your Senators and Assemblymembers to support this bill and include it as part of the State Budget currently under negotiation by sending a letter from here. The template letter urges support for the legislation or the use of other monies, such as the hundreds of millions in dollars accruing to the State as a result of settlements with financial institutions, to help pay these outstanding claims.

You must remind your legislators that, with physicians facing so many other challenges in seeking to keep their doors open to deliver patient care, including high liability costs, expensive electronic medical record equipment, employee costs, insurance companies dropping physicians from their networks and declining payments from insurers, failure to assure payment for these claims would have serious negative consequences for patient care and employment in your community.
(AUSTER, DEARS)


Physicians Must Continue to Let Their Legislators Know of Concerns with Adverse Workers’ Compensation Budget Proposal
All physicians must continue to contact their State Senators and Assemblymembers to express their strong opposition to sweeping Workers’ Compensation reform proposals contained in the Executive Budget.

MSSNY staff continues to meet with key legislative leaders and staff to voice its very serious concerns with Budget proposals that would:

  • Expand the list of non-physicians who can treat and be paid directly for care to injured workers without any clarity as to how these non-physicians will coordinate care delivery when specialized care is needed;
  • Expand the circumstances when a physician or other health care provider can have their authorization removed and empowers the Board to impose significant fines on a physician or any other Board-authorized health care provider for violating a Workers Compensation rule;
  • Remove the authority of county medical societies to recommend physicians to serve as treating providers or independent medical examiners under Workers Compensation.
  • Reduce choice for injured workers by expanding the circumstances when an injured worker must seek care within a PPO network; and
  • Remove the requirement for a referral by a physician for an injured worker as a pre-condition to receive psychological care;

In the 30-day Executive Budget amendments, the proposal was made even more adverse by a) requiring physicians and other currently authorized WC providers to execute an “authorization agreement” with the Board (as of now, it is unclear what would be contained within such “authorization agreement”) within 12 months of the effective date of the proposal, if it were to be enacted; and b) removing the ability of professional associations, such as MSSNY, to recommend arbitrators to resolve medical fee disputes between health care providers and carriers.

Working closely with MSSNY, county medical society leaders from across the State have been writing to, and meeting with, their local Senators and Assemblymembers to request that these proposals be jettisoned from the Budget. Moreover, many of these proposals are being opposed by other stakeholders, including the NYS AFL-CIO, the NYS Trial Lawyers Association, the Injured Workers Bar Association and the New York Insurance Association.
(AUSTER, DEARS)


Legislation To Make Changes to The Erx Law to Exempt Low Volume Prescribers and to Enable Nurses in Ltc Facilities to Act as Agent for the Physician Reported by Senate Health Committee
Legislation (A. 9335, Gottfried/ S.6779, Hannon) which would exempt low volume prescribers from the e-prescribing mandate entirely was reported from the Senate Health Committee to the floor of the Senate this week. MSSNY is aware that physicians who are low volume prescribers (those who write less than 25 prescriptions a year) are receiving waivers from the mandate; but those waivers are only good for one year requiring low volume physicians to reapply each year. This measure would eliminate the need for them to re-apply for a waiver each year.

The bill would also amend the eRx law by eliminating existing provisions which require prescribers who invoke one or more of the exemptions to the eRx mandate to contact the department when they exercise an exemption. Instead, the bill would require a prescriber to make a notation in the patient’s record that the exercise of the exemption was utilized.

A second proposal (A.9334, Gottfried/S.6778, Hannon), also supported by MSSNY, was also reported by the Senate Health Committee this week to the Senate floor. Specifically this proposal would allow prescriptions for non-controlled substances for nursing home residents to be made orally rather than electronically.  For decades, nurses, acting as the agent to the physician, have been authorized to take oral orders from the physician for non-controlled medications through the nursing home medication administration system to deliver medications to residents safely and without delay. In this long-standing system, the physician then routinely signs the oral orders within 48 hours.

Physicians are not physically present in nursing homes 24 hours a day. Nurses serve a vital role ensuring proper medication administration in nursing homes. This bill is necessary to assure that physicians’ orders are timely filled to protect the health and well-being for each resident in a safe and secure method.(DEARS,AUSTER)


Endo Enters Into Settlement With NY AG to Limit Marketing of Opana
Attorney General Eric T. Schneiderman announced an agreement with Endo Pharmaceuticals this week which requires Endo to cease all misrepresentations regarding the properties of Opana ER, to describe accurately the risk of addiction to Opana ER, and to summarize studies regarding Opana ER on its website.  To read the AG’s full press release, click here.

Specifically, the settlement requires Endo to:

  • Provide truthful and complete information regarding addiction risks associated with Opana ER;
  • Stop improperly marketing Opana ER as being crush resistant;
  • Create an Abuse and Diversion Detection Program that requires Endo’s sales representatives to report to the company health care providers it suspects of engaging in abuse and illegal diversion of opioids, and for Endo to cease marketing opioids to certain prescribers;
  • Post results of clinical studies on Endo’s website;
  • Encourage health care providers to seek training on appropriate opioid prescribing practices; and
  • Provide health care providers with information about addiction treatment resources for their patients.

Furthermore, the Attorney General also imposed a $200,000 penalty on Endo.
(AUSTER) 


NY AG Investigates Health Insurers Over Hep C Coverage
New York Attorney General Eric Schneiderman has asked 16 health insurance companies for information regarding their coverage rules for patients with hepatitis C, requesting documents explaining how they make decisions on who to cover or not, according to several media reports.  As is noted in these articles (see here), the companies being investigated include Anthem, Aetna and Emblem.  (AUSTER)


Physicians Now Have Until July 1 to Apply For 2015 EHR Meaningful Use Hardship Waiver
CMS announced late last week that physicians will now have until July 1to apply for a “hardship exemption” from the electronic health record (EHR) meaningful use financial penalties for the 2015 program year.   Without obtaining such “hardship exemption”, physicians could face up to a 3% cut in their Medicare payments in 2017.  In its statement announcing the delay, CMS noted that it “is extending the deadline so providers have sufficient time to submit their applications to avoid adjustments to their Medicare payments in 2017.”

The AMA has advised that all physicians should apply for the exemption since  CMS has said that submitting an application for a hardship exemption will not prevent those who qualify from receiving an incentive payment.

To obtain the application, click here. The AMA has developed step-by-step instructions to help simplify the submission process. Physicians do not need to include documentation of their circumstances with their application, but should hold onto it for their own records.

Moreover, new this year, individuals can apply on behalf of a group of physicians, an important change enacted by Congress at the end of 2015 as a result of the combined advocacy of MSSNY, the AMA and many medical and specialty societies from across the country.
(AUSTER)


PTSB and TBI in Returning Veterans:  March – June Webinars
MSSNY will be holding a series of CME webinars on PTSD and TBI in returning veterans on eight dates listed below from March through June. The faculty presenters will be Frank Dowling, MD and Joshua Cohen, MD.

Course objectives:

  • Explore the two most prevalent mental disorders facing American veterans today, their causes, symptoms, and comorbidities;
  • Outline treatment options including evidence-based psychotherapy and pharmacotherapy;
  • Discuss barriers to treatment, including those unique to military culture, and how to overcome them;
  • Outline the process of recovery and post-traumatic grow. 

To register for this webinar, click on a date below and fill out the registration form

Wednesday, March 9, 7:30-8:30 AM
Tuesday, Mach 22, 6-7 PM
Thursday, April 7, 6-7 PM
Tuesday, April 12, 7:30-8:30 AM
Thursday, May 5, 6-7 PM
Thursday, May 19, 7:30-8:30 AM
Thursday, June 2, 6-7 PM
Thursday, June 9, 7:30-8:30 AM
(ELPERIN)


Clinical Update for Primary Care Providers on Pre-Exposure Prophylaxis (Prep)
The New York State (NYS) Department of Health AIDS Institute Clinical Education Initiative (CEI) and Mount Sinai Institute for Advanced Medicine will be offering an educational program on the Treatment for Hepatitis C: New Tests, New Drugs & New Recommendations on Thursday, March 31, 2016, 9:00am – 12:00pm at St. Mary’s Healthcare, Amsterdam – Carondelet Pavilion Auditorium, 380 Guy Park Ave. Amsterdam, New York 12010. 

Registration:   On-line registration is required as space will be limited.

This free event will focus on the current epidemiological trends, updates on prevention and care best practices, and NYSDOH guidance on HIV & HCV, as well as therapeutic regimens and monitoring plans.

This event is open to New York State clinical providers, such as physicians, physician assistants, nurses, nurse practitioners, and pharmacists.  The New York State (NYS) Department of Health AIDS Institute Clinical Education Initiative (CEI) is designed to enhance the capacity of New York’s diverse health care workforce to deliver clinical services to improve health outcomes related to HIV, sexually transmitted diseases (STDs) and hepatitis C (HCV). The aims of the CEI are fourfold:

  • provide progressive HIV, HCV and STD education to clinicians
  • disseminate AIDS Institute clinical practice guidelines
  • expand the base of providers able to diagnose and care for HIV, HCV and STD patients
  • foster partnerships between community-based providers and HIV, HCV and STD specialists

Mount Sinai serves as The HIV/HCV Center and provides free education and training for medical providers in NYS. Clinicians are updated on the latest NYS guidelines to enhance the capacity to deliver clinical services to improve health outcomes related to HIV/HCV.  Further information is available by contacting Robert Walsh at 212-636-1315 or at rwalsh@chpnet.org.
(CLANCY) 


MSSNY Joins New York Kicks Butts Campaign
The Medical Society of the State of New York has joined the “New York Kicks Butts” campaign which is a week-long citywide effort to encourage all smokers in New York City to quit smoking.   Smoking Cessation Week will be held May 31-June 6, 2016 and will encourage smokers in the New York City area to seeking assistance from physicians and other health care professionals to learn about the tools and support available to assist them to quit smoking.  MSSNY has joined with American Cancer Society, Cancer Action Network, NYC Smoke-Free, the American Lung Association, the Campaign for Tobacco Free Kids and other health groups in this campaign.  Further information on this campaign will be available shortly from MSSNY and through the campaign’s website(CLANCY)


 MSSNY-HCA Collaborate on Legislation to Address Health Care Disparities
Following MSSNY’s most recent Health Care Disparities Committee meeting, the Home Care Association of New York State (HCA) and MSSNY have joined forces to address health care disparities. After circulating the idea among members of the Black, Puerto Rican, Hispanic and Asian Legislative Caucus and receiving positive feedback—next week, MSSNY and HCA will present legislation and a grant proposal to all 50 members of the Caucus. Our proposal will allow physicians, home care agencies and hospitals to collaborate, by applying individually or collectively to the DOH for grant funding for programs to address a wide array of health care disparities. MSSNY hopes that the legislation will not only allow for spirited, localized programs specific to community needs, but also provide funding for: continuing medical education programs on health care disparities issues and educational outreach initiatives to attract adolescent members of minority population to the profession of medicine.                                                                                 
(MCPARTLON)
 


President Obama Lauds Affordable Care Act Achievements
On Thursday, March 03, 2016, President Obama announced that since the passage of the Affordable Care Act, more than 20 million have gained health insurance and the country has the lowest uninsured rate ever recorded. The President also announced that as of January 16th more than 30 percent of Medicare Part A and B payments are tied to alternative payment models (nearly a year ahead of schedule.)  In a press release issued by the Center for Medicare & Medicaid Services (CMS), it stated it was proud to achieve such a timely result and shift to quality and value of care. More information and CMS’ press release can be found here.(MCPARTLON) 


Governor Cuomo Continues Push for 12 Week Paid Family Leave
With One-House Budget bills only days away, Governor Cuomo renewed his call for paid family leave in two Op-Ed pieces, one published by Newsday and the other by the Buffalo News. In Newsday, striving to appeal to small business owners worried about their bottom-line, the Governor reiterated its zero cost to business owners as an employee-funded benefit that will reduce turnover and strengthen the state-wide labor force.  In the Buffalo News, Governor Cuomo delivered an appeal for New Yorkers to spend time with their loved ones when they need it most. Both articles can be found here (Newsday / Buffalo News ).
(MCPARTLON) 


Final Opioid Prescribing Webinar on March 10th;  Registration is Now Open
The fourth and final webinar in the opioid series will be held on Thursday, March 10th at 7:30 a.m. Title of the program is “Treatment of Opioid Use Disorders”.   Physicians and other prescribers are encouraged to register this for this webinar  at the this link.

Click on the upcoming tab and select the programs.

Physicians and other prescribers are allowed to register up to ½ hour before the webinar.

The Medical Society of the State of New York, the New York State Office for Alcoholism and Substance Abuse Service and the NYS Department of Health’s Bureau of Narcotic Enforcement, are jointly providing this free, four part webinar series on opioid prescribing. 

Entitled,) “Revisiting the Role of Opioid Analgesics for Simple and Complex Patients with Chronic Pain”, faculty for the session will be Charles Argoff, MD and Charles Morgan, MD, FASAM, FAAFP, DABAM.   The educational objectives are:    Recommend tools to assist in the management of patients for whom opioids are indicated and prescribed; discuss strategies to reduce risk of treating pain in patients with substance use disorders.

Physicians and other prescribers can take one or all of the webinars. 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.

Please contact Pat Clancy at pclancy@mssny.org or Terri Holmes at tholmes@mssny.org for further information.                                        (CLANCY, DEARS) 


MSSNY’s Opioid Webinars are Now Available Through Its Cme Online Site
The Medical Society has archived its opioid webinar series on its continuing medical education website at http://cme.mssny.org/   The webinars that are currently on the site are:  Webinar 1 Pain Management at the Crossroads:  A Tale of Two Public Health Problems and Webinar 2   Rational Opioid Prescribing:  Is this Possible for Chronic Pain?  Physicians and other prescribers can earn up to one hour of continuing medical credits by viewing this webinar and completing the test.    The reminder of the webinars will be placed on line in the very near future. 

The MSSNY CME site requires new users to register, but once registered physicians and other health care providers will have a personalized training page to take the webinars and other course work located on the site.   New registrants to the site will create a username and password, which should be retained and be used for continued access to the site.

Once registered and logged into the site, physicians will be taken to an instruction page.   Click on the tool bar menu located at the top of the page and click on “My training” to view and take the various courses.     MSSNY has over 50 programs at this site and physicians are able to earn continuing medical education credits for each course. 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 online program has various programs with the number of continuing medical education credits, but the majority of the programs are for 1.0 AMA/PRA Category 1 credit™.  Further information on all these programs may be obtained by contacting Pat Clancy at pclancy@mssny.org.
(CLANCY) 


MSSNY to Conduct Medical Matters Webinar on Zika Virus on March 16, April Session on Ebola
The Medical Society, in conjunction with the New York State Department of Health will conduct a Medical Matters webinar on the  “Zika Virus: An Evolving Story” on March 16th at 7:30 a.m.   Registration for this program is now open. Click on the ‘Upcoming’ tab and select the ‘Programs’.

The educational objectives for this program are: 1) Describe the epidemiology of Zika Virus infection;

2) Understand the modes of transmission; 3) Understand how to advise patients; and 4) Learn methods for prevention of infection.  William Valenti, MD, chair of MSSNY’s Infectious Disease Committee, and Elizabeth Dufort, MD,  Medical Director, Division of Epidemiology from the New York State Department of Health will conduct this presentation.

The April session of Medical Matters will take place at the MSSNY House of Delegates and is entitled, “Ebola: A Perspective from the Field”.  The program will be conducted by Dario Gonzalez, MD, FACEP. Associate Medical Director,  Fire Department City of New York/Office of Medical Affairs.  Dr. Gonzalez was deployed for nine weeks by Americares to Liberia, West Africa as part of the US response to the Ebola epidemic.  The program will be held on Thursday, April 14, 2016 at 2:00pm. Physicians may attend the session at the Westchester Marriott, 670 White Plains Road, Tarrytown, NY 10591 or by webinar.  Registration is now open. Click on the ‘Upcoming’ tab and select the ‘Programs’.

The educational objective is: Offer perspective and lessons learned from an individual who treated Ebola patients firsthand.

The May session will be “Radiological Emergencies”, this session will be held on May 18, 2016 at 7:30 AM. (Please note that this session was originally scheduled for March 16, 2016) Faculty for this session will be Cham Dallas, PhD.  Dr. Dallas is a professor in the Department of Health Policy and Management at the College of Public Health, University of Georgia.  He is also the Director of the Institute for Disaster Management at the University of Georgia and a Board Member of the National Disaster Life Support Foundation (NDLSF).  Dr. Dallas has a national/international reputation in toxicology and emergency preparedness and response, including over 30 years of experience.

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.

Further information or assistance in registering for any of these programs may be obtained by contacting Melissa Hoffman at mhoffman@mssny.org.
(CLANCY, HOFFMAN)

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

pschuh@mssny.org ldears@mssny.org            mauster@mssny.org  
pclancy@mssny.org jMcPartlon@mssny.org    

enews large

Michael J. Schoppmann Joins MLMIC’s Service Company
MLMIC announces the appointment of Michael J. Schoppmann, Esq. as President of our service company subsidiary. In this role, Schoppmann will work closely with Edward J. Amsler, CEO of the service company, to serve the needs of MLMIC policyholders.

Schoppmann’s long history of protecting doctors in New York State will contribute to the superior protection, sound defense and active risk management we offer all of our insureds.

Michael J. Schoppmann’s legal career spans 30 years, and his tenure defending healthcare professionals has earned him national regard. Prior to joining MLMIC, Schoppmann was the managing principal partner in a private firm (Kern, Augustine, Conroy & Schoppmann) where he dedicated more than two decades of his career to providing counsel to physicians and other health care providers. His background, reputation and drive will be extremely valuable to MLMIC as we continue to serve policyholders in an increasingly competitive environment. 


Endoscope Maker Olympus to Pay Record $623 Million to Settle Kickback Allegations
The nation’s largest endoscope distributor will pay $623.2 million to resolve civil and criminal allegations that it paid kickbacks to hospitals and doctors in exchange for purchasing its devices, the Justice Department announced Tuesday.

Olympus Corporation of the Americas has agreed to pay a record-setting $310.8 million to settle civil claims that it violated the False Claims Act because its claims were tainted by illegal kickbacks. The sum is the largest ever paid by a medical-device company over violations related to the federal anti-kickback law, according to the government. Olympus will also pay a $312.4 million criminal penalty over the allegations. The company admitted to paying doctors and hospitals in the form of consulting payments, travel, meals, grants and free endoscopes in exchange for their business, according to the Justice Department.

The company admitted, for example, to paying for three doctors’ trips to Japan in 2007 in exchange for their hospital’s decision to use Olympus. The company gave another doctor who had a major role in his medical center’s buying decisions free of use of $400,000 in equipment.

Nacho Abia, CEO of Olympus Corporation of the Americas, said in a statement, said “Olympus is committed to complying with all laws and regulations and to adhering to our own rigorous code of conduct which guides our business processes, decisions and behavior.”Abia also noted that the company’s past actions didn’t affect patient health or care. He said the settlements will not affect the company’s ability to offer its products and services.

According to the Justice Department, the kickbacks helped the company make more than $600 million in sales and gross profits of more than $230 million. The company entered into a deferred prosecution agreement that will allow it to avoid conviction if it follows certain requirements.


The NYeC PQRS Registry is Open for Business and Ready to Support You
If you are a Medicare provider, but still haven’t selected a registry to submit your PQRS measurements and want to avoid payment penalties, NYeC as a CMS qualified Registry can help you control your reporting process. Remember this is a time sensitive program, and your data needs to be received by NYeC by March 17th to ensure your submission meets the CMS deadline of March 31, 2016.

Learn more about our full service PQRS Registry at http://bit.do/nyecpqrsportal. You can also email us at supportpqrs@nyehealth.org or call 646-619-6485.

Join them for a FREE informational webinar about their full service CMS qualified registry.

Webinar dates:

  • Monday, March 7, 2016, 10:00 am EST

REGISTER NOW

Topics to be covered:

  • Review of Eligible Professionals required to participate in the PQRS Program
  • How to avoid negative payment adjustments
  • Participation informs quality ratings that compare providers to their peers
  • Overview of New York eHealth Collaborative’s Registry Services
  • Review of reporting methodologies Registration, fees, support, and critical deadlines

The webinar should be for total of 45 minutes (30 min informational and 15 min Q&A).


The Medicare EHR Incentive Program Hardship Application Deadline for All Providers is Now July 1, 2016
This week, CMS is extending the application deadline for the Medicare EHR Incentive Program hardship exception process that reduces burden on clinicians, hospitals, and critical access hospitals (CAHs). The new deadline for Eligible Professionals, Eligible Hospitals and Critical Access Hospitals is July 1, 2016. CMS is extending the deadline so providers have sufficient time to submit their applications to avoid adjustments to their Medicare payments in 2017.

In January, CMS posted new, streamlined hardship exception application forms that reduce the amount of information that eligible professionals (EPs), eligible hospitals, and CAHs must submit to apply for an exception. The new applications and instructions for providers seeking a hardship exception are available here.


Reminder: Time for Physicians and Teaching Hospitals to Complete Open Payments System Registration
As a reminder, the Open Payments system is available for Physician and Teaching Hospital registration. The review and dispute period for physicians and teaching hospitals is targeted to start in April 2016. Just a reminder, only information that has been submitted in the current program year is eligible for review and dispute.

Registering in the Open Payments system is voluntary for physicians and teaching hospitals. However, registering is required if a physician or teaching hospital wants the opportunity to review and dispute data. The data is submitted by applicable manufacturers and applicable group purchasing organizations (GPOs) prior to public posting on June 30, 2016. If a physician or teaching hospital registered last year, they are not required to register again this year.

However, if it has been over 180 days since a physician or teaching hospital has logged onto the Enterprise Identity Management System (EIDM), the account has been deactivated for security purposes. If an account has been deactivated, contact the Help Desk. The Help Desk hours are from 8:30 a.m. – 7:30 p.m. (EST). For new users, the quick reference guide on the EIDM system can be found here. In addition, the quick reference guides on teaching hospital registration can be found here, and the guide for physician registration can be found here.

CMS plans to publish the 2015 payment data and make any applicable updates to the 2013 and 2014 data in June 2016. More information about Open Payments is available at www.cms.gov/openpayments.


FLU View

The most recent FluView report shows increasing flu activity in the United States. Ongoing flu activity is expected for several weeks. (NY is Region 2)

CDC reports this season’s flu vaccine is nearly 60 percent effective against all circulating viruses. It is not too late to get your flu vaccine this season.


CDC Interim Recommendations re Olympics and Zika Virus in Pregnancy
Because Zika virus infection in a pregnant woman is linked to a serious birth defect of the brain called microcephaly and miscarriage, CDC recommends special precautions for the following groups:

  • Women who are pregnant (in any trimester): Consider not going to the Olympics; if you have a male partner who goes to the Olympics, either use condoms or abstain from sex for the duration of your pregnancy. If you must go, talk to your doctor or other health care provider first; you and your partner should strictly follow steps to prevent mosquito bites and use condoms or abstain from sex.
  • Women who are trying to become pregnant: Before you travel, talk to your doctor or other health care provider about your plans to become pregnant and the risk of Zika virus infection. You and your male partner should strictly follow steps.
  • Men with pregnant partners should use condoms or abstain from vaginal, anal, or oral sex for the duration of the pregnancy.

Specific areas where Zika virus transmission is ongoing are often difficult to determine and are likely to change over time. As more information becomes available, this travel notice will be updated. Please check back frequently for the most up-to-date recommendations.


Onondaga County Holds Annual Legislative Roundtable
Onondaga County Legislative Roundtable
The Onondaga County Medical Society held its annual Legislative Breakfast and Roundtable discussion with area federal and state legislators on February 27. The following elected representatives were in attendance:  Congressman John Katko, Sen. John DeFrancisco, Sen. David Valesky, Assemblywoman Pamela Hunter, and Assemblyman Albert Stirpe.  Director Jennifer Cook represented Assemblyman Will Barclay, Special Assistant Pamela Kirkwood represented Assemblyman Gary Finch and Craig Swyecki represented Assemblyman William Magnarelli.

This annual event gives interested physician members and our governing body the opportunity to talk with local federal and state representatives about issues of concern. Physicians in attendance were: Drs. Beers, Abdulky, Nave, Halleran, Semeran, Sneider, Hart, Huang, Walsh, and Practice Manager Anne Zecchio of Nephrology Associates.


 


CLASSIFIED

Want to Sublease Your Clinic Space or Rent Space to Expand Your Practice? List with Clineeds
Clineeds is an online platform designed to help physicians find and sublease clinic space. Listing is completely FREE! Sign up today at http://clineeds.com/signup We take care of the rest!


Jerome I. Sager – Attorney at Law
The health care law experts representing medical professionals for more than 25 years.  See us for Professional Medical Conduct Defense, Medicaid and Medicare Fraud Cases, DEA and Controlled Substance Issues, Third party insurance issues. We can handle most legal matters. Call us for a free consultation. 212-685-2333 / 917-312-6631, jeromesager@cs.com



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

 

 

 

 

 

 

 

 

 

 

 

 

 

February 26, 2016 – Physicians Shaping the Discourse

drmaldonado PRESIDENT’S  MESSAGE
 Dr. Joseph R.  Maldonado
asset.find.us.on.facebook.lgTwitter_logo_blue1

February 26,  2016
Volume 16, Number 8

Dear Colleagues:

This week, I attended the AMA National Advocacy Conference in Washington, DC.   New York had a very prominent number of physicians in attendance, many of whom went on their own dime.  It made me proud of their dedication and passion to take time from their busy schedules to go down to Washington and meet with our Federal legislators.  I was most impressed by Senator Schumer’s open style and graciousness in meeting with us.  He listened and made very insightful suggestions for our efforts.  Honestly I had not expected this level of engagement and I was glad to have seen it firsthand.

The sessions in Washington with the staff members of many of our legislators were refreshing.  They are a young group of individuals with a broad range of knowledge of the subject.  All of them have a keen aptitude and intellect in capturing the important concepts and engaging with them.  There was a seemingly genuine interest in listening to our perspective, which as a cynic of the Washington process, I had not expected.

While I tend to relate best to the seasoned staff of legislators in Albany, the group in Washington seemed to have a freshness about them that gave me hope that perhaps they were not jaded by years of work in the Washington arena.  They did a lot of listening, and didn’t seem to have established opinions.  They asked reasonable and smart questions.  They seemed interested in our views as physicians about how the problems could be addressed.  They offered options on how we might best tackle challenges facing us.

Most importantly, it was a pleasure not getting the sense that we were dealing with a group of young individuals who had an agenda to carry out and would indulge us on only those issues that complemented their agendas.  I’m not certain if there is a “Washington Staff Etiquette” course new staff members take before starting to work for Federal legislators, but the receptive style of engagement gave me hope that perhaps if we could not convince our legislators on key issues, engagement with their staff might provide them with the data needed for them to more effectively carry out the task on our behalf.

All in all, the advocacy experience was very positive.  Join us in Albany next week and see what your experience as a physician in the trenches can do for changing policymakers’ perspectives on healthcare.

Joseph Maldonado, M.D, MSc, MBA, DipEBHC
MSSNY President

Please send your comments to comments@mssny.org


MLMIC_011916_Enews_550x150


Capital_Update_Banner

MSSNY Lobby Day Scheduled for March 8th – Physicians Urged to Attend and Wear Your White Lab Coats
MSSNY’s “Physician Advocacy Day” will be held on March 8th in the Lewis Swyer Theatre in the Egg located at the Empire State Plaza in Albany, New York.  If you plan to attend, please register here.

A full slate of legislators and top Administration officials will attend and dialogue with Advocacy Day participants including:

  • Donna Frescatore, Executive Director, NYS Health Benefit Exchange;
  • Troy Oechsner, Executive Deputy Superintendent, Department of Financial Services;
  • Legislative Panel: Senate Health Chair Kemp Hannon; Assembly Health Chair Richard Gottfried; Senate Insurance Chair James Seward; Assembly Insurance Chair Kevin Cahill.

In addition, Assembly Majority Leader Joe Morelle and Senate Majority Leader John Flanagan have also agreed to attend the morning proceedings.  Speaker Heastie has also been invited.  A brief informal luncheon to which members of each House are invited to speak with their constituents will follow the morning program.   County Medical Societies will be scheduling appointments for physicians to meet with their elected representatives.

PHYSICIANS ARE ENCOURAGED TO IMMEDIATELY REGISTER THROUGH THE LINK BELOW TO ATTEND THE MARCH 8TH LOBBY DAY IN ALBANY.  http://goo.gl/forms/Mw7CX8JfzL                (DIVISION OF GOVERNMENTAL AFFAIRS)


Physicians Invited to Attend Fireside Chat with MSSNY President Dr. Joseph Maldonado and Troy Oechsner, Deputy Superintendent of Insurance
On March 7th, the evening before MSSNY’s Lobby Day, Joseph Maldonado, Jr., MD, MSc, MBA, will conduct a “fireside chat” with Troy Oechsner, Deputy Superintendent at DFS.

This is a relaxed and fluid format in which Dr. Maldonado and Mr. Oechsner can discuss issues of concern to the medical community (network adequacy, action taken by Emblem Health to narrow its network,  the collapse of Health Republic, etc). Physicians are invited to be physically present at this event in the DGA offices located at Ste 408, One Commerce Building, in Albany or can engage in real time by submitting their questions during the LIVE webcast of the event through the this link.

