Jan. 25, 2019 – Are YOU for Single Payer?

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


MSSNY eNews
January 25, 2019
Volume 22  Number 4

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Colleagues:

We’ve been getting reacquainted with snow and other forms of precipitation in Western New York this week. Water is essential to life, but like so many other substances there can be too much of a good thing, and excess can lead to significant problems.  Indeed, MSSNY and the New York State Academy of Family Physicians suffered from the consequences of Mother Nature’s intemperance.  Travel was challenging over the weekend and the NYAFP leadership thoughtfully curtailed the end of their Scientific Assembly meeting to allow safe travel for their members.

NYSAFP provided an excellent review of many clinical topics.  I provided an update on the changing legislative landscape within New York State.  Subsequently, NYSAFP President Marc Price and I had a fireside chat with the attendees to discuss various items of concern to our memberships.  NYSAFP and MSSNY are in policy agreement with the vast majority of issues.  Our organizations have had a long standing difference in support for a single payer healthcare system.  MSSNY has long standing policy against endorsement of single payer, but in 2017 directed our leadership to engage in discussions that would be beneficial to patients and physicians.  NYSAFP has had policy for single payer for a number of years. Both of us agree that the devil is in the details.  The New York Health Act continues to be modified by its primary sponsors, Assemblyman Richard Gottfried and Senator Gustavo Rivera.  Senator Rivera indicated to me earlier in the week at a public event that he planned on further refinement of the bill to address the concerns of his constituents.

Assemblyman Gottfried indicated earlier this week that he was attempting to address some of MSSNYs concerns based on discussions we had in the fall.  I emphasized to the assembled group the importance of continuing the dialogue to improve policy for our patients and members and to shape the healthcare environment for our patients and our practices.  There are a number of other items under serious discussion with the Governor and Legislature, including the legalization of some hydrophobic substances currently prohibited by law.  NYSAFP and MSSNY are in strong agreement with regards to equity in law enforcement, and high quality research regarding the risks and benefits and long term effects of a certain oily, herbal substance with psychotropic activity before further expansion of its availability.

You can make a difference!

I believe we are at one of those tipping points in our state and country.  We (MSSNY, NYSAFP, our other specialty societies, and you personally) have a professional duty to inform the discussions and decisions of our elected officials during their deliberations.  Join me in Albany March 6th as we meet our elected leaders to share our concerns and policy recommendations for the health and welfare of our patients and fellow citizens with the unique insight we have caring for individual patients and informed by the basic and clinical science we employ on a daily basis.

Your duty doesn’t stop there.  You also need to engage your representatives at home.  Our Physician Advocacy Liaison (PAL) program can help you get there

Some former members have voiced that our efforts are inconsequential, that NY is run by “ three men in a room.”  There may have been some truth to that in the past, but “the times they are a changing.”  The 2018 election has changed the dynamics substantially and as noted above we have substantial input into the discussion.  Our political leaders are now seek our thoughts on how to proceed with these difficult questions.  Our MSSNY Leaders and our excellent Government Affairs staff continue with ongoing discussions with Assembly and Senate leaders and the Governor’s Management Team.  We continue to seek other healthcare allies in our discussion.

You can empower our patients and our profession further with your help in Albany and at home. Remember together we really are stronger!

Excelsior

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

Thomas J. Madejski, MD
MSSNY President



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SAVE THE DATE: MSSNY’s Annual “Physician Advocacy Day” (3/6)!
With nearly 40 newly elected legislators in Albany, the need for physician advocacy and grassroots involvement is greater than ever. With so much new representation, it’s vital for physicians to forge new relationships, as well as strengthen existing relationships to ensure the physician community’s message is heard about policies that could impact patient care.

One opportunity is to participate in MSSNY’s “Physician Advocacy Day” that will be held on Wednesday, March 6th in the Lewis Swyer Theatre in the Egg located at the Empire State Plaza, Albany NY. Click HERE to register!

Join your colleagues from all around New York State and come to MSSNY’s Physician Advocacy Day to speak with your legislators and key policymakers to ensure they’re making the right choices for New York’s physicians and their patients.

Join us to urge your legislators to:

  • Proceed very cautiously on paradigm shifting proposals such as legalization of recreational marijuana (proposed in the State Budget) and creating a single payor health insurance structure.
  • Reject proposed unfair cuts to physicians treating patients covered by both Medicare and Medicaid;
  • Reject proposals that would add prior authorization burdens for care provided to Medicaid patients;
  • Support legislation to reduce excessive health insurer prior authorization hassles that delay patient care.
  • Reduce the high cost of medical liability insurance through comprehensive reforms.
  • Preserve opportunities for medical students and residents to become New York’s future health care leaders.

A brief informal luncheon to which members of each House are invited to speak with their constituents will follow the morning program. County Medical Societies will be scheduling afternoon appointments for physicians to meet with their elected representatives.

If you have any questions/comments, please contact Carrie Harring at charring@mssny.org. (HARRING)


Governor Proposes $175 Billion Budget for 2019-20; Many Items of Impact to Medicine
As reported last week, Governor Andrew Cuomo has formally announced his proposed $175 Billion Budget for the FY 2019-20 Fiscal Year that would close a $3 billion Budget deficit.

Some positive items in the Executive Budget include: 

  • Increase from 18-21 the legal age to purchase tobacco and e-cigarettes; Ban flavored liquids and sales in pharmacies (See Dr. Madejski’s statement of support here.
  • Regulate the practices of Pharmaceutical Benefit Managers (PBMs).
  • Assuring comprehensive health insurance coverage for those suffering from a mental health condition (MH, SUD or autism).
  • Prohibit pre-authorization for Medication-Assisted Treatment (MAT) to address opioid addiction.
  • Extension of the Excess Medical Malpractice Program for an additional policy year.
  • Reduce the current 9% interest rate on court judgments, which could have the effect of reducing liability premiums for physicians.
  • Require Medicaid to cover services under the National Diabetes Prevention Programs for individuals diagnosed with prediabetes.
  • Create a statewide Maternal Mortality Board with necessary confidentiality protections.

Some items of potentially significant concern include:

  • Cuts Medicaid payments for the deductibles of “dual eligible” patients, which could have a significant adverse impact for those physicians whose patient mix includes a substantial number of Medicare/Medicaid dual eligible patients. Send a letter to your legislator here.
  • Legalize the sale of recreational marijuana to those 21 and over.
  • Expands the existing medical marijuana program to add additional health conditions which would be eligible for “Medical Cannabis”.
  • Permit Nurse Practitioners and licensed social workers to treat injured workers and be directly reimbursed under Workers Compensation without coordination with a physician.
  • Repeal “prescriber prevails” protections for prescriptions for Medicaid FFS patients that are not on the Medicaid formulary. 

Some items of Interest and Further Review Include:

  • Codify New York’s Health Insurance Exchange, and assure NY has continued coverage for pre-existing conditions, Essential Health Benefits and provide physician a clear method to appeal medications not included on insurers’ formulary
  • Expand health insurance coverage for IVF;
  • Require ED physicians to check I-STOP database;
  • Create a Commission on Universal Access to Health Care comprised of health policy and insurance experts to devise ways to achieve universal access to high quality, affordable health care;

Staff is continuing to pore through the thousands of pages of Executive Budget legislation and will provide further detailed updates.                                                                          (DIVISION OF GOVERNMENTAL AFFAIRS)


Governor Proposes “The Cannabis Act” To Legalize Use of Recreational Marijuana
Governor Andrew Cuomo proposed in his New York State Budget legislation a comprehensive component that would provide for the legalization of recreational marijuana.  Contained within the legislation is the existing program on medical marijuana.  The Medical Society is asking for the NYS Legislature to remove this provision form the budget proposal and are asking physicians to send a letter to the NY Legislature and to the governor through its Grassroots Action Center (GAC):

