MSSNY eNews: September 4, 2020 – Laboring on Your Behalf: Telehealth and PPE Advocacy Updates; New PPE Offering


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Colleagues:

The COVID crisis has ushered in big changes in how we see and treat patients. Telehealth has emerged as a new safe and effective tool in our box. Many appointments have been shifted from in-office visits to telehealth appointments, a fact that I shared with our NYS legislature on August 12th during testimony at a joint hearing of the NYS Assembly and Senate on COVID-19 and hospitals. I discussed the importance of payment parity for telehealth visits, both audio and video.

Telehealth Issues

On August 26, I was invited by the Home Care Association (HCA) to participate in a panel discussion with HANYS, HPA, LANY, MSSNY and HCA on “Collaborating Across the Continuum.” Telehealth was an issue that emerged as a common theme and we will build on that discussion. Assemblywoman Carrie Woerner (D- Saratoga) has introduced A.9667, which would require insurance companies to provide payment parity for primary care services delivered via telehealth, equal to payment for in-office visits. We have conveyed that this bill should be expanded to include parity for all specialties. We will continue to build a coalition and work with the NYS legislature, to pass payment parity legislation this year.

PPE Still an Issue

Thankfully, COVID-19 positivity rates have remained at low levels throughout the summer in NYS.  However, the PPE crisis continues with cost and acquisition remaining as significant problems for New York State physicians. I discussed this in my testimony to the NYS legislature in August and this was another item of common concern on the HCA panel discussion.  MSSNY this month has met with the Governor’s office and the members of the NYS legislature to discuss the problem and solutions.

Last week, we met with the Health Plan Association (HPA) and we discussed this as a safety issue for plan members, panel physicians and physicians’ staff.  We were told that some plans are providing their members with free PPE.  In addition, NY HPA President, Eric Linzer agreed to work with us on additional solutions. In the meantime, MSSNY has been informed that some physician practices are billing CPT 99070 – Supplies and materials provided by the physician or other qualified health care professional over and above those usually included with the office visit or other services rendered to represent charges for PPE; and, that some companies are intermittently allowing these charges. We will be following up with the HPA as well as the legislature and the Governor’s office to resolve the PPE supply and cost issues.

Face Shields Available Soon

As you know, from time to time MSSNY has been able to secure quality PPE for our members. Another such opportunity has arisen. MSSNY reached out the Ford Motor Company who has been working on providing PPE to healthcare companies in need. Ford responded to our request by donating 6,000 face shields to MSSNY. We will be distributing these face shields on a first-come, first-served basis in quantities of 25 per member (while supplies last) for the cost of shipping and handling. Keep checking your email for details concerning this offer.

At MSSNY, we have your back, advocating relentlessly on your behalf and listening to and providing for your needs.

I wish all a happy and healthy Labor Day Weekend.

Bonnie Litvack, MD
MSSNY President


Three Hour Pain Management, Palliative Care and Addiction Coursework
Due
October 1st Available at MSSNY CME Website
The Medical Society of the State of New York updated 2020 Pain Management, Palliative Care and Addiction modules are now available on-line here.  The three-hour program must be completed by all physicians and providers who hold a DEA license by October 1, 2020.  The requirement was delayed from July to October due to the COVID 19 pandemic.

The three one hour 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.

These online programs cover all eight topics required in the New York State statute:

  • New York State and federal requirements for prescribing controlled substances
  • Pain management
  • Appropriate prescribing
  • Managing acute pain
  • Palliative medicine
  • Prevention, screening and signs of addiction
  • Responses to abuse and addiction
  • End of life care

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. These courses are entitled:

  • PM, PC & A 2020: Understanding the Current Legal Landscape in New York State
  • PM, PC & A 2020: When to Consider Opioid Therapy for Chronic Non-Cancer Pain and in Palliative Care
  • PM, PC & A 2020: Patients with Opioid Use Disorders 

Additional information or technical support may be obtained by contacting cme@mssny.org

Attestation Process for Mandatory Prescribers

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.  The process is described in the Frequently Asked Questions.

Further information may be obtained by contacting BNE at 1-866-811-7957 or narcotic@health.ny.gov. Or here.


CDC: Over 50% of COVID-19 Medications in March and April Were Prescribed by Primary Doctors
The CDC stated that “primary care prescribers were responsible for more than half of hydroxychloroquine and chloroquine prescriptions dispensed at outpatient retail pharmacies between March and April in the” U.S. After analyzing “outpatient retail pharmacy transaction data to identify potential differences in prescriptions by provider type between January and June,” researchers found that “new prescriptions of hydroxychloroquine and chloroquine by specialists who did not typically prescribe those medications increased from 1,143 prescriptions in February 2020 to 75,569 in March 2020 – an 80-fold increase compared with March 2019,” with “primary care prescribers…responsible for writing 10,350 dispensed prescriptions for hydroxychloroquine and chloroquine in March 2019 and 108,705 in March 2020.” The findings were published in the CDC’s Morbidity and Mortality Weekly Report.


