MSSNY eNews – May 24, 2019 – Memorials and Decorations

Arthur Fougner MSSNY Presiident

Arthur Fougner, MD
MSSNY President

May 24, 2019

Vol. 22  Number 20




This is Memorial Day weekend. We celebrate the unofficial beginning of summer with barbecues, sitting in traffic en route to newly opened pools and beaches, or perhaps strolling in lower Manhattan for the Fleet Week celebration. Maybe you take care of that long delayed yard work and sit on the back porch, sipping lemonade or something stronger, enjoying the weather. But really, is this what Memorial Day is about?

Memorial Day began as separate remembrances in 1866 in both the North and the South. In the town of Waterloo, NY, a ceremony was held to honor the local veterans. (This was later recognized by President Lyndon Johnson as the birthplace of Memorial Day.) In 1868, Gen. Logan declared May 30 Decoration Day for the official placing of florals on the graves of the Union War Dead. As America entered World War I, Decoration Day became today’s Memorial Day to honor those who died in all America’s wars.

One of the earliest of those was a physician. Gen. Joseph Warren was a Boston physician who once saved a young John Quincy Adams finger from amputation. A prominent member of the Sons of Liberty, Warren had enlisted Paul Revere and William Dawes to take that famous ride. Though a General, he chose to fight with the enlisted men who stood their ground on Breed’s Hill (Yes, the Battle of Bunker Hill was actually fought on Breed’s Hill.) Dr. Warren gave his all for what would become our United States in the British troops final assault.

We should also remember one of our own – Dr. Ralph Schlossman. Although he did not die in battle, he served our country honorably and was perhaps the first US physician to fly jets. Dr. Schlossman’s cause was and remains our cause – the good of all patients and their doctors.

So as you enjoy that last hot dog, perhaps washing it down with an adult beverage or two, do remember those who served and gave their all for their cause – us.

The torch; be yours to hold it high.
If ye break faith with us who die
We shall not sleep, though poppies grow
In Flanders fields.  – John McCrae, Flanders Fields

Arthur Fougner, MD
MSSNY President 

Comments?; @mssnytweet; @sonodoc99

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Capital Update

Physician Action Needed to Help Stop Measles Outbreak, NYS Has 810 Confirmed Cases!
There are 810 confirmed measles cases in New York State and the number continues to grow.  The Medical Society of the State of New York continues to advocate for passage of legislation that would allow only medical exemptions for immunizations.  The measure, A.2371/S.2994A, is in the Assembly & Senate Health Committees.   MSSNY, along with 28 other medical organizations, patient advocacy groups and public health organizations, have been meeting with members of the Legislature to advocate for passage of this measure. The Medical Society of the State of New York’s Memo in support of A.2371/S.2994A can be found here and a copy of the memo  produced by physician and public health organizations, and parent and patient advocacy groups memo is available here.

Physicians are strongly urged to contact members of the Assembly Health Committee.  Please call them at 518-455-4100 and ask for the following Assemblymembers: Gottfried, Schimminger, Galef, Dinowitz, Cahill, Paulin, Cymbrowitz, Gunther, L. Rosenthal, Hevesi, Jaffee, Steck, Abinanti, Braunstein, Kim, Solages, Bichotte, Barron, Sayegh,Raia, McDonough, Ra, Garbarino, Byrne, Byrnes,Ashby.  Tell them that you support passage of A.2371/S.2994, which would repeal the religious exemption, ensuring that the only allowable exemptions to vaccination will be for medical reasons.  Additionally, please send a letter via the MSSNY Grassroots Action Center (GAC) to your legislator!   Please click here..

Physicians are also encouraged to work with local county medical society to schedule a legislative meeting within your area with! Or call your State Senator and Assembly Member’s office to voice your support of this legislation.     There is strength in numbers! Please look them up here: Please click here

MSSNY President Arthur Fougner, MD and M. Monica Sweeney, MD, a member of the MSSNY’s Committee on Infectious Disease and Health Disparities participated in a press conference this week with the bill sponsors, calling upon the NY State Legislature to pass this vital bill.  Joining the Medical Society in support of repealing religious exemptions are the following groups:  American Academy of Pediatrics, NYS District II, Chapters 1, 2 & 3, American Nurses Association – New York (ANA-NY),  Associated Medical Schools of New York, Autism Science Foundation, Citizen Committee for Children of New York, Inc., Children’s Defense Fund-New York, Erie County Department of Health, Ithaca Is Immunized, Kimberly Coffey Foundation, Nurses Who Vaccinate, March of Dimes, Meningitis B Action Project,  Nurse Practitioner Association New York State, New York American College of Emergency Physicians, New York State Society of Dermatology and Dermatologic Surgery, NY Chapter American College of Physicians, NYS Academy of Family Physicians, NYS Association of County Health Officials (NYSACHO), NY Occupational and Environmental Medical Association (NYOEMA), NY State Neurological Society, NY State Neurosurgical Society, NYS Ophthalmological Society, NYS Society of Otolaryngology-Head and Neck Surgery, NYS Public Health Association, New York State Society of Anesthesiologists, Inc., The New York State Radiological Society, Schuyler Center For Analysis and Advocacy, The Children’s Agenda, Tompkins County Department of Health.      (CLANCY)

Wrongful Death Bill on Senate Judiciary Agenda
A bill to authorize additional compensation in wrongful death actions will be considered in the Senate Judiciary Committee on Thursday. Senator Hoylman and Assemblyman Weinstein’s S.4006/A.5612 would expand the possible award in a wrongful death action to include compensation for grief or anguish, the loss of love and companionship, loss of services and support and the loss of nurture and guidance.

Current law allows the family and/or estate of a decedent to sue for both economic damages and for pain and suffering that the decedent may have experienced prior to death. They also may sue for economic loss incurred due to the death. This bill would greatly expand the permissible compensation and would likely lead to drastic increases in already outrageously high liability insurance premiums. Actuarial estimates have indicated that passage of this legislation could increase premiums by over 50%.

With New York consistently being ranked 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, passage of this legislation would likely exacerbate these issues, making the practice environment even worse. Physicians are urged to contact their legislators and let them know how harmful this bill would be by going here. (AVELLA)

Advocating to Reduce Health Insurer Hassles – Take Action Now!
As we progress toward the end of session, it is vital that physicians let legislators know how they feel about a variety of insurance-related legislative measures that would impact physicians and their patients’ relationships with insurance companies. The following three bills would help patients to be able to receive timelier treatment with greater choice of physician.  Please take action by contacting your legislators and asking them to support these bills. 

Collective negotiations – Negotiating with insurance companies is extremely difficult, especially when monolithic payers control a huge portion (or all) of the market that you practice in. The fact that you are barred from banding together with your colleagues is unfair, so we strongly support legislation introduced by Senator Rivera and Assemblymember Gottfried (S.3462/A.2393) that would allow physicians to collectively negotiate patient care terms with insurance companies in certain situations.

The bill is currently in the Assembly Ways and Means Committee and in the Senate Health Committee. Please urge your Assemblymember and Senator to join on as a co-sponsor please click here

Mid-year formulary changes – Surprisingly, current law does not restrict insurance companies from making substantial changes to their formularies mid-year. This is an egregious practice when you consider the fact that your patients choose insurance plans based on the coverage presented to them – and they generally are not able to switch plans mid-year. Senator Breslin and Assemblymember Peoples-Stokes have introduced legislation (S.2849/A.2969) that would prevent mid-year formulary changes so that patients do not experience removal of a drug or changes in tiering when there is no similarly effective option.

The bill is on the Senate floor, and advanced this week from the Assembly Insurance Committee to Codes Committee.  Please urge your Assemblymember and Senator to join on as a co-sponsor please click here

Prior authorizations – Prior authorizations continue to be a major roadblock to care and cause endless hassles for you and your staff. The burdens caused by excessive and often unjustified prior authorization requirements take away from the time that physicians can spend with their patients and lead to far too many hours being spent on paperwork. Senator Breslin and Assemblymember Gottfried have introduced an “omnibus bill” (S.2847/A.3038) that would reduce the hassles in a variety of ways, including updating UR standards and reducing the need for repeat prior authorizations.

The bill is advanced from the Senate Health Committee to the Senate floor this week, and is in the Assembly Insurance Committee. Please urge your Assemblymember andSenator to join on as a co-sponsor please click here (Avella, Auster)

Varying Proposals to Address Surprise Medical Bills Contain Positive and Concerning Elements
US House and Senate leaders have each released bi-partisan proposals this week to address the issue of “surprise” out of network medical bills received by patients.    While the House and Senate proposals have some similarities to New York’s law, there are also important differences which raise serious concerns.  Physicians are urged to send a letter from here (please click here) urging their member of Congress to fight for a law that is consistent with New York’s approach, and to oppose legislation that would undermine New York’s proven model.

The American Medical Association testified this week at a hearing of the House Ways and Means Committee examining this issue.  Moreover, Representative Joe Morelle (D-NY) together with Representative Van Taylor (R-TX) and Raul Ruiz (D-CA) released a summary of a proposal that seeks to mirror New York’s law, though the actual legislative text has not been released yet.

Last week, a bipartisan working group led by Dr. William Cassidy (R-LA) released a proposal that attempts to address several issues that cause patients to have surprise bills in the first instance, including increasing insurer transparency of patient cost-sharing requirements, of networks for the varying plans offered by a particular insurer, and annual reporting to HHS of the out of network services it has paid in the previous year.  Moreover, for “surprise” medical bills, it preserves state approaches to addressing surprise bills for patients insured in state-regulated plans.

With regard to ERISA regulated plans, it recommends using New York’s “baseball” arbitration approach, but of great concern, the IDR benchmark would be “commercially reasonable rates (which must be based on in-network rates and not charges) for that geographic area” This approach could greatly undermine New York’s law and eliminate any incentive for a health insurer to negotiate fairly with a physician.  To read more, click here: please click here.

Another proposal, from House Energy & Commerce Chair Frank Pallone (D-NJ) and Ranking Member Greg Walden (R-OR) would also prohibit balance billing for all emergency services and patients would only be held responsible for the amount they would have paid in-network.  It also preserves a state’s ability to determine their own payment standards for plans regulated by the state.   But of great concern, it would establish a minimum payment standard set at the median contracted (in-network) rate for the service in the geographic area the service was delivered. Again, this approach could greatly undermine New York’s law and eliminate any incentive for a health insurer to negotiate fairly with a physician. To read more, click here: please click here.

MSSNY has written to the New York Congressional delegation to raise concerns with the Cassidy and Pallone proposals, as well as to highlight approaches such as the Morelle-Ruiz-Taylor proposal that would mirror New York’s law for ERISA plans. Again, physicians are urged to send a letter to their members of Congress urging that they follow NY’s approach.   (AUSTER)                                                   

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Bill Requiring Physicians to Maintain Excessive Documentation of Discussion of Risks of Prescribing Opioids Moves to Senate Floor; Action Needed!
Physicians are urged to contact their legislators in opposition to legislation (S.4277-A/A.7285-A) which would require physicians and health practitioners who prescribe an opioid or other Schedule II Controlled Substance to discuss with patients’ the risks prior to prescribing the medications. The Medical Society is opposed to this measure and encourages physicians to send a letter to their legislator at the MSSNY Grassroots Action Center (GAC) please click here.

The bill is on the Senate floor and can be voted on at any time.  This legislation would require physicians to discuss (and by extension document that such discussions took place) the following: a) the risks of addiction and overdose associated with opioid medications; b) the reason why the prescription is necessary; c) alternative treatments that may be available; and, d) the risks associated with the use of these medications. Moreover, it would require the physician to counsel the patient on the risks of overdose and the availability of an opioid antagonist each year.

While this legislation is well intended, it ignores existing Public Health Law that essentially requires the patient’s informed consent. This means that when a patient needs treatment, their physician must give them information regarding risks so that they can make an informed decision. Additionally, this is duplicative of requirements that currently exist under other laws mandating that after a physician prescribes the medication, the pharmacist is required to again inform the patient about the risks of taking a controlled substance.

Moreover, for their patients who are on opioid medications longer than 90 days, physicians are required to have a written treatment plan that includes discussing with patients the risks of these medications and possible alternatives to these medications.  MSSNY is also concerned that such requirements will further discourage physicians from prescribing pain medications for patients who need them – already a growing concern – and could potentially scare patients who truly need pain medication away from taking this medication. (CLANCY, AUSTER)

MSSNY Raises Substantial Concerns with Legislation to Expand List of Conditions for Medical Marijuana Program and Allows Smoking of Marijuana
Assembly Bill A7467, sponsored by Assemblymember Richard Gottfried, has moved from the Assembly Health Committee to the Codes Committee.  This measure would greatly expand New York State medical program for certifying patients for use of marijuana. The bill would expand the medical program for use of marijuana by eliminating “serious condition” and its definition of debilitating or condition to just “condition” and further expands the list of conditions.

Conditions currently eligible include: cancer,  positive  status  for  human  immunodeficiency virus or acquired immune deficiency syndrome, amyotrophic lateral sclerosis,  Parkinson’s  disease,  multiple  sclerosis, damage to the nervous tissue of the spinal cord  with  objective  neurological  indication  of intractable  spasticity,  epilepsy, inflammatory bowel disease, neuropathies, Huntington’s disease, post-traumatic stress disorder,  pain  that degrades health and functional capability where the use of medical marijuana is  an  alternative  to  opioid  use,  substance  use  disorder.  The bill would add Alzheimer’s, muscular dystrophy, dystonia, rheumatoid arthritis, autism or any other conditions to the list of conditions that the practitioner may certify.

There is a lack of scientific study regarding the use of marijuana to treat many of these conditions and using marijuana has the potential to exacerbate certain medical conditions.  This legislation would also authorize the “smoking” of marijuana as a modality for treatment.   Furthermore, the list of individuals who can certify the patient for use of marijuana would be expanded to include dentists and podiatrists.   It requires that the practitioner undergo a two hour course as determined by the commissioner of health. The Medical Society of the State of New York is opposed to this measure as we have serious concerns about government legitimizing in statute that a particular treatment is suitable without an appropriate level of scientific review.

This is yet another reason why MSSNY supports rescheduling of marijuana at federal level so that necessary research can be done.  While there is increasing evidence that shows marijuana may be a beneficial treatment for some conditions, there are also significant personal and public health risks related to its use.  The measure also encompasses many of the concepts contained in the 2019-20 Executive Budget proposals to legalize recreational marijuana.   This legislation is an attempt to further expand the use of marijuana under the guise of a “medical” program.  Senator Diane Savino is carrying the bill S. 5657 in the Senate and that bill is currently in the Senate Health Committee.      (CLANCY)

Senate Health Committee Approves Allowing Pharmacists to Use CLIA-Waived Tests; Bill On the Senate Calendar For A Vote

  1. 5092/ A. 3867, sponsored by Senate Health Chair Gustavo Rivera and Assemblymember John McDonald, has moved from the Senate Health Committee to the Senate Floor. The measure would add pharmacists to the list of licensed health care professionals authorized under public health law to perform non-invasive laboratory tests as an adjunct to their professional services. The Medical Society of the State of New York is opposed to this measure. This measure runs contrary to the continuum of integrated care that has become essential and is expected in today’s medical practice and would lead to siloed care. The present system recognizes that CLIA-waived testing of patients by pharmacists must occur under an established protocol and the supervision of a physician who can help to interpret the test results, provide needed context and most importantly set forth a care plan for the patient.   MSSNY has serious concerns that this legislation is a back-door attempt to allow for the establishment of retail clinics within pharmacies.  Additionally, there is absolutely no demonstrated need for not continuing the present system of how a CLIA-waived test is conducted in the pharmacy.  Having physician oversight of this process is an important step in protecting the continuum of health care. (CLANCY, AUSTER)

Bill to Expand Pharmacists Immunization Authority on Senate Calendar
A bill to allow pharmacists to administer all vaccines to adults is on the New York State Senate Calendar awaiting a vote.  Sponsored by Senator Rachel May and Assemblymember Amy Paulin, S. 5227/A. 6511-A would allow pharmacists to provide ALL immunizations on the Advisory Committee on Immunizations Practices (ACIP) list recommended for adults.  This bill significantly expands on legislation enacted in 2008 and 2012 which provided pharmacists only very limited ability to administer vaccinations to adults.

The bill would lift the sunset provision enacted in the 2012 legislation and make permanent the pharmacist’s authority to administer vaccinations to adults.  This law would expand a pharmacists’ current authority to provide seven vaccines to 16 vaccines that are on the ACIP schedule. Many of these immunizations are given as a series with specific time parameters, and calling back a patient within a physician’s office, where contact information available, is at times difficult.  Calling back an individual to a pharmacy to get the additional immunizations may be beyond the capability of that pharmacy.

More importantly, this legislation prevents a review by the NY Legislature as to whether pharmacists should be performing any additional immunizations that may be recommended by ACIP in the future as ACIP reviews newer vaccines.    The measure is currently pending in the Assembly Higher Education Committee.  The Medical Society opposes this bill and urges physicians to call their legislator regarding this measure.   (CLANCY)

Partial Fill Legislation on Senate Health Committee
Senate Bill S1813, sponsored by Senator Gustavo Rivera, is on the Senate Health Committee next week.   This measure allows a prescriber to issue a prescription to a patient for a Controlled Substance II, III or IV that can be filled partially.  It also allows them to prescribe up to a 30-day supply of Controlled Schedule II, III, and IV with a notation to the pharmacist that he/she should only dispense the agreed to amount. Each partial filling would be dispensed and recorded in the same manner as a refilling (i.e., date refilled, amount dispensed, initials of dispensing pharmacist, etc.).

The total quantity dispensed in all partial fillings may not exceed the total quantity prescribed. Partial fills of prescriptions for Controlled Substance II are allowable under federal law but are currently prohibited in New York State. Its companion measure, Assembly Bill 3918, sponsored by Assemblymember John McDonald, has passed the NYS Assembly.  The Medical Society of the State of New York supports this measure.    (CLANCY)

AMA Urges Delay in Marijuana Legalization Efforts
With the New York State Legislature still actively considering legislation to legalize “recreational” or “adult use” marijuana, the American Medical Association this week sent letters to Governor Cuomo, Senate Majority Leader Stewart-Cousins and Assembly Speaker Heastie urging New York State “to delay initiating the legalization of cannabis for recreational (non-medicinal) use until further research is completed on the public health, medical, economic and social consequences of its use.”

Specifically, the AMA letters raised concerns regarding “the effect of recreational cannabis legalization on public health, as well as the impact of its use particularly in high-risk populations such as youth, pregnant women and women who are breastfeeding.”  The letter also noted that “Early data from jurisdictions that have legalized cannabis demonstrate concerns particularly around unintentional pediatric exposures resulting in increased calls to poison control centers and emergency department visits, as well as an increase in traffic deaths due to cannabis-related impaired driving.”  The AMA also raised concerns that “experiences with other legal drugs (i.e., alcohol and tobacco) suggest that for-profit corporations will attempt to weaken regulations intended to protect health in order to maximize profits—resulting in significant public health harms.”

Recognizing that the State Legislature is also looking at proposals to expand the medical marijuana program for various health conditions without adequate scientific justification, the letter noted that importance of facilitating ongoing research to assure health care providers and legislators make informed decisions.  Specifically, the letter noted “the AMA believes that scientifically valid and well-controlled clinical trials conducted under federal investigational new drug applications are necessary to assess the safety and effectiveness of all new drugs, including potential cannabis products for medical use. The AMA supports efforts to ease current barriers to research by encouraging valid scientific and clinical research, expanding sources of research-grade cannabis and facilitating the commercial production of FDA-approved cannabinoid-based drugs.”  (AUSTER, CLANCY)

MSSNY and Specialties Oppose Change to Podiatric Scope of Practice
MSSNY working together with the New York State Society of Orthopedic Surgeons (NYSSOS) and other specialty societies are opposing legislation (S.5395, Jackson) that would inappropriately expand the scope of podiatrists.  The legislation advanced this week from the Senate Higher Education Committee to the Senate floor, with several Senators, including Senators Amedore, Breslin, LaValle and Robach voting without recommendation.  While purporting to be a “technical” correction of the podiatry scope statute, there are several substantive and concerning changes this legislation would make including:

  • Reducing certification requirements for podiatrists seeking to have advanced surgical privileges
  • Removing the requirement that a podiatrist seeking either standard ankle surgery or advanced ankle surgery privileges be directly supervised by a podiatrist with an advanced license from the NYSED or a physician; and
  • Would enable the treatment of wounds that are not contiguous with structures of the foot or ankle

Identical legislation (A.6185, Pretlow) remains in the Assembly Higher Education Committee.  Physicians are urged to contact their legislators to express their opposition to this proposed scope change.                                                         (AUSTER)

Veterans Matters: Military Culture: Everything Physicians Need to Know About Veterans as Patients Live Seminar in Saratoga

When: Tuesday May 28 2019 at 6:45pm (Reception at 6:00pm)

Where: Jacob & Anthony’s « 38 High Rock Road « Saratoga, NY  12866

Faculty: Lt. Col Lance Allen Wang (Ret)

Educational Objectives

  1. Describe the unique aspects of military culture and how they impact patients who are veterans
  2. Explain the Dwyer Peer-to-Peer program as a resource to assist veteran patients re-acclimating from a group to an individual mentality
  3. Review and identify resources to improve physician’s ability to fully treat veterans who are transitioning back into civilian life

For more information, contact Gregory Pinto, MD at or call (518) 587-0772 ext. 12

* Note: There is no charge for MSSNY members and their spouses, but there will be a $40.00 dinner charge for non-MSSNY members

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.

Registration Now Open for Veterans Matters CME Webinar on June 5th
Register now for MSSNY’s next Veterans Matters webinar June 5th at 7:30am. This webinar is entitled Substance Use Disorders in Veterans.  Register for this program here .

Veterans Matters: Substance Use Disorders in Veterans

When:  Wednesday June 5 2019 at 7:30am – Register here

Faculty: Frank Dowling, MD

Educational Objectives

  1. Define Substance Use Disorders (SUDs), symptoms, warning signs, comorbidities
  2. Explore evidence-based intervention and treatment options for SUDs among veterans
  3. Identify barriers to diagnosis and treatment and methods to overcome them

Additional information or assistance with registration can be obtained by contacting Melissa Hoffman at or (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 creditsä.  Physicians should claim only the credit commensurate with the extent of their participation in the activity.                                                                                                                       


Garfunkel Ad

Bloomberg Editorial Board: A Wise Pause on Marijuana Legalization
Bloomberg’s Editorial Board wrote a strong opinion (5/19) on the slick road to marijuana legalization pointing out the downsides in Colorado—spiking of emergency room visits and rise of fatal car accidents. MSSNY’s Immediate Past President, Dr. Tom Madejski, has led the charge to have marijuana moved from Schedule I to Schedule II so it can receive funded research on its negative and positive effects. The piece asks for more research on the long and short term effects of marijuana before rushing to legalize it.

New Yorkers Spend Less on Health Care than Other Americans
New York families with employer-sponsored coverage had the second-lowest annual spending on health insurance premiums and out-of-pocket costs among workers in the 50 states and the District of Columbia, according to a new analysis from the Commonwealth Fund.

The median New York family with a job-based plan spent a combined $2,320 on premiums and out-of-pocket costs. The median in the nation was $3,700. The data come from the two most recent editions of the Current Population Survey, which is produced by the U.S. Census Bureau. The analysis covers information reported based on insurance costs in 2016 and 2017. When isolating premiums and out-of-pocket costs, the median New York family contributed $1,300 to their plan’s premiums and spent $500 on out-of-pocket costs, such as copays and deductible payments. That compares with $2,200 and $800, respectively, nationwide. There were also a smaller percentage of families in New York for whom premium contributions represented at least 10% of household income—9.6% compared with 11.6% nationally.

The data present a vastly different picture from a December analysis by the Commonwealth Fund of employers’ benefit plans. That report noted that employer-sponsored plans in New York had some of the highest premiums in the country and fast-growing deductibles.

NY Nursing Homes’ Report Cards Average 3.19 of 5.0
The scores of New York’s nursing homes dipped to an average of 3.19 out of 5 stars in the federal government’s latest Nursing Home Compare report card, down from 3.33 in January.

However, the national average dropped even further, from 3.35 stars to 3.06. New York’s standing improved from 31st to 27th among the 50 states.

The New York City area, with 300 nursing homes rated, had the best regional average at 3.82. The 31 rated homes in the North Country had the lowest regional average at 2.16.

New York’s middling statewide performance comes in spite of high costs. The median price of a semi-private room, at $141,000 per year, was the fifth highest in the country, according to a 2018 survey by the long-term insurance firm Genworth.

The state’s per capita spending on nursing homes was 29 percent above the national average in 2014, according to National Health Expenditures data.

The state’s nursing home industry gets much better grades, as a group, than its hospitals – which collectively ranked 50th out of 50 states in the most recent Hospital Compare report card.

Individual nursing homes can be searched by state, city and ZIP code at Center for Medicare & Medicaid Services’ Nursing Home Compare website. (NY Torch Public Policy)

NYFD Backing Bill Allowing Insurance Reimbursement for Medical Services
The four largest groups representing New York firefighting organizations presented their case to state lawmakers on Monday in favor of a bill, S.3685/A.1778 that would allow fire departments to be paid for medical services by insurers. Currently, “firefighters are prohibited from charging patients for medical care provided through emergency and ambulance services,” which “differs from private ambulance companies and volunteer ambulance corps, which are able to bill patients’ insurers.” The legislation “has met resistance from insurers.” Crain’s New York Business (subscription only) (5/21)

Nassau County Medical Society to Hold Annual Meeting on May 29
Nassau County Medical Society will hold its annual membership meeting at the Westbury Manor on May 29th.  The evening will honor members who have been in the practice of medicine for fifty years and will include presentations on Legal Services: Member Benefits by Jay Silverman, Esq. and An Overview of the NYS Sexual Harassment Law by Nicole Della Ragione, Esq.  Registration and dinner begin at 6:30 pm. Click here for more informationTo reserve a seat, email

August 10th – December 7th 2019 | 9am – 5:30pm
Exam Date: December 14th, 2019 | 9am -3pm | Book Check at 8am
Includes One Year AAPC Membership (New Enrollments Only)
& Coding Books! REGISTER TODAY

Study: 5.2% of New Cancer Cases in Adults May be Attributable to Poor Diet
Researchers analyzed data from the National Health and Nutrition Examination Survey and concluded that “an estimated 80,110 new cancer cases among adults 20 and older in the United States in 2015 were attributable simply to eating a poor diet.” The study’s first author, Dr. Fang Fang Zhang of Tufts University, said, “This is equivalent to about 5.2% of all invasive cancer cases newly diagnosed among US adults in 2015,” which “is comparable to the proportion of cancer burden attributable to alcohol.” The findings were published in JNCI Cancer Spectrum.



QPP Tip of the Month: Navigating the QPP
With annual updates to the Quality Payment Program (QPP), and especially for the Merit-based Incentive Payment System (MIPS) pathway, it can be difficult for physician practices to track year-to-year changes and integrate them into their MIPS planning. PAI’s MACRA QPP Resource Center has several resources that can help you navigate the QPP for 2019:



Medical Office Space for Rent!
Beautiful Newly Renovated Medical Office on the Upper East Side between Madison and Park Avenue! Conveniently located near all public transportation and Mount Sinai Hospital. Consult and Exam room available for rent part time or full time (see pictures). Please call 212-860-0300 or email for further information.
Pictures of office space for rent on Madison Ave

Park Avenue Medical Office for Sale
On Park Ave, for sale is a large medical office, in a beautiful full service co-op with two entrances, one of which is an impressive doorman in lobby entrance.The office has high ceilings, easily adaptable to any specialty and priced to sell. Three good size rooms easily converted to five exams, plus consult, bathroom, reception and large waiting room. Outstanding location. A must see. View floorplan Call Jeff Tanenbaum,  646-234-2226 or email for showings and more information.

Fully Renovated Office Space for Part-Time Lease in Hauppauge
Available Tuesdays/Fridays, $450 half session, $750 full session. Elegant office space, beautiful waiting room with new stone and granite reception desk, custom molding, large windows, abundant natural light, TV, and refreshment counter.  Four new exam rooms and dictation room.  New stainless and granite kitchenette.  State-of-the-art network infrastructure meets HIPPA & PCI DSS compliance standards.  Digital X-ray room with PACS in each exam room available as an option.  Located in close proximity to LIE, Northern State Pkwy, and Vets Memorial Hwy. Contact us at (631) 486-8855;  Please see our listing:

Office Rental 30 Central Park South.
Two fully equipped exam, two certified operating, bathrooms and consultation room.  Shared secretarial and waiting rooms. Elegantly decorated, central a/c, hardwood floors. Next to Park Lane and Plaza hotels. $1250 for four days a month. Available full or part-time.

5th Ave Medical Office for Share
Facing Central Park in exclusive building, ground floor, separate entrance.
Perfect for psychiatrist, physiatrist, osteopath, or other.
880 5th Avenue (between 69th and 70th Sts.), New York, N.Y.
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?
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Multi-Specialty Medical Office Looking To Bring On More Doctors
New York Medicine Doctors Center is a multi-specialty Medical Agency networking some of the best medical professionals and specialists in the New York Tri-State area. Our offices currently serve both Manhattan and Queens, providing a variety of advanced technological on site testing, imaging, and services for the most rapid results.

We are actively looking to bring on board an array of Doctors specializing in Primary Care, Gynecology, Gastroenterology, ENT, Urology, Podiatry, and Dermatology.

As we continue to broaden our medical services in both locations, we also provide individualized on-boarding contracts with health benefits, tailored in-house marketing and advertising, practice management assistance, and in house team of administration dedicated in serving any and all concerns whether it be credentialing or equipment related tasks.

If you are interested in joining our growing network, please do not hesitate to contact us

at 718-360-9550 or 212-931-8533. Our direct email is

Primary Contact: Oksana

Seeking Executive Director of the Onondaga County Medical Society
 An exciting opportunity for the right person to provide leadership for physicians Salary: Commensurate with experience Job Description: Direct day-to-day operations of the Onondaga County Medical Society Some evening meetings, travel required. RequirementsExperience with leading political advocacy; political sophistication. Must know how to interface with government officials. Good networking and communication skills. Conversant with budgets and finance. Excellent media relations skills, including electronic, social media, and written communications. Familiar with medical issues and comfortable discussing them. Education: BA/BS required.  MPH or MBA desirable. We expect innovation and project initiation. The Executive Director will receive a contract that increases remuneration commensurate with membership growth. Application Instructions: Please direct your application to: Dr. Brian Johnson,

Nurse, RN Utilization Review Full-Time-Westbury, NY (In-office position only)
Excellent opportunity for a RN who is seeking a position performing utilization review.  We require 1-2 years recent experience in hospital and/or insurer utilization review and experience using Interqual criteria and/or MCG Guidelines. Data entry/PC skills a plus. Benefits include 401(k), paid vacation and holidays. Send resume and salary requirements to: Empire State Medical Scientific and Educational Foundation, Inc. Human Resource Department e-mail:  Fax: (1-516) 833-4760 Equal Oppty Employer M/F