The program will run for one hour from 5:30-6:30PM on March 7th.  To register to attend the event, click here.
(DIVISION OF GOVERNMENTAL AFFAIRS)


Why Physicians Need to Take a Day Away From Your Practice to Lobby Albany on March 8, 2016

  • Think you pay too much in malpractice insurance costs?  The Trial Bar doesn’t care. They have introduced legislation that will certainly increase your premium costs.
  • If you practice in the Capital District, Southern Tier, Central NY, or Western NY, New York State wants to take away your Excess Liability Insurance Coverage.
  • New York State wants to enable NPs to deliver care to injured workers and take away County Medical Society review of authorized physicians rather than fixing what ails the Workers’ Compensation system.
  • The Proposed NYS Budget does nothing to compensate physicians for the unpaid care they have provided to Health Republic insureds.
  • New York State wants to enable Walmart and Target to hire NPs to deliver care to the public to compete directly against you.
  • Patient health could be threatened by inappropriately expanding the scope of practice of countless non-physicians, including dentists, optometrists and psychologists.
  • We need to prevent insurers from offering patients narrow networks for Exchange plans and denying patient access to out of network physicians.

These are very real issues that are currently being discussed and will be resolved either in the State Budget which will be enacted by April 1st or before the end of Session on June 16th. You need to come to Albany, and speak with your elected officials so that they can hear your concerns. Otherwise, all they will hear are the perspectives of trial lawyers and insurance companies.

PLEASE  JOIN YOUR COLLEAGUES FROM ACROSS THE STATE TO LOBBY YOUR ELECTED LEADERS IN PERSON IN ALBANY MARCH 8TH. REGISTER HERE.
(DIVISION OF GOVERNMENTAL AFFAIRS)


Legislation to Make Changes to the ERx Law to Exempt Low Volume Prescribers and to Enable Nurses in LTC Facilities to Act as Agent for the Physician Introduced and Reported by Assembly Health Committee
Just this week, legislation (A. 9335, Gottfried/ S.6779, Hannon) was introduced at MSSNY’s request which would exempt low volume prescribers from the e-prescribing mandate entirely. MSSNY is aware that physicians who are low volume prescribers (those who write less than 25 prescriptions a year) are receiving waivers from the mandate; but those waivers are only good for one year requiring low volume physicians to reapply each year. This measure would eliminate the need for them to re-apply for a waiver each year.

The bill would also amend the eRx law by eliminating existing provisions which require prescribers who invoke one or more of the exemptions to the eRx mandate to contact the department when they exercise an exemption. Instead, the bill would require a prescriber to make a notation in the patient’s record that the exercise of the exemption was utilized.

The Assembly bill was reported unanimously from the Assembly Health Committee to the Assembly Codes Committee. The Senate counterpart is on next week’s Senate Health Committee.

A second proposal (A.9334, Gottfried/S.6778, Hannon), also supported by MSSNY, was unanimously reported by the Assembly Health Committee this week to the Assembly floor. Specifically this proposal would allow prescirptions for non-controlled substances for nursing home residents to be made orally rather than electronically.  For decades, nurses, acting as the agent to the physician, have been authorized to take oral orders from the physician for non-controlled medications through the nursing home medication administration system to deliver medications to residents safely and without delay. In this long-standing system, the physician then routinely signs the oral orders within 48 hours.

Physicians are not physically present in nursing homes 24 hours a day. Nurses serve a vital role ensuring proper medication administration in nursing homes. This bill is necessary to assure that physician’s orders are timely filled to protect the health and well-being for each resident in a safe and secure method. The Senate counterpart to the Assembly bill is also on next week’s Senate Health Committee agenda.
(DEARS, AUSTER)


Senate Advances Legislation to Limit Opioid Prescribing to 3-10 Days for Patients in Acute Pain
Senate Bill 6091A, sponsored by Senator Kemp Hannon, has moved to the Senate floor for a vote.  This bill would limit the initial prescription by a physician or other prescriber of Controlled Substance, Schedule II or III, to a three to 10 day supply for patients suffering acute pain.   Its companion measure, A. 8601, sponsored by Assemblymember John McDonald, is in the Assembly Health Committee.  

The bill, if enacted, would establish a limitation on a physician’s license by prohibiting the physician from practicing to the fullest extent of his/her education and training when they seek to prescribe Schedule II or III controlled substance.  Senate Bill 6091A/A.8601 would effectively prevent a physician from exercising his/her clinical judgement on behalf of the patient.   Moreover, this action would set a dangerous precedent in New York State and represents an enormous encroachment of the New York State Legislature into the practice of medicine.  The Medical Society of the State of New York is strongly opposed to this measure.  Physicians are urged to contact their legislator and urge them not to enact this measure.   Physicians may call the NY Senate at 518-455-2800 or the Assembly at 518-455-4100.
(CLANCY, DEARS)


Health Republic Guarantee Fund Legislation (S.6667/A.9311) Picks Up Several New Assembly Co-Sponsors
13 Assemblymembers  have joined Assembly Health Committee Chair Richard Gottfried  and Assemblyman Charles Lavine (D-Nassau County) in introducing legislation (A.9311) to establish a Guarantee Fund to help to assure the payment of the hundreds of millions that Health Republic owes physicians and hospitals across New York State, as well as to protect consumers and health care providers from future health plan insolvencies.  To view the list of co-sponsors, click here.

Identical legislation (S.6667, Valesky, also with several co-sponsors) has been introduced in the State Senate.  Right now, New York is the only state in the country that does not have such a Guarantee Fund.  With the health insurance industry in strong opposition to this proposal, it is imperative that you urge your Senators and Assemblymembers to support this bill and include it as part of the State Budget currently under negotiation by sending a letter from here.

You must remind your legislators that, with physicians facing so many other challenges in seeking to keep their doors open to deliver patient care, including high liability costs, expensive electronic medical record equipment, employee costs, insurance companies dropping physicians from their networks and declining payments from insurers, failure to assure payment for these claims would have serious negative consequences for patient care and employment in your community.
(AUSTER, DEARS)


Please Complete Survey to Let Us Know What You are Owed as a Result of Health Republic Debacle
MSSNY’s updated survey of outstanding Health Republic claims shows that, based upon results received, physicians are owed nearly $25,000,000.  However, we believe that far more physicians who have been adversely impacted have yet to respond.  As we continue our advocacy in support of legislation (A.9311, Gottfried/S.6667, Valesky) to create a Guarantee fund and/or the allocation of other monies to pay for the unpaid claims as a result of the Health Republic demise, we need those of you who have not completed the survey to provide us with updated information regarding the amounts you are due from Health Republic.  To complete the survey, click hereThis data is critical to our advocacy efforts!   We need to obtain updated and more precise numbers from as many impacted physicians as possible since many legislators have asked us for this data.
(AUSTER, DEARS)


Physicians Must Continue to Let Their Legislators Know of Concerns with Adverse Workers’ Compensation Budget Proposal
All physicians must continue to contact their State Senators and Assemblymembers to express their strong opposition to sweeping Workers’ Compensation reform proposals contained in the Executive Budget.

MSSNY staff continues to meet with key legislative leaders and staff to voice its very serious concerns with Budget proposals that would:

  • Expand the list of non-physicians who can treat and be paid directly for care to injured workers without any clarity as to how these non-physicians will coordinate care delivery when specialized care is needed;
  • Expand the circumstances when a physician or other health care provider can have their authorization removed and empowers the Board to impose significant fines on a physician or any other Board-authorized health care provider for violating a Workers Compensation rule;
  • Remove the authority of county medical societies to recommend physicians to serve as treating providers or independent medical examiners under Workers Compensation.
  • Reduce choice for injured workers by expanding the circumstances when an injured worker must seek care within a PPO network; and
  • Remove the requirement for a referral by a physician for an injured worker as a pre-condition to receive psychological care;

In the 30-day Executive Budget amendments, the proposal was made even more adverse by a) requiring physicians and other currently authorized WC providers to execute an “authorization agreement” with the Board (as of now, it is unclear what would be contained within such “authorization agreement”) within 12 months of the effective date of the proposal, if it were to be enacted; and b) removing the ability of professional associations, such as MSSNY, to recommend arbitrators to resolve medical fee disputes between health care providers and carriers.

MSSNY has also reached out to labor organizations and associations representing attorneys for injured workers to coordinate its advocacy in opposition.  We are pleased to learn that the New York Insurance Association has released a memo in opposition to the provisions that would expand the role of non-physicians in Workers Compensation.  MSSNY has also been working closely with county medical society leadership from across the State to encourage their outreach to their local Senators and Assemblymembers to request that these proposals be jettisoned from the Budget.
(AUSTER, DEARS)


Please Advocate for Due Process Rights When Physicians are Non-Renewed by a Health Insurer
Physicians are urged to contact their legislators to support a bill (A.1212, Lavine/S.4751, Hannon) that would assure physicians are accorded a fair peer review appeals mechanism before their participation contract with a health insurance company can be non-renewed.  To send a letter in support of this legislation here:.  The bill is currently on the Assembly calendar and in the Senate Insurance Committee.  The legislation is in response to situations such as the recent example of Emblem dropping 750 of its network physicians in October based upon specious allegation of failure to transition to value-based payments, severing patient treatment relationships for countless patients.  MSSNY has strenuously urged to the Department of Financial Services, Department of Health, and Attorney General that these physicians be given a fair opportunity to be reinstated, and have shared this information with the entire New York State Legislature. (See MSSNY letter to DFS here.

The Attorney General’s office continues to investigate specific complaints raised by individual physicians whether they were given a fair chance to appeal these non-renewals.
(AUSTER, DEARS)


Tell Your Legislators to Reduce Your Liability Costs, Not Expand Them!
All physicians must continue to contact their legislators to urge that they oppose legislation (A.285-A, Weinstein/S.6596, DeFrancisco) that could drastically increase New York’s already exorbitantly high medical liability premiums by changing the medical liability Statute of limitations to a “Date of Discovery” rule.

You need to tell your legislators that no liability increases can be tolerated.  MLMIC’s estimate is that this bill could increase physician liability premiums by nearly 15%!   New York physicians continue to pay liability premiums that are among the very highest in the country.  By way of example, a neurosurgeon practicing on Long Island must pay an astounding $338,252 for just one year of insurance coverage and an OB/GYN practicing in the Bronx or Staten Island must pay $186,639.   New York far surpasses all other states in terms of total medical liability payouts, per capita payments, and medical liability awards above $1 million.

This week, MSSNY joined the Greater New York Hospital Association (GNYHA) and Healthcare Association of New York State (HANYS) in an ad in the Albany Times-Union with the headline “NEW YORK’S HOSPITALS AND DOCTORS HAVE THE HIGHEST MEDICAL MALPRACTICE COSTS – AND THAT MAKES NO SENSE”.

To make matters even worse, trial lawyers are aggressively pushing the Legislature to consider additional liability expansion bills such as legislation that would eliminate the statutory limitation on contingency fees in medical liability actions, legislation that MLMIC has estimated could have the effect of raising your premiums by over 10%.   Please tell your legislators to enact comprehensive liability reform to bring down these costs, not legislation that increases them!                                                                                                       (AUSTER, DEARS)


Physicians Advocate for Their Colleagues and Patients in Nation’s Capitol
Several New York leader physicians and MSSNY staff traveled to Washington DC this week to meet with key members of New York’s Congressional delegation.  The meetings were in conjunction with the AMA’s National Advocacy Conference.  The physicians participating in these Hill visits included:

  • Rome urologist and MSSNY President Dr. Joseph Maldonado;
  • Manhattan physiatrist and MSSNY President-elect Dr. Malcolm Reid;
  • Saratoga Springs ENT and MSSNY Board of Trustees member Dr. Robert Hughes;
  • Touro College of Osteopathic Medicine Dean and past MSSNY President Dr. Robert Goldberg;
  • Schenectady ophthalmologist and MSSNY Councilor Dr. John Kennedy;
  • Harrison allergist and MSSNY House of Delegates Speaker Dr. Kira Geraci-Ciardullo;
  • Rochester Psychiatrist Dr. John McIntyre; and
  • Buffalo Urologist Dr. Willie Underwood

The physicians urged members of Congress to address a number of issues that are adversely affecting the delivery of patient care in New York State, including: assuring the claims of failed co-op insurer Health Republic are paid; simplifying the enormously cumbersome Meaningful Use program; assuring fairness in Medicare Recovery Audits; supporting comprehensive multipronged efforts to reduce the nation’s opioid abuse crisis in a way that does not inadvertently limit treatment options for patients; and pushing CMS to investigate Medicare Advantage plans (such as Emblem) interfering with existing treatment relationships by dropping scores of physicians from their networks.

In addition to meetings with many New York Congressional delegation members and staff, in conjunction with physician leaders of several other state medical societies, meetings were held with US House Ways & Means Chair Kevin Brady (R-TX); Rep. Dr. Michael Burgess, a key leader of the House Doctors Caucus; and with key health policy “central” staff for both the US House and US Senate.
(AUSTER)

burgess
AMA National Advocacy Conference. L-R: Former MSSNY President  Dr. Robert Hughes, Representative .Dr. Michael Burgess (R-TX), Phil Schuh, MSSNY Executive VP

IMG_2251
Dr. Robert Goldberg, Dr. John Kennedy, Representative Eliot Engel, Dr. Malcolm Reid, Dr. Kira Geraci, and MSSNY VP Moe Auster

IMG_2254
MSSNY leadership with Ways and Means Chair Kevin Brady (R-TX)) & representatives of the  TX, CA, NJ, OK and NC state medical societies


Bill to Require  Physicians to Prescribe Medications in Accordance to Guidelines Moves Forward in Assembly; Would Create a New Element of Professional Misconduct
Assembly Bill 2230, sponsored by Assemblyman Richard Gottfried, has moved to the Assembly floor for a vote.  This legislation requires health care professionals to order, prescribe, administer and dispense pain-relieving medications in accordance with professional standards and guidelines. The bill would provide limited protections for physicians from professional discipline and criminal liability for ordering, prescribing, and administering pain relieving medications in accordance with reasonable standards of care including an “accepted guideline”.  The definition of “accepted guideline”, under the proposed legislation, means a peer reviewed clinical practice guideline for pain management developed, as applicable, by a nationally-recognized health care professional or specialty association, or a nationally-recognized pain management association.  However, Assembly Bill  2230 establishes  a new element of professional misconduct for failure to adequately order, prescribe, administer or dispense pain-reliving medications or other treatments for the relief of pain in accordance with the reasonable standard of care of the health care practitioner’s profession, including an accepted guideline. This legislation would apply to all patients with pain.   The Medical Society of the State of New York is opposed to this measure.                                                                            (CLANCY, DEARS)


Final Opioid Prescribing Webinar on March 10th;  Registration is Now Open
The final webinar in the opioid series will be held on Thursday, March 10th at 7:30 a.m. Title of the program is “Treatment of Opioid Use Disorders”.   Physicians and other prescribers are encouraged to register for the remaining webinars  at this link.  Click on the upcoming tab and select the programs.

Physicians will need to register for each webinar; each webinar has different topics described below. Physicians and other prescribers are allowed to register up to ½ hour before the webinar.

The Medical Society of the State of New York, the New York State Office for Alcoholism and Substance Abuse Service and the NYS Department of Health’s Bureau of Narcotic Enforcement, are jointly providing this free, four part webinar series on opioid prescribing. 

Entitled “Revisiting the Role of Opioid Analgesics for Simple and Complex Patients with Chronic Pain”, faculty for the session will be Charles Argoff, MD and Charles Morgan, MD, FASAM, FAAFP, DABAM.   The educational objectives are:    Recommend tools to assist in the management of patients for whom opioids are indicated and prescribed; and discuss strategies to reduce risk of treating pain in patients with substance use disordershysicians and other prescribers can take one or all of the webinars. 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.

Please contact Pat Clancy at pclancy@mssny.org or Terri Holmes at tholmes@mssny.org for further information.                                       (CLANCY, DEARS)


MSSNY’s Opioid Webinars are Now Available Through its CME Online Site
The Medical Society has archived its opioid webinar series on its continuing medical education website at http://cme.mssny.org.  The webinars that are currently on the site are:  Webinar 1 Pain Management at the Crossroads:  A Tale of Two Public Health Problems and Webinar 2   Rational Opioid Prescribing:  Is this Possible for Chronic Pain?  Physicians and other prescribers can earn up to one hour of continuing medical credits by viewing this webinar and completing the test.    The reminder of the webinars will be placed on line in the very near future. 

The MSSNY CME site requires new users to register, but once registered physicians and other health care providers will have a personalized training page to take the webinars and other course work located on the site.   New registrants to the site will create a username and password, which should be retained and be used for continued access to the site. Once registered and logged into the site, physicians will be taken to an instruction page.   Click on the tool bar menu located at the top of the page and click on “My training” to view and take the various courses.    

MSSNY has over 50 programs at this site and physicians are able to earn continuing medical education credits for each course.  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 number of continuing medical education credits for these online programs vary, but the majority of the programs are for 1.0 AMA/PRA Category 1 credit.  Further information on all these programs may be obtained by contacting Pat Clancy at pclancy@mssny.org.            (CLANCY)


PTSD and TBI in Returning Veterans:  March – June Webinars
MSSNY will be holding a series of CME webinars on PTSD and TBI in returning veterans on eight dates listed below from March through June. The faculty presenters will be Frank Dowling, MD and Joshua Cohen, MD.

Course objectives:

  • Explore the two most prevalent mental disorders facing American veterans today, their causes, symptoms, and comorbidities
  • Outline treatment options including evidence-based psychotherapy and pharmacotherapy
  • Discuss barriers to treatment, including those unique to military culture, and how to overcome them
  • Outline the process of recovery and post-traumatic grow

To register for this webinar, click on a date below and fill out the registration form

Wednesday, March 9, 7:30-8:30 AM

Tuesday, Mach 22, 6-7 PM

Thursday, April 7, 6-7 PM

Tuesday, April 12, 7:30-8:30 AM

Thursday, May 5, 6-7 PM

Thursday, May 19, 7:30-8:30 AM

Thursday, June 2, 6-7 PM

Thursday, June 9, 7:30-8:30 AM


MSSNY to Conduct Medical Matters Webinar on Zika Virus on March 16, April Session on Ebola
The Medical Society, in conjunction with the New York State Department of Health will conduct a Medical Matters webinar on the  “Zika Virus: An Evolving Story” on March 16th at 7:30 a.m.   Registration for this program is now open at. Click hereClick on the upcoming tab and select the programs.

The educational objectives for this program are: 1) Describe the epidemiology of Zika Virus infection;

2) Understand the modes of transmission; 3) Understand how to advise patients; and 4) Learn methods for prevention of infection.  William Valenti, MD, chair of MSSNY’s Infectious Disease Committee, and Elizabeth Dufort, MD,  Medical Director, Division of Epidemiology from the New York State Department of Health will conduct this presentation.

The April session of Medical Matters will take place at the MSSNY House of Delegates and is entitled,

“Ebola: A Perspective from the Field”.  The program will be conducted by Dario Gonzalez, MD, FACEP, Associate Medical Director,  Fire Department City of New York/Office of Medical Affairs.  Dr. Gonzalez was deployed for nine weeks by Americares to Liberia, West Africa as part of the US response to the Ebola epidemic.  The program will be held on Thursday, April 14, 2016 at 2:00pm. Physicians may attend the session at the Westchester Marriott, 670 White Plains Road, Tarrytown, NY 10591 or by webinar.  Registration is now. Click here.  Click on the upcoming tab and select the program.

The educational objective is: Offer perspective and lessons learned from an individual who treated Ebola patients firsthand.

The May session will be “Radiological Emergencies”, this session will be held on May 18, 2016 at 7:30 AM. (Please note that this session was originally scheduled for March 16, 2016) Faculty for this session will be Cham Dallas, PhD.  Dr. Dallas is a professor in the Department of Health Policy and Management at the College of Public Health, University of Georgia.  He is also the Director of the Institute for Disaster Management at the University of Georgia and a Board Member of the National Disaster Life Support Foundation (NDLSF).  Dr. Dallas has a national/international reputation in toxicology and emergency preparedness and response, including over 30 years of experience.

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.

Further information or assistance in registering for any of these programs may be obtained by contacting Melissa Hoffman at mhoffman@mssny.org.
(CLANCY, HOFFMAN)

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

pschuh@mssny.org ldears@mssny.org            mauster@mssny.org  
pclancy@mssny.org jMcPartlon@mssny.org    

enews large


MSSNY President Dr. Joseph Maldonado Quoted in Wall Street Journal Article on Looming E-Prescribing Deadline
In a Wall Street Journal article on Tuesday, Corinne Ramey reports that some medical institutions in New York are asking for more time to comply with a state law that will take effect on March 27th, requiring that all medications be prescribed electronically in order to cut down on drug abuse, errors, and fraud. Commenting on how the new policy will limit patients’ ability to shop for lower drug costs or take the prescription to another pharmacy, Medical Society of the State of New York President Joseph Maldonado stated, “The physician now has to deal with an angry patient, a belligerent patient or a patient that insists they want this in writing.” 


This Year’s Flu Vaccine Is 59% Effective, Preliminary Data Show
The CDC reported this week preliminary overall influenza effectiveness of 59 percent this year. Unlike last year, this year’s vaccine is a good match to the strains that make people sick. These data were presented at a meeting of the agency’s Advisory Committee for Immunization Practices (ACIP) in Atlanta. This finding is comparable to past estimates for seasons when most circulating flu viruses and vaccine viruses have been similar.

“This means that getting a flu vaccine this season reduced the risk of having to go to the doctor because of flu by nearly 60 percent,” said Joseph Bresee, M.D., chief of CDC’s Epidemiology and Prevention Branch. “It’s good news and underscores the importance and the benefit of both annual and ongoing vaccination efforts this season.”


CDC Study: HPV Infections Decline Among Teenage Girls
A CDC study published in the March issue of Pediatrics suggests that fewer US women are entering adulthood infected with HPV thanks to a vaccination program that began a decade ago. The study is the first to show falling levels of dangerous strains of the virus among American women in their early 20s. Girls between 14 and 19 years old saw infection rates on the four types of HPV covered by the Gardasil vaccine fall 64 percent from the rate prior to the vaccine’s introduction — from 11.5 percent in 2003-2006 to 4.3 percent between 2009 and 2012.


MSSNY Member Richard Lockwood, MD Named Vice President and Chief Medical Officer of Excellus BlueCross BlueShield Central New York Region
Excellus BlueCross BlueShield has named Richard Lockwood, M.D., vice president and chief medical officer of the company’s Central New York region. He replaces Marybeth McCall, M.D., who is now serving as vice president and chief medical officer of Excellus BlueCross BlueShield’s Utica region.

Lockwood has been vice president and chief medical officer of utilization management for Excellus BlueCross BlueShield since July 2015. He joined the company as a part-time associate medical director in 1999 and was named medical director for the company’s Central New York region in 2011.

In his professional career, Lockwood has been in private practice with Onondaga Hill Internists, Family Care Medical Group, Van Duyn Home and Hospital, Loretto, and Hill Haven Nursing Home, all in Syracuse. He has held the position of medical director at Iroquois Nursing Home, Jamesville, since 2005.

After graduating cum laude from Syracuse University and SUNY Downstate College of Medicine, Brooklyn, Lockwood completed his internship and residency in internal medicine at the Medical College of Pennsylvania in Philadelphia. He is a clinical instructor at SUNY Upstate Medical Center, Syracuse, and has hospital privileges at Upstate Medical University and Upstate University Hospital Community Campus, where he served as president of the medical staff prior to the hospital’s merger with Upstate Medical University.

A member of MSSNY since 1982, Dr. Lockwood is also a member of the Onondaga County Medical Society and American College of Physicians,  and is a Fellow of the American Board of Internal Medicine.


CMS Webinar on TCPI and CJR Programs
The New York City Regional Office of the Centers for Medicare & Medicaid Services will be hosting a webinar entitled “New Program Initiatives – Goals and Operations” on Tuesday, March 8, 2016, from 11:30 AM – 1:00 PM EST.  The programs that will be discussed along with a Q & A segment include:

  • Transforming Clinical Practice Initiative (TCPI) &
  • Comprehensive Joint Replacement Program (CJR)

The target audience is State Health and Trade Associations, Hospitals, Group, Specialty and Individual Physician Practices, and Ancillary providers (all provider types).

There is no charge to attend, but registration is required.  To register, click here 


Do You Have Expertise in Physician Stress and Burnout? We Need You!
At the 2015 House of Delegates of the Medical Society of the State of New York, a resolution was passed calling for action to address the prevalence of physician burnout.

We need your help!

We are looking to assemble the MSSNY team to tackle this work. This calls for physicians who have experience or expertise in designing or implementing physician health programs or stress/burnout programs for physicians. Please contact eskelly@mssny.org with a short bio and letter expressing your interest, expertise and what you intend to bring to the taskforce to advance the mission of the project.


Physician Entrepreneurship: Transform the Future of Health Care
Interested in opportunities to impact medicine beyond your clinical practice? Join the AMA for an exclusive event to discuss how physicians are getting involved in and, indeed, helping to lead health care innovation.

A dynamic panel of physicians will share their perspectives, accomplishments and insights gleaned as they’ve developed new products, formed companies, advised start-ups and invested in innovative health care ventures.

WHEN: 7 p.m., Tuesday, March 1. Cocktails and hors d’oeuvres will be provided.

WHERE: Impact Hub NYC, 394 Broadway, New York, NY

Register today! Free for AMA members. Limited seating available. $500 for non-AMA members.


Poster Symposium Seeks Judges on April 15 in Tarrytown
If you’re coming to the House of Delegates in Tarrytown – or just live in the neighborhood – and are free on Friday afternoon, April 15, from 2 – 4 pm, please consider participating as a judge at the MSSNY Resident and Fellow Section Poster Symposium. It’s always an exciting, lively event! Please contact sbennett@mssny.org or 516-488-6100 extension 383 if you’re interested. Thank you.


CLASSIFIED

Want to Sublease Your Clinic Space or Rent Space to Expand Your Practice? List with Clineeds
Clineeds is an online platform designed to help physicians find and sublease clinic space. Listing is completely FREE! Sign up today at http://clineeds.com/signup We take care of the rest!

Office Rental 30 Central Park South
Two fully equipped exam rooms, two certified operating rooms, 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.


Jerome I. Sager – Attorney at Law
The health care law experts representing medical professionals for more than 25 years.  See us for Professional Medical Conduct Defense, Medicaid and Medicare Fraud Cases, DEA and Controlled Substance Issues, Third party insurance issues. We can handle most legal matters. Call us for a free consultation. 212-685-2333 / 917-312-6631, jeromesager@cs.com



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

February 19, 2016 – We Are NOT Burned Out or Stressed! We Are Fed Up!

drmaldonado PRESIDENT’S MESSAGE
 Dr. Joseph R.  Maldonado
asset.find.us.on.facebook.lgTwitter_logo_blue1

February 19, 2016
Volume 16, Number 7

Dear Colleagues:

We Are NOT Burned Out or Stressed!  We Are Fed Up!

Over the past year, we have all read headlines highlighting physician burnout and stress.

I have to admit that I have been advocating for greater physician awareness and attention to physician burnout and stress.  I have established a taskforce that seeks to address physician stress and burnout.  I have done so by trying to look at the stressors placed on our lives from an observer perspective.

From that perspective, one frames physician stress as a common phenomenon.  The observer perspective allows us to distance ourselves from the overwhelming stresses, identify them for others while framing those affecting us differently.  From an observer perspective, our stresses are manageable and we are always capable of effectively dealing with stresses.  We are, of course, different than those other doctors who have a difficult time effectively coping with their stresses.  For those physicians, we clearly need solutions for managing stress and burnout – or so we frame it to distance ourselves from “those” colleagues.

This week, I came to realize the fallacy of this framework.  Yes, there are physicians who are coping ineffectively with stress.  Some physicians do burn out. HOWEVER, there is something ABSOLUTELY WRONG about framing the stresses facing physicians in context of our coping abilities.  Such framing seems to make it perfectly acceptable and normal to pile stressor upon stressor upon stressor onto physicians.  Any failure of a physician to respond like Superman or Wonder Woman is viewed as weakness.

The failing is NOT the inability of physicians to merrily face the assaults on the profession.  The failing is in our buying into these assaults and stresses as part of what we bought into when we entered our profession.  We must stop accepting these assaults and must fight back!  We are not stressed!  We are not burnt out.  WE ARE FED UP AND HAVE HAD ENOUGH!

This is NOT what I bought into when I became a doctor.  It’s time we reframed this demoralization within our profession.  We must stand up and say, “The problem is not with my abilities to cope with stress or burnout.  The problem lies in the assaults on us and our profession!  Enough is Enough!  We will not continue to accept these assaults.  We will walk away before burning out.”

I’m MAD AS HELL AND I’M NOT GONNA TAKE THIS ANYMORE!

I’M GONNA GIVE SOME LEGISLATORS A PIECE OF MY MIND NEXT MONTH!

Joseph Maldonado, M.D, MSc, MBA, DipEBHC
MSSNY President

Please send your comments to comments@mssny.org


MLMIC_011916_Enews_550x150


Capital_Update_Banner

MSSNY Lobby Day Scheduled for March 8th – Physicians Urged to Attend and Wear  Your White Lab Coats
MSSNY’s “Physician Advocacy Day” will be held on March 8th in the Lewis Swyer Theatre in the Egg located at the Empire State Plaza in Albany, New York.  If you plan to attend, please register here.

A full slate of legislators and top Administration officials will attend and dialogue with Advocacy Day participants including:

  • Donna Frescatore, Executive Director, NYS Health Benefit Exchange;
  • Troy Oechsner, Executive Deputy Superintendent, Department of Financial Services;
  • Legislative Panel: Senate Health Chair Kemp Hannon; Assembly Health Chair Richard Gottfried; Senate Insurance Chair James Seward; Assembly Insurance Chair Kevin Cahill.

