US House of Representatives Seeking to Reduce Medical Liability Costs

For Immediate Release



June 28, 2017

MSSNY Applauds US House of Representatives for Seeking to Reduce Medical Liability Costs 

Statement from Charles Rothberg, MD, President, Medical Society of the State of New York:

“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 today be included in these efforts.”

# # #

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:
Julie Vecchione
Manager, Communications Division
Medical Society of the State of New York
865 Merrick Avenue
Westbury, NY 11590
516.488.6100 x 340
jvecchione@mssny.org

June 23, 2017 – Operating in Obscurity-Wrong, Wrong, Wrong!


PRESIDENT’S MESSAGE
Charles Rothberg, MD
June 23, 2017
Volume 17
Number 24

Dear Colleagues:

On Thursday, a medical liability expansion bill, fast-tracked by a select group of New York State Republican Senators was delivered to their peers amid a totally unacceptable veil.  While quite early to deconstruct this ‘failure’ for the house of medicine, some important lessons are evident.

Healthcare is such a vital issue to the people of our nation that any legislative endeavor regarding this complicated topic deserves to be thoroughly scrutinized to assure it provides the highest standards possible prior to its enactment.

In that spirit, I must question how it is that any bill be considered if it has not been made available for public review and comment prior to its presentation on the floor of the Senate, or worse—after it has been voted into law?

To operate in obscurity is wrong. The public wants to know what doctors think. With rare exception, the public still trusts us to protect their interests—especially their health.

In that spirit, the MSSNY Council considered the manner in which the United States Senate has been crafting its ACA replacement – behind closed doors!  While the Senate did (finally) release the language of the bill just yesterday, it plans to vote as early as next week, an unreasonably short time for public—let alone expert comment.  It was the consensus of the MSSNY Council to advise Congress and the public of our desire to review and comment on health legislation, and to recommend that a similar position be taken by the American Medical Association.

Political Not Medical

I should say that at certain times, such as deliberations regarding investigations or national security, “closed door” deliberation may be appropriate. But in health care deliberations, the motive of closed-door deliberation is purely political. The result will be a political rather than a medical solution—not likely the best service to our sector or to the public we serve.

Our objections to the closed door manner of the Senate proceedings on health care is being disseminated to our entire physician membership, our patient population, and all media to advise the population-at-large of our concerns for their health and welfare—today and in the future.

Expansion of Liability Issue

Our position on the statute of limitations expansion bill that was passed on Wednesday is that it is a poor solution. We still require comprehensive laws to serve all stakeholders in the long term.

Lavern Wilkinson (of Lavern’ Law) was treated at a public hospital, a venue that enjoys a shortened 15-month statute of limitations.  The remedy for Laverne could have extended the statute for public hospitals to 30 months (like all non-public venues).  But instead, the new law unnecessarily expands liability for all physicians and all hospitals. There is major dysfunction operating here

You may recall that in 2008-2009, the New York Medicaid Redesign Team delivered 79 recommendations, including medical liability reform. Originally, MRT was to be enacted as a package up or down.  But ultimately only one provision was excluded, tort reform. The other 78 became law and the genesis of DSRIP!

Both the Senators in Washington and those in the New York legislature cross paths in their exclusion of input from the major healthcare stakeholders—physicians and hospitals.

1) We urge Governor Cuomo to veto this legislation and to then bring parties together to pass comprehensive, not one-sided medical liability reform.   

2) We urge congress to solicit, not exclude input from the local health care experts – our physicians.

Sincerely,
Charles Rothberg, MD
MSSNY President

Please send your comments to comments@mssny.org



Dear Physicians: 

As you may be aware, the State Legislature ended its formally scheduled 2017 Legislative Session late Wednesday (though it is possible for them to return to Albany on a limited basis).  Despite being besieged with numerous adverse proposals in the final weeks of Session, we are happy to report that the Session ended with MSSNY, working together with many other allies, able to assure that the scores of the adverse legislative proposals were rejected, including legislation that would have:

  • Enabled corporate-owned Retail Clinics staffed by physician extenders
  • Significantly expanded the information required to be included in the Physician Profile
  • Limited injured worker choice of physician in Workers Compensation, expanded the role of Non-Physicians under Workers Compensation, and eliminated the county medical society role in processing applications
  • Imposed burdensome new requirements on the prescribing of pain medications to patients;
  • Required urgent care  office –based surgery centers to use electronic health records
  • Expanded the scope of practice of numerous non-physicians, including podiatrists, Nurse-anesthetists, optometrists, psychologists, chiropractors, and naturopaths; and
  • Formally permitted non-physicians to perform laser hair removal with virtually no physician oversight. 

Moreover, working with many other public health groups, we scored an important public health victory by assuring that e-cigarettes are regulated similar to other tobacco products. 

However, as you will note below, we are very disappointed that the Legislature chose to pass a one-sided liability expansion bill at a time when physicians and hospitals already face exorbitant liability costs, and potentially significant cuts from Washington.  With Governor Cuomo waging on aggressive public campaign to warn the public about the threat to our health care system and New Yorkers generally if cuts arising from various proposals to repeal the ACA are enacted, please let him know that further increases in liability costs would make these health care access problems even worse. 

We thank the many of you who responded to our call throughout the Session to contact your legislators when requested. 

Sincerely,

Your MSSNY Division of Government Affairs Team

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 Click Here:

urging that he veto a purported “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 instead he work towards enacting comprehensive medical liability reform.

The 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 the premium increase needed for this legislation (if signed) from the 15% projected to be needed for an earlier version of this bill, there is great ambiguity in the language that could generate significant litigation as to which cases it would apply.    Moreover, the bill does not just apply to cases that may arise in the future but has a retroactive impact. The ambiguities are likely the result of the bill being “rushed into print” late Sunday night to meet the constitutional “3-day aging” requirement before a bill can be considered by the Legislature, as the Legislature was planning to adjourn its 2017 Session Wednesday.

The bill passed the State Senate by a 56-6 vote (those voting no included Senators Hannon, Klein, Murphy, Ortt, O’Mara, and Valesky) and the Assembly by a 112-27 vote (to see how your Assembly member voted, Click Here:

In response to the passage, Dr. Rothberg issued the following statement (Click Here) expressing MSSNY’s great concerns with proposals to expand liability when are in desperate cost decreases:

“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.”

  • Rothberg’s concerns here noted in both the Daily News and Crains Health Pulse.

We thank all of you who took the time to contact their legislators over the last several days to oppose these and the myriad of other liability expansion bills that were also being aggressively pushed by the Trial Bar in the Session’s final days (for example, the attorney contingency fee limit removal was also under serious consideration but was defeated: Click Here.

Again, please urge the Governor to veto the bill and encourage your colleagues to do the same! Please let the Governor how patient access to care will be harmed if this bill were to be enacted.   (DIVISION OF GOVERNMENTAL AFFAIRS) 

New York State Legislature Approves Bill Banning E-Cigarettes From Bars, Restaurants
The New York State Legislature has approved A. 516A/S. 2543A expanding the state’s Clean Indoor Air Act so that it now bans e-cigarettes from bars and restaurants.  Assembly member Linda Rosenthal and Senator Kemp Hannon were the sponsors of the measure.  The Medical Society of the State of New York strongly supported this measure and worked with other health organizations on the bill’s passage.  Governor Andrew Cuomo, who proposed the measure in his budget earlier this year, is expected to sign the bill.        (CLANCY)

Legislature Does Not Take Up Retail Clinic Legislation
The Legislature ended its regularly scheduled session Wednesday night without taking action on legislation strongly opposed by MSSNY (A.958, Paulin) that would permit corporate-owned retail clinics, which would have veered New York away from its long history of opposition to corporately owned care delivery.    Big box store interests were aggressively pursuing this legislation.  The bill advanced from the Assembly Health Committee to the Assembly Codes Committee earlier this year, but moved no further. This legislation was also opposed by the New York State Nurses Association.
(AUSTER)                 


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


Anti-Physician Workers Compensation “Reform” Proposals Not Taken Up
The Legislature left Albany without taking action on legislation (A.8387, Pretlow and S.6349, Alcantara)   that could have significantly impaired injured workers access to care from WC-authorized physicians including giving greater discretion to the Board to penalize physicians, expanding the scope of numerous non-physicians to treat injured workers without requiring coordination with a physician, and limiting the ability of your county medical society to assist physicians in completing applications to become WC-authorized.

Moreover, MSSNY expressed concerns that the bill does nothing to address the myriad of administrative hassles that physicians have experienced with the Workers Compensation system that have forced many physicians to leave the program.  Similar legislation was considered during negotiations of the State Budget, but was ultimately rejected.   Discussions on this topic are likely to continue over into next year.
(AUSTER, BELMONT)

Legislature Does Not Take Up Bill to Empower Non-Physicians to Perform Laser Hair Removal
The Legislature left Albany without taking action on legislation (S.6088-A, Savino/A.7977-A, Paulin) to expressly permit estheticians and others to perform laser hair removal with only minimal physician oversight.  The bill, strongly opposed by MSSNY and other specialty societies, had advanced from the Senate Consumer Protection to the Rules Committee, but moved no further. 

MSSNY has adopted policy that vigorously opposes certification of non-physicians (including non-medical personnel) to perform laser and intense pulsed light source skin enhancement procedures.   That is because lasers have the potential to cause painful burns and permanent scarring if not used properly.  With laser hair removal largely unregulated in New York, legislation to provide strong physician oversight of this process would be appropriate.   However, the only physician oversight this legislation would have required is a once per year audit of policies and procedures.
(AUSTER)

Legislature Rejects Scope of Practice Changes
Working together with the affected specialty societies MSSNY was successful in convincing the legislature to reject various bills that would have expanded the scope of practice for various professions.  These bills include:

  • Certification of Certified Registered Nurse Anesthetists (CRNAs)

A.442 (Paulin) / S.1385 (Gallivan) – This measure would provide for the certification by the education department of certified registered nurse anesthetists (CRNAs).  Because this bill fails to define a scope of practice we had conserns that it could have given the Education Dept authority to enable independent practice for CRNA’s.

  • Broadens scope of practice of dentistry

A.4543 (Morelle) / S.3551 (Golden) – This measure would permit dentists to perform a wide range of medical surgical procedures involving the oral and maxillofacial area. This bill would expand the current scope of practice for dentist which is currently limited to the oral and maxillofacial area relating to restoring and maintaining dental health.

  • Podiatric Scope of Practice

A.1880 (Pretlow) – This bill would expand the scope of practice of podiatrists to allow podiatrists to “diagnose, treat, operate or prescribe for cutaneous conditions of the ankle to the level of the distal tibial tuberocity” (knee).

  • Allows PA’s to Operate Fluoroscopy Imaging Technology

A.4716 (Gottfried) -This bill would allow physician assistants (PAs) who have completed a training program approved by the Department of Education to operate fluoroscopy imaging technology as part of a diagnostic or treatment procedure.      

  • Psychologists Prescribing

A.2851(Mcdonald) / S.4498 (Lanza) – would permit Psychologists to prescribe medications
(BELMONT)

Assembly and Senate Pass Legislation Designed to Regulate Biosimilar Substitutions
The Assembly and Senate passed legislation (S.4788-A/A.7509-A) this week that would establish rules regarding the substitution of interchangeable biological products.  While New York State law regulates the substitution by pharmacists of generic drugs for their branded counterparts, the existing law has not been updated to set forth the circumstances under which a biologic products can be substituted with a FDA approved interchangeable biologic.  Importantly, it would prohibit a pharmacist from substituting an interchangeable biological product (as defined by the FDA) prescribed by a physician if the physician affirmatively requests that the product be dispensed as written.

If the physician does not specify that the biological medication should be dispensed as written, then the pharmacist may substitute an interchangeable biological product but only if the pharmacist provides notice to the physician within 5 days of the substitution.  It would also establish a 5-year sunset on these provisions.
(AUSTER)

New York State Legislature Approves Bill Allowing Medical Marijuana For Treatment Of PTSD
The New York State Senate approved legislation A.7006/S.5629, sponsored by Assembly member Richard Gottfried and Senator Diane J. Savino, that allows medical marijuana to be used to treat post-traumatic stress disorder [PTSD].  The Assembly had passed the bill in May.  The measure now heads to Gov. Andrew M. Cuomo for signature.  The Medical Society of the State of New York opposes the use of marijuana in treatment for PTSD.  Furthermore, MSSNY has expressed concerns about the law due to possible federal prosecution of physicians.
(CLANCY)  

Public Health Issues
Sepsis Awareness Program –   The New York State Legislature has passed a bill which would establish a sepsis awareness, prevention and education program to educate students, parents and school personnel about sepsis awareness on sepsis has passed the state Assembly.

This measure, A. 6053/S.4971, sponsored by Assemblywoman Catherine Nolan and Senator Carl Marcellino, also amends New York State’s amends Public Health Law to require that information on  sepsis  be part of course work in infection control practices already taken by all healthcare providers and would require that this coursework be completed on or before July 1, 2022. 

Raise the Age for Tobacco Purchase—S.3978/A.273, which would increase the purchasing age for tobacco products from eighteen to 21 years of age remained in the Assembly Codes Committee and the Senate Finance Committee.   MSSNY continues to support this measure. 

Three Day Limitation on Pain Medication— There was no action taken on A. 7741/S.6246, sponsored by Assemblyman John McDonald and Senator Kemp Hannon, which would have limited the initial prescription of a Schedule II or III for the alleviation of acute pain from a seven-day supply to a three-day supply for someone suffering from acute pain.  Most importantly, patients throughout New York State who are suffering acute pain, such as acute postoperative pain; acute back or chest pain; acute pain related to an injury, post-herpetic neuralgia, or acute pain related to disease or condition, could be significantly impacted. The Medical Society of the State of New York continues to strongly oppose this measure.

Conversion Therapy—A.3977/S.263, sponsored by Assemblywoman Deborah Glick and Senator Brad Hoylman, would prohibit mental health professionals from engaging in sexual orientation change efforts with a patient under the age of eighteen years and expands the definition of professional misconduct with respect to mental health professionals.   The measure had passed the New York State Assembly, but remained in the in the Senate’s Mental Health and Development Disabilities Committee.    (CLANCY)  

Bill Passes to Prohibit Medical Record Charges When Needed to Support a Patient’s Government Benefit Application
The Senate and Assembly passed legislation (S.6078, Valesky/A.7842, Gottfried) that would prohibit health care providers and entities from charging patients for copies of medical records when such records are needed “for the purpose of supporting an application, claim or appeal for any government benefit or program”.

The purpose of the legislation is to respond to numerous complaints lodged by patients where they were charged for medical records necessary to assist applications and appeals for government programs assisting lower income patients such as Social Security Disability Insurance (SSDI) and the Supplemental Nutritional Assistance Program (SNAP), despite provisions in existing law that prohibit charging a fee for medical records where a patient is unable to pay.

MSSNY had expressed concerns that the terminology “any government benefit or program” was too broad, and suggested that the bill be amended to identify specifically those low-income government benefit programs to which this fee prohibition should apply.  However, that change was not made.                                                                                                              (AUSTER)

US Senate Releases Its Own Health Care Reform Proposal
The US Senate this week released its own proposal to repeal substantial portions of the Affordable Care Act, entitled the “Better Care Reconciliation Act of 2017”, with a vote possibly before the July 4 recess.

While the framework of the legislation mirrors the American Health Care Act (AHCA) passed in May by the US House of Representatives, there are some important differences, including with respect to the length of time for the existing Medicaid expansion to be phased out, as well as the distribution of the tax credits to be provided to subsidize the cost of health insurance coverage.

The bill would continue the current tax credit structure provided under the ACA through 2019.  Beginning in 2020, advanceable refundable tax credits would be available for those with incomes up to 350% FPL, down from the existing 400% FPL.  It would not base the size of the tax credit on a person’s age, as was proposed in the House’s AHCA bill.  The benchmark for determining the subsidy would be based on 58% of a health insurance plan’s actuarial value.

Similar to the House’s AHCA legislation, it would contain provisions supported by MSSNY to eliminate the current limitations on a person’s contribution to their HSA, as well as delaying until 2026 enforcement of the “Cadillac Tax” on comprehensive health insurance coverage.

However, of significant concern, it would repeal existing cost-sharing subsidies similar to the AHCA.  That would have the effect of repealing funding for New York’s Essential Plan, which provides low out -of-pocket cost coverage for over 600,000 New Yorkers who make between 138-200% FPL.  It would also phase out from 2021-2024 the existing option to have Medicaid cover individuals who make unto 138% FPL.

Moreover, the bill also contains the “Faso-Collins amendment” contained in the AHCA that would shift $2.3 billion in county Medicaid costs to New York State, which could result in additional cuts or an expansion of risk-based payments in Medicaid to make up the difference.

Next week, Governor Cuomo will host a series of regional forums across New York State to discuss the potential impact of these proposals on New York’s health care system and its citizens. MSSNY Treasurer and Cobleskill Internist/Pediatrician Dr. Joseph Sellers will participate at the forum on Monday, June 26 in Hudson.  The Governor issued a statement on Thursday expressing great concerns with the US Senate’s proposal. MSSNY working together with the AMA and state medical societies across the country are continuing their review of this proposal and will follow up with more detailed information about this proposal and whether the Senate will be able to pass it.
(AUSTER)

CMS Proposes Simplifications to the MIPS Program to Ease Physician Compliance
This week CMS proposed a revised rule implementing the Medicare Quality Payment Program (QPP) as required under MACRA.  According to a summary provided by the AMA, CMS is proposing a number of policies to help small practices,  including a significant expansion of the “low-volume” exemption  threshold to $90,000 (up from $30,000) or less in Medicare Part B allowed charges OR 200 or fewer Medicare Part B patients (up from 100 patients).

CMS estimates that, under this proposed rule, more than 94% of eligible clinicians would earn either a positive or neutral payment adjustment.

In addition to increasing the low volume exemptions, other highlights articulated by the AMA include:

Additional accommodations for small practices

  • Creates virtual groups to assist small practices;
  • Adds 5 bonus points to the final MIPS scores for practices of 15 or fewer clinicians; and
  • Adds a hardship exception from the Advancing Care Information (previously Meaningful Use) category for practices of 15 or fewer clinicians.

Advancing Care Information Category

  • Allows the use of 2014 edition certified electronic health records technology (CEHRT) past 2017 – CMS will not mandate that physicians update their EHRs in 2018;
  • Permits physicians to continue to report on Modified Stage 2 measures in 2018 instead of new Stage 3 measures.

Quality Category

  • Increases the quality performance category weight to 60% in 2018 (due to the Cost category weight remaining at zero in 2018);
  • No additional cross-cutting measure requirements added in 2018;

Cost Category

  • CMS proposes a zero weight for costs again in the 2018 performance/2020 payment year, which would rise to 30% for 2019/2021.
  • Physicians will receive information on how they would have scored under the two current value-based modifier measures (total costs per beneficiary and spending from 3 days before to 30 days after hospital admission)

Improvement Activities (IAs)

  • CMS continues to allow physicians to report on IAs through simple attestation;
  • The proposed rule creates stability in program requirements by not changing the number of IAs physicians must report; and
  • It also develops additional IAs, including adding two activities related to diabetes prevention programs, and clarifies existing IAs to be inclusive of additional activities.
    For more information, Click Here.
    (AUSTER)


DOH Attestation Process for Pain Management CME Must Be Completed by July 1, 2017! One WEEK LEFT!
The New York State Department of Health has announced the attestation process for prescribers required to complete Pain Management CME. Prescribers must attest to the completion of the pain management, palliative care and addiction course work or training by July 1, 2017, and again every three years thereafter. The prescriber should only attest after completion of at least three hours of course work or training covering all eight topics.

A prescriber with a Health Commerce System (HCS) account will attest online using the Narcotic Education Attestation Tracker (NEAT) application.  Complete the steps to access the NEAT (Narcotic Education Attestation Tracker) application in the NYS Health Commerce System (HCS):

  1. Log into the HCS
  2. Under “My Content” click on “All Applications”
  3. Click on “N”
  4. Scroll down to NEAT (Narcotic Education Attestation Tracker) and double click to open the application. You may also click on the “+” sign to add this application under “My Applications” on the left side of the Home screen.

Complete the steps to ATTEST to the completion of the education requirement.   A full set of instructions can be found here.

Prescribers that do not have access to a computer can request a paper attestation form by calling the Bureau of Narcotic Enforcement (BNE) toll-free at 1-866-811-7957. They may then complete the form and return it by mail to the address provided in the form. The Bureau of Narcotic Enforcement has also released a Frequently Asked Questions (FAQs) on the prescriber mandate.   A copy of the FAQs can be found here. 

In certain limited circumstances, the New York State Department of Health may grant an exemption to the required course work or training to an individual prescriber who clearly demonstrates to the department that there is no need to complete such training.  Exemptions will be granted only in very limited circumstances, and not solely on the basis of

Economic hardship, technological limitations, prescribing volume, practice area, specialty, or board certification.

Prescribers may apply for an exemption through the Health Commerce System. Further information may be obtained by contacting BNE at 1-866-811-7957 or narcotic@health.ny.gov.  (CLANCY)

Physicians Have One Week To Meet the  Pain Management Mandatory Education By July 1, 2017
The Medical Society of the State of New York Pain Management, Palliative Care and Addiction modules are now available on-line here.  These modules are being offered free of charge to all MSSNY members.  Physicians who are new users to the MSSNY CME site will be required to register as a new user.

As a new user, physicians and non-physicians will be required to enter fields that include: position; name (the name should be what you want to appear on the CME certificate); email  address; and then create a password.  MSSNY members who encounter a payment page or have difficulty registering, please email cme@mssny.org for technical support.  Directions for creating a new account/or logging in can be found here.   Non-MSSNY physicians will be charged $50 per module. 

The MSSNY CME is a new site and while many MSSNY members have an account with mssny.org a MSSNY member may not necessary have an account with cme.mssny.org   If in doubt, try to create an account and if it tells you that the email address is unavailable or in use,  an account exists.   Passwords can be reset if you don’t know it. 

Physicians who have previously had an account at the MSSNY CME site will need to log into the site using their email and password. The MSSNY CME site provides the ability for physicians and other prescribers to view the archived webinar at their leisure, take the required test, and download their certificate. The online program covers all eight topics required in the New York State statute. MSSNY developed the program with the NYS Office of Alcoholism and Substance Abuse Services (OASAS).  MSSNY is listed as an accrediting organization by the NYS DOH Bureau of Narcotic Enforcement.   Information on the three CME modules is available here.  Additional information or technical support may be obtained by contacting cme@mssny.org.
(CLANCY)

pschuh@mssny.org mauster@mssny.org
pclancy@mssny.org jbelmont@mssny.org

enews large

Council Notes from June 22, 2017

  • Discussion of the effects in the near future of hospitals and physicians regarding the expansion of liability law
  • MSSNY Council Don Moy advised physicians that they should keep medical records dating back 10 years
  • MLMIC reported that the Berkshire Hathaway deal was moving forward without problems
  • MSSNY won two contested elections at the AMA –Dr. Robert Goldberg , DO, AMA Council on Medical Education; Jerry Cohen MD was reelected to the AMA Council on Constitution and Bylaws;and Meena Davaluri, MD was elected to the Resident slot on the Council on Medical Service. MSSNY now has seats on all AMA Councils that provide guidance on the policies being adopted. AMA Delegation Chair Dr. John Kennedy thanked the 38 delegates and alternates who came to the AMA Annual Meeting in Chicago.
  • Joe Sellers, MD, PAC Chairman said “too many doctors remain on the sidelines with fewer giving even more support” to the PAC. He said that “Doctor to Doctor” solicitation is the most effective was to recruit new PAC members and that the PAC would be happy to meet with small groups throughout the state in an effort to increase PAC membership.
  • Donald Moy, Lawrence Kobak and Thomas Gallo from Kern Augustine will be serving as MSSNY General Counsel.
  • MSSNY Task Force on Physician Stress and Burnout Chair Michael Privitera, MD, made recommendations on the Task Force’s findings for further research collaboration for data analysis
  • Parag Mehta, MD, Commissioner of Membership, presented a resolution about alternate types of memberships for Nonaffiliated Groups of Physicians

Anthem: Minor Conditions No Longer Covered in ED as of July 1
Anthem recently announced that as of July 1, it will no longer cover emergency department visits for most instances of minor conditions that could “safely [be] treated in less acute facilities.” Jay Moore, CMO for Anthem Blue Cross Blue Shield (BCBS) Missouri, said the policy has long been part of coverage contracts, but it has not always been enforced.

A spokeswoman for the insurer, Said its goal was to control costs by steering patients away from expensive ER services and toward doctor offices or urgent care clinics when those are more appropriate settings for treatment. She said the policy wouldn’t apply when the patient is 14 or younger, an urgent care clinic isn’t located within 15 miles, or the visit occurs on a Sunday or holiday. She said it’s aimed at manifestly minor ailments — “If you had cold symptoms; if you have a sore throat. Symptoms of potentially more serious conditions, such as chest pains, could be seen at the ER even if they turn out to be indigestion.” (CBS News & LA Times)

Buffalo Health Centers: ACA Will “Strip People of Their Health Insurance”
The Buffalo (NY) News (6/21) reports that “leaders of Kaleida Health, Erie County Medical Center and the University at Buffalo issued a joint statement this week warning that the bill, known as the American Health Care Act, ‘will ultimately make health care more expensive for patients, doctors and hospitals’” or “strip people of their health insurance, ‘either through prohibitively high premiums for people with pre-existing conditions, elimination of the Medicaid safety net or forcing patients into severely underfunded high-risk pools.’”

The group also said that two key areas of western New York’s economic recovery are medical education and biomedical research, to which “potential cutbacks that stem from the legislation will pose a challenge.”


MSSNY Members Only: Unpaid Claims
We Can Help!
In 2016, MSSNY’s Ombudsman Program was successful in recovering $89,815.79 for physicians who had reached a stalemate regarding unpaid claims. From January to June of 2017, the program recovered $121,441.68 for our members who availed them of the Ombudsman service.If you are a member in good standing, this service is available to you for FREE!For further information, call 516-4886100 ext. 334 or 332.



AMA: New Video Shows Physicians How to Avoid Medicare Payment Penalties
The AMA and the M are looking to help physicians avoid a negative Medicare payment adjustment in 2019—an effort that may be particularly relevant to physicians who have not previously participated in Medicare reporting programs, and/or physicians in smaller practices. The AMA has designated the week starting June 26, 2017 as Pick Your Pace Week, and will broadly disseminate simple instructions on how to report “one patient, one measure, no penalty.” The new materials, available on the AMA website, include:

  • A short video: One patient, one measure, no penalty: How to avoid a Medicare payment penalty with basic reporting.
  • A sample CMS-1500 claim form
  • Links to quality measures on the CMS website

A link to the CMS MIPS eligibility tool

Important Notice Regarding Handwriting on Claims Submitted to Medicare
Beginning 7/1/2017, NGS will return to the provider any paper claim submitted with handwriting on the face of the claim that is not a signature field, (i.e., Items 12, 13, or 31). A notice will be attached to the front of the returned claim and you will need to submit a new claim.

The Centers for Medicare & Medicaid Services (CMS) Internet-Only Manual (IOM) Publication 100-04, Medicare Claims Processing Manual, Chapter 26, Section 30, “Printing Standards and Print File Specifications Form CMS-1500” (700 KB) contains the printing specifications for the CMS-1500 claim form. These printing specifications do not provide instructions to submit handwritten claims. Please use this CMS IOM reference to ensure you are completing paper claims correctly.

We understand this may require some substantial changes to your office practices and we at NGS have two alternatives to handwritten paper claims that would be of little cost to your practice:

NGSConnex is our web-based self-service portal, free of charge, and available through Internet access. You can login to NGSConnex and submit claims to us. In addition to claims submission, NGSConnex has other useful functions like verifying Medicare entitlement, submitting appeals on claims, and viewing and downloading your remittance advice. Take this opportunity to get started on NGSConnex today!

Electronic claim submission and other transactions submitted electronically process considerably faster than paper submission. The Electronic Data Interchange (EDI) page on our website, explains how to enroll and what capabilities your office needs to be able to submit electronic claims.

$7M in Overpayments on Electronic Submissions; Recovery Attempt Expected
In the attachment please find the latest report from the Dept. of Health and Human Services, Office of the Inspector General, regarding their recently completed analysis of the Electronic Health Record Incentive Program. The report basically outlines their approach in reviewing the program through which participants received billions in incentive payments for adoption of electronic health records.

They are now asserting that upwards of $729,424,395 (amount reached through extrapolation) of those payments could have been made in situations that did not actually meet the necessary requirements of the program. Therefore, you should be aware that a recovery attempt might be undertaken to get back some of those funds previously paid out to early adopters.  More information here.

Only 25% of Youth with Opioid Use Disorder Receive Buprenorphine or Naltrexone
According to a JAMA Pediatrics study, only 25% of youth with opioid use disorder receive buprenorphine or naltrexone. Guidelines from the American Academy of Pediatrics recommend that clinicians consider offering pharmacotherapy to adolescents with opioid use disorder. Using a health insurance database, researchers tracked the treatment of youth aged 13 to 25 who were diagnosed with opioid use disorder between 2001 and 2014.

The proportion of patients with opioid use disorder who received buprenorphine or naltrexone increased from 3% in 2002 to 32% in 2009, but by 2014 it had fallen to 28%. Meanwhile, prevalence of opioid use disorder in this age group rose more than fivefold.

The authors and editorialists both note that few pediatricians have the necessary waiver to prescribe buprenorphine. “These findings suggest that provision of [buprenorphine and naltrexone] is not keeping up with the growing need for these treatments among youth.”

Physicians Invited to Meaningful Use MIPS Webinar
Physicians are invited to CAPG Educational Series 2017 webinar with CMS, Advancing Care Information: How to Implement the New Meaningful Use Component of MIPS, on July 7. Space is filling quickly, so please make sure to reserve your place – register now! CMS will provide an overview of the substantive changes to the program from meaningful use to ACI. Additionally, CMS will answer audience questions on the specific ACI component of the Quality Payment Program.

CAPG will have its members cover key implementation steps for physicians and physician organizations starting on this important transition. Our members will tell the audience about the rationale behind their strategy and any implications this will have on their organization.

Please visit our Educational Series web page to learn more and register here for July’s webinar.

Register: CMS Webinar on Proposed Rule for Year 2 of the Quality Payment
Join CMS Webinar on Proposed Rule for Year 2 of the Quality Payment Program

On Monday, June 26 at 1:00 p.m. ET, the Centers for Medicare & Medicaid Services (CMS) will host an overview webinar on the Medicare Quality Payment Program Year 2 proposed rule.

Join the webinar to hear CMS policy experts provide an overview of proposed participation requirements for the second year of the Quality Payment Program.

Webinar Details:

  • Title: Medicare Quality Payment Program Year 2 Proposed Rule Overview
  • Date: Monday, June 26
  • Time: 1:00 – 2:30 p.m. ET
  • Registration page, click here.

Please note:

  • Space for this webinar is limited. Register now to secure your spot. After you register, you will receive a follow-up e-mail with step-by-step instructions about how to log-in to the webinar.
  • The audio portion of this webinar will be broadcast through the web. You can listen to the presentation through your computer speakers. If you cannot hear audio through your computer speakers, please contact CMSQualityTeam@ketchum.com.
  • There will be a Q&A session if time allows. However, CMS must protect the rulemaking process and comply with the Administrative Procedure Act. Participants are invited to share initial comments or questions, but only comments formally submitted through the process outlined by the Federal Register will be taken into consideration by CMS. See the proposed rule for information on how to submit a comment.


CLASSIFIEDS


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

STATUTE OF LIMITATIONS EXPANSION BILL

For Immediate Release

June 21, 2017

STATEMENT FROM MEDICAL SOCIETY OF THE STATE OF NEW YORK PRESIDENT, CHARLES ROTHBERG, MD
RE: STATUTE OF LIMITATIONS EXPANSION 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 were 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.”

# # #

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 Ave.
Westbury, New York
516-488-6100 ext 302
rraia@mssny.org

June 16, 2017 WIN, WIN for MSSNY at AMA


PRESIDENT’S MESSAGE
Charles Rothberg, MD
June 16, 2017
Volume 17
Number 23

Dear Colleagues:

The MSSNY delegation to the annual meeting of the American Medical Association has just returned from Chicago. Our efforts on behalf of our MSSNY members are important to maintaining a presence in ongoing federal and state affairs focused on medicine. Our team of 38 delegates and alternate delegates is led by John Kennedy, MD of Schenectady.

In addition to exhaustive days dealing with more than 200 reports and resolutions, there has been a major effort to assure that New York is well represented on the AMA Councils, which provide guidance on the policies being adopted. To this end, Robert Goldberg, DO was elected to the AMA Council on Medical Education. Bob’s background as Dean at Touro in NYC makes him particularly well suited to this four-year post. Tom Donoghue, once again, worked his magic to elect another MSSNY candidate to victory in a very tough race.

In addition, Jerry Cohen, MD was re-elected to the AMA Council on Constitution and Bylaws; Meena Davaluri, MD was elected to the Resident slot on the Council on Medical Service. She will be working alongside Tom Madejski, MD who already holds a seat on that important Council.

New York is also represented by MSSNY HOD Speaker Kira Geraci, MD who is an elected member of the AMA Council on Science and Public Health and Jacqueline Bello, MD who was re-elected to her seat on the Council on Medical Education. Finally, our delegation works closely with Willy Underwood MD, a MSSNY member and urologist at Roswell Park who holds a seat on the Council on Long Range Planning and Development.

MSSNY was also well-represented on the Reference Committees by Corliss Varnum, MD who chaired the Reference Committee on Public Health and Rose Berkun, MD who worked on the Reference Committee on Medical Practice.

Chicago is truly a great city but, candidly, our MSSNY Delegation does not get to see much of it. Our New York caucus usually begins at 7am and each delegation member has specific assignments to explain New York’s position at reference committee hearings and to represent our viewpoint to colleagues in other states. Usually our position prevails.

At a time when health care issues are “front and center” in Washington, it is critical that we effectively participate in helping steer the national discussion. This we do through our continued participation with the American Medical Association. As our groups, hospitals and private practices push for RVU production and taking time away from work becomes more difficult, we all owe a special thanks to our AMA team leader John Kennedy, MD and the MSSNY delegates and alternates who work on AMA issues on our behalf.

Thanks to MSSNY staffers Laurie Mayer and Michael Reyes for their hard work before, during and after the meeting.

Sincerely,
Charles Rothberg, MD
MSSNY President

Please send your comments to comments@mssny.org



Physicians Urged to Continue to Oppose Liability Expansion Bills
We need physicians to continue to contact click here their legislators to oppose several bills poised to move in the Legislature that could drastically increase the cost of medical liability insurance at a time when no increases can be tolerated. Even if you are employed by a health system, enactment of any of these bills could prompt serious cuts to your system.  These bills include:

  • Eliminating Contingency Fee Limits (S.6738/A8644) – Would remove the long-standing statutory limits on attorney contingency fees, which would undoubtedly lead to much more litigation, higher awards in medical liability actions, and potentially taking away from an award to an injured plaintiff. Actuaries have predicted that this bill could increase your liability premiums by over 10%
  • Lengthening the Medical Liability Statute of Limitations (A.3339/S.4080) – Would substantially lengthen the statute of limitations for medical malpractice actions by making it subject to a “date of discovery” of the alleged malpractice.  If enacted this bill could increase your liability premiums by 15%.
  • Expansion of Wrongful Death Actions (A.1386/ S.411) – Would greatly expand the categories of damages which a plaintiff may recover in a wrongful death action.  Actuarial studies have predicted that this bill could increase liability premiums by over 50%.; and
  • Prohibiting Ex-Parte Interviews of Plaintiff’s Treating Physician (S.243/A.1404) – would prohibit a physician’s defense counsel in a medical liability action from conducting an interview with the plaintiff’s treating physician. This bill would present significant issues for physicians in a medical liability action by limiting the opportunity to fully examine the plaintiff’s health condition to evaluate the merit of the plaintiff’s claim.

Please let your legislators know that the timing of these bills could not be worse. We now have multiple malpractice insurance companies operating in New York State that appear to be in serious financial jeopardy which can ill-afford to absorb the substantial costs of a brand new cause of action. Moreover there is a tremendous uncertainty in the NY healthcare delivery system as a result of legislation before Congress that could profoundly restructure Medicaid spending, and trigger huge cuts to our healthcare system. 

We thank the many physicians who have taken the time to respond to MSSNY’s “Call to Action”, but far more contacts are needed. MSSNY has been working closely with hospital associations and specialty societies to demonstrate our shared concerns regarding the serious adverse consequences to our healthcare system were any of such one-sided bills to be adopted, including placing advertisements in publications such as City & State and Politico-NY click here.
(DIVISION OF GOVERNMENTAL AFFAIRS)

Senate Passes Opioid Package; Discussions Continue Regarding Legislation To Combat Opioid Crisis
The New York State Senate passed a series of bills to address the state’s opioid epidemic and the package focuses on enforcement to hold drug dealers more accountable, regulates many synthetic opioids, and calls for expansion of treatment programs.   Many of the bills put forth in the Senate package do not have an Assembly sponsor.   It is anticipated that Governor Cuomo will also introduce an omnibus bill addressing the opioid crisis that will include greater access to treatment.   In the Senate package there are two bills that concern MSSNY.  The first bill, S. 5949 would require a physician to obtain written consent from a minor’s parent or legal guardian prior to prescribing opioids.

MSSNY is concerned that the bill does not take into account other sections of law, such as Public Health Law 2504, which define the circumstances when a minor may make health care decisions for themselves. The second bill, S.5670, would require that the prescriber provide counseling prior to issuing a Schedule II opioid prescription.  The Medical Society believes that patient education that would be required by this legislation is already being accomplished by the requirement enacted last year to have pharmacists provide education to patients at the time of filling the prescription.   Therefore, MSSNY believes that this legislation is unnecessary and duplicates efforts. To view the Senate package, click here. As the Legislature enters the final weeks, there are on-going discussions about legislation to address the opioid crisis.
(DIVISION OF GOVERNMENTAL AFFAIRS)           

Passage of Bill to Place E-cigarettes under the Clean Indoor Air Act Pending in Both Houses
Legislation, to place e-cigarettes under the Clean Indoor Air Act (CIAA) was recently amended to include the term “vape” and is on the floor in both houses.   Assembly Bill 516A/S.2543A,  sponsored by Assemblywoman Linda Rosenthal and by Senator Kemp Hannon, would apply the same protection for e-cigarettes that currently exist for tobacco products.  Concurrently, there is also legislation that would Raise the Age for Tobacco Purchase before the NYS Legislature. S.3978/A. 273, would increase the purchasing age for tobacco products from eighteen to 21 years of age.  It is now in the Assembly Codes Committee and is pending in the Senate Finance Committee.   MSSNY supports both these measures. In the final days of the legislative session, physicians are urged to send a letter in support of both these measures from MSSNY Grassroots Action Center (GAC) or can call their Senator at 518-488-2800. To send a letter, please click here.
(CLANCY)

Physicians Urged to Support Legislation Requiring Annual Report On Compliance with MH/SUD Federal and State Parity Laws
Physicians are urged contact their legislators to urge passage S.1156-A/A.3694-A which would authorize the superintendent of Department of Financial Services and the Commissioner of Health to expand the information and data that health insurers and health plans are required to submit to include additional information and data necessary to evaluate performance with respect to the implementation of New York State and Federal Mental Health and Substance Use Disorder (MH/SUD) parity laws.

Sponsored by Senator Robert Ortt and Assemblywoman Aileen Gunther, the legislation would require that the information collected be analyzed and used for the preparation of a parity compliance report in the “Consumer Guide to Health Insurers” issued annually by Department of Financial Services, in consultation with the Department of Health. While federal and state parity laws have been on the books for approximately a decade, there continues to be examples of disparate and unequal treatment of MH/SUD in a number of areas including among others utilization reviews, prior authorizations, medical necessity and network adequacy. The enactment of this legislation is imperative for continuing efforts to achieve full implementation of the parity laws and holding insurers and health plans accountable.   Physicians are urged to send a letter by clicking here
(AUSTER, CLANCY)


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


NYS Assembly Will Consider Tanning Ban
Next week, the New York Assembly is expected to consider and vote on A. 7218A/S5585A which would remove the procedures to grant 17-18 year olds access to tanning booth and would prohibit anyone 18 years or younger from using a tanning booth.  This bill is on the calendar in the Assembly and is still pending in the Senate Health Committee.   The measure is sponsored by Assemblywoman Ellen Jaffe and Senator Phil Boyle.  MSSNY supports this measure.(CLANCY)

Physicians Urged to Oppose Retail Clinic Legislation
As the Legislature enters its final few days, big box store interests are aggressively pursuing legislation strongly opposed by MSSNY (A.958, Paulin) that would permit corporate-owned retail clinics, which would veer New York away from its long history of opposition to corporately owned care delivery. Earlier this year, the bill advanced from the Assembly Health Committee to the Assembly Codes Committee despite opposition from several members of the Committee.   Physicians are urged to send a letter in opposition click here.
(AUSTER) 

Legislation Moving to Continue to Permit Limited Antitrust Immunity for Healthcare Collaboratives
Legislation (S.5342, Hannon/A.7748, Gottfried) passed the Senate this week that would extend through 2020 the authority of the Commissioner of Health to approve a Certificate of Public Advantage (COPA) that enables various health care providers to join in collaborative arrangements that otherwise may be prevented by federal and state antitrust laws. The bill has also advanced to the Assembly floor.

COPAs are designed to facilitate the ability of health care providers to engage in arrangements such as (but not limited to) mergers and clinical integration agreements that promote improvements in access to care and quality of care. The original law was enacted in 2011, but expired at the end of 2016.  In order for a group of health care providers to be awarded a COPA, the application must be reviewed by both the Department of Health and New York Attorney General. If it is approved, the arrangement is subject to ongoing State supervision.  So far, three entities have applied for receiving a COPA designation.  To read more, click here.
(AUSTER)

Please Oppose Workers Compensation Proposals to Expand Role of Non-Physicians and Remove County Society Assistance
As the Legislature enters its final days of the 2017 Session, legislation (A.8387, Pretlow and S.6349, Alcantara) remains under discussion that could significantly impair injured workers access to care from WC-authorized physicians including giving greater discretion to the Board to penalize physicians, expanding the scope of numerous non-physicians to treat injured workers without requiring coordination with a physician, and limiting the ability of your county medical society to assist physicians in completing applications to become WC-authorized.

Moreover, the bill does nothing to address the myriad of administrative hassles that physicians have experienced with the Workers Compensation system that have forced many physicians to leave the program. Similar legislation was considered during negotiations of the State Budget, but was ultimately rejected. Please contact your legislators to oppose these bills by sending a letter click here.
(AUSTER, BELMONT) 

Legislation to Expand Collaborative Drug Therapy Management Protocols Delayed
MSSNY shared our strong concerns on legislation, S.4296 sponsored by Senator LaValle, that would greatly expand existing law to allow pharmacists to enter into collaborative drug therapy management (CDTM) protocols with physicians or nurse practitioners to manage, adjust or change the medications of patients.  When the bill popped up on a senate committee agenda, MSSNY worked with the senate sponsor to delay passing the bill to work on our concerns.  If structured properly, these programs can be helpful to managing the treatment of a patient.  The current collaborative drug therapy law was originally established with a “sunset date” in 2015, and was extended by the State Legislature to continue until 2018.

However, this proposal goes well beyond this demonstration program to allow nurse practitioners to participate in the program and would allow up to fifteen community-practice sites where pharmacists and physicians or nurse practitioners may propose to enter into collaborative arrangements. Currently, only physicians are currently permitted to enter into such protocols within the hospital.

We are concerned that there has been no demonstration within a specific care setting in New York, such as in a hospital, that nurse practitioners have the sufficient pharmacology background to successfully work with pharmacists on managing patient medications on a large scale basis as is contemplated in this proposal.  By contrast, physician-pharmacist CDTM protocols were studied extensively following the enactment of New York’s law, which led to the Legislature extending the existing program in 2015.  As such, it would be premature to now add nurse practitioners.
(BELMONT)

Physicians Must Take Pain Management Mandatory Education By July 1, 2017, Just Two Weeks Away!
The Medical Society of the State of New York Pain Management, Palliative Care and Addiction modules are now available on-line here.   These modules are being offered free of charge to all MSSNY members.  Physicians who are new users to the MSSNY CME site will be required to register as a new user. As a new user, physicians and non-physicians will be required to enter fields that include: position; name (the name should be what you want to appear on the CME certificate); email address; and then create a password.  MSSNY members who encounter a payment page or have difficulty registering, please email cme@mssny.org for technical support.  Directions for creating a new account/or logging in can be found here.   Non-MSSNY physicians will be charged $50 per module. 

The MSSNY CME is a new site and while many MSSNY members have an account with mssny.org a MSSNY member may not necessary have an account with cme.mssny.org   If in doubt, try to create an account and if it tells you that the email address is unavailable or in use,  an account exists.   Passwords can be reset if you don’t know it.  Physicians who have previously had an account at the MSSNY CME site will need to log into the site using their email and password.

The MSSNY CME site provides the ability for physicians and other prescribers to view the archived webinar at their leisure, take the required test, and download their certificate. The online program covers all eight topics required in the New York State statute. MSSNY developed the program with the NYS Office of Alcoholism and Substance Abuse Services (OASAS).  MSSNY is listed as an accrediting organization by the NYS DOH Bureau of Narcotic Enforcement.   Information on the three CME modules is available here.  Additional information or technical support may be obtained by contacting cme@mssny.org.
(CLANCY)

DOH Attestation Process for Pain Management CME Must Be Completed by July 1, 2017! Just 2 Weeks Away!
The New York State Department of Health has announced the attestation process for prescribers required to complete Pain Management CME. Prescribers must attest to the completion of the pain management, palliative care and addiction course work or training by July 1, 2017, and again every three years thereafter. The prescriber should only attest after completion of at least three hours of course work or training covering all eight topics. A prescriber with a Health Commerce System (HCS) account will attest online using the Narcotic Education Attestation Tracker (NEAT) application.  Complete the steps to access the NEAT (Narcotic Education Attestation Tracker) application in the NYS Health Commerce System (HCS):

  1. Log into the HCS
  2. Under “My Content” click on “All Applications”
  3. Click on “N”
  4. Scroll down to NEAT (Narcotic Education Attestation Tracker) and double click to open the application. You may also click on the “+” sign to add this application under “My Applications” on the left side of the Home screen.

Complete the steps to ATTEST to the completion of the education requirement.   A full set of instructions can be found here.

Prescribers that do not have access to a computer can request a paper attestation form by calling the Bureau of Narcotic Enforcement (BNE) toll-free at 1-866-811-7957. They may then complete the form and return it by mail to the address provided in the form. The Bureau of Narcotic Enforcement has also released a Frequently Asked Questions (FAQs) on the prescriber mandate.   A copy of the FAQs can be found here. 

In certain limited circumstances, the New York State Department of Health may grant an exemption to the required course work or training to an individual prescriber who clearly demonstrates to the department that there is no need to complete such training.  Exemptions will be granted only in very limited circumstances, and not solely on the basis of economic hardship, technological limitations, prescribing volume, practice area, specialty, or board certification.  Prescribers may apply for an exemption through the Health Commerce System. Further information may be obtained by contacting BNE at 1-866-811-7957 or narcotic@health.ny.gov.
(CLANCY)

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

pschuh@mssny.org mauster@mssny.org
pclancy@mssny.org jbelmont@mssny.org

enews large

NYU Langone: Lawsuit Goes Up Against 1199 SEIU
NYU Langone Medical Center has pitted itself against the state’s largest health care union, 1199 SEIU, four of its chief hospital competitors and a collective-bargaining unit that represents 109 nonprofit hospitals and nursing homes.

In a lawsuit filed yesterday in Manhattan at the U.S. District Court for the Southern District of New York, NYU Langone alleges that 1199 SEIU and the League of Voluntary Hospitals and Homes of New York have forced it to make about $25 million in additional payments to the 1199 Benefit Fund for Health and Human Service Employees since it withdrew from the League on March 28, 2016. The payments cover medical, dental and disability benefits.

Other defendants in the lawsuit are Montefiore Medical Center, Mount Sinai Hospital, New York-Presbyterian Hospital and Northwell Health’s Long Island Jewish Medical Center.

The medical center said in the lawsuit that the League’s actions violated federal antitrust law. After the withdrawal, the League no longer represented NYU Langone in negotiations with the union, but the health system was still bound by a 2014 agreement concerning wages and benefits and required to pay dues, according to the complaint.

In August 2016, 1199 recalculated the rate NYU Langone was required to contribute to the Benefit Fund, using the methodology for non-League members, which were typically nursing homes and other non-hospital health care providers. The contribution rate for these employers was lower but had no cap, which resulted in much higher contributions for an employer with higher-paid employees like NYU Langone.

The lawsuit argues that the penalties harm competition in the New York City hospital market. NYU Langone is paying $25 million in extra benefit contributions it could otherwise spend on technology and new facilities that help it attract patients and spur its competitors to make investments, according to the complaint. (Crains, 6/16)

Dr. William Spencer Kicks Off Meningitis B Awareness Week at Press Conference
MSSNY’s William Spencer, MD addressed a June 12 press conference to kick off Meningitis B Awareness Week. MSSNY hosted the press conference in its Westbury offices in partnership with the Kimberly Coffey Foundation to urge parents to vaccinate their children to prevent Meningitis B, a potentially deadly, but preventable disease.

Both the New York State Senate and the New York Assembly recently declared June 12-16 Meningitis B Awareness Week. “The importance of vaccines begins in infancy and continues right through adulthood and MSSNY is committed to ensuring that all individuals receive immunizations,” said Dr. Spencer, a Pediatric Otolaryngologist and Suffolk County Legislator (18th District). “In 2015, MSSNY helped to successfully advocate for a law that required children entering 7th and 12th grades in all public and private schools in New York State be fully vaccinated against meningococcal disease types A, C, W and Y in order to attend school. The law does not require immunization of the Serogroup B meningococcal vaccine, but this vaccine is available for teens and young adults.”

Teen Girls: Fastest Rising Number of Torn Ligament Procedures
Jama Pediatrics reports a growing number of US athletes are getting operations to repair torn knee ligaments in a recently published in JAMA Pediatrics http://bit.ly/2ro9RlM The article suggests that  injury rates are “highest and rising fastest among teen girls.” The research on “private insurance data for 148 million US residents found that overall, the average annual” anterior cruciate ligament (ACL) “surgery rate climbed 22 percent from 2002 to 2014, when it reached 75 procedures for every 100,000 people.” But, “for teen girls…the average annual knee surgery rate rose by 59 percent during the study period to 269 procedures for every 100,000 people.” 

Five Ways for Physicians to Get Ready for New Medicare Cards
Medicare is taking steps to remove Social Security numbers from Medicare cards. Through this initiative the Centers for Medicare & Medicaid Services (CMS) will prevent fraud, fight identity theft and protect essential program funding and the private healthcare and financial information of our Medicare beneficiaries.

CMS will issue new Medicare cards with a new unique, randomly-assigned number called a Medicare Beneficiary Identifier (MBI) to replace the existing Social Security-based Health Insurance Claim Number (HICN) both on the cards and in various CMS systems we use now.   CMS will start mailing new cards to people with Medicare benefits in April 2018. All Medicare cards will be replaced by April 2019.

Based on feedback from healthcare professionals, practice managers and other stakeholders, CMS is developing capabilities whereby doctors will be able to look up the new MBI through a secure tool at the point of service. To make this change easier, there is a 21-month transition period where all healthcare providers will be able to use either the MBI or the HICN for billing purposes.

Therefore, even though your systems will need to be able to accept the new MBI format by April 2018, you can continue to bill and file healthcare claims using a patient’s HICN during the transition period. We encourage you to work with your billing vendor to make sure that your system will be updated to reflect these changes as well.

Beginning in April 2018, Medicare patients will come to your office with new cards in hand. CMS is committed to giving you information you need to help your office get ready for new Medicare cards and MBIs.

Here are 5 steps you can take today to help your office or healthcare facility get ready:

  1. Go to the CMS provider website and sign-up for the weekly MLN Connects® newsletter.
  2. Attend quarterly calls to get more information. We’ll let you know when calls are scheduled in the MLN Connects newsletter.
  3. Verify all of your Medicare patients’ addresses. If the addresses you have on file are different than the Medicare address you get on electronic eligibility transactions, ask your patients to contact Social Security and update their Medicare records.
  4. Work with us to help your Medicare patients adjust to their new Medicare card. When available later this fall, you can display helpful information about the new Medicare cards. Hang posters about the change in your offices to help us spread the word.
  5. Test your system changes and work with your billing office staff to be sure your office is ready to use the new MBI format.


Important Modification on E&M Exam Expectations for Expanded Problem Focused and Detailed Levels of E&M
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.

EmblemHealth Backlog Update
There will be delays for a short period of time in processing claims and responding to inquiries. EmblemHealth has hired additional staff to work on backlogs. As required by statute, claims processed past the prompt pay time frame will be paid applicable interest. You should see marked improvement within 60-90 days.  We apologize for this inconvenience.

One of the efficiency measures EmblemHealth has put in place is a change to the radiopharmaceutical claims process. Notification letters were sent to affected providers on February 28, 2017. Starting with claims for dates of service on or after June 1, 2017, you will no longer need to send an invoice for your GHI PPO/EPO claims to be paid when billing radiopharmaceutical codes. This change should allow your new claims to process faster and accurately.  If your staff is not already sending in these claims electronically, they will now be able to do so.

For radiopharmaceuticals, defined by Health Common Procedure Coding System (HCPCS) codes below,

EmblemHealth will pay health care professionals at Average Sales Pricing (ASP) plus 15%. If ASP pricing is not available, then the reimbursement rate is Average Wholesale Pricing (AWP) minus 15%:

  • A9500-A9700
  • A4641-A4647
  • Q9949-Q9969

If you have questions, please contact EmblemHealth’s Provider Call Center at 1-866-447-9717.


CMS Accepts Future Measures/Activities for 3 MIPS Categories until June 30
The Centers for Medicare & Medicaid Services� (CMS) Annual Call for Measures and Activities for the Merit-based Incentive Payment System (MIPS) track of the Quality Payment Program (QPP) is open until June 30, 2017.

CMS encourages clinicians, measure stewards, organizations, and other stakeholders to identify and submit measures and activities to be considered for the Quality, Advancing Care Information, and Improvement Activities performance categories of MIPS in future years.