CDC Sends Plans to States for COVID-19 Vaccine Distribution by Early November
The CDC has sent three documents to all 50 states telling them how to prepare to distribute a COVID-19 vaccine as soon as late October or early November, The New York Times reported. The documents outline technical scenarios to state public health officials for the distribution of two potential COVID-19 vaccines, referred to as Vaccine A and Vaccine B. The descriptions of the vaccine seem to match the vaccines being developed by Pfizer and Moderna, according to the Times. They are the two vaccines furthest along in late-stage clinical trials.

The accelerated timeline has raised concern that the government is trying to rush distribution of a vaccine before election day on Nov. 3, according to the Times. The three documents were sent to states Aug. 27, the same day President Donald Trump said in his speech at the Republican National Convention that a COVID-19 vaccine may be available before the end of the year.

The CDC acknowledged that the plans are hypothetical, saying, “The Covid-19 vaccine landscape is evolving and uncertain, and these scenarios may evolve as more information is available.” Approving a vaccine before late-stage clinical trial data is available could lead to rare but dangerous side effects surfacing over a period of time, the Times reported.

The plans detail requirements for shipping, mixing, administration and storage of a potential vaccine. They say that healthcare professionals would be among the first to receive a vaccine, along with other essential workers and national security employees. People over 65, people from racial and ethnic minority populations, and incarcerated people are also prioritized in the documents. The documents predict that Vaccine A will have about 2 million doses ready by early November and Vaccine B will have about 1 million doses ready.


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Sept. 13 Deadline: CMS How to Apply for PRF Funding are Shown Below
CMS has announced that Sunday, September 13th, is the new deadline for Medicaid and Child Health Plus (CHP) providers to apply for the Provider Relief Fund (PRF) under the Coronavirus Aid, Relief, and Economic Security (CARES) Act and the Paycheck Protection Program and Health Care Enhancement Act.

To Apply:

All eligible medical, dental, and long-term services and supports (LTSS) providers may begin the application process at: hhs.gov/providerrelief. Also available here are Medicaid and CHIP Provider Distribution Instructions and the Medicaid and CHIP Provider Distribution Application Form. It is recommended that you use these documents to help you complete the process through the Enhanced Provider Relief Fund Payment Portal.

Visit the CMS website here.


CME

Veterans Matters: The Special Mental Health Needs of Women Veterans Webinar
The Medical Society of the State of New York is hosting a CME live webinar entitled Veterans Matters: The Special Mental Health Needs of Women Veterans on Tuesday, September 15, 2020 at 7:30 am.

Click HERE to view the flyer and register for the program!

When:   September 15, 2020 at 7:30 am
Faculty: Malene Ingram, MD and Colonel, U.S. Army Reserves 

Educational Objectives:

  • Review how the increased role of women in the military has impacted their mental health
  • Describe mental health concerns unique to women veterans and how to identify them
  • Identify the barriers that women veterans face in getting the specific care they need

For more information, contact Jangmu Sherpa at jsherpa@mssny.org or call (518) 465-8085.

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

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

Fauci says COVID vaccine trials could end early if results are overwhelming.


Sept. 23, 2020 @ 7:30am Medical Matters CME Webinar Registration Now Open
The Importance of Herd Immunity: 2020 Update with a COVID-19 Twist
The first of MSSNY’s 2020 Medical Matters continuing medical education (CME) webinar series is: “The Importance of Herd Immunity: 2020 Update with a COVID-19 Twist” on Wednesday, September 23, 2020 at 7:30 a.m.  William Valenti, MD, chair of MSSNY Infectious Disease Committee and a member of the Emergency Preparedness and Disaster/Terrorism Response Committee will serve as faculty for this program. Registration is now open for this webinar here.  To view the flyer for this program, please click here

Educational objectives are:

  • Review the epidemiology vaccine-preventable infectious diseases and the role of
    herd immunity.
  • Describe how herd immunity protects vulnerable populations such as newborns,
    the elderly and those who are too sick to be vaccinated.
  • Discuss the percentage(s) of a population who need to be vaccinated for herd
    immunity to be effective.
  • Examine the role of herd immunity in relation to the COVID-19 pandemic

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

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

The Medical Society of the State of New York designates 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.


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AMA’s First Major Overhaul of CPT Codes in 25 Years
The first major overhaul in more than 25 years to the codes and guidelines for office and other outpatient evaluation and management (E/M) services was included in today’s release of the 2021 Current Procedural Terminology (CPT®) code set AMA.

These foundational modifications were designed to make E/M office visit coding and documentation simpler and more flexible, freeing physicians and care teams from clinically irrelevant administrative burdens that led to time-wasting note bloat and box-checking. The changes to CPT codes ranging from 99201-99215 are proposed for adoption by the Centers for Medicare and Medicaid Services on Jan. 1, 2021.

The E/M office visit modifications include:

  • Eliminating history and physical exam as elements for code selection.
  • Allowing physicians to choose the best patient care by permitting code level selection based on medical decision-making (MDM) or total time.
  • Promoting payer consistency with more detail added to CPT code descriptors and guidelines.

Among this year’s important additions to the CPT code set are new medical testing services sparked by the public health response to the COVID-19 pandemic. The 2021 CPT codes and descriptors can be imported straight into existing claims and billing software using the downloadable CPT 2021 Data File. The file contains the updated code set’s complete descriptor package, including official descriptors for consumers and physicians, and the complete official CPT coding guidelines.


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Office Space and Quad-A Certified O.R. for Rent