MSSNY eNews – May 31, 2019 – WHO YOU GONNA CALL? MSSNY!

PRESIDENT’S MESSAGE< Arthur Fougner, MD MSSNY President MSSNY eNews May 31, 2019 Vol. 22  Number 21

 

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Colleagues:

We get asked all the time: “Why MSSNY”? Or perhaps, “What does MSSNY do for me?” For two Bronx physicians, that answer is resoundingly clear— “MSSNY saved our practice.”

Two Bronx doctors received notification from their largest carrier that because of an issue with their Maintenance of Certification (this will be the subject of a future piece), they were about to be dropped from participation. These physicians do not practice in the trendy Hamptons or on the tony Upper West Side. They do primary care for patients of modest means and, I must say, do it well.

So they reached out to us with a cry for help. Right away, our in-house ombudsman Regina McNally contacted the carrier for more information. We also suggested they reach out to Bronx State Senator Gustavo Rivera who now chairs the Health Committee about the problem. We also did the same.

Lo and behold, the physicians received a follow-up letter from the carrier apologizing for a “mistake,” assuring them that they would remain an integral part of their network.

Funny how that works, right?

So the next time anyone asks “Why MSSNY?,” invite them to pull up a chair and tell them the story of the two Bronx physicians.

As a postscript, the following week, I met up with Sen. Rivera at an event and he told me that after speaking with those same doctors, he was introducing legislation on this whole “MOC business.”

Stay tuned.

Get up, Stand up. Stand up for your right.
Get up, Stand up. Don’t give up the fight.

Bob Marley

Arthur Fougner, MD
MSSNY President 

Comments? comments@mssny.org; @mssnytweet; @sonodoc99

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Capital Update

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Wrongful Death Bill Reported Out of Judiciary Committees
All physicians are urged to contact their legislators to oppose a bill that would cause enormous increases in medical liability premiums by expanding damages awarded in wrongful death actions. Senator Hoylman and Assemblyman Weinstein’s S.4006/A.5612, which was reported out of the Senate and Assembly Judiciary Committees on Thursday,  which will now be considered in the Senate Finance and Assembly Codes committees, 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.  An Actuarial estimate released by the NY Lawsuit Reform Alliance indicated that passage of this legislation could increase premiums by nearly 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) 

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NYS Has 845 Confirmed Measles Cases—Physicians Urged to Call Legislators to Demand Action on this Public Health Epidemic
As of May 24, 2019, there are 940 confirmed cases of measles nationally—with 845 of them here in New York State.   Physicians throughout the state are encouraged to call their legislators and urge action on a bill that would allow only medical exemptions for immunizations.  The measure, A.2371/S.2994A, is in the Assembly & Senate Health Committees.   The Medical Society of the State of New York has joined 29 other medical organizations, patient advocacy groups and public health organizations, meeting with members of the Legislature to advocate for passage of this measure.

Advocates against mandatory vaccinations continue to call and meet with legislators and were in Albany again this week.  It is vitally important that physicians call or send messages to their legislators urging action on this measure.  You can help by following these steps:

• Physicians are strongly urged to contact members of the Assembly Health Committee. Please call 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 exemption to vaccination will be for medical reasons.
• Please send a letter to your legislator via the MSSNY Grassroots Action Center (GAC).  Please click here !
• Physicians are encouraged to work with their local county medical society to schedule a local legislative meeting with your with local legislators! Please call your State Senator and Assembly Member’s office to voice your support of this legislation. There is strength in numbers! Please click here

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.

Senate Majority Leader Andrea Stewart-Cousins has indicated that she has enough votes to pass this measure in the Senate and Governor Andrew Cuomo has publicly stated that he will sign the bill if it comes to his desk.  The question is whether there will be enough votes in support in the New York State Assembly Health Committee.

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 and the Tompkins Board of Health.(CLANCY)

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Rural Health Care Hearing Highlights Roots of Rural Access Issues
On Friday the Assembly Health Committee held a hearing to discuss issues surrounding access to care in rural communities. The committee heard testimony from a wide array of individuals, including those representing physicians, hospitals, home care organizations and other providers. The theme was consistent as those testifying spoke to the need to increase reimbursement to rural areas.

Dr. Chris Kjolhede, