August 11, 2017 – MOC: There Has To Be A Better Way


PRESIDENT’S MESSAGE
Charles Rothberg, MD
August 11, 2017
Volume 17
Number 31

Dear Colleagues:

This week, MSSNY joined 32 other state medical societies—along with a number of national specialty societies—in signing a letter that was sent to the ABMS and its boards outlining the problems associated with Maintenance of Certification (MOC). The group has requested a meeting with ABMS for December.

There is a long-standing absence of transparent communication from the certifying boards. The letter we have signed onto—and the proposed meeting—are steps towards making the boards aware of the significant problems physicians are having with MOC.  We want to work with the leaders of the certifying boards to ensure physician self-regulation.

Among the many things I oppose regarding MOC are the high stakes exams that cost physicians thousands of dollars to comply and take time away from work. There is a lack of relevance to the process—they test knowledge but there is no evidence that they test competence. The theoretical purpose of these exams is to assure competence and evidence of lifelong learning, when in fact they accomplish neither goal. In fact, the MOC exams simply do not relate to the way physicians practice medicine.

Another issue is the ability of the board to withdraw certification.  Clinical practice is always evolving, based on the health needs of the population, technical advances and physician interests.  A board should not be able to retract a certification that a physician has earned; for example, a physician who is board certified in pediatrics and goes on to earn a board certification in ophthalmology should not have his or her pediatrics certification clawed back (this happened to OB-GYNs that treated men).  If you earn a B.S. in psychology from Harvard and end up becoming a journalist, does that void the B.S. in psychology?

The certifying boards have a history of overreaching. They need to return to the business of providing certification that physicians have completed their training with a certain level of competence.

The MOC process needs to be restructured. There simply has to be a better way.

Sincerely,
Charles Rothberg, MD
MSSNY President

Please send your comments to comments@mssny.org


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Another Voice Calls for Governor Cuomo to Veto Medical Liability Bill
This week, Monroe County Medical Society President Dr. Peter Ronchetti’s letter entitled “Neither Patients nor Physicians Benefit from Medical Liability Bill” ran in the Rochester Business Journal. “This bill would do nothing to improve the ability of New Yorkers to access high-quality health care or improve outcomes,” writes Dr. Ronchetti. “In fact, if passed, at the very least it will drive physicians out of New York and create a barrier to new physicians choosing to practice here.” Click here to read Dr. Ronchetti’s letter in full.

Physicians: Tell Gov. to Reject Liability Expansion Bill/Call for Comprehensive Liability Reform

All physicians are urged to continue to call Governor Cuomo at 518-474-8390 and send a letter here urging that he veto a so-called “cancer only” medical liability statute of limitations expansion bill (S.6800/A.8516) that passed the Legislature over the strong objections of MSSNY, the specialty societies, the hospital industry and MLMIC.

Please urge that legislation be enacted that provides for comprehensive medical liability reform. This ambiguously drafted bill, introduced in the final days and passed in the final hours of the 2017 Legislative Session, would expand the medical liability statute of limitations for cases involving “alleged negligent failure to diagnose a malignant tumor or cancer”.   The bill would permit lawsuits 2.5 years from the “date of discovery” of such alleged negligence, up to an outside limit of 7 years.  Actuaries have estimated that this legislation could increase already exorbitant premiums by 10-15% at a time when no increases can be tolerated.

Again, please urge the Governor to veto this bill and encourage your colleagues to do the same! Please let the Governor know how this bill will harm patient care and exacerbate existing physician shortage issues in your community.

Trump’s Shift on Opioid Crisis
President Donald Trump on Thursday declared the country’s opioid epidemic “a national emergency,” just days after HHS Secretary Tom Price said the opioid misuse epidemic could be “addressed without the declaration of an emergency.” President Trump said he’s drafting the necessary paperwork to put the declaration into effect.

According to the Washington Post, Trump delivered the announcement “to reporters outside a national security briefing” in Bedminster, New Jersey, adding his Administration is “going to spend a lot of time, a lot of effort and a lot of money on the opioid crisis.” The Post says the declaration of emergency will permit the Administration “to remove some barriers and waive some federal rules enabling states and localities to have more flexibility to respond.”

Implementation of Face to Face Documentation Requirement for NY Medicaid Home Health Coverage
Please see this guidance from the New York State Department of Health announcing that, effective July 1, there must be a documented face-to-face (F2F) encounter by a physician or other care provider with certain Medicaid insured patients for the initial authorization for home health services provided by a Certified Home Health Agency (CHHA).    The requirement is the result of a provision contained in the Affordable Care Act.

As set forth in the guidance, the F2F documentation requirements for Medicaid patients in need of home health care only apply to Medicaid fee-for-service (FFS) coverage serviced by CHHAs. The CHHA must maintain a copy of the F2F documentation in the clinical record.  F2F rules are not applied to managed care cases, or to cases that are personal care service-only.  Moreover, DOH confirmed that the following are also exempt from Medicaid F2F documentation requirements: Fully Integrated Duals Advantage (FIDA); Medicaid Advantage; Special Needs Plans (SNPs); the Program for All-Inclusive Care for the Elderly (PACE); and Health and Recovery Plans (HARP).

MSSNY worked together with the Home Care Association of New York State (HCA) to draft guidelines well before the July 1 effective date for DOH to use as the basis for implementation of the Medicaid F2F rules required by the ACA. The purpose was to ensure a streamlined process for physicians and home care agencies, and the narrowest applicability of the requirements to avoid the kinds of extensive, onerous, duplicative and confusing standards set by the U.S. Centers for Medicare and Medicaid Services (CMS) in the case of F2F for Medicare home health services.


Your membership yields results and will continue to do so. When your 2018 invoice arrives, please renew. KEEP MSSNY STRONG!


DSRIP Program Reduces Potentially Preventable Readmissions and ER Visits, According to DOH
New York Medicaid Director Jason Helgerson recently announced the progress that New York’s Medicaid Delivery System Reform Incentive Program (DSRIP) has made, noting that New York had closed its second year with a 14.9% reduction in Potentially Preventable Readmissions and an 11.8% reduction in Potentially Preventable ER Visits.

The report also noted that, if the current Reduction rates are maintained, New York will achieve its goal of a 25% reduction in avoidable hospital use by DSRIP Year 5.  The report also noted that New York’s Performing Provider Systems (PPS) have earned a total of $2.4 billion, which is 95% of all available funds.

While these are important achievements for New York’s DSRIP program, MSSNY continues to raise concerns to state officials that funds allocated to many of these PPS across the State are not ultimately being distributed to the downstream PPS participating providers to support their efforts in helping to bring about these important reductions.



Why I Joined MSSNY



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Calling All IMGs!
Essen Health Care will host an IMG Symposium on August 16th from 6-8 pm at Jacobi Medical Center in the Bronx. Topics range from Navigating Residency: What to Expect to Residency Application and Interview Tips; and from Organized Medicine and Support Network to Primary Care Pathway.

IMGs are invited to participate in a pre-symposium networking from 5:30 PM to 6:00 PM. If you are driving please park in Parking Lot #4. The lot will be open from 5:30 PM to 8:00 PM.

Click here for more information on the symposium.

Check out MSSNY’s New CME Website and Listen to our Many Podcasts!
Did you know that we recently updated and completely revamped the MSSNY CME website?  Check it out here (Note: new users to the site will need to create an account).  You can earn free CME credits on emergency preparedness topics that range from our four-part Physician’s Electronic Emergency Preparedness Toolkit to Ebola, a Perspective from the Field or Mosquito Borne Diseases.  We also have a module on concussion in pediatric and adult patients as well as a CME accredited podcast on the same topic.

MSSNY also has more than ten informative podcasts that you can listen to here.  There are multiple brief podcasts on immunizations as well as others on Zika virus and MSSNY’s Physician’s Emergency Preparedness Toolkit.  Each podcast offers insight from medical experts on topics they are extensively well versed on.


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East 68th Street full or part-time, 1 consult room, 2 exams rooms, large waiting room, high ceilings, central A/C, carpeted throughout , window in every room, X-Ray facility in-house.  Also for Rent- Large furnished room ideal for Psychiatrist/Psychologist. Please call 212-639-1800

For Rent or Share – Woodbury, Long Island
Beautiful recently renovated Plastic Surgery
office available for part-time share and
AAAA-certified (by end of summer).
OR available for rent. Centrally located
on Long Island.Close to expressways.
3 exam rooms, 1 procedure room /OR.
Waiting room, break room and personal office.
Free WIFI. Available for full or half-days.
Suits Plastic/Cosmetic Surgeons/Derm/ENT/
ObGyn/Podiatry or other Medical MDs.
Contact Patricia at info@cosmetichg.com
or 631-318-4008

Want to Sell Your Medical Practice? Do You Have Medical Office Space to Sell or Share?
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CALL FOR RATES & INFO. CHRISTINA SOUTHARD: 516-488-6100 ext. 355

August 4, 2017 – Hospital Consolidations and Med Staff Independence


PRESIDENT’S MESSAGE
Charles Rothberg, MD
August 4, 2017
Volume 17
Number 30

Dear Colleagues:

With the announcement last week that John T. Mather Memorial Hospital in Port Jefferson has signed a letter of intent to join Northwell Health, it’s imperative that we contemplate the impact of hospital consolidation on the independence of the medical staff.

There is an inherent value in the independence of the medical staff. According to NY State law, “the medical staff shall be organized and accountable to the governing body for the quality of the medical care provided to all patients…and establish objective standards of care and conduct.” Additionally, the law requires that the medical staff monitor patient care performance, including monitoring practitioner compliance with bylaws of the medical staff.

Physicians as a rule have a strong commitment to their institutions—and want to see them thrive—so they tend to be supportive when consolidations are proposed, as they often include an infusion of funds for hospital infrastructure and medical services that benefit patients and the community.

But a relatively small medical staff has little leverage in arguing with a huge health system over rules and policies that affect medical care and medical decision-making.

Do these hospital consolidations constrain the medical staff so much that the needs of the community are not being served?

A constant theme of the Organized Medical Staff Sections of MSSNY and the AMA has been the necessity to have strong medical staff bylaws.  In consolidation, a staff could lose hard-won provisions protecting due process rights for physicians and clinical decision-making authority.

Those who object to rules that they feel impede care can be labeled as disruptive, or subject to sanctions that will harm their careers.

Might pressure be applied to interfere with long-standing referral patterns and require that referrals be made within the overall system?

Consolidation can include many benefits for the institution, the physicians and the patients they both serve, but care must be taken to ensure that the medical staff does not lose sight of its responsibility to ensure the best possible care for patients.

Sincerely,
Charles Rothberg, MD
MSSNY President

Please send your comments to comments@mssny.org


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In Syracuse Post-Standard, Onondaga County Medical Society President is the Latest Voice Calling for Comphrehensive Liability Reform
In a letter published in The Post-Standard in Syracuse on Tuesday, Onondaga County Medical Society President Dr. Mary Abdulky writes, “If signed by Gov. Andrew Cuomo, this bill (S6800/A8516) could worsen the exodus of physicians leaving New York to practice in other states that are more economically advantageous. We already lose 55 percent of the resident physicians trained here to other regions of the country, and face some difficulty attracting new physicians to the area due to the excessive medical liability premiums that our physicians must pay.”

Physicians: Tell Gov. to Reject Liability Expansion Bill/Call for Comprehensive Liability Reform
All physicians are urged to continue to call Governor Cuomo at 518-474-8390 and send a letter here urging that he veto a so-called “cancer only” medical liability statute of limitations expansion bill (S.6800/A.8516) that passed the Legislature over the strong objections of MSSNY, the specialty societies, the hospital industry and MLMIC.

Please urge that legislation be enacted that provides for comprehensive medical liability reform. This ambiguously drafted bill, introduced in the final days and passed in the final hours of the 2017 Legislative Session, would expand the medical liability statute of limitations for cases involving “alleged negligent failure to diagnose a malignant tumor or cancer”.   The bill would permit lawsuits 2.5 years from the “date of discovery” of such alleged negligence, up to an outside limit of 7 years.  Actuaries have estimated that this legislation could increase already exorbitant premiums by 10-15% at a time when no increases can be tolerated.

Again, please urge the Governor to veto this bill and encourage your colleagues to do the same! Please let the Governor know how this bill will harm patient care and exacerbate existing physician shortage issues in your community.


Senate Confirms Dr. Jerome Adams as Surgeon General
The US Senate has approved Jerome Adams, MD, to be the next surgeon general. Pledging to take on the nation’s opioid epidemic, he wrote in his nomination committee statement: “The addictive properties of prescription opioids is a scourge in America and it must be stopped.”

Over the past weeks, numerous publications across the country included quotes from MSSNY President Charles Rothberg, MD regarding Dr. Adams’ nomination, including this from the New York Times: “Charles N. Rothberg, president of the Medical Society of the State of New York, said Dr. Adams reminded him of C. Everett Koop, who was surgeon general through much of the 1980s. ‘Dr. Adams has a proven track record to make public health a priority despite political hurdles,’ Dr. Rothberg said in an email. ‘Dr. Adams is in touch with the public needs.’”

HBO’s VICE News Video: Doctors Explain Why U.S. Healthcare Is So Expensive
VICE News visited several doctors—including MSSNY’s Dr. Donald Moore—in an attempt to make sense of our convoluted health care costs. What do the doctors say is needed to improve overall cost and care? Many of them shared the same solution. Watch the video here.