In addition, Assembly Majority Leader Joe Morelle and Senate Majority Leader John Flanagan have also agreed to attend the morning proceedings and Speaker Heastie has been invited to the event but has not yet confirmed his participation. A brief informal luncheon to which members of each House are invited to speak with their constituents will follow the morning program.   County Medical Societies will be scheduling appointments for physicians to meet with their elected representatives.

PHYSICIANS ARE ENCOURAGED TO IMMEDIATELY REGISTER THROUGH THE LINK BELOW TO ATTEND THE MARCH 8TH LOBBY DAY IN ALBANY. http://goo.gl/forms/Mw7CX8JfzL (DIVISION OF GOVERNMENTAL AFFAIRS) 


MSSNY Lobby Team to Conduct one more Pre-Lobby Day Webinar on Issues to be Discussed on March 8th
In advance of the Lobby Day, MSSNY DGA staff will offer one more morning briefing program so that you can hit the ground running on March 8th. The next briefing program will be held on Wednesday, February 24 from 7:30-8:30AM. If you and/or your colleagues wish to participate on this briefing session, please register by clicking onto the link below.

February 24 briefing session 7:30-8:30AM:
(DIVISION OF GOVERNMENTAL AFFAIRS)


Physicians Invited to Attend Fireside Chat With MSSNY President Dr. Joseph Maldonado and Troy Oechsner, Deputy Superintendent of Insurance and Donna Frescatore, Executive Director of the NY State of Health
On March 7th, the evening before MSSNY’s Lobby Day, Joseph Maldonado, Jr., MD, MSc, MBA, will conduct a “fireside chat” with Troy Oechsner, Deputy Superintendent at DFS and Donna Frescatore, Executive Director for the NY State of Health in the MSSNY office. This is a relaxed and fluid format in which Dr. Maldonado, Mr. Oechsner and Ms. Frascatore can discuss issues of concern to the medical community (network adequacy, action taken by Emblem Health to narrow its network,  the collapse of Health Republic, etc). Physicians are invited to be physically present at this event in the DGA offices located at Ste 408, One Commerce Building, in Albany or can engage in real time by emailing their questions during the LIVE webcast of the event. The program will run for one hour from 5:30-6:30PM on March 7th.  To register to attend the event, click onto this link:
(DIVISION OF GOVERNMENTAL AFFAIRS)


Why Physicians Need to Take a Day Away from Your Practice To Lobby Albany on March 8, 2016

  • Think you pay too much in malpractice insurance costs?  The Trial Bar doesn’t care. They have introduced legislation that will certainly increase your premium costs.
  • If you practice in the Capital District, Southern Tier, Central NY, or Western NY, New York State wants to take away your Excess Liability Insurance Coverage.
  • New York State wants to enable NPs to deliver care to injured workers and take away County Medical Society review of authorized physicians rather than fixing what ails the Workers’ Compensation system.
  • The Proposed NYS Budget does nothing to compensate physicians for the unpaid care they have provided to Health Republic insureds.
  • New York State wants to enable Walmart and Target to hire NPs to deliver care to the public to compete directly against you.
  • Patient health could be threatened by inappropriately expanding the scope of practice of countless non-physicians, including dentists, optometrists and psychologists.
  • We need to prevent insurers from offering patients narrow networks for Exchange plans and denying patient access to out of network physicians.

These are very real issues that are currently being discussed and will be resolved either in the State Budget which will be enacted by April 1st or before the end of Session on June 16th. You need to come to Albany, and speak with your elected officials so that they can hear your concerns. Otherwise, all they will hear are the perspectives of trial lawyers and insurance companies.

PLEASE JOIN YOUR COLLEAGUES FROM ACROSS THE STATE TO LOBBY YOUR ELECTED LEADERS IN PERSON IN ALBANY MARCH 8TH.
REGISTER HERE.
(DIVISION OF GOVERNMENTAL AFFAIRS)


Urge Your Legislators to Support Health Republic Guarantee Fund Legislation (S.6667/A.9311)
Assembly Health Committee Chair Richard Gottfried together with Assemblyman Charles Lavine (D-Nassau County) introduced legislation (A.9311) this week to establish a Guaranty Fund to help to assure the payment of the hundreds of millions that Health Republic owes physicians and hospitals across New York State, as well as to protect consumers and health care providers from future health plan insolvencies.  Identical legislation (S.6667, Valesky, with several co-sponsors) has been introduced in the State Senate.  Right now, New York is the only state in the country that does not have such a Guarantee Fund.  With the health insurance industry in strong opposition to this proposal, it is imperative that you urge your Senators and Assemblymembers to support this bill and include it as part of the State Budget currently under negotiation by sending a letter from 
here .

You must remind your legislators that, with physicians facing so many other challenges in seeking to keep their doors open to deliver patient care, including high liability costs, expensive electronic medical record equipment, employee costs, insurance companies dropping physicians from their networks and declining payments from insurers, failure to assure payment for these claims would have serious negative consequences for patient care and employment in your community.
(AUSTER, DEARS)


Please Complete Survey to Let Us Know What You Are Owed as a Result of Health Republic Debacle
MSSNY’s updated survey of outstanding Health Republic claims shows that, based upon results received, physicians are owed nearly $25,000,000.  However, we believe that far more physicians who have been adversely impacted have yet to respond.  As we continue our advocacy in support of a Guarantee or other special fund to pay for the unpaid claims as a result of the Health Republic demise, we need those of you who have not completed the survey to provide us with updated information regarding the amounts you are due from Health Republic.  To complete the survey, click hereThis data is critical to our advocacy efforts!   We need to obtain updated and more precise numbers from as many impacted physicians as possible since many legislators have asked us for this data.
 (AUSTER, DEARS)


Physicians Urged to Oppose Huge Cuts to Excess Medical Liability Insurance Program
Physicians are urged to continue to contact their legislators to object to a provision in the Executive Budget that would cause more than half of physicians to lose their Excess Medical Malpractice Insurance coverage.

Specifically, the proposal would cut funding by $25 million, with the effect that 55% of physicians who currently receive this essential coverage being dropped from the program.  Across much of upstate New York, only neurosurgeons, bariatric surgeons and OB-GYNs would keep this coverage.  That means that in the Capital District, in Northern New York, in Central New York, in western New York and in the Southern Tier every family physician, internist, pediatrician, ophthalmologist, emergency room physician, vascular surgeon, cardiologist, radiologist, pathologist, otolaryngologist, dermatologist and allergist would be automatically dropped.  And downstate, many primary care physicians, ophthalmologists, otolaryngologists, pathologists, dermatologists and allergists would be dropped.

The Excess Medical Liability Insurance Program provides an additional layer of $1M of coverage to physicians with hospital privileges who maintain primary coverage at the $1.3 million/$3.9 million level.  The program was created over 30 years ago as a result of the liability insurance crisis of the mid-1980’s to address concerns among physicians that their liability exposure far exceeded available coverage limitations.  Absent meaningful liability reform, with verdicts and physician liability premiums continuing to be far out of proportion compared to the rest of the country, full funding for the Excess program is absolutely essential in today’s very challenging practice environment.

At a time when the state is seeking to attract and retain physicians, this proposal deters physicians from wanting to practice in New York State for fear of putting themselves and their families in financial jeopardy for judgements and settlements exceeding the limits of their primary coverage.  Please urge your legislators to reject these cuts and restore full funding for the program!  (AUSTER, DEARS)


Physicians Urged to Oppose Adverse Workers’ Compensation Budget Proposal; 30-Day Amendments Bring Additional Concerns
All physicians must continue to contact their State Senators and Assemblymembers to express their strong opposition to sweeping Workers’ Compensation reform proposals contained in the Executive Budget.

MSSNY staff continues to meet with key legislative leaders and staff to voice its very serious concerns with Budget proposals that would:

  • Enable treatment of injured workers and direct payment for care by various non-physicians without clarity as to: how non-physicians treating patients with serious health conditions will coordinate patient care delivery when specialized care is needed; whether existing fees will need to be cut to cover this expanded list of care providers; and whether a non-physician can perform an IME of an injured worker to review the care provided by a physician to an injured worker;
  • Expand the circumstances when a physician or other health care provider can have their authorization removed and empowers the Board to impose significant fines on a physician or any other Board-authorized health care provider for violating a Workers Compensation rule;
  • Remove the authority of county medical societies to recommend physicians to serve as treating providers or independent medical examiners under Workers Compensation, which is currently an important peer review function provided by county medical societies to assure physician applications are complete and physician applicants are appropriately qualified to deliver this needed care to injured workers.
  • Reduce choice for injured workers by prohibiting in many instances an injured worker from seeking medical treatment from outside a Workers Compensation PPO before 120 days after his or her first visit to a PPO provider;
  • Remove the requirement for a referral by a physician for an injured worker as a pre-condition to receive psychological care;

In the 30-day Executive Budget amendments released last weekend, the proposal was made even more adverse by a) requiring all physicians and other currently authorized WC providers to execute an “authorization agreement” with the Board (as of now, it is unclear what would be contained within such “authorization agreement”) within 12 months of the effective date of the proposal, if it were to be enacted; and b) removing the ability of professional associations, such as MSSNY, to recommend arbitrators to resolve medical fee disputes between health care providers and carriers.

Exacerbating these concerns is that the proposal also does not meaningfully address the many excessive administrative hassles and payment delays that have caused many physicians to be unable to participate in the Workers Compensation program.   While there have been some modestly positive actions taken by the WCB in recent years to encourage physician participation in the WC program through removal of arbitration fees and development of an electronic portal for facilitating authorizations from carriers, the Budget proposals if enacted could further chase physicians away from the program.

MSSNY has also reached out to labor organizations and associations representing attorneys for injured workers to coordinate its advocacy in opposition.  MSSNY has also been working closely with county medical society leadership from across the State to encourage their outreach to their local Senators and Assemblymembers to request that these proposals be jettisoned from the Budget.
(AUSTER, DEARS)


MSSNY President Appears on News Program to Urge Passage of Legislation to Enable Override of Insurer “Fail First” Medication Policies
Concerned about health insurer policies that require your patients to “fail first” on certain prescription medications before they are able to take the medication that you believe is most medically appropriate to improve their health?  MSSNY is working together with a number of patient advocacy groups in support of legislation (A.2834-A, Titone/S.3419-A, Young) to provide physicians with an expeditious manner to override an insurer “fail first” policy when it is in the best interest of their patients’ health.  To send a letter in support of this legislation click here.   This week, MSSNY President Dr. Joseph Maldonado appeared on the YNN Statewide news program Capital Tonight along with Matthew Shapiro of the National Alliance on Mental Illness’ Matthew Shapiro to discuss the importance of the legislation.  To watch the broadcast, click here.(AUSTER, DEARS)


Please Advocate for Due Process Rights When Physicians are Non-Renewed by a Health Insurer
Physicians are urged to contact their legislators to support a bill (A.1212, Lavine/S.4751, Hannon) that would assure physicians are accorded a fair peer review appeals mechanism before their participation contract with a health insurance company can be non-renewed.  To send a letter in support of this legislation here.  The legislation is in response to situations such as the disrespectful way by which Emblem treated 750 of its network physicians who were unceremoniously dropped from the network in October based upon specious allegations of failure to transition to value-based payments, severing patient treatment relationships for countless patients.  MSSNY has strenuously urged to the Department of Financial Services, Department of Health, and Attorney General that these physicians be given a fair opportunity to be reinstated, and have shared this information with the entire New York State Legislature. (See MSSNY letter to DFS here.   The Attorney General’s office continues to investigate specific complaints raised by individual physicians whether they were given a fair chance to appeal these non-renewals.
 (AUSTER, DEARS)


To Physicians in Long Island, NYC, Hudson Valley, and Capital District:  Please Complete this Survey
State and federal regulators are very interested in knowing the prospective effects of these possible mergers on your practice and patient care.   In this regard, MSSNY working together with the American Medical Association Advocacy Resource Center have developed a survey seeking physician input on the potential impact on these proposed mergers.

Last fall, the AMA released a report articulating the significant potential anticompetitive effects that would occur in numerous regions all across the country as a result of this merger.  Among the identified regions of concern in New York State were Long Island, New York City, the Hudson Valley, the Capital District and the Glens Falls area.  Therefore, physicians practicing in these regions are asked to complete the Survey! 


Opioid Prescribing Webinar on Feb 23rd; Registration is Now Open
Registration is on-going for the third webinar in the opioid series which will be held Tuesday, February 23rd at 7:30 a.m. Title of the program is “Treatment of Opioid Use Disorders”.   Physicians and other prescribers are encouraged to register for the remaining webinars  at the this link.

Click on the upcoming tab and select the programs.

Physicians will need to register for each webinar; each webinar has different topics described below. Physicians and other prescribers are allowed to register up to ½ hour before the webinar.

The Medical Society of the State of New York, the New York State Office for Alcoholism and Substance Abuse Service and the NYS Department of Health’s Bureau of Narcotic Enforcement, are jointly providing this free, four part webinar series on opioid prescribing. 

Entitled,) “Revisiting the Role of Opioid Analgesics for Simple and Complex Patients with Chronic Pain”.  Faculty for the session will be Jeffrey Selzer, MD and the educational objective:  Describe potential for patient addiction, screening, diagnosis and subsequent treatment or referral.

The fourth webinar will be held on Thursday, March 10, 2016, 7:30 a.m. Faculty: Charles E. Argoff, MD and Charles Morgan, MD, FASAM, FAAFP, DABAM and the educational objectives:  Recommend tools to assist in the management of patients for whom opioids are indicated and prescribed; discuss strategies to reduce risk of treating pain in patients with substance use disorders.

Physicians and other prescribers can take one or all of the webinars. 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.

Please contact Pat Clancy at pclancy@mssny.org or Terri Holmes at tholmes@mssny.org for further information.                                        (CLANCY, DEARS)


MSSNY Continues Work to Address Disparities in Health Care
MSSNY’s Committee to Eliminate Health Care Disparities met this Friday, February 19th, and hosted Kyle Ishmael, the Executive Director of the Black, Puerto Rican, Hispanic and Asian Legislative Caucus. Mr. Ishmael spoke at length on the background of the Caucus and its legislative priorities outlined in the Caucus’ 2016-17 People’s Budget.

As budget season progresses, MSSNY hopes to collaborate with the Caucus and develop synergies to address health care disparities among minority populations. With a wide variety of illnesses and ailments disproportionately affecting minority populations, MSSNY remains diligent in its efforts to address these disparities and committed to attracting members of minority populations to the practice of medicine. A special thanks to Kyle Ishmael and the Black, Puerto Rican, Hispanic and Asian Legislative Caucus.
(MCPARTLON)


MSSNY to Conduct Medical Matters Webinar on Zika Virus on March 16, April Session on Ebola
The Medical Society, in conjunction with the New York State Department of Health will conduct a Medical Matters webinar on the  “Zika Virus: An Evolving Story” on March 16th at 7:30 a.m.  
Registration for this program is now open.

Click on the upcoming tab and select the programs.

The educational objectives for this program are: 1) Describe the epidemiology of Zika Virus infection;

2) Understand the modes of transmission; 3) Understand how to advise patients; and 4) Learn methods for prevention of infection.  William Valenti, MD, chair of MSSNY’s Infectious Disease Committee, and physicians from the New York State Department of Health will conduct this presentation.  Further information will be available shortly.

The April session of Medical Matters will take place at the MSSNY House of Delegates and is entitled,

“Ebola: A Perspective from the Field”.  The program will be conducted by Dario Gonzalez, MD, FACEP. Associate Medical Director,  Fire Department City of New York/Office of Medical Affairs.  Dr. Gonzalez was deployed for nine weeks by Americares to Liberia, West Africa as part of the US response to the Ebola epidemic.  The program will be held on Thursday, April 14, 2016 at 2:00pm. Physicians may attend the session at the Westchester Marriott, 670 White Plains Road, Tarrytown, NY 10591 or by webinar.  Registration is now open.

Click on the upcoming tab and select the program.

The educational objective is: Offer perspective and lessons learned from an individual who treated Ebola patients firsthand.

The May session will be “Radiological Emergencies”, this session will be held on May 18, 2016 at 7:30 AM. (Please note that this session was originally scheduled for March 16, 2016) Faculty for this session will be Cham Dallas, PhD.  Dr. Dallas is a professor in the Department of Health Policy and Management at the College of Public Health, University of Georgia.  He is also the Director of the Institute for Disaster Management at the University of Georgia and a Board Member of the National Disaster Life Support Foundation (NDLSF).  Dr. Dallas has a national/international reputation in toxicology and emergency preparedness and response, including over 30 years of experience.

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.

Further information or assistance in registering for any of these programs may be obtained by contacting  Melissa Hoffman at mhoffman@mssny.org.                                                      
(CLANCY, HOFFMAN)
 


PTSD and TBI in Returning Veterans: March – June Webinars
MSSNY will be holding a series of CME webinars on PTSD and TBI in returning veterans on eight dates listed below from March through June. The faculty presenters will be Frank Dowling, MD and Joshua Cohen, MD.

Course objectives:

  • Explore the two most prevalent mental disorders facing American veterans today, their causes, symptoms, and comorbidities;
  • Outline treatment options including evidence-based psychotherapy and pharmacotherapy;
  • Discuss barriers to treatment, including those unique to military culture, and how to overcome them;Outline the process of recovery and post-traumatic grow. 

To register for this webinar, click on a date below and fill out the registration form

Wednesday, March 9, 7:30-8:30 AM

Tuesday, Mach 22, 6-7 PM

Thursday, April 7, 6-7 PM

Tuesday, April 12, 7:30-8:30 AM

Thursday, May 5, 6-7 PM

Thursday, May 19, 7:30-8:30 AM

Thursday, June 2, 6-7 PM

Thursday, June 9, 7:30-8:30 AM

(ELPERIN, DEARS)

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 ldears@mssny.org            mauster@mssny.org  
pclancy@mssny.org jMcPartlon@mssny.org    


enews large

Do You Have Expertise in Physician Stress and Burnout? We Need You!
At the 2015 House of Delegates of the Medical Society of the State of New York, a resolution was passed calling for action to address the prevalence of physician burnout.

We need your help!

We are looking to assemble the MSSNY team to tackle this work. This calls for physicians who have experience or expertise in designing or implementing physician health programs or stress/burnout programs for physicians. Please contact eskelly@mssny.org with a short bio and letter expressing your interest, expertise and what you intend to bring to the taskforce to advance the mission of the project.


CDC Report: New Yorkers and Others Not Getting Enough Sleep
The CDC released a report revealing that about one-third of adults in the US appear to be getting insufficient sleep. Prevalence of healthy sleep duration varied among states and ranged from 56.1% in Hawaii to 71.6% in South Dakota (Table 2). Most of the Great Plains states were in the upper quintile for healthy sleep duration; states in the southeastern United States and along the Appalachian Mountains tended to be in the lower quintiles (Figure). After surveying some 444,000 US adults in 2014, the CDC “also found that while two-thirds of white people nationally got enough sleep, only about half of blacks, Native Hawaiians and Pacific Islanders did.”

In New York, 61.6-63.2 % of age-adjusted percentage of adults reported ≥7 hours sleep per 24-hour period.


Humana Fined $500,000 for Discriminating Against AIDS /HIV Patients
The Florida Office of Insurance Regulation (FOIR) announced this week that it had concluded its market examination of Humana and fined the health insurer $500,000 for failing to cooperate with investigators. In a consent order dated February 16, 2016, Humana agreed to “maintain procedures to ensure that it does not by effect or design treat people living with HIV/AIDS less favorably than any other condition.”

In 2014, The AIDS Institute and NHeLP filed a complaint with the U.S. Department of Health and Human Services’ Office for Civil Rights (OCR) charging four Florida health plans, including Humana, with unlawful discrimination against people living with HIV and AIDS by placing all HIV medications, including generics, on the highest cost sharing tier, thus requiring enrollees to pay as much as 50 percent co-insurance for every HIV drug. In the complaint, the groups contend that such practices discourage people with HIV/AIDS from enrolling in the plans and violate the Affordable Care Act’s (ACA) non-discrimination provisions. The ACA bans plans from discriminating against individuals based upon disability and prohibits them from discouraging enrollment by people with significant health needs.

Last year, HHS issued guidance to all plans nationwide informing them that such practices are discriminatory; and in proposed regulations implementing the ACA’s non-discrimination provision, Section 1557, HHS made clear that plan benefits cannot be designed to discriminate. However, OCR has yet to issue a ruling on the complaint.

The AIDS Institute’s analysis of Florida’s 2016 qualified health plans found that coverage for nearly all Hepatitis B and C drugs by several insurers remains subject to high co-insurance levels. Humana places almost all Hepatitis C drugs on Tier 5, which translates into coinsurance of either a 40 or 50 percent of drug cost, after the patient pays a $3,800 deductible. Aetna and CoventryOne place all Hepatitis C drugs and almost all hepatitis B drugs on Tiers 4 and 5, which carry coinsurance of 40 percent and 50 percent of drug cost, after a $2,750 deductible.


Young Adults on Adderall: Dramatic Increase in Emergency Room Visits
A study published online Feb. 16 in the Journal of Clinical Psychiatry indicates that “incidences of misuse and emergency room visits related to Adderall increased dramatically for young adults between 2006 and 2011.” Researchers arrived at this conclusion after examining data from the “National Disease and Therapeutic Index, a survey of office-based practices; National Survey on Drug Use and Health, a population survey of substance use; and Drug Abuse Warning Network, a survey of hospital emergency department visits.”


Medical School Deans Promote Three-Year Medical Degree
In an opinion piece in the Wall Street Journal (2/18, A11), dean and CEO Robert I. Grossman, MD, and vice dean for education, faculty, and academic affairs Steven B. Abramson, MD, of New York University’s Langone Medical Center and the NYU School of Medicine, write in favor of the three-year medical degree instead of the traditional four-year path as a way to save students money and help medical education adapt to the needs of the current century.


CA Hospital Pays “Ransomware”
Hollywood Presbyterian Medical Center paid a ransom in bitcoins equivalent to about $17,000 to hackers who infiltrated and disabled its computer network, the hospital’s chief executive said Wednesday. It was in the hospital’s best interest to pay the ransom of 40 bitcoins after the hacking that began Feb. 5, the C.E.O., Allen Stefanek said. The F.B.I. is investigating the attack, often called “ransomware,” in which hackers encrypt a computer network’s data to hold it hostage, providing a digital decryption key to unlock it for a price. “The quickest and most efficient way to restore our systems and administrative functions was to pay the ransom and obtain the decryption key,” Mr. Stefanek said. Bitcoins, an online currency, are hard to trace. The Los Angeles hospital network was operating fully again Monday, and patient care was not affected by the hacking, Mr. Stefanek said. 


CMS Plans to Correct Attestation System to Allow EPs to Claim an Exclusion for Measure 1 of the Patient Electronic Access Objective
The Centers for Medicare & Medicaid Services (CMS) will shut down the Medicare & Medicaid EHR Incentive Program Registration and Attestation System on Sunday, February 21, 2016, between 6:00 a.m. and 10:00 a.m. EST, to correct an error that is preventing eligible professionals (EPs) from claiming an exclusion for Measure 1 of the Patient Electronic Access Objective (referred to as 8A in the attestation system).

  • Patient Electronic Access, Measure 1 Exclusion: Any EP who neither orders nor creates any of the information listed for inclusion as part of the measures except for ‘Patient Name’ and ‘Provider’s name and office contact information.

EPs whose attestation was rejected as a result of not meeting objective 8 may modify and resubmit their attestation information after February 21, 2016. EPs who have successfully attested to the EHR Incentive Programs 2015 requirements do not need to take any action.

Batch attestation users who have not yet submitted their files will also need to wait to submit their data until after February 21. To successfully upload a batch attestation with this exclusion, please ensure the batch files include a Y/N indicator for each provider record on the file. Users who have already submitted a batch attestation file for the 2015 program year do not need to resubmit.

For More Information

Visit the CMS website or contact the EHR Information Center Help Desk at (888) 734-6433/ TTY: (888) 734-6563. The hours of operation are Monday through Friday between 7:30 a.m. and 6:30 p.m. EST.


CLASSIFIED

Want to sublease your clinic space? Or would you like to rent space to expand your practice? Clineeds is an online platform designed to help physicians find and sublease clinic space. Listing is completely FREE! Sign up today at http://clineeds.com/signup We take care of the rest!


OFFICE SPACE – Sutton Place
Newly renovated medical office. Windows in every room looks out to a park like setting on the plaza level. 2-4 exam rooms/offices available, possible procedure room or gym. Separate reception and waiting area, use of 3 bathrooms and a shower. Central air and wireless. All specialties welcome. Public transportation nearby. Please call 212-772-6011 or e-mail: advocate@medicalpassport.org

Office Rental 30 Central Park South
Two fully equipped exam rooms, two certified operating rooms, 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.


Jerome I. Sager – Attorney at Law
The health care law experts representing medical professionals for more than 25 years.  See us for Professional Medical Conduct Defense, Medicaid and Medicare Fraud Cases, DEA and Controlled Substance Issues, Third party insurance issues. 212-685-2333 / 917-312-6631, jeromesager@cs.com.



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

February 12, 2016 – NY Doctors Are Under Attack

drmaldonado PRESIDENT’S MESSAGE
 Dr. Joseph R.  Maldonado
asset.find.us.on.facebook.lgTwitter_logo_blue1

February 12, 2016
Volume 16, Number 6

Dear Colleagues:

THE DOCTORS OF NEW YORK ARE UNDER ATTACK—the likes of which we have not seen since the malpractice crisis of 1975. AT that time, we joined together and did the impossible—we created our own malpractice insurance company!

This time, the assault comes in the form of the change to the date of discovery and extension of the statute of limitations as well as the cut in the excess liability program.

The net effect of passage of these efforts will be a 30% increase in malpractice premiums. Is there any doctor in New York who can stay in practice with such an increase?

It is imperative that you be in Albany on March 8— if we stand any chance to stop this assault on our profession.

If that is not enough, consider the loss of millions of dollars to doctors from the Health Republic debacle, the radical changes in methodology through the DSRIP and SCHIP initiatives and the mounting efforts to kick doctors off insurance networks.

The events in this legislative session are going to radically change the practice of medicine in New York.

This year’s issues are of critical importance to YOU.

The outcome will change the ability of many physicians to remain in practice.

Last year, 15,000 teachers marched on Albany to demand their rights. Do teachers care more about their profession than we care about ours?

A lot of doctors feel it is someone else’s responsibility. This year, it is YOUR responsibility.

We will NOT have a second opportunity to turn this situation around.

Every physician in NY who is not engaged in emergency care must be in Albany on March 8 to lobby their legislators.

BE there –it’s YOUR FUTURE!

We cannot afford to allow the trial lawyers to expand the statute of limitations to 10 years.

We cannot afford physicians to lose millions of dollars in the Health Republic fiasco.

We cannot afford to lose the excess layer of coverage.

We cannot afford to have physicians excluded from insurance plans.

YOU MAY THINK YOU CANNOT AFFORD TO TAKE A DAY OFF TO COME TO ALBANY ON LOBBY DAY! But I can assure you that you will NOT be able to afford to stay in practice if you stay home.

NEXT YEAR MAY BE TOO LATE!

REGISTER NOW!

Joseph Maldonado, M.D, MSc, MBA, DipEBHC
MSSNY President

Please send your comments to comments@mssny.org


MLMIC_011916_Enews_550x150


Capital_Update_Banner

MSSNY Lobby Day Scheduled for March 8th – Physicians Urged to Attend and Wear Your White Lab Coats
MSSNY’s “Physician Advocacy Day” will be held on March 8th in the Lewis Swyer Theatre in the Egg located at the Empire State Plaza in Albany, New York.  If you plan to attend, please register here.

A full slate of legislators and top Administration officials will attend and dialogue with Advocacy Day participants including:

  • Donna Frescatore, Executive Director, NYS Health Benefit Exchange;
  • Troy Oechsner, Executive Deputy Superintendent, Department of Financial Services;
  • Legislative Panel: Senate Health Chair Kemp Hannon; Assembly Health Chair, Richard Gottfried; Senate Insurance Chair, James Seward; Assembly Insurance Chair Kevin Cahill.

In addition, Assembly Majority Leader Joe Morelle and Senate Majority Leader John Flanagan have also agreed to attend the morning proceedings and Speaker Heastie has been invited to the event but has not yet confirmed his participation. A brief informal luncheon to which members of each House are invited to speak with their constituents will follow the morning program.   County Medical Societies will be scheduling appointments for physicians to meet with their elected representatives.

It is imperative for physicians to attend given the wide range of threats physicians face including legislation that would expand the statute of limitations with a broad date of discovery exception potentially increasing physician premiums by 14.5%; legislation to repeal the Trial Lawyers contingency fee limits, potentially increasing premiums by over 10%; significant reductions in eligibility of the Excess Program; legislation that will mandate physicians to take a 4-hour Pain Management CME course every two years; and a move to effectuate statutory and regulatory changes to implement a value-based payment structure under Medicaid and potentially to Medicare and commercial products as well. 

PHYSICIANS ARE ENCOURAGED TO IMMEDIATELY REGISTER THROUGH THE LINK BELOW TO ATTEND THE MARCH 8TH LOBBY DAY IN ALBANY.   http://goo.gl/forms/Mw7CX8JfzL      
(DIVISION OF GOVERNMENTAL AFFAIRS)
 


MSSNY Lobby Team to Conduct Pre-Lobby Day Webinars on Issues to be Discussed on March 8th
In advance of the Lobby Day, MSSNY DGA staff will offer two morning briefing programs so that you can hit the ground running on March 8th. Those briefing programs will be held on Tuesday, February 16 from 8:00-9:00AM and on Wednesday, February 24 from 7:30-8:30AM.

If you and/or your colleagues wish to participate on either of these briefing sessions, please register by clicking onto the appropriate link below.

February 16 briefing session: 8:00-9:00AM:

https://mssny.webex.com/mssny/k2/j.php?MTID=t20bd638fa04191a6a1ef419b97ccf6ec 

February 24 briefing session 7:30-8:30AM:

https://mssny.webex.com/mssny/k2/j.php?MTID=t93c8681382ad535070e436984c4e19ce
(DIVISION OF GOVERNMENTAL AFFAIRS) 


Physicians Invited to Attend Fireside Chat with MSSNY President Dr. Joseph Maldonado and Troy Oechsner, Deputy Superintendent of Insurance and Donna Frescatore, Executive Director of the NY State of Health
On March 7th, the evening before MSSNY’s Lobby Day, Joseph Maldonado, Jr., MD, MSc, MBA, will conduct a “fireside chat” with Troy Oechsner, Deputy Superintendent at DFS and Donna Frescatore, Executive Director for the NY State of Health in the MSSNY office. This is a relaxed and fluid format in which Dr. Maldonado, Mr. Oechsner and Ms. Frascatore can discuss issues of concern to the medical community (network adequacy, action taken by Emblem Health to narrow its network,  the collapse of Health Republic, etc). Physicians are invited to be physically present at this event in the DGA offices located at Ste 408, One Commerce Building, in Albany or can engage in real time by emailing their questions during the LIVE webcast of the event.  To View this event CLICK HERE.  The program will run for one hour from 5:30-6:30PM on March 7th.
(DIVISION OF GOVERNMENTAL AFFAIRS) 

Why Physicians Need to Take a Day Away from Your Practice To Lobby Albany on March 8, 2016
Think you pay too much in malpractice insurance costs?  The Trial Bar doesn’t care. They have introduced legislation that will certainly increase your premium costs.

  • If you practice in the Capital District, Southern Tier, Central NY, or Western NY, New York State wants to take away your Excess Liability Insurance Coverage.
  • New York State wants to enable NPs to deliver care to injured workers and take away County Medical Society review of authorized physicians rather than fixing the broken Workers Compensation system.
  • The Proposed NYS Budget does nothing to compensate physicians for the unpaid care they have provided to Health Republic insureds.
  • New York State wants to enable Walmart and Target to hire NPs to deliver care to the public to compete directly against you.
  • Patient health could be threatened by inappropriately expanding the scope of practice of countless non-physicians, including dentists, optometrists and psychologists.
  • We need to prevent insurers from offering patients narrow networks for Exchange plans and denying patient access to out of network physicians.

These are very real issues that are currently being discussed and will be resolved either in the State Budget which will be enacted by April 1st or before the end of Session on June 16th. You need to come to Albany, and speak with your elected officials so that they can hear your concerns. Otherwise, all they will hear are the perspectives of trial lawyers and insurance companies.


PLEASE JOIN YOUR COLLEAGUES FROM ACROSS THE STATE TO LOBBY YOUR ELECTED LEADERS IN PERSON IN ALBANY MARCH 8THREGISTER HERE.
 (DIVISION OF GOVERNMENTAL AFFAIRS)


Contact Your Legislators to Support a Health Republic Guarantee Fund (S.6667)
With the failure of the Executive Budget to include a Guarantee or other fund to cover the likely   hundreds of millions in payments due to Health Republic contracted providers, all physicians are urged to continue to contact their legislators and demand that the State Legislature take action to create such Guarantee or other fund to cover these costs as part of the State Budget process.

Senator David Valesky (D-Onondaga County) has introduced legislation (S.6667) to create such a Guarantee Fund.  The bill is co-sponsored by Senators Tony Avella (D-Queens), David Carlucci (D-Rockland County), Marc Panepinto (D-Erie County) and Diane Savino (D-Richmond County).  It is anticipated that similar legislation will be introduced in the Assembly shortly.

To read MSSNY’s memo in support of a Guarantee Fund, click here.

You must remind your legislators that, with physicians facing so many other challenges in seeking to keep their doors open to deliver patient care, including high liability costs, expensive electronic medical record equipment, employee costs, insurance companies dropping physicians from their networks and declining payments from insurers, failure to assure payment for these claims would have serious negative consequences for patient care and employment in your community.
(AUSTER, DEARS)


Please Complete Survey to Let Us Know What You Are Owed as a Result of Health Republic Debacle
As MSSNY continues its advocacy in support of a special fund to pay for the unpaid claims as a result of the Health Republic demise, we need you to take the time to complete a MSSNY survey to provide us with updated information regarding the amounts you are due from Health Republic.  To complete the survey, click here: https://www.surveymonkey.com/r/HRepublic2This data is critical to our advocacy efforts!  We thank the many of you who provided data in November detailing the amounts you are owed, but we need to obtain updated and more precise numbers since many legislators have asked us for this data.
(AUSTER, DEARS)

Physicians Urged to Oppose Huge Cuts to Excess Medical Liability Insurance Program
Physicians are urged to continue to contact their legislators (http://cqrcengage.com/mssny/app/onestep-write-a-letter?0&engagementId=161374) to object to a provision in the Executive Budget that would cause more than half of physicians currenty enrolled to lose their Excess Medical Malpractice Insurance coverage.     

MSSNY has expressed its strong opposition to these cuts in numerous meetings with Senators and Assemblymembers and in testimony to the Assembly Ways & Means and Senate Finance Committees.   To read MSSNY’s memo in opposition, click here.

Specifically, the proposal would cut funding by $25 million, with the effect that 55% of physicians who currently receive this essential coverage being dropped from the program.  Across much of upstate New York, only neurosurgeons, bariatric surgeons and OB-GYNs would keep this coverage.  That means that in the Capital District, in Northern New York, in Central New York, in western New York and in the Southern Tier every family physician, internist, pediatrician, ophthalmologist, emergency room physician, vascular surgeon, cardiologist, radiologist, pathologist, otolaryngologist, dermatologist and allergist would be automatically dropped.  And downstate, many primary care physicians, ophthalmologists, otolaryngologists, pathologists, dermatologists and allergists would be dropped.

The Excess Medical Liability Insurance Program provides an additional layer of $1M of coverage to physicians with hospital privileges who maintain primary coverage at the $1.3 million/$3.9 million level.  The program was created over 30 years ago as a result of the liability insurance crisis of the mid-1980’s to address concerns among physicians that their liability exposure far exceeded available coverage limitations.  Absent meaningful liability reform, with verdicts and physician liability premiums continuing to be far out of proportion compared to the rest of the country, full funding for the Excess program is absolutely essential in today’s very challenging practice environment.

At a time when the state is seeking to attract and retain physicians, this proposal deters physicians from wanting to practice in New York State for fear of putting themselves and their families in financial jeopardy for judgements and settlements exceeding the limits of their primary coverage.  Please urge your legislators to reject these cuts and restore full funding for the program!                         (AUSTER, DEARS)


Tell Your Legislators to Reduce Your Liability Costs, Not Expand Them!
All physicians must continue to contact their legislators to urge that they oppose legislation (A.285-A, Weinstein/S.6596, DeFrancisco) that could drastically increase New York’s already exorbitantly high medical liability premiums by changing the medical liability Statute of limitations to a “Date of Discovery” rule.   

You need to tell your legislators that no liability increases can be tolerated.  MLMIC’s estimate is that this bill could increase physician liability premiums by nearly 15%!   New York physicians continue to pay liability premiums that are among the very highest in the country.  By way of example, a neurosurgeon practicing on Long Island must pay an astounding $338,252 for just one year of insurance coverage and an OB/GYN practicing in the Bronx or Staten Island must pay $186,639.   New York far surpasses all other states in terms of total medical liability payouts, per capita payments, and medical liability awards above $1 million.

They also face rapidly increasing overhead costs to remain in practice such as the huge costs associated with implementing expensive and cumbersome electronic medical record systems.  At the same time, they face reduced payments from Medicare and commercial insurers, and many practices face losses of tens of thousands, hundreds of thousands and in some cases millions of dollars in losses due to the collapse of Health Republic.

And to make matters even worse, trial lawyers are aggressively pushing the Legislature to consider additional liability expansion bills such as legislation that would eliminate the statutory limitation on contingency fees in medical liability actions, legislation that MLMIC has estimated could have the effect of raising your premiums by over 10%.   Please tell your legislators to enact comprehensive liability reform to bring down these costs, not legislation that increases them!                                                                                  (AUSTER, DEARS) 


Physicians Urged to Continue to Oppose Adverse Workers Compensation Budget Proposal
All physicians should continue to contact their State Senators and Assemblymembers to express their strong opposition to sweeping Workers’ Compensation reform proposals contained in the Executive Budget.

MSSNY staff continues to meet with key legislative leaders and staff to voice its very serious concerns with Budget proposals that would:

  • Enable treatment of injured workers and direct payment for care by various non-physicians without clarity as to: how non-physicians treating patients with serious health conditions will coordinate patient care delivery when specialized care is needed; whether existing fees will need to be cut to cover this expanded list of care providers; and whether a non-physician can perform an IME of an injured worker to review the care provided by a physician to an injured worker;
  • Expand the circumstances when a physician or other health care provider can have their authorization removed and empowers the Board to impose significant fines on a physician or any other Board-authorized health care provider for violating a Workers Compensation rule;
  • Remove the authority of county medical societies to recommend physicians to serve as treating providers or independent medical examiners under Workers Compensation, which is currently an important peer review function provided by county medical societies to assure physician applications are complete and physician applicants are appropriately qualified to deliver this needed care to injured workers.
  • Reduce choice for injured workers by prohibiting an injured worker not subject to a collective bargaining agreement from seeking medical treatment from outside a Workers Compensation PPO before 120 days after his or her first visit to a PPO provider;
  • Remove the requirement for a referral by a physician for an injured worker as a pre-condition to receive psychological care;

Exacerbating these concerns is that the proposal also does not meaningfully address the many excessive administrative hassles and payment delays that have caused many physicians to be unable to participate in the Workers Compensation program.   While there have been some modestly positive actions taken by the WCB in recent years to encourage physician participation in the WC program through removal of arbitration fees and development of an electronic portal for facilitating authorizations from carriers, the Budget proposals if enacted could further chase physicians away from the program.

MSSNY has also reached out to labor organizations and associations representing attorneys for injured workers to coordinate its advocacy in opposition.  MSSNY has also been working closely with county medical society leadership from across the State to encourage their outreach to their local Senators and Assemblymembers to request that these proposals be jettisoned from the Budget.
(AUSTER, DEARS) 


Please Urge Support for Legislation to Accord Due Process Rights When Physicians Are Non-Renewed by a Health Insurer
Legislation (A.1212, Lavine/S.4751, Hannon) is back before the full Assembly that would assure physicians are accorded a fair peer review appeals mechanism before their participation contract with a health insurance company can be non-renewed.  The legislation is in response to situations such as the disrespectful way by which Emblem treated 750 of its network physicians who were unceremoniously dropped from the network in October based upon specious allegation of failure to transition to value-based payments, severing patient treatments relationships for countless patients.  MSSNY has strenuously urged to the Department of Financial Services, Department of Health, and Attorney General that these physicians be given a fair opportunity to be reinstated, and have shared this information with the entire New York State Legislature. (See MSSNY letter to DFS here.

A.1212 passed the Assembly overwhelmingly in 2015, but not the Senate.  Physicians can send a letter in support of this legislation here.  A customizable template is provided.                                                                                                           (AUSTER, DEARS)


Urge Your Legislators to Pass Legislation to Override Insurer “Fail First” Medication Policies
Concerned about insurer policies that require your patients to “fail first” on certain prescription medications before they are able to take the medication that you believe is most medically appropriate to improve their health?  MSSNY is working together with a number of patient advocacy groups in support of legislation (A.2834-A, Titone/S.3419-B, Young) to provide physicians with an expeditious manner to override an insurer “fail first” policy when it is in the best interest of their patients’ health.  To send a letter in support of this legislation click here.  To read an op-ed in the Albany Times-Union from earlier this week from Mental Health Association CEO Glenn Liebman articulating the need for this legislation, click here. (TU password required).
(AUSTER, DEARS) 


Third Webinar on Opioid Prescribing to be Held Feb 23rd; Registration Is Now Open
The third webinar in the opioid series will be held Tuesday, February 23rd at 7:30 a.m. Physicians and other prescribers are encouraged to register for the entire webinar series at this link.

Click on the upcoming tab and select the programs.

Physicians will need to register for each webinar; each webinar has different topics described below. Physicians and other prescribers are allowed to register up to ½ hour before the webinar.

The Medical Society of the State of New York, the New York State Office for Alcoholism and Substance Abuse Service and the NYS Department of Health’s Bureau of Narcotic Enforcement, are jointly providing this free, four part webinar series on opioid prescribing.  

Entitled, “Revisiting the Role of Opioid Analgesics for Simple and Complex Patients with Chronic Pain”.  Faculty for the session will be Jeffrey Selzer, MD and the educational objective:  Describe potential for patient addiction, screening, diagnosis and subsequent treatment or referral.

The fourth webinar will be held on Thursday, March 10, 2016, 7:30 a.m. Faculty: Charles E. Argoff, MD and Charles Morgan, MD, FASAM, FAAFP, DABAM and the educational objectives:  Recommend tools to assist in the management of patients for whom opioids are indicated and prescribed; discuss strategies to reduce risk of treating pain in patients with substance use disorders.

Physicians and other prescribers can take one or all of the webinars; each webinar has been accredited for one hour of continuing medical education credits.
(CLANCY, DEARS) 


To Physicians In Long Island, NYC, Hudson Valley, and Capital District: Please Complete This Survey Regarding Impact of Proposed Cigna-Anthem Merger
As many physicians know, Anthem, the parent of Empire Blue Cross/Blue Shield, has filed paperwork to acquire CIGNA.   MSSNY has written to the New York State Department of Financial Services and Attorney General’s office to express its concerns about the impact to patient care as a result of further health insurer consolidation.

State and federal regulators are very interested in knowing the prospective effects of these possible mergers on your practice and patient care.   In this regard, MSSNY working together with the American Medical Association Advocacy Research Center have developed a survey seeking physician input on the potential impact on these proposed mergers.

Last fall, the AMA released a report articulating the significant potential anticompetitive effects that would occur in numerous regions all across the country as a result of this merger.  Among the identified regions of concern in New York State were Long Island, New York City, the Hudson Valley, the Capital District and the Glens Falls area.  Therefore, physicians practicing in these regions are asked to complete the Survey!
(AUSTER) 


Influenza Declared Prevalent in New York State Requiring Unvaccinated Health Care Workers to Wear Masks
On Thursday, New York State Health Commissioner Dr. Howard Zucker declared influenza prevalent in New York State, subsequently requiring health care workers who are not vaccinated against influenza to wear surgical or procedure masks in areas where patients are typically present.

In a statement Dr. Zucker reasoned, “Health care workers play a vital role in containing the spread of the flu…Although flu shots are a safe and effective way to reduce the risk for flu, not all health care workers choose to get vaccinated. By requiring those who are unvaccinated to wear masks when they’re around patients, we’re doing what we can to protect the most vulnerable.”

So far this year the flu has been confirmed in 44 counties and all five boroughs of New York City, along with 817 flu-related hospitalizations.

More information about influenza and NYS’ monitoring techniques can be found here.
(MCPARTLON) 

NYS DOH to Conduct Webinar Update on Zika Virus
New York State Department of Health will be offering a session of the ‘Zika Virus Webinar: an Update for Healthcare Providers’ on Wednesday February 17th, 2016 at noon. This webinar will provide updated guidance on Zika virus and review Zika virus testing eligibility, processes, and interpretation of results The webinar is being offered again to provide clinicians with another opportunity to join. Additionally, the webinar will be posted on the NYSDOH website.

Zika Virus Webinar: An Update on New Guidance and Testing for New York State Healthcare Providers

Time: 12-1pm; Presenter: Elizabeth Dufort, MD, FAAP, Medical Director, Division of Epidemiology, New York State Department of Health.
Registration
(CLANCY)


MSSNY to Sponsor Free CME Webinar On Public Health Preparedness on Feb. 17th
Public Health Preparedness 101 will be the topic of MSSNY’s Medical Matters webinar on Wednesday, February 17, 2016 with. Kira Geraci-Ciardullo, MD, MPH and Arthur Cooper, MD, MS serving as faculty.  This program is designed to help physicians and staff on how to prepare professionally and personally for a public health emergency.  The program will begin at 7:30 a.m.   Registration is now open to physicians and other public health officials:.

Go to training session and click on the upcoming sessions tab.

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.

Further information or assistance in registering for any of these programs,  may be obtained by contact Melissa Hoffman at mhoffman@mssny.org.       
(
CLANCY, HOFFMAN)

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

pschuh@mssny.org ldears@mssny.org            mauster@mssny.org  
pclancy@mssny.org jMcPartlon@mssny.org    

enews large

DOH Commissioner Zucker: Flu Prevalent in New York
On February 11, State health commissioner Dr. Howard Zucker declared flu prevalent in New York State, meaning all health care workers who are not vaccinated must wear surgical masks when dealing with patients. The flu virus has been found in 44 counties and all five boroughs of New York City, according to the state health department. There have been no flu-related deaths so far this season.   “Health care workers play a vital role in containing the spread of the flu,” Dr. Zucker said. “Although flu shots are a safe and effective way to reduce the risk for flu, not all health care workers choose to get vaccinated. By requiring those who are unvaccinated to wear masks when they’re around patients, we’re doing what we can to protect the most vulnerable, which includes the sick and the elderly.”

So far this season in New York, 817 flu-related hospitalizations have been reported, and no reports of pediatric deaths from flu. Over the last three seasons, there have been 26 pediatric flu deaths in New York and an average of 9,966 flu-related hospitalizations each season.


New Cases of Hepatitis C  Increasing In NYC
The number of New York City residents newly diagnosed with chronic hepatitis C increased to 7,691 in 2014, a 13 percent jump from 2013 and the most new cases the city has seen since 2011.” According to a new report from the city’s health department “an estimated 146,000 New Yorkers over the age of 20 – 2.4 percent of that population – have hepatitis C.” According to the report, “an estimated 146,000 New Yorkers over the age of 20 – 2.4 percent of that population – have hepatitis C.  Bedford-Stuyvesant and Crown Heights lead the city in new HIV infections, according to data.


Travel Alerts on Zika Virus
The CDC has issued a Health Advisory on Zika Virus infections for returning travelers from Central America, South America, the Caribbean, and Mexico. The CDC has also issued a Level 2 Travel Advisory for those same areas. For maps of the latest affected areas, visit the websites for the Center for Disease Control and Prevention (CDC) and the Pan American Health Organization (PAHO).
·       Health Advisory: Zika Virus Testing Process – February 9, 2016 (PDF, 112KB)
Two additional cases of Zika virus infections have been identified in Suffolk County, bringing the statewide total to 12 cases. On February 11, the CDC reported that two women who contracted the Zika virus while traveling out of the country miscarried after returning home. The virus was later found in the placentas.


Gov. Cuomo Proposes Extending Confidentiality for Minors with HIV
The New York Times (2/11) reports, “A new proposal from Gov. Andrew M. Cuomo’s office seeks” to extend “to minors the confidentiality that is already given to them for the treatment of other sexually transmitted infections.” Currently, minors in New York “generally cannot be treated or get medication to prevent its transmission without parental consent,” which physicians “say can deter minors from seeking help.” In 2013, “only 48 percent of HIV-positive people aged 13 to 24 in New York took medications that reduced their virus levels to very low levels, compared with the overall statewide rate of 63 percent, the governor’s office said.”


Do You Want to Be on IPA Task Force? Looking for Leaders Successful Models
Do You Have Expertise in Physician Stress and Burnout? We Need You!

At the 2015 House of Delegates of the Medical Society of the State of New York, a resolution was passed calling for action to address the prevalence of physician burnout.

We need your help!

We are looking to assemble the MSSNY team to tackle this work. This calls for physicians who have experience or expertise in designing or implementing physician health programs or stress/burnout programs for physicians. Please contact eskelly@mssny.org with a short bio and letter expressing your interest, expertise and what you intend to bring to the taskforce to advance the mission of the project.



Physician Entrepreneurship: Transform the Future of Health Care.

Interested in opportunities to impact medicine beyond your clinical practice? Join the AMA for an exclusive event to discuss how physicians are getting involved in and, indeed, helping to lead health care innovation.

A dynamic panel of physicians will share their perspectives, accomplishments and insights gleaned as they’ve developed new products, formed companies, advised start-ups and invested in innovative health care ventures.

WHEN: 7 p.m., Tuesday, March 1. Cocktails and hors d’oeuvres will be provided.

WHERE: Impact Hub NYC, 394 Broadway, New York, NY
Register today! Free for AMA members. Limited seating available. $500 for non-AMA members.


Opinion: Repealing Certificate-Of-Need Laws Will Improve Healthcare in NY
Nathan Nascimento, director of state initiatives at Freedom Partners Chamber of Commerce, wrote an opinion piece for the Buffalo (NY) News (2/6) arguing that the states outdated laws and regulations, “including New York’s decades old certificate-of-need laws,” are contributing to the “troubling trend” of “rising costs and fewer choices in health care.” Nascimento concluded that “for the sake of New Yorkers, all of whom deserve access to the best and most affordable health care, state legislators in Albany should start 2016 by cutting the red tape blocking the door to the doctor’s office.” Adopted in 1966, it requires New York health care providers to obtain permission from the Department of Health before adding new medical equipment, opening a new facility, expanding a current practice or even relocating.

“In practice, certificate-of-need laws drive up costs and deprive people of more health care choices. It requires reams of paperwork – forcing health care providers to satisfy bureaucrats over their patients. This is all in addition to other licenses and training requirements physicians face. Although 14 states have repealed their own versions of these laws, New Yorkers continue to deal with the negative impact of this red tape.

When health care providers submit their applications for a certificate, competitors are often invited to weigh in, and frequently succeed in blocking the certificate from being granted. In fact, practicing physicians and hospital representatives even sit on many state certificate-of-need boards, regulating the very industry in which they work.


NY Presbyterian and Northwell Run Super Bowl Ads
Crain’s New York Business (2/5) reports that “rivals New York-Presbyterian and Northwell Health” launched new television advertisements during the Super Bowl on Sunday in order “to attract new patients.” New York-Presbyterian is running a Super Bowl ad “to highlight innovation and scientific discovery at the health system and its medical schools.” Northwell Health ran three ads to “highlight the 42,000 babies delivered at Northwell hospitals each year, which was also the theme of its commercial introducing its new moniker on Jan. 1.”

Classifieds

 


Classifieds


OFFICE SPACE – Sutton Place
Newly renovated medical office. Windows in every room looks out to a park like setting on the plaza level. 2-4 exam rooms/offices available, possible procedure room or gym. Separate reception and waiting area, use of 3 bathrooms and a shower. Central air and wireless. All specialties welcome. Public transportation nearby. Please call 212-772-6011 or e-mail: advocate@medicalpassport.org

Office Rental 30 Central Park South
Two fully equipped exam rooms, two certified operating rooms, 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.


Jerome I. Sager – Attorney at Law
The health care law experts representing medical professionals for more than 25 years.  See us for Professional Medical Conduct Defense, Medicaid and Medicare Fraud Cases, DEA and Controlled Substance Issues, Third party insurance issues. 212-685-2333 / 917-312-6631, jeromesager@cs.com.



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

February 5, 2016 – Come on March 8th or Retire

drmaldonado PRESIDENT’S MESSAGE
 Dr. Joseph R. Maldonado
asset.find.us.on.facebook.lgTwitter_logo_blue1

February 5, 2016
Volume 16, Number 5

Dear Colleagues:

Reschedule Your Schedule for March 8 or Go Ahead and Take Early Retirement

It is IMPERATIVE that Doctors across New York who are not providing critically necessary medical services to patients be in ALBANY on March 8, 2016.  The medical malpractice crisis with the almost certain lengthening of the Statute of Limitations will adversely affect every physician in the state.  The failure to address the Health Republic debacle will cost millions of dollars to doctors across the state.  Unfunded mandates and radical changes in how we are reimbursed will change the practice of medicine like nothing in the past century.  IF YOU ARE NOT IN ALBANY on MARCH 8th, 2016 you may as well retire from medicine.  Most of us in this society will find the looming threats too onerous to remain in solo or small independent practices.  MSSNY CAN NOT BRING ABOUT THE NECESSARY CHANGES WITH A FEW DOCTORS.  New York’s PHYSICIANS MUST RISE UP AND COME TO ALBANY AND CONVEY OUR POSITION TO THE LEGISLATOR AND THE GOVERNOR.  Contact your county society to make plans to be present that date.  RESCHEDULE your patients.  Be in Albany on March 8, 2016.

Follow-up on last week’s column

Last week’s President’s column evoked the greatest response to date for my column.  Before elaborating further on the response, I want to thank you all for reading my column, and especially to those who took time from their busy schedules to share their views.  For all readers, it should be clear that the column reflects my personal views on issues I believe to be relevant to New York physicians.  On occasion, they may reflect MSSNY policy and in those instances, I state it.

While most applauded the idea of reframing the discussion to de-politicize the issue in the context in which it is currently debated, a few felt the reframe raised other concerns.  These included most importantly, those raised by colleagues in the mental health community who are concerned that I have advanced the notion that individuals with mental illness perpetrate violent crimes.  I do not believe nor do I in anyway support the notion that individuals with mental illness are more prone than members of the general population to commit violent crimes.  However, I do hold the belief that many individuals who commit violent crimes have untreated mental illness which may have in addition to other factors, contributed to their perpetration of acts of violence.  The nuances of this complex discussion can be better understood by carefully reading the Position Statement of the American Psychiatry Association   the press release by the American Psychological Association at:

Joseph Maldonado, M.D, MSc, MBA, DipEBHC
MSSNY President

Please send your comments to comments@mssny.org


MLMIC_011916_Enews_550x150


Capital_Update_Banner

MSSNY Lobby Day Scheduled for March 8th – Physicians Urged to Attend And Wear Your White Lab Coats
MSSNY’s “Physician Advocacy Day” will be held on March 8th in the Lewis Swyer Theatre in the Egg located at the Empire State Plaza in Albany, New York.  If you plan to attend, please register here.

A full slate of legislators and top Administration officials have been invited to dialogue with Advocacy Day participants including:

  • Donna Frescatore, Executive Director, NYS Health Benefit Exchange;
  • Troy Oechsner, Executive Deputy Superintendent, Department of Financial Services;
  • Legislative Panel: Senate Health Chair Kemp Hannon; Assembly Health Chair, Richard Gottfried; Senate Insurance Chair, James Seward; Assembly Insurance Chair Kevin Cahill.

 

In addition, Assembly Speaker Carl Heastie, Assembly Majority Leader Joe Morelle and Senate Majority Leader John Flanagan have been invited.  A brief informal luncheon to which members of each House are invited to dine and speak with their constituents will follow the morning program.   County Medical Societies will be scheduling appointments for physicians to meet with their elected representatives.

Given the wide range of threats physicians face including legislation that would expand the statute of limitations with a broad date of discovery exception potentially increasing physician premiums by 14.5%; legislation to repeal the Trial Lawyers contingency fee limits, potentially increasing premiums by over 10%; significant reductions in eligibility of the Excess Program; legislation that will mandate physicians to take a 4-hour Pain Management CME course every two years; and a move to effectuate statutory and regulatory changes to implement a value-based payment structure under Medicaid and potentially to Medicare and commercial products as well. 

PHYSICIANS ARE ENCOURAGED TO IMMEDIATELY REGISTER THROUGH THE LINK BELOW TO ATTEND THE MARCH 8TH LOBBY DAY IN ALBANY.   

http://goo.gl/forms/Mw7CX8JfzL                                                                            (GOVERNMENTAL AFFAIRS STAFF)


Contact Your Legislators to Support a Health Republic Guarantee Fund; Senator Valesky Introduces Legislation

With the failure of the Executive Budget to include a Guarantee or other fund to cover the likely   hundreds of millions in payments due to Health Republic contracted providers, all physicians are urged to continue to contact their legislators and demand that the State Legislature take action to create such Guarantee or other fund to cover these costs.

This week Senator David Valesky (D-Onondaga County) and fellow Independent Democratic Conference member David Carlucci (D-Rockland County) introduced legislation (S.6667) to create such a Guarantee Fund.  Senator Valesky’s press release announcing the introduction of this legislation

(http://www.nysenate.gov/newsroom/press-releases/david-j-valesky/senator-valesky-proposes-guaranty-fund-rx-consumer-and) included a statement from MSSNY President Dr. Joseph Maldonado that “Physicians thank Senator Valesky for introducing legislation to assure that Physicians can receive payment for services rendered to their patients who had health insurance coverage through the now defunct Health Republic. Physicians and other healthcare stakeholders should not bear the losses associated with the demise of this company. The failure to address this problem will have a de-stabilizing effect on our already fragile health care system at a time changes are being demanded of by policymakers on physicians to accept far greater insurance risk”.  The press release also included statements in support by the Healthcare Association of New York State and the Greater New York Hospital Association, groups MSSNY has been working with to support such a fund.

Urging the Legislature to enact a Guarantee fund as part of the State Budget process was a major component of the testimony that MSSNY recently to a joint hearing of the Assembly Ways & Means and Senate Finance Committees.  For more information, see here.

Remind your legislators that, with physicians facing so many other challenges in seeking to keep their doors open to deliver patient care, including high liability costs, expensive electronic medical record equipment, employee costs, insurance companies dropping physicians from their networks and declining payments from insurers, failure to assure payment for these claims would have serious negative consequences for patient care and employment in your community.                                                                                                (AUSTER, DEARS)


Physicians Urged to Oppose Huge Cuts to Excess Medical Liability Insurance Program
Physicians are urged to continue to contact their legislators  to object to the huge cuts contained in the Executive Budget to the Excess Medical Malpractice Insurance program.      MSSNY’s strong opposition to these cuts was a major component of MSSNY’s recent testimony to the Assembly Ways & Means and Senate Finance Committees, as well as in meetings with legislators and key legislative staff.  For more information, click here.

Specifically, the proposal would cut funding by $25 million, with the effect that 55% of physicians who currently receive this essential coverage being dropped from the program.  Across much of upstate New York, only neurosurgeons, bariatric surgeons and OB-GYNs would keep this coverage. That means that in the Capital District, in Northern New York, in Central New York, in western New York and in the Southern Tier every family physician, internist, pediatrician, ophthalmologist, emergency room physician, vascular surgeon, cardiologist, radiologist, pathologist, otolaryngologist, dermatologist and allergist would be automatically dropped.  And downstate, many primary care physicians, ophthalmologists, otolaryngologists, pathologists, dermatologists and allergists would be dropped.

The Excess Medical Liability Insurance Program provides an additional layer of $1M of coverage to physicians with hospital privileges who maintain primary coverage at the $1.3 million/$3.9 million level.  The program was created over 30 years ago as a result of the liability insurance crisis of the mid-1980’s to address concerns among physicians that their liability exposure far exceeded available coverage limitations.  Absent meaningful liability reform, with verdicts and physician liability premiums continuing to be far out of proportion compared to the rest of the country, full funding for the Excess program is absolutely essential in today’s very challenging practice environment.

At a time when the state is seeking to attract and retain physicians, this proposal deters physicians from wanting to practice in New York State for fear of putting themselves and their families in financial jeopardy for judgements and settlements exceeding the limits of their primary coverage.  Please urge your legislators to reject these cuts and restore full funding for the program!
(AUSTER, DEARS)


Disastrous Liability Expansion Bill Back on Assembly Calendar and Now Re-Introduced in Senate; Physicians Must Contact Their Legislators to Oppose Now!
All physicians must continue to contact their Senators and Assembly members to urge that they oppose legislation (A.285, Weinstein, S. 6596, DeFrancisco) that could drastically increase New York’s already exorbitantly high medical liability premiums by changing the medical liability Statute of limitations to a “Date of Discovery” rule.   The letter can be sent here.

With the bill having passed the Assembly in 2015, but not the Senate, it resumed a place on the Assembly Calendar, where it could be voted on by the full Assembly at any time.   The bill was brought up for initial consideration on Monday 1/11, but was “laid aside” by the Assembly Republican Conference.

At the conclusion of the 2015 Legislative Session, Senate Majority Leader Flanagan noted in response to a question from a Daily News reporter that issues like malpractice reform “have never been done in isolation” and that they would be working with representatives on both sides of this issue.  Since that time, MSSNY working together with MLMIC and hospital associations have met with top Senate staff to discuss comprehensive medical liability proposals to work towards legislation that would reduce the outrageous cost of physician medical liability premiums.

As these discussions ensue, you need to let your legislators know that no liability increases can be tolerated!  MLMIC’s estimate is that A.285/S.6596 could increase physician liability premiums by an untenable 15%!   New York physicians continue to pay liability premiums that are among the very highest in the country.  They also face rapidly increasing overhead costs to remain in practice such as the huge costs associated with implementing expensive and cumbersome electronic medical record systems.  At the same time, they face reduced payments from Medicare and commercial insurers, and many practices face losses of tens of thousands, hundreds of thousands and in some cases millions of dollars in losses due to the collapse of Health Republic.

And to make matters even worse, trial lawyers are aggressively pushing the Legislature to consider additional liability expansion bills such as legislation that would eliminate the statutory limitation on contingency fees in medical liability actions, legislation that MLMIC has estimated could have the effect of raising your premiums by over 10%.   Physicians need liability reform to bring down these costs, not legislation that increases them!                                                                                                                                                                                 (AUSTER, DEARS)

Physicians Urged to Continue to Oppose One-Sided Workers Compensation Reform Proposals
All physicians should continue to contact their State Senators and Assemblymembers here to express their strong opposition to sweeping Workers’ Compensation reform proposals contained in the Executive Budget.

MSSNY recently gave testimony to the Senate Finance and Assembly Ways & Means Committees raising significant concerns with Budget proposals that would:

  • Enable treatment of injured workers and direct payment for care by various non-physicians without clarity as to: how non-physicians treating patients with serious health conditions will coordinate patient care delivery when specialized care is needed; whether new funds will be allocated or whether existing fees will need to be cut to cover this expanded list of care providers; and whether a non-physician can perform an IME of an injured worker to review the care provided by a physician to an injured worker;
  • Expand the circumstances when a physician or other health care provider can have their authorization removed and empowers the Board to impose significant fines on a physician or any other Board-authorized health care provider for violating a Workers Compensation rule;
  • Remove the authority of county medical societies to recommend physicians to serve as treating providers or independent medical examiners under Workers Compensation, which is currently an important peer review function provided by county medical societies to assure physician applications are complete and physician applicants are appropriately qualified to deliver this needed care to injured workers;
  • Reduce choice for injured workers by prohibiting an injured worker not subject to a collective bargaining agreement from seeking medical treatment from outside a Workers Compensation PPO before 120 days after his or her first visit to a PPO provider; and
  • Remove the requirement for a referral by a physician for an injured worker as a pre-condition to receive psychological care;

Exacerbating these concerns is that the proposal also does not meaningfully address the many excessive administrative hassles and payment delays that have caused many physicians to be unable to participate in the Workers Compensation program.   While there have been some modestly positive actions taken by the WCB in recent years to encourage physician participation in the WC program through removal of arbitration fees and development of an electronic portal for facilitating authorizations from carriers, these one-sided Budget proposals, if enacted, could further chase physicians away from the program.

MSSNY has reached out to labor organizations and attorneys for injured workers to coordinate its advocacy in opposition to these adverse proposals.  MSSNY has also been working closely with county medical society leadership from across the State to encourage their outreach to their local Senators and Assemblymembers to request that these proposals be jettisoned from the Budget.
(AUSTER, DEARS)


MSSNY Testifies Before Joint Senate Finance and Assembly Ways & Means Committee
Last week, MSSNY submitted its testimony of the proposed budget for fiscal year 2016-17.  Noting the fact that many physician practices are struggling to remain viable with the significantly decreasing compensation and increasing overhead costs, including medical liability premium costs, they must bear, MSSNY representatives advocated that the Legislature take action to assure that we create and preserve an economically sensible health care delivery system.

First and foremost, in the testimony MSSNY focused on the financial hardship that has been created as a result of the collapse of Health Republic and the need for the creation of a Guarantee Fund or other pool of monies to assure that physicians and other stakeholders will be made whole. MSSNY also encouraged the Legislature to reject the programmatic changes to the Excess program proposed in the budget which would result in the dropping of 55% of physicians who currently have the extra $1M layer of coverage from the program. MSSNY urged the restoration of the $25M funding cut to the historic $127.4M level. MSSNY continues to oppose the establishment by publicly traded corporations of limited-services clinics in pharmacies and other retail establishments, particularly at a time when MACRA and other transformational payment structures reward physicians only if they provide same day access to care, provide for care collaboration and enhanced quality of care. MSSNY expressed its opposition to the sweeping Workers’ Compensation reform proposal contained in the Executive Budget including provisions which would removes the authority of county medical societies to recommend physicians to serve as treating providers or independent medical examiners under Workers Compensation and enable treatment of injured workers and direct payment for care by nurse practitioners and physician assistants, without clarity as to: how non-physicians treating patients with serious health conditions will coordinate patient care delivery with physicians and no new funds to cover this expanded list of care providers. MSSNY also opposed proposed language that would eliminate existing “prescriber prevails” protection for prescriptions for Medicaid patients.

Most importantly, MSSNY urged comprehensive reform of our flawed medical liability adjudication system including reforms which would: place reasonable limits on non-economic damages, which 30 other states have enacted; identifying and assuring qualified expert witnesses; eliminating joint and several liability; strengthening our weak Certificate of Merit requirement; and assuring statements of apology are immunized from discovery.  Other important measures we support include alternative systems for resolving Medical Liability claims such as Medical Courts or a Neurologically Impaired Infants Fund that applies to physicians.   A copy of the Testimony can be accessed through the following link.
(DEARS, AUSTER) 


To Physicians in Long Island, NYC, Hudson Valley, and Capital District: Please Complete Survey Regarding Impact of Proposed Cigna-Anthem Merger
As many physicians know, Anthem, the parent of Empire Blue Cross/Blue Shield, has filed paperwork to acquire CIGNA.   MSSNY has written to the New York State Department of Financial Services and Attorney General’s office to express its concerns about the impact to patient care as a result of further health insurer consolidation.

State and federal regulators are very interested in knowing the prospective effects of these possible mergers on your practice and patient care.  In this regard, MSSNY working together with the American Medical Association Advocacy Resource Center have developed a survey seeking physician input on the potential impact on these proposed mergers.

Last fall, the AMA released a report articulating the significant potential anticompetitive effects that would occur in numerous regions all across the country as a result of this merger.  Among the identified regions of concern in New York State were Long Island, New York City, the Hudson Valley, the Capital District and the Glens Falls area.  Therefore, physicians practicing in these regions are asked to complete the Survey!

This survey, and any information collected in response, will be used by the Medical Society solely for the purpose of petitioning state and federal government concerning the antitrust issues raised by Anthem’s proposed acquisition of Cigna. The antitrust laws prohibit the state medical association from using any information collected pursuant to this survey for any anticompetitive purposes, including, but not limited to, using that information in discussions with health insurers and other payers in an effort to raise physician payment or otherwise increase physician compensation. The state medical society will also not disclose any information received in response to this survey to its physician members without first consulting experienced antitrust Counsel.                                                                         (AUSTER)


Rescheduled Webinar on Opioid Prescribing to be Held Feb. 9th; Second Webinar in Series to be Held Feb 10
The first webinar in the opioid series will be held Tuesday, February 9th at 7:30 a.m. followed on February 10, 2016 with the second webinar at 7:30 a.m.   Physicians and other prescribers are encouraged to register for the entire webinar series at the following link. Click on the upcoming tab and select the programs.

Physicians will need to register for each webinar; each webinar has different topics described below. Physicians and other prescribers are allowed to register up to ½ hour before the webinar.

The Medical Society of the State of New York and New York State Office for Alcoholism and Substance Abuse Services are jointly providing this free,  four part webinar series on opioid prescribing.  

Entitled, “Revisiting the Role of Opioid Analgesics for Simple and Complex Patients with Chronic Pain”, the series will begin on Tuesday, February 9, 2016 at 7:30 a.m.,  and will be conducted by Charles Morgan, MD, FASAM, FAAFP, DABAM and Patricia Bruckenthal PhD, APRN-BC, ANP, FAAN and the educational objectives are:

  • Compare and contrast the dual epidemics of chronic pain and opioid abuse and the implications on public health
  • Understand requirements of New York State laws/regulations with regard to prescribing of controlled substances.

The second webinar will be held on Wednesday, February 10, 2016, 7:30 a.m. Faculty:  Charles E. Argoff, MD.  The educational objective is to:  Discuss evidence based best practice recommendations for opioid therapy for chronic pain, patient risk assessment and documentation. 

The remaining webinars in the series are scheduled for:

Tuesday, February 23, 2016, 7:30 a.m.  Faculty:  Jeffrey Selzer, MD and the educational objective:  Describe potential for patient addiction, screening, diagnosis and subsequent treatment or referral.

Thursday, March 10, 2016, 7:30 a.m. Faculty: Charles E. Argoff, MD and Charles Morgan, MD, FASAM, FAAFP, DABAM and the educational objectives:  Recommend tools to assist in the management of patients for whom opioids are indicated and prescribed; discuss strategies to reduce risk of treating pain in patients with substance use disorders.

Physicians and other prescribers can take one or all of the webinars; each webinar has been accredited for one hour of continuing medical education credits.
(CLANCY)


Please Complete the New Health Republic Survey!
As MSSNY continues its advocacy in support of a special fund to pay for the unpaid claims as a result of the Health Republic demise, we need you to take the time to complete a MSSNY survey to provide us with updated information regarding the amounts you are due from Health Republic.  To complete the survey, click here: https://www.surveymonkey.com/r/HRepublic2This data is critical to our advocacy efforts!  We thank the many of you who provided data in November detailing the amounts you are owed, but we need to obtain updated and more precise numbers since many legislators have asked us for this data.
(AUSTER, DEARS)

NYS Department of Health Issues Protocals for Zika Virus
The New York State Department of Health has issued new protocols for Zika virus which now include the collection of a urine sample in addition to blood samples.   The health advisory and guidelines for pregnant women may be found at the department website.

The World Health Organization has declared a global emergency due to the Zika virus and NY state officials have indicated that guidelines may change.   DOH Commissioner Howard Zucker indicated that the state will be monitoring mosquitoes closely as the weather gets warmer.  The Department of Health conducted a webinar on Zika and the webinar is now available at the department’s website.
(CLANCY)

 


MSSNY to Sponsor Free CME Webinar on Public Health Preparedness on Feb. 17th
Public Health Preparedness 101 will be the topic of MSSNY’s Medical Matters webinar on Wednesday, February 17, 2016 with. Kira Geraci-Ciardullo, MD, MPH and Arthur Cooper, MD, MS serving as faculty.  This program is designed to help physicians and staff on how to prepare professionally and personally for a public health emergency.  The program will begin at 7:30 a.m.   Registration is now open to physicians and other public health officials.  Go to training session and click on the upcoming sessions tab.

Further information on these programs can be found here.

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.

Further information or assistance in registering for any of these programs,  may be obtained by contact Melissa Hoffman at mhoffman@mssny.org.                                                                                                     (CLANCY, HOFFMAN) 


Assembly Gottfried Seeks to Double the Number of In-State Med. Marijuana Dispensaries
With only several hundred physicians currently registered to certify the use of medical marijuana for their patients, Assemblyman Gottfried introduced legislation (A.9151) last Friday to double to number of marijuana manufacturers and dispensaries in the state. Under the current program, 49 counties with an aggregate population of 7.5 million lack access to a medical marijuana dispensary in their county. With counties underserved and “978,500 New Yorkers for every medical marijuana dispensary”, Assemblyman Gottfried’s legislation would allow for five additional manufacturers, each permitted to operate up to four dispensaries. Currently, the legislation is a one-house bill, without a Senate same-as.
(MCPARTLON) 


NYU Arthur Caplan – It’s Time to Cancel the Summer Olympics
In Wednesday’s Forbes Sport Money section, Arthur Caplan, PhD, of NYU Langone Medical Center, presents the case for evaluating whether the 2016 Summer Olympic Games in Rio de Janiero should to be cancelled. Caplan argues that it is irresponsible to allow the games to take place in an area under a wide-spread outbreak of the Zika virus, which the WHO recently declared an “explosively spreading” “public health emergency of international concern”.            (MCPARTLON)

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 ldears@mssny.org            mauster@mssny.org  
pclancy@mssny.org jMcPartlon@mssny.org    

enews large


Physicians and Zika Virus
Commissioner of Health Howard Zucker, MD, JD NYS has placed on the DOH website, “Zika Virus What New York State Clinicians Need to Know” dated February 1, 2016.


Resolutions for the 2016 House of Delegates
The deadline for resolutions is 5:00pm on February 19; or for resolutions resulting from our Lobby Day, 5:00 on March 11 is the deadline. Send all resolutions to lmayer@mssny.org
 


New York State Earns Mixed Reviews in New Tobacco Report
In a report from the American Lung Association (ALA) titled “State of Tobacco Control 2016,” reports, New York earned an “A” in 2015 “on policies that promote smoke-free air.” However, the ALA “called on New York officials to increase funding for the state’s tobacco control programs by $10 million to $52 million per year and expand New York’s Clean Indoor Air Act to restrict the use of electronic cigarettes.”

The smoking rate among the state’s high school students has dropped to 7.3 percent, while the adult smoking rate has dropped to 14.5 percent, below the national average of 17.8 percent, according to figures released by the state last year.

The lung association raised concerns, however, about an increase in the use of products like e-cigarettes and hookahs. And it gave the state failing grades for funding and providing access to programs that help people quit smoking.

The advocacy group called on New York officials to increase funding for the state’s tobacco control programs by $10 million to $52 million per year and expand New York’s Clean Indoor Air Act to restrict the use of electronic cigarettes.


From Socio-Med VP Regina McNally: Go with Dr. First for
E-Prescribing
I have been receiving many calls from physicians regarding the upcoming NYS e-prescribing mandate of March 27, 2016 and you might be getting calls, too. We endorse DrFirst as a “stand-alone” e-prescribing product.  I believe software would be added to the physician’s existing computer.  This stand-alone product will help those physicians who have an EMR or EHR that might not be ready by the 3/27/16 deadline.  Please see the following:  http://www.drfirst.com/mssny/mssny-lp/

MSSNY members get a discount!  DrFirst’s MSSNY hotline number is (866)980-0553.

If a physician member can document either financial or technical limits, s/he can apply for a waiver from electronic prescribing.  The application for the waiver would apply for both controlled and non-controlled prescription drugs.  Note, there’s no guarantee that the waiver will be granted.  Please see the attached for waiver information.

As a point of physician protection, a medical record for the patient (spouse, family, friends, etc.) must be maintained (even if it is on an index card) for every prescription written in either paper or electronic mode. 

E-prescribing of both controlled and non-controlled substances is currently permissible in New York. Practitioners must ensure compliance with the requirement, including working with their software vendors to implement the additional security requirements needed for e-prescribing of controlled substances, and registering their certified software applications with the Bureau of Narcotic Enforcement

Below are highlights/key points that may be of particular interest to prescribers and pharmacists:

  • A prescription generated on an electronic system that is printed out to the Official New York State Prescription form or faxed is NOT an electronic prescription.
  • After March 27, 2016, a pharmacist is NOT required to verify that a practitioner properly falls under one of the exceptions from the requirement to electronically prescribe. Pharmacists may continue to dispense medications from valid written, oral, or fax prescriptions that are consistent with current laws, regulations, and Medicaid policies.

A comprehensive list of FAQs can be found here.

The FAQs provide an explanation of the laws and regulations, pharmacy registration forms, registration for official prescriptions and e-prescribing systems (ROPES), software and data requirements, waivers and exceptions, and resource information and contacts.

Questions? Please contact the Bureau of Narcotic Enforcement at

1-866-811-7957 or via e-mail to narcotic@health.ny.gov


Poster Symposium Seeks Judges on April 15 in Tarrytown
If you’re coming to the House of Delegates in Tarrytown – or just live in the neighborhood – and are free on Friday afternoon, April 15, from 2 – 4 pm, please consider participating as a judge at the MSSNY Resident and Fellow Section Poster Symposium. It’s always an exciting, lively event! Please contact sbennett@mssny.org or 516-488-6100 extension 383 if you’re interested. Thank you.


AMA: All Physicians Subject to 2015 Medicare MU Program Should Apply for Hardship
Prior to adjourning for the holidays, Congress passed the Patient Access and Medicare Protection Act (PAMPA), which directed CMS)to make AMA-supported changes to the Medicare EHR Incentive Program hardship exception process that allows physicians to avoid a Meaningful Use (MU) penalty in 2017.

CMS has stated that it will broadly accept hardship exemptions because of the delayed publication of the program regulations. Applying for the hardship will NOT prevent a physician from earning an incentive. It simply protects a physician from receiving an MU penalty. Therefore, physicians who believe that they met the MU requirements for the 2015 reporting period should still apply for the hardship protection. Note that the program operates on a two-year look-back period, meaning that physicians who are granted an exception for the 2015 program will avoid a financial penalty for 2017.

Step-by-step instructions for completing the hardship exception application are attached.

The new applications and instructions for a hardship exception from the Medicare Electronic Health Records Incentive Program 2017 payment adjustment are available here.

This new, streamlined application process is the result of PAMPA, which established that the Secretary may consider hardship exceptions for “categories” of EPs, eligible hospitals, and CAHs that were identified on CMS’ website as of December 15, 2015. Prior to this law, CMS was required to review all applications on a “case-by-case” basis.

Importantly, EPs, eligible hospitals, and CAHs that wish to use the streamlined application must submit their application according to the timeline established in PAMPA:

  • Eligible Professionals: March 15, 2016
  • Eligible Hospitals & CAHs: April 1, 2016

Please note:

Following Congress’ efforts in PAMPA, we have reviewed our administrative authorities and determined that groups of providers may apply for a hardship exception on a single application. Under the group application, multiple providers and provider types may apply together using a single submission. The hardship exception categories are the same as those applicable for the individual provider application. 


NEJM: Surgical Residents’ Long Shifts May Have No Impact on Patient Outcomes
Research published online in the New England Journal of Medicine indicated that “allowing surgeons in training to work extremely long shifts without breaks had no effect on patient outcomes and created only minor dissatisfaction among the young” physicians. http://bit.ly/1P9tCnV Investigators “looked at how many patients died or had serious complications in the month after surgery and found the same low rate – about 9 percent – in both groups.” Meanwhile, “residents’ self-rated dissatisfaction with their education and with their well-being were similarly low – 11 percent and roughly 13 percent respectively in each group.” In an accompanying editorial at http://bit.ly/1VRjodv, Dr. John Birkmeyer “wrote the experiment’s results ‘effectively debunks concerns that patients will suffer as a result of increased handoffs and breaks in continuity of care.’”


Nat’l Center on Addiction/Substance Abuse Releases Report on Food Addiction
The National Center on Addiction and Substance Abuse announced the release of a report that lays out the characterizing symptoms, risk factors and underlying neurobiological characteristics of food addiction, and how these features overlap with those of obesity, eating disorders and substance addiction. This report, Understanding and Addressing Food Addiction: A Science-Based Approach to Policy, Practice and Research, highlights how the knowledge and experience gained from years of substance use research and work in substance prevention, intervention and policy might be applied to controlling unhealthy eating and the food environment that contributes to it. It offers evidence-based recommendations for policy, prevention, health care practice and research to help reduce the deadly and costly health consequences of unhealthy eating.
Highlights of the report include:

  • Evidence regarding the prevalence of food addiction and its co-occurrence with obesity, binge eating disorder and other health conditions
  • The risk factors, characterizing symptoms and biological mechanisms of food addiction and related disorders and how these overlap with other eating disorders and with substance addiction
  • Recommendations for policy, prevention, health care practice and research, and resources for additional information

The report is available for download at no cost and can be found here.

Classifieds

OFFICE SPACE – Sutton Place
Newly renovated medical office. Windows in every room looks out to a park like setting on the plaza level. 2-4 exam rooms/offices available, possible procedure room or gym. Separate reception and waiting area, use of 3 bathrooms and a shower. Central air and wireless. All specialties welcome. Public transportation nearby. Please call 212-772-6011 or e-mail: advocate@medicalpassport.org

Office Rental 30 Central Park South
Two fully equipped exam rooms, two certified operating rooms, bathrooms and consultation room.  Shared secretarial and waiting rooms.  Elegantly decorated, central a/c, hardwood floors. Next to Park Lane and Plaza hotels. $1250 for four days a month. Available full or part-time. 212.371.0468 / drdese@gmail.com.
Jerome I. Sager – Attorney at Law
The health care law experts representing medical professionals for more than 25 years.  See us for Professional Medical Conduct Defense, Medicaid and Medicare Fraud Cases, DEA and Controlled Substance Issues, Third party insurance issues. 212-685-2333 / 917-312-6631, jeromesager@cs.com.

 

 



Classifieds


OFFICE SPACE – Sutton Place
Newly renovated medical office. Windows in every room looks out to a park like setting on the plaza level. 2-4 exam rooms/offices available, possible procedure room or gym. Separate reception and waiting area, use of 3 bathrooms and a shower. Central air and wireless. All specialties welcome. Public transportation nearby. Please call 212-772-6011 or e-mail: advocate@medicalpassport.org

Office Rental 30 Central Park South
Two fully equipped exam rooms, two certified operating rooms, 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.


Jerome I. Sager – Attorney at Law
The health care law experts representing medical professionals for more than 25 years.  See us for Professional Medical Conduct Defense, Medicaid and Medicare Fraud Cases, DEA and Controlled Substance Issues, Third party insurance issues. 212-685-2333 / 917-312-6631, jeromesager@cs.com.



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

January 29, 2016 – Violence, Not Weapons, Is the Issue!

drmaldonado PRESIDENT’S MESSAGE
 Dr. Joseph R. Maldonado
asset.find.us.on.facebook.lgTwitter_logo_blue1
January 29, 2016
Volume 16, Number 4

Dear Colleagues:

This past week, a family friend was hacked to death in New York by a machete-wielding neighbor.

Mrs. Carmen Torres-Gonzalez was born in my mother’s home town.  She had been a caregiver for my mother’s sister several years back during her unsuccessful fight against metastatic Adrenal Cancer.  My mother was also the elementary school teacher of one of Mrs. Torres-Gonzalez’s daughters.  As I googled the news story of her gruesome death, I found many more stories of other Americans who were victims of machete wielding criminals this month.  I was surprised to find so many incidents of fatal assaults with the use of a machete.  It made me pause to wonder why I had not previously been aware of the frequent use of machetes in violent deaths.

It seems to me that most of the attention paid to violent death has focused on gun violence.  Indeed, guns rank highest as the weapon used in violent deaths.  However, the benign neglect of violent deaths due to other weapons seem to me to highlight the political agenda of those who focus on gun violence rather than on the more important issue of deadly violence regardless of the weapon of choice as the more critical issue for the public and our society at large.  When we focus attention on gun violence, rather than on the mental illness or drug use which often lies at the core of why perpetrators resort to deadly violence towards others and themselves, we aid and abet political agendas and fail to focus on relevant solutions.

The tragic death of  family friend Mrs. Torres-Gonzalez and that of Jessica Parker, an American Physician Assistant brutally murdered in Grenada this past week, highlight the fact that gun violence is not the real problem on which we must focus as a society.  While most violent deaths in our country are due to guns, the violent deaths with other instruments of harm highlight the fact that the true area of focus needs to be addressing the mental health needs of the mentally ill.  If we fail in this endeavor, we will see that the focus on making guns less accessible will be met with a mounting number of deaths due to the use of other weapons.

We can lead our state and nation in getting the discussion on the right track by refusing to make our public health discussions center on gun violence.  Rather we should take the discussion to activism that focuses on addressing the problems of mental illness and drug abuse which underpin behaviors that express themselves in violence and death, be it with a gun or with a machete.

Joseph Maldonado, M.D, MSc, MBA, DipEBHC
MSSNY President

In a separate note, last week, we lost a great friend of our Society, Dr. Rufus Nichols, a former longstanding delegate to the House and active committee member from Brooklyn.  A scholarship fund has been established in his memory . It is a scholarship established through the National Medical Association that when awarded will pay for the registration fees and section dues of an Ob/Gyn resident or medical student planning to attend the NMA’s Annual Convention and Scientific Assembly. Checks should be made out to: The National Medical Association, Ob/Gyn Section. The mailing address is: Carole West,OB/Gyn Section Administrator, National Medical Association, 80 Jesse Hill Jr. Dr., SE PO Box 26076, Atlanta, Georgia 30303. Please reference the “Rufus A. Nichols Scholarship Fund” in the memo area of your check.

Please send your comments to comments@mssny.org


MLMIC_011916_Enews_550x150


Capital_Update_Banner


MSSNY Lobby Day Scheduled for March 8th – Physicians Urged to Attend and Wear Your White Lab Coats
MSSNY’s “Physician Advocacy Day” will be held on March 8th in the Lewis Swyer Theatre in the Egg located at the Empire State Plaza in Albany, New York.  If you plan to attend, please register.

A full slate of legislators have been invited to dialogue with Advocacy Day participants including:

  • Donna Frescatore, Executive Director, NYS Health Benefit Exchange;
  • Troy Oechsner, Executive Deputy Superintendent, Department of Financial Services;
  • Legislative Panel: Senate Health Chair Kemp Hannon; Assembly Health Chair, Richard Gottfried; Senate Insurance Chair, James Seward; Assembly Insurance Chair Kevin Cahill.

In addition, Assembly Speaker Carl Heastie, Assembly Majority Leader Joe Morelle and Senate Majority Leader John Flanagan have been invited.  A brief informal luncheon to which members of each House are invited to dine and speak with their constituents will follow the morning program.   County Medical Societies will be scheduling appointments for physicians to meet with their elected representatives.

Given the wide range of threats physicians face including legislation that would expand the statute of limitations with a broad date of discovery exception potentially increasing physician premiums by 14.5%; legislation to repeal the Trial Lawyers contingency fee limits, potentially increasing premiums by over 10%; significant reductions in eligibility of the Excess Program; legislation that will mandate physicians to take a 4-hour Pain Management CME course every two years; and a move to effectuate statutory and regulatory changes to implement a value-based payment structure under Medicaid and potentially to Medicare and commercial products as well. 

PHYSICIANS ARE ENCOURAGED TO IMMEDIATELY REGISTER THROUGH THE LINK BELOW TO ATTEND THE MARCH 8TH LOBBY DAY IN ALBANY.
More Information
http://goo.gl/forms/Mw7CX8JfzL              (GOVERNMENTAL AFFAIRS STAFF) 


MSSNY Testifies Before Joint Senate Finance and Assembly Ways & Means Committee
Earlier this week, MSSNY submitted its testimony of the proposed budget for fiscal year 2016-17.  Noting the fact that many physician practices are struggling to remain viable with the significantly decreasing compensation and increasing overhead costs, including medical liability premium costs, they must bear, MSSNY representatives advocated that the Legislature take action to assure that we create and preserve an economically sensible health care delivery system.

First and foremost, in the testimony MSSNY focused on the financial hardship that has been created as a result of the collapse of Health Republic and the need for the creation of a Guarantee Fund or other pool of monies to assure that physicians and other stakeholders will be made whole. MSSNY also encouraged the Legislature to reject the programmatic changes to the Excess program proposed in the budget which would result in the  dropping of 55% of physicians who currently have the extra $1M layer of coverage from the program. MSSNY urged the restoration of the $25M funding cut to the historic $127.4M level. MSSNY continues to oppose the establishment by publicly traded corporations of limited-services clinics in pharmacies and other retail establishments, particularly at a time when MACRA and other transformational payment structures reward physicians only if they provide same day access to care, provide for care collaboration and enhanced quality of care. MSSNY expressed its opposition to the sweeping Workers’ Compensation reform proposal contained in the Executive Budget including provisions which would removes the authority of county medical societies to recommend physicians to serve as treating providers or independent medical examiners under Workers Compensation and enable treatment of injured workers and direct payment for care by nurse practitioners and physician assistants, without clarity as to: how non-physicians treating patients with serious health conditions will coordinate patient care delivery with physicians and no new funds to cover this expanded list of care providers. MSSNY also opposed proposed language that would eliminate existing “prescriber prevails” protection for prescriptions for Medicaid patients.

Most importantly, MSSNY urged comprehensive reform of our flawed medical liability adjudication system including reforms which would: place reasonable limits on non-economic damages, which 30 other states have enacted; identifying and assuring qualified expert witnesses; eliminating joint and several liability; strengthening our weak Certificate of Merit requirement; and assuring statements of apology are immunized from discovery.  Other important measures we support include alternative systems for resolving Medical Liability claims such as Medical Courts or a Neurologically Impaired Infants Fund that applies to physicians.   A copy of the Testimony can be accessed here.                                                                                                    (DEARS, AUSTER) 


Physicians Urged to Oppose Huge Cuts to Excess Medical Liability Insurance Program
Physicians are urged to continue to contact their legislators to object to the huge cuts contained in the Executive Budget to the Excess Medical Malpractice Insurance program.      MSSNY’s strong opposition to these cuts was a major component of MSSNY’s testimony to the joint meeting of the Assembly Ways & Means and Senate Finance Committees this week, as well as in meetings with legislators and key legislative staff.  For more information, click here and here.

Specifically, the proposal would cut funding by $25 million, with the effect that 55% of physicians who currently receive this essential coverage being dropped from the program.  Across much of upstate New York, only neurosurgeons, bariatric surgeons and OB-GYNs would keep this coverage. That means that in the Capital District, in Northern New York, in Central New York, in western New York and in the Southern Tier every family physician, internist, pediatrician, ophthalmologist, emergency room physician, vascular surgeon, cardiologist, radiologist, pathologist, otolaryngologist, dermatologist and allergist would be automatically dropped.  And downstate, many primary care physicians, ophthalmologists, otolaryngologists, pathologists, dermatologists and allergists would be dropped.

The Excess Medical Liability Insurance Program provides an additional layer of $1M of coverage to physicians with hospital privileges who maintain primary coverage at the $1.3 million/$3.9 million level.  The program was created over 30 years ago as a result of the liability insurance crisis of the mid-1980’s to address concerns among physicians that their liability exposure far exceeded available coverage limitations.  They legitimately feared that everything they had worked for all of their professional lives could be lost as a result of one wildly aberrant jury verdict. This fear continues today since New York State has failed to enact meaningful tort reform to ameliorate this risk. The size of verdicts in New York State has continued to grow significantly and physician liability premiums remain far out of proportion compared to the rest of the country.  Absent meaningful liability reform, full funding for the Excess program is absolutely essential in today’s very challenging practice environment.

At a time when the state is seeking to attract and retain physicians, this proposal deters physicians from wanting to practice in New York State for fear of putting themselves and their families in financial jeopardy for judgements and settlements exceeding the limits of their primary coverage.

Please urge your legislators to reject these cuts and restore full funding for the program!
(AUSTER, DEARS) 


Contact Your Legislators to Support a Health Republic Guarantee Fund
With the failure of the Executive Budget to include a Guarantee or other fund to cover the likely hundreds of millions in payments due to Health Republic contracted providers, all physicians are urged to continue to contact their legislators and demand that the State Legislature take action to create such Guarantee or other fund.  Urging the Legislature to enact a Guarantee fund as part of the State Budget process was a major component of the testimony that MSSNY gave this past week at a joint meeting of the Assembly Ways & Means and Senate Finance Committees.  For more information, see here and here.

Moreover, please take the time to complete an updated MSSNY survey (sent out earlier this week) to provide us with updated information regarding the amounts you are due from Health Republic.  To complete the survey, click here.  This data is critical to our advocacy efforts!

MSSNY has worked with hospital associations to press key State Legislative leaders that it is absolutely imperative for the stability of our health care system that this be addressed soon.  We have shared with public officials the results of MSSNY’s earlier survey that concluded that physicians are owed at least tens of millions of dollars in outstanding claims, of which:

  • 11% are owed $100,000 or more;
  • 20% are owed $25,000 or more; and
  • 49% are owed $5,000 or more.

Moreover, we have shared data from 5 large medical practices in the Lower Hudson Valley that together are owed over $12 million.

Remind your legislators that, with physicians facing so many other challenges in seeking to keep their doors open to deliver patient care, including high liability costs, expensive electronic medical record equipment, employee costs, insurance companies dropping physicians from their networks and declining payments from insurers, failure to assure payment for these claims would have serious negative consequences for patient care and employment in your community.
(AUSTER, DEARS) 


CME Mandate Bill Reported by Senate Health Committee; Now Before Full Senate
Senate Bill 4348A (Hannon), which would create a continuing medical education mandate for practitioners with prescribing privileges was approved by the Senate Health Committee and is now before the full Senate for a vote.     Physician action is vitally important.

Physicians are urged to contact their elected representatives to urge that they vote against this mandate!  Send an email through MSSNY’s Grassroots Action Center.

4348A, sponsored by Senator Kemp Hannon, authorizes the Commissioner of Health to establish standards and to review requirements for CME on pain management, palliative care and addiction, would require health care professionals authorized to prescribe controlled substances to complete three hours of continuing medical education, prior to renewal of registration to practice, that involves pain management. The curricula must include but is not limited to, I-STOP and drug enforcement administration requirements for prescribing control substances; pain management; appropriate prescribing; managing acute pain; pain; palliative medicine; prevention, screening and signs of addiction; responses to abuse and addiction; and end of life care. The Commissioner may allow for exemptions if the health care professionals meet requirements to the Commissioner’s satisfaction.

The Commissioner must report on the impact of this legislation and any recommendations no later than three years after its enactment. A similar measure, A. 355, sponsored by Assembly Linda Rosenthal, is in the Assembly Health Committee.                                         
(CLANCY, DEARS)
 


Bill to Limit Opioid Prescriptions to Three-Ten Day Supply Poised for Full Senate Vote
Senate Bill 6091A, which would limit the initial prescription of Schedule II or III Controlled Substance to a three to ten day supply,  has passed the Senate Health Committee and is now before the NY Senate for a full vote.    Sponsored by Senator Kemp Hannon, the bill is intended to encourage patients whose acute pain lasts longer than initially expected to follow up with a physician and it lessens the number of the pills left in medicine cabinets and available for diversion.

The bill does limit the number of co-pays for patients should they need additional prescriptions.   The Medical Society of the State of New York is opposed to this measure and believes that having the New York State Legislature place an arbitrary limit on any type of prescriptions interferes with the practice of medicine.   Its companion measure, A. 8601, sponsored by Assemblymember John T. MacDonald III, is in the Assembly Health Committee.   Physicians are urged to contact senators and urge defeat of this measure.  Senators can be reached here.
(CLANCY, DEARS)


Disastrous Liability Expansion Bill on Assembly Calendar; Physicians Must Contact Their Legislators to Oppose Now!
All physicians must continue to contact their legislators to urge that they oppose legislation (A.285-A, Weinstein) before the full Assembly that could drastically increase New York’s already exorbitantly high medical liability premiums by changing the medical liability Statute of limitations to a “Date of Discovery” rule.   The letter can be sent here.

While the bill currently does not have a Senate sponsor, it is possible that similar legislation could be introduced shortly.   At the conclusion of the 2015 Legislative Session, Senate Majority Leader Flanagan noted in response to a question from a Daily News reporter that issues like malpractice reform “have never been done in isolation” and that they would be working with representatives on both sides of this issue.  Since that time, MSSNY working together with MLMIC and hospital associations have met with top Senate staff to discuss comprehensive medical liability proposals to work towards legislation that would reduce the outrageous cost of physician medical liability premiums.

As these discussions ensue, you need to let your legislators know that no liability increases can be tolerated!  MLMIC’s estimate is that this bill could increase physician liability premiums by an untenable 15%!   New York physicians continue to pay liability premiums that are among the very highest in the country.  By way of example, a neurosurgeon practicing on Long Island must pay an astounding $338,252 for just one year of insurance coverage and an OB/GYN practicing in the Bronx or Staten Island must pay $186,639.   New York far surpasses all other states in terms of total medical liability payouts, per capita payments, and medical liability awards above $1 million.

They also face rapidly increasing overhead costs to remain in practice such as the huge costs associated with implementing expensive and cumbersome electronic medical record systems.  At the same time, they face reduced payments from Medicare and commercial insurers, and many practices face losses of tens of thousands, hundreds of thousands and in some cases millions of dollars in losses due to the collapse of Health Republic.

And to make matters even worse, trial lawyers are aggressively pushing the Legislature to consider additional liability expansion bills such as legislation that would eliminate the statutory limitation on contingency fees in medical liability actions, legislation that MLMIC has estimated could have the effect of raising your premiums by over 10%.   Physicians need liability reform to bring down these costs, not legislation that increases them!
(AUSTER, DEARS)


Physicians Urged to Shared Concerns with Legislators Regarding Workers Compensation Reform Proposals in Executive Budget
MSSNY’s testimony to the Senate Finance and Assembly Ways & Means Committees this week raised significant concerns with the sweeping Workers’ Compensation reform proposal contained in the Executive Budget.   Physicians are urged to contact their State Senators and Assemblymembers to express their opposition to these proposals.

Among the proposals of greatest concern to physicians and their injured worker patients:

  • Enables treatment of injured workers and direct payment for care by nurse practitioners and physician assistants, without clarity as to: how non-physicians treating patients with serious health conditions will coordinate patient care delivery when specialized care is needed; whether new funds will be allocated or whether existing fees will need to be cut to cover this expanded list of care providers; and whether a non-physician can perform an IME of an injured worker to review the care provided by a physician to an injured worker;
  • Removes the requirement for a referral by a physician for an injured worker as a pre-condition to receive psychological care;
  • Expand the circumstances when a physician or other health care provider can have their authorization removed and empowers the Board to impose a $5,000 fine on a physician or any other Board-authorized health care provider for violating a Workers Compensation rule;
  • Prohibits an injured worker not subject to a collective bargaining agreement from seeking medical treatment from outside a Workers Compensation PPO before 120 days after his or her first visit to a preferred provider organization provider; and
  • Removes the authority of county medical societies to recommend physicians to serve as treating providers or independent medical examiners under Workers Compensation, which is currently an important peer review function provided by county medical societies to assure physician applications are complete and physician applicants are appropriately qualified to deliver this needed care to injured workers.

Exacerbating these concerns is that the proposal also does not meaningfully address the many excessive administrative hassles identified by physicians that have caused many physicians to withdraw from participation in the Workers Compensation program.   While there have been some modestly positive actions taken by the WCB in recent years to encourage physician participation in the WC program through removal of arbitration fees and development of an electronic portal for facilitating authorizations from carrier, the Budget proposals if enacted could further chase physicians away from the program.

MSSNY has reached out to labor organizations and attorneys for injured workers to coordinate its advocacy in opposition to these adverse proposals.  MSSNY has also been working closely with county medical society leadership from across the State to encourage their outreach to their local Senators and Assemblymembers to request that these proposals be jettisoned from the Budget.
(AUSTER, DEARS)


Contact Your Legislators to Oppose the Expansion of Retail Clinics
With the inclusion of language to permit public corporations to own and operate retail clinics, or “”limited service clinics”, throughout NYS in the Governor’s Proposed Budget and with introductions of one house bills in both the Assembly & Senate all physicians are urged to contact their legislators and demand that the State Legislature prevent the proliferation of publicly-traded corporations practice of medicine. 

While various versions of legislation exist, each seeks to allow publicly traded corporations to establish health clinics without need for certificate of need for review—for the first time in New York State. By permitting this practice, NYS will infringe upon the independence of medical decision-making and the integrity of the doctor-patient relationship. Furthermore, corporately owned and operated retail clinics will open the floodgates to conflicts of interest posed to exist as retail clinics directly profit from the very prescriptions they write, and treatments they recommend—all under the very same roof.

At a time when we in NYS are working hard to ensure and expand primary care and medical home capacity, retail clinics threaten the very viability of primary care physician’s practices. Contact your legislator today, and urge them to oppose the expansion of Retail Clinics in New York State.
(McPARTLON, DEARS)


DOH Files HCA-Proposed Flexibility in Signed M.D. Order Rules, Billing Deadlines for Home Care
The Home Care Association of New York State (“HCA”), working together with MSSNY’S Long-Term Care Subcommittee, has succeeded in urging the NYSDOH to examine its proposal to provide flexibility in signed physicians-order and Medicaid billing deadlines for home care services under Medicaid, allowing a full year to obtain physician orders and then bill. When implemented, the proposed regulations will positively impact collaboration between home care agencies and physicians.

DOH officials reported that the proposed regulations were filed on January 22nd, and they expect the regulations to be published in the February 10th State Register for a 45-day comment period.

Several months ago, HCA obtained an initial agreement from the state to consider HCA-drafted regulatory language to align state deadlines for signed physician orders with the broader time constraints allowed by Medicare, replacing the current 30-day limit for signed orders (and 90-day deadline to bill Medicaid) with a one-year outside window for signed orders and billing.

Of important note is that this does not change the requirements for having physician orders for start of care or revisions in care plans. The rule change applies specifically to the signed order requirements, which form the basis for the state’s current 30-day and 90-day billing compliance standards.

MSSNY will notify Long-Term Care Subcommittee members once the proposed regulations are published.
(McPARTLON)

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 ldears@mssny.org            mauster@mssny.org  
pclancy@mssny.org bellman@mssny.org    

enews large

REMINDER:  All Prescriptions Must Be Sent Electronically Beginning March 27th

Tell your patients NOW that you will NOT be issuing papers scripts as of March 27. With the e-prescribing mandate quickly approaching, we at MSSNY are concerned about the lack of preparedness expressed by New York doctors.  Our recent survey showed that more than 40% of responding physicians are not yet prepared to meet the e-prescribing mandate. 

We DO NOT expect an extension of the deadline, and urge you to ACT NOW to ensure you are compliant with the law. 


Do Not Wait until March; Buy E-Prescribing Software NOWAs a MSSNY member benefit, you qualify for a substantial discount on DrFirst’s industry-leading Rcopia® with EPCS GoldSM.  The cost is $500 for a one-year license (a $299 discount) and includes e-prescribing for both legend drugs and controlled substances, as well as the DEA-required identity proofing and two-factor authentication soft token.

If you buy now, you’ll be ready when the deadline arrives, and DrFirst will extend your software license from now until March 27, 2017 at no additional charge. To purchase online, visit www.drfirst.com/MSSNY and use coupon code MSSNY, or call the MSSNY E-prescribing Hotline at 866-980-0553. 


Shortcut to Apply for Medicare EHR Incentive Program Hardship Exception
Prior to adjourning for the holidays, MSSNY worked with the AMA and other state medical associations in support of a measure passed by Congress to direct CMS to make changes to the Medicare EHR Incentive Program hardship exception process that allows physicians to avoid a Meaningful Use (MU) penalty in 2017. The AMA has developed a short document that details the steps physicians should take to apply for this hardship. The AMA is encouraging ALL physicians subject to the 2015 Medicare MU program to apply for the hardship.   According to the AMA, applying for the hardship will not prevent a physician from earning an incentive. It simply protects a physician from receiving an MU penalty. Therefore, physicians who believe that they met the MU requirements for the 2015 reporting period should still apply for the hardship protection. Note that the program operates on a two-year look-back period, meaning that physicians who are granted an exception for the 2015 program will avoid a financial penalty for 2017.


Young Physicians Section Annual Meeting
Saturday, February 27, 2016
8:00 am – 1:00 pm
865 Merrick Avenue, Westbury (MSSNY HQ) and Hilton Garden Inn (across street)Don’t miss this essential leadership presentation by Richard Popovic, a highly experienced consultant in the fields of physician leadership, strategy, management and patient safety. CME available, no charge:

  • Learn tips on how to take an active role in shaping public policy on healthcare
  • Increase your ability to make decisions in the best interest of quality care and patient safety
  • Find the right balance between clinical and administrative duties
  • Identify barriers to physician leadership and advocacy
  • Define goals and assess needs of your organization – and achieve results!

MSSNY’s three sections, YPS, RFS, and MSS will gather for the presentation at the Hilton. If you wish to stay overnight, the Hilton is offering a corporate room rate (contact sbennett@mssny.org).

YPS will start at MSSNY HQ with business and breakfast, then proceed to the Hilton for the presentation. Lunch will follow back at MSSNY.

This activity has been planned and implemented in accordance with the Accreditation Requirements and Policies of the Medical Society of the State of New York (MSSNY) through the joint providership of MSSNY and the Medical Educational & Scientific Foundation of New York, Inc. (MESF). MSSNY 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 1.5 AMA PRA Category 1 CreditsTM. Physicians should claim only the credit commensurate with the extent of their participation in the activity.


Want to Join MSSNY’S Task Force for Independent Physicians?
At the 2015 House of Delegates of the Medical Society of the State of New York, Resolution 210 was passed calling for the creation of a Task Force on Independent Practice. The purpose of the taskforce is two-fold. First, the Taskforce would explore viable options for independent physicians to collaborate and create practice models to achieve the goals of “diversity of service, economy of scale and collective negotiations.” Second, consult experts and examine successful independent practice models in NY and elsewhere that will facilitate the preservation of independent practice in the State of New York. We need your help!

I am looking to assemble the MSSNY team to tackle this work. This calls for physicians who have developed innovative business models of private practice as well as those who have working knowledge of practice models that can accomplish the goals of the committee. This is NOT a committee for those who want to learn on the job. Rather, it is a team of individuals who have working experience both at the individual practice level establishing new medical business ventures as well as those who have expertise through academic, business and health policy endeavors.

Is your practice unique in what it offers? Have you created an IPA? Have you written a master’s thesis on collective negotiations and messenger model negotiations? Are you a physician offering concierge services or a telemedicine based practice? Are you a physician with a law degree or an MBA that has innovated healthcare delivery for your practice in a non-traditional manner or in an innovatively thriving traditional practice? This taskforce can use your skills.

Please contact Eunice Skelly at MSSNY (eskelly@mssny.org) with a short bio and letter expressing your interest, expertise and what you intend to bring to the taskforce to advance the mission of the project. I will be looking for diversity of practice location as well as types of innovations that may contribute to a robust and comprehensive report and plan of action for preserving independent practice in New York. 


USPSTF Calls for Routine Depression Screening of All Adults
The guidelines from the USPTF were published online Jan. 26 in JAMA that recommended that general physicians screen all adults for depression and treat those affected by the mood disorder with antidepressant medication, refer them to psychotherapy or do both. In a previous recommendation made in 2009, the USPSTF “had recommended screening adults for depression only when mental health services were available.” An accompanying editorial  
observed that primary care professionals “should screen people with a history of depression at every visit.”


NEJM: One Percent of Physicians Account for 32% of Paid Claims
A study published Thursday in the New England Journal of Medicine that found “the more often a doctor is sued, the more likely he or she will be sued again,” based on the past ten years of claims listed in the National Practitioner Data Bank.

The study found “one percent of all doctors account for 32 percent of all paid malpractice claims.” Neurosurgeons and orthopedic surgeons were more likely to have a paid claims, while “pediatricians were 30 percent less likely to have one.”

“Approximately 1% of all physicians accounted for 32% of paid claims. Among physicians with paid claims, 84% incurred only one during the study period (accounting for 68% of all paid claims), 16% had at least two paid claims (accounting for 32% of the claims), and 4% had at least three paid claims (accounting for 12% of the claims). In adjusted analyses, the risk of recurrence increased with the number of previous paid claims. For example, as compared with physicians who had one previous paid claim, the 2160 physicians who had three paid claims had three times the risk of incurring another (hazard ratio, 3.11; 95% confidence interval [CI], 2.84 to 3.41); this corresponded in absolute terms to a 24% chance (95% CI, 22 to 26) of another paid claim within 2 years. Risks of recurrence also varied widely according to specialty — for example, the risk among neurosurgeons was four times as great as the risk among psychiatrists.” 


MSSNY/NYS Psychiatric Assn. Present Veterans Mental Health Primary Care Training Initiative

When: Friday, February 5, 2016, 8:00 a.m. to 9:00 a.m.

Where: Niagara Falls Conference Center, 101 Old Falls Street, Niagara Falls, New York

Topic  : PTSD and TBI In Returning Veterans: Identification and Treatment

Presented By Frank Dowling, M.D.

Program Summary:  The Medical Society of the State (MSSNY) and NYSPA (NYSPA) welcome primary care physicians and providers, including those in internal medicine, family practice, emergency medicine, and OB/GYN, to attend this one hour training. The objectives:

(1) Explain the two most common disorders facing returning veterans today, their prevalence, risks, costs, and comorbidities.

(2) Identify common symptoms and causes of PTSD and Traumatic Brain Injury (TBI), especially those that affect returning veterans the most.

(3) Outline proven treatment options in psychotherapy and pharmacotherapy, from concept to implementation.

(4) Outline the process of recovery and post-traumatic growth.

(5) Discuss barriers to treatment, including those unique to military culture, and how to overcome them.

Following the training physicians are welcome to attend a panel discussion hosted by MSSNY, NYSPA, and the National Association of Social Workers – New York State Chapter, starting at approximately 9:15 a.m. regarding the post deployment experiences and challenges veterans have faced, specifically focusing on treatment.

REGISTRATION REQUIRED:  Click Here

For more information, contact Greg Elperin at MSSNY via gelperin@mssny.org or (518) 465-8085; or Donna Gajda at NYSPA via centraloffice@nyspsych.org or at (516) 542-0077.

Accreditation Statement: 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.

Disclosure Statement: The Medical Society of The State of New York relies upon planners and faculty participants in its CME activities to provide educational information that is objective and free of bias. In this spirit and in accordance with the guidelines of MSSNY and the ACCME, all speakers and planners for CME activities must disclose any relevant financial relationships with commercial interests whose products, devices or services may be discussed in the content of a CME activity, that might be perceived as a real or apparent conflict of interest. None of the planners and presenters has any relevant financial relationships to disclose. 

The Veterans Mental Health – Primary Care Training Initiative is supported by a grant provided by the New York State Legislature and administered through the New York State Office of Mental Health. 


Seven New York Residents Diagnosed with Zika Virus
Dr. Mary T. Bassett, the city’s health commissioner, and Dr. Herminia Palacio, New York City’s deputy mayor for health and human services, held a news conference at City Hall on Thursday, saying that at least seven people in the state of New York have been diagnosed with Zika virus. The officials announced plans to build on the “robust infrastructure” created in response to West Nile virus and other mosquito-borne illnesses as a way to prevent Zika from entrenching itself in the city

The NYS-DOH reported that two Zika patients have been confirmed in New York City, one in Orange County, one in Nassau County, and one in upstate Monroe County. All of them contracted the virus abroad.

The U.S. Centers for Disease Control and Prevention has said pregnant women or those who may become pregnant, should try to avoid travel to 24 countries and territories, mostly in Latin America and the Caribbean, where Zika virus has been spreading.

The CDC travel alert names the following countries and territories where pregnant women in any trimester should consider staying away, and all visitors should take care to protect against mosquitoes, CBS News reported:

  • In Latin America: Bolivia, Brazil, Colombia, Ecuador, El Salvador, French Guiana, Guatemala, Guyana, Honduras, Mexico, Panama, Paraguay, Suriname and Venezuela.
    • In the Caribbean: Barbados, the Dominican Republic, Guadeloupe, Haiti, Martinique, St. Martin, Puerto Rico, the U.S. Virgin Islands.
    • Cape Verde, off the coast of western Africa.
    • Samoa in the South Pacific.

https://www.health.ny.gov/press/releases/2016/2016-01-22_three_cases_of_zika_virus.htm

Dear Physicians:

TELL YOUR PATIENTS NOW THAT YOU WILL NOT BE GIVING PAPER SCRIPTS AS OF MARCH 27.


CMS-1500 Claim Form ICD Indicators
The National Government Services Mail and Distribution department has noticed an increase of claims returned as unprocessable due to an invalid diagnosis code indicator. The CMS-1500 Claim Form ICD Indicators news article explains the details of reporting the ICD indicator and shows exactly where the indicator should be added.


Check Out Doctors Without Borders’ LIVE Recruitment Webinar
All interested MEDICAL AND NON-MEDICAL aid workers are invited to join us for a live teleconference and webinar to learn how you can be a part of Doctors Without Borders’ field work.
Thursday, February 25, 2016 @ 7:00PM EST Register here.

Human Resources Officers will discuss requirements and the recruitment process, a Doctors Without Borders aid worker will talk about life in the field, and participants will be able to ask questions.
SPACE IS LIMITED.  PLEASE REGISTER.
Click here for more information.


Classifieds


OFFICE SPACE – Sutton Place
Newly renovated medical office. Windows in every room looks out to a park like setting on the plaza level. 2-4 exam rooms/offices available, possible procedure room or gym. Separate reception and waiting area, use of 3 bathrooms and a shower. Central air and wireless. All specialties welcome. Public transportation nearby. Please call 212-772-6011 or e-mail: advocate@medicalpassport.org

Office Rental 30 Central Park South
Two fully equipped exam rooms, two certified operating rooms, 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.


Office Near UN for Rent
Modern, 3000 sq. ft. medical office to rent near the United Nations. Located at 340 East 49th Street, this ground level office is handicapped accessible. Private reception area; secretarial area available; 6 exam rooms. Ideal for ophthalmologist/optometrist. Could suit other specialties. Available for full or part time. $1300 per month for one day per week. Please contact Dr. Weissman at uneyes@verizon.net or call 914-772-5581



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

January 22, 2016 – Yes to Corporate Partnerships?

drmaldonado PRESIDENT’S MESSAGE
 Dr. Joseph R. Maldonado
asset.find.us.on.facebook.lgTwitter_logo_blue1
January 22, 2016
Volume 16, Number 3

Dear Colleagues:

Yesterday’s Council meeting included a lengthy discussion concerning changes related to the corporate practice of medicine statutes being considered by the New York State Departments of Health and Financial Services. The architects of healthcare reform in the state of New York are seeking to improve how healthcare services are delivered to the residents of the state. There is a prevailing view that in order to improve health outcomes, adjustments need to be made that change how relevant services are delivered.

The current view is that services that are critical to improving outcomes for many costly chronic conditions is delivered in an incomplete and/or fragmented fashion.  In order to improve outcomes, we must improve the coordination of services as well as the modalities and organizations that provide the relevant services. This is where things get wickedly complex and where we, as the highest order licensed healthcare professionals, have the duty to weigh in to insure safe delivery of high quality, evidence-based medical care.

Separation of Physicians and Non-Physicians

We enter into the arena of “wicked problems,” because the healthcare initiatives being considered challenge many of our longstanding beliefs concerning the practice of medicine and the separation of licensed professionals so that non-physicians cannot create professional medical organizations to deliver professional services. These new models do not always seek to create entities that deliver professional physician services. Rather, they seek to allow for the creation of new— perhaps hybrid— entities wherein physicians can deliver professional services that only they can deliver while others—perhaps non-professionals— deliver other services that are critical to the improvement of the physicians’ medical services.

Do we allow room for exploring new delivery models that challenge our views of how we protect the scope of practice of our profession? Do we push the envelope a bit to allow room to explore new models, making sure that physicians have the professional medical and financial control of these new delivery models?  Do we simply draw a line in the ground and raise the standard in the name of protecting our patients while archaic and cumbersome models continue to fail us?  Do we take the risk that our hard stance on the corporate practice of medicine gets railroaded by the political and regulatory machinery to the detriment of our patients because we were unwilling to initiate changes in a manner whereby we could safeguard the health and wellbeing of our patients and our profession?

The challenges facing us are great.  Many of us do not like the changes being proposed. Nonetheless, our Oath, when we entered the profession, requires us to rise above long-held beliefs, and rethink these beliefs in light of changes.

We Must Lead the Way

We must consider these changes and create the mechanisms that improve the delivery of care while we stand firm in the defense that it is the MEDICAL PROFESSION that must lead and control these novel delivery systems in order to insure evidence-based quality and safety outcomes that provide the desired value for our money.

Short of these, the most advanced healthcare system in the world is doomed to collapse or fall into mediocrity.

Joseph Maldonado, M.D, MSc, MBA, DipEBHC
MSSNY President

Please send your comments to comments@mssny.org


MLMIC_011916_Enews_550x150


MSSNY Lobby Day Scheduled for March 8th – Physicians Urged to Attend and Wear Your White Lab Coats
MSSNY’s “Physician Advocacy Day” will be held on March 8th in the Lewis Swyer Theatre in the Egg located at the

Empire State Plaza in Albany, New York.  Please register here if you plan to attend.

A full slate of legislators have been invited to dialogue with Advocacy Day participants including:

  • Donna Frescatore, Executive Director, NYS Health Benefit Exchange;
  • Troy Oechsner, Special Assistant to the Superintendent, Department of Financial Services;
  • Legislative Panel: Senate Health Chair Kemp Hannon; Assembly Health Chair, Richard Gottfried; Senate Insurance Chair, James Seward; Assembly Insurance Chair Kevin Cahill.

In addition, Assembly Speaker Carl Heastie, Assembly Majority Leader Joe Morelle and Senate Majority Leader John Flanagan have been invited.  A brief luncheon to which members of each House are invited to dine and speak with their constituents will follow the morning program.   County Medical Societies will be scheduling appointments for physicians to meet with their elected representatives.

Given the wide range of threats physicians face including legislation that would expand the statute of limitations with a broad date of discovery exception potentially increasing physician premiums by 14.5%; legislation to repeal the Trial Lawyers contingency fee limits, potentially increasing premiums by over 10%; significant reductions in eligibility of the Excess Program; legislation that will mandate physicians to take a 4-hour Pain Management CME course every two years; and a move to effectuate statutory and regulatory changes to implement a value-based payment structure under Medicaid and potentially to Medicare and commercial products as well.

PHYSICIANS ARE ENCOURAGED TO IMMEDIATELY REGISTER TO ATTEND THE MARCH 8TH LOBBY DAY IN ALBANY.                                            
(GOVERNMENTAL AFFAIRS STAFF)


Physicians Urged to Oppose Huge Cuts to Excess Medical Liability Insurance Program
Physicians are urged to contact their legislators to object to the huge cuts contained in the Executive Budget to the Excess Medical Malpractice Insurance program.  If permitted to go forwarded, it would unfairly result in more than half of the physicians currently enrolled being dropped.   MSSNY’s strong opposition to these cuts will be a major component of MSSNY’s testimony to the joint meeting of the Assembly Ways & Means and Senate Finance Committees this Monday examining the proposed Health Budget.

Specifically, the proposal would prioritize funding for those physicians who practice in higher risk specialties and in more litigious regions of the State.  However, by cutting the funding by $25 million, it would mean that 55% of physicians who currently receive this essential coverage would be dropped from the program.  In upstate communities north and west of Greene and Columbia counties, coverage would continue only for neurosurgeons, bariatric surgeons and OB-GYNs. That means that in the Capital District, in Northern New York, in Central New York, in western New York and in the Southern Tier every family physician, internist, pediatrician, ophthalmologist, emergency room physician, vascular surgeon, cardiologist, radiologist, pathologist, otolaryngologist, dermatologist and allergist would be automatically dropped.  Even in some downstate communities including in the Bronx, Kings, Queens, Westchester, Sullivan and Orange counties, many primary care physicians, ophthalmologists, otolaryngologists, pathologists, dermatologists and allergists would be dropped.

The Excess Medical Liability Insurance Program provides an additional layer of $1M of coverage to physicians with hospital privileges who maintain primary coverage at the $1.3 million/$3.9 million level.  The program was created over 30 years ago as a result of the liability insurance crisis of the mid-1980’s to address concerns among physicians that their liability exposure far exceeded available coverage limitations.  They legitimately feared that everything they had worked for all of their professional lives could be lost as a result of one wildly aberrant jury verdict. This fear continues today since New York State has failed to enact meaningful tort reform to ameliorate this risk. The size of verdicts in New York State has continued to grow significantly and physician liability premiums remain far out of proportion compared to the rest of the country.  Absent meaningful liability reform, full funding for the Excess program is absolutely essential in today’s very challenging practice environment.

At a time when the state is seeking to attract and retain physicians, this proposal deters physicians from wanting to practice in New York State for fear of putting themselves and their families in financial jeopardy for judgements and settlements exceeding the limits of their primary coverage.

Please urge your legislators to reject these cuts and restore full funding for the program!
(AUSTER, DEARS)


Contact Your Legislators to Support a  Health Republic Guarantee Fund
With the failure of the Executive Budget to include a Guarantee or other fund to cover the likely   hundreds of millions in payments due to Health Republic contracted providers, all physicians are urged to continue to contact their legislators and demand that the State Legislature take action to create such Guarantee or other fund.  Urging the Legislature to enact a Guarantee fund as part of the State Budget process will be a major component of the testimony that MSSNY will give this Monday at a joint meeting of the Assembly Ways & Means and Senate Finance Committees. 

MSSNY has worked with hospital associations to press key State Legislative leaders that it is absolutely imperative for the stability of our health care system that this be addressed soon.  We have shared with public officials the results of MSSNY’s survey that concluded that physicians are owed at least tens of millions of dollars in outstanding claims, of which:

  • 11% are owed $100,000 or more;
  • 20% are owed $25,000 or more; and
  • 49% are owed $5,000 or more.

Moreover, we have shared data from 5 large medical practices in the Lower Hudson Valley that together are owed over $12 million.

Please be on the lookout early next week for a new survey that seeks updated information from you whether this amount has grown since our initial survey was sent in November.  Please take the time to complete this survey, as the data is critical to our advocacy efforts.

And please take the time to send a letter to your legislators at this link.

Remind them that, with physicians facing so many other challenges in seeking to keep their doors open to deliver patient care, including high liability costs, expensive electronic medical record equipment, employee costs, insurance companies dropping physicians from their networks and declining payments from insurers, failure to assure payment for these claims would have serious negative consequences for patient care and employment in your community.
(AUSTER, DEARS) 


Disastrous Liability Expansion Bill Back on Assembly Calendar; Physicians Must Contact Their Legislators to Oppose Now!
All physicians must continue to contact their Senators and Assembly members to urge that they oppose legislation (A.285, Weinstein) that could drastically increase New York’s already exorbitantly high medical liability premiums by changing the medical liability Statute of limitations to a “Date of Discovery” rule.   The letter can be sent here.

With the bill having passed the Assembly in 2015, but not the Senate, it resumed a place on the Assembly Calendar, where it could be voted on by the full Assembly at any time.   The bill was brought up for initial consideration on Monday 1/11, but was “laid aside” by the Assembly Republican Conference.

While the bill currently does not have a Senate sponsor, it is possible that similar legislation could be introduced shortly.   At the conclusion of the 2015 Legislative Session, Senate Majority Leader Flanagan noted in response to a question from a Daily News reporter that issues like malpractice reform “have never been done in isolation” and that they would be working with representatives on both sides of this issue.  Since that time, MSSNY working together with MLMIC and hospital associations have met with top Senate staff to discuss comprehensive medical liability proposals to work towards legislation that would reduce the outrageous cost of physician medical liability premiums.

As these discussions ensue, you need to let your legislators know that no liability increases can be tolerated!  MLMIC’s estimate is that A.285 could increase physician liability premiums by an untenable 15%!   New York physicians continue to pay liability premiums that are among the very highest in the country.  They also face rapidly increasing overhead costs to remain in practice such as the huge costs associated with implementing expensive and cumbersome electronic medical record systems.  At the same time, they face reduced payments from Medicare and commercial insurers, and many practices face losses of tens of thousands, hundreds of thousands and in some cases millions of dollars in losses due to the collapse of Health Republic.

And to make matters even worse, trial lawyers are aggressively pushing the Legislature to consider additional liability expansion bills such as legislation that would eliminate the statutory limitation on contingency fees in medical liability actions, legislation that MLMIC has estimated could have the effect of raising your premiums by over 10%.   Physicians need liability reform to bring down these costs, not legislation that increases them!
(AUSTER, DEARS)


CME Mandate Bill Taken Off NYS Assembly Health Committee Agenda; Senate Bill Moving in Health Committee
Assembly Bill 355 (Rosenthal) and Senate Bill 4348A (Hannon) which would create a continuing medical education mandate for practitioners with prescribing privileges was taken off the agenda of the Assembly Health Committee on Thursday but a slightly different Senate version of the legislation is on the Senate Health Committee agenda for next week.  Physician action is vitally important.  They are urged to contact their elected representatives to urge that they vote against this mandate!  Send an email through MSSNY’s Grassroots Action Center.

  1. 4348A, sponsored by Senator Kemp Hannon, authorizes the Commissioner of Health to establish standards and to review requirements for CME on pain management, palliative care and addiction, is on the Senate Health Committee agenda for Tuesday, January 26th. It would require health care professionals authorized to prescribe controlled substances to complete three hours of continuing medical education, prior to renewal of registration to practice, that involves pain management. The curricula must include but is not limited to, I-STOP and drug enforcement administration requirements for prescribing control substances; pain management; appropriate prescribing; managing acute pain; pain; palliative medicine; preventative, screening and signs of addiction; responses to abuse and addiction; and end of life care. The Commissioner may allow for exemptions if the health care professionals meet requirements to the Commissioner’s satisfaction. The Commissioner must report on the impact of this legislation and any recommendations no later than three years after its enactment.

MSSNY has strongly opposed this measure in previous legislative sessions. Continuing Medical Education is valuable to physicians in keeping up-to-date on new clinical information, and physicians throughout the state voluntarily take continuing medical education for continued professional development in those areas that pertain to their individualized practice.  However, this bill fails to recognize that the Medical Society of the State of New York, the specialty societies, the American Board of Medical Specialties, and the American Osteopathic Association have all been aggressively promoting voluntary CME on pain management and that there is other course work that addresses many of the above issues. (CLANCY, DEARS)


Concerns with One-Sided Workers Compensation Reform Proposals to be an Important Component of MSSNY’s Budget Testimony
MSSNY’s testimony to the Senate Finance and Assembly Ways & Means Committees to be presented this Monday will raise significant concerns with the sweeping Workers’ Compensation reform proposal contained in the Executive Budget.  Among the proposals of greatest concern to physicians and their injured worker patients:

  • Removes the authority of county medical societies to recommend physicians to serve as treating providers or independent medical examiners under Workers Compensation, which is currently an important peer review function provided by county medical societies to assure physician applications are complete and physician applicants are appropriately qualified to deliver this needed care to injured workers;
  • Enables treatment of injured workers and direct payment for care by nurse practitioners and physician assistants, without clarity as to: how non-physicians treating patients with serious health conditions will coordinate patient care delivery with physicians; whether new funds will be allocated or whether existing fees will need to be cut to cover this expanded list of care providers; and whether a non-physician can perform an IME of an injured worker to review the care provided by a physician to an injured worker;
  • Removes the requirement for a referral by a physician as a pre-condition for an injured worker to receive psychological care;
  • Expand the circumstances when a physician or other health care provider can have their authorization removed and empowers the Board to impose a $5,000 fine on a physician or any other Board-authorized health care provider for violating a Workers Compensation rule; and
  • Prohibits an injured worker not subject to a collective bargaining agreement from seeking medical treatment from outside a Workers Compensation PPO before 120 days after his or her first visit to a preferred provider organization provider.

Exacerbating these concerns is that the proposal also does not meaningfully address the many excessive administrative hassles identified by physicians that have caused many physicians to choose to not participate in the Workers Compensation program.   While there have been some modestly positive actions taken by the WCB in recent years to encourage physician participation in the WC program through removal of arbitration fees and development of an electronic portal for facilitating authorizations from carrier, the Budget proposals if enacted could further chase physicians away from the program.

MSSNY has reached out to labor organizations to coordinate its advocacy in opposition to these adverse proposals.  MSSNY has also been working closely with county medical society leadership from across the State to encourage their outreach to their local Senators and Assemblymembers to request that these proposals be jettisoned from the Budget.
(AUSTER, DEARS)


Physicians Encouraged to Register for Opioid Prescribing Webinar on January 26
Physicians and other prescribers are encouraged to register for the first free webinar on opioid prescribing which will take place on Tuesday, January 26th at 12:30 p.m.  at the following link.

Click on the upcoming tab and select the programs. Physicians will need to register for each webinar.

The Medical Society of the State of New York and New York State Office for Alcoholism and Substance Abuse Services are jointly providing this free,  four part webinar series on opioid prescribing.  Entitled, “Revisiting the Role of Opioid Analgesics for Simple and Complex Patients with Chronic Pain”, the series will begin on Tuesday, January 26, 2016.

The first webinar will be conducted by Charles Morgan, MD, FASAM, FAAFP, DABAM and Patricia Bruckenthal PhD, APRN-BC, ANP, FAAN and the educational objectives are:

  • Compare and contrast the dual epidemics of chronic pain and opioid abuse and the implications on public health
  • Understand requirements of New York State laws/regulations with regard to prescribing of controlled substances.

The remaining webinar series will be held on:

Wednesday, February 10, 2016, 7:30 a.m. Faculty:  Charles E. Argoff, MD.  The educational objective:  Discuss evidence based best practice recommendations for opioid therapy for chronic pain, patient risk assessment and documentation.

Tuesday, February 23, 2016, 7:30 a.m.  Faculty:  Jeffrey Selzer, MD and the educational objective:    Describe potential for patient addiction, screening, diagnosis and subsequent treatment or referral.

Thursday, March 10, 2016, 7:30 a.m. Faculty: Charles E. Argoff, MD and Charles Morgan, MD, FASAM, FAAFP, DABAM and the educational objectives:  Recommend tools to assist in the management of patients for whom opioids are indicated and prescribed; discuss strategies to reduce risk of treating pain in patients with substance use disorders.

Opioid abuse is a national epidemic that physicians and other prescribers have the power to help prevent.  This series will provide information on managing pain, understanding the potential for patient addiction, and determining best practices for safe, responsible opioid prescribing.

Physicians and other prescribers can take one or all of the webinars; each webinar has been accredited for one hour of continuing medical education credits.

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.

For further information or assistance in registering for the program, please contact Pat Clancy at pclancy@mssny.org or Terri Holmes at tholmes@mssny.org.
(CLANCY, DEARS)


Bill to Limit Opioid Prescriptions to Three-Ten Day Supply on Senate Health Agenda
Senate Bill 6091A, which would limit the initial prescription of Schedule II or III Controlled Substance to a three to ten day supply, is on the Senate Health Committee agenda for Tuesday, January 26th.   Sponsored by Senator Kemp Hannon, the bill is intended to encourage patients whose acute pain lasts longer than initially expected to follow up with a physician and it lessens the number of the pills left in medicine cabinets and available for diversion.  The bill does limit the number of co-pays for patients should they need additional prescriptions.

The Medical Society of the State of New York is opposed to this measure and believes that having the New York State Legislature place an arbitrary limit on any type of prescriptions interferes with the practice of medicine.   Its companion measure, A. 8601, sponsored by Assemblymember John T. MacDonald III, is in the Assembly Health Committee.

Physicians are urged to contact Senators on the Health Committee and urge defeat of this measure.  Senate Health Committee members are:   Senators Kemp Hannon, Hugh Farley, Simcha Felder, Martin Golden, Ruth Hassell-Thompson, Brad Hoylman, William Larkin, Betty Little, Jack Martins, Velmanette Montgomery, Terrence Murphy, Roxane Persaud, Gustavo Rivera, James Seward, Toby Stavisky, David Valesky, and Catharine Young.  
(CLANCY, DEARS)


Governor Nominates Vullo for DFS Superintendent
Governor Andrew Cuomo this week nominated Maria T. Vullo to serve as the Superintendent of the New York State Department of Financial Services. She is currently of counsel at Paul, Weiss, Rifkind, Wharton & Garrison LLP, where she was a partner for 20 years, and previously oversaw the Economic Justice Division in the Office of the New York State Attorney General.   DFS has had multiple Interim Superintendents since the previous Superintendent, Benjamin Lawsky, left the position last spring.  To read more about Ms. Vullo’s background, click here.
(AUSTER)


Centerlight Healthcare Settles for $47 Million in Medicaid Fraud Case
On Thursday, January 21st, Attorney General Eric Schneiderman announced a $47 million settlement with CenterLight Health Care and Centerlight Health System stemming from allegations of fraudulent Medicaid billing for unrendered services to 1,200 Medicaid recipients. As part of the settlement agreement CenterLight admitted that it enrolled ineligible Medicaid beneficiaries in its Managed Long Term Care Plan (“MLTCP”), which was contracted by NYS DOH to provide long-term community based health care; and that it used adult day care centers to provide community-based MLTCP personal care services that did not qualify as personal care services. In addition to its $47 million settlement, CenterLight agreed to additional monitoring for two-years by an independent compliance monitor and the A.G.’s Medicaid Fraud Control unit, and if necessary to revise its compliance policies.
(MCPARTLON) 


Inside Correctional Facilities—Increase in Staff Training on Inmate Mental Health
On January 21st, the New York State Senate passed a one-house bill sponsored by Senator Carlucci (D- Rockland/Westchester) which clarifies the eight-hour annual requirement for training of residential mental health treatment unit staff, as well as security, program services, mental health and medical staff with direct contact of inmates with mental illnesses. The bill was passed unanimously by the Senate, as it contains the language of a previously negotiated chapter amendment to a bill signed into law by Governor Cuomo last month. Current NYS Correction Law similarly requires that new corrections staff receive initial training in mental health treatment upon recruitment. The training topics include: types and symptoms of mental illnesses, the goals of mental health treatment, the prevention of suicide and training in how to effectively and safely manage inmates with mental illness. While a same-as bill has yet to be introduced in the Assembly, it will likely do so shortly.                                                                                            (MCPARTLON)


CMS Posts Information Regarding How Physicians Can Apply for Meaningful Use Hardship
The Center for Medicare and Medicaid Services (CMS) today posted information regarding changes to Medicare EHR Incentive Program hardship exception process.  Medicare is implementing these modifications as a result of the recently passed Patient Access and Medicare Protection Act, which established that the Secretary may consider hardship exceptions for “categories” of EPs, eligible hospitals, and CAHs that were identified on CMS’ website as of December 15, 2015.  Prior to this law, CMS was required to review all applications on a “case-by-case” basis.   The AMA had advised that it will review CMS’ materials and begin to educate physicians about how they can best apply for the exception.  Here is a link to the information CMS posted.

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 ldears@mssny.org            mauster@mssny.org  
pclancy@mssny.org bellman@mssny.org    


Council Meeting Notes: January 21, 2016

  • MLMIC’s Vice President, Don Fager, announced a 20% dividend for policyholders who are insured by May 1, 2016, and maintain continuous coverage through July 1, 2016.
  • Council approved the Board of Trustees report, which included approval of $100/day for delegates at the 2016 House of Delegates and approval for a MSSNY financial audit for 2015.
  • Council discussed MSSNY’s approach regarding the corporate practice of medicine as being proposed within the DSRIP program and agreed to enable leadership to carry on discussions with appropriate parties.
  • Dr. Maldonado stressed the importance of Legislative Day this year, which will be held on March 8 in Albany. He called on physicians to help ensure a large turnout to demonstrate the importance of our issues to legislators.
  • MSSNY will partner with the American Cancer Society and the American Cancer Society Action Network in a new anti-smoking campaign, 2016 New York is Kicking Butts Quit Smoking Campaign. The campaign is currently centered on NYC, but ACS hopes to expand it throughout the state. In New York City, smoking continues to be the number one cause of preventable death.
  • Council approved the following Resolutions:
  • 2015-268: MSSNY will encourage further research into genomic sequencing, including its ethical implications, its clinical implications and its financial implications and will also encourage efforts to increase the number of qualified genetic counselors in anticipation of the increasing clinical need.
  • 2015-253: MSSNY will seek federal legislation to ensure that as the government moves forward to value based payment and reform that the legislature and federal agencies seek direct physician input to ensure that bundled payments result in quality care and best patient outcomes, rather than just concentrating on the cost of care.
  • 2015-263: MSSNY will seek legislation or regulation to ensure that Medicare, Medicaid and insurance plans allow physicians to make dosing adjustments for approved medications to allow the patient to achieve therapeutic levels regardless of BMI and differing metabolic considerations. The dose administered should be within the purview of the treating practitioners based on clinical parameters, documented in the medical record.
  • First District Branch E-Prescribing Motion: MSSNY will press for legislation or regulation that would allow patients’ requests for paper prescription and pharmacy choice to be honored and that this legislation or regulation permit any patient to request opting out of electronic prescribing by requesting the same in writing to a physician who will then be permitted to issue a paper prescription in person or by fax.


MLMIC Policyholders Will Receive 20% Dividend
Our mission is to provide insurance at cost, without a profit motive. To offset premiums, we offer dividends to our policyholders whenever we can. This year, MLMIC policyholders will receive a 20% dividend. To take advantage of this dividend, you simply need to be insured by May 1, 2016, and maintain continuous coverage through July 1, 2016.

MLMIC is a mutual insurer, owned by our policyholders. Over the years, our financial strength has allowed us to pay more than $300 million in dividends to our policyholders, something no other insurer can match.

Learn More  or call (888) 793-0393. 


Medical Schools Seek Dollars for Diversity
The Associated Medical Schools of New York is lobbying the state legislature to boost its funding for fiscal 2017. The organization, which represents 16 public and private medical schools throughout the state, is requesting $2.4 million for scholarships and diversity initiatives, up from $1.6 million last year. The bulk of the money, $2 million, would fund four post-baccalaureate programs that help students from underrepresented backgrounds get into medical school. An additional $400,000 is for launching a new scholarship. African-Americans, Latinos and indigenous peoples make up 35% of New York’s population but only 9% of the physician workforce, according to a 2014 report from the SUNY Albany Center for Health Workforce Studies. Funding for AMSNY’s diversity initiatives was slashed by about 20% after the 2008 financial crisis. The requested funding would help restore the programming that was dropped, said Jo Wiederhorn, the group’s president and chief executive.


Mt. Sinai HCV Intensive Training Preceptorship Program
The Mount Sinai Institute for Advanced Medicine – CEI HIV/HCV Center for Excellence is proud to debut our HCV Intensive Training Preceptorship program! This 2-day clinical education program (March 24-25, 2016) provides an intensive experience for practicing clinicians (e.g. physicians, physician assistants, nurses and nurse practitioners) in New York State. Through a combination of didactic sessions and experiential training, clinicians are able to enhance their HCV prevention, treatment, and care knowledge and competence to better serve their patients.

All clinical experience shadowing will take place at a Mount Sinai affiliated clinic located in Manhattan, NY. Accepted applicants from upstate New York will be provided with an honorarium to assist with transportation and lodging expenses.

The deadline to apply is Friday, January 25 at 5pm. For more information, please visit: https://www.surveymonkey.com/r/HepCPreceptorship or contact sjobe@chpnet.org. 


EHR Incentive Hardship Exception Instructions Available NOW
Today, CMS has posted new, streamlined hardship applications, reducing the amount of information that eligible professionals (EPs), eligible hospitals, and CAHs must submit to apply for an exception. The new applications and instructions for a hardship exception from the Medicare Electronic Health Records Incentive Program 2017 payment adjustment are available here.

This new, streamlined application process is the result of PAMPA, which established that the Secretary may consider hardship exceptions for “categories” of EPs, eligible hospitals, and CAHs that were identified on CMS’ website as of December 15, 2015. Prior to this law, CMS was required to review all applications on a “case-by-case” basis.

Importantly, EPs, eligible hospitals, and CAHs that wish to use the streamlined application must submit their application according to the timeline established in PAMPA:

  • Eligible Professionals: March 15, 2016
  • Eligible Hospitals & CAHs: April 1, 2016

Please note: CAHs should use the form specific for the CAH hardship exceptions related to an EHR reporting period in 2015. CAHs that have already submitted a form for 2015 are not required to resubmit.

In addition, we have heard from stakeholders that they would like a more efficient approach for submitting applications from groups of providers. We have reviewed our administrative authorities and determined that groups of providers may apply for a hardship exception on a single application. Under the group application, multiple providers and provider types may apply together using a single submission. The hardship exception categories are the same as those applicable for the individual provider application.

Providers will have the option to submit an electronic file (in excel or csv formats) with all National Provider Identifiers (NPIs) or CMS Certification Numbers (CCNs) for providers within the group or use a multiple NPI or CCN form to submit their application. In addition, facilities which include both inpatient and outpatient settings may include both the individual NPIs for any eligible professionals and the CCN for the eligible hospitals and CAHs on the same single submission for their organization.


Physicians in Western New York Wary about Medical Marijuana Treatment
The Buffalo (NY) News (1/19, Davis) reports that “of the 226 doctors certified to recommend marijuana in New York State as of last week, 12 of them work” at the Dent Neurologic Institute in Amherst. Dr. Laszlo Mechtler, Dent’s medical director, is a “strong advocate for marijuana’s use where the scientific evidence shows it can help,” but “like many other physicians – remains wary about the drug.”

For physicians, the four-hour NYSDOH approved course is now available online. The online course is provided by TheAnswerPage, an established online medical education site, and includes the following topics: the pharmacology of marijuana; contraindications; side effects; adverse reactions; overdose prevention; drug interactions; dosing; routes of administration; risks and benefits; warnings and precautions; and abuse and dependence. The course will cost $249 to take. Successful completion of the course will provide 4.5 hours of CME credits. The course may be accessed here.


Peconic Bay Joins Northwell Health Group
Newsday (1/19, Ochs) reports that Peconic Bay Medical Center and Northwell Health Group signed a formal agreement on Tuesday, making Peconic Bay the “21st hospital in the health system and anchoring Northwell’s presence on the East End.”  Peconic Bay chief executive Andrew Mitchell “said the agreement signals the beginning of a ‘new era for health care in central and eastern Suffolk’ that will make Peconic Bay, which serves about 200,000 patients and employs 1,300, a regional health care provider.” The agreement also signals the end of “Peconic Bay’s 10-year relationship with Stony Brook University Hospital and the demise of the East End Health Alliance formed in 2008.” 


CDC: Physicians Should Be Aware of Zika Virus in Pregnant Women
The CDC issued a travel warning to pregnant women and women of child-bearing age to avoid traveling to 14 countries in Central America and the Caribbean due to the risk of contracting the Zika virus, which is linked to severe birth defects. CDC is warning physicians to look out for symptoms of the Zika virus in pregnant women returning from trips to South and Central America http://wwwnc.cdc.gov/Travel. Published in

MMWR, the recommendations include:

  • All pregnant women should be asked if they have recently traveled to areas with active Zika virus transmission.
  • Those with recent travel to such areas and with symptoms of fever, rash, muscle aches, or conjunctivitis during or within 2 weeks of travel should be tested for Zika.
  • For pregnant women who test positive for Zika, clinicians should consider conducting ultrasounds every 3 to 4 weeks to monitor the fetus’s growth.

Zika is a mosquito-borne virus suspected of causing thousands of cases of microcephaly in infants born in Brazil over the past year. Last week, the CDC warned pregnant women to consider postponing travel to countries with ongoing Zika transmission.  Click here to read the full MMWR article.


Physicians Should Avoid Overuse of Antibiotics For Respiratory Problems
The CDC and the American College of Physicians have issued guidelines available at http://annals.org/article.aspx?articleid=2481815 intended to help physicians avoid overuse of antibiotics for respiratory problems. The guidelines were published in Annals of Internal Medicine. The guidelines “lay out how doctors begin deciding if antibiotics are warranted for” certain “respiratory complaints, explain that decision to patients and offer guidance on symptom relief.”


Longtime MSSNY Member Rufus Nichols, MD Passes Away
Rufus Nichols, MD passed away on January 20, 2016 after a battling a long illness.  Today would have marked Dr. Nichols’ 46 years as a member of the Society.  Many of you may remember seeing him at the House of Delegates. He served on many important MSSNY Committees: Committee to Eliminate Health Care Disparities; International Medical Graduates Committee; Long Term Care Committee; Organized Medical Staff Section (Officer); and Preventive Medicine and Family Health Committee.

Notes of condolence may be sent to Mrs. Jackie Nichols, 394 Joanne Court, Bartonsville, PA 18321.The funeral will be held at Bethlehem Church, 89-45 Lefferts Blvd., Richmond Hill, NY 11418.  Here is the website – Bethlehem Church NYC.

Services are as follows:


Classifieds

Office Rental 30 Central Park South
Two fully equipped exam rooms, two certified operating rooms, 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.


Office Near UN for Rent
Modern, 3000 sq. ft. medical office to rent near the United Nations. Located at 340 East 49th Street, this ground level office is handicapped accessible. Private reception area; secretarial area available; 6 exam rooms. Ideal for ophthalmologist/optometrist. Could suit other specialties. Available for full or part time. $1300 per month for one day per week. Please contact Dr. Weissman at uneyes@verizon.net or call 914-772-5581



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

January 15, 2016 – Governor’s Speech Challenges Physicians

drmaldonado PRESIDENT’S MESSAGE
 Dr. Joseph R. Maldonado
asset.find.us.on.facebook.lgTwitter_logo_blue1
January 15, 2015
Volume 16, Number 2

Dear Colleagues:

While on the surface the course of healthcare delivery in New York appears to be moving along unfettered, much is happening at levels that have not fully gotten doctors’ full attention.  This week, I would like to highlight several for you.  It is impossible to provide a full review of all the issues in one short column so I ask that you do your homework with others in your group, hospital medical staff or county society.