The bill’s components are as follows:

  • “The Cannabis Act” stated purpose– “It is hereby declared as a policy of the state of New York that it is necessary to properly regulate and control the cultivation, processing, manufacture, wholesale and retail production, distribution, transportation and sale of cannabis, cannabis-related products, medical cannabis and help cannabis within the state of New York, for the purposes of fostering and promoting temperance in their consumption, to properly protect the public health, safety and welfare, and to promote social equality.”
  • Creates an Office of Cannabis Management — The plan calls for creation of a new state agency called the Office of Cannabis Management. It will be run by an executive director and be a division of the state’s Alcoholic Beverage Control office. The executive director can place limitations on the number of licenses, regulate potency and the types of marijuana products to be sold.  Office will have the ability to halt all cultivation and sales “at any time of public emergency.”
  • The director will work with other agencies, including the agriculture department, to develop rules governing the safe production of marijuana plants, including devising restrictions on pesticide use. The office is also charged with developing rules to prevent people under 21 from obtaining marijuana.  The recreational program will be the three-tiered grow/distribute/sell approach.   This is significantly different than the existing medical marijuana program which is a “vertically integrated” system in which one company does all three things.
  • Local Authority — The proposal permits both individual counties and cities with more than 100,000 residents to opt out – and therefore not permit cultivation or retail pot facilities in their jurisdictions – if their governing body adopts an ordinance, law or resolution to “completely prohibit the establishment or operation” of any of the -licensed entities.
  • Tax projections– Administration projections are for $300 million a year coming from three separate taxes on the marijuana supply chain, including 22 percent of sales and excise taxes. No revenues are expected this year and $83 million next year is expected in tax receipts.
  • Location of stores– Selling marijuana without a license is prohibited. Stores must be located at street level, be or a public thoroughfare, or on an arcade or “sub-surface thoroughfare leading to a railroad terminal.’’   They must be certain distances away from schools and houses of worship.
  • Penalties—Unlawful possession of cannabis $150 fine. Possession of under 21 and less than one-half of one ounce fine is not more than $100. Fine for smoking marijuana in a public place is $150. Possession of more than one ounce of cannabis would be a $125 fine, and more than 2 ounces would result in a fine of $125 per additional ounce possessed above two ounces.  Criminal sale less than one ounce would be a $250 fine or 2x the value of the sale; Criminal sale of more than one ounce would be a $500 fine or 2x the value of the sale; Criminal sale of 4 ounces would be $1,000 fine or 2x the value of the sale.
  • It would also be unlawful to take any adverse employment action against an employee based on conduct allowed. Employers would be permitted to “take adverse employment action” against workers “for the possession or use of intoxicating substances during work hours.”
  • Creates the NYS Cannabis Revenue Fund—monies collected for the administration of the program, data gathering, monitoring and reporting, the governor’s traffic safety committee, small business development and loans, substance abuse, harm reduction and mental health treatment and prevention, public health education and intervention, research on cannabis uses and applications, program evaluation and improvements and any other identified purpose recommended by the executive director and approved by the budget director.
  • Advertising – The bill authorizes the office to promulgate rules prohibiting advertising that is deception; promotes overconsumption; depicts consummation by children; is designed in any way to appeal to children or minors; within 200 feet of a school, playground, child care center, public park or library; in a public transit or station; in publicly owned or operate property and makes medical claims or promotes adult-use cannabis for a medical or wellness purpose. It also allows the office to determine marking, branding, packaging, labeling, location of cannabis retailers and advertised that are aim at young people.

Medical Marijuana

  • Removes the medical marijuana program out of DOH and into the Office of Cannabis Management.
  • Allows anyone who is authorized to prescribe controlled substances in New York to certify patients.
  • Reduces from 3 hours to 2 hours course work requirements.
  • Expands list of conditions to include: Alzheimer’s, muscular dystrophy, dystonia, rheumatoid arthritis, autism, and any condition authorized as part of a cannabis research license.   It authorizes the executive director to add additional conditions to the list.
  • Authorizes the executive director to set the per dose price.
  • Allows certified patients, over 21, to cultivate up to four plants at home.
  • Allows for research studies.
  • Creates the Medical Cannabis Trust Fund—25% of monies shall be transferred to the counties where cannabis is manufactured; 22% shall be transferred to the counties in which cannabis was dispensed and allocated in proportion to the gross sales; 5% to OASAS; 5% to criminal justice services for a program of discretionary grants to state and local law enforcement agencies.

While MSSNY has supported marijuana de-criminalization, the broad reach of this proposed program is of significant concern.  With many articles detailing the teen vaping epidemic, MSSNY is concerned with similar dynamics taking hold with marijuana legalization.  (CLANCY, AUSTER)


NYS Legislature Passes and Governor Signs in to Law the Reproductive Health Act
The New York State Legislature passed the Reproductive Health Act on January 22, 2019 and it was immediately signed into law by Governor Andrew Cuomo as Chapter 1, Laws of 2019.    Assembly Bill 21 and Senate Bill 240, sponsored by Assemblymember Deborah Glick and Senator Liz Krueger, amended the public health law by codifying the abortion procedure within New York State’s public health law and removing it from the penal law.  The bill passed the NYS Senate by a vote of 38-24 and the NYS Assembly by 95-49.  The law creates a statement of purpose and says that an abortion may be performed a licensed, certified or authorized practitioner acting within their defined scope of practice under Title 8 of the Education Law.   Under the law, an abortion can be performed within 24 weeks from the commencement of pregnancy, an absence of fetal viability or at any time when necessary to protect a patient’s life or health. 

MSSNY has policy that opposes the criminalization of the exercise of clinical judgement in the delivery of medical care.   Moving the abortion procedure from the penal law to the public health law is consistent with this position.   The law does not expand the current scope of practices for health care providers.    It does, however, specify that health care practitioners can perform an abortion if it otherwise enabled by their current scope of practice as defined under the NYS Education Law.  Nurse practitioners are allowed to perform a medicated abortion procedure already under their scope of practice.  Nurse practitioners scope does not include “surgery” and cannot perform a surgical abortion.  The American College of Obstetricians and Gynecologists (ACOG), District II and the NYS Academy of Family Physicians (NYAFP) supported this measure.  (CLANCY) 


Comprehensive Contraception Coverage Act Passed by NYS Legislature; Awaits Governor Action
“The Contraceptive Equity Act” has passed the NYS Legislature.    Assembly Bill 585-A/Senate Bill 659-A, sponsored by Assemblymember Kevin Cahill and Senator Julia Salazar, requires health insurance policies to include coverage of all FDA-approved contraceptive drugs, devices and productions.  The bill also requires insurance coverage for emergency contraception when prescribed or when lawfully provided over the counter and allows for dispensing of up to twelve months of contraception.  The bill would also require coverage of voluntary sterilization procedures for women and men and would require coverage for patient education and counseling about contraception.

The bill would also require that any follow-up care related to the covered contraceptives including management of side-effects, counseling and device insertion and removal be covered.  The legislation also importantly contains a “prescriber prevails” provision.  MSSNY has policy that supports allowing greater access to emergency contraception and supports insurance coverage for contraceptive drugs and devices.  The bill was also supported by COG and NYAFP. (CLANCY)


Conversion Therapy Bill Signed Into Law By Gov. Cuomo; MSSNY Participates In Bill Signing Ceremony
On Friday, January 25, 2019, Governor Andrew Cuomo signed legislation that would prohibit a mental health professional from engaging in sexual orientation change efforts with a patient under 18 years of age.  A. 576/S. 1046, sponsored by Assemblymember Deborah Glick and Senator Brad Hoylman, provides that any sexual orientation change efforts attempted on a patient under 18 years of age by a licensed mental health professional shall be considered unprofessional conduct and shall subject the provider to discipline by the provider’s licensing entity.   Frank Dowling, MD, MSSNY Secretary, participated in the bill signing ceremony.  The Medical Society of the State of New York has supported this measure and it has been part of our legislative program for several years. (CLANCY)


Firearm Safety Package Moving in NYS Legislature
The New York State Legislature will be considering a series of firearm safety measures next week. Senate Bill 2448, sponsored by Senator Luis Sepulveda, would prohibit the possession, manufacture and transport of rapid-fire modification devices which are commonly referred to as a “bump stock” mechanism.  This legislation is on the Senate Codes Committee for its consideration on Monday.  Its companion measure, A.2684, sponsored by Assemblywoman Patricia Fahy is also on the Assembly Codes Committee.   Senate Bill 2374/A.2690 sponsored by Senator Michael Gianaris and Assemblymember Amy Paulin, would establish a waiting period before a firearm, shotgun or rifle can be sold or transferred.  The bill requires either the National Instant Criminal Background Check System (NICS) or its successor to issue a “proceed” response to the licensee or a 30 day waiting period to expire.  The measure is on the Senate and Assembly Codes Committee for action.

At its 2018 House of Delegates, the Medical Society of the State of New York enacted policy that  supports legislation that blocks the sale of any device or modification, not limited to bump stocks, that functionally converts a firearm into a weapon that mimics fully-automatic operations.   MSSNY also supports legislation that requires a waiting period and background checks prior to the purchase of firearms, including person-to-person transfers, internet sales and interstate transactions. Also coming before the Senate Judiciary Committee is S.2451, sponsored by Senator Brian Kavanagh.   Its companion measure Assembly bill 2689, sponsored by Assemblymember JoAnne Simon, is on the Assembly Codes Committee.

This bill, commonly referred to as a “red flag” law, would establish an Extreme Risk Protection Order (ERPO) which is an order of protection prohibiting certain persons from purchasing, possessing or attempting to purchase or possess a firearm, rifle or shotgun.  Under the measure, a police officer, a family or household member, a school administrator or his/her designee, can request a court-issued order of protection when it is believed that a person has threatened or committed an act of violence towards themselves or others, or situations where an order of protection has been violated, or where there is a pending charge or conviction for an offense involving the use of a weapon.  The bill provides grounds for the request and surrendering of the firearm.  MSSNY’s Taskforce on Firearm Safety recently recommended, and the MSSNY Council agreed, that MSSNY support the concept of “red flag” provisions.              (CLANCY)


Empire Center Forum Examines Implication of Proposed New York Health Act
This week the Empire Center for Public Policy held a widely attended seminar in Albany at which legislators and industry experts discussed the provisions and ramifications of the New York Health Act (NYHA), as well as possible alternatives for achieving universal health care.  NYHA bill sponsors Senator Gustavo Rivera and Assemblyman Richard Gottfried presented their case for a single-payer system, including the articulation of their goal to assure coverage for the currently uninsured and underinsured by re-directing the enormous amount of health care dollars that currently goes toward administrative spending. 

In response, representatives of HANYS and the NYS Conference of Blues Plans raised significant concerns with the legislation, including possible ERISA pre-emption and the elimination of employer-funded insurance as an option for patients.  They also noted that, while the goals of expanded coverage are agreed to by many, the “devil is in the details” regarding how such a program would be constructed and implemented.  Assemblyman Gottfried and Senator Rivera indicated a revised NYHA bill would be introduced soon, including provisions to clarify that pre-authorization requirements for needed care would be no more burdensome that what is currently imposed by Medicare (a concern raised by MSSNY).

The Empire Center’s health policy director Bill Hammond noted that the NYHA would require a significant tax increase which could be greater than $139 billion (plus long term care) suggested by a recent Rand study. Hammond also presented information outlining how New Yorkers would be affected financially.   Hammond also noted that, while many people would pay less for health insurance, many from across financial strata, would pay more. In fact, Hammond noted that many of those that would pay more would be low- and middle-income individuals and families.

The second panel, moderated by Hammond, was comprised of Eric Linzer, CEO of the NY Health Plan Association, Michael Sparer, professor and Chair of Health Policy at Columbia University, and Michael Capaldo, a board member of the NYS Association of Health Underwriters.

Sparer advocated for allowing individuals to buy into government programs like Medicaid, the Essential Plan and CHP in order to assist the un- and underinsured in achieving more affordable coverage. He also noted the great difficulties that the federal government’s unwillingness to provide waivers would present. Linzer noted his support for state subsidies for those who qualify for little to no subsidies (ie, 400-600% FPL) in order to expand affordable coverage and help to stabilize the risk pool. He also discussed focusing on transparency within the pharmaceutical industry.  Capaldo advocated to expand the use of New York’s All Payer Database so that individuals can better shop for care. He also proposed innovating network coverage, such as permitting members to go to a non-participating provider if they are cheaper than a participating provider, and possibly allowing the member to share in the savings.  (AVELLA, AUSTER, HARRING)



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

The measles outbreak in New York State continues to spread with at least 177 confirmed cases.  In Rockland County, there have been 18 new cases in January, 2019, after a drop in cases in December.  MSSNY conducted a just-in-time Medical Matters webinar entitled “The Continued Public Health Threat of Measles 2018” in December, 2018.  This webinar has now been posted to the MSSNY CME website. Please check it out and keep yourself informed about the ongoing measles outbreak throughout New York State.  You can also listen to MSSNY’s brief podcast on the Measles, Mumps and Rubella vaccine here.            (HOFFMAN, CLANCY)


“What’s Your Diagnosis? Psychological First Aid” Interactive CME Webinar February 20, 2019 @ 7:30am – Registration Now Open

MSSNY’s next Medical Matters webinar is entitled What’s Your Diagnosis? Psychological First Aid.  This is a newly formatted interactive program that is more immersive for participants.  You will be asked to answer questions about a case and discussion will follow.  Find out if you’re fully prepared to include psychological first aid during a public emergency on February 20th at 7:30am.  Registration is open for this program here.  Faculty will be Craig Katz, MD, co-vice chair of MSSNY’s Emergency Preparedness and Disaster/Terrorism Response Committee.

Educational Objectives:

  • Describe the basic tenets of psychological first aid (PFA)
  • Identify resources to assist patients during and after trauma
  • Describe a scenario and review questions and answers

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

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

eNews

New York’s Capital Region Reports Boost in Crucial NIH Funding Last Year
The Albany (NY) Times Union (1/17, Mendoza) reports the Albany, New York area “saw a significant jump in funding for biotech research last year from the National Institutes of Health,” according to the Albany-based Center for Economic Growth. The center found that the NIH “directed $62 million in funding to 20 institutions across an eight-county area,” a sum that “is the most the area has received from the NIH since 2013.” According to the article, “More than half of the Capital Region’s federal life sciences research and development funding comes from the National Institutes of Health,” an infusion that researchers regard as critical to scientific institutions.


JAMA Observational Study on Pharma Marketing v. Opioid Overdose
An observational study published in JAMA Network Open analyzes the link between how much money pharmaceutical companies spend marketing to doctors and opioid overdose death rates a year later. The companies spent nearly $40 million to market their medications to U.S. doctors between 2013 and 2015.

The researchers who conducted the JAMA study looked at more than 2,000 counties across the United States to see whether overdose death rates changed in the year after doctors in the area received payments and/or marketing material from opioid manufacturers. The counties that got more marketing attention did later experience higher overdose death rates.

The study authors point out that prescription opioids account for about 40 percent of all overdose deaths and, more importantly, are the first opioid a person typically encounters. While most overdose deaths are related to illicitly obtained opioids, mainly heroin and fentanyl, the authors say using prescription opioids first may lead to OD deaths from any type of opioid. Although the study did not prove causation, it does show that pharmaceutical companies and doctors may play an unexpected role in the opioid epidemic, and it raises questions about how the U.S. health care system could more effectively address the opioid crisis.

Sourced from: JAMA Network Open


Free Buprenorphine Waiver Training in Albany Feb 22
When:  Fri Feb 22 12-5
Where: Desmond Hotel, Albany

The PCSS-MAT Half-and-Half Medication Assisted Treatment (MAT) waiver training course provides an overview of the FDA-approved medication—buprenorphine—prescribed for the treatment of opioid use disorder (OUD). This course provides the required 8-hour training to prescribe buprenorphine for the treatment of OUD. The course provides an overview of prevention, identification, and treatment of substance use disorders emphasizing OUD.

Tuition: Free

More information/ to register: www.nyacp.org


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USAF Looking for Medical School Applicants, Med Students, Fellows and Residents

The NY USAF office handles applications for the Office of the Surgeon General’s following programs:

1. Medical Corps Health Professions Scholarships Program
(Up to 100% Tuition & Fees Scholarship for 4 years, with $2,330/month Stipend,   $20K Sign-up bonus, and materials reimbursement quarterly)
     a. Undergraduates and graduates applying to medical school
     b. Current medical school students
     c. Students already enrolled in early assurance programs at the undergrad or       graduate levels
2. Medical Corps Health Professions Financial Assistance Program 
(Earn up to an additional $73K per PGY on top of what their residency program is already paying)
    a. Final year medical school students playing in the match cycle
    b. Final year medical school students already matched
    C. Current Residents
    d. Current Fellows
3. Direct Accessions of BE/BC Physicians
(Initial Sign-on bonuses from $250-400K depending on specialty + competitive pay    and unmatched benefits)
           a. Final year residents and fellows
           b. Practicing Physicians seeking a change, challenge, or privilege to serve
           c. Any ‘a’ or ‘b’ candidate wanting to gain additional training, licensing, and experience as an Aerospace Medicine Doctor (a.k.a. Flight Surgery or Flight Medicine)
           d. A pathway to highly specialized and elite physician programs and teams like Special Operations Surgical Teams (SOST), Critical Care Assessment Teams (CCAT), Ground Surgical Teams (GST), Center for Sustainment of Trauma and Readiness Skills (CSTARS)  and many, many, more growth and career broadening pathways.

MSSNY Past President and Family Physician Ralph Schlossman, MD Died Jan. 17
Dr. SchlossmanMSSNY Past President Ralph Schlossman, MD, 88, died at his home surrounded by his wife of 64 years, Ruth, family and friends on January 17, 2019. Interment was on, January 20 at Mount Hebron Cemetery.

He graduated from New York University School of Medicine in 1955 and joined the Medical Society of the County of Queens in January 27, 1959. Dr. Schlossman became President of Medical Society of the County of Queens in 1970-1971 and President of Medical Society of the State of New York in 1998-1999. He was MSSNY Councilor from 1984-1992. He was elected to the Board of Trustees in 2000 and served on it until 2005 and he was Chair of the Board from 2004-2005. Dr. Schlossman received the Medical Society of the State of New York’s most prestigious award, the Henry I. Feinberg Award for leadership.

Dr. Schlossman served in the United States Air Force from 1956-1958 and was Chief Flight Surgeon 31st Tactical Fighter Wing and Commander of 31st Tactical Hospital. He was proud of his service in the U.S. Air Force, becoming the flight surgeon of a wing of the first generation of supersonic fighter bombers and one of the first physicians to fly faster than the speed of sound.

Dr. Schlossman and his wife Ruth have three children Andrew, Wendy and Marcie. The Family requests contributions may be made to Hadassah or Wounded Warriors Project.


Workers Compensation New Medical Fee Schedule
The new Medical Fee Schedule will be effective for services provided on or after April 1, 2019. The Board adopted the use of ICD-10 October 1, 2015, as previously announced in Subject Number 046-785 Chair Announces Adoption of ICD-10. Therefore, effective April 1, 2019, the Board will require full compliance with ICD-10.

The Workers’ Compensation Medical Fee Schedule is published by Optum Insight. Copies may be obtained by mail, telephone, or online.

By telephone: Call (800) 464-3649, option 1.

Online: Go to www.optum360coding.com, keyword New York, or https://www.optum360coding.com/Product/40508/. 


Erie County Medical Society Physicians Meet with Local Legislative Delegation
On January 4, 2019, physician leaders of the Medical Society of the County of Erie (MSCE) met with several key local legislators representing Western New York in Albany and Washington.  Participating Senators and Assembly Members included Senator Patrick Gallivan, Ranking Member of the Senate Health Committee on Health, and Assembly Members Angelo Morinello, Michael Norris and Monica Wallace.  Also participating were top staff from Senator Michael Ranzenhofer, Senator Tim Kennedy, US Representative Chris Collins and US Representative Brian Higgins.

In anticipation of the 2019 legislative session, two important topics were discussed – physician concerns with proposals to legalize recreational marijuana (proposed in the Governor’s Executive Budget) and legislation to create a statewide single-payer insurance program.

MSCE representatives included: Drs. Robert Armstrong, Secretary/Treasurer MSCE; Rose Berkun, Chair Legislative Committee MSCE (and MSSNY Legislative Committee Vice-Chair); Gale Burstein, Erie County Health Commissioner and Chair of Public Health Committee MSCE; John Gillespie, President MSCE; Kenneth Eckhert III, President-Elect MSCE; Gordon Tussing, Chair Practice Management Committee MSCE; Willie Underwood, Immediate Past President MSCE; Joseph McCarthy, Esq., MSCE Counsel and Jennifer Scharf, Esq., Co-Chair Health Law Committee MSCE.

Have you had a local meeting with your legislators on key legislative issues impacting physicians and their patients?  Please share with us to include in future issues of the MSSNY e-news.


Cost of Insulin for Treating T1D Nearly Doubled Over Five-Year Period
Reuters (1/22)reports, “The cost of insulin for treating type 1 diabetes [T1D] in the United States nearly doubled over a five-year period,” researchers found in “a report due to be released on Tuesday by the nonprofit Health Care Cost Institute (HCCI).” The report revealed that an individual with T1D “incurred annual insulin costs of $5,705, on average, in 2016,” compared to an “average cost” of “$2,864 per patient in 2012.” According to Reuters, these numbers “represent the combined amount paid by a patient and their health plan for the medicine and do not reflect rebates paid at a later date.”


What’s Changed for 2019 E&M Services?
For those of you who bill Medicare for Evaluation and Management and some telehealth services, you will need to know what has changed based on the 2019 Final Rule for Medicare.  You or your staff should review the changes through the following link:
What’s Changed as a Result of CMS Final Rule 2019


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Please call 917-715-2464


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


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


PHYSICIAN OPPORTUNITIES

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


Physician Insights Wanted to Help Shape the Future of Primary Care
98point6 is a healthcare technology company committed to delivering more affordable, accessible, high-quality primary care. To support our mission, we need the insights of forward-thinking physicians that have opinions about the current state of primary care and are interested in the role technology can play in healthcare. Members of our exclusive Primary Care Council have no clinical responsibilities and are generally compensated for participation, which requires only a few hours per year. Interested? Learn more and apply today at www.98point6.com/pcc


Avoid nuisance lawsuits!! Make sure your website is compliant with the Americans with Disabilities Act! We can do a free audit of your website and let you know if corrections are needed. Call 516-830-1973 or visit tinyurl.com/ADAWebsiteHelp for more information.


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