White House Opioid Panel Urges Trump to Declare State of Emergency
In an interim report released this week, the White House Commission on Combating Drug Addiction and the Opioid Crisis described the crisis as unparalleled and urged President Trump to declare the US opioid misuse epidemic a national emergency. The report states, “It would also awaken every American to this simple fact: If this scourge has not found you or your family yet, without bold action by everyone, it soon will. … You, Mr. President, are the only person who can bring this type of intensity to the emergency and we believe you have the will to do so and to do so immediately.”

Editing Human Genes
A team of biologists in Oregon have successfully edited genes in human embryos to correct a disease-causing mutation, according to a study published this week in Nature, a weekly international journal of science. The experiment is not the first of its kind, but it is the first such study completed in the US and goes beyond past research in both scope and findings. The study “marks a major milestone and…raises the prospect that gene editing may one day protect babies from a variety of hereditary conditions,” but also raises ethical concerns about human genetic engineering. (Source: New York Times, 8/2)

Letter to the Editor re: The Skinny on “The Skinny”
Dear Editor:

In the past two editions of Enews our President, Charles Rothberg MD, touched upon crucial issues that impel consideration of what role our medical society should play in advocacy for our patients and the practice of medicine.

The Department of Health and Human Services has embarked on a mission to cripple the effectiveness of the Affordable Care Act (ACA) using taxpayer money to create 23 videos disparaging “Obamacare” including several testimonials by physicians.  It is illegal for HHS and the executive branch to engage in direct advocacy, “purely partisan activity” or promoting legislation.   The current administration has also failed to offer assurances to insurers that key components of the ACA such as enforcement of the individual mandate and cost sharing subsidies will be carried out.

These policy decisions have served to imperil the stability of the insurance market and hence the health of our patients.  The executive branch is empowered to execute legislation, and until directed otherwise by Congress, has a responsibility, legally and morally, to work diligently in carrying out the provisions of the ACA.  Anything less places our patients and practices in harm’s way for partisan expediency.   The AMA endorsed Tom Price for Secretary of HHS and it is time we use or advocacy role to place pressure on Secretary Price, the administration and our congressman to act first and foremost to protect the health of our patients.

Despite the recent failure of attempts to repeal the ACA there will be continued efforts to either repeal, replace or reform the legislation.  This is appropriate as there are many areas for improvement.  During the continuing policy debates it is important that we as physicians are aware of the enormous beneficial impact the ACA has had to date for many our patients.   In May 2017 New York released the report on open enrollment for 2017.

More than 3.6 million people or about 18% of New Yorkers were enrolled in health insurance through the ACA (Marketplace and Essential Plans).  This corresponds to a decrease in the rate of uninsured New Yorkers from 10 to 5 % in the past 4 years.  Share of enrollees by region within New York is proportional to population indicating that this program is not one that is more beneficial to downstate versus upstate or within the urban, suburban, or rural regions of our state.

The collapse of proposed legislation to repeal the ACA during the past few weeks offers an opportunity for our state and national society to advocate for bipartisan initiatives to preserve the achievements within our state while addressing many of the still present shortcomings within our healthcare system.

What has become evident in the past few months, although still unspoken in some quarters, is a consensus that affordable healthcare is a right for which our government has a responsibility.  The way this right to healthcare is attained is a matter of partisan policy but the ideal of affordable healthcare for all guaranteed by our society through governmental action is no longer a partisan divide.

Neil Herbsman MD
Gastroenterology of the Bronx
1600 Hering Ave.
Bronx, New York


Check out MSSNY’s New CME Website and Listen to our Many Podcasts!
Did you know that we recently updated and completely revamped the MSSNY CME website?  Check it out here (Note: new users to the site will need to create an account).  You can earn free CME credits on emergency preparedness topics that range from our four-part Physician’s Electronic Emergency Preparedness Toolkit to Ebola, a Perspective from the Field or Mosquito Borne Diseases.  We also have a module on concussion in pediatric and adult patients as well as a CME accredited podcast on the same topic.

MSSNY also has more than ten informative podcasts that you can listen to here.  There are multiple brief podcasts on immunizations as well as others on Zika virus and MSSNY’s Physician’s Emergency Preparedness Toolkit.  Each podcast offers insight from medical experts on topics they are extensively well versed on.



Why I Joined MSSNY




Your membership yields results and will continue to do so. When your 2018 invoice arrives, please renew. KEEP MSSNY STRONG!



Quality Payment Program Hardship Exception Application for 2017 Transition Year Now Open
Clinicians Can Now Submit Quality Payment Program Hardship Exception Applications

The Quality Payment Program Hardship Exception Application for the 2017 transition year is now available on the Quality Payment Program website.

MIPS eligible clinicians and groups may qualify for a reweighting of their Advancing Care Information performance category score to 0% of the final score, and can submit a hardship exception application, for one of the following specified reasons:

  • Insufficient internet connectivity
  • Extreme and uncontrollable circumstances
  • Lack of control over the availability of Certified EHR Technology (CEHRT)

There are some MIPS eligible clinicians who are considered Special Status, who will be automatically reweighted (or, exempted in the case of MIPS eligible clinicians participating in a MIPS APM) and do not need to submit a Quality Payment Program Hardship Exception Application.

About the Hardship Exception Application Process

In addition to submitting an application via the Quality Payment Program website, clinicians may also contact the Quality Payment Program Service Center and work with a representative to verbally submit an application.

To submit an application, you’ll need:

  • Your Taxpayer Identification Number (TIN) for group applications or National Provider Identifier (NPI) for individual applications;
  • Contact information for the person working on behalf of the individual clinician or group, including first and last name, e-mail address, and telephone number; and
  • Selection of hardship exception category (listed above) and supplemental information.

If you’re applying for a hardship exception based on the Extreme and Uncontrollable Circumstance category, you must select one of the following and provide a start and end date of when the circumstance occurred:

  • Disaster (e.g., a natural disaster in which the CEHRT was damaged or destroyed)
  • Practice or hospital closure
  • Severe financial distress (bankruptcy or debt restructuring)
  • EHR certification/vendor issues (CEHRT issues)

Please note: Once an application is submitted, you will receive a confirmation email that your application was submitted and is pending, approved, or dismissed. Applications will be processed on a rolling basis.

For More Information


MACRA/QPP: Pick Your Pace and New Resources
The AMA continues to hear from physicians who feel unprepared to participate successfully in Medicare’s new Merit-based Incentive Payment System, despite the transitional flexibility provided for 2017.  In particular, it seems that physicians who never participated in Medicare reporting programs before need basic information on how to avoid a payment penalty in 2019 through minimal reporting in 2017.

To help address this need, which we believe is particularly acute for physicians in smaller practices, the AMA is extending “Pick Your Pace” activities to run through the end of the year to disseminate simple instructions on how to report “one patient, one measure, no penalty.”    To help amplify our outreach for this educational effort, we are encouraging state medical societies and national medical specialty societies to participate and share this information from now through Dec. 31.

The AMA developed a short video, entitled “One patient, one measure, no penalty: How to avoid a Medicare payment penalty with basic reporting,” which is accessible on the AMA web site at ama-assn.org/qpp-reporting.  Also on this web site physicians can find a sample CMS-1500 claim form, links to quality measures on the CMS web site, a link to the CMS MIPS eligibility tool, and other materials.   Please visit this page, view the resources, and consider joining us for a coordinated outreach to physician practices so that we can help as many physicians as possible avoid a negative 4 percent Medicare payment reduction in 2019.

MIPS Action Plan
The AMA has released a new customizable resource, the MIPS Action Plan, geared towards helping physicians think strategically about how to successfully implement MIPS in 2017. This resource will help physicians determine the right course of action for their practice, provide recommended steps to meet program requirements, and measure their performance against important milestones. DON’T DELAY – act now to avoid penalties and succeed in MIPS for 2017.


CLASSIFIEDS


For Rent or Share – Woodbury, Long Island
Beautiful recently renovated Plastic Surgery
office available for part-time share and
AAAA-certified (by end of summer).
OR available for rent. Centrally located
on Long Island.Close to expressways.
3 exam rooms, 1 procedure room /OR.
Waiting room, break room and personal office.
Free WIFI. Available for full or half-days.
Suits Plastic/Cosmetic Surgeons/Derm/ENT/
ObGyn/Podiatry or other Medical MDs.
Contact Patricia at info@cosmetichg.com
or 631-318-4008

Want to Sell Your Medical Practice? Do You Have Medical Office Space to Sell or Share?
Clineeds is a new online platform designed to help medical providers sell their practice or buy, sell and share medical office space. Listing is FREE! No contracts. No commitments. No fees. Sign up today at http://www.clineeds.com/sign-up

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

July 28, 2017 – The Skinny on “The Skinny”


PRESIDENT’S MESSAGE
Charles Rothberg, MD
July 28, 2017
Volume 17
Number 29

Dear Colleagues:

With the overnight failure of the “skinny bill,” apparently due to the miscalculation of a slender and fractured Senate majority, it’s time to draw parallels to the New York State legislature, our own physician advocacy, and what happens to our initiatives when the divisions overcome what our organizational/professional objectives are (paralysis).

It is worth mentioning that the Congressional Budget Office estimated that 16 million fewer people would have health insurance by the end of the decade. Estimates are here.

Of course, we must now move forward to improve the health and coverage of our patients and the funding of our practices and infrastructure. 

Transgender Issue

Also this week, health insurance for certain members of our Armed Forces became an issue. I thought I’s share relevant MSSNY and AMA policy. MSSNY supported the following resolution:

  • 969 Removing Barriers to Care for Transgender Patients:

MSSNY supports the resolution being presented at the American Medical Association’s

A’08 Meeting by the AMA-Medical Student Section and AMA-Resident and Fellow Section which asks that the AMA (1) support public and private health insurance coverage for treatment of gender identity disorder, and (2) oppose categorical exclusions of coverage for treatment of gender identity disorder when prescribed by a physician. (HOD 2008-171)

Moreover, the President of the AMA, Dr. David Barbie, issued their statement on the issue:

  • AMA policy also supports public and private health insurance coverage for treatment of gender dysphoria as recommended by the patient’s physician. According to the Rand study on the impact of transgender individuals in the military, the financial cost is a rounding error in the defense budget and should not be used as an excuse to deny patriotic Americans an opportunity to serve their country. We should be honoring their service – not trying to end it.

Sincerely,
Charles Rothberg, MD
MSSNY President

Please send your comments to comments@mssny.org


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AMA Summary of What Occurred Last Night and What the Actual Issues Were
Early this morning, the so-called “skinny” or “partial ACA repeal” package was defeated by a vote of 49 to 51 with Senators Collins, Murkowski and McCain joining all 48 Democrats in opposing the proposal.  Elements included in the “skinny” package were:

  • Repeal of the individual mandate by zeroing out the penalty beginning after December 31, 2015.
  • Repeal of the employer mandate by zeroing out the penalties, but only from January 1, 2016 to December 31, 2024.
  • Extend the moratorium on the medical device tax from December 31, 2017 to December 31, 2020.
  • Increase for three years (2018 to 2020) the maximum contribution limit to health care savings accounts (HSA) to the amount of the deductible and out-of-pocket limitations.
  • Defund Planned Parenthood for one year (and expands the one-year defunding to certain other providers that provide abortions if they receive more than $1 million in federal and state funding).
  • Sunset the funding for the Prevention and Public Health Fund after FY 2018.
  • Provide $422 million in additional funding for the Community Health Center Program in 2017.
  • Amend section 1332 of the ACA (Waiver for State Innovation) by: authorizing and appropriating $2 billion for states that submit or implement state innovation waivers; requiring HHS to approve a 1332 waiver if the secretary determine that the application meets the benefit comprehensiveness, cost sharing, enrollment, and budget neutrality guardrail requirements; requiring a waiver determination within 45 days (instead of 180 days); and extending waivers from 5 to 8 years with unlimited renewals for 8-year periods that may not be cancelled by the secretary.

This is not the end of the process.  Hearings and bipartisan discussions about legislation to stabilize the individual market are anticipated when Congress returns from the August recess. We extend thanks and deep appreciation to physician, patient, hospital and other provider groups that joined the AMA in this effort and made this outcome possible.   The ingredients for this success were sound policy guided by clear objectives, effective AMA spokespersons, a broad based coalition and a tremendous grassroots response and engagement with elected officials.

There is much more work to be done on this and other issues to improve the health of the nation.

Tell Gov. to Reject Liability Expansion Bill/Call for Comprehensive Liability Reform
All physicians are urged to continue to call Governor Cuomo at 518-474-8390 and send a letter here  urging that he veto a so-called “cancer only” medical liability statute of limitations expansion bill (S.6800/A.8516) that passed the Legislature over the strong objections of MSSNY, the specialty societies, the hospital industry and MLMIC.  Please urge that legislation be enacted instead that provides for comprehensive medical liability reform.

This ambiguously drafted bill, introduced in the final days and passed in the final hours of the 2017 Legislative Session, would expand the medical liability statute of limitations for cases involving “alleged negligent failure to diagnose a malignant tumor or cancer”.   The bill would permit lawsuits 2.5 years from the “date of discovery” of such alleged negligence, up to an outside limit of 7 years.  Actuaries have estimated that this legislation could increase already exorbitant premiums by 10-15% at a time when no increases can be tolerated.

This week, op-eds appeared in papers across the State from the Presidents of the Albany County , Monroe County and Chautauqua County medical societies urging Governor Cuomo to veto the bill.   The Legislative Gazette also had an article that referenced the opposition of MSSNY and the Lawsuit Reform Alliance.

Again, please urge the Governor to veto this bill and encourage your colleagues to do the same! Please let the Governor know how this bill will harm patient care and exacerbate existing physician shortage issues in your community.




Drinking Alcohol 3 to 4 Days a Week Tied to Lowest Risk for Diabetes
Moderate drinking spread out over several days during the week is associated with the lowest risk for diabetes, according to a study in Diabetologia. Some 70,000 Danish adults without diabetes completed questionnaires about their drinking habits and then were followed for a median of 5 years, during which 2% developed diabetes.

The lowest diabetes risks were among men who reported consuming 14 drinks per week and women who consumed 9 drinks per week. After multivariable adjustment, men who consumed 7–13 drinks or 14 or more drinks over 3–4 days weekly had 30%–40% lower risks for diabetes than those who consumed less than 1 drink weekly. Women who consumed 1–6 drinks or 7 or more drinks over 3–4 days saw similar risk reductions.

The researchers point to numerous study limitations but conclude, “Our results further indicate that frequent consumption of alcohol is associated with the lowest risk of diabetes.” As one potential mechanism, they note that the polyphenols in red wine “may exert beneficial effects on blood glucose control … thereby lowering the risk of type 2 diabetes.” Diabetologia article




Your membership yields results and will continue to do so. When your 2018 invoice arrives, please renew. KEEP MSSNY STRONG!



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CTE in Football Players: Characteristics in Brain Donors Explored
A study of some 200 donated brains from American football players shows a generally increasing prevalence of chronic traumatic encephalopathy (CTE) with higher levels of play.

The deceased donors’ football exposure ranged from two players with only pre-high school experience (neither of whom had CTE) to 111 with National Football League experience (99% of whom had CTE).

All cases of CTE had shown mood, behavioral, or cognitive symptoms, according to interviews with family members, whereas motor symptoms were common mostly in severe cases. Also common in severe cases was the accumulation of neurodegenerative proteins, such as amyloid-beta.

The authors, writing in JAMA, caution against estimating CTE prevalence on the basis of their “convenience” sample, saying their purpose was to characterize CTE’s neuropathological and clinical features. An editorialist agrees, writing that “such a sample is likely to be biased to include more impaired individuals.” JAMA article.


Research: Sperm Count, Concentration Declining Among Men in Western World
Research published in Human Reproduction Update http://bit.ly/2uGlLda found “a 52.4 percent decline in sperm concentration and a 59.3 percent decline in total sperm count among North American, European, Australian and New Zealand men” in 2011 compared with 1973.” The study also indicated that “the quality was worse.” For the study, investigators looked at “data from 185 studies and 42,000 men. The researchers report that while the investigators did not see “a similar decline in non-Western men – those from Africa, Asia and South America,” they “admitted that this absence of a trend may be due to a lack of data.” They added that additional research is required “to determine causation,” investigators “think that our lifestyle choices (smoking, stress and obesity) may be to blame for the drop in sperm count.”

Explanation of Special Status Calculation
The Centers for Medicare and Medicaid Services (CMS) has introduced new information on qpp.cms.gov that indicates whether clinicians have “special status” and can therefore be considered exempt from the Quality Payment Program.

To determine if a clinicians’ participation should be considered as special status under the Quality Payment Program, CMS retrieves and analyzes Medicare Part B claims data. A series of calculations are run to indicate a circumstance of the clinician’s practice for which special rules under the Quality Payment Program will affect the number of total measures, activities or entire categories that an individual clinician or group must report. These circumstances are applicable for clinicians in: Health Professional Shortage Area (HPSA), Rural, Non-patient facing, Hospital Based, and Small Practices.

For more information, please visit the Quality Payment Program website.

Now Available: Accredited Online Course – Quality Payment Program 2017 Merit-Based Incentive Payment System: Improvement Activities Performance Category
A new, online and self-paced overview course on the Quality Payment is now available through the MLN Learning Management System. Learners will receive information on:

  • The Improvement Activities performance category requirements, and how this category fits into the larger Quality Payment Program
  • The steps you need to take to report Improvement Activities data to CMS
  • The basics about scoring of the Improvement Activities performance category

This course is the third course in an evolving curriculum on the Quality Payment Program, where learners will gain knowledge and insight on the program all while earning valuable continuing education credit. Keep checking back with us for updates on new courses. First time learners will need to register for the MLN Learning Management System. Once registered, learners will be able to access additional courses without having to register. For information on how to login or find training, please visit our MLN Learning Management System FAQ sheet.

The Centers for Medicare & Medicaid Services designates this enduring material for a maximum of 0.5 AMA PRA Category 1 Credits™. Physicians should claim only the credit commensurate with the extent of their participation in the activity. Credit for this course expires June 1, 2020. AMA PRA Category 1 Credit™ is a trademark of the American Medical Association.

Accreditation Statements
Please click here for accreditation statements.


CLASSIFIEDS


For Rent or Share – Woodbury, Long Island
Beautiful recently renovated Plastic Surgery
office available for part-time share and
AAAA-certified (by end of summer).
OR available for rent. Centrally located
on Long Island.Close to expressways.
3 exam rooms, 1 procedure room /OR.
Waiting room, break room and personal office.
Free WIFI. Available for full or half-days.
Suits Plastic/Cosmetic Surgeons/Derm/ENT/
ObGyn/Podiatry or other Medical MDs.
Contact Patricia at info@cosmetichg.com
or 631-318-4008

Medical Space Available for Leasing
Currently (last 7 years) occupied by Lab Corp.
2,500 sq. ft. ADA compliant.
25-15 Steinway Street, Astoria, NY 11103
Please contact Landlord: 1-800-283-0602;
e mail: wwwevans@yahoo.com

Want to Sell Your Medical Practice? Do You Have Medical Office Space to Sell or Share?
Clineeds is a new online platform designed to help medical providers sell their practice or buy, sell and share medical office space. Listing is FREE! No contracts. No commitments. No fees. Sign up today at http://www.clineeds.com/sign-up

Physician Opportunities



Job Posting – Chief Medical Officer – Cayuga Medical Associates

Cayuga Medical Associates (CMA), a growing multi-specialty group located in the heart of the beautiful Finger Lakes Region in Central New York, is currently seeking a Chief Medical Officer to work within the organization. This newly created senior leadership position is designed to ensure that high quality, service-oriented patient care is delivered by Cayuga Medical Associates’ physicians on a consistent basis. The Chief Medical Officer has primary responsibility for clinical issues pertaining to the delivery of patient care services, patient satisfaction, and quality at the practice level. This position will report to the President of CMA, with an administrative dyad/partnership to the Chief Operating Officer. In this role, the Chief Medical Officer will work in an administrative capacity 2 days a week, and will practice as a physician for the remaining 3 days of the workweek.

This position will require the physician to:

  • Engage in Physician recruitment, engagement and retention, in collaboration with President and Chief Operating Officer
  •  Set and communicate performance, service standards and expectations to  all providers
  •  Exercise professional clinical leadership regarding specific cases or questions of quality or compliance
  • Assist with compensation model refinements and redesign, with specific focus on quality and productivity metrics
  •  Oversee CMA’s Physician Action Council (PAC)
  •  Develop and implements physician peer review system, medical policies, and clinical programs

Qualifications for this position include:

  • Graduate from accredited medical school and appropriate residency training
  • Board certified physician in a primary care or related sub-specialty area
  •  Active NYS medical license
  •  At least 3-5 years of relevant work experience in a physician practice setting, prior experience in physician leadership role preferred
  • Strong leadership skills to develop a close, collaborative working relationship with senior leadership team, physician leaders, and practice  management staff

The Finger Lakes region of New York offers endless opportunities for outdoor adventures, as well as rich support of the arts and diverse cultural opportunities, excellent school districts, and charming villages, towns and small cities to call home.  If you are dedicated to excellence and possess a commitment to patient-centered care, please submit your CV and cover letter to cma_hr@cayugamedicalassociates.org or fax to (607) 277-1415, attention Human Resources. CMA offers a competitive pay and benefits package and is an equal opportunity employer.


Position Available for Critical Care Physician to Join Established Practice in Nassau County, Long Island, NY.
The Physician will join our existing team of Board-Eligible/Board-Certified Intensivists. This is a PT/FT position including both nocturnal and daytime responsibilities. The Physician will work with a dedicated group of highly trained mid-level practitioners, respiratory therapists and nurses to provide Critical Care at St. Francis Hospital in Roslyn, NY. St. Francis was ranked one of the top 10 hospitals in the nation for Cardiac Care and is top rated nationally in seven other adult specialties.
We are expanding our Intensivist Program and are expecting to add an Intensivist to our group.
Nassau Chest Physicians, P.C. was established in 1978 to provide state-of-the-art care to patients with pulmonary diseases on Long Island. We have expanded our practice to include 8 Intensivist/Pulmonologists and 5 pure Intensivists. Since 2006, we have assumed management of Critical Care services at St. Francis Hospital-The Heart Center in Roslyn, NY.
St. Francis Hospital is New York State’s only specialty designated cardiac center and is a nationally recognized leader in cardiology and heart surgery, ear-nose-throat, gastroenterology and GI surgery, geriatrics, neurology and neurosurgery. More cardiac procedures are performed at St. Francis than at any other hospital in New York State. The hospital is located on the North Shore of Long Island; approximately 30 minutes from Manhattan. The hospital combines unrivaled expertise in cardiovascular medicine with top-ranged nursing (AACN Magnet Award) to provide the very best in patient care.
In addition, St. Francis offers excellent Thoracic, Vascular, Oncologic, Neurosurgical, and Orthopedic Surgical Programs. We have a very active Emergency Department. The hospital offers the latest in technologies such as Therapeutic Temperature Modification, Impella, ECMO and LVAD. Our excellent and experienced medical staff supports strong medical and surgical subspecialty programs.

Aside from Certified Critical Care Nurses, many who have more than 20 years of experience and are expert at caring for this complex patient population, we have a growing pool of Intensivist mid-level practitioners who work hand in hand with our Intensivist physicians to coordinate the care of the critically ill patient, minister to them and perform procedures.

Of course, a New York License is required. J1 or H1 VISAS accepted.
Additional Salary Information: Salary and benefits are competitive and commensurate with experience. Interested applicants, send resume to: dr.sorett@nassauchest.com


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

July 21, 2017 – Spending $ Foolishly?


PRESIDENT’S MESSAGE
Charles Rothberg, MD
July 21, 2017
Volume 17
Number 28

Dear Colleagues:

The Daily Beast and other publications reported this week that the current Administration and the Department of Health and Human Services used taxpayer money—earmarked for encouraging enrollment in the ACA—on a multi-pronged public relations campaign designed to damage public opinion of Obamacare.

How is it possible that an agency tasked with overseeing the existing health care law and educating the public can instead divert taxpayer dollars to fly people dissatisfied with the ACA to DC from all over the country to produce negative videos?

The ACA website has also been redesigned. Instead of a direct link to access the sign-up portal, the site criticizes the healthcare.gov and encourages people to use private sector web brokers.
Former HHS Secretary Kathleen Sebelius told The Daily Beast: “I’m on a daily basis horrified by leaders at the Department of Health and Human Services who seem intent on taking healthcare away from the constituents they are supposed to serve. We always believed that delivering health and human services was the mission of the department. That seems to not be the mission of the current leadership.”

Governor Awards $76.3 M

Also, this week, Gov. Cuomo awarded $76.3 million (see list below)to support 27 projects that will protect and transform New York’s health care system. More dollars for healthcare is good for patients, good for physicians, and good for our communities.

Sincerely,
Charles Rothberg, MD
MSSNY President

Please send your comments to comments@mssny.org

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MSSNY Objects to UHC Policy Change re Consultation Reimbursement
In the June United Healthcare Bulletin, the plan placed a notice regarding the elimination of reimbursement for consultation codes effective October 1, 2017. UHC indicates that they are adopting a policy that was put forth by CMS for the Medicare program back in 2010. MSSNY is joining with other entities of organized medicine to voice our strong opposition to UHC regarding this egregious policy change.

ACA Repeal/Replacement Could Affect Coverage of Some 370,000 Long Islanders
Newsday (NY) (7/15) reported that nearly 370,000 people in Long Island “could see their access to health coverage directly affected by the possible repeal and replacement of the 2010 Affordable Care Act.” In a statement, Dr. Charles Rothberg, President of the Medical Society of the State of New York, said, ‘While a wholesale review of the flaws of the ACA should be undertaken, we are deeply concerned about potentially significant adverse consequences to New York’s residents and its health care system arising from proposals before the House and Senate.’” Dr. Rothberg said in an interview, “I think New York and Long Island have the potential to be devastated.”

$491 Million Awarded Statewide to Health Care Facility Transformation Program
27 Awards to Support Essential Health Care Services
This week, Governor Cuomo announced $76.3 million to support 27 projects that will protect and transform New York City’s health care system. As part of the $491 million Statewide Health Care Facility Transformation Program, this funding will improve patient care through the development of high-quality medical facilities and programs serving the inpatient, primary care, mental health, substance use disorder and long-term care needs of communities throughout New York State.

“Now, more than ever, we need to protect health care in New York and ensure the system in place is meeting the needs of current and future generations of New Yorkers,” Governor Cuomo said. “While others seek to decimate our hospitals and reduce access to quality healthcare, we are investing to help ensure a stronger, healthier New York for all.”

For more information about the 27 awarded providers, the specific funding awarded, and the details about the awarded projects, click here .



Your membership yields results and will continue to do so. When your 2018 invoice arrives, please renew. KEEP MSSNY STRONG!


AMA Update on Senate Reform Bill
While there was considerable activity in the Senate this week, plans for bringing a health system reform bill to the floor for a vote remain very fluid.  Up until this week, Majority Leader McConnell could only afford to lose two Republican votes to pass an Affordable Care Act (ACA) “repeal and replace” bill, and with the sad news that Senator John McCain’s illness may keep him away from Washington next week that number could be reduced to one.  Nevertheless, under pressure from both from President Trump and a long legislative to-do list, Senator McConnell said he will attempt to bring repeal legislation to the floor next Tuesday.

Process
Senators will be asked on Tuesday to approve a motion to open debate on the House-passed American Health Care Act, H.R. 1628.  At this point, it appears that two substitute amendments for the House-passed text are likely candidates to serve as the basis for Senate debate and amendment:

  • A revised version of the Obamacare Repeal and Reconciliation Act (ORRA), vetoed by President Obama in 2015, that eliminates mandate penalties as well as all premium subsidies and Medicaid expansion funds; or
  • The Better Care Reconciliation Act (BCRA), with modification that include additional funding for opioid addiction treatment and for market stabilization, among other changes.

It is unclear whether there are 50 votes to approve the motion to proceed, let alone for passage of either of these substitute amendments (which could be revised further before Tuesday).  To date, enough Senators have expressed opposition to proceeding to either substitute to block its consideration, though negotiations are ongoing.

Want to Get Involved? AMPAC Campaign School October 27-29
The 2017 AMPAC Campaign School will be taking place Oct. 27-29 at the AMA Office in Washington, DC. The school is targeted to AMA members, their spouses, residents, medical students and medical society staff who want to become more involved in the campaign process. Running an effective campaign can be the difference between winning and losing a race. That’s why the AMPAC Campaign School is designed to give you the skills and strategic approach you will need out on the campaign trail. The AMA  team of political experts will teach you everything you need to know to run a successful campaign or be a sought-after volunteer.

During the two and a half day in-person portion of the program under the direction of  political experts, participants will be broken into campaign staff teams to run a simulated congressional campaign using what they’ve learned from the pre-school workbook activities and videos along with the group sessions on strategy, vote targeting, social media, advertising and more.

NOTE: Faculty, materials (including the pre-school workbooks, videos and all in-person meeting materials) and all meals during the meeting are covered by AMPAC. Participants are responsible for the registration fee ($350 for AMA Members / $1000 for non-members), airfare, and hotel accommodations at the Hyatt Regency Washington on Capitol Hill (AMA has secured a room block for a discounted rate). The registration fee is waived for residents and students, however, space is limited to four slots and the AMPAC Board will review and select qualified participants from the pool of resident and student applicants.

For more information or to apply click here.


CLASSIFIEDS


For Rent or Share – Woodbury, Long Island
Beautiful recently renovated Plastic Surgery
office available for part-time share and
AAAA-certified (by end of summer).
OR available for rent. Centrally located
on Long Island.Close to expressways.
3 exam rooms, 1 procedure room /OR.
Waiting room, break room and personal office.
Free WIFI. Available for full or half-days.
Suits Plastic/Cosmetic Surgeons/Derm/ENT/
ObGyn/Podiatry or other Medical MDs.
Contact Patricia at info@cosmetichg.com
or 631-318-4008

Medical Space Available for Leasing
Currently (last 7 years) occupied by Lab Corp.
2,500 sq. ft. ADA compliant.
25-15 Steinway Street, Astoria, NY 11103
Please contact Landlord: 1-800-283-0602;
e mail: wwwevans@yahoo.com

Want to Sell Your Medical Practice? Do You Have Medical Office Space to Sell or Share?
Clineeds is a new online platform designed to help medical providers sell their practice or buy, sell and share medical office space. Listing is FREE! No contracts. No commitments. No fees. Sign up today at http://www.clineeds.com/sign-up

Physician Opportunities



Job Posting – Chief Medical Officer – Cayuga Medical Associates

Cayuga Medical Associates (CMA), a growing multi-specialty group located in the heart of the beautiful Finger Lakes Region in Central New York, is currently seeking a Chief Medical Officer to work within the organization. This newly created senior leadership position is designed to ensure that high quality, service-oriented patient care is delivered by Cayuga Medical Associates’ physicians on a consistent basis. The Chief Medical Officer has primary responsibility for clinical issues pertaining to the delivery of patient care services, patient satisfaction, and quality at the practice level. This position will report to the President of CMA, with an administrative dyad/partnership to the Chief Operating Officer. In this role, the Chief Medical Officer will work in an administrative capacity 2 days a week, and will practice as a physician for the remaining 3 days of the workweek.

This position will require the physician to:

  • Engage in Physician recruitment, engagement and retention, in collaboration with President and Chief Operating Officer
  •  Set and communicate performance, service standards and expectations to  all providers
  •  Exercise professional clinical leadership regarding specific cases or questions of quality or compliance
  • Assist with compensation model refinements and redesign, with specific focus on quality and productivity metrics
  •  Oversee CMA’s Physician Action Council (PAC)
  •  Develop and implements physician peer review system, medical policies, and clinical programs

Qualifications for this position include:

  • Graduate from accredited medical school and appropriate residency training
  • Board certified physician in a primary care or related sub-specialty area
  •  Active NYS medical license
  •  At least 3-5 years of relevant work experience in a physician practice setting, prior experience in physician leadership role preferred
  • Strong leadership skills to develop a close, collaborative working relationship with senior leadership team, physician leaders, and practice  management staff

The Finger Lakes region of New York offers endless opportunities for outdoor adventures, as well as rich support of the arts and diverse cultural opportunities, excellent school districts, and charming villages, towns and small cities to call home.  If you are dedicated to excellence and possess a commitment to patient-centered care, please submit your CV and cover letter to cma_hr@cayugamedicalassociates.org or fax to (607) 277-1415, attention Human Resources. CMA offers a competitive pay and benefits package and is an equal opportunity employer.


Position Available for Critical Care Physician to Join Established Practice in Nassau County, Long Island, NY.
The Physician will join our existing team of Board-Eligible/Board-Certified Intensivists. This is a PT/FT position including both nocturnal and daytime responsibilities. The Physician will work with a dedicated group of highly trained mid-level practitioners, respiratory therapists and nurses to provide Critical Care at St. Francis Hospital in Roslyn, NY. St. Francis was ranked one of the top 10 hospitals in the nation for Cardiac Care and is top rated nationally in seven other adult specialties.
We are expanding our Intensivist Program and are expecting to add an Intensivist to our group.
Nassau Chest Physicians, P.C. was established in 1978 to provide state-of-the-art care to patients with pulmonary diseases on Long Island. We have expanded our practice to include 8 Intensivist/Pulmonologists and 5 pure Intensivists. Since 2006, we have assumed management of Critical Care services at St. Francis Hospital-The Heart Center in Roslyn, NY.
St. Francis Hospital is New York State’s only specialty designated cardiac center and is a nationally recognized leader in cardiology and heart surgery, ear-nose-throat, gastroenterology and GI surgery, geriatrics, neurology and neurosurgery. More cardiac procedures are performed at St. Francis than at any other hospital in New York State. The hospital is located on the North Shore of Long Island; approximately 30 minutes from Manhattan. The hospital combines unrivaled expertise in cardiovascular medicine with top-ranged nursing (AACN Magnet Award) to provide the very best in patient care.
In addition, St. Francis offers excellent Thoracic, Vascular, Oncologic, Neurosurgical, and Orthopedic Surgical Programs. We have a very active Emergency Department. The hospital offers the latest in technologies such as Therapeutic Temperature Modification, Impella, ECMO and LVAD. Our excellent and experienced medical staff supports strong medical and surgical subspecialty programs.

Aside from Certified Critical Care Nurses, many who have more than 20 years of experience and are expert at caring for this complex patient population, we have a growing pool of Intensivist mid-level practitioners who work hand in hand with our Intensivist physicians to coordinate the care of the critically ill patient, minister to them and perform procedures.

Of course, a New York License is required. J1 or H1 VISAS accepted.
Additional Salary Information: Salary and benefits are competitive and commensurate with experience. Interested applicants, send resume to: dr.sorett@nassauchest.com


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

July 14, 2017 – Last Chance to Demand VETO!


PRESIDENT’S MESSAGE
Charles Rothberg, MD
July 14, 2017
Volume 17
Number 27

Dear Colleagues:

Bad week for medicine, law and money. Last week I wrote about the NYS legislature passing an over reaching and defective expansion of medical liability (“Lavern’s Law”) that seriously burdens all providers, but at the same time leaves an unsuspecting public nearly as unprotected as before.

This week, a discredited, convicted legislative leader— perhaps best known as an opponent of liability reforms, had his corruption conviction overturned on appeal.

And, in that leader, the medical connection extends beyond medical liability. Mr. Sheldon Silver was convicted of using his office to provide public money to a medical researcher in exchange for referrals of patients (also possible plaintiffs).  Mr. Silver was in turn paid for those referrals. He did no work—an activity illegal for doctors but—perfectly legal for lawyers.

For this, Mr. Silver was convicted in 2015. But in another case in 2016, the US Supreme Court narrowed the definition of corruption sufficiently to provide the technicality to overturn Mr. Silver’s conviction.

His story of conflicts regarding the legislature, the legal profession, and the medical profession illustrates the difficulty of obtaining a legislative solution to overcome the deficiencies of our medical liability system.  And while a stunning story, there persists within the legislature a cultural barrier to the best solutions.  Last year, in New York State, medical liability payouts were $700 million.  The public deserves better for the money.

When will our elected officials finally examine the adversarial trial process, its distortions, unintended consequences, and inefficiencies in order to institute reforms that return the process to its public purpose?

Meanwhile, I urge the Governor to veto this version of Lavern’s law instead of doubling down on this outrageous charade. Now, more than ever, we need comprehensive reform.

PHYSICIANS MUST CONTINUE TO CALL GOVERNOR CUOMO AT 518-474-8390 and send a letter from here

Sincerely,
Charles Rothberg, MD
MSSNY President

Please send your comments to comments@mssny.org

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We Can Assure the Stability of MLMIC
In today’s marketplace, stability is top-of-mind for many us. And given recent reports from July 6, 2017, by the Albany Times Union and Politico, that New York State has ousted the CEO of the state’s second largest medical malpractice insurance carrier, this is unsurprising.

However, MLMIC, our trusted partner and longstanding endorsed professional liability insurer, continues to maintain a sound financial condition. And for 40+ years, MLMIC has provided exceptional coverage, an unyielding defense, strong risk management programs, and high-quality legal counsel to the physicians of the State of New York.

MSSNY and MLMIC remain unwavering in our commitment to protecting you and your practice.

Please do not hesitate to contact our offices and/or reach out to MLMIC directly at mlmic.com or (888) 412-2012 should you have any questions or need additional information.

Senate Released Revised ACA Repeal/Replace Bill; Possible Floor Consideration Next Week
This week, the Senate released a revised version of the Better Care Reconciliation Act (BCRA), a bill designed to repeal and replace much of the Affordable Care Act (ACA).  While review of the new bill is ongoing, at first glance it does not appear to remediate concerns with the earlier version of this legislation that it could potentially significantly expand the number of New Yorkers who will face higher cost-sharing.

AMA President Dr. David Barbe issued the following statement in response: “The revised bill does not address the key concerns of physicians and patients regarding proposed Medicaid cuts and inadequate subsidies that will result in millions of Americans losing health insurance coverage. The additional funding to address the opioid epidemic is a positive step, however, those suffering from substance use disorder have other health care needs that are not likely to be addressed if they lose coverage through a rollback of the Medicaid expansion. While stabilizing the individual market is an initial step, more bipartisan collaboration is needed in the months ahead to improve the delivery and financing of health care.”

According to the AMA, revised estimates by the Congressional Budget Office on the impact on spending and health insurance coverage are expected to be released on Monday.  Senate floor consideration is likely to begin on Tuesday or Wednesday.    However, Senators Rand Paul (R-KY) and Susan Collins (R-ME) have indicated they would oppose the “motion to proceed” to begin consideration of the bill, putting into question whether there will be enough votes to begin floor consideration.

Please stay alert for further updates.

Upstate Fatality in Case of Powassan Virus
Since 2000, only 24 cases of Powassan virus have been confirmed in New York.  Five of them were fatal. The most recent case was 74-year-old Charles Smith from Gansevoort. His family reported that he was bitten by a tick on April 28. He went to the doctor on May 1 and was sent home. However, by May 11, he had fever and chills and was hospitalized. He died June 6.

“Powassan is a serious illness,” said Bryon Backenson, New York State DOH’s Deputy Director of Communicable Disease Control. There is no cure for Powassan’s, which is deadly about 10-percent of the time because it affects the central nervous system in about half the cases. “You’re trying to do things to reduce swelling in the brain or reduce swelling on the lining of the brain,” explained Backenson. Symptoms of Powassan’s include headache, fever, vomiting, weakness, and confusion, loss of coordination, speech difficulty and seizures.

It can take up to four weeks for Powassan’s to be confirmed by blood and cerebrospinal fluid testing, making early treatment important when it’s suspected. “With a disease like Powassan that tick only has to be on 10 or 15 minutes before it has the potential to transmit what it’s carrying because Powassan is a virus,” warned Backenson.

Unlike Lyme disease which is a bacteria and can take up to 36 hours for infection to occur.

Without a specific treatment, the need to protect against tick bites is key. “This is a very severe illness. It’s an illness that can cause deaths, but it’s also one that’s extremely rare,” explained Backenson. (WNYT, July 12)


 

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


FDA To Implement Stricter Education Requirements for Opioid Makers
FDA Commissioner Scott Gottlieb “announced plans Monday to require manufacturers of painkillers to provide more extensive education for physicians and other health-care professionals who prescribe the drugs.” Previously, only manufacturers of extended-released opioids, which account for ten percent of opioid prescriptions, were required to provide the training. Dr. Gottlieb said the agency would also consider legal action on any drugs that it concludes pose a larger risk than benefit. The FDA did that last month when it concluded that the painkiller Opana ER was linked to injection drug abuse. Its maker, Endo Pharmaceutical, Inc. pulled the drug from the market last week at the FDA’s request. (Wall Street Journal (7/10)

CMS Proposes Medicare Physician Payment Rule for 2018
On July 13, CMS issued a proposed rule to update the Medicare physician fee schedule for 2018.

To read the CMS press release announcing some of the key policy changes proposed in the rule, click here.

To read the entire rule, click here.

A chart listing the specialty by specialty impact of the proposed rule changes is on pp.727-728.   Specifically, the chart notes that, as a result of these proposed changes, the following specialties will see an overall +1% in allowed charges: geriatrics, hand surgery, infectious disease, physical medicine, psychiatry and radiation oncology.

The chart notes that the following specialties could see an overall -1% in permitted charges: colon and rectal surgery, emergency medicine, gastroenterology, general surgery, interventional radiology, neurosurgery, OB-GYN, pathology, radiology, thoracic surgery, and urology.

The chart also notes that the following specialties could see an overall -2% in permitted charges: cardiac surgery, cardiology, otolaryngology and vascular surgery, with a -3% projected for allergy/immunology.

MSSNY, working together with the AMA and the federation of medicine, will be reviewing the rule and will follow up with further analysis.

CMS Proposed Rule for Implementation of Diabetes Prevention Program (MDPP)
On July 13, 2017, CMS issued the Calendar Year (CY) 2018 Physician Fee Schedule (PFS) proposed rule that would make additional proposals to implement the Medicare Diabetes Prevention Program (MDPP) expanded model starting in 2018.

The MDPP expanded model was announced in early 2016, when it was determined that the Diabetes Prevention Program (DPP) model test through the Center for Medicare and Medicaid Innovation’s Health Care Innovation Awards met the statutory criteria for expansion. Through expansion of this model test, more Medicare beneficiaries will be able to access evidence-based diabetes prevention services, potentially resulting in a lowered rate of progression to type 2 diabetes, improved health, and reduced costs.

The Medicare Diabetes Prevention Program expanded model is a structured intervention with the goal of preventing progression to type 2 diabetes in individuals with an indication of pre-diabetes. The clinical intervention, the result of National Institutes of Health-funded research, consists of a minimum of 16 intensive “core” sessions of a Centers for Disease Control and Prevention (CDC) approved curriculum furnished over six months in a group-based, classroom-style setting that provides practical training in long-term dietary change, increased physical activity, and behavior change strategies for weight control.

After completing the core sessions, less intensive follow-up meetings furnished monthly will help ensure that the participants maintain healthy behaviors. The primary goal of the expanded model is at least 5 percent weight loss by participants. 

Long-Term Dietary Improvements Associated with Decreased Risk of Death
The New England Journal of Medicine reports that “long-term improvements in diet were associated with a significantly decreased risk of death,” researchers found. The study revealed that “making mostly healthier choices for 12 years could decrease someone’s risk of death during the next 12 years by 20 percent.”

NGS Claim Submission Changes
Healthcare continues to keep up with technology with the new claim submission changes issued by National Government Services (NGS). Beginning July 10, 2017 NGS will no longer be accepting claim submissions with handwriting on the CMS 1500 form (except in the specified signature boxes). As per the new alert issued on June 29th, handwritten claims received will be returned to the provider with a notice to submit a new claim in the acceptable format.

The CMS Pub. 100-04, Medicare Claims Processing Manual, Chapter 26, Section 30 notes the CMS 1500 form specifications are “required to facilitate the use of image processing technology such as Optical Character Recognition (OCR), facsimile transmission, and image storing.”

NGS currently allows for claims to be submitted online via NGSConnex. If you are currently submitting handwritten claims it is recommended to open a dialogue with your billers and consider alternatives, as many private insurance carriers look towards Medicare and Medicaid for guidance. 

Sources:
http://ow.ly/hM5E30drukU
https://www.cms.gov/Regulations-and-Guidance/Guidance/Manuals/Downloads/clm104c26.pdf
Lorna Simons CPC, Medco Consultants Inc.

Former Suffolk County President Dr. Bernard Lane Dies
MSSNY member Bernard P. Lane, MD, passed away on July 5, 2017 at the age of 79 after a long battle with cancer.  The Brooklyn native—known to friends and colleagues as Bernie—graduated from Brown University and NYU Medical School.

A founding faculty member of Stony Brook University School of Medicine, Dr. Lane contributed over 45 years of service to medical science and education including his faculty years at NYU and Stony Brook medical schools.  In addition to his duties as Professor of Pathology, Dr. Lane also served as Deputy Chairman, Interim Chair, and Director of the Electron Microscopy Laboratory.  He was the Pathology residency program director for 25 years, mentoring scores of pathologists who have gone on to positions in hospitals and academic medical centers both locally and nationally.

Dr. Lane served as President of the Stony Brook University Faculty Senate, and was the Founding Chairman of the Board of Directors of the Clinical Practice Management Plan at the University Hospital, serving in that capacity for nearly 20 years.

An active member of organized medicine, Dr. Lane was a member of MSSNY since 1986 and served as President of the Suffolk County Medical Society in 1990 and 1991.  He was Chair of the National Group on Faculty Practice of the Association of American Medical Colleges, and president of the Suffolk County Pathology Society.

Dr. Lane and his wife, Dr. Dorothy Lane (nee Spiegel), celebrated their 53rd wedding anniversary in August 2016. In addition to his wife, Dr. Lane is survived by his daughter Erika Neil, his sons Dr. Andrew Lane and Matthew Lane, his daughter-in-law Dr. Wendy Lane, and his grandchildren Zachary Lane, Jacob Lane, Rachel Neil and Justin Neil.

A graveside funeral service was held on Friday, July 7, 2017 at the Washington Memorial Park cemetery in Mount Sinai. In lieu of flowers, the family requests that donations be made in his memory to the Stony Brook Cancer Center or the American Cancer Society.


CLASSIFIEDS


Medical Space Available for Leasing
Currently (last 7 years) occupied by Lab Corp.
2,500 sq. ft. ADA compliant.
25-15 Steinway Street, Astoria, NY 11103
Please contact Landlord: 1-800-283-0602;
e mail: wwwevans@yahoo.com

Want to Sell Your Medical Practice? Do You Have Medical Office Space to Sell or Share?
Clineeds is a new online platform designed to help medical providers sell their practice or buy, sell and share medical office space. Listing is FREE! No contracts. No commitments. No fees. Sign up today at http://www.clineeds.com/sign-up

Physician Opportunities


Medical Director – Cayuga Medical Associates
Cayuga Medical Associates (CMA), a growing multispecialty group located in the heart of the beautiful Finger Lakes Region in Central New York, is currently seeking a Medical Director to work within the organization. This senior leadership position is designed to ensure that high quality, service-oriented patient care is delivered by Cayuga Medical Associates’ physicians on a consistent basis. The medical director has primary responsibility for clinical issues pertaining to the delivery of patient care services, patient satisfaction, and quality at the practice level. This position will report to the Chief Operating Officer of CMA, and will serve as an ex-officio board member. In this role, the Medical Director will work in an administrative capacity 2 days a week, and will practice as a physician for the remaining 3 days of the workweek.This position will require the physician to:

  • Engage in Physician recruitment, engagement and retention, in collaboration with Executive Director
  • Set and communicate performance, service standards and expectations to all providers
  • Exercise professional clinical leadership regarding specific cases or questions of quality or compliance
  • Assist with compensation model refinements and redesign, with specific focus on quality and productivity metrics
  • Oversee CMA’s Physician Action Council (PAC)
  • Develop and implements physician peer review system, medical policies, and clinical programs

Qualifications for this position include:

  • Graduate from accredited medical school and appropriate residency training
  • Board certified physician in a primary care or related sub-specialty area
  • Active NYS medical license

At least 3-5 years of relevant work experience in a physician practice setting, prior experience in physician leadership role preferred

vStrong leadership skills to develop a close, collaborative working relationship with senior leadership team, physician leaders, and practice management staff

The Finger Lakes region of New York offers endless opportunities for outdoor adventures, as well as rich support of the arts and diverse cultural opportunities, excellent school districts, and charming villages, towns and small cities to call home.  If you are dedicated to excellence and possess a commitment to patient-centered care, please submit your CV and cover letter to cma_hr@cayugamedicalassociates.org or fax to (607) 277-1415, attention Human Resources. CMA offers a competitive pay and benefits package and is an equal opportunity employer.


Position Available for Critical Care Physician to Join Established Practice in Nassau County, Long Island, NY.
The Physician will join our existing team of Board-Eligible/Board-Certified Intensivists. This is a PT/FT position including both nocturnal and daytime responsibilities. The Physician will work with a dedicated group of highly trained mid-level practitioners, respiratory therapists and nurses to provide Critical Care at St. Francis Hospital in Roslyn, NY. St. Francis was ranked one of the top 10 hospitals in the nation for Cardiac Care and is top rated nationally in seven other adult specialties.
We are expanding our Intensivist Program and are expecting to add an Intensivist to our group.
Nassau Chest Physicians, P.C. was established in 1978 to provide state-of-the-art care to patients with pulmonary diseases on Long Island. We have expanded our practice to include 8 Intensivist/Pulmonologists and 5 pure Intensivists. Since 2006, we have assumed management of Critical Care services at St. Francis Hospital-The Heart Center in Roslyn, NY.
St. Francis Hospital is New York State’s only specialty designated cardiac center and is a nationally recognized leader in cardiology and heart surgery, ear-nose-throat, gastroenterology and GI surgery, geriatrics, neurology and neurosurgery. More cardiac procedures are performed at St. Francis than at any other hospital in New York State. The hospital is located on the North Shore of Long Island; approximately 30 minutes from Manhattan. The hospital combines unrivaled expertise in cardiovascular medicine with top-ranged nursing (AACN Magnet Award) to provide the very best in patient care.
In addition, St. Francis offers excellent Thoracic, Vascular, Oncologic, Neurosurgical, and Orthopedic Surgical Programs. We have a very active Emergency Department. The hospital offers the latest in technologies such as Therapeutic Temperature Modification, Impella, ECMO and LVAD. Our excellent and experienced medical staff supports strong medical and surgical subspecialty programs.

Aside from Certified Critical Care Nurses, many who have more than 20 years of experience and are expert at caring for this complex patient population, we have a growing pool of Intensivist mid-level practitioners who work hand in hand with our Intensivist physicians to coordinate the care of the critically ill patient, minister to them and perform procedures.

Of course, a New York License is required. J1 or H1 VISAS accepted.
Additional Salary Information: Salary and benefits are competitive and commensurate with experience. Interested applicants, send resume to: dr.sorett@nassauchest.com


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

July 7, 2017 – PRI Oust & Urge Gov Veto


PRESIDENT’S MESSAGE
Charles Rothberg, MD
July 7, 2017
Volume 17
Number 26

Dear Colleagues:

Today’s press has reported the Department of Financial Services (DFS) findings following a yearlong audit of PRI, the second largest malpractice carrier in the state.  As a result of their findings the CEO of PRI has been ousted. The superintendent of the DFS, Maria Vullo, stated, “…, the examination determined that AFP (PRI’s management company) and its top executives, including its CEO and owner, Anthony J. Bonomo, disregarded sound actuarial principles when setting PRI’s loss reserves, and then tried to cover it up by seeking to silence outside auditors and employees who objected to this misconduct.”

The board of PRI voted yesterday to void the company’s management contract with Administrators for the Professions, a subsidiary of AJB Ventures, which Mr. Bonomo owns. The new management contract will be given to PRIMMA, LLC, and a wholly-owned subsidiary of PRI. PRIMMA will be run on an interim basis by The Princeton Partnership, a firm that specializes in turnaround and runoff management. Read more here.

More importantly, this information comes at a volatile time for New York’s malpractice industry, especially in view of the Expansion of Liability bill that will be delivered to the Governor. He needs to make a decision whether or not this is the appropriate time to sign such legislation into law. This does not appear to be the optimal time to further destabilize the climate of the malpractice industry in New York.

Expansion of Liability Bill

New York has a reputation of being a difficult place to be a doctor.  Yet the legislature in Albany has potentially made this problem far worse.  It passed a “one-sided” bill that, if enacted, will drastically increase health care costs by radically increasing the number of lawsuits that could be brought against our doctors and hospitals. But the law ignores much of the problem illustrated by the story of Lavern.

Voice your opposition here!

The bill is a hastily conceived legislative response to the sad case of Lavern Wilkinson.  Ms. Wilkinson, treated at a public hospital, was not informed of a cancerous lesion present on an x-ray.  Sometime later, when Ms. Wilkinson ‘discovered’ the cancer, it had already spread.  She was unable to sue for medical negligence owing to the short 15-month statute of limitations that applies to public hospitals like the one that treated her.  Had she been treated elsewhere in New York, with the standard 30-month statute, Lavern would have been able to sue.  Sadly, she succumbed to this cancer.

The legislature could have solved Lavern’s medical liability ‘problem’ by simply extending the shortened statute against public hospitals to 30 months (like in non-public hospitals). Instead, they unreasonably extended the statute to date of discovery (as long as 7 years from treatment) to all venues. If this law is enacted, despite the unnecessary burden on all physicians and hospitals, patients presenting to public hospitals might still find themselves unable to sue.  For example, a patient presenting to a public hospital for evaluation following a motor vehicle accident, not informed of an aneurysm on x-ray, would still be unable to sue after 15 months’ time. This bill, that would increase liability costs for physician practices by 15%, would not provide a remedy for many patients like Lavern!

We are not alone in this fight. HANYS and the Greater New York Hospital Association are equally opposed. Ken Raske, in a letter to the Governor, stated that they are “deeply disappointed with the Senate leadership—whom we have repeatedly supported—for putting this onerous, extremely damaging bill forward… At the very least, it will lead to more litigation, as parties seek to take advantage of the bill’s drafting ambiguities.” Specialty societies were against it, too.

But if there is a need to expand the time to bring lawsuits; it must be balanced with legislation to address the numerous flaws of our medical liability system that drive our excessive costs – “comprehensive” reform.  Unfortunately, the Legislature, with its hasty one-sided remedy, ignored the risk of harm to our already fragile care delivery infrastructure.

Governor Cuomo must veto this bill and instead work for comprehensive medical malpractice reform effort that address deficiencies raised by all sides – patients, lawyers and doctors. New York is already the worst state to be a doctor largely because our medical liability costs and premiums far exceed any other state.  Many other states such as California, Texas and Florida, along with the majority of others, have put reasonable controls on liability awards to preserve some stability in their health care systems.

What do our legislators not see?

Governor Cuomo must insist on fair balance by vetoing this bill and pushing for comprehensive reform instead.

Voice your opposition here!

Sincerely,
Charles Rothberg, MD
MSSNY President

Please send your comments to comments@mssny.org


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


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Please Contact Gov. to Urge Veto to Prevent More Lawsuits and Increased Costs
All physicians are urged to contact Governor Andrew Cuomo to veto legislation (S.6800/A.8516) that would prompt significant increases in medical malpractice lawsuits and premiums at a time when no further increases can be tolerated.  Please call at (518) 474-8390, and send a letter here: Take Action

This week, MSSNY President-elect Dr. Thomas Madejski and Erie County Medical Society President Dr. Willie Underwood authored an op-ed that appeared in the Buffalo News urging the Governor to veto the bill, and press for comprehensive medical liability reform instead.  Read the op-ed here.

Introduced in the final days and passed in the final hours of the 2017 Legislative Session over the strong objections of MSSNY, the specialty societies, the hospital industry and medical liability insurers, S6800/A8516 would expand the medical liability statute of limitations for cases involving “alleged negligent failure to diagnose a malignant tumor or cancer”.   The bill would permit lawsuits 2.5 years from the “date of discovery” of such alleged negligence, up to an outside limit of 7 years from the date of the alleged negligent act.

While it is likely that a more narrowly focused bill will reduce somewhat the premium increase needed from the 15% projected increase for an earlier version of this bill, there is great ambiguity in the legislation as to which cases the 7-year limit would apply.  Moreover, the bill does not just apply to treatment that occurs after the proposed effective date of the bill but has a very significant retroactive impact, subject to numerous interpretations, for which insurance companies have not reserved premium dollars (another reason to veto the bill!).  These errors and/or ambiguities are likely the result of the bill being “rushed into print” to meet the constitutional “3-day aging” requirement before a bill can be considered by the Legislature.

Of greatest concern, the bill fails to include needed tort reforms to help bring down our already exorbitant medical liability costs.

While it is not known when the bill will be officially delivered to the Governor for his consideration, it could be sent at any time.  Please take action and urge your colleagues to do the same.

DOH Announces Additional Four-Hour Medical Marijuana Course
The New York State Department of Health announced the availability of an additional four-hour medical use of marijuana course. Practitioners who wish to register with the Department and certify their patients for the Medical Marijuana Program must complete one of the available approved courses.  The Department also streamlined the process for practitioners to register with the program. See the following press release for additional information on these enhancements to the program.

CDC: Opioid Prescribing Down Since 2010, But Varies Widely
The amount of opioids prescribed in the United States decreased each year between 2010 and 2015, according to a Vital Signs report released this week by the CDC. The amount of opioids prescribed per capita fell from a peak of 782 morphine milligram equivalents in 2010 to 640 MME in 2015, but remains about three times higher than in 1999 and varies widely by county, with some counties prescribing six times as much as others.

“This variation highlights the need for health care providers to consider evidence-based guidance when prescribing opioids,” said Deborah Dowell, M.D., chief medical officer for CDC’s Division of Unintentional Injury Prevention. Between 2010 and 2015, MME per capita decreased in half of US counties and increased in 23% of counties.

NAM Collaborative Calls for Research to Address Clinician Burnout
The National Academy of Medicine Action Collaborative on Clinician Well-Being and Resilience, whose sponsors include the AHA, yesterday issued a discussion paper calling for research to identify the organizational and health system factors that place physicians, nurses and other health care professionals at increased risk for burnout; the implications for health care outcomes; and effective interventions to improve clinician well-being.

“The U.S. health care system is rapidly changing in an effort to deliver better care, improve health, and lower costs while providing care for an aging population with high rates of chronic disease and co-morbidities,” notes the paper, whose co-authors include AHA Chief Medical Officer Jay Bhatt, D.O. “…Navigating these changes are health care professionals, whose daily work is critical to the success of health care improvement.

Unfortunately, as a result of these changes and resulting added pressures, many HCPs are burned out, a syndrome characterized by a high degree of emotional exhaustion and high depersonalization (i.e., cynicism), and a low sense of personal accomplishment from work.” On July 14, the collaborative will host its first public meeting to solicit feedback and highlight research and examples of promising approaches to promoting clinician well-being. To attend in person or via webcast, register here.

In July: Pilot for Office-Based Surgery Practitioners New Online Practice Report
To assist in the promotion of patient safety and quality of care for patients undergoing procedures in the office-based setting, the NYS Department of Health (NYS DOH) Office-Based Surgery (OBS) Program has developed a new online Practice Report. This Report will assist in providing context for the interpretation of Adverse Event information received by the NYS DOH. Public Health Law provides the NYS DOH with authority to require OBS practices to report additional data for the interpretation of adverse events.[1] Beginning in January 2018, all NYS OBS practice sites will be required to complete an annual Practice Report.

In July of 2017, the NYS DOH will conduct a pilot with OBS practices to ensure practitioners and practices are aware of the report content and are able to complete the Practice Report. They are requesting practices complete the pilot Practice Report using information from January 1 through December 31, 2016. Practices newly accredited in 2017, may provide available 2017 data. The NYS DOH has contacted OBS practices with details regarding the pilot by email.

In late Fall 2017, the NYS DOH will share feedback received from the pilot and any subsequent changes to the report. The NYS DOH is hopeful the pilot Practice Report will assist OBS practices in preparing for the first annual Practice report in January of 2018.  If you have any questions, please contact the Office-Based Surgery Program at 518-408-1219 or obs@health.ny.gov.
[1]PHL § 230-d, 4. (b);  “the department may also require licensees to report additional data such as procedural information as needed for the interpretation of adverse events”

Athenahealth: The Case for Staying Independent
Join online on Wednesday, July 12, at 2pm ET
Reserve your spot
If you think that merging your independent practice with a larger healthcare system is the only way for it to survive, this webinar is for you. On the heels of Independence Day, this free one-hour presentation takes a close look at topics such as:

  • Why it’s so overwhelming for independent practices to operate today
  • The measurable advantages independent practices have over larger systems
  • 3 case studies of once-struggling independent practices that are thriving today

Know what athenahealth knows about helping you run your practice your way.                                    REGISTER TODAY


Less Expensive Hearing Devices May Work as Well as Traditional Hearing Aids
Some over-the-counter sound amplification devices are nearly as effective as prescription hearing aids, according to a small JAMA study.

Researchers compared five personal sound amplification products with one hearing aid in 40 older adults with mild-to-moderate hearing loss. Speech understanding improved with the hearing aid and four of the amplification products. For three of the products (Sound World Solution sCS50+, Soundhawk, Etymotic BEAN), the improvement in speech understanding was within 5 percentage points of that of the hearing aid.

The authors conclude: “Results lend support to current national initiatives … requesting that the US Food and Drug Administration create a new regulatory classification for hearing devices meeting appropriate specifications to be available over the counter.”
JAMA research letter

New Web Page for Doctors Working in Small, Rural, or Underserved Areas
CMS announced the launch of a new section on the Quality Payment Program on https://qpp.cms.gov/about/small-underserved-rural-practices  dedicated to doctors and other clinicians working in small or rural practices as well as those treating patients in underserved areas. This page serves as a single point of reference to help physicians prepare for, and actively participate in, the Quality Payment Program, especially, for those of you participating under the Merit-based Incentive Payment System (MIPS) track.

Physicians can quickly locate contact information for the organizations providing assistance to practices through the Small, Underserved, and Rural Support initiative using a simple interactive map. These local, experienced, community-based organizations provide hands-on training to help thousands of small practices, especially those that practice in historically under-resourced areas including rural areas, health professional shortage areas, and medically underserved areas.

The training and education resources are available nationwide and will be provided at no cost to eligible clinicians and practices. Physicians can also review the flexibilities to help reduce the participation and reporting burden on small practices for 2017. We anticipate adding more features and information over time and will continue to keep the lines of communication open, as CMS values physician feedback in helping to improve their experience in the Quality Payment Program.


CLASSIFIEDS


Medical Space Available for Leasing
Currently (last 7 years) occupied by Lab Corp.
2,500 sq. ft. ADA compliant.
25-15 Steinway Street, Astoria, NY 11103
Please contact Landlord: 1-800-283-0602;
e mail: wwwevans@yahoo.com

Want to Sell Your Medical Practice? Do You Have Medical Office Space to Sell or Share?
Clineeds is a new online platform designed to help medical providers sell their practice or buy, sell and share medical office space. Listing is FREE! No contracts. No commitments. No fees. Sign up today at http://www.clineeds.com/sign-up

Physician Opportunities


Medical Director – Cayuga Medical Associates
Cayuga Medical Associates (CMA), a growing multispecialty group located in the heart of the beautiful Finger Lakes Region in Central New York, is currently seeking a Medical Director to work within the organization. This senior leadership position is designed to ensure that high quality, service-oriented patient care is delivered by Cayuga Medical Associates’ physicians on a consistent basis. The medical director has primary responsibility for clinical issues pertaining to the delivery of patient care services, patient satisfaction, and quality at the practice level. This position will report to the Chief Operating Officer of CMA, and will serve as an ex-officio board member. In this role, the Medical Director will work in an administrative capacity 2 days a week, and will practice as a physician for the remaining 3 days of the workweek.This position will require the physician to:

  • Engage in Physician recruitment, engagement and retention, in collaboration with Executive Director
  • Set and communicate performance, service standards and expectations to all providers
  • Exercise professional clinical leadership regarding specific cases or questions of quality or compliance
  • Assist with compensation model refinements and redesign, with specific focus on quality and productivity metrics
  • Oversee CMA’s Physician Action Council (PAC)
  • Develop and implements physician peer review system, medical policies, and clinical programs

Qualifications for this position include:

  • Graduate from accredited medical school and appropriate residency training
  • Board certified physician in a primary care or related sub-specialty area
  • Active NYS medical license

At least 3-5 years of relevant work experience in a physician practice setting, prior experience in physician leadership role preferred

vStrong leadership skills to develop a close, collaborative working relationship with senior leadership team, physician leaders, and practice management staff

The Finger Lakes region of New York offers endless opportunities for outdoor adventures, as well as rich support of the arts and diverse cultural opportunities, excellent school districts, and charming villages, towns and small cities to call home.  If you are dedicated to excellence and possess a commitment to patient-centered care, please submit your CV and cover letter to cma_hr@cayugamedicalassociates.org or fax to (607) 277-1415, attention Human Resources. CMA offers a competitive pay and benefits package and is an equal opportunity employer.