Submission Details

Measures and activities should be relevant, reliable, and valid at the individual clinician level. To be considered, proposals must include measure specifications, related research, and background.

A final list of measures and activities for MIPS clinicians will be published in the Federal Register no later than November 1 of the year prior to the first day of the performance period. Please note that some Advancing Care Information measures finalized in the 2018 final rule may not take effect until 2020, depending on the functionalities and workflow changes needed for implementation.

For More Information Remember to review the Annual Call for Measures and Activities fact sheet to learn more and understand the process for submitting measures and activities for the MIPS performance categories. Please direct any questions on measure and activity submissions to the QPP Service Center at QPP@cms.hhs.gov.


CLASSIFIEDS


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

Medical Practice for Sale in Upscale Westchester Community
Successful well established (1984) and actively growing Internal Medicine/ Primary Care Practice conveniently located only 45 minutes from midtown Manhattan. Great Opportunity for established physician to expand his patient base or for entrepreneurial new graduate.  Lease assignable with option to renew.

Facilities / Business Details

Well known Professional Building with convenient free parking; ground/first floor location, handicap accessible. Contemporary office recently built and painted. Two large exam rooms; one consultation room/doctor’s office, lab, spacious receptionist area and large waiting room. As an independent practice, it provides an extremely appealing option for the patient that does not want to go to a huge impersonal multi-specialty group. Approximately 80% commercial payers; 20% Medicare. Doctor retiring but willing to stay on to introduce new physician to patients and assist in transition.

Asking Price: 
$175,000

Contact: rpcdb51@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


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


Paging Primary Care MDs Who Love Technology
98point6 is a Seattle startup who wants your input. We’re seeking practicing physicians to join our council and help shape the next generation of primary care. If the fusion of health care and technology inspires you, please apply here.

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

June 9, 2017 – Lavern’s Law Down to the Wire


PRESIDENT’S MESSAGE
Charles Rothberg, MD
June 9, 2017
Volume 17
Number 22

Dear Colleagues:

Thank you for answering our call.

Earlier this week, we sent out an urgent alert requesting physicians to contact their legislators to oppose several bills moving through the Legislature that could trigger drastic increases in medical liability insurance costs.  These include bills to change the nature of “wrongful death” awards and to greatly lengthen the medical liability statute of limitations to make it a “date of discovery” rule.

Of particular concern was an editorial in the Daily News this past Monday supporting changes to the Statute of Limitations that would likely trigger an immediate 15% increase in our liability premiums.  If you are employed, it would likely prompt significant cutbacks in your health system and/or other new financial pressures.

We immediately wrote to the paper to express our strong dismay that it would endorse a completely one-sided piece of legislation to greatly expand liability exposure, at a time when no new costs could be tolerated by our health care system.

We highlighted that physicians in New York City and Long Island already pay liability premiums that are among the highest in the country. And that New York has far more medical liability payouts than any other state, far exceeding states such as California, Florida and Texas, both cumulatively and per person.

We also noted the significant financial challenges facing some of the medical malpractice insurance companies operating in New York, as well potentially huge cuts our health care system could face in the years ahead as a result of proposals before Congress to repeal much of the ACA.

While well over 1,000 physicians answered out call to contact their legislators to oppose these adverse bills, many more contacts are needed.  If you have yet not called or written, please do so now here.

There are only two weeks left in the Legislative Session, a time when anything can happen.

Please let your legislators know how patient access to needed care could be harmed if physicians and hospitals would have to absorb enormous new overhead costs.

Please urge them to fight for comprehensive medical liability reform, instead of one-sided proposals.

Please do not wait to make these contacts.

Sincerely,
Charles Rothberg, MD
MSSNY President

Please send your comments to comments@mssny.org




Physicians Urged to Continue to Oppose Liability Expansion Bills
Physicians are urged to continue to contact their legislators (here) to oppose bills moving in the Legislature that could drastically increase the cost of medical liability insurance at a time when no increases can be tolerated.  We thank the many physicians who took the time this week to respond to MSSNY’s “Call to Action”, but more contacts are needed.  MSSNY has been working closely with hospital associations and specialty societies to demonstrate our shared concerns regarding the serious adverse consequences to our healthcare system were any of such one-sided bills to be adopted, including placing advertisements in “inside the Beltway” publications such as City & State and Politico-NY.

The timing of these bills could not be worse.  We now have multiple malpractice insurance companies operating in New York State that appear to be in serious financial jeopardy which can ill-afford to absorb the substantial costs of a brand new cause of action. Moreover there is a great uncertainty in the NY healthcare delivery system as a result of legislation before Congress that could profoundly restructure Medicaid spending.    Please urge you elected officials to oppose the following bills, all of which are before the full Assembly and can be voted on at any time:

Lengthening the Medical Liability Statute of Limitations (A.3339/S.4080) – would substantially lengthen the statute of limitations for medical malpractice actions and lead to enormous increases in the cost of liability insurance for physicians and hospitals.  If enacted this bill could increase your liability premiums by 15%.  

Expansion of Wrongful Death Actions (A.1386/ S.411) – would greatly expand the categories of damages which a plaintiff may recover in a wrongful death action.  Actuarial studies have predicted that this bill could increase liability premiums by over 50%. 

Direct Actions Against a Third Party Defendant (A.1500 / S. 412) – would permit a plaintiff to bypass the defendant he or she sued to collect a judgment from a third party defendant who or which had been sued by the defendant for contribution or indemnification as a result of the underlying action.  

Prohibiting Ex-Parte Interviews of Plaintiff’s Treating Physician (S.243/A.1404) – would prohibit a physician’s defense counsel in a medical liability action from conducting an interview with the plaintiff’s treating physician. This bill would present significant issues for physicians in a medical liability action by limiting the opportunity to fully examine the plaintiff’s health condition to evaluate the merit of the plaintiff’s claim.                                                   (DIVISION OF GOVERMENTAL AFFAIRS)

Governor Cuomo Announces Action to Protect New Yorkers’ Insurance Coverage Should ACA Be Repealed
Governor Cuomo announced earlier this week actions to be taken by the New York Department of Financial Services (DFS) and Department of Health (DOH) designed to protect New Yorkers from issues that could arise were legislation to be enacted by Congress that would repeal many of the protections contained within the Affordable Care Act (ACA).  Among the steps announced included:

  • Directing DFS to promulgate new emergency regulations mandating that health insurance companies do not discriminate against New Yorkers with preexisting conditions or based on age or gender, in addition to safeguarding the 10 categories of “Essential Benefits” guaranteed by the ACA;
  • Directing DOH to prohibit all insurers who withdraw from offering Qualified Health Plans on the State Health Insurance Exchange from future participation in any program that interacts with the Exchange, including Medicaid, Child Health Plus, and the Essential Plan; and
  • Finalizing regulations that will ensure that contraceptive drugs and devices are covered by commercial health insurance policies without co-pays, coinsurance, or deductibles

MSSNY President Dr. Charles Rothberg issued the following statement praising the Governor for taking this action to better ensure comprehensive protections for patients:  “We applaud Governor Cuomo for taking action to assure that New Yorkers are able to maintain comprehensive health insurance benefits were the ACA to be repealed by Congress.

However, such coverage could become an illusory benefit based upon provisions in the AHCA legislation that would have the effect of replacing existing “first dollar” coverage with tax credits.  The proposed tax credits would provide nowhere near the same level of coverage as is currently available.  We call on New York’s Congressional delegation to assure that any health reform package enacted in Washington expands, rather than reduces, New Yorkers’ access to comprehensive health insurance options.”  Dr. Rothberg’s comments were picked up in several AP articles (here and here) across the State, as well as Crains Health Pulse.
(AUSTER)

Physicians Urged to Oppose Retail Clinic Legislation
As the Legislature enters its final days, big box store interests are aggressively pursuing legislation strongly opposed by MSSNY (A.958, Paulin) that would permit corporate-owned retail clinics, which would veer New York away from its long history of opposition to corporately owned care delivery.  Earlier this year, the bill advanced from the Assembly Health Committee to the Assembly Codes Committee despite opposition from several members of the Committee.  The bill has not been officially introduced in the Senate, but versions have passed the Senate in previous sessions.  Physicians are urged to send a letter in opposition here.
(AUSTER)


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



Public Health Issues Pending in Final Days of the NYS Legislature
There are several public health legislative issues that physicians should be aware of in the final days of the NYS Legislative Session.   These include:

Placement E-cigarettes under the Clean Indoor Air Act— Assembly Bill 516, which would place electronic cigarettes under the Clean Indoor Air Act (CIAA) has passed the New York State Assembly.   The measure, sponsored by Assemblywoman Linda Rosenthal, would prevent the use of electronic cigarettes in public places and certain outdoor areas.   Its companion measure, S. 2543, sponsored by Senator Kemp Hannon, is on the calendar in the NYS Senate and can be voted at any time.

Raise the Age for Tobacco Purchase— S.3978/A.273, which would increase the purchasing age for tobacco products from eighteen to 21 years of age is in the Assembly Health Committee and the Senate Finance Committee.   MSSNY supports both these measures. Physicians are urged to send a letter in support of both these measures from MSSNY Grassroots Action Center (GAC) or can call their Senator at 518-488-2800. To send a letter, please click here.

Tanning Ban— A. 7218A/S5585A sponsored by Assemblywoman Ellen Jaffe and Senator Phil Boyle has moved out of the Assembly Health Committee to the Assembly Codes Committee.   This bill would remove the procedures to grant 17-18 year olds access to tanning booth and would prohibit anyone 18 years or younger from using a tanning both.   MSSNY supports this measure.  The bill is in the Senate Health Committee.

Three Day Limitation on Pain Medication— A. 7741/S.6246, sponsored by Assemblyman John McDonald and Senator Kemp Hannon would limiting the initial prescription of a Schedule II or III for the alleviation of acute pain from a seven-day supply to a three-day supply.  While the bill is still in the Assembly and Senate Health Committee, there is talk about an “opioid package” being enacted during the last days of session  The limitation proposed is not based on any clinical evidence that shows limiting medication is effective.  Most importantly, patients throughout New York State who are suffering acute pain, such as acute postoperative pain; acute back or chest pain; acute pain related to an injury, post-herpetic neuralgia, or acute pain related to disease or condition, could be significantly impacted. The Medical Society of the State of New York is strongly opposed to this measure.

Bill to Allow Parents to Sign A Religious Exemption for Immunization– A. 8123a/S.6141, sponsored by Assemblymember Richard Gottfried and Senator Martin Golden would expand the ability of parents to claim a “religious” exemption to avoid immunizing their children.  This bill has recently been amended and is the Education Committee of both houses.   Advocates for this measure are urging that this measure be brought to the floor.   New York State currently has religious exemption legislation and a functional regulatory structure.  Families who have true religious issues with immunization, can, and do meet the tenets of their religious beliefs within the context of current law.  This measure, however, would provide for huge expansion of this exemption by permitting parents to ask for this exemption without clearly stating the decision basis for such an exemption. Parent need only state that they are opposed to immunization for “religious” reasons.  MSSNY is strongly opposed to this measure and will work with other health organizations in opposition to this measure. 

Conversion Therapy—A.3977/S.263, sponsored by Assemblywoman Deborah Glick and Senator Brad Hoylman, would prohibit mental health professionals from engaging in sexual orientation change efforts with a patient under the age of eighteen years and expands the definition of professional misconduct with respect to mental health professionals.   The measure has passed the New York State Assembly and is in the Senate’s Mental Health and Development Disabilities Committee.   The Medical Society and the New York State Psychiatric Association are working together to secure passage of this measure.   Physicians are encouraged to go to the MSSNY Grassroots  Action Center (GAC) to send a letter to their Senator by clicking here

 Sepsis Awareness Program – A bill which would establish a sepsis awareness, prevention and education program to educate students, parents and school personnel about sepsis awareness on sepsis has passed the state Assembly.   This measure, A. 6053/S.4971, sponsored by Assemblywoman Catherine Nolan and Senator Carl Marcellino, would also amend New York State’s existing infection control CME requirement for health care professionals to require the inclusion of information regarding the  detection of  the signs  and  symptoms  of  sepsis  and would require that this coursework be completed before July 1, 2022.            
(CLANCY)

Please Call Your Legislators to Oppose Legislation to Further Empower Non-Physicians to Perform Laser Hair Removal
Legislation (S.6088, Savino/A.7977, Paulin) to expressly permit estheticians and others to perform laser hair removal with only minimal physician oversight advanced from the Senate Consumer Protection to the Rules Committee this week.  MSSNY along with other specialty societies have expressed their strong opposition to this legislation.

MSSNY has adopted policy that vigorously opposes certification of non-physicians (including non-medical personnel) to perform laser and intense pulsed light source skin enhancement procedures.   That is because lasers have the potential to cause painful burns and permanent scarring if not used properly.  MSSNY’s memo to the Legislature noted a 2013 article in the Journal of the American Medical Association that showed that, despite the fact that approximately only 1/3 of laser hair removal procedures are performed by non-physicians, 75.5% of hair removal lawsuits from 2004 to 2012 were performed by non-physicians, and that from 2008 to 2012, this percentage increased to 85.7%.

With laser hair removal largely unregulated in New York, legislation to provide strong physician oversight of this process is essential.   However, the only physician oversight this legislation would require is a once per year audit of policies and procedures.

Please call your legislators to oppose this bill.  Senate 518-455-2800.  Assembly 518-455-4100.
(AUSTER)

Please Take a Moment to Review Your Online Health Plan Participation Information Available Through New DOH Website
As previously reported, the New York State Department of Health, together with the NY State of Health, has announced the launch of the NYS Provider & Health Plan Look-Up, an online tool that consumers can use to look up the health insurance plans with which a physician 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.  Moreover, physicians seeking to assure the accuracy of the participation information about themselves made publicly available by a health insurance company would have to go to the website of each insurance company.

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. According to a recent MSSNY survey, over 50% of responding physicians indicated that they were inappropriately listed as a participating provider on a health insurer’s website.  MSSNY has argued that these inaccurate listings could result in a situation where an inadequate physician network appears to be more comprehensive, and thereby able to meet state requirements for network adequacy.

So far we have heard from several physicians who have indicated that some of the information posted on this site is inaccurate.  DOH has advised that 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 (https://pndslookup.health.ny.gov/contact), and complete the electronic form.  The issue will be routed electronically to the DOH and to the selected health plan(s) for review and follow-up.

Again, your involvement is essential in MSSNY’s efforts to ensure health insurance plans truly have comprehensive health insurer networks.                                                                                                             (AUSTER)

Support Legislation to Repeal Arbitrary Limits on Compensation Arrangements with Billing Vendors
The New York State Senate passed legislation this week supported by MSSNY that would  the eliminate the “one of a kind” New York law that prohibits health care practitioners from entering into contracts with practice management companies that use percentage-based billing arrangements.

At the April MSSNY House of Delegates meeting, a resolution was adopted calling on MSSNY to “work for repeal of the New York State law barring percentage-based payment arrangements between physicians and their billing agents” and, to “oppose efforts by state government officials to demand refunds from physicians based upon allegations that claims were submitted to Medicaid using percentage-based arrangements between physicians and their billing agents”.  This legislation would accomplish one of the goals of this resolution.  Identical legislation (A.193, Buchwald) has been introduced in the Assembly and referred to the Health Committee.  Physicians are urged to send a letter to their legislators in support of this legislation here.
(AUSTER)

MSSNY Joins Many Others Advocacy Groups to Oppose Harmful Medicare Part B Reimbursement Cuts
MSSNY joined nearly 300 other physician and patient advocacy associations across the country in a letter to HHS Secretary Dr. Tom Price to express strong concerns with proposals recommended by the Medicare Payment Advisory Commission (MedPAC) and Center for Medicare and Medicaid Innovation (CMMI) to reduce reimbursement for medications covered by Medicare Part B.  These medications are primarily provided to patients in physician offices.  The recommendation is similar to a proposal that was advanced by CMS last year.

The letter noted the appreciation for the leading role that Dr. Price played “last year to raise awareness of the harmful impact that the Obama Administration’s Part B Drug Payment Model experiment would have had on physicians and patients. This model is problematic for many reasons, including pushing mandatory, disruptive, and near-nationwide policy changes under the guise of a ‘demonstration’ that could have significantly hurt the sickest and most vulnerable patients.”  Furthermore, the letter noted concerns that, if Medicare Part B drug reimbursements were to be cut, “patients would be left with fewer locations where they could receive care, resulting in less access and higher costs”, as well as forcing patients to “require traveling a longer distance to receive care and would result in higher out of pocket costs, particularly in rural communities.”
(AUSTER)

Physicians Must Take Pain Management Mandatory Education By July 1,2017!  Just 3 Weeks Away!
The Medical Society of the State of New York Pain Management, Palliative Care and Addiction modules are now available on-line here. 

These modules are being offered free of charge to all MSSNY members.  Physicians who are new users to the MSSNY CME site will be required to register as a new user.  As a new user, physicians and non-physicians will be required to enter fields that include: position; name (the name should be what you want to appear on the CME certificate); email address; and then create a password.  MSSNY members who encounter a payment page or have difficulty registering, please email cme@mssny.org for technical support.  Directions for creating a new account/or logging in can be found here.   Non-MSSNY physicians will be charged $50 per module. 

The MSSNY CME is a new site and while many MSSNY members have an account with mssny.org a MSSNY member may not necessary have an account with cme.mssny.org   If in doubt, try to create an account and if it tells you that the email address is unavailable or in use,  an account exists.   Passwords can be reset if you don’t know it.  Physicians who have previously had an account at the MSSNY CME site will need to log into the site using their email and password.

The MSSNY CME site provides the ability for physicians and other prescribers to view the archived webinar at their leisure, take the required test, and download their certificate. The online program covers all eight topics required in the New York State statute. MSSNY developed the program with the NYS Office of Alcoholism and Substance Abuse Services (OASAS).  MSSNY is listed as an accrediting organization by the NYS DOH Bureau of Narcotic Enforcement.   Information on the three CME modules is available here.  Additional information or technical support may be obtained by contacting cme@mssny.org                                                  (CLANCY)      

DOH Attestation Process for Pain Management CME Must Be Completed by July 1, 2017! Just 3 Weeks Away!
The New York State Department of Health has announced the attestation process for prescribers required to complete Pain Management CME. Prescribers must attest to the completion of the pain management, palliative care and addiction course work or training by July 1, 2017, and again every three years thereafter. The prescriber should only attest after completion of at least three hours of course work or training covering all eight topics.

A prescriber with a Health Commerce System (HCS) account will attest online using the Narcotic Education Attestation Tracker (NEAT) application.  Complete the steps to access the NEAT (Narcotic Education Attestation Tracker) application in the NYS Health Commerce System (HCS):

  1. Log into the HCS
  2. Under “My Content” click on “All Applications”
  3. Click on “N”
  4. Scroll down to NEAT (Narcotic Education Attestation Tracker) and double click to open the application. You may also click on the “+” sign to add this application under “My Applications” on the left side of the Home screen.

Complete the steps to ATTEST to the completion of the education requirement.   A full set of instructions can be found here.

Prescribers that do not have access to a computer can request a paper attestation form by calling the Bureau of Narcotic Enforcement (BNE) toll-free at 1-866-811-7957. They may then complete the form and return it by mail to the address provided in the form. The Bureau of Narcotic Enforcement has also released a Frequently Asked Questions (FAQs) on the prescriber mandate.   A copy of the FAQs can be found here. 

In certain limited circumstances, the New York State Department of Health may grant an exemption to the required course work or training to an individual prescriber who clearly demonstrates to the department that there is no need to complete such training.

Exemptions will be granted only in very limited circumstances, and not solely on the basis of economic hardship, technological limitations, prescribing volume, practice area, specialty, or board certification.  Prescribers may apply for an exemption through the Health Commerce System. Further information may be obtained by contacting BNE at 1-866-811-7957 or narcotic@health.ny.gov.           (CLANCY)

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

pschuh@mssny.org mauster@mssny.org
pclancy@mssny.org jbelmont@mssny.org

enews large

PAI Launches Free MACRA QPP Physician Education Initiative
The Physicians Advocacy Institute (PAI), of which MSSNY is a Charter Member, has developed educational resources to help physician practices succeed under the Medicare Quality Payment Program (QPP), enacted as part of the MACRA law of 2015. This valuable information is for MEMBERS ONLY.

PAI is sharing this comprehensive array of resources free of charge to help any physician practice, regardless of its level of readiness or knowledge, assess its preparedness and determine the best approach to succeed under the MACRA QPP payment rules.

PAI collaborated with Healthsperien, a Washington D.C.-based health care consulting firm, to develop the resources, which are housed on the PAI website.

The resources include: Twenty-four stand-alone issue briefs – providing a comprehensive, detailed understanding of the program, including MIPS/APM tracks, reporting mechanisms and much more, including:

  • A “10-Step Guide” to Navigating the QPP for physicians with little understanding of the program
  • A searchable online FAQ resource with detailed answers to questions shared by Work Group members from your state associations
  • Five taped webinars and accompanying slide decks that allow physicians to learn more about specific aspects of the program

To access these resources and for more information about PAI, please visit the MSSNY website at www.mssny.org

Mount Sinai Residents Resist Signing New Contract without a Raise
Resident physicians at Mount Sinai St. Luke’s and Mount Sinai West have been locked in contract negotiations with their employer since October. They’re demanding a raise they say Mount Sinai has refused to put on the table. Instead, the health system has offered residents a one-time bonus of $850 during the three-year contract period, according to the Committee of Interns and Residents SEIU, the union representing the residents.Resident salaries at Mount Sinai are based on how many years they’ve been in their program.

They range from $62,682 for a first-year resident to about $80,000 for someone in their seventh year, according to CIR SEIU. New York-Presbyterian and NYU Langone pay residents similar starting salaries, while Northwell Health pays $68,500 to start, according to figures the union provided. (Crains 6/8)

Insurers Seek 16.6% Rate Hike in Individual Market in 2018
UnitedHealthcare is looking for the biggest premium rate hike in the downstate area in 2018, with a requested increase of 38.5% in the individual market. Overall, New York insurers are requesting an average rate increase of 16.6% in the individual market, and 11.5% in the small group market, according to the summary of rate requests the Department of Financial Services posted online Wednesday evening.
In the individual market, EmblemHealth is seeking a rate increase of 24.9%, Care Connect is seeking a 29.7% increase and Oscar is asking for an 11.1% hike.

Prepare Your Practice for Medicare’s Quality Payment Program (QPP) with CMS-Funded Technical Resources Webinar on June 15th at 5pm for NY Clinicians & Staff
CMS will be hosting a webinar on June 15th to provide an overview of some of the upcoming deadlines practices are facing to avoid payment adjustments under QPP and other CMS payment programs, and to provide an overview of the CMS-funded technical assistance available to assist them in successfully participating in QPP and in transforming their practices.

As you know, those practices that are successful can receive significantly higher reimbursement from CMS in the future, but many clinicians still have questions and concerns about this program, and are unsure where to go for help.

Please join our webinar on June 15th at 5pm.  We will be joined by CMS grantees and contractors that are funded to assist clinicians with QPP, and we will be sharing information about other available resources. The link for the webinar and dial-in information will be emailed to those who register a few days before the call.

Improvements to the Medicare Claims Appeal Process and Statistical Sampling
When: Thursday, June 29, 2017

Time:   1:00pm to 3:00pm EST

Target Audience: All Medicare Fee-For-Service providers

To register or for more information, visit MLN Connects Event Registration

A question and answer session follows the presentation.

Are you aware of recent regulatory changes to the Medicare claims appeal process? During this call, CMS and the Office of Medicare Hearings and Appeals (OMHA) discuss the HHS Medicare Appeals Final Rule, published on January 17, 2017. Learn about changes intended to streamline the administrative appeal processes, reduce the backlog of pending appeals, and increase consistency in decision making across appeal levels.

For an overview of the Final Rule, see the HHS fact sheet. Did you know that certain appeals pending at OMHA may be eligible for more efficient adjudication through statistical sampling? Learn about the expansion of this program based on feedback from the pilot phase and how your participation may advance the adjudication of your appeals.

June Workshop at MET Museum! Medicine at The Met: The Art of Seeing
​How can art help you enhance visual diagnostic skills, increase your capacity for presence and give you the the tools to communicate more effectively? Join us for ArtMed inSight’s Medicine at the MET: The Art of Seeing at the MET Museum on June 23, 2017 from 6 to 8.30 pm and June 24, 2017 from 5 to 7.30 pm. For more information and to register go to: http://artmedinsight.org/?page_id=606

Fair Health Features Fee Estimator on Local Healthcare Pricing
When making strategic decisions about pricing in the context of their local markets, providers in individual or small-group practices often are working in the dark. The FH Fee Estimator® is an affordable, easy-to-use online tool that sheds light on actual local market-level fees, procedure by procedure—and helps to inform decisions critical to a provider practice.

An FH Fee Estimator license provides access to current, reliable and independent fee-for-service charge data by specialty and geozip area—the same trusted benchmarks that payors nationwide frequently consult when establishing out-of-network fee schedules. (Geozips generally track to the first three digits of a zip code or groups of three-digit zip codes.)

Physicians and their practice managers have access to benchmark data for dentistry and over 40 clinical medical specialties, based on claims data from 493 geographic areas across the United States, updated twice a year. Access is provided to charge benchmarks from the 50th to 95th percentile for each procedure code/geographic area combination. Medicare facility and non-facility professional fees also are provided.

With just a few keystrokes, users select the specialties and geozips they are interested in, complete a payment and check-out process and then download their data or work with it online. Equipped with this data, providers and practice managers can:

  • Review and design fee schedules;
  • Evaluate network participation and inform negotiations with payors;
  • Investigate practice expansion to new geographic areas;
  • Project revenue associated with the purchase or lease of new equipment; and
  • Compare their own fees to regional market data and Medicare fees and much more.

For more information about the FH Fee Estimator-mail at info@fairhealth.org or call us at 855-301-3247, Monday through Friday, 9 am to 6 pm ET.


CLASSIFIEDS


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. ssonia@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

Medical Practice for Sale in Upscale Westchester Community
Successful well established (1984) and actively growing Internal Medicine/ Primary Care Practice conveniently located only 45 minutes from midtown Manhattan. Great Opportunity for established physician to expand his patient base or for entrepreneurial new graduate.  Lease assignable with option to renew.

Facilities / Business Details

Well known Professional Building with convenient free parking; ground/first floor location, handicap accessible. Contemporary office recently built and painted. Two large exam rooms; one consultation room/doctor’s office, lab, spacious receptionist area and large waiting room. As an independent practice, it provides an extremely appealing option for the patient that does not want to go to a huge impersonal multi-specialty group. Approximately 80% commercial payers; 20% Medicare. Doctor retiring but willing to stay on to introduce new physician to patients and assist in transition.

Asking Price: 
$175,000

Contact: rpcdb51@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


Paging Primary Care MDs Who Love Technology
98point6 is a Seattle startup who wants your input. We’re seeking practicing physicians to join our council and help shape the next generation of primary care. If the fusion of health care and technology inspires you, please apply here.


Ophthalmologist Part Time
Ophthalmologist needed to work at multiple nursing homes in all 5 boros except Staten Island. Part time or full-time position available.  Generous salary and incentives.Ttech provided. Opportunity to perform surgery, but not required. Please email cv to privacyssw@gmail.com


Multiple Physician Positions with DOHMH Office of School Health
Office of School Health is the largest program of the New York City Department of Health and Mental Hygiene (DOHMH). This bureau is responsible for managing the health issues and promoting the well-being of the over 1.3 million children and adolescents enrolled in New York City’s 1700 school buildings.

Positions with the Office of School Health (OSH) combine clinical skills and public health training. OSH focuses on child health, asthma prevention, obesity and nutrition, vision screening, dental care, mental health, reproductive health, and childhood disability. We collaborate with various city and community based agencies to provide social and academic services to address the needs of all New York City school children, especially those facing the most significant social, economic, and health challenges.

The Office of School Health is currently undergoing expansion. There is an immediate need for physicians with an expertise in pediatric, adolescent, or family medicine, with the capacity to utilize primary care skills set through a public health lens. OSH is also  interested in public health and preventive medicine graduates with programmatic, analytic, and social medicine skills.

The NYC DOHMH is reaching out to identify candidates for this recruitment. We are enlisting your help to nominate medical professionals who are committed to contributing their talents to improve health and academic outcomes in our schools. Please consider applying for these positions or passing these opportunities on to talented physicians among your own personal networks.

Attached are the American Academy of Pediatrics position statements on the role of the School Physician as well as the job description and recruitment flyers:

  • Adolescent School Health Physician, Family and Child Health/SH Reproductive/City Medical Specialist, Level: 01/Part-time/Flexible Work Schedule (20-35 hrs/week) To learn more about this position & apply, please submit your resume & cover letter to:https://a127-jobs.nyc.gov/ In the Job ID search bar enter: Job ID: 277208
  • Field Doctor, Bureau of School Health/SH Medical (pre-K-8 Programs or High School) City Medical Specialist, Level: 01/Part-time/Flexible Work Schedule (20-35 hrs/week) To learn more about this position & apply, please submit your resume & cover letter to:https://a127-jobs.nyc.gov/ In the Job ID search bar enter: Job ID: 265869
  • Supervising Medical Doctor,Bureau of School Health/SH Reproductive Health, City Medical Specialist, Level: 02/Part-time (35 hrs/week) To learn more about this position & apply, please submit your resume & cover letter to: https://a127-jobs.nyc.gov/ Job ID:  277026

Please list in your cover letter how you heard about this position (including name of the professional association, website, or individual who referred you). If you have questions, please contact Caroline Volel, MD, MPH at OSH@health.nyc.gov.


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

June 2, 2017 – VW Does EHR?


PRESIDENT’S MESSAGE
Charles Rothberg, MD
June 2, 2017
Volume 17
Number 21

Dear Colleagues:

This week, when the news broke about eClinicalWorks’ misdeeds, the phrase that immediately came to mind was “Volkswagen Does Electronic Health Records.”

The real story is EHR vendor eClinicalWorks has agreed to pay $155 million to resolve a False Claims Act lawsuit that alleged it gave customers kickbacks for publicly promoting its products. The fine stemmed from a whistleblower suit alleging that it falsely obtained certification for meeting certain criteria as part of the meaningful use EHR reimbursement program.

EClinicalWorks disputes the charges but said it settled anyway to avoid the “cost and uncertainty inherent in protracted litigation.”  Really?

This sounds fishy to me. Why would someone pay out a $155 million fine if they were not guilty? This outcome is an outrage. If a physician attempted such a scam, they would not be fined. They would go directly to jail and would never be able to reclaim their medical license.

The DOJ alleges that eClinicalWorks opted to add the 16 drug codes necessary for certification into its software rather than enable the product to access those from a complete database; failed to accurately record user actions with audit log functionality; did not always accurately record diagnostic imaging orders or conduct drug-drug interaction checks; and, finally, eClinicalWorks did not satisfy data portability requirements designed to enable doctors to transfer patient data over to other vendor’s EHRs.

“As a result of these and other deficiencies in its software, ECW caused the submission of false claims for federal incentive payments based on the use of ECW’s software,” the Vermont DOJ said.

Why do we try to privatize when firms are self-serving and do not hold public trust with sanctity? All they have to do is pay a fine when accused of willful wrongdoing.

By the way, the lawsuit was originally filed by whistleblower Brendan Delaney, who at the time was a software technician at the New York City Division of Health Care Access and Improvement. He will receive approximately $30 million as part of the resolution.

The vendor accepted terms in a 5-year settlement agreement that the Office of the Inspector General called innovative.  “eClinicalWorks must allow customers to obtain updated versions of their software free of charge and to give customers the option to have eClinicalWorks transfer their data to another EHR software provider without penalties or service charges,” the notice said. “eClinicalWorks must also retain an Independent Review Organization to review eClinicalWorks arrangements with healthcare providers to ensure compliance with the Anti-Kickback Statute.”

“This resolution demonstrates that EHR companies will not succeed in flouting the certification requirements,” said Acting U.S. Attorney for the District of Vermont Eugenia Cowles.

I think one already did succeed.

Sincerely,
Charles Rothberg, MD
MSSNY President

Please send your comments to comments@mssny.org


Crunch Time as the End of the Legislative Session Nears
The legislature will return to Albany next week.  With only three weeks left of session, we need to remain active in the legislative process.  The end of session usually brings a lot of negotiations and deals on various bills and regularly includes surprises. While it’s hard for us to predict the unpredictable, there are ways to get involved and tip the odds in our favor.  As we monitor bill introductions and meet with every legislator, our physicians must keep up on the most up- to-date information and important material to boost our efforts.  Our grassroots action network click here is filled with informational materials and ways to contact your legislators.  Please call, write and meet with your legislators before the end of session which is scheduled for June 21st.
(BELMONT)

Physicians Urged to Continue to Oppose Liability Expansion Bills
All physicians are urged to continue to contact their legislators (click here) to oppose bills moving in the Legislature that could drastically increase the cost of medical liability insurance at a time when no increases can be tolerated.  MSSNY has been working closely with hospital associations and specialty societies to demonstrate the health care community’s  shared concerns regarding the serious adverse consequences to our healthcare system were any of such one-sided bills to be adopted.

The timing of these bills could not be worse.  We now have multiple malpractice insurance companies operating in New York State that appear to be in serious financial jeopardy which can ill-afford to absorb the substantial costs of a brand new cause of action. Moreover there is a great uncertainty in the NY healthcare delivery system as a result of legislation before Congress that could profoundly restructure Medicaid spending.    Please urge you elected officials to oppose the following bills:

  • Lengthening the Medical Liability Statute of Limitations (3339/S.4080) – would substantially lengthen the statute of limitations for medical malpractice actions and lead to enormous increases in the cost of liability insurance for physicians and hospitals.  If enacted this bill could increase your liability premiums by 15%.  This bill is on the Assembly floor and can be voted on at any time.
  • Expansion of Wrongful Death Actions (A.1386/ S.411) – would greatly expand the categories of damages which a plaintiff may recover in a wrongful death action.  Actuarial studies have predicted that this bill could increase liability premiums by over 50%.  This bill is on the Assembly Codes Committee next week.
  • Direct Actions Against a Third Party Defendant (A.1500 / S. 412) – would permit a plaintiff to bypass the defendant he or she sued to collect a judgment from a third party defendant who or which had been sued by the defendant for contribution or indemnification as a result of the underlying action.
  • Prohibiting Ex-Parte Interviews of Plaintiff’s Treating Physician (S.243/A.1404) – would prohibit a physician’s defense counsel in a medical liability action from conducting an interview with the plaintiff’s treating physician. This bill would present significant issues for physicians in a medical liability action by limiting the opportunity to fully examine the plaintiff’s health condition to evaluate the merit of the plaintiff’s claim.
    (DIVISION OF GOVERNMENTAL AFFAIRS)


Please Urge Your Legislators to Enact Legislation to Address Prior Authorization Hassles and Expand Patient Choice of Physicians
With just a few weeks left in the Legislative Session, physicians are urged to contact their legislators to ask them to support legislation strongly supported by MSSNY to address prior authorization hassles imposed by health insurance companies, increase coverage for patients, and to limit the ability of health insurers to narrow their networks.  These bills include:

  • 3943 (Hannon)/A.2704 (Lavine) – would provide physicians and other health care practitioners with necessary due process protections where health insurers seek to terminate a physician from its network by failing to renew the physician’s contract.  The bill has passed the Assembly and was recently reported to the Senate floor. Please send a letter in support click here.
  • 3663 (Hannon)/A.4472 (Gottfried) – would permit independently practicing physicians to collectively negotiate patient care terms with market dominant health insurers under close state supervision. In addition to the ability to push back against exorbitant administrative hassles imposed by insurers, it would also help to protect physicians to have a stronger option to remain in independent practice. The bills have advanced to the Senate Finance Committee, and the Assembly Ways and Means Committee.  Please send a letter to your legislators in support click here.
  • 5675 (Hannon)/A.7671 (Rosenthal) – would require health insurers to make out of network coverage options available through the New York Health Insurance Exchange. Currently, there are no out of network coverage options in the Exchange in downstate New York, despite Exchange officials strongly encouraging the offering of these options by insurers.  The bills are in the Senate Health and Assembly Insurance Committee. Please send a letter to your legislators in support click here.    (DIVISION OF GOVERNMENTAL AFFAIRS)

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




Support Legislation to Repeal Arbitrary Limits on Compensation Arrangements with Billing Vendors
At the April MSSNY House of Delegates meeting, a resolution was adopted calling on MSSNY to “work for repeal of the New York State law barring percentage-based payment arrangements between physicians and their billing agents” and, to “oppose efforts by state government officials to demand refunds from physicians based upon allegations that claims were submitted to Medicaid using percentage-based arrangements between physicians and their billing agents”.  Legislation (A.193, Buchwald/S.2247, Hannon) has been introduced that would accomplish one of the goals of the resolution by eliminating the “one of a kind” New York law that prohibits health care practitioners from entering into contracts with practice management companies that use percentage-based billing arrangements.  The legislation has advanced from the Senate Health Committee to the Senate floor, and in the Assembly has been referred to the Health Committee.  Physicians are urged to send a letter to their legislators in support of this legislation click here.
(AUSTER)


Physicians Can Still Participate in NYS Meaningful Use Program Under Medicaid
The NYS Department of Health has sent out a notice that the deadline to register and report for Meaningful Use in the New York State Medicaid Electronic Health Records (EHR) Program is September 15, 2017.  This will be the last opportunity for physicians and other eligible professionals to join the program. Incentive payments to Eligible Professionals (EPs) are disbursed over the course of six participation years. EPs may receive up to $21,250 for the first participation year and $8,500 for each remaining participation year.   To participate in the EHR Incentive Program, you must have a certified EHR system, be enrolled as a fee-for-service New York Medicaid provider, and be registered with CMS.   Further information and to register may be obtained here.

MSSNY is seeking information from the DOH regarding the number of physicians participating in the Medicaid EHR program as well as the reasons why some physicians started in the program but did not continue.  
(CLANCY)


Need to Meet Your Pain Management CME Requirement?  MSSNY Pain Management, Palliative Care and Addiction Online Program Available
The Medical Society of the State of New York Pain Management, Palliative Care and Addiction modules are now available on-line here.

These modules are being offered free of charge to all MSSNY members.  Physicians who are new users to the MSSNY CME site will be required to register as a new user.  As a new user, physicians and non-physicians will be required to enter fields that include: position; name (the name should be what you want to appear on the CME certificate); email address; and then create a password.  MSSNY members who encounter a payment page or have difficulty registering, please email cme@mssny.org for technical support.  Directions for creating a new account/or logging in can be found here.   Non-MSSNY physicians will be charged $50 per module.

The MSSNY CME is a new site and while many MSSNY members have an account with mssny.org a MSSNY member may not necessary have an account with cme.mssny.org   If in doubt, try to create an account and if it tells you that the email address is unavailable or in use,  an account exists.   Passwords can be reset if you don’t know it.  Physicians who have previously had an account at the MSSNY CME site will need to log into the site using their email and password. The MSSNY CME site provides the ability for physicians and other prescribers to view the archived webinar at their leisure, take the required test, and download their certificate.

The online program covers all eight topics required in the New York State statute. MSSNY developed the program with the NYS Office of Alcoholism and Substance Abuse Services (OASAS).  MSSNY is listed as an accrediting organization by the NYS DOH Bureau of Narcotic Enforcement.   Information on the three CME modules is available here.  Additional information or technical support may be obtained by contacting cme@mssny.org .
(CLANCY)

 DOH Attestation Process for Pain Management CME Must Be Completed by July 1, 2017
The New York State Department of Health has announced the attestation process for prescribers required to complete Pain Management CME. Prescribers must attest to the completion of the pain management, palliative care and addiction course work or training by July 1, 2017, and again every three years thereafter. The prescriber should only attest after completion of at least three hours of course work or training covering all eight topics. A prescriber with a Health Commerce System (HCS) account will attest online using the Narcotic Education Attestation Tracker (NEAT) application.  Complete the steps to access the NEAT (Narcotic Education Attestation Tracker) application in the NYS Health Commerce System (HCS):

  1. Log into the HCS
  2. Under “My Content” click on “All Applications”
  3. Click on “N”
  4. Scroll down to NEAT (Narcotic Education Attestation Tracker) and double click to open the application. You may also click on the “+” sign to add this application under “My Applications” on the left side of the Home screen.

Complete the steps to ATTEST to the completion of the education requirement.   A full set of instructions can be found here.

Prescribers that do not have access to a computer can request a paper attestation form by calling the Bureau of Narcotic Enforcement (BNE) toll-free at 1-866-811-7957. They may then complete the form and return it by mail to the address provided in the form. The Bureau of Narcotic Enforcement has also released a Frequently Asked Questions (FAQs) on the prescriber mandate.   A copy of the FAQs can be found here.

In certain limited circumstances, the New York State Department of Health may grant an exemption to the required course work or training to an individual prescriber who clearly demonstrates to the department that there is no need to complete such training.  Exemptions will be granted only in very limited circumstances, and not solely on the basis of economic hardship, technological limitations, prescribing volume, practice area, specialty, or board certification.  Prescribers may apply for an exemption through the Health Commerce System. Further information may be obtained by contacting BNE at 1-866-811-7957 or narcotic@health.ny.gov.             (CLANCY)

MSSNY & NYSDOH Podcast: Current Concepts in Concussion for Pediatric and Adult Patients
MSSNY’s Continuing Medical Education pre-recorded podcast on Current Concepts in Concussion for Pediatric and Adult Patients is now available on the MSSNY CME webpage for your participation. Listen in on a discussion between Dr. John Pugh, assistant professor of Neurology at Albany Medical Center and Dr. Deborah Light, Director of the Sports Medicine Fellowship at Albany Medical Center while they share their expertise on topics including identifying symptoms indicative of concussion, outlining appropriate management plans, and methods for primary and secondary prevention of concussion.  Click here to listen to the podcast and fulfill the requirements to receive a certificate awarding 1 hour of CME.                                                                                           (HARRING)


Paid Family Leave Benefits Begin in 2018; Payroll Deductions Begin in July 2017
All physician employers should be aware that, beginning January 1, 2018, their employees who have worked for 26 or more consecutive weeks (or part-time for at least 175 days) will be eligible for Paid Family Leave (PFL), as a result of legislation enacted last year as part of the 2016-17 State Budget. Employees will be eligible to receive up to 8 weeks of paid leave in 2018, with this amount going up to ten weeks in 2019 and 12 weeks in 2021.   Premiums for the PFL program are fully funded through employee payroll contributions.

Employees are eligible for PFL benefits for a) maternity or paternity leave for birth of a child, b) caring for a close relative with a serious health condition or c) when a spouse, child, domestic partner or parent of the employee is on active duty or has been notified of an impending call or order of active duty.

Employers may begin to withhold the weekly employee contribution beginning July 1, 2017, for the coverage that begins on January 1, 2018.

For more information from New York State about this new program: click here.  For additional online summaries about this new law, you can review (click here) and (click here).                                                             (AUSTER)

Encourage your patients to listen to MSSNY’s podcast: “What Patients Need to Know About Zika”
The Medical Society of the State of New York has produced an audio podcast entitled “What Patients Need to Know About Zika”.  This audio podcast is available to individuals free of charge and provides New York State patients with important information on the Zika virus.  Individuals may listen to the podcast here:

Developed by MSSNY’s Committee on Emergency Preparedness and Disaster/Terrorism Response, the podcast has Dr. William Valenti, an infectious disease specialist, and Dr. Elizabeth Dufort, medical director, Division of Epidemiology, NYS Department of Health, discussing the Zika virus.  Topics covered in the podcast include general information about Zika, symptoms and treatment; sexual transmission; pregnancy risks; travel to countries where the virus is prevalent and prevention steps.

MSSNY Committee on Emergency Preparedness and Disaster/Terrorism Response has been developing educational programming on emergency preparedness for physicians and the health care community since 2001.  Partnering with the New York State Department of Health, MSSNY has conducted various educational webinars and online programs on topics ranging from Zika virus to pandemic flu.   Arthur Cooper, MD, MS is chair of the committee and Lorraine Giordano, MD is vice chair.   Physicians’ education is available on the MSSNY CME site at:  http://cme.mssny.org/

Additionally, MSSNY has also developed for physicians and health care providers an audio podcast discusses the epidemiology of Zika virus. It also provides information on disease transmittal, diagnosis and the measures that the New York State Department of Health has taken to guide and protect all New Yorkers.   This podcast is available here.
(HOFFMAN, CLANCY)


Register Now For The Next Medical Matters 2017 CME Webinar
The next “Medical Matters 2017” webinar is entitled “Mosquito Borne Diseases”.  On June 14, 2017, at 7:30am, MSSNY will present an update on Zika virus along with several other prominent mosquito-borne diseases.  Please register here.

William Valenti, MD, chair of MSSNY’s Infectious Disease Committee, and Elizabeth Dufort, MD, Medical Director, Division of Epidemiology from the New York State Department of Health will conduct this presentation.

The educational objectives for this live webinar are: 1) Identify the most prominent mosquito borne diseases, including chikungunya, dengue, West Nile virus, yellow fever and zika.  2)  Describe the epidemiology of mosquito borne diseases.  3)  Review modes of transmission and methods of prevention of infection.

The Medical Society of the State of New York (MSSNY) is accredited by the Accreditation Council for Continuing Medical Education (ACCME) to provide continuing medical education for physicians.  MSSNY designates this live activity for a maximum of 1.0 AMA PRA Category 1 Credits™.   Physicians should claim only the credit commensurate with the extent of their participation in the activity.                                                    (CLANCY, HOFFMAN)

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

pschuh@mssny.org mauster@mssny.org
pclancy@mssny.org jbelmont@mssny.org

enews large

New Medicare Cards Will No Longer Contain Social Security Numbers
CMS is readying a fraud prevention initiative that removes Social Security numbers from Medicare cards to help combat identity theft, and safeguard taxpayer dollars. The new cards will use a unique, randomly-assigned number called a Medicare Beneficiary Identifier (MBI), to replace the Social Security-based Health Insurance Claim Number (HICN) currently used on the Medicare card. CMS will begin mailing new cards in April 2018 and will meet the congressional deadline for replacing all Medicare cards by April 2019.

Health care professionals and beneficiaries will both be able to use secure look up tools that will support quick access to MBIs when they need them. There will also be a 21-month transition period where providers will be able to use either the MBI or the HICN further easing the transition.

CMS will assign all Medicare beneficiaries a new, unique MBI number which will contain a combination of numbers and uppercase letters. Issuance of the new MBI will not change the benefits a Medicare beneficiary receives.

CMS has a website dedicated to the Social Security Removal Initiative (SSNRI) where providers can find the latest information and sign-up for newsletters. CMS is also planning regular calls as a way to share updates and answer provider questions before and after new cards are mailed beginning in April 2018.

For more information, please visit here.


New Powerful Mobile ePrescribing App Available to MSSNY Members

The Medical Society of the State of New York (MSSNY) has partnered with DrFirst to offer MSSNY members a free one-year license of DrFirst’s  new mobile e-prescribing app, iPrescribe®.Optimized for mobile experiences on small screens, iPrescribe brings you the full power of e-prescribing in an intuitive interface that allows you to e-prescribe from anywhere.

  • Faster e-prescribing
    Prescribe legend drugs and controlled substances with just a few taps on your phone.
  • Smarter e-prescribing
    Access patients’ health insurance formulary and co-pay costs as you e-prescribe.
  • Safer e-prescribing
    Receive clinical alerts and consult the most robust medication history available in the industry.
  • Better e-prescribing
    Exchange secure messages with patients and your care team.

Sign up here by July 31st to receive a one-year free trial for iPrescribe. Enter MSSNY when prompted for a promo code. As part of this special offer for MSSNY members, DrFirst is waiving all costs associated with ID proofing and the cost of obtaining the two-factor authentication token required for controlled substance prescribing (EPCS). As an additional courtesy to MSSNY members, DrFirst will also facilitate the upload of patient data into the app.
To learn more about this limited-time offer visit our iPrescribe page.


NYS DOH Launches “Provider & Health Plan Look Up:” Check ASAP for Errors
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.

According to a recent MSSNY survey, over 50% of responding physicians indicated that they were inappropriately listed as a participating provider on a health insurer’s website.  One physicians who contacted us reported that he as listed as having 167 practice locations! 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.

This newly created DOH website is strictly limited to those physicians who have contracts to participate in a health plan’s network. If you participate in ONLY traditional fee for service Medicare/Medicaid or only in academia, this website is not for you! If you cannot locate your name on your initial search, please be sure to enter the county where you practice.

NY’s Medical Marijuana Program: Free Webinar June 20th, 2017 12-1pm
What all healthcare providers should know!

Please join the Garfunkel Wild law firm for a complimentary webinar and hear from two former high-ranking New York Department of Health (NYDOH) attorneys James E. Dering, former NYSDOH General Counsel and Sandra M. Jensen, former NYSDOH Acting Director of Bureau of House Counsel, both of whom who were involved with the implementation of the Medical Marijuana program.

With the growth and expansion of New York’s Medical Marijuana Program, its highly regulated nature, and recent changes to the program’s regulations, it is important for all healthcare providers to have an understanding of how the program works and its restrictions. This is important not only for practitioners who are considering registering with the program but those already registered so that they are aware of restrictions and rules on resident or patient use – – including new regulations with provisions specific to hospitals. Space is limited. Register here:


More Deaths from Alzheimer’s and More Occurring at HomeU.S. death rates from Alzheimer’s disease rose by about 55 percent between 1999 and 2014—with a growing percentage of such deaths occurring at home, according to a CDC report released last week. CDC said Alzheimer’s is the sixth leading cause of death in the United States, accounting for 3.6 percent of all deaths in 2014.

Medicaid Questions

    1. How do I reactivate Medicaid billing? Should I if I’m not doing Medicaid billing? 

Visit https://www.emedny.org/info/ProviderEnrollment/ If you are going to write scripts for a traditional fee-for-service Medicaid recipient or refer them for labs or x-rays, you need to have a Medicaid fee-for-service provider number so that you can Order & Refer.  Please understand that the pharmacy, lab, radiologist, etc. lists your number on their claim submission to Medicaid to show that their service was Ordered or Referred by you.  If your number is not active/valid, they will not get paid.

  1.    Do I need it for all of my Medicaid managed care billing?
    With Medicaid Managed Care (MMC), you are enrolled/contracted with a specific MMC plan(s).  Based on your enrollment/contract with that plan, you would have the plan’s active provider number.  So this would not affect those contract(s)/plan(s).


New Quality Payment Program Resources Available – and New Site Look
CMS has recently revamped the look of the Quality Payment Program website, and also posted new resources to help clinicians successfully participate in the first year of the Quality Payment Program.CMS encourages clinicians to visit the website to review the following new resources:

Note: Final approval of these organizations is dependent on satisfactory completion of CMS training and submission of a Quality Assurance Plan. A final list of the CAHPS for MIPS Survey vendors approved by CMS to administer the 2017 survey will be made publicly available this summer.

  • Medicare Shared Savings Program and Quality Payment Program Fact Sheet: Explains how the Shared Savings Program and the Quality Payment Program align reporting requirements for participating Accountable Care Organizations (ACOs) and MIPS clinicians, and how certain tracks in Shared Savings Program ACOs meet Advanced Alternative Payment Model (APM) criteria under the Quality Payment Program.
  • MIPS APM Fact Sheet: Provides an overview of a specific type of APM, called a “MIPS APM,” and the special APM scoring standard used for those in MIPS APMs.


CMA Hosting June 15 5PM Webinar to Avoid Payment Adjustments under QPP
CMS will be hosting a webinar on June 15th at 5pm to provide an overview of some of the upcoming deadlines practices are facing to avoid payment adjustments under QPP and other CMS payment programs, and to provide an overview of the CMS-funded technical assistance available to assist them in successfully participating in QPP and in transforming their practices.  As you know, those practices that are successful can receive significantly higher reimbursement from CMS in the future, but many clinicians still have questions and concerns about this program, and are unsure where to go for help.

The webinar will include CMS grantees and contractors that are funded to assist clinicians with QPP, and we will be sharing information about other available resources. The link for the webinar and dial-in information will be emailed to those who register a few days before the call.

https://www.eventbrite.com/e/macra-quality-payment-program-deadlines-and-resources-in-new-york-tickets-35012449178

For More Information

To get the latest information, visit the Quality Payment Program website. The Quality Payment Program Service Center can also be reached at 1-866-288-8292 (TTY 1-877-715- 6222), available Monday through Friday, 8:00 AM-8:00 PM ET or via email at QPP@cms.hhs.gov.

What is the Status of the New CMS Primary Care Payment Initiative?
Last summer, the CMS announced a new initiative intended to improve payment for primary care. The program, called “Comprehensive Primary Care Plus” (“CPC+”), was begun in 14 regions, including 11 whole states. In this area, it included all of New Jersey,
the North Hudson Valley in New York
and the Greater Philadelphia area in Pennsylvania.

These areas were selected on the basis of density and interest shown by providers and payers. Under CPC+, providers are to be paid a monthly fee for primary care visits.
The new markets to be added include the Greater Buffalo Region in New York, encompassing Erie and Niagara Counties
, as well as Louisiana, Nebraska and North Dakota. No reasons have been given for the apparent lack of interest in this initiative, which resulted in it being rolled out in fewer new markets than anticipated. The four new markets for the initiative, to begin in January, 2018.

The initiative is intended to improve outcomes and lower costs. The initiative has two tracks – under track one, providers receive a monthly fee for specific services, in addition to fee-for-service payments. Under track two, providers will receive an upfront monthly care management fee and reduced fee for service payments.

This is intended to allow providers to offer care outside of traditional face to face encounters. Depending upon the volume of patients, providers could potentially earn an additional $100,000 to $250,000 per year under the model. The model was supposed to launch in up to 20 regions, but CMS saw less interest than was expected, and this pattern has held when the program was recently expanded.

CMS does have a number of events coming up that might be of interest; dates, times and registration information can be found here: https://innovation.cms.gov/Files/x/cpcplus-calendarevents.pdf

CMS also has two short videos that provide helpful information about the model:

CMS has stated that if any of the organizations would like to talk directly about the model, they would be happy to set up some time.  Please let me know if you would like to arrange a meeting/talk with some CMS subject matter experts. I, Regina McNally, can reached by email at rmcnally@mssny.org or call me 516-488-6100 ext. 332.

Weekly Charting Tip:

What can be the cause of a False Claim Act being filed against you by the Federal Government?

  • Up-coding procedures
  • Unbundling procedures
  • Filing multiple claims for the same procedure
  • Billing for medically unnecessary procedures
  • Violating the Anti-Kickback Statute
  • Putting down the incorrect place where the service was rendered
  • Putting down the incorrect health care provider that claimed to have rendered the services
  • Oh yes, and a disgruntled former employee to call the government so that he or she can claim a piece of the action!

Be forewarned.

Until next week, Larry Kobak, Partner, Kern Augustine, PC questions, please contact Kern Augustine, P.C. at 1-800-445-0954 or via email at info@DrLaw.com.



CLASSIFIEDS


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

Medical Practice for Sale in Upscale Westchester Community
Successful well established (1984) and actively growing Internal Medicine/ Primary Care Practice conveniently located only 45 minutes from midtown Manhattan. Great Opportunity for established physician to expand his patient base or for entrepreneurial new graduate.  Lease assignable with option to renew.

Facilities / Business Details

Well known Professional Building with convenient free parking; ground/first floor location, handicap accessible. Contemporary office recently built and painted. Two large exam rooms; one consultation room/doctor’s office, lab, spacious receptionist area and large waiting room. As an independent practice, it provides an extremely appealing option for the patient that does not want to go to a huge impersonal multi-specialty group. Approximately 80% commercial payers; 20% Medicare. Doctor retiring but willing to stay on to introduce new physician to patients and assist in transition.

Asking Price: 
$175,000

Contact: rpcdb51@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


Paging Primary Care MDs Who Love Technology
98point6 is a Seattle startup who wants your input. We’re seeking practicing physicians to join our council and help shape the next generation of primary care. If the fusion of health care and technology inspires you, please apply here.


Ophthalmologist Part Time
Ophthalmologist needed to work at multiple nursing homes in all 5 boros except Staten Island. Part time or full-time position available.  Generous salary and incentives.Ttech provided. Opportunity to perform surgery, but not required. Please email cv to privacyssw@gmail.com


Multiple Physician Positions with DOHMH Office of School Health
Office of School Health is the largest program of the New York City Department of Health and Mental Hygiene (DOHMH). This bureau is responsible for managing the health issues and promoting the well-being of the over 1.3 million children and adolescents enrolled in New York City’s 1700 school buildings.

Positions with the Office of School Health (OSH) combine clinical skills and public health training. OSH focuses on child health, asthma prevention, obesity and nutrition, vision screening, dental care, mental health, reproductive health, and childhood disability. We collaborate with various city and community based agencies to provide social and academic services to address the needs of all New York City school children, especially those facing the most significant social, economic, and health challenges.

The Office of School Health is currently undergoing expansion. There is an immediate need for physicians with an expertise in pediatric, adolescent, or family medicine, with the capacity to utilize primary care skills set through a public health lens. OSH is also  interested in public health and preventive medicine graduates with programmatic, analytic, and social medicine skills.

The NYC DOHMH is reaching out to identify candidates for this recruitment. We are enlisting your help to nominate medical professionals who are committed to contributing their talents to improve health and academic outcomes in our schools. Please consider applying for these positions or passing these opportunities on to talented physicians among your own personal networks.

Attached are the American Academy of Pediatrics position statements on the role of the School Physician as well as the job description and recruitment flyers:

  • Adolescent School Health Physician, Family and Child Health/SH Reproductive/City Medical Specialist, Level: 01/Part-time/Flexible Work Schedule (20-35 hrs/week) To learn more about this position & apply, please submit your resume & cover letter to:https://a127-jobs.nyc.gov/ In the Job ID search bar enter: Job ID: 277208
  • Field Doctor, Bureau of School Health/SH Medical (pre-K-8 Programs or High School) City Medical Specialist, Level: 01/Part-time/Flexible Work Schedule (20-35 hrs/week) To learn more about this position & apply, please submit your resume & cover letter to:https://a127-jobs.nyc.gov/ In the Job ID search bar enter: Job ID: 265869
  • Supervising Medical Doctor,Bureau of School Health/SH Reproductive Health, City Medical Specialist, Level: 02/Part-time (35 hrs/week) To learn more about this position & apply, please submit your resume & cover letter to: https://a127-jobs.nyc.gov/ Job ID:  277026

Please list in your cover letter how you heard about this position (including name of the professional association, website, or individual who referred you). If you have questions, please contact Caroline Volel, MD, MPH at OSH@health.nyc.gov.


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

Capital Update: May 25, 2017


PRESIDENT’S MESSAGE
Charles Rothberg, MD
May 25, 2017
Volume 17
Number 20

As End of Session Nears, Now is the Time to Act to Prevent Enactment of Disastrous Liability Expansion Bill
MSSNY is urging all physicians to take action (click here) to oppose bills moving in the Legislature that could drastically increase the cost of medical liability insurance.  There are only a few weeks left of the 2017 Legislative Session.  Next week, the Legislature will be in their home districts for Memorial Day weekend and the observance of Shavuot.  It is the perfect time to contact your legislators in their district office.

The timing of these bills could not be worse.  We now have multiple malpractice insurance companies operating in New York State that appear to be in serious financial jeopardy which can ill-afford to absorb the substantial costs of a brand new cause of action. Moreover there is a great uncertainty in the NY healthcare delivery system as a result of legislation before Congress that could profoundly restructure Medicaid spending.    Please urge you elected officials to oppose the following bills:   

  • Expanding the Medical Liability Lawsuits (A.3339/S.4080) – would substantially lengthen the statute of limitations for medical malpractice actions and lead to enormous increases in the cost of liability insurance for physicians and hospitals.  If enacted this bill could increase your liability premiums by 15%.
  • Expansion of Medical Liability Damages (A.1386/ S.411) – would greatly expand the categories of damages which a plaintiff may recover in a wrongful death action.  Actuarial studies have predicted that this bill could increase liability premiums by over 50%.
  • Third Party Defendant (A.1500 / S. 412) – would permit a plaintiff to bypass the defendant he or she sued to collect a judgment from a third party defendant who or which had been sued by the defendant for contribution or indemnification as a result of the underlying action.
  • Prohibiting Ex-Parte Interviews of Plaintiff’s Treating Physician (S.243/A.1404) – would prohibit a physician’s defense counsel in a medical liability action from conducting an interview with the plaintiff’s treating physician. This bill would present significant issues for physicians in a medical liability action by limiting the opportunity to fully examine the plaintiff’s health condition to evaluate the merit of the plaintiff’s claim.    (DIVISION OF GOVERMENTAL AFFAIRS)


Please Urge Your Legislators to Enact Legislation to Permit Collective Negotiations and Expand Patient Choice of Physicians
With just a few weeks left in the Legislative Session, physicians are urged to contact their legislators to ask them to support legislation strongly supported by MSSNY to address prior authorization hassles imposed by health insurance companies, increase coverage for patients, and to limit the ability of health insurers to narrow their networks.  These bills include:

  • 3943 (Hannon)/A.2704 (Lavine) – would provide physicians and other health care practitioners with necessary due process protections where health insurers seek to terminate a physician from its network by failing to renew the physician’s contract.  The bill has passed the Assembly and was recently reported to the Senate floor. Please send a letter in support here
  • S.3663 (Hannon)/A.4472 (Gottfried) – would permit independently practicing physicians to collectively negotiate patient care terms with market dominant health insurers under close state supervision.  In addition to the ability to push back against exorbitant administrative hassles imposed by insurers, it would also help to protect physicians to have a stronger option to remain in independent practice. The bills have advanced to the Senate Finance Committee, and the Assembly Ways and Means Committee.  Please send a letter to your legislators .in support here.
  • 5675 (Hannon)/A.7671 (Rosenthal) – would require health insurers to make out of network coverage options available through the New York Health Insurance Exchange. Currently, there are no out of network coverage options in the Exchange in downstate New York, despite Exchange officials strongly encouraging the offering of these options by insurers.  The bills are in the Senate Health and Assembly Insurance Committee. Please send a letter to your legislators in support here.(DIVISION OF GOVERNMENTAL)



Physicians Should Avail Themselves of New NYSDOH Website to Enable Expedited Search of Health Plan Networks
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, and please let MSSNY know so we can let DOH officials know.  According to a recent MSSNY survey, over 50% of responding physicians indicated that they were inappropriately listed as a participating provider on a health insurer’s website.  MSSNY has previously expressed concerns to the Legislature and state agency officials that inaccurate health insurer network listings may mask situations where an insurer has an inadequate physician network.

According to the DOH press release, the NYS Provider & Health Plan Look-Up will initially include information on the health care providers that participate with plans offered on the NY State of Health Marketplace, including Qualified Health Plans, the Essential Plan, Child Health Plus and Medicaid Managed Care. The tool also includes information about provider networks for other Medicaid managed care programs including Managed Long Term Care (MLTC), Health and Recovery Plans (HARPs) and Fully Integrated Dual Advantage (FIDA) Plans. The website will be regularly updated using data submitted by health plans. The website will be updated later this year to add provider network data for commercial insurance products.  (AUSTER)


Legislation About Educating Athletes About Sudden Cardiac Arrest Advances In NYS Legislature
Assembly Bill 6538/Senate Bill 3149, sponsored by Assemblymember Michael Cusick and Senator Andrew Lanza has passed the New York State Assembly and is on the Senate calendar for a vote.   This measure requires that the New York State Department of Health develop educational materials for students, their parents and guardians, regarding sudden cardiac arrest. The materials would be developed in conjunction with the Commissioner of Education, the Medical Society of the State of New York, the New York Chapter of the American Academy of Pediatrics, and the American Heart  Association.

The materials would include an explanation of sudden cardiac arrest, a description of early warning signs, and an overview of options that are presently available for screening. Sudden death in young athletes is a rare but tragic event. The possibility that young, well-trained athletes at the high school, college, or professional level could die suddenly seems incomprehensible. It is a dramatic and tragic event that devastates families and the community. Physical exertion associated with competitive sports and other physical athletic activities can exacerbate a pre-existing condition and can result in an untimely death of a student.  The State of New Jersey currently has a similar program where brochures are sent home to parents and guardians. This legislation would establish a similar program by developing brochures that could be given to parents as well as pediatricians to distribute. (CLANCY)


Special Election Results
This week, Democratic candidate Brian Benjamin won the open 30th Senate District (New York County) seat to replace Democrat Bill Perkins who won a seat on the New York City Council.   On Long Island, Democrat Christine Pellegrino defeated Republican Thomas Gargiulo in the 9th Assembly District.  Pellegrino, an elementary school teacher, filled the seat vacated by Republican Joseph Saladino to serve as Oyster Bay Town supervisor.  Pellegrino won by a margin of 58 percent of the vote over Gargiulo, who got 42 percent in a seat that historically has been a Republican seat.   (BELMONT)


CBO Release Scoring of AHCA Proposal; AMA Sends Recommendations for Improvements to US Senate
The Congressional Budget Office released a document this week noting the American Health Care Act recently passed by the US House and under consideration by the US Senate would  “reduce federal deficits by $119 billion over the coming decade but  increase the number of people who are uninsured by 23 million by 2026”.  Also this week, the American Medical Association sent a letter to US Senate Finance Committee Chair Orrin Hatch this week to provide recommendations to improve the AHCA.  The comments focused primarily on premium affordability, insurance market stabilization, and the Medicaid safety net—topics that are generally consistent with the scope of a budget reconciliation bill. Among the AMA’s recommendations:

  • Continue to Fund the cost-sharing reductions (CSRs) for 2017 and 2018.
  • Provide young adults (ages 19-30) with enhanced tax credits—e.g., $50 per month—while maintaining the current premium tax credit structure which is inversely related to income;
  • Fix the ACA’s “family glitch,” which denies premium and cost-sharing subsidies to purchase coverage on health insurance exchanges to families facing high-cost employer-sponsored insurance when one family member has access to affordable employee-only coverage, ignoring the cost of family coverage;
  • To address problems of high deductibles and cost-sharing for individuals with incomes above 250% FPL,  consider modestly funding HSAs.  Many individuals eligible for premium tax credits, but not cost-sharing subsidies, are having difficulties in affording the cost-sharing requirements in the plans they have enrolled;
  • Create demonstration projects to allow individuals eligible for cost-sharing subsidies—who forego these subsidies by enrolling in a bronze plan—to have access to a pre-funded HSA in an amount determined to be equivalent to the cost-sharing subsidy they would have received if they had enrolled in a silver plan.
  • Lower the cap on premiums for the second lowest cost silver plan for the highest incomes eligible for premium tax credits (for example, from 9.69 percent to 8.5 percent of household income), and lower premium caps for lower incomes accordingly. Lowering premiums for individuals eligible for premium tax credits would serve as a greater incentive to this population becoming and remaining insured.
  • Protecting the Medicaid Expansion, or assure that any changes to the Medicaid program must ensure that those who have benefited continue to have the ability to obtain quality, affordable coverage. (AUSTER)


CMS Delays Medicare Bundled Payment Programs Until January 2018
The Centers for Medicare & Medicaid Services (CMS) recently released a final rule that postponed until January 1, 2018 the effective date of various bundled payment programs for Medicare.  The delay is applicable to the proposed expansion of the Comprehensive Care for Joint replacement (CJR) model as well as implementation of the Advancing Care Coordination through Episode Payment Models (EPMs) and the Cardiac Rehabilitation Incentive Payment Model.   Under these “virtual bundling” programs, hospitals and physicians would continue to be paid by Medicare Part A and Part B on a fee for service basis for the care delivered.  However, there will be a retrospective assessment of the total costs of care provided under Medicare Part A and Part B to patients during their hospitalization and for 90 days after discharge. Initially, hospitals will receive bonuses if their costs fall below historical benchmarks and meet quality standards.  Beginning in 2019, hospitals will have to reimburse CMS if their costs exceed the benchmark, and could require physicians to share in the upside and downside risk. (AUSTER)


Need to Meet Your Pain Management CME Requirement?  MSSNY Pain Management, Palliative Care and Addiction Online Program Available
The Medical Society of the State of New York Pain Management, Palliative Care and Addiction modules are now available on-line here. 

These modules are being offered free of charge to all MSSNY members.  Physicians who are new users to the MSSNY CME site will be required to register as a new user.  As a new user, physicians and non-physicians will be required to enter fields that include: position; name (the name should be what you want to appear on the CME certificate); email address; and then create a password.  MSSNY members who encounter a payment page or have difficulty registering, please email cme@mssny.org for technical support.  Directions for creating a new account/or logging in can be found here.   Non-MSSNY physicians will be charged $50 per module. 

The MSSNY CME is a new site and while many MSSNY members have an account with mssny.org a MSSNY member may not necessary have an account with cme.mssny.org   If in doubt, try to create an account and if it tells you that the email address is unavailable or in use,  an account exists.   Passwords can be reset if you don’t know it.  Physicians who have previously had an account at the MSSNY CME site will need to log into the site using their email and password. The MSSNY CME site provides the ability for physicians and other prescribers to view the archived webinar at their leisure, take the required test, and download their certificate. The online program covers all eight topics required in the New York State statute. MSSNY developed the program with the NYS Office of Alcoholism and Substance Abuse Services (OASAS).  MSSNY is listed as an accrediting organization by the NYS DOH Bureau of Narcotic Enforcement.   Information on the three CME modules is available here.  Additional information or technical support may be obtained by contacting cme@mssny.org . (CLANCY)


DOH Attestation Process for Pain Management CME Must Be Completed by July 1, 2017
The New York State Department of Health has announced the attestation process for prescribers required to complete Pain Management CME.  Prescribers must attest to the completion of the pain management, palliative care and addiction course work or training by July 1, 2017, and again every three years thereafter. The prescriber should only attest after completion of at least three hours of course work or training covering all eight topics. A prescriber with a Health Commerce System (HCS) account will attest online using the Narcotic Education Attestation Tracker (NEAT) application.

Complete the steps to access the NEAT (Narcotic Education Attestation Tracker) application in the NYS Health Commerce System (HCS):

  1. Log into the HCS
  2. Under “My Content” click on “All Applications”
  3. Click on “N”
  4. Scroll down to NEAT (Narcotic Education Attestation Tracker) and double click to open the application. You may also click on the “+” sign to add this application under “My Applications” on the left side of the Home screen.

Complete the steps to ATTEST to the completion of the education requirement.   A full set of instructions can be found here.

Prescribers that do not have access to a computer can request a paper attestation form by calling the Bureau of Narcotic Enforcement (BNE) toll-free at 1-866-811-7957. They may then complete the form and return it by mail to the address provided in the form. The Bureau of Narcotic Enforcement has also released a Frequently Asked Questions (FAQs) on the prescriber mandate.   A copy of the FAQs can be found here. In certain limited circumstances, the New York State Department of Health may grant an exemption to the required course work or training to an individual prescriber who clearly demonstrates to the department that there is no need to complete such training.  Exemptions will be granted only in very limited circumstances, and not solely on the basis of economic hardship, technological limitations, prescribing volume, practice area, specialty, or board certification.  Prescribers may apply for an exemption through the Health Commerce System. Further information may be obtained by contacting BNE at 1-866-811-7957 or narcotic@health.ny.gov.   (CLANCY)


NYS DOH Confirms a Case of Measles; Warns About Potential Exposure to Others
On May 23, 2017, the New York State Department of Health in a press statement confirmed that a tourist from India traveling in western New York has measles.  This tourist has visited a NYS Thruway Travel Plaza in Herkimer County, a Monroe County hotel, Niagara Falls State Park, and a Niagara Falls restaurant between May 11 and May 12, 2017, potentially exposing others to measles. Anyone who visited the following locations may have been exposed:

  • The Iroquois Travel Plaza (rest stop) between Exit 29 (Canajoharie) and Exit 29A (Little Falls) on the NYS Thruway between 8:30 p.m. – 12:30 a.m. on May 11– 12, 2017.
  • The Hampton Inn, 4873 Lake Road, Brockport, N.Y. between 12:00 a.m. – 12:00 p.m. on May 12, 2017.
  • Niagara Falls State Park, Niagara Falls, N.Y. between 11:00 a.m. – 5:00 p.m. on May 12, 2017, which includes the Maid of the Mist.
  • Swagat Fine Indian Cuisine, 24 Buffalo Avenue, Niagara Falls, N.Y. between 2:00 – 6:00 p.m. on May 12, 2017.

According to the DOH, “the times reflect the period that the infected individual was in these areas and a two-hour period after the individual left the area, as the virus remains alive in air and on surfaces for up to two hours. This explains the overlap in times. In a statement by DOH, individuals are not at risk of contracting measles if they are immune. A person is unlikely to get measles if they were born before January 1, 1957, have received two doses of the MMR (Measles, Mumps and Rubella) vaccine or have a lab test confirming immunity. Those individuals lacking immunity or not sure if they have been vaccinated, should contact their health care provider if they develop measles symptoms. Symptoms include a fever, rash, cough, conjunctivitis or runny nose. Symptoms usually appear in 10-12 days after exposure, although they may occur as late as June 2, 2017. To prevent the spread of illness, the NYSDOH is advising individuals who may have been exposed and who have symptoms consistent with measles to contact their health care provider or a local emergency department before going for care. This will help to prevent others at these facilities from being exposed to the illness. Measles is a highly contagious respiratory disease caused by a virus that is spread by direct contact with nasal or throat secretions of infected people.  Symptoms generally appear in two stages. “    (CLANCY)


Register Now for Upcoming Medical Matters 2017 CME Webinar Series
Registration is now open for “Mosquito Borne Diseases” on Wednesday, June 14, 2017 at 7:30 a.m.  Faculty for this webinar are William Valenti, MD chair of MSSNY’s Infectious Disease Committee and member of the MSSNY’s Emergency Preparedness and Disaster/Terrorism Response Committee and Elizabeth Dufort, MD medical director, Division of Epidemiology from the New York State Department of Health.  .  Registration is now available at this link.

 The educational objectives are: 1) Identify the most prominent mosquito borne diseases, including chikungunya, dengue, West Nile virus, yellow fever and zika.  2)  Describe the epidemiology of mosquito borne diseases.  3)  Review modes of transmission and methods of prevention of infection.  Additional information or assistance with registration may be obtained by contacting Melissa Hoffman at mhoffman@mssny.org.  Medical Matters is a series of CME webinars sponsored by MSSNY’s Committee on Emergency Preparedness and Disaster/Terrorism Response. 

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

MSSNY designates this live activity for a maximum of 1.0 AMA PRA Category 1 Credits™.   Physicians should claim only the credit commensurate with the extent of their participation in the activity.

Can’t wait until June 14th?  Listen to MSSNY’s Zika podcast here.   (Clancy, Hoffman)


Available for Physicians & Patients – Immunization Podcasts
The importance of immunizations remains paramount!  The Medical Society of the State of New York (MSSNY) has released ten brief informational podcasts for physicians and patients to learn about vaccines.  MSSNY’s immunization podcast series addresses the importance of adult immunizations, as well as herd immunity.  This series was created by MSSNY’s Preventive Medicine and Family Health and Infectious Disease Committees.  Each of these brief podcasts offers insightful commentary about immunizations from committee members (all experts in their fields).  MSSNY’s immunization podcast series can be accessed here .

The topics discussed include

  • Hepatitis B
  • Human Papillomavirus (HPV)
  • Influenza
  • Measles, Mumps and Rubella (MMR)
  • Meningococcal Disease
  • Pneumococcal
  • Tetanus, Diphtheria and Pertussis (TD & Tdap)
  • Young Adults
  • Zoster.

Share this link with your patients: http://www.buzzsprout.com/51522

Additionally, you can contact Melissa Hoffman at mhoffman@mssny.org to request some take-away cards for your patients with links to MSSNY’s immunization podcast series.(Hoffman, Clancy)

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

pschuh@mssny.org mauster@mssny.org
pclancy@mssny.org jbelmont@mssny.org

CLASSIFIEDS


Medical Practice for Sale in Upscale Westchester Community
Successful well established (1984) and actively growing Internal Medicine/ Primary Care Practice conveniently located only 45 minutes from midtown Manhattan. Great Opportunity for established physician to expand his patient base or for entrepreneurial new graduate.  Lease assignable with option to renew.

Facilities / Business Details

Well known Professional Building with convenient free parking; ground/first floor location, handicap accessible. Contemporary office recently built and painted. Two large exam rooms; one consultation room/doctor’s office, lab, spacious receptionist area and large waiting room. As an independent practice, it provides an extremely appealing option for the patient that does not want to go to a huge impersonal multi-specialty group. Approximately 80% commercial payers; 20% Medicare. Doctor retiring but willing to stay on to introduce new physician to patients and assist in transition.

Asking Price: 
$175,000

Contact: rpcdb51@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


Paging Primary Care MDs Who Love Technology
98point6 is a Seattle startup who wants your input. We’re seeking practicing physicians to join our council and help shape the next generation of primary care. If the fusion of health care and technology inspires you, please apply here.


Ophthalmologist Part Time
Ophthalmologist needed to work at multiple nursing homes in all 5 boros except Staten Island. Part time or full-time position available.  Generous salary and incentives.Ttech provided. Opportunity to perform surgery, but not required. Please email cv to privacyssw@gmail.com


Multiple Physician Positions with DOHMH Office of School Health
Office of School Health is the largest program of the New York City Department of Health and Mental Hygiene (DOHMH). This bureau is responsible for managing the health issues and promoting the well-being of the over 1.3 million children and adolescents enrolled in New York City’s 1700 school buildings.

Positions with the Office of School Health (OSH) combine clinical skills and public health training. OSH focuses on child health, asthma prevention, obesity and nutrition, vision screening, dental care, mental health, reproductive health, and childhood disability. We collaborate with various city and community based agencies to provide social and academic services to address the needs of all New York City school children, especially those facing the most significant social, economic, and health challenges.

The Office of School Health is currently undergoing expansion. There is an immediate need for physicians with an expertise in pediatric, adolescent, or family medicine, with the capacity to utilize primary care skills set through a public health lens. OSH is also  interested in public health and preventive medicine graduates with programmatic, analytic, and social medicine skills.

The NYC DOHMH is reaching out to identify candidates for this recruitment. We are enlisting your help to nominate medical professionals who are committed to contributing their talents to improve health and academic outcomes in our schools. Please consider applying for these positions or passing these opportunities on to talented physicians among your own personal networks.

Attached are the American Academy of Pediatrics position statements on the role of the School Physician as well as the job description and recruitment flyers:

  • Adolescent School Health Physician, Family and Child Health/SH Reproductive/City Medical Specialist, Level: 01/Part-time/Flexible Work Schedule (20-35 hrs/week) To learn more about this position & apply, please submit your resume & cover letter to:https://a127-jobs.nyc.gov/ In the Job ID search bar enter: Job ID: 277208
  • Field Doctor, Bureau of School Health/SH Medical (pre-K-8 Programs or High School) City Medical Specialist, Level: 01/Part-time/Flexible Work Schedule (20-35 hrs/week) To learn more about this position & apply, please submit your resume & cover letter to:https://a127-jobs.nyc.gov/ In the Job ID search bar enter: Job ID: 265869
  • Supervising Medical Doctor,Bureau of School Health/SH Reproductive Health, City Medical Specialist, Level: 02/Part-time (35 hrs/week) To learn more about this position & apply, please submit your resume & cover letter to: https://a127-jobs.nyc.gov/ Job ID:  277026

Please list in your cover letter how you heard about this position (including name of the professional association, website, or individual who referred you). If you have questions, please contact Caroline Volel, MD, MPH at OSH@health.nyc.gov.


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

May 19, 2017 – Speak Now or Forever Hold…


PRESIDENT’S MESSAGE
Charles Rothberg, MD
May 19, 2017
Volume 17
Number 19

MLMIC Insurance

Dear Colleagues:

There are some extremely important issues that affect every physician. You might want to take a minute to go to our Grassroots Action Center —it really only takes a minute—to let your opinion be known to YOUR legislator. With the legislative session expected to end June 21, MSSNY is currently advocating for various pieces of legislation so that you can assure your patients they will continue to receive timely and quality care.

  • Collective Negotiation
    In my opinion, a primary goal of having collective negotiation (under states’ rights doctrine) is to level the currently one-sided contracting playing field, which would minimize the need to actually engage in bargaining. And we have precedent in the effectiveness of this concept in surprise bill legislation whereby physicians and payers seem to come to terms, mostly without resorting to the dispute resolution process. One of MSSNY’s priority bills recently moved through the Senate Health Committee to the Finance Committee. The bill (S.3663, Hannon / A.4472, Gottfried) would allow independently practicing physicians to collectively negotiate patient care terms with market dominant health insurers under close state supervision. Its Assembly counterpart has advanced to the Assembly Ways & Means Committee. It is very important that you send a letter to your legislators so that we can inform them how important the bill is for physicians. Physicians can send a letter here.
  • Expanding Medical Liability Lawsuits (3339/S.4080)
    If we do not continue to talk about this, our adversaries will win. The Assembly bill has advanced to the Assembly floor and can be voted on at any time. It is very important that you send a letter to your legislators so that we can inform them how important the bill is for physicians. This bill would substantially lengthen the statute of limitations for medical malpractice actions and lead to enormous increases in the cost of liability insurance for physicians and hospitals. If enacted this bill could increase your liability premiums by 15%.  Please send a letter in opposition click here.
  • Conversion Therapy
    Legislation (A.3977/S.263) would bar mental health providers from trying to change the sexual orientation of anyone under the age of 18, something 5 states have already done.Gov. Cuomo signed an executive order in February precluding insurance companies in the state from covering conversion therapy. The DFS is issuing regulations barring New York insurers from providing coverage for conversion therapy given to an individual under the age of 18.The NYS DOH is prohibiting coverage of conversion therapy under New York’s Medicaid program.

You can call your legislator’s directly in their legislative offices in Albany to speak about the issues impacting your ability to treat patients. The bill
Senate: 518-455-2800
Assembly: 518-455-4100.

Finally, I attended the Queens County Annual Dinner this week where Dr. Carlos Zapata was inaugurated as President. I congratulate Carlos and am thrilled how quickly he has zipped up the ranks as I “mentored” him back in his medical school days.

Sincerely,
Charles Rothberg, MD
MSSNY President

Please send your comments to comments@mssny.org


Please Contact Your Legislator to Oppose One Sided Liability Expansion Bills
All physicians should contact their legislators to urge them to oppose a package of bills that moved through the Assembly Codes and Judiciary Committees this past week. Physicians can send a letter please here. These bills would drastically increase New York’s already exorbitantly high medical liability premiums when no premium increases can be tolerated.  The timing of these bills could not be worse.  We now have multiple malpractice insurance companies operating in New York State that appear to be in serious financial jeopardy which can ill-afford to absorb the substantial costs of a brand new cause of action. Moreover there is a great uncertainty in the NY healthcare delivery system as a result of legislation before Congress that could profoundly restructure Medicaid spending.

Among the bills that MSSNY is opposing include:

  • Expanding the Medical Statute of Limitations Lawsuits (A.3339/S.4080) – would substantially lengthen the statute of limitations for medical malpractice actions and lead to enormous increases in the cost of liability insurance for physicians and hospitals.  If enacted this bill could increase your liability premiums by 15.
  • Expansion of Medical Liability Damages (A.1386/ S.411) – would greatly expand the categories of damages which a plaintiff may recover in a wrongful death action.  Actuarial studies have predicted that this bill could increase liability premiums by over 50%.
  • Third Party Defendant (A.1500 / S. 412) – would permit a plaintiff to bypass the defendant he or she sued to collect a judgment from a third party defendant who or which had been sued by the defendant for contribution or indemnification as a result of the underlying action.
  • Prohibiting Ex-Parte Interviews of Plaintiff’s Treating Physician (S.243/A.1404) – would prohibit a physician’s defense counsel in a medical liability action from conducting an interview with the plaintiff’s treating physician. This bill would present significant issues for physicians in a medical liability action by limiting the opportunity to fully examine the plaintiff’s health condition to evaluate the merit of the plaintiff’s claim.     

Contact your legislature today!
(DIVISION OF GOVERNMENTAL AFFAIRS)


A Collective Voice Matters
MSSNY will continue to push for comprehensive liability reform to preserve access to care for patients, not one-sided proposals that would further reduce access.  With the trial lawyers having their Lobby Day in Albany this week, it is important that we counteract their message.  With only a few weeks left in session, we must be active in every way.  Please call and write your legislators.  MSSNY continues to oppose legislation that would have drastic consequences on York’s health care system.  It is imperative that legislators hear directly from their physicians, family and friends.   Decisions on these issues will be based on the feedback from each and every legislator.

Here are some facts to help you with your contacts:

  • A recent analysis from the website WalletHub listed New York as the worst state in the country in which to practice medicine, in large part due to its overwhelming liability exposure as compared to other states in the country.
  • New York physicians have reached the breaking point and already face extraordinary overhead costs, declining payments from insurers, and increasing mandates from government, such as required participation in unproven value based payment systems.
  • Many New York physicians already pay extraordinary medical liability premiums to remain in practice, premiums which are among the highest in the country.   Shockingly, many New York physicians pay premiums that far exceed $100,000 and in some cases even exceed $300,000.
  • New York has by far and away the highest total of medical liability payouts and per capita payouts than any other state in the country, according to a recent study Dietrich Healthcare.  (BELMONT)


Legislation Placing E-cigarette Under the Clean Indoor Air Act Passes NYS Assembly
Assembly Bill 516, which would place electronic cigarettes under the Clean Indoor Air Act (CIAA) passed the New York State Assembly this week.  The measure, sponsored by Assemblywoman Linda Rosenthal, would prohibit the use of electronic cigarettes in public places and certain outdoor areas.

Its companion measure, S. 2543, sponsored by Senator Kemp Hannon, is on the calendar in the NYS Senate and can be voted on as early as next week.   Additionally, S.3978/A.273, which would increase the purchasing age for tobacco products from eighteen to 21 years of age is in the Assembly Health Committee and the Senate Finance Committee.   Physicians are urged to send a letter in support of both these measures from MSSNY Grassroots Action Center (GAC) or can call their senator at 518-488-2800. To send a letter, please click here.
(CLANCY, HARRING)

Please Urge Your Legislators to Enact Legislation to Address Prior Authorization Hassles and Expand Patient Choice of Physicians
With just a few weeks left in the legislative session, physicians are urged to contact their legislators to ask them to support legislation strongly supported by MSSNY to address prior authorization hassles imposed by health insurance companies, increase coverage for patients, and to limit the ability of health insurers to narrow their networks.  These bills include:

  • S.3943 (Hannon)/A.2704 (Lavine) – would provide physicians and other health care practitioners with necessary due process protections where health insurers seek to terminate a physician from its network by failing to renew the physician’s contract.  The bill has passed the Assembly and was recently reported to the Senate floor.  Please send a letter in support please: click here.
  • S.3663 (Hannon)/A.4472 (Gottfried) – would permit independently practicing physicians to collectively negotiate patient care terms with market dominant health insurers under close state supervision.  In addition to the ability to push back against exorbitant administrative hassles imposed by insurers, it would also help to protect physicians to have a stronger option to remain in independent practice. The bills have advanced to the Senate Finance Committee, and the Assembly Ways and Means Committee.  Please send a letter to your legislators in support by clicking here.
  • S.5675 (Hannon)/A.7671 (Rosenthal) – would require health insurers to make out of network coverage options available through the New York Health Insurance Exchange.  Currently, there are no out of network coverage options in the Exchange in downstate New York, despite Exchange officials strongly encouraging the offering of these options by insurers.  The bills are in the Senate Health and Assembly Insurance Committee. Please send a letter to your legislators in support  click here.

Moreover, legislation is likely to be introduced shortly that would help to reduce insurer-imposed administrative hassles consistent with the recently released document entitled Prior Authorization and Utilization Management Reform Principles please click here.  These principles were developed by the American Medical Association, American Hospital Association, Medical Group Management Association, American Pharmacists Association, and Arthritis Foundation along with other health and patient advocacy associations including MSSNY.
(DIVISION OF GOVERNMENTAL AFFAIRS)


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



Support Legislation to Repeal Arbitrary Limits on Compensation Arrangements with Billing Vendors
At the April MSSNY House of Delegates meeting, a resolution was adopted calling on MSSNY to “work for repeal of the New York State law barring percentage-based payment arrangements between physicians and their billing agents” and, to “oppose efforts by state government officials to demand refunds from physicians based upon allegations that claims were submitted to Medicaid using percentage-based arrangements between physicians and their billing agents”.

Legislation (A.193, Buchwald/S.2247, Hannon) has been introduced that would accomplish one of the goals of the resolution by eliminating the “one of a kind” New York law that prohibits health care practitioners from entering into contracts with practice management companies that use percentage-based billing arrangements.  Physicians are urged to send a letter to their legislators in support of this legislation please click here.
(AUSTER)

Bill to Prohibit Mid-Year Formulary Changes Advances to Assembly Floor
After receiving unanimous support from the Assembly’s Insurance Committee, legislation (A.2317, Peoples-Stokes) has advanced to the Assembly Floor that would protect patients from unforeseen changes in prescription drug formularies during a policy year that could in turn seriously interfere with their drug therapy.  This bill would protect thousands of insured New Yorkers by preventing the imposition of higher out of pocket costs. The Medical Society of the State of New York supports enactment of this measure. Similar legislation has been introduced by Senator Sue Serino (S.5022), and has referred to the Senate Insurance Committee.
(HARRING)

Register Now for Upcoming Medical Matters 2017 CME Webinar Series
Registration is now open for Mosquito Borne Diseases” on Wednesday, June 14, 2017 at 7:30 a.m.  Faculty for this webinar are William Valenti, MD chair of MSSNY’s Infectious Disease Committee and member of the MSSNY’s Emergency Preparedness and Disaster/Terrorism Response Committee and Elizabeth Dufort, MD medical director, Division of Epidemiology from the New York State Department of Health.   Registration is now available at this link.

The educational objectives are: 1) Identify the most prominent mosquito borne diseases, including chikungunya, dengue, West Nile virus, yellow fever and zika.  2)  Describe the epidemiology of mosquito borne diseases.  3)  Review modes of transmission and methods of prevention of infection.  Additional information or assistance with registration may be obtained by contacting Melissa Hoffman at mhoffman@mssny.org.  Medical Matters is a series of CME webinars sponsored by MSSNY’s Committee on Emergency Preparedness and Disaster/Terrorism Response. 

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

MSSNY designates this live activity for a maximum of 1.0 AMA PRA Category 1 Credits™.   Physicians should claim only the credit commensurate with the extent of their participation in the activity.                                        (CLANCY, HOFFMAN)

MSSNY & NYSDOH Presents Current Concepts in Concussion for Pediatric and Adult Patients
MSSNY’s Continuing Medical Education webinar on Current Concepts in Concussion for Pediatric and Adult Patients is available on the MSSNY CME website Dr. John Pugh, assistant professor of Neurology at Albany Medical Center, and Dr. Deborah Light, Director of the Sports Medicine Fellowship at Albany Medical Center, discuss topics including identifying symptoms indicative of concussion, outlining appropriate management plans, and methods for primary and secondary prevention of concussion.

Click here  to view the webinar and fulfill the requirements to receive a certificate awarding one hour of CME. COMING SOON – Dr. John Pugh and Dr. Deborah Light discuss the topic of concussion in MSSNY’s podcast on Current Concepts in Concussion for Pediatric and Adult Patients. The podcast will soon be posted to MSSNY’s CME webpage.
(HARRING)


NYS DOH Expands HIV Testing Website
The New York State Department of Health announced the release of its newly designed New York State Expanded HIV Testing website: www.NYSEHT.org.  DOH has streamlined its site to better serve hospital and clinic administrators and New York State clinical providers.  Physicians are encouraged to visit the site and refer to it for all routine HIV testing questions and needs.  Additionally, physicians are invited to partake in a research study entitled “Usability and evaluation of the NYS Expanded HIV Testing Website” conducted by the University of Rochester and the New York State Department of Health.  The purpose of the study is to help DOH understand practicing providers’ current HIV testing practices.

DOH will use this information to address potential gaps in routine HIV testing.  This study involves an on-line survey that should take no more than three minutes to complete. To learn more about the study or complete the survey, click here If there are additional questions or need assistance to complete the survey, please email the study coordinator at:  margaret_demment@urmc.rochester.edu  Physicians will receive up to two follow-up emails about participating in this study.  If you would like to stop receiving these emails please let us know at:
margaret_demment@urmc.rochester.edu                                                            (CLANCY)

NYS DOH Conducts Buprenorphine Waiver Trainings throughout New York State
The NYS Department of Health, AIDS Institute, Office of Drug User Health, is sponsoring free buprenorphine waiver trainings for all clinical providers at various locations throughout the state.  Training will take place on Saturday, May 20th, from 8:00 a.m. to 1:00 p.m. at Champlain Valley Physicians Hospital, 75 Beekman Street, Plattsburgh, NY 12901.   Online registration please  click here   Additional information, registration, and locations please   click here.      (CLANCY)   

Join MSSNY and Support MSSNYPAC Today
MSSNY and MSSNYPAC enables physicians to pool their resources to fight the multitude of misguided proposals being pushed by many groups whose agendas are diametrically opposed to physicians and the patients they treat.   It also provides resources to help fight for needed changes in our health care system so physicians can continue to deliver the quality and timely care expected by their patients.

We thank you for your support and urge you to make sure your colleagues also join us in these efforts.  If all physicians were to join MSSNY and MSSNYPAC there is little we could not accomplish.  Please do not let your colleagues ignore the need for a strongly supported MSSNY and MSSNYPAC.
(BELMONT)

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

pschuh@mssny.org mauster@mssny.org
pclancy@mssny.org jbelmont@mssny.org

enews large

HHS notification: International Cyber Threat to Healthcare Organizations
Dear HPH Sector Colleagues,
HHS is aware of a significant cyber security issue in the UK and other international locations affecting hospitals and healthcare information systems. We are also aware that there is evidence of this attack occurring inside the United States. We are working with our partners across government and in the private sector to develop a better understanding of the threat and to provide additional information on measures to protect your systems. We advise that you continue to exercise cyber security best practices – particularly with respect to email.

Laura Wolf,
Critical Infrastructure Protection Lead
HHS-ASPR-OEM

May 12, 2017
Additional information on ransomware provided by HHS Office for Civil Rights can be found at:

Cyber Newsletters:
https://www.hhs.gov/sites/default/files/hippa-cyber-awareness-monthly-issue1.pdf
https://www.hhs.gov/sites/default/files/hipaa-cyber-awareness-monthly-issue3.pdf
https://www.hhs.gov/sites/default/files/february-2017-ocr-cyber-awareness-newsletter.pdf

Ransomware Guidance:
https://www.hhs.gov/sites/default/files/RansomwareFactSheet.pdf 

Doctors Do Dismiss Patients for Difficult or Inappropriate Behaviors
Nine out of 10 health care provider practices have “fired” a patient because of poor patient behaviors, according to research published this week in JAMA Internal Medicine. According to the researchers, the findings show that physicians are not dismissing patients because of particularly difficult or complex medical issues as insurers shift from fee-for-service reimbursement toward value-based payments. “The reasons practices are dismissing patients aren’t so much related to the things people were worrying about — that if [insurers reimburse more for] quality of care, doctors might start cherry-picking patients,” said Dr. Ann O’Malley, Mathematica Policy Research senior fellow and lead author.

Among the reasons the nearly 800 practices surveyed gave for cutting ties with a patient:

  • Violent, “disruptive,” or inappropriate behavior toward doctors or staff
  • Violation of policies related to chronic pain and controlled substances
  • Failure to show up to scheduled appointments
  • Repeated disregard of a doctor’s medical recommendations
  • Violation of bill payment policies


Agencies Warn of Faulty Blood Tests for Lead, Recommend Retesting
Some blood tests made by Magellan Diagnostics may falsely report low lead levels in children and adults, the FDA and CDC cautioned on Wednesday. The FDA is warning against using Magellan Diagnostics LeadCare analyzers with venous blood samples. The alert doesn’t apply to blood collected by finger- or heelstick.

Children currently younger than 6 years need to be retested if they had venous blood samples analyzed with any of the following Magellan products — LeadCare, LeadCare II (which is used in provider offices and clinics), LeadCare Plus, or LeadCare Ultra – and their results were 10 µg/dL or less. Pregnant and nursing women should also be retested.

The problem with falsely low readings began as far back as 2014, the FDA said. FDA news releaseCDC health advisory

Join CMS May 22nd to Learn More re Quality Payment Participation Requirements
On Monday, May 22nd at 1:00 PM ET, CMS will host an overview webinar on the participation criteria used to determine inclusion in the Merit-based Incentive Payment System (MIPS) and Advanced Alternative Payment Models (APMs).

Webinar Details
Title: Quality Payment Program Participation Criteria Webinar
Date: Monday, May 22, 2017
Time: 2:00 PM ET

Description: During this webinar, CMS will provide an overview of:

  • MIPS participation requirements for individual clinicians and groups
  • >Participation requirements for Advanced APMs and MIPS APMs
  • A new tool that allows clinicians to check if they are included in MIPS
  • The recent participation letter sent to clinician offices

Event Registration: https://engage.vevent.com/rt/cms/index.jsp?seid=828

The audio portion of this webinar will be broadcast through the web. You can listen to the presentation through your computer speakers. If you cannot hear audio through your computer speakers, please contact CMSQualityTeam@ketchum.com. Phone lines will be available for the Q&A portion of the webinar.

Have a specific question about the Quality Payment Program? Please e-mail QPP@cms.hhs.gov
For More Information<
Visit qpp.cms.gov to learn more about the MIPS participation requirements and other information on MIPS and the Quality Payment Program. To review presentations from previous webinars, visit the Quality Payment Program Events page.

Many Americans Skipping MMR Vaccination before Traveling Abroad
Of US adults who go to travel clinics before traveling internationally, only about half of those eligible for the measles, mumps, and rubella (MMR) vaccine actually receive it, a study in the Annals of Internal Medicine finds.

Researchers studied 40,000 U.S. adults who presented to clinics for pretravel consultation. Of the 6600 who were eligible to receive the MMR vaccine based on self-reported disease and immunization history, 53% did not get vaccinated. Nearly half of the unvaccinated had refused the vaccine; most said they refused because they were not concerned about acquiring measles.

Roughly 28% of eligible patients didn’t receive the vaccine because of the provider’s decision; the vast majority of providers believed that the vaccine was not indicated.

Editorialists conclude: “If persons traveling abroad continue to underestimate the importance of pretravel MMR vaccination, our society is destined to be affected by imported cases of measles, leading to morbidity and mortality from this disease.”
Annals of Internal Medicine article

USPSTF Stance against Using Hormone Therapy to Prevent Chronic Conditions
The U.S. Preventive Services Task Force, in a draft recommendation statement, is again advising against the use of hormone therapy to prevent chronic conditions in postmenopausal women.

In particular, the task force recommends against use of combined estrogen-progestin for this purpose, and against estrogen alone in women who’ve had a hysterectomy. The grade D recommendations are in line with the group’s prior recommendations, issued in 2012 and 2005.

While the USPSTF found evidence that hormone therapy offers some benefits, including reduced risks for fracture and diabetes, it found evidence of more potential harms, including increased risks for invasive breast cancer (with estrogen-progestin only), venous thromboembolism, stroke, dementia, gallbladder disease, and urinary incontinence.

The recommendations do not apply to hormone therapy for the treatment of menopausal symptoms, such as hot flashes and night sweats.
LINK(S):
USPSTF draft recommendation statementUSPSTF grade definitions



CLASSIFIEDS


Medical Practice for Sale in Upscale Westchester Community
Successful well established (1984) and actively growing Internal Medicine/ Primary Care Practice conveniently located only 45 minutes from midtown Manhattan. Great Opportunity for established physician to expand his patient base or for entrepreneurial new graduate.  Lease assignable with option to renew.

Facilities / Business Details

Well known Professional Building with convenient free parking; ground/first floor location, handicap accessible. Contemporary office recently built and painted. Two large exam rooms; one consultation room/doctor’s office, lab, spacious receptionist area and large waiting room. As an independent practice, it provides an extremely appealing option for the patient that does not want to go to a huge impersonal multi-specialty group. Approximately 80% commercial payers; 20% Medicare. Doctor retiring but willing to stay on to introduce new physician to patients and assist in transition.

Asking Price: 
$175,000

Contact: rpcdb51@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


Paging Primary Care MDs Who Love Technology
98point6 is a Seattle startup who wants your input. We’re seeking practicing physicians to join our council and help shape the next generation of primary care. If the fusion of health care and technology inspires you, please apply here.


Ophthalmologist Part Time
Ophthalmologist needed to work at multiple nursing homes in all 5 boros except Staten Island. Part time or full-time position available.  Generous salary and incentives.Ttech provided. Opportunity to perform surgery, but not required. Please email cv to privacyssw@gmail.com


Multiple Physician Positions with DOHMH Office of School Health
Office of School Health is the largest program of the New York City Department of Health and Mental Hygiene (DOHMH). This bureau is responsible for managing the health issues and promoting the well-being of the over 1.3 million children and adolescents enrolled in New York City’s 1700 school buildings.

Positions with the Office of School Health (OSH) combine clinical skills and public health training. OSH focuses on child health, asthma prevention, obesity and nutrition, vision screening, dental care, mental health, reproductive health, and childhood disability. We collaborate with various city and community based agencies to provide social and academic services to address the needs of all New York City school children, especially those facing the most significant social, economic, and health challenges.

The Office of School Health is currently undergoing expansion. There is an immediate need for physicians with an expertise in pediatric, adolescent, or family medicine, with the capacity to utilize primary care skills set through a public health lens. OSH is also  interested in public health and preventive medicine graduates with programmatic, analytic, and social medicine skills.

The NYC DOHMH is reaching out to identify candidates for this recruitment. We are enlisting your help to nominate medical professionals who are committed to contributing their talents to improve health and academic outcomes in our schools. Please consider applying for these positions or passing these opportunities on to talented physicians among your own personal networks.

Attached are the American Academy of Pediatrics position statements on the role of the School Physician as well as the job description and recruitment flyers:

  • Adolescent School Health Physician, Family and Child Health/SH Reproductive/City Medical Specialist, Level: 01/Part-time/Flexible Work Schedule (20-35 hrs/week) To learn more about this position & apply, please submit your resume & cover letter to:https://a127-jobs.nyc.gov/ In the Job ID search bar enter: Job ID: 277208
  • Field Doctor, Bureau of School Health/SH Medical (pre-K-8 Programs or High School) City Medical Specialist, Level: 01/Part-time/Flexible Work Schedule (20-35 hrs/week) To learn more about this position & apply, please submit your resume & cover letter to:https://a127-jobs.nyc.gov/ In the Job ID search bar enter: Job ID: 265869
  • Supervising Medical Doctor,Bureau of School Health/SH Reproductive Health, City Medical Specialist, Level: 02/Part-time (35 hrs/week) To learn more about this position & apply, please submit your resume & cover letter to: https://a127-jobs.nyc.gov/ Job ID:  277026

Please list in your cover letter how you heard about this position (including name of the professional association, website, or individual who referred you). If you have questions, please contact Caroline Volel, MD, MPH at OSH@health.nyc.gov.


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

May 12, 2017 – In It or Can’t Win It!


PRESIDENT’S MESSAGE
Charles Rothberg. MD
May 12, 2017
Volume 17
Number 18

MLMIC Insurance

Dear Colleagues:

As you know, MSSNY has, in the past, issued a statement that expressed significant concerns about the impact to New York practices, patients and the State Budget regarding the American Health Care Act (AHCA) legislation. At the same time, MSSNY’s statement noted the need for substantial revisions to the ACA.

In order to craft a clear physician message, we must come to understand where it is that we stand on health legislation and then come to an agreement on the merits or lack of them.

Last week, we sent out a five-question survey to our MSSNY’s Legislation and Advocacy Committee regarding their opinion of the AHCA legislation. I did not cherry-pick physicians for the survey because I figured that these physicians constitute a group that is interested, engaged and well informed on physician issues in New York.

On the recent AHCA bill, exactly 50% were opposed, 20% supported it and an amazing 30% neither supported nor opposed. On the matter of the 2010 Affordable Care Act (ACA) now in place, the outcome was evenly balanced—50% answered that the ACA (not the AHCA) should be repealed and 50% opposed repeal.

Last week MSSNY joined over 20 patient advocacy organizations in a letter to New York’s Congressional delegation stating that “…the AHCA would have significant adverse consequences to millions of New Yorkers.”  The letter urged that New York’s Congressional Delegation fight to:

  • ensure uninterrupted healthcare coverage for the 850,000 New Yorkers who gained coverage under the ACA;
  • not harm New York State’s budget and not shortchange New York’s Medicaid program; and
  • protect the more than 600,000 New Yorkers who gained coverage under the essential plan.

I have been traveling all over the state since my inauguration to speak with county society members. They want to talk about this issue. The ACA certainly caused animus among us but not division. One of our physician survey-responders commented that “we should never be in the position of opposing proposed legislation. It is far better to at least remain neutral and help craft it to our liking.”

Who better to shape this than physicians?

I attended a hospital Medical Staff meeting this week, too. Hospitals are very worried about the AHCA bill. HANYS opposes the AHCA for the following reasons:

  • It would increase by 24 million the number of uninsured nationwide, placing 2.7 million New Yorkers at risk;
  • It would upend the Medicaid program, stripping hospitals and health systems of needed resources while they care for more uninsured and underinsured patients; and
  • It would weaken federal protections for New Yorkers with pre-existing conditions.

Is the ACA working? For some yes. The patients that seem to be most negatively affected by this law are those who are “too rich for Medicaid” but too poor to afford insurance.

We all must get active and come up with better ideas.  We want to engage you on this matter—Please follow us on Twitter @MSSNYRothberg.

If you need help setting up an account, call Roseann Raia at 516-488-6100 ext. 302 to assist you.

Your comments are welcome. The elected officials’ ideas are not up to snuff.

When physicians ask me what I think, I offer them my mantra. All decisions should be made after they consider how it will affect their practice, their patients, their community and their profession.

Sincerely,
Charles Rothberg, MD
MSSNY President

Please send your comments to comments@mssny.org


Please Urge Your Legislators to Enact Legislation to Address Prior Authorization Hassles and Expand Patient Choice of Physicians
With just 6 weeks left in the Legislative Session, MSSNY is strongly advocating for a number of bills to address prior authorization hassles imposed by health insurance companies, increase coverage for patients, and to limit the ability of health insurers to narrow their networks.  These bills include:

  • 3943 (Hannon)/A.2704 (Lavine) – would provide physicians and other health care practitioners with necessary due process protections where health insurers seek to terminate a physician from its network by failing to renew the physician’s contract.  The bill has passed the Assembly and was recently reported to the Senate floor. Please send a letter in support, click here.
  • 3663 (Hannon)/A.4472 (Gottfried) – would permit independently practicing physicians to collectively negotiate patient care terms with market dominant health insurers under close state supervision. In addition to the ability to push back against exorbitant administrative hassles imposed by insurers, it would also help to protect physicians to have a stronger option to remain in independent practice. The bills have advanced to the Senate Finance Committee, and the Assembly Ways and Means Committee.  Please send a letter to your legislators in support, click here.
  • 5675 (Hannon)/A.7671 (Rosenthal) – would require health insurers to make out of network coverage options available to consumers through the New York Health Insurance Exchange. Currently, there are no out of network coverage options in the Exchange in downstate New York, despite Exchange officials strongly encouraging the offering of these options by insurers.  The bills are in the Senate Health and Assembly Insurance Committee. Please send a letter to your legislators in support, click here.
     (DIVISION OF GOVERNMENTAL AFFAIRS) 


Disastrous Liability Expansion Bill on Assembly Codes Committee Next Week; Contact Your Legislators to Oppose
All physicians are urged to contact their legislators to oppose legislation (A.3339) before the Assembly Codes Committee next week that would substantially lengthen New York’s medical liability statute of limitations.  Physicians can send a letter in opposition here: click here.  An actuarial analysis of substantially similar legislation indicated that enactment of this legislation could produce a medical liability premium increase of 15%, perhaps even greater, at a time when no increases can be tolerated and at a time when there is tremendous instability in our health care system.    Similar, but not identical legislation (S.4080) has been introduced in the Senate and is in the Senate Judiciary Committee.  Please let your legislators know that we need comprehensive medical liability reform, not one-sided proposals that will harm access to care!                                        (AUSTER)

US Senate Begins Review of AHCA
The United State Senate has begun its review of legislation that narrowly passed the US House of Representatives that enacts a partial repeal and significant revision of the ACA.  The Senate announced a 13-Senator working group to look at changes to the American Health Care Act (AHCA) legislation that was objected to by many patient and health care provider associations across the country and here in New York State.

MSSNY had previously issued statements that expressed significant concerns about the impact of the AHCA legislation to New York patients and the State Budget.   MSSNY recently joined with nearly two dozen patient advocacy organizations in a letter to New York’s Congressional delegation that noted that “while the Affordable Care Act (ACA) can be improved, replacing it with the AHCA would have significant adverse consequences to millions of New Yorkers”.   Instead, the letter urged that New York’s Congressional Delegation fight to: “Ensure uninterrupted healthcare coverage for the 24 million Americans, including the 850,000 New Yorkers who gained coverage under the ACA; Do not harm New York State’s budget and do not shortchange New York’s Medicaid program; and Protect the more than 600,000 New Yorkers who gained coverage under the Essential plan.”

These concerns were reiterated at a meeting this week of the Albany County Medical Society where physicians heard a presentation from Representative John Faso (R-Upper Hudson Valley), one of the key “swing” votes that led to the AHCA being passed by the House.  Rep. Faso’s detailed comments regarding his support for the legislation led to a spirited debate among physician attendees regarding the potential consequences to our health care delivery if this or similar legislation were to be enacted, as well as the potential consequences if this or similar legislation were not enacted.

As has been previously reported, the AHCA would maintain some provisions from the ACA, such as required coverage for pre-existing conditions, and requiring dependent coverage up to age 26.   It also contains components supported by MSSNY, such as significantly expanding the amount of funds that a person could direct to their Health Savings Account and delaying for several years implementation of the “Cadillac Tax” on comprehensive health insurance coverage.

However, the bill would jeopardize the availability of affordable health insurance coverage options for many in New York.   While the expanded eligibility for Medicaid (up to 138% FPL) would be available through the end of 2019, starting in 2020 such expanded coverage would only be continued for those who had such coverage prior to the end of 2019.  The AHCA would also repeal the tax credits currently provided to help cover cost-sharing amounts for coverage for individuals who earn too much to qualify for Medicaid.  Instead, tax credits of $2,000-$4,500 (depending upon age) would be provided to enable the purchase of health insurance coverage.   It should be noted that these tax credits would not be available for any health insurance policy that covers abortions (which is required in New York.)

Tax credits will be available in full to individuals earning less than $75,000 and households earning less than $150,000, but they will be capped for higher earners.  The AHCA would also completely eliminate funding for New York’s Essential Plan, which provides low-cost insurance coverage with little cost-sharing responsibilities for over 600,000 New Yorkers who make between 138% -200% FPL.  As the US Senate continues its review and revisions over the next weeks and months, please remain alert for further updates.    (AUSTER)

Anthem Calls Off Proposed Takeover of Cigna
Several media sources were reporting this afternoon that Anthem (the parent of Empire Blue Cross) is terminating its proposed merger with Cigna. The decision comes after a Delaware judge ruled Thursday that Cigna could walk away from the deal, which Anthem had tried to stop.  Two weeks ago, a federal appeals court upheld a lower-court ruling that blocked this proposed mega-merger from moving forward.

MSSNY worked together with the AMA and several other state medical associations to oppose this proposed merger.  Last fall, then-MSSNY President Dr. Malcolm Reid as well as AMA representatives testified at a public hearing hosted by the New York Department of Financial Services examining this proposed merger.  Dr. Reid’s testimony emphasized the already very difficult practice environment for physicians in New York State that has become worse in recent years, as a result of the narrowing of health insurer participating provider networks and increasing pre-authorization burdens, problems which undoubtedly would be made worse had this merger been permitted to move forward.

DFS Superintendent Maria Vullo issued a letter last August that highlighted concerns with the significant market impact the merger would have had if approved.  New York Attorney General Eric Schneiderman, joined several AGs across the country in litigation to oppose the proposed merger.

Following Anthem’s announcement, the AMA released a statement noting that:

“Today’s action marks the end of a proposed merger that the American Medical Association, courts and regulators widely condemned as a bad deal for patients and harmful to the nation’s health system. The termination of the Anthem-Cigna merger is a clear victory to preserve competition in the health insurance industry. To the detriment of patients, there is already far too little competition among insurers. Networks are already too narrow, and premiums are already too high…Today’s action concludes a successful campaign by the AMA and 17 state medical societies to stop the Anthem-Cigna merger. The AMA and its coalition of state medical societies worked tirelessly to protect patients and block both this merger and the Aetna-Humana merger.”
(AUSTER) 

Bills That Would Raise The Purchasing Age For Tobacco And Restrict E-Cigarettes Moving In The NYS Legislature
Two tobacco related pieces of legislation are advancing in the NYS Legislature and physicians are urged to contact their legislators to support both measures.  S.2543/A.516, which would include the use of electronic cigarettes or e-cigarettes under the Clean Indoor Air Act, is now on the calendar in both houses and can be voted on at any time.   S.3978/A.273, which would increase the purchasing age for tobacco products from eighteen to 21 years of age, is on the Senate Finance Committee for its consideration.   The Medical Society of the State of New York strongly supports both these measures and urges physicians to contact their legislators to vote in support for both bills.  Physicians can send a letter to their legislators by clicking on the link here                                                                  (HARRING, CLANCY) 

Please Contact Your Legislators to Reject Bill that Would Potentially Expand CRNA Scope
Physicians should continue to contact their legislators to urge defeat of legislation (A.442/S.1385), which purports to statutorily recognize the title of a nurse anesthetist, but is written in such a way that it could potentially empower CRNAs to work beyond the scope of their training and work independently of physician supervision.  The legislation was recently advanced from the Assembly Higher Education Committee to the Assembly Ways & Means Committee.  MSSNY and the New York State Society of Anesthesiologists oppose this legislation.  Physicians can send a letter here, click here.                                                                                             (AUSTER)            

Please Review DFS Q&A Regarding New Law to Give Physicians Power to Challenge Improper Step Therapy Protocols
The New York Department of Financial Services has released a detailed Q&A regarding the legislation enacted last year that provides physicians with a stronger ability to override health insurer step therapy medication protocols to better ensure that their patients will have coverage for the most appropriate medications.  To read the DFS Q&A, click here.

The new law requires health insurers to grant a physician’s override request of an insurer step therapy medication protocol if the drug required by the insurer is contraindicated for the patient, likely to be ineffective for the patient, or if the patient is stable on the medication requested by the physician.  If the physician’s request for an override of the step therapy protocol is denied, it would enable a physician to formally appeal the decision both within the plan’s existing appeal mechanism as well as taking an independent external appeal to assure the patient receives coverage for the medication needed by the patient.  MSSNY strongly supported this bill, and worked with a wide array of patient advocacy organizations and physician specialty societies to achieve enactment of this legislation.

The DFS Q&A notes that these new protections apply to any health insurance policy that was delivered, issued for delivery or renewed after January 1, 2017 (this would typically be group plans, which are approved by DFS on a “rolling” basis throughout the calendar year).   For example, if a policy is issued or renewed on March 1, 2017, it must comply with the new step therapy law.  However, for plans obtained through the individual market, which began this past January 1, the effective date for the step therapy protections will not be until January 1, 2018.  Please let us know if you have questions regarding this important new law.                                                          (AUSTER)  

New York Among Several States to Resolve Allegations Against CareCore for Alleged Improper Review of Imaging Requests
New York Attorney General Eric Schneiderman announced this week that New York was one of 20 states to reach an agreement with CareCore National LLC, an entity that reviews the medical necessity of imaging services.   According to the press release, the agreement settles allegations that CareCore instituted a scheme to “auto-approve” hundreds of radiology service requests on a daily basis, deeming those diagnostic services as reasonable and medically necessary, even though there had been no evaluation of those cases by the appropriate medical personnel. CareCore will pay the federal government $54 million, of which $18 million will go to the state Medicaid programs, including over $7.6 million to be returned to New York.    To read the AG’s press release, click here.

According to the press release, the agreement would resolve allegations that from January 1, 2005 through June 13, 2013, CareCore developed and implemented a program through which CareCore improperly approved over 200,000 prior authorization requests which CareCore initially determined could not be approved based on the information provided.   The press release also notes that the settlement resolves allegations that CareCore auto-approved the requests in an effort to keep up with the volume of preauthorization requests for diagnostic radiology services and to avoid a contractual monetary penalty per case for untimely reviews, which caused false or fraudulent claims to be submitted to and reimbursed by the State’s Medicaid program.                                                     (AUSTER)

Need to Meet Your Pain Management Requirement?  MSSNY Pain Management, Palliative Care and Addiction Online Program Available
The Medical Society of the State of New York Pain Management, Palliative Care and Addiction modules are now available on-line here. 

These modules are being offered free of charge to all MSSNY members.  Physicians who are new users to the MSSNY CME site will be required to register as a new user.  As a new user, physicians and non-physicians will be required to enter fields that include: position; name (the name should be what you want to appear on the CME certificate); email address; and then create a password.  MSSNY members who encounter a payment page or have difficulty registering, please email cme@mssny.org for technical support.  Directions for creating a new account/or logging in can be found here.  Non-MSSNY physicians will be charged $50 per module. 

The MSSNY CME is a new site and while many MSSNY members have an account with mssny.org a MSSNY member may not necessary have an account with cme.mssny.org   If in doubt, try to create an account and if it tells you that the email address is unavailable or in use,  an account exists.   Passwords can be reset if you don’t know it.  Physicians who have previously had an account at the MSSNY CME site will need to log into the site using their email and password.

The MSSNY CME site provides the ability for physicians and other prescribers to view the archived webinar at their leisure, take the required test, and download their certificate. The online program covers all eight topics required in the New York State statute. MSSNY developed the program with the NYS Office of Alcoholism and Substance Abuse Services (OASAS).  MSSNY is listed as an accrediting organization by the NYS DOH Bureau of Narcotic Enforcement.   Information on the three CME modules is available here.  Additional information or technical support may be obtained by contacting cme@mssny.org .
(CLANCY)

DOH Attestation Process for Pain Management CME Must Be Completed by July 1, 2017
The New York State Department of Health has announced the attestation process for prescribers required to complete Pain Management CME. Prescribers must attest to the completion of the pain management, palliative care and addiction course work or training by July 1, 2017, and again every three years thereafter. The prescriber should only attest after completion of at least three hours of course work or training covering all eight topics. A prescriber with a Health Commerce System (HCS) account will attest online using the Narcotic Education Attestation Tracker (NEAT) application.  Complete the steps to access the NEAT (Narcotic Education Attestation Tracker) application in the NYS Health Commerce System (HCS):

  1. Log into the HCS
  2. Under “My Content” click on “All Applications”
  3. Click on “N”
  4. Scroll down to NEAT (Narcotic Education Attestation Tracker) and double click to open the application. You may also click on the “+” sign to add this application under “My Applications” on the left side of the Home screen.

Complete the steps to ATTEST to the completion of the education requirement.   A full set of instructions can be found here.

Prescribers that do not have access to a computer can request a paper attestation form by calling the Bureau of Narcotic Enforcement (BNE) toll-free at 1-866-811-7957. They may then complete the form and return it by mail to the address provided in the form. The Bureau of Narcotic Enforcement has also released a Frequently Asked Questions (FAQs) on the prescriber mandate.   A copy of the FAQs can be found here.

In certain limited circumstances, the New York State Department of Health may grant an exemption to the required course work or training to an individual prescriber who clearly demonstrates to the department that there is no need to complete such training.  Exemptions will be granted only in very limited circumstances, and not solely on the basis of economic hardship, technological limitations, prescribing volume, practice area, specialty, or board certification.  Prescribers may applied for an exemption through the Health Commerce System.Further information may be obtained by contacting BNE at 1-866-811-7957 or narcotic@health.ny.gov.                                                                                                          (CLANCY)

Register Now For Upcoming Medical Matters 2017 CME Webinar Series
Registration is now open for the next Medical Matters webinar on Wednesday, May 7, 2017 at 7:30 a.m.  “Exercise Response to Novel Influenza Strains” will be conducted by Pat Anders, MS, MEP, Manager, Health Emergency Preparedness Exercises, New York State Department of Health, Office of Health Emergency Preparedness.  Registration is now available at this link.

The educational objectives are: 1)  Understand preparedness and response actions of public health and healthcare to a novel pandemic influenza, simulated in full-scale exercise.  2)  Describe two delineated strategies in which public health and office-based physicians would interact in a pandemic influenza.

Registration is also open for “Mosquito Borne Diseases” on Wednesday, June 14, 2017 at 7:30 a.m.  Faculty for this webinar are William Valenti, MD chair of MSSNY’s Infectious Disease Committee and member of the MSSNY’s Emergency Preparedness and Disaster/Terrorism Response Committee and Elizabeth Dufort, MD medical director, Division of Epidemiology from the New York State Department of Health.  .  Registration is now available at this link.

The educational objectives are: 1) Identify the most prominent mosquito borne diseases, including chikungunya, dengue, West Nile virus, yellow fever and zika.  2)  Describe the epidemiology of mosquito borne diseases.  3)  Review modes of transmission and methods of prevention of infection.  Additional information or assistance with registration may be obtained by contacting Melissa Hoffman at mhoffman@mssny.org.  Medical Matters is a series of CME webinars sponsored by MSSNY’s Committee on Emergency Preparedness and Disaster/Terrorism Response.  

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

MSSNY designates this live activity for a maximum of 1.0 AMA PRA Category 1 Credits™.   Physicians should claim only the credit commensurate with the extent of their participation in the activity.              (CLANCY, HOFFMAN) 

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

pschuh@mssny.org mauster@mssny.org pclancy@mssny.org jbelmont@mssny.org

enews large

CMS: 800,000 Clinicians Given a Pass on MACRA Requirements
According to Modern Healthcare (5/11), 806,879 clinicians will not have to comply with Merit-based Incentive Payment System reporting requirements outlined in MACRA. They will not be evaluated under MIPS in 2017. Regina McNally, VP of MSSNY Socio-Economic Division, stated that the 806,879 number includes not only physicians—but also— physician assistants, Nurse practitioners, Clinical nurse specialists, and Certified registered nurse anesthetists. She has asked CMS officials for a breakdown. “Physicians who are excluded should have received a letter from their Medicare Contractor by now. If you have not received, you are probably NOT included. If you want to verify, you can use the QPP Exemption Lookup Tool. Just type in your 10-digit NPI number,” said Ms. McNally.

The majority of physician practices were expected to use the Merit-based Incentive Payment System, known as MIPS, to comply with MACRA as opposed to alternative pay models. Under MIPS, payments would be based on a compilation of quality measures and use of electronic health records.

The exempted physicians include those with less than $30,000 in Medicare charges or fewer than 100 unique Medicare patients per year. Clinicians new to Medicare this year are also exempt this year. The agency also gave a pass to providers who have implemented a MACRA-compliant Advanced Alternative Payment Model, which is the other value-based reimbursement track doctors complying with the law can choose.

Under MIPS, physician pay will be based on success in four performance categories: quality, resource use, clinical practice improvement and “advancing care information” through use of health information technology. The advancing care criteria is based on the government’s meaningful-use program, which is used to decide whether doctors should be rewarded for using EHRs.

Medicare reimbursement for providers in 2019 will be based on how well doctors perform on these metrics this year. Under MIPS, physicians can earn a bonus or penalty of 4% of their reimbursement in 2019.

Participation Notification Letters

See a sample of the letter (zip) on the Education page of https://qpp.cms.gov/. This tool is another resource for clinicians to use to determine their status.

To get the latest information, visit the Quality Payment Program website. The Quality Payment Program Service Center may be reached at 1-866-288-8292available Monday through Friday, 8:00 AM-8:00 PM ET or via email at QPP@cms.hhs.gov. 

IPRO Supporting CMS Payment Program
IPRO has been awarded a special contract from the Centers for Medicare & Medicaid Services (CMS) to help physician practices in New York, Maryland, Virginia and the District of Columbia prepare for and participate in the new Quality Payment Program, established by the Medicare Access and CHIP Reauthorization Act of 2015 (MACRA). This technical assistance, authorized and funded under MACRA, brings direct support to an estimated thousands of Merit-based Incentive Payment System (MIPS) eligible clinicians in small practices with 15 or fewer clinicians, including small practices in rural locations, health professional shortage areas, and medically underserved areas across the country. 

The direct technical assistance is available immediately, free to all MIPS eligible clinicians, and will deliver support for up to a five-year period. “We’re very pleased to be able to support CMS in this effort to offer free technical assistance to thousands of physicians as they implement the new value-based Medicare payment system,” said IPRO Chief Medical Officer Clare Bradley, MD, MPH. IPRO will provide customized technical assistance to MIPS eligible clinicians, which may include, but is not limited to, the following:

  • Conveying the MIPS expectations and timelines,
  • Explaining the MIPS feedback report,
  • Creating a MIPS-score improvement plan,
  • Evaluating practice readiness for joining an Advanced Alternative Payment Model (APM),
  • Assessing and optimizing Health Information Technology,

Supporting change management and strategic planning,

  • Developing and disseminating education and training materials,
  • Enabling peer-to-peer learning and local partnerships.

For more information regarding this support service, go to www.mssny.org for contact information or to seek assistance.

CMP Medica 2017 Staff Salary Results
Looking to see if your staff salaries are in line with national bencharks? Check out our national data on key positions in medical practices broken out by years of experience. http://bit.ly/2qa6H7c

FDA: Doctors Should Get Info re Acupuncture/Chiropractic for Treating Pain
The Food and Drug Administration released proposed changes Wednesday to its blueprint on educating health care providers about treating pain http://bit.ly/2qb5hJk The guidelines now recommend that doctors get information about chiropractic care and acupuncture as therapies that might help patients avoid prescription opioids. “[Health care providers] should be knowledgeable about the range of available therapies, when they may be helpful, and when they should be used as part of a multidisciplinary approach to pain management,” the agency wrote in the proposal.

Expired EpiPens May Still Contain Effective Doses of Epinephrine
In a small study published in the Annals of Internal Medicine, researchers analyzed the contents of 31 EpiPens and 9 EpiPen Jrs that had expired in the prior 1–50 months. None had developed discoloration. Roughly 65% of the EpiPens and 56% of the EpiPen Jrs still had at least 90% of the labeled concentration of epinephrine. An EpiPen that had expired 50 months earlier still had 84% of the stated amount of epinephrine.

The authors conclude: “Although we observed declining concentrations of epinephrine over time, we expect that the dose available 50 months after expiration would still provide a beneficial pharmacologic response. Thus, we conclude that the process for establishing expiration dates for EpiPens should be revised and that, in the setting of outpatient anaphylaxis without other therapeutic alternatives, patients and caregivers should consider the potential benefits of using an expired EpiPen.”

Annals of Internal Medicine letter

Seven Rules of OSHA for Physicians
OSHA, the Occupational Safety and Health Administration is quite alive and well when it comes to enforcing its regulations against physicians. The seven rules that apply to physicians involve:

  1. Having a plan to reduce exposure to bloodborne pathogens.
  2. You must have a safety plan for exiting your office.
  3. You must have a plan for hazard communication; this involves hazardous chemicals of any kind. There must be a written list along with several other requirements.
  4. Electrical safety rules must be observed.
  5. New York does not require reporting occupational injuries and illnesses. There is a federal exemption for medical office reporting.
  6. Every practice must display an approved OSHA poster showing the employee rights to a safe working environment.
  7. For practices that use x-rays and imaging services, there are rules, such as radiation exposure badges.

Do NOT ignore the OSHA requirements as the fines may be substantial.

By Larry Kobak, Esq. If you have any questions, please contact Kern Augustine, P.C. at 1-800-445-0954 or via email at info@DrLaw.com.

Teens Drinking Less but Binge Drinking More
A report from the CDC that states that “teen drinking appears to have reached a new low.” The report indicates that “the percent of teens who reported drinking at least one drink per month dropped from 50.8 percent in 1991 to just 32.8 percent in 2015.” But, “those who reported drinking tended to also report what is considered binge drinking: 57.8 percent of teens who reported drinking said they have had five drinks in a row.”

The prevalence of binge drinking increased from 31.3% in 1991 to 31.5% in 1999, then declined significantly to 17.7% in 2015. However, in 2015, approximately one in three high school students drank alcohol during the past 30 days and one in six were binge drinkers. Most high school students who drank (57.8%) were also binge drinkers, and more than two in five binge drinkers consumed eight or more drinks in a row.

Open Payments Physician and Dispute Period Ends Next Week
Physicians and teaching hospitals have until May 15, 2017 to review data reported by drug and medical device makers about them and, if necessary, dispute the payments before the data is made public on June 30, 2017.

To review and dispute data, physicians and teaching hospitals must register in the Open Payments system.

If You Have Never Registered In Open Payments Before:

Make sure you have your National Provider Identifier (NPI) number, Drug Enforcement Agency (DEA) number, and State license number (SLN).  Initial registration is a two-step process and should only take about 30 minutes:

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

Please remember to select the role of “Applicable Manufacturer/GPO, Physician, or Teaching Hospital”, when registering in EIDM. If any other role is requested, no access to the Open Payments System will be granted. For any additional information on registering in EIDM, refer to the Open Payments System Quick Reference Guide Enterprise Identity Management System (EIDM) Registration here.

For Users That Registered Last Year and Have Accessed Their Accounts in the Last 60 Days:

Physicians who registered last year do not need to reregister in the EIDM or the Open Payments system. If the account has been accessed within the last 60 days, go to the CMS Enterprise Portal, log in using your user ID and password, and navigate to the Open Payments system home page.

For Users That Registered Last Year but Have Been Inactive for More than 60 Days:

The EIDM locks accounts if there is no activity for 60 days or more. To unlock an account, go to the CMS Enterprise Portal, enter your user ID and correctly answer all challenge questions; you’ll then be prompted to enter a new password.

For Users That Registered Last Year but Have Been Inactive for More than 180 Days:

The EIDM deactivates accounts if there is no activity for 180 days or more. To reinstate an account that has been deactivated, call the Open Payments Help Desk at 1-855-326-8366.

Learn more about the review and dispute process by accessing the educational materials available on the Resources page of the Open Payments website.



CLASSIFIEDS



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


Paging Primary Care MDs Who Love Technology
98point6 is a Seattle startup who wants your input. We’re seeking practicing physicians to join our council and help shape the next generation of primary care. If the fusion of health care and technology inspires you, please apply here.


Ophthalmologist Part Time
Ophthalmologist needed to work at multiple nursing homes in all 5 boros except Staten Island. Part time or full-time position available.  Generous salary and incentives.Ttech provided. Opportunity to perform surgery, but not required. Please email cv to privacyssw@gmail.com


Multiple Physician Positions with DOHMH Office of School Health
Office of School Health is the largest program of the New York City Department of Health and Mental Hygiene (DOHMH). This bureau is responsible for managing the health issues and promoting the well-being of the over 1.3 million children and adolescents enrolled in New York City’s 1700 school buildings.

Positions with the Office of School Health (OSH) combine clinical skills and public health training. OSH focuses on child health, asthma prevention, obesity and nutrition, vision screening, dental care, mental health, reproductive health, and childhood disability. We collaborate with various city and community based agencies to provide social and academic services to address the needs of all New York City school children, especially those facing the most significant social, economic, and health challenges.

The Office of School Health is currently undergoing expansion. There is an immediate need for physicians with an expertise in pediatric, adolescent, or family medicine, with the capacity to utilize primary care skills set through a public health lens. OSH is also  interested in public health and preventive medicine graduates with programmatic, analytic, and social medicine skills.

The NYC DOHMH is reaching out to identify candidates for this recruitment. We are enlisting your help to nominate medical professionals who are committed to contributing their talents to improve health and academic outcomes in our schools. Please consider applying for these positions or passing these opportunities on to talented physicians among your own personal networks.

Attached are the American Academy of Pediatrics position statements on the role of the School Physician as well as the job description and recruitment flyers:

  • Adolescent School Health Physician, Family and Child Health/SH Reproductive/City Medical Specialist, Level: 01/Part-time/Flexible Work Schedule (20-35 hrs/week) To learn more about this position & apply, please submit your resume & cover letter to:https://a127-jobs.nyc.gov/ In the Job ID search bar enter: Job ID: 277208
  • Field Doctor, Bureau of School Health/SH Medical (pre-K-8 Programs or High School) City Medical Specialist, Level: 01/Part-time/Flexible Work Schedule (20-35 hrs/week) To learn more about this position & apply, please submit your resume & cover letter to:https://a127-jobs.nyc.gov/ In the Job ID search bar enter: Job ID: 265869
  • Supervising Medical Doctor,Bureau of School Health/SH Reproductive Health, City Medical Specialist, Level: 02/Part-time (35 hrs/week) To learn more about this position & apply, please submit your resume & cover letter to: https://a127-jobs.nyc.gov/ Job ID:  277026

Please list in your cover letter how you heard about this position (including name of the professional association, website, or individual who referred you). If you have questions, please contact Caroline Volel, MD, MPH at OSH@health.nyc.gov.


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

May 5, 2017 – Many Object to ACA Repeal


PRESIDENT’S MESSAGE
Charles Rothberg. MD
May 5, 2017
Volume 17
Number 17

MLMIC Insurance

Dear Colleagues:

This week, I traveled to Rochester to speak to the Monroe County Medical Society.

Although I had prepared a speech—mercifully, I cut it short. The physicians were very eager to talk about the AHCA bill and what it meant to medicine and their practices. I told them that I had been interviewed recently by Crain’s Health Pulse and they mistitled the article, “State Doctors’ Group Stays Neutral on AHCA.”

Doctors are NOT neutral on this topic. However, we are divided.

It is unfortunate that the newest health bill would have the effect of watering down existing protections for pre-existing conditions as the means to reduce premiums.  As to our physician community, any state or national health care legislation should provide better solutions that are less burdensome on our profession, our patients and their health outcomes. Let us not be divided on these essentials.

Moe Auster, VP of MSSNY Legislative and Regulatory Affairs, has provided us with an overview how the ACA affects New York.

House of Representatives Approves ACA Repeal Legislation Objected to by Many
By a 217-213 vote, the US House of Representatives passed an amended version of the American Health Care Act (AHCA) that was objected to by many patient and health care provider associations across the country and here in New York State.  Several media outlets have reported that the prospects for passage in the Senate are uncertain, as several GOP Senators have expressed concerns with various provisions.

MSSNY Issued Concerns

MSSNY had previously issued statements that expressed significant concerns about the impact to New York patients and the State Budget as a result of this legislation. Last week, MSSNY joined with nearly two dozen patient advocacy organizations in a letter to New York’s Congressional delegation that noted that “while the Affordable Care Act (ACA) can be improved, replacing it with the AHCA would have significant adverse consequences to millions of New Yorkers”  Instead, the letter urged that New York’s Congressional Delegation fight to: “Ensure uninterrupted healthcare coverage for the 24 million Americans, including the 850,000 New Yorkers who gained coverage under the ACA; Do not harm New York State’s budget and do not shortchange New York’s Medicaid program; and Protect the more than 600,000 New Yorkers who gained coverage under the Essential plan.”

AMA President Dr. Andrew Gurman issued a statement expressing great concerns with the bill that passed the House:

“The bill passed by the House … will result in millions of Americans losing access to quality, affordable health insurance and those with pre-existing health conditions face the possibility of going back to the time when insurers could charge them premiums that made access to coverage out of the question. Action is needed, however, to improve the current health care insurance system … while preserving the safety net for vulnerable populations.”