Senate Roundtable on Health Republic

Last week, Dr. Scott Hayworth (Mt. Kisco Medical Group) and I participated in a Senate roundtable on the Health Republic fiasco.  Other parties included representatives from the DOH, DFS, hospital provider side and other insurers. By far, the largest cohort was that of the insurers. It was an opportunity for the Committee on Health to hear views from stakeholders as to the causes of the debacle and how we should move forward.

Dr. Hayworth and I were clear in our presentations on three points:

1) MSSNY alerted NYS health officials a year earlier to the closing that Health Republic had serious payment problems.

2) Physicians have been harmed significantly, leaving them with financial losses that will impact their abilities to provide necessary services to other patients.

3)  Failure to make physicians whole in the solutions brought forth by the state will likely dissuade doctors from participating in any future DSRIP and SHIP initiatives for fear of another failed healthcare reform project sinking them.  We made it very clear—a guaranteed State Fund is necessary to make physicians whole and ensure future success of physician engagement in DSRIP and SHIP.

Governor’s Budget

The Governor’s Budget this year presents several challenges to physicians.  First, there is the proposal once again to expand the terms under which retail clinics can operate in New York.  Second, there is once again an effort to eliminate the second layer of excess coverage for malpractice at a time when the legislature is consideration expanding the date of discovery and statute of limitations on filing a lawsuit for malpractice.  Third, there is a push to expand the scope of healthcare providers who can participate in the Workmen’s Compensation Board program. Finally, there is NO budgetary proposal for the establishment of a guarantee fund to address the losses in the Health Republic debacle.  

Insurer Mergers and Physician Opposition

This past week, the Physician Advocacy Institute sent a 14-page letter outlining its opposition to the merger of several large insurers in the country, highlighting the problems that such controlling entities would have in the marketplace and on the practices of physicians.  I encourage you to review this work done by an organization MSSNY helped found through the United Healthcare lawsuit settlement several years ago.

E-prescribing

Finally, it is imperative that physicians who have not as yet enrolled in the state’s e-prescribing program do so ASAP. The March 27, 2017 is looming.  A caveat–it will be impossible to complete the instructions before the deadline if you wait much longer.  We encourage you to consider the member discounted DrFirst option endorsed by MSSNY.

If you believe you qualify for a waiver, apply NOW.

Have a Happy Martin Luther King’s Day!

Joseph Maldonado, M.D, MSc, MBA, DipEBHC
MSSNY President

Please send your comments to comments@mssny.org


MLMIC Physianns Insurance


Governor Andrew Cuomo Delivers Joint State of the State and Budget Message
Gov. Andrew Cuomo this week set forth his state of the state message proclaiming the accomplishments of his administration over the past five years of his term and unveiling143.6 billion budget for the coming 2016-17 fiscal year.

Many of Cuomo’s 2016 priorities have been released over the past week including plans for a massive, multi-year infrastructure investment for airports, roads and bridge construction as well as a strengthening of mass transit systems in the New York City area, and increasing the state’s minimum wage to $15 (in NYC by 2018  and by July 2021 for businesses in the rest of State) and proposing 12 weeks of paid family leave in the budget, which would be paid for with a $1 paycheck deduction for employees.

Earlier in the week, Governor Cuomo announced a $7M grant to four organizations working to control obesity, diabetes, heart disease and stroke. The funding will allow each organization to implement strategies to encourage lifestyle change and link community programs to include clinical services. Included among the four organizations awarded funding were: Albany County Department of Health ($879,880); HealtheConnections ($2M); Hudson River Healthcare ($2M) and P2 Collaborative of WNY ($2M).

Cuomo proposed divvying up more than $2 billion in settlement relief funds to a variety of areas. He wants to spend $700 million on a plan that would stabilize the Thruway Authority’s finances, $340 million for what is being term a toll “reduction” plan, $200 million on a transportation capital plan, $640 million to provide affordable housing and combat homelessness and $225 million for economic development.

Cuomo’s proposal included an increase of $1.4 B on education aid, an increase of more than 6 percent. Overall, education aid would increase by $2.1 billion over the next two years.

Components of the Governor’s tax cut for small businesses include: a reduction of the corporate tax rate for small businesses from 6.5% to 4%; increasing the exemption from 5-15% of income for tax purposes for sole proprietors and farmers; and granting a 15% exemption for partnerships and s-corps.

The Governor proposes adoption of broad new ethics measures, including limits on outside income for the Legislature. He also proposed to limit how much money lawmakers can earn in the private sector to 15 percent of their base salary. Cuomo also proposed that lawmakers end the practice of allowing single donors to give unlimited contributions through a network of limited liability companies. Cuomo also proposed public financing of political campaigns, which Senate Republicans have insisted they will not pass.

Describing the personal issues faced by his partner Sandra Lee last year, the Governor ended his presentation by proposing a $90M program in NYS for breast cancer screening and an initiative to require all health insurers to cover breast cancer screening.

In addition, the budget contains a number of initiatives—some of which we have seen previously- which will if ultimately enacted by the Legislature impact physicians and patients across NYS including the proposals listed below:

  • Limit Access to Excess Medical Malpractice Coverage. The Governor has again proposed (as he did three years ago) to significantly limit access to the second layer of medical malpractice coverage. Specifically, the proposal would require the Superintendent to, at least once every five years beginning on July 1, 2016, rank from highest to lowest each class and territory combination used for apportionment of premiums to pay for the excess coverage.  Ranking will be a function of physician primary coverage costs and “applicable” (and unspecified) excess tier factors. The proposal requires the Superintendent to grant priority for purchasing policies in descending order beginning with high risk class and territory combination until the appropriation is exhausted. This initiative will result in a $25 million reduction to the program from $127.4M to $102.4M. Three years ago, he proposed somewhat different language but his articulated goal was to limit Excess coverage to physicians with the highest risk…which would have left nearly 40% of physicians who currently have such coverage without it.
  • Authorizes Establishment of Retail Clinics. The Governor has proposed to enable the establishment of ‘limited service’ clinics which provide a limited list of services in retail stores- provided that they adhere to regulations which would among other things require them: to be accredited; accept walk ins; adhere to advertising and signage standards; disclose ownership interests; directly employ a medical director; and strengthen primary care through integration of services with the patient’s other health care providers. The justification given for this proposal is “to increase access to economical primary care services for Medicaid recipients and reduce unnecessary emergency room and inpatient visits”. This proposal is also somewhat modified from those advanced in previous years. It now would allow diagnostic and treatment centers (owned by hospitals), community health centers and federally qualified health centers to operate a limited services clinic.  The proposal would also require an establishment to ‘demonstrate a commitment’ to operate limited service clinics in medically underserved areas; and would allow the department in determining whether to approve additional limited service clinic locations, to consider whether the operator has fulfilled its commitment to operate limited services clinics in medically underserved areas of the state.
  • Makes Significant Changes to Workers Compensation program. The Governor’s proposal would expand the list of providers who are eligible to deliver (and receive payment directly form the W/C program) to include acupuncturists, nurse practitioners, physician assistants, and social workers. Currently, only chiropractors, physicians, podiatrists, psychologists and physical therapists were authorized to receive reimbursement from the workers’ compensation program. Ostensibly, NPs and PAs employed by physicians provided care but the physician’s practice was reimbursed. The proposal also eliminates need for county medical society review of physicians looking to be authorized to deliver care. The initiative would also enhance the flexibility of hearing times and enables virtual hearings for workers compensation cases. See related article.
  • Health Republic. The Governor’s proposed budget does not include language to require the creation of a Guarantee Fund or identify the use of any settlement monies or other pool of monies to address the financial plight of physicians and other providers due to the recent demise of Health Republic. MSSNY is working closely with several physician practices, the Greater New York Hospital Association and HANYS to urge enactment of legislation to reimburse providers who have incurred significant losses as a result of providing care to HR insureds.
  • Statutory Proposals to advance DSRIP/VBP. The Governor’s proposed budget did not include the statutory language changes that have been advanced by various subcommittees to the VBP Workgroup, the Governor’s State of the State message did stipulate that “in 2016, DSRIP will move to the next phase of transforming the health care delivery system in New York by implementing pilot programs to replace expensive fee-for-service payments with ‘value-base’ payments that reward providers for successful patient outcomes and help achieve one of the core DSRIP goals of reducing avoidable hospital admissions by 25 percent over five years.”
  • Additional funding ($200M) to combat AIDS. Specifically, these funds will be used to expand the availability of affordable housing and housing assistance for those living with HIV and identify undiagnosed persons, link them with treatment and facilitate access to necessary medications to keep them HIV negative to prevent spreading the disease.
  • Additional funding ($6M) to combat heroin epidemic. These funds will continue to support prevention, treatment and recovery programs targeted toward chemical dependency, residential service opportunities, and public awareness and education activities.
  • Permits certain state facilities to share patient medical records. Permits facilities, including facilities operated or licensed by the Department of Mental Hygiene, to share clinical records with managed care organizations, behavioral health organizations, health homes, and other entities authorized by the Department or Department of Health (DOH) to provide, arrange or coordinate health care services for Medicaid recipients for whom such entities are responsible.
  • Eliminates the prescriber prevails. Eliminates existing statutory prescriber prevails protections for medications for patients covered in the Medicaid program, except for atypical antipsychotic and anti-depressants. (DEARS, AUSTER, CLANCY, MCPARTLON) 

Executive Budget Seeks to Marginalize Physician Care to Injured Workers
The Governor’s proposed Budget released this week contains sweeping changes to long standing Workers’ Compensation laws to, according to the supporting memo: ensure the system provides more timely and appropriate medical and wage replacement benefits to workers; provide broader and more accessible options for medical care; make hearings more accessible through flexible scheduling and use of virtual hearings; and streamline Workers’ Compensation Board processes and administration to expedite decision making.

While these goals are obviously shared by the physician community, the proposal includes a number of seriously problematic proposals that could further discourage physician participation in the Workers’ Compensation program.  Among the proposals:

  • Removes the authority of county medical societies to recommend physicians to serve as treating providers or independent medical examiners under Workers Compensation, which is currently an important community function provide by county medical societies;
  • Enables treatment of injured workers and direct payment for care by nurse practitioners and physician assistants, without clarity as to: how non-physicians treating patients with serious health conditions will coordinate patient care delivery with physicians; whether new funds will be allocated or whether existing fees will need to be cut to cover this expanded list of care providers; and whether a non-physician can perform an IME of an injured worker to review the care provided by a physician to an injured worker;
  • Removes the requirement for a referral by a physician for an injured worker as a pre-condition to receive psychological care;
  • Expand the circumstances when a physician or other health care provider can have their authorization removed and empowers the Board to impose a $5,000 fine on a physician or any other Board-authorized health care provider for violating a Workers Compensation rule; and
  • Prohibits an injured worker not subject to a collective bargaining agreement from seeking medical treatment from outside a Workers Compensation PPO before 120 days after his or her first visit to a preferred provider organization provider.

Of further concern, the proposal does not address any of the many excessive administrative hassles identified by physicians that have caused many physicians to choose to not participate in the Workers Compensation program.   While there have been some modestly positive actions taken by the WCB in recent years to encourage physician participation in the WC program through removal of arbitration fees and development of an electronic portal for facilitating authorizations from carrier, the Budget proposals if enacted could further chase physicians away from the program.   MSSNY has reached out to labor organizations to coordinate its advocacy in opposition to these adverse proposals. (AUSTER)


MSSNY Lobby Day Scheduled For March 8th– Physicians Urged To Attend And To Wear Your White Coats
SAVE THE DATE- MSSNY’s Physician’s Lobby Day will be held on March 8th in the Louis Swyer Theater in the Egg located on the Empire State Plaza in Albany New York.  A full slate of legislators and key staff to the Departments of Health and Financial Services has been invited to dialogue with Lobby Day participants including:

  • Donna Frescatore, Executive Director of the NYS Health Benefit Exchange
  • Troy Oechsner, Acting Executive Deputy Superintendent Of Insurance , Department of Financial Services
  • Jason HElgerson, Medicaid Director, Department of Health
  • Legislative Panel: Senate Health Chair Kemp Hannon; Assembly Health Chair Richard Gottfried; Senate Insurance Committee Chair and Assembly Insurance Chair Kevin Cahill.
  • Senate Majority Leader John Flanagan, Assembly Speaker Carl Heastie

A brief luncheon to which members of each House are invited to dine and speak with their constituents will follow the morning program. County Medical Societies will be scheduling appointments for physicians to meet with their elected representatives.
(DEARS)


Date of Discovery Liability Expansion Bill Back on Assembly Calendar; Physicians Must Contact Their Legislators to Oppose Now!
With the Legislature back in Session, all physicians must again contact their legislators to urge that they oppose legislation (A.285, Weinstein) that could drastically increase New York’s already exorbitantly high medical liability premiums by changing the medical liability Statute of limitations to a “Date of Discovery” rule.   The letter can be sent here.

With the bill having passed the Assembly in 2015, but not the Senate, it resumes a place on the Assembly Calendar, where it could be voted on by the full Assembly at any time.   The bill was brought up for initial consideration on Monday 1/11, but was “laid aside” by the Assembly Republican Conference  at MSSNY’s rquest.  While the bill currently does not have a Senate sponsor, it is likely to be introduced shortly.

MLMIC’s estimate based upon similar legislation is that this single bill could increase physician liability premiums by an untenable 15%!   New York physicians continue to pay liability premiums that are among the very highest in the country.  They also face rapidly increasing overhead costs to remain in practice such as the huge costs associated with implementing expensive and cumbersome electronic medical record systems.  At the same time, they face reduced payments from Medicare and commercial insurers, and many practices face losses of tens of thousands, hundreds of thousands and in some cases millions of dollars due to the collapse of Health Republic.  Therefore, YOU NEED TO LET YOUR LEGISLATORS KNOW THAT NO LIABILITY INCREASES CAN BE TOLERATED!

MSSNY is working with many other groups also impacted by this legislation, including hospitals, nursing homes, other specialty societies and the Lawsuit Reform Alliance of New York, in an effort to defeat this disastrous legislation.   (AUSTER, DEARS)


Contact Your Legislators to Support a Health Republic Guarantee Fund
With the failure of the Executive Budget to include a Guarantee or other fund to cover the likely   hundreds of millions in payments due to Health Republic contracted providers, all physicians are urged to continue to contact their legislators and demand that the State Legislature take action to create such Guarantee or other fund.

Last week, MSSNY President Dr. Joseph Maldonado strongly urged key State Senators to work to enact a fund to assure that Health Republic claims are completely paid, and that this legislation be enacted in the opening weeks of the 2016 Legislative Session.   Dr. Maldonado’s statements were made as part of a Senate Health & Insurance Committees Roundtable discussion examining the demise of Health Republic, discussing solutions to minimize its adverse consequences, and working to prevent similar events in the future.  The meeting was chaired by Senate Health Committee Chair Kemp Hannon and Insurance Committee Chair James Seward.

To read Dr. Maldonado’s full written statement to the State Senate click here.

Dr. Maldonado’s comments received extensive media coverage, including in Buffalo Business First, Crain’s Health Pulse, and in an Associated Press article that was printed in papers across the country. 

Please remind your legislators that, with physicians facing so many other challenges in seeking to keep their doors open to deliver patient care, including high liability costs, expensive electronic medical record equipment, employee costs and declining payments from insurers, failure to assure payment for these claims would have serious negative consequences for your community.
(AUSTER, DEARS)


Legislation Before Assembly to Accord Due Process Rights When Physicians Are Non-Renewed By A Health Insurer
Legislation (A.1212, Lavine/S.4751, Hannon) is back before the full Assembly that would assure physicians are accorded a fair peer review appeals mechanism before their participation contract with a health insurance company can be non-renewed.  The legislation is in response to situations such as the disrespectful way by which Emblem treated 750 of its network physicians who were unceremoniously dropped from the network in October based upon specious allegation of failure to transition to value-based payments, severing patient treatments relationships for countless patients.  MSSNY has raised this issue with Department of Financial Services, Department of Health, and Attorney General, as well as the entire New York State Legislature. (See MSSNY letter to DFS here.

The legislation passed the Assembly overwhelmingly in 2015, but not the Senate.  Physicians can send a letter in support of this legislation here.  A customizable template is provided.
(AUSTER, DEARS)


Cuomo Calls for Ethics Reform
On Wednesday, Governor Cuomo introduced two freestanding Article VII Ethics reform bills in his budget proposal designed to address the public perception of Albany’s political culture quagmire.

The first bill, a smorgasbord of ethics reform, tackles: (1) closing the LLC Loophole by removing an LLC’s designation as an individual, requiring LLCs making political expenditures to register with the State of Board  of Elections, and to disclose direct and indirect LLC ownership thereby proportionally attributing such political expenditures toward individual campaign contribution limits; (2) capping outside earned income of legislators to no more than 15% of member base compensation, with exceptions for investments and capital gains accrued prior to taking office, and tying members’ ability to vote in the legislature on compliance with civil penalties up to $50,000; (3) reforming campaign finance with heightened disclosure requirements for intermediaries, and proposing a system for the public financing of campaigns; (4) reforming the Freedom of Information Law (FOIL) by statutorily making both houses of the legislature subject to FOIL requirements; (5) expanding the Joint Commission of Public Ethics (JCOPE) civil penalty jurisdiction and mandating JCOPE hold one meeting location for every meeting open to the public; and (6) requiring political consultants to register as lobbyists.

The second bill, a constitutional amendment subject to voter approval, would strip a public official of his or her pension or retirement benefits/privileges if they are convicted of a crime related to public office. The constitutional amendment would be retroactive in the sense that benefits/privileges are subject to forfeiture regardless of when such rights accrued or vested.

The ambitious and seemingly all-inclusive ethics reform bills are highly contentious in both houses, and are unlikely pass without significant changes.
(DEARS, MCPARTLON)

MSSNY and OASAS to Conduct CME Webinars on Opioid Use; Registration Now Open
The Medical Society of the State of New York and New York State Office for Alcoholism and Substance Abuse Services are pleased to present a free,  four part webinar series on opioid prescribing.  Entitled, “Revisiting the Role of Opioid Analgesics for Simple and Complex Patients with Chronic Pain”, the series will begin on Tuesday, January 26, 2016.

Registration is now open.

A copy of the flyer can be found here.

Opioid abuse is a national epidemic that physicians and other prescribers have the power to help prevent.  This series will provide information on managing pain, understanding the potential for patient addiction, and determining best practices for safe, responsible opioid prescribing. 

Tuesday January 26, 2016,  12:30 p.m.

Faculty: Charles Morgan, MD, FASAM, FAAFP, DABAM and Patricia Bruckenthal PhD, APRN-BC, ANP, FAAN

Educational Objectives:

  • Compare and contrast the dual epidemics of chronic pain and opioid abuse and the implications on public health
  • Understand requirements of New York State laws/regulations with regard to prescribing of controlled substances.

Wednesday, February 10, 2016, 7:30 a.m.

Faculty:  Charles E. Argoff, MD

Educational Objective:

  • Discuss evidence based best practice recommendations for opioid therapy for chronic pain, patient risk assessment and documentation. 

Tuesday, February 23, 2016, 7:30 a.m.

Faculty:  Jeffrey Selzer, MD

Educational Objective:

  • Describe potential for patient addiction, screening, diagnosis and subsequent treatment or referral.  

Thursday, March 10, 2016, 7:30 a.m.

Faculty: Charles E. Argoff, MD and Charles Morgan, MD, FASAM, FAAFP, DABAM

Educational Objectives:

  • Recommend tools to assist in the management of patients for whom opioids are indicated and prescribed.
  • Discuss strategies to reduce risk of treating pain in patients with substance use disorders

Physicians and other prescribers can take one or all of the webinars; each webinar has been accredited for one hour of continuing medical education credits.  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.

For further information or assistance in registering for the program, please contact Pat Clancy at pclancy@mssny.org or Terri Holmes at tholmes@mssny.org.
(CLANCY, DEARS)


MSSNY E-Prescribing Webinar Now Available on MSSNY CME Site
MSSNY e-prescribing webinar, entitled, “NYS Requirement for E-prescribing ALL Substances” is now available at MSSNY Continuing Medical Education site at http://cme.mssny.org/  Faculty for this program is Sandra Knapp, Manager, Official Prescription Program, NYS Department of Health, Bureau of Narcotic Enforcement.    The requirement to e-prescribe all substances will become effective on March 27, 2016.   The Medical Society of the State of New York designates this enduring activity for a maximum of 1.0 AMA/PRA Category 1 credit™. New registrants to the site will have to register and create a username and password, which should be retained and be used for continued access to the site. Once registered and logged into the site, physicians will be taken to an instruction page.   Click on the menu on “My training page” to view and take the e-prescribing course.  There are over 50 free courses that are also available.  Further information on all these programs may be obtained by contacting Pat Clancy at pclancy@mssny.org.                                         (CLANCY)


E-Prescribing Waiver Applications Now Available from BNE
With March 27, 2016 as the date that all prescriptions must be electronically submitted, the New York Bureau of Narcotic Enforcement has announced the availability of the Electronic Prescribing Waivers (EPW) application on the Health Commerce System (HCS).

A prescriber must have a HCS account in order to file an electronic prescribing waiver.  Using the HCS account is the quickest way to file the EPW application.

This application allows an institution, medical group practice or an individual practitioner to submit a request for a waiver from the requirement to electronically prescribe. Below are links to instructions for completing the online application on the Health Commerce System, based on the type of requestor:

Institution

Medical Group Practice

Individual Practitioner

If physicians do not have an HCS account, a paper version is NOW available upon request. Please contact the BNE at 1-866-811-7957, option 1.  The paper form is available for applications for institutions, group practices and individual practices and will be sent to requestors.

If physicians experience difficulties with their HCS account,  please call:  1-866-529-1890.  If a prescriber experiences any issues with the on-line Electronic Prescribing Waiver, they should call 1-866-811-7957.                                                                 (CLANCY, DEARS) 


MSSNY Announces 2016 Medical Matters Schedule
The Medical Society of the State of New York will begin its 2016 Medical Matters webinars on January 20, 2016 with a program entitled Immunizations During A Disaster, with Dr. William Valenti as faculty.  All programs will begin at 7:30 a.m.   Registration is now open to physicians and other public health officials:

Go to training session and upcoming sessions tab

Educational objectives for the January 20 program are:

  • Review recommendations for immunizations during disasters
  • Review recommendations for immunizations for responders
  • Describe best practices to avoid vaccine preventable diseases (VPD) during disasters
  • Describe the importance of herd immunity

Additional programs are: Public Health Preparedness 101 on February 17, 2016 and Radiological Emergencies on March 16, 2016.   Further information on these programs can be found here.

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.

Further information or assistance in registering for any of these programs,  may be obtained by contact Melissa Hoffman at mhoffman@mssny.org.
(CLANCY, HOFFMAN) 


NYS DOH AIDS Institute Announces HCV Provider Directory
The AIDS Institute Viral Hepatitis Section is excited to announce the launch of the NYS HCV Provider Directory.  The purpose of the directory is to provide the public and other providers with a listing of HCV care and treatment providers within the State. The directory is an expansion of the existing HIV Provider Directory re-launched last year by the AIDS Institute.

Participation in this directory is voluntary. The information is compiled through provider self-identification, and includes physicians, nurse practitioners, physician assistants, and doctors of osteopathic medicine with the experience in HCV care and treatment and who meet the NYSDOH definition of an experienced HCV provider.

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 ldears@mssny.org            mauster@mssny.org  
pclancy@mssny.org bellman@mssny.org    


CVS Pharmacies in NY Can Sell Naloxone without Prescriptions
Yesterday, the New York State DOH announced an agreement with CVS/pharmacy to help prevent opioid overdose deaths in New York State. This agreement, which became effective January 2, authorizes 479 CVS/pharmacy locations across the State to provide naloxone to their customers without a prescription. Pharmacists are currently receiving training and ordering naloxone for their stores. Naloxone (also known as Narcan®) is a medication that reverses opioid overdose.
Although traditionally administered by emergency medical (EMS) or hospital personnel, naloxone can be administered by laypeople with minimal training. CVS pharmacists are now able to provide this training in addition to dispensing the naloxone to their customers. All individuals who are given naloxone should still go to the hospital with EMS personnel. Naloxone is effective in blocking the effects of an opioid for 30 to 90 minutes. When the naloxone has worn off, someone may slip back into a life-threatening overdose. For more information, click here.


REMINDER:  All Prescriptions Must Be Sent Electronically Beginning March 27th
With the e-prescribing mandate quickly approaching on March 27th, we at MSSNY yare concerned about the lack of preparedness expressed by New York doctors.  Our recent survey showed that more than 40% of responding physicians are not yet prepared to meet the e-prescribing mandate.

We DO NOT expect an extension of the deadline, and urge you to ACT NOW to ensure you are compliant with the law.

As a MSSNY member benefit, you qualify for a substantial discount on DrFirst’s industry-leading Rcopia® with EPCS GoldSM.  The cost is $500 for a one-year license (a $299 discount) and includes e-prescribing for both legend drugs and controlled substances, as well as the DEA-required identity proofing and two-factor authentication soft token.

If you buy now, you’ll be ready when the deadline arrives, and DrFirst will extend your software license from now until March 27, 2016 at no additional charge. To purchase online, visit www.drfirst.com/MSSNY and use coupon code MSSNY, or call the MSSNY E-prescribing Hotline at 866-980-0553.

To learn more, register for DrFirst’s educational e-prescribing webinar to help you learn more about I-STOP and the patient safety and workflow benefits of using e-prescribing.  Sign-up today using the registration links below:

1/19 @ 12:00 pm – http://www.drfirst.com/mssny/mssny-lp/#webinar


MSSNY Multi-Section Meeting February 27 for YPS, Residents and Students
MSSNY’s Young Physicians, Resident and Fellow, and Medical Students Sections will hold a joint meeting on Saturday, February 27, 2016. While the business portions will be held separately, all three sections will get together to partake in a leadership presentation* by Richard Popovic, a highly experienced consultant in the fields of physician leadership, strategy, management and patient safety.

Don’t miss this essential leadership presentation and opportunity to discuss relevant issues with your colleagues and help shape MSSNY policy. Section Governing Council elections will be held. Business meetings will take place at MSSNY offices, 865 Merrick Avenue, Westbury, and the leadership presentation at the Hilton Garden Inn (across the street). Web conferencing will be available. The Hilton is offering a corporate room rate of $164.00 for those who may wish to stay overnight (contact sbennett@mssny.org for corporate number).

YPS and RFS can register at sbennett@mssny.org. Students can register at mreyes@mssny.org.

  • YPS business 8:00 am
  • MSS business 9:00 am and after lunch as necessary
  • Presentation 10:30 am
  • Lunch noon
  • RFS business 1:00 pm

*This activity has been planned and implemented in accordance with the Accreditation Requirements and Policies of the Medical Society of the State of New York (MSSNY) through the joint providership of MSSNY and the Medical Educational & Scientific Foundation of New York, Inc. (MESF). MSSNY 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 1.5 AMA PRA Category 1 Creditsä. Physicians should claim only the credit commensurate with the extent of their participation in the activity.


CDC To Provide $2M to Combat Chronic Diseases in Western NY
Buffalo Business First reports that the nonprofit organization, the P2 Collaborative of Western New York, “will receive $2 million over three years from CDC to fight chronic diseases such as obesity, diabetes, heart disease and stroke in the eight-county region. The article points out that “P2 is among four organizations across New York that will receive $7 million in all.” Recipients for the grants were “selected based on high rates of chronic disease and/or more than 40 percent minority population in the counties they serve.” The funds “will support strategies in community and care settings that promote health, support and reinforce healthful behaviors, encourage lifestyle change program participation and link community programs to clinical services.” 


Eight Marijuana Dispensaries Open throughout State
On January 7, Columbia Care opened the first medical marijuana dispensary in New York City on East 14th Street in Manhattan; other dispensaries that opened in the state were in White Plains, Syracuse, Williamsville, Albany, Kingston, Amherst, and Liverpool.


Average Age of First-Time Moms in US at All-Time High
On January 14, a report released by the Centers for Disease Control and Prevention revealed that the average age of first-time mothers is at an all-time high in the United States http://www.cdc.gov/nchs/data/databriefs/db232.htm The report put the average age at 26 years, 4 months for first-time moms in 2014. Lead author T.J. Mathews from the CDC attributed the change to the drop in teen moms. Overall, the average age of first-time moms “has been rising in every racial and ethnic group, and in every state,” but the highest average ages for first-time moms are still in the Northeast.

American Academy of Pain Medicine Meeting in February in Palm Springs
The American Academy of Pain Medicine (AAPM) 32nd Annual Meeting will be held February 18-21, 2016, in Palm Springs, CA. The theme of this year’s event is Ensuring Access to Pain Care: Engaging Pain Medicine and Primary Care Teams. Of particular connection to their work on the AMA task force, the Academy is offering a preconference session titled Opioid and Non-Opioid Medications Management: Filling in the Gaps, Prescribing for the Whole Patient. Learn more by visiting www.painmed.org/annualmeeting.


Classifieds

Office Rental 30 Central Park South
Two fully equipped exam rooms, two certified operating rooms, 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.


Office Near UN for Rent
Modern, 3000 sq. ft. medical office to rent near the United Nations. Located at 340 East 49th Street, this ground level office is handicapped accessible. Private reception area; secretarial area available; 6 exam rooms. Ideal for ophthalmologist/optometrist. Could suit other specialties. Available for full or part time. $1300 per month for one day per week. Please contact Dr. Weissman at uneyes@verizon.net or call 914-772-5581



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

1 21 22 23 24 25 26