Position Available for Critical Care Physician to Join Established Practice in Nassau County, Long Island, NY.
The Physician will join our existing team of Board-Eligible/Board-Certified Intensivists. This is a PT/FT position including both nocturnal and daytime responsibilities. The Physician will work with a dedicated group of highly trained mid-level practitioners, respiratory therapists and nurses to provide Critical Care at St. Francis Hospital in Roslyn, NY. St. Francis was ranked one of the top 10 hospitals in the nation for Cardiac Care and is top rated nationally in seven other adult specialties.
We are expanding our Intensivist Program and are expecting to add an Intensivist to our group.
Nassau Chest Physicians, P.C. was established in 1978 to provide state-of-the-art care to patients with pulmonary diseases on Long Island. We have expanded our practice to include 8 Intensivist/Pulmonologists and 5 pure Intensivists. Since 2006, we have assumed management of Critical Care services at St. Francis Hospital-The Heart Center in Roslyn, NY.
St. Francis Hospital is New York State’s only specialty designated cardiac center and is a nationally recognized leader in cardiology and heart surgery, ear-nose-throat, gastroenterology and GI surgery, geriatrics, neurology and neurosurgery. More cardiac procedures are performed at St. Francis than at any other hospital in New York State. The hospital is located on the North Shore of Long Island; approximately 30 minutes from Manhattan. The hospital combines unrivaled expertise in cardiovascular medicine with top-ranged nursing (AACN Magnet Award) to provide the very best in patient care.
In addition, St. Francis offers excellent Thoracic, Vascular, Oncologic, Neurosurgical, and Orthopedic Surgical Programs. We have a very active Emergency Department. The hospital offers the latest in technologies such as Therapeutic Temperature Modification, Impella, ECMO and LVAD. Our excellent and experienced medical staff supports strong medical and surgical subspecialty programs.

Aside from Certified Critical Care Nurses, many who have more than 20 years of experience and are expert at caring for this complex patient population, we have a growing pool of Intensivist mid-level practitioners who work hand in hand with our Intensivist physicians to coordinate the care of the critically ill patient, minister to them and perform procedures.

Of course, a New York License is required. J1 or H1 VISAS accepted.
Additional Salary Information: Salary and benefits are competitive and commensurate with experience. Interested applicants, send resume to: dr.sorett@nassauchest.com


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

Press coverage of MSSNY’s statement on Surgeon General Nominee

Health Medicine Network – 06/30/17
Trump Nominates Indiana Health Commissioner as Surgeon General
(MSSNY President Dr. Charles Rothberg, MD quoted)

USA Today – 06/30/17
Trump nominates Indiana doctor for surgeon general
(MSSNY statement included)

The Tennessean – 06/30/17
Trump nominates Indiana doctor for surgeon general

The Commercial Appeal – 06/30/17
Trump nominates Indiana doctor for surgeon general

Springfield News-Leader – 06/30/17
Trump nominates Indiana doctor for surgeon general

Democrat and Chronicle   – 06/30/17
Trump nominates Indiana doctor for surgeon general

My Northshore NOW   – 06/30/17
Trump nominates Indiana doctor for surgeon general

Lake Country NOW  – 06/30/17
Trump nominates Indiana doctor for surgeon general

The Asbury Park Press (AP)  – 06/30/17
Trump nominates Indiana doctor for surgeon general

HometownLife.com  – 06/30/17
Trump nominates Indiana doctor for surgeon general 

Courier-Journal  – 06/30/17
Trump nominates Indiana doctor for surgeon general

Central Florida Future – 06/30/17
Trump nominates Indiana doctor for surgeon general 

Post-Crescent  – 06/30/17
Trump nominates Indiana doctor for surgeon general

The Newark Advocate  – 06/30/17
Trump nominates Indiana doctor for surgeon general

WaukeshaNow  – 06/30/17
Trump nominates Indiana doctor for surgeon general

The Californian – 06/30/17
Trump nominates Indiana doctor for surgeon general

LoHud.com  – 06/30/17
Trump nominates Indiana doctor for surgeon general 

Northwest Now  – 06/30/17
Trump nominates Indiana doctor for surgeon general

Ruidoso News  – 06/30/17
Trump nominates Indiana doctor for surgeon general

The News Leader (AP) – 06/30/17
Trump nominates Indiana doctor for surgeon general

Chambersburg Public Opinion  – 06/30/17
Trump nominates Indiana doctor for surgeon general

Tallahassee Democrat  – 06/30/17
Trump nominates Indiana doctor for surgeon general

June 30, 2017 – Fix Insurance System NOT Healthcare System


PRESIDENT’S MESSAGE
Charles Rothberg, MD
June 30, 2017
Volume 17
Number 25

Dear Colleagues:

According to the Washington Post, Senate Majority Leader Mitch McConnell (R-KY) “intends to send a revised version of his health-care bill to the Congressional Budget Office today according to Capitol Hill aides and lobbyists.” This timeline points to McConnell’s attempt to hold a vote before the August recess.

We need to promote a message, by July 3, to Mitch McConnell and all the federal legislators, while they are home in their districts, that what is needed is to fix the health insurance system— not healthcare.

If we get them to rethink patient costs related to premiums, deductibles, co-insurance and/or co-payments, then affordable, usable quality healthcare can be provided to patients with medical needs.  (A $6000 deductible is not usable to most people.) Both political parties will need to work together to get this done.

To help make America greater, we must put away party politics and get health insurance reform back on track. Outrageous deductible amounts are unaffordable to working families with health care needs.  High deductibles mean high out-of-pocket cost to insureds, who (despite high premium costs) are left with paying for office visits as though they don’t have insurance.  This is not right.

For example, an individual insurance premium of $10K+ annually, whereby that individual pays $140 in co-payments for TWO specialist visits and $80 for TWO PCP visits, while the health plan pays just $20 for all FOUR visits is not right either.  Before Obamacare, this ‘feature’ of managed care was a deplorable hurdle and it still is.  It was not right then, it is not right now.  Current proposals don’t appear to address this issue at all.

The insurance industry is to blame and that is where more focus should be. There is far too much talk about perverse ‘incentives’ and ‘payment reform’ for providers of medical services such as physicians and hospitals.  That, too, is wrong.  Insurance reform is what is needed to fix the ills in the system.

Now – Senate, House, Republican and Democrat, how do you propose do fix the system?

Sincerely,
Charles Rothberg, MD
MSSNY President

Please send your comments to comments@mssny.org


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


enews large

US House Passes Medical Liability Reform Bill
By a largely party line 218-210 vote the US House of Representatives passed legislation to expand patient access to care by reducing the exorbitant cost of medical liability insurance.  Among other provisions, the bill contains a provision that would limit to $250,000 the amount of non-economic damages that could be awarded in cases where the patient is enrolled in a Government-subsidized program like Medicare, Medicaid or an Exchange plan.    It would also define federal standards for attorney contingency fees, statutes of limitations, certificates of merit and prohibiting apologies from being introduced into evidence.

After the bill was passed, MSSNY President Dr. Charles Rothberg issued the following statement praising the action of the US House:

“We have long maintained that medical liability reform is an essential component of health reform.  We commend the House of Representatives for passing legislation (HR 1215) that if enacted could help to reduce some of the extraordinary costs faced by our physicians and hospitals and restore some balance to our medical liability system.

New York State was recently designated as the worst state in the country to practice medicine, in large part due to our excessive liability exposure as compared to all other states.  Indeed, physicians in New York City, Long Island and the Lower Hudson Valley pay some of the highest liability premiums in the country.  New York not only far exceeds all other states in terms of total medical liability payouts, we also spend more on a per capita than any other state in the country.

The actions of the US House of Representatives to address this huge problem stands in stark contrast to the New York State Legislature, which despite New York’s exorbitant costs, just passed legislation that would actually expand lawsuits against doctors and hospitals and impose huge new costs.  MSSNY and many other health care provider associations are urging Governor Cuomo to veto this legislation.

As efforts continue to be undertaken to fix the flaws of the Affordable Care Act, we urge that comprehensive medical liability reform be included in these efforts.”

All 9 Republican members of New York’s Congressional delegation (Collins, Donovan, Faso, Katko, King, Reed, Stefanik, Tenney and Zeldin) voted in favor of the bill.  All 18 Democrat members of New York’s Congressional delegation (Clarke, Crowley, Engel, Espaillat, Jeffries, Higgins, Lowey, C. Maloney, S.P. Maloney, Meeks, Meng, Nadler, Rice, Serrano, Slaughter, Suozzi, Tonko, and Velasquez) voted against the bill.

At this point, it is not clear what the Senate will do with this legislation.  It has been reported that some US Senators are seeking to include medical liability reform provisions within the broader health care reform debate.

Tell Governor Cuomo to Reject Medical Liability Expansion Bill and Call for Comprehensive Liability Reform
All physicians are urged to call Governor Cuomo at 518-474-8390 and send a letter here urging that he veto a so-called “cancer only” medical liability statute of limitations expansion bill (S.6800/A.8516) that passed the Legislature over the strong objections of MSSNY, the specialty societies, the hospital industry and MLMIC.  Please urge that legislation be enacted instead that provides for comprehensive medical liability reform.

This ambiguously drafted bill, introduced in the final days and passed in the final hours of the 2017 Legislative Session, would expand the medical liability statute of limitations for cases involving “alleged negligent failure to diagnose a malignant tumor or cancer”.   The bill would permit lawsuits 2.5 years from the “date of discovery” of such alleged negligence, up to an outside limit of 7 years.

While it is likely that a more narrowly focused bill will reduce somewhat the premium increase needed from the 15% projected increase for an earlier version of this bill, there is great ambiguity in the legislation as to which cases the 7-year limit would apply that will undoubtedly generate significant litigation.    Moreover, the bill does not just apply to treatment that occurs after the proposed effective date of the bill but has a very significant retroactive impact, subject to numerous interpretations, for which insurance companies have not reserved premium dollars (another reason to veto the bill!).  These errors and/or ambiguities are likely the result of the bill being “rushed into print” to meet the constitutional “3-day aging” requirement before a bill can be considered by the Legislature.

Besides the bill’s drafting errors, of greatest concern, the bill completely ignores the exorbitant medical liability costs that New York physicians already pay, which was reflected in MSSNY President Dr. Rothberg’s statement about the failings of this bill:

“New York’s physicians are extremely concerned about the ultimate impact to New Yorkers’ access to care if the statute of limitations expansion bill (S.6800/S.8516) considered by the Legislature today is ultimately signed into law.  Many New York hospitals and physicians are already struggling to keep their doors open.

New York State has already earned the dubious distinction as the absolute worst state in the country in which to practice medicine, in large part due to its overwhelming liability costs.  The bill will add significantly to these costs that have already driven physician after physician out of private practice, and in many cases driving them out of New York altogether.  It will also discourage countless others from coming here to practice.  We urge Governor Cuomo to veto this legislation and bring parties together to pass comprehensive, not one-sided, medical liability reform. New Yorkers’ access to health care is at stake.”

Again, please urge the Governor to veto this bill and encourage your colleagues to do the same! Please let the Governor know how this bill will harm patient care and exacerbate existing physician shortage issues in your community. 

MSSNY President Issues Statement Expressing Deep Concerns US Senate Health Reform Legislation, Communicates to NY Congressional Delegation
As the US Senate was deciding this week whether to begin floor debate on its proposal to repeal and revise much of the Affordable Care Act, MSSNY President Dr. Charles Rothberg issued the following statement expressing deep concerns about the legislation’s impact to New York:

“While a wholesale review of the flaws of the ACA should be undertaken, we are deeply concerned about potentially significant adverse consequences to New York’s residents and its health care system arising from proposals before the House and Senate. 

The House and Senate bills will replace the low cost coverage hundreds of thousands of New Yorkers currently have with tax credits that for many will be insufficient to purchase coverage. Patients may face huge new out of pocket costs or worse, they may not purchase any coverage at all. In addition, we also have strong concerns about the bill’s long-term impact on funding for New York’s health care system. 

We look forward to working with the members of New York’s Congressional delegation and urge that they work towards enactment of legislation that enhances rather than reduces affordable and comprehensive coverage options for our patients. We also urge that they work proactively with physicians and physician advocacy associations to ensure that proposed remedies will truly address patient care and coverage needs.”

This week, MSSNY also joined on to a letter to New York’s Congressional delegation along with over 30 other New York health care advocacy organization that noted that “By eliminating the cost-sharing reduction payments in 2020, and pegging tax credits for consumers to the very low actuarial value Bronze Plan, the Senate bill will significantly reduce funding for our state’s Essential Plan, jeopardizing coverage for 700,000 low-income New Yorkers. These changes will also lead to higher prices in our state’s individual insurance market, especially for older New Yorkers. And the bill hits providers hard by imposing cuts at the same time as the number of uninsured people seeking care will rise.”  Specifically, the letter called on New York’s Congressional delegation to:

  • Ensure uninterrupted health insurance coverage for the 24 million Americans, including the 850,000 New Yorkers, who gained coverage under the Affordable Care Act (ACA);
  • Do not harm New York State’s budget and do not shortchange New York’s Medicaid program by repealing the expansion under the ACA and profoundly restructuring it into a per capita cap program;
  • Protect the more than 700,000 New Yorkers who gained coverage under the ACA’s Essential Plan;
  • Do not harm health care consumers and providers;
  • Maintain and improve our insurance markets for individuals, families, and small employers


MSSNY/County Society Physician Leaders Participate in Regional ACA Town Hall Forums
This week MSSNY and county society physician leaders participated in forums organized by the Cuomo Administration designed to highlight concerns to the public with the legislation before the Congress that would repeal and revise much of the Affordable Care Act (ACA).  MSSNY Treasurer and Cobleskill internist/pediatrician Dr. Joseph Sellers participated at the forum in Hudson, and Erie County Medical Society President and Roswell Park urologist Dr. Willie Underwood participated at the forum in Buffalo (along with former MSSNY House of Delegates Speaker and AMA President Dr. Nancy Nielsen).