As has been previously reported, the AHCA would maintain some provisions from the ACA, such as required coverage for pre-existing conditions, and requiring dependent coverage up to age 26.   It also contains components supported by MSSNY, such as significantly expanding the amount of funds that a person could direct to their Health Savings Account and delaying for several years implementation of the “Cadillac Tax” on comprehensive health insurance coverage.

Bill Would Jeopardize Available Options

However, the bill would jeopardize the availability of affordable health insurance coverage options for many in New York. While the expanded eligibility for Medicaid (up to 138% FPL) would be available through the end of 2019, starting in 2020 such expanded coverage would only be continued for those who had such coverage prior to the end of 2019.  The AHCA would also repeal the tax credits currently provided to help cover cost-sharing amounts for coverage for individuals who earn too much to qualify for Medicaid.  Instead, tax credits of $2,000-$4,500 (depending upon age) would be provided to enable the purchase of health insurance coverage.   Tax credits will be available in full to individuals earning less than $75,000 and households earning less than $150,000, but they will be capped for higher earners.  The AHCA would also completely eliminate funding for New York’s Essential Plan, which provides low-cost insurance coverage with little cost-sharing responsibilities for over 600,000 New Yorkers who make between 138% -200% FPL.

How They Voted

All 18 Democrats in New York’s Congressional delegation opposed the bill, as did Republicans Dan Donovan (Staten Island) and John Katko (Syracuse).  New York Republicans supporting the bill include Chris Collins (Western New York), John Faso (Hudson Valley), Peter King (Nassau County), Tom Reed (Southern Tier), Elise Stefanik (Northern New York), Claudia Tenney (Mohawk Valley), and Lee Zeldin (Suffolk County).

Sincerely,
Charles Rothberg, MD
MSSNY President

Please send your comments to comments@mssny.org




House of Representatives Approves Partial ACA Repeal Legislation Objected to by Many Patient Advocacy Organizations
By a 217-213 vote, the US House of Representatives passed an amended version of the American Health Care Act (AHCA) that was objected to by many patient and health care provider associations across the country and here in New York State.  Several media outlets have reported that the prospects for passage in the Senate are uncertain, as several GOP Senators have expressed concerns with various provisions.

MSSNY had previously issued statements that expressed significant concerns about the impact to New York patients and the State Budget as a result of this legislation. Last week, MSSNY joined with nearly two dozen patient advocacy organizations in a letter to New York’s Congressional delegation that noted that “while the Affordable Care Act (ACA) can be improved, replacing it with the AHCA would have significant adverse consequences to millions of New Yorkers”  Instead, the letter urged that New York’s Congressional Delegation fight to: “Ensure uninterrupted healthcare coverage for the 24 million Americans, including the 850,000 New Yorkers who gained coverage under the ACA; Do not harm New York State’s budget and do not shortchange New York’s Medicaid program; and Protect the more than 600,000 New Yorkers who gained coverage under the Essential plan.”

AMA President Dr. Andrew Gurman issued the following statement expressing great concerns with the bill that passed the House:

The bill passed by the House today will result in millions of Americans losing access to quality, affordable health insurance and those with pre-existing health conditions face the possibility of going back to the time when insurers could charge them premiums that made access to coverage out of the question. Action is needed, however, to improve the current health care insurance system. The AMA urges the Senate and the Administration to work with physician, patient, hospital and other provider groups to craft bipartisan solutions so all American families can access affordable and meaningful coverage, while preserving the safety net for vulnerable populations.

As has been previously reported, the AHCA would maintain some provisions from the ACA, such as required, availability of coverage for those with  pre-existing conditions, and requiring dependent coverage up to age 26.   It also contains components supported by MSSNY, such as significantly expanding the amount of funds that a person could direct to their Health Savings Account and delaying for several years implementation of the “Cadillac Tax” on comprehensive health insurance coverage. However, the bill would jeopardize the availability of affordable health insurance coverage options for many in New York.

While the expanded eligibility for Medicaid (up to 138% FPL) would be available through the end of 2019, starting in 2020 such expanded coverage would only be continued for those who had such coverage prior to the end of 2019.  The AHCA would also repeal the tax credits currently provided to help cover cost-sharing amounts for coverage for individuals who earn too much to qualify for Medicaid.  Instead, tax credits of $2,000-$4,500 (depending upon age) would be provided to enable the purchase of health insurance coverage.

Tax credits will be available in full to individuals earning less than $75,000 and households earning less than $150,000, but they will be capped for higher earners.  The AHCA would also completely eliminate funding for New York’s Essential Plan, which provides low-cost insurance coverage with little cost-sharing responsibilities for over 600,000 New Yorkers who make between 138% -200% FPL. All 18 Democrats in New York’s Congressional delegation opposed the bill, as did Republicans Dan Donovan (Staten Island) and John Katko (Syracuse).  New York Republicans supporting the bill include Chris Collins (Western New York), John Faso (Hudson Valley), Peter King (Nassau County), Tom Reed (Southern Tier), Elise Stefanik (Northern New York), Claudia Tenney (Mohawk Valley), and Lee Zeldin (Suffolk County).
(AUSTER)                               


Bills That Would Raise The Purchasing Age For Tobacco And Restrict E-Cigarettes Moving In The NYS Legislature
Two tobacco related pieces of legislation are advancing in the NYS Legislature and physicians are urged to contact their legislators to support both measures.  S.2543/A.516, which would include the use of electronic cigarettes or e-cigarettes under the Clean Indoor Air Act, is now on the calendar in both houses and can be voted on at any time.   S.3978/A.273, which would increase the purchasing age for tobacco products from eighteen to 21 years of age, is in the Senate Finance Committee.

The Medical Society of the State of New York strongly supports both these measures and urges physicians to contact their legislators to vote in support for both bills.  Physicians can send a letter to their legislators by clicking on the link: here.                                                                                                                       (HARRING, CLANCY)

Collective Negotiation Bill Advances – Get Active and Contact Your Legislators
With the legislative session expected to end June 21st.MSSNY is currently advocating for various pieces of legislation to better enable physicians to be able to continue to assure their patient are able to receive timely and quality care.  This week, one of MSSNY’s priority bills just moved through the Senate Health Committee to the Finance Committee. The bill (S.3663, Hannon / A.4472, Gottfried ) would allow independently practicing physicians to collectively negotiate patient care terms with market dominant health insurers under close state supervision.

Its Assembly counterpart has advanced to the Assembly Ways & Means Committee. It is very important that you send a letter to your legislators so that we can inform our legislators how important the bill is for physicians. Physicians can send a letter  here. The Legislature is scheduled for a three day session next week, covering Monday through Wednesday. You can call your legislator’s directly in their legislative offices in Albany to speak about the issues impacting your ability to treat patients including this issue.

Senate- 518-455-2800
Assembly- 518-455-4100
(BELMONT)


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


Please Contact Your Legislators to Reject CRNA Scope Expansion Bill
Physicians are urged to contact their legislators to urge defeat of legislation (A.442/S.1385) which purports to statutorily recognize the title of a nurse anesthetist, but would potentially empower CRNAs to work beyond the scope of their training and work independently of physician supervision.  The legislation was advanced from the Assembly Higher Education Committee to the Assembly Ways & Means Committee this week.  MSSNY and the New York State Society of Anesthesiologists oppose this legislation.  Physicians can send a letter  here.
(AUSTER) 

IPRO CME Webinar on MAPPP App
Alex C Spyropoulos, MD, FACP, FCCP, FRCPC and Jessica Cohen, MD will serve as faculty for an IPRO CME webinar entitled “Management of Anticoagulation in the Peri-Procedural Period (MAPPP) App:  Overview, Instructions and Case Studies.”  The webinar will be held on Friday, 5/12/17, 11-12am ET.  Registration is required.  The registration and webinar connection information can also be found under “Event” at this link:  http://mappp.ipro.org.

Program flyer may be accessed here.

This activity has been planned and implemented in accordance with the accreditation requirements and policies of the Accreditation Council for Continuing Medical Education (ACCME) through the joint providership of The Medical Society of the State of New York (MSSNY) and IPRO.  MSSNY is accredited by ACCME to provide continuing medical education for physicians.

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

For more information contact: Anne Myrka, IPRO Director, Drug Safety (518) 320-3591 anne.myrka@area-i.hcqis.org. (HARDIN)

MSSNY Pain Management, Palliative Care and Addiction Online Program Available
The Medical Society of the State of New York Pain Management, Palliative Care and Addiction modules are now available on-line here. 

These modules are being offered free of charge to all MSSNY members.  Physicians who are new users to the MSSNY CME site will be required to register as a new user.  As a new user, physicians and non-physicians will be required to enter fields that include: position; name (the name should be what you want to appear on the CME certificate); email address; and then create a password.  MSSNY members who encounter a payment page or have difficulty registering, please email cme@mssny.org for technical support.  Directions for creating a new account/or logging in can be found here..  Non-MSSNY physicians will be charged $50 per module. 

The MSSNY CME is a new site and while many MSSNY members have an account with mssny.org a MSSNY member may not necessary have an account with cme.mssny.org   If in doubt, try to create an account and if it tells you that the email address is unavailable or in use,  an account exists.   Passwords can be reset if you don’t know it.  Physicians who have previously had an account at the MSSNY CME site will need to log into the site using their email and password.

The MSSNY CME site provides the ability for physicians and other prescribers to view the archived webinar at their leisure, take the required test, and download their certificate. The online program covers all eight topics required in the New York State statute. MSSNY developed the program with the NYS Office of Alcoholism and Substance Abuse Services (OASAS).  MSSNY is listed as an accrediting organization by the NYS DOH Bureau of Narcotic Enforcement.   Information on the three CME modules is available here.  Additional information or technical support may be obtained by contacting cme@mssny.org.

DOH Attestation Process for Pain Management CME Must Be Completed by July 1, 2017
The New York State Department of Health has announced the attestation process for prescribers required to complete Pain Management CME . Prescribers must attest to the completion of the pain management, palliative care and addiction course work or training by July 1, 2017, and again every three years thereafter. The prescriber should only attest after completion of at least three hours of course work or training covering all eight topics. A prescriber with a Health Commerce System (HCS) account will attest online using the Narcotic Education Attestation Tracker (NEAT) application.  Complete the steps to access the NEAT (Narcotic Education Attestation Tracker) application in the NYS Health Commerce System (HCS):

  1. Log into the HCS
  2. Under “My Content” click on “All Applications”
  3. Click on “N”
  4. Scroll down to NEAT (Narcotic Education Attestation Tracker) and double click to open the application. You may also click on the “+” sign to add this application under “My Applications” on the left side of the Home screen.

Complete the steps to ATTEST to the completion of the education requirement.   A full set of instructions can be found here.

Prescribers that do not have access to a computer can request a paper attestation form by calling the Bureau of Narcotic Enforcement (BNE) toll-free at 1-866-811-7957. They may then complete the form and return it by mail to the address provided in the form. The Bureau of Narcotic Enforcement has also released a Frequently Asked Questions (FAQs) on the prescriber mandate.   A copy of the FAQs can be found here. In certain limited circumstances, the New York State Department of Health may grant an exemption to the required course work or training to an individual prescriber who clearly demonstrates to the department that there is no need to complete such training.

Exemptions will be granted only in very limited circumstances, and not solely on the basis of economic hardship, technological limitations, prescribing volume, practice area, specialty, or board certification.  Prescribers may applied for an exemption through the Health Commerce System. Further information may be obtained by contacting BNE at 1-866-811-7957 or narcotic@health.ny.gov.             (CLANCY)

Rep. Crowley Re-Introduces Bi-Partisan Resident Physician Reduction Shortage Act
House Democratic Caucus Chair Joseph Crowley (D-Queens) and Representative Ryan Costello (R-Pennsylvania) announced this week the reintroduction of legislation to increase the current cap on the number of Medicare-supported training slots for doctors, to help meet the growing demands for physicians as our nation faces a looming doctor shortage.

The legislation would increase the number of Medicare-supported hospital residency positions by 15,000 (3,000 slots per year, over five years), bringing the total number of slots available to 105,000 and opening up significant new opportunities for future physicians and for the teaching hospitals that train them.  The press release noted that the U.S. is expected to face a shortage of up to 104,900 physicians by 2030, including shortages in both primary and specialty care, according to the Association of American Medical Colleges.  MSSNY has policy, adopted at its 2011 House of Delegates, calling for elimination of the cap on the number of Medicare funded residency programs.  This legislation would go a long way towards addressing the goals of this resolution. Rep. Crowley noted in the press release: “A doctor shortage is something we just can’t ignore.

This is a nationwide problem and the path to ensuring all Americans have access to high-quality, well-trained physicians is through the strengthening of GME programs.” Rep. Costello noted in the press release “A strong physician workforce is vital to ensuring all Americans have timely access to essential and quality healthcare.  This legislation would allow Congress to address concerns about physician shortages by providing teaching hospitals with the necessary resources to support increased residency openings.”        (AUSTER)

Register Now For Upcoming Medical Matters 2017 CME Webinar Series
Registration is now open for the next Medical Matters webinar on Wednesday, May 7, 2017 at 7:30 a.m.  “Exercise Response to Novel Influenza Strains” will be conducted by Pat Anders, MS, MEP, Manager, Health Emergency Preparedness Exercises, New York State Department of Health, Office of Health Emergency Preparedness.  Registration is now available at this link. The educational objectives are: 1)  Understand preparedness and response actions of public health and healthcare to a novel pandemic influenza, simulated in full-scale exercise.  2)  Describe two delineated strategies in which public health and office-based physicians would interact in a pandemic influenza.  Registration is also open for Mosquito Borne Diseases” on Wednesday, June 14, 2017 at 7:30 a.m.  Faculty for this webinar are William Valenti, MD chair of MSSNY’s Infectious Disease Committee and member of the MSSNY’s Emergency Preparedness and Disaster/Terrorism Response Committee and Elizabeth Dufort, MD medical director, Division of Epidemiology from the New York State Department of Health.  Registration is now available at this link.

The educational objectives are: 1) Identify the most prominent mosquito borne diseases, including chikungunya, dengue, West Nile virus, yellow fever and zika.  2)  Describe the epidemiology of mosquito borne diseases.  3)  Review modes of transmission and methods of prevention of infection.  Additional information or assistance with registration may be obtained by contacting Melissa Hoffman at mhoffman@mssny.org.  Medical Matters is a series of CME webinars sponsored by MSSNY’s Committee on Emergency Preparedness and Disaster/Terrorism Response.  

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

MSSNY designates this live activity for a maximum of 1.0 AMA PRA Category 1 Credits™.   Physicians should claim only the credit commensurate with the extent of their participation in the activity.
(CLANCY, HOFFMAN)

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

pschuh@mssny.org mauster@mssny.org pclancy@mssny.org jbelmont@mssny.org

enews large


More than 6,000 New York Organ Donors Signed Up in One Week
Gov. Andrew Cuomo announced that 6,326 people enrolled in the New York State Donate Life Registry in the week ending April 27th.

Cuomo signed legislation last year requiring the health department to add the organ donation component to its health insurance application.

Anyone 16 or older completing an application, renewing a plan, or making a life status change is now asked if they would like to be added to the Donate Life Registry.

Organ donors also enroll at the websites for the Department of Health, the Department of Motor Vehicles, the Board of Elections, and when applying for the NYC Identification Card.

HCS Will Discontinue Access for Computers Running Windows XP and Internet Explorer9 (IE9)
The Health Commerce System (HCS) will be discontinuing access for computers running Windows XP and Microsoft Internet Explorer 9 (IE9) and older web browsers as they pose a security risk to HCS applications.  Windows XP users must upgrade their operating system and IE9 users must upgrade their browser by June 1, 2017 to continue using the HCS, as the HCS will block connections from computers running Windows XP and IE9 browser and older.

  • What:  The HCS will discontinue access for PCs using Windows XP and Microsoft IE9 and older web browsers. Upon implementation of this change, any computer running Windows XP or IE9 or older will not be able to connect to or open https://commerce.health.state.ny.us.
  • When:  This change is scheduled for June 1, 2017.
  • Why:  Due to NYS application and data security requirements, HCS access will be discontinued for unsecured IE9 and older web browsers and Windows XP operating system on June 1, 2017.
  • What is at stake:  Inability to access the HCS will affect your ability to: comply with New York State Public Health and Education laws; access critical information and data; and receive HCS technical support.

Specifically, you will not be allowed access to the following applications:

  • Patient narcotic histories (i-STOP/PMP);
  • E-Prescribing waivers;
  • Your Physician Profile;
  • The New York State Immunization Information System;
  • Environmental Health EHCitrix Platform;
  • Evacuation of Facilities in Disasters System (eFINDS);
  • The Health Electronic Response Data System (HERDS); and
  • Other mission-critical applications.

What to do next:  If you are using Windows XP or IE9, you must upgrade your PC to a modern, secure operating system as soon as possible, and upgrade your IE9 or older web browser.  It is suggested you perform the following actions to upgrade your PC and browser:

1.      OPERATING SYSTEM: To upgrade to a current Windows operating system please visit http://www.microsoft.com to determine if your computer can be upgraded.  To upgrade, follow the instructions on the Microsoft website. Please note that Windows 10 users will still need to use Microsoft Internet Explorer 11 or Google Chrome as most HCS applications do not yet support the Microsoft Edge browser, which is the default browser for Microsoft 10.

2.      BROWSER: If you are not sure which Internet browser you are using, please visit http://whatsmybrowser.org to determine your browser and version.

On the Windows platform, the HCS currently supports Microsoft Internet Explorer and Google Chrome, and offers partial support for Mozilla Firefox. You may download the latest version of these browsers from the following links:

Microsoft Internet Explorer:
http://windows.microsoft.com/en-us/internet-explorer/download-ie
Google Chrome:
https://www.google.com/chrome/browser/desktop/
Mozilla Firefox:
https://www.mozilla.org/en-US/firefox/new/

User of MacOS, OSX, Windows 7, Windows 8, or Windows 10 and users of Google Chrome, Microsoft Internet Explorer 10 or newer, or Safari on the Mac platform, are not affected by this change.Please contact hcsxpeol@health.ny.gov for questions or assistance.

NRMP 2017 Main Residency Match Report: Record-High 31,554 Positions Filled
The National Resident Matching Program® (NRMP®) has released the Results and Data Book for the 2017 Main Residency Match®, the system through which U.S. and international medical school students and graduates obtain residency positions in United States teaching institutions. The Match included a record-high 43,157 registered applicants and 31,757 positions. When the matching algorithm was processed 30,478 positions were filled, and of the 1,177 positions offered through the Match Week Supplemental Offer and Acceptance Program® (SOAP®), 1,076 were filled. Only 203 positions remained unfilled at the conclusion of SOAP, resulting in an overall fill rate of 99.4 percent. 

Other Highlights

  • Although the number of Match registrants was the most ever, the increase was due primarily to growth in U.S. allopathic medical school seniors (increase of 362) and students/graduates of U.S. osteopathic medical schools (increase of 722).
  • The number of U.S. citizen and non-U.S. citizen international medical school students and graduates (IMGs) who submitted program choices declined; however, their match rates of 54.8% and 52.4% respectively were the highest in more than a decade.
  • In the six years since implementation of the All In Policy in 2013, the primary care specialties of Internal Medicine, Family Medicine, and Pediatrics have added a combined 2,900 positions, a 25.8 percent increase.
  • Since 2012, the number of U.S. allopathic seniors matching to Family Medicine has increased every year from 1,322 to 1,513.

The Results and Data Book is widely recognized as the most comprehensive data and analysis resource about the Main Residency Match. The report documents matches by specialty and applicant type, applicant preferred specialty, trends in specialty competitiveness, and positions per active applicant.

View and download the report Match by the Numbers

Poll: Lowering Prescription Drug Costs a High Priority for Many Americans
Six in 10 Americans identify lowering the cost of prescription drugs as a “top priority” for President Trump and Congress when it comes to health care, according to a recent poll by the Kaiser Family Foundation. When asked about specific proposals to hold down drug costs, a majority of adults support allowing the federal government to negotiate with drug companies to lower prices for Medicare beneficiaries (92%); making it easier for generic drugs to come to market (87%); requiring drug companies to release information on how they set prices (86%); limiting what drug companies can charge for certain high-cost drugs (78%); allowing Americans to buy drugs imported from Canada (72%); and creating an independent group to oversee drug pricing (72%).

US Health Officials Concerned That Puerto Rico Not Reporting All Zika Cases
Health officials claim that Puerto Rico is downplaying the extent of its Zika problem and have struggled to get a grasp on the issue because of a protracted dispute with health officials in the territory, according to a document obtained by STAT.

The rift was so contentious that, at one point, health leaders in Puerto Rico refused to meet with their counterparts from the CDC. The multipage document suggests that the dispute has obscured the extent of the territory’s problem for more than half a year.

The focus of the dispute centers on Puerto Rico’s handling of a surveillance system set up to track pregnant women and identify infants and fetuses with Zika-related birth defects — and concerns that officials there are undercounting cases. The registry is called ZAPSS (the Zika Active Pregnancy Surveillance System) and the CDC awarded Puerto Rico’s Department of Health $9.5 million in grants to establish and operate it on the island.

New York RX Card Can Help Patients with Prescription Costs
With healthcare costs rising, many of your patients need assistance. The New York Rx Card can help with those prescription costs and is a free program available to all New York residents. There are no eligibility requirements or forms to fill out. Tell your patients to simply take the card into the pharmacy to get savings of up to 75% on prescription medications for their whole family. New York Rx Card is a proud supporter of Children’s Miracle Network. A donation will be made to your local CMN hospital each time a prescription is processed through the New York Rx Card. Your patients can find and print their FREE card here!

CMS is Accepting Measure Submissions for the Advancing Care Information Performance Category until June 30
There’s still time to submit measures for the Advancing Care Information performance category of the Merit-based Incentive Payment System (MIPS). The Centers for Medicare and Medicaid Services (CMS) Annual Call for Measures and Activities ends June 30, 2017.

CMS encourages providers to identify and submit measures for the MIPS Advancing Care Information performance category. To be considered, proposals must include specific criteria including, but not limited to, measure description, measure type and numerator and denominator descriptions.

CMS requests that stakeholders consider outcome-based measures, patient safety measures, and measures are cross cutting which use certified EHR technology to support the improvement activities and quality performance categories of MIPS.

How to Submit

Please use the Advancing Care Information Submission Form to propose measures for inclusion, and send the form to CMSCallforMeasuresACI@ketchum.com. 

For More Information

To learn more about the process for submitting measures, please visit the Call for Measures webpage, and review the Call for Measures and Activities fact sheet.

Applications(RFA) for Doctors Across New York Ambulatory Care Training Program
The New York State Department of Health’s Office of Primary Care and Health Systems Management (OPCHSM), Center for Health Care Policy and Resource Development, Division of Workforce Transformation, has issued a Request for Applications (RFA) for Doctors Across New York Ambulatory Care Training Program.  Information is available on the Department website at:  www.health.ny.gov/funding/ and the RFA is available on the New York State Grants Gateway at:  Doctors Across New York Ambulatory Care Training Program.To apply, eligible applicants must submit applications via the Grants Gateway.  The link to the site is as follows:  https://grantsgateway.ny.gov.

Written questions must be submitted to GME@health.ny.gov by May 22nd 2017 and they should note in the subject line: “DANY Ambulatory Care RFA Question”.  Questions, answers and updates will be posted on or about June 1st 2017. Proposals are due via the Grants Gateway by June 22nd 2017 by 4:00 PM EST.

Physician Foundation “Practice of Medicine” Series in Health Affairs May Issue
The Physicians Foundation, of which MSSNY is a Charter Member, is proudly sponsoring a new Health Affairs series, “The Practice of Medicine.” The second study of the series, “The Medicare Access and CHIP Reauthorization Act and the Corporate Transformation of American Medicine,” was published this week in the Health Affairs May issue. The full article is attached and available to read through http://bit.ly/2p1RwtL ifyou have a Health Affairs subscription.



CLASSIFIEDS


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


Luxurious Medical Office Space to Share in Manhattan
Spacious and modern wellness office suite off 5th avenue, near grand central, and all major subway lines. Newly renovated space catering to the needs of various health practitioners and their clients (vision, chiropractors, acupuncturists, psychologists, nutritionists, etc.) 13 foot ceilings throughout. Two spacious waiting areas, elegantly furnished. Two bathrooms en suite. Fully equipped kitchen/pantry area. Two elevators. Free coffee/tea station, hot/cold water cooler, free mail sorting services. Windowed offices starting from $2,800. Utilities, cleanings and high speed internet. Call: 570-499-5851 / email: columbuslaservision@gmail.com


Physician Opportunities


Paging Primary Care MDs Who Love Technology
98point6 is a Seattle startup who wants your input. We’re seeking practicing physicians to join our council and help shape the next generation of primary care. If the fusion of health care and technology inspires you, please apply here.


Ophthalmologist Part Time
Ophthalmologist needed to work at multiple nursing homes in all 5 boros except Staten Island. Part time or full-time position available.  Generous salary and incentives.Ttech provided. Opportunity to perform surgery, but not required. Please email cv to privacyssw@gmail.com


Multiple Physician Positions with DOHMH Office of School Health
Office of School Health is the largest program of the New York City Department of Health and Mental Hygiene (DOHMH). This bureau is responsible for managing the health issues and promoting the well-being of the over 1.3 million children and adolescents enrolled in New York City’s 1700 school buildings.

Positions with the Office of School Health (OSH) combine clinical skills and public health training. OSH focuses on child health, asthma prevention, obesity and nutrition, vision screening, dental care, mental health, reproductive health, and childhood disability. We collaborate with various city and community based agencies to provide social and academic services to address the needs of all New York City school children, especially those facing the most significant social, economic, and health challenges.

The Office of School Health is currently undergoing expansion. There is an immediate need for physicians with an expertise in pediatric, adolescent, or family medicine, with the capacity to utilize primary care skills set through a public health lens. OSH is also  interested in public health and preventive medicine graduates with programmatic, analytic, and social medicine skills.

The NYC DOHMH is reaching out to identify candidates for this recruitment. We are enlisting your help to nominate medical professionals who are committed to contributing their talents to improve health and academic outcomes in our schools. Please consider applying for these positions or passing these opportunities on to talented physicians among your own personal networks.

Attached are the American Academy of Pediatrics position statements on the role of the School Physician as well as the job description and recruitment flyers:

  • Adolescent School Health Physician, Family and Child Health/SH Reproductive/City Medical Specialist, Level: 01/Part-time/Flexible Work Schedule (20-35 hrs/week) To learn more about this position & apply, please submit your resume & cover letter to:https://a127-jobs.nyc.gov/ In the Job ID search bar enter: Job ID: 277208
  • Field Doctor, Bureau of School Health/SH Medical (pre-K-8 Programs or High School) City Medical Specialist, Level: 01/Part-time/Flexible Work Schedule (20-35 hrs/week) To learn more about this position & apply, please submit your resume & cover letter to:https://a127-jobs.nyc.gov/ In the Job ID search bar enter: Job ID: 265869
  • Supervising Medical Doctor,Bureau of School Health/SH Reproductive Health, City Medical Specialist, Level: 02/Part-time (35 hrs/week) To learn more about this position & apply, please submit your resume & cover letter to: https://a127-jobs.nyc.gov/ Job ID:  277026

Please list in your cover letter how you heard about this position (including name of the professional association, website, or individual who referred you). If you have questions, please contact Caroline Volel, MD, MPH at OSH@health.nyc.gov.


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

1 49 50 51 52 53 61