Both Dr. Sellers and Dr. Underwood noted that it was appropriate for Congress to examine and seek to fix the flaws of the ACA, given the increasing use of health plans with narrow networks and high deductibles.  However, both Dr. Sellers and Dr. Underwood noted MSSNY’s concerns “with proposals before Congress that would replace provisions that may cause New Yorkers who currently have low cost, “first dollar” coverage through the Essential Plan or expanded Medicaid to lose this coverage.  Instead they will have to purchase coverage with tax credits where they may only be able afford policies with high deductibles and other high cost sharing responsibilities.

Or worse yet, they may not purchase any coverage at all.” Moreover, both articulated to the Governor’s top health care staff at these forums the importance of including medical liability reform within ACA reform discussions, given New York’s recent designation as the worst state in the country to be a physician, in large part due to its excessive liability costs.

AG: Would Sue Federal if Provision Affecting NY Medicaid Spending Became Law
Crain’s New York Business (6/27) reports New York Attorney General Eric Schneiderman said on Tuesday that he would “sue the federal government if Senate Republicans pass their bill to repeal the Affordable Care Act.” Schneiderman said the measure unconstitutionally interfered in the governance of New York by shifting Medicaid costs from counties to the state government.

MSSNY President Charles Rothberg, MD with Jerome Adams, MD

MSSNY President Charles Rothberg, MD with Jerome Adams, MD

MSSNY Supports Dr. Jerome M. Adams’ Nomination as US Surgeon General
Indiana State Health Commissioner Jerome Adams, MD, MPH, has been nominated as Surgeon General of the US by President Donald Trump.

Trained as an anesthesiologist, Adams has been outspoken about the risks of prescription opioid painkillers and the need to address the opioid epidemic. Dr. Adams took the helm at the Indiana Health Department in October 2014. Just a month later, the first cases of what would later be recognized as a full-blown HIV outbreak were detected in the community of Austin in southeastern Indiana.

The virus was being spread primarily by intravenous drug users sharing needles to inject the prescription opioid oxymorphone. In 2015, Dr. Adams worked to persuade then Governor Michael Pence to authorize an emergency needle exchange for 30 days, although Governor Pence was morally against needle sharing.

MSSNY President Charles N. Rothberg, MD, stated, “Dr. Adams has a proven track record to make public health a priority despite political hurdles. He is reminiscent of  Dr. C. Everett Koop (US Surgeon General, 1982-1989), who was a champion of public health.  Dr. Adams is in touch with the public needs.”

Dr. Adams wrote in May 2015, “We are building a model for prevention and response should this type of outbreak happen in other communities in the US. I would like nothing better than to tell you this unprecedented HIV epidemic will never happen anywhere else. But I can’t do that.”

In July of 2016, Indiana joined the list of states with standing orders for naloxone, the antidote to revive people who overdose on opioids. Subsequently, Indiana, residents can go to registered pharmacies, nonprofit organizations, and health centers and get naloxone without needing a prescription.

In 2016, Dr. Adams gave a presentation on fighting the spread of hepatitis C and HIV at the National Rx Drug Abuse & Heroin Summit in Atlanta.  He said in his presentation, “Speak to your audience in their language. To change behavior, public health program workers need to confront ignorance and denial, conduct small pilot programs, and use successes to gain support.”

Dr. Adams earned bachelor’s degrees in biochemistry and biopsychology from the University of Maryland in 1997. He then earned a master’s degree in public health from the University of California at Berkley, and a medical degree from the Indiana University Medical School. He has been a researcher at medical schools in both the Netherlands and Zimbabwe and has worked under Nobel Prize winner Dr. Tom Cech.

Dr. Adams is married and has three children.

Click here to read press coverage of MSSNY’s support of Dr. Adams’ nomination. 

NYS Provider & Health Plan Look-Up
The New York State Department of Health, together with the NY State of Health, this week announced the launch of the NYS Provider & Health Plan Look-Up, an online tool that consumers can use to research those health insurance plans with which a physician (and other health care practitioners) participates.  It also lists practice locations for each physician.  Previously, a consumer would have to go to the website of each health insurance company to determine if a physician participated with a particular plan.

Physicians should take the opportunity to go to the website to see with which health plans they are listed to participate to determine if there are inaccuracies in their listings. The most efficient way to report an error is for the physician or someone on his or her behalf to select the  Contact Us button on the website. Then select the health plan and the reason for the contact. The issue will be routed electronically to the DOH and to the selected health plan(s) for review and follow-up.

CDC Working on New Approach for Early-Stage Lyme Disease Detection
STAT (6/28) reports that the number of Lyme disease cases is rising, and given that the current FDA-approved laboratory test does not consistently detect the disease in its early stages, the CDC is focusing on creating a new Lyme test using “metabolomics,” which measures “metabolite biosignatures” rather than the body’s immune response. The article extensively quotes CDC microbiologist Claudia Molins, who says, “We want a test that can be used within the first two weeks of infection and that does not rely on antibody production.” STAT adds that by using metabolomics, “the CDC aims to create a Lyme ‘signature’ of small molecules in the blood – an approach that, in early testing, catches a dramatically higher share of early infections.”

2018 EHR Hardship Exemption
July 1 is the deadline for avoiding the 2018 penalty imposed by the federal government’s Electronic Health Record (EHR) Incentive Program in its final year if you were not successful in reporting Meaningful Use in 2016 (the performance year for the 2018 penalty).  If you think you might not have reported sufficient data please review the following links:

Instructions
Hardship Application

The deadline for the hardship application is 11:59 PM on Saturday, July 1, 2017

Social Security Number Removal Initiative (SSNRI)
As we reported previously, beginning in April 2018, CMS will start mailing new Medicare cards with Medicare Beneficiary Identifier (MBIs) to people with Medicare. CMS is figuring out the best way to mail the cards. CMS will keep clinicians and beneficiaries posted about critical information so everyone can be ready to ask Medicare patients at the time of service if they have a new card with an MBI.

Beginning in October 2018, through the transition period, when physicians submit a claim using the patient’s valid and active Health Insurance Claim Number (HICN), NGS Medicare will return both the HICN and the MBI on every remittance advice. The MBI will be in the same place you currently get the “changed HICN.” The new MBI format is explained at the following website: https://www.cms.gov › Regulations and Guidance › EHR Incentive Programs

Important Modification on E&M Exam for Expanded Problem and Detailed Levels
The originally planned differentiation in examination requirements for Expanded Problem Focused (2-5) and Detailed (6-7) levels of service will no longer be considered mandatory for providers as of 7/1/2017. NGS developed these suggestions in response to multiple provider queries on the original levels (both EPF and Detailed at 2-7), and has received strong provider support for delineating the two levels as a means of more accurately coding a service.

We will not, however, mandate the changes as previously announced; all medical records reviewed will be subject to the original standard of 2-7 or the newly suggested levels of 2-5 and 6-7, in whatever manner is more beneficial to our providers. These suggestions apply to services coded as per the CMS 1995 Documentation Guidelines for Evaluation and Management Services; suggestions do not apply to services coded as per the CMS 1997 Documentation Guidelines for Evaluation and Management Services.

The posted NGS Evaluation & Management Documentation Training Tool reflects the 2-7 exam component standard for both coding levels, and will remain unchanged.


CLASSIFIEDS


Medical Space Available for Leasing
Currently (last 7 years) occupied by Lab Corp.
2,500 sq. ft. ADA compliant.
25-15 Steinway Street, Astoria, NY 11103
Please contact Landlord: 1-800-283-0602;
e mail: wwwevans@yahoo.com

Office Space Available within Beautiful Medical Spa in Woodbury NY
Seeking an MD that is looking to rent space in Woodbury, NY within a beautiful, state-of-the-art Medical Spa. Located in the Woodbury Common with high profile brands such as Soul Cycle, Athleta, Chop’t and more, this area is exclusive, elite and high-traffic. Rental space can include from 1 – 4 rooms with office space, shared reception and retail area. Size of area and price are negotiable. Great opportunity to share like-minded patients. ssoni@becomemedspa.com.

Manhasset Suite
Medical Suite to share- located at 1201 Northern Blvd, Manhasset. The medical space includes 4 exam rooms and consultation rooms. Direct access to office-  NO STEPS. Conveniently located between St.Francis Hospital and NS/LIJ Hospitals. For more information, please call 516-365-4616 or email RSwe777@aol.com


Want to Sell Your Medical Practice? Do You Have Medical Office Space to Sell or Share?
Clineeds is a new online platform designed to help medical providers sell their practice or buy, sell and share medical office space. Listing is FREE! No contracts. No commitments. No fees. Sign up today at http://www.clineeds.com/sign-up

Physician Opportunities


Position Available for Critical Care Physician to Join Established Practice in Nassau County, Long Island, NY.
The Physician will join our existing team of Board-Eligible/Board-Certified Intensivists. This is a PT/FT position including both nocturnal and daytime responsibilities. The Physician will work with a dedicated group of highly trained mid-level practitioners, respiratory therapists and nurses to provide Critical Care at St. Francis Hospital in Roslyn, NY. St. Francis was ranked one of the top 10 hospitals in the nation for Cardiac Care and is top rated nationally in seven other adult specialties.
We are expanding our Intensivist Program and are expecting to add an Intensivist to our group.
Nassau Chest Physicians, P.C. was established in 1978 to provide state-of-the-art care to patients with pulmonary diseases on Long Island. We have expanded our practice to include 8 Intensivist/Pulmonologists and 5 pure Intensivists. Since 2006, we have assumed management of Critical Care services at St. Francis Hospital-The Heart Center in Roslyn, NY.
St. Francis Hospital is New York State’s only specialty designated cardiac center and is a nationally recognized leader in cardiology and heart surgery, ear-nose-throat, gastroenterology and GI surgery, geriatrics, neurology and neurosurgery. More cardiac procedures are performed at St. Francis than at any other hospital in New York State. The hospital is located on the North Shore of Long Island; approximately 30 minutes from Manhattan. The hospital combines unrivaled expertise in cardiovascular medicine with top-ranged nursing (AACN Magnet Award) to provide the very best in patient care.
In addition, St. Francis offers excellent Thoracic, Vascular, Oncologic, Neurosurgical, and Orthopedic Surgical Programs. We have a very active Emergency Department. The hospital offers the latest in technologies such as Therapeutic Temperature Modification, Impella, ECMO and LVAD. Our excellent and experienced medical staff supports strong medical and surgical subspecialty programs.

Aside from Certified Critical Care Nurses, many who have more than 20 years of experience and are expert at caring for this complex patient population, we have a growing pool of Intensivist mid-level practitioners who work hand in hand with our Intensivist physicians to coordinate the care of the critically ill patient, minister to them and perform procedures.

Of course, a New York License is required. J1 or H1 VISAS accepted.
Additional Salary Information: Salary and benefits are competitive and commensurate with experience. Interested applicants, send resume to: dr.sorett@nassauchest.com


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

MSSNY Supports Dr. Jerome M. Adams’ Nomination as US Surgeon General

 
Above: MSSNY President Charles Rothberg, MD with Jerome Adams, MD

For Immediate Release

June 29, 2017

MSSNY Supports Dr. Jerome M. Adams’ Nomination as US Surgeon General

Indiana State Health Commissioner Jerome Adams, MD, MPH, has been nominated as Surgeon General of the US by President Donald Trump.

Trained as an anesthesiologist, Adams has been outspoken about the risks of prescription opioid painkillers and the need to address the opioid epidemic. Dr. Adams took the helm at the Indiana Health Department in October 2014. Just a month later, the first cases of what would later be recognized as a full-blown HIV outbreak were detected in the community of Austin in southeastern Indiana. The virus was being spread primarily by intravenous drug users sharing needles to inject the prescription opioid oxymorphone. In 2015, Dr. Adams worked to persuade then Governor Michael Pence to authorize an emergency needle exchange for 30 days, although Governor Pence was morally against needle sharing.

MSSNY President Charles N. Rothberg, MD, stated, “Dr. Adams has a proven track record to make public health a priority despite political hurdles. He is reminiscent of  Dr. C. Everett Koop (US Surgeon General, 1982-1989), who was a champion of public health.  Dr. Adams is in touch with the public needs.”

Dr. Adams wrote in May 2015, “We are building a model for prevention and response should this type of outbreak happen in other communities in the US. I would like nothing better than to tell you this unprecedented HIV epidemic will never happen anywhere else. But I can’t do that.”

In July of 2016, Indiana joined the list of states with standing orders for naloxone, the antidote to revive people who overdose on opioids. Subsequently, Indiana, residents can go to registered pharmacies, nonprofit organizations, and health centers and get naloxone without needing a prescription.

In 2016, Dr. Adams gave a presentation on fighting the spread of hepatitis C and HIV at the National Rx Drug Abuse & Heroin Summit in Atlanta.  He said in his presentation, “Speak to your audience in their language. To change behavior, public health program workers need to confront ignorance and denial, conduct small pilot programs, and use successes to gain support.”

 

Dr. Adams earned bachelor’s degrees in biochemistry and biopsychology from the University of Maryland in 1997. He then earned a master’s degree in public health from the University of California at Berkley, and a medical degree from the Indiana University Medical School. He has been a researcher at medical schools in both the Netherlands and Zimbabwe and has worked under Nobel Prize winner Dr. Tom Cech.

Dr. Adams is married and has three children.

# # #

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

Press Contact:
Roseann Raia
Media and Marketing Relations
Medical Society of the State of New York
865 Merrick Avenue
Westbury, New York 11590
Phone:  516-488-6100 ext. 302
email: rraia@mssny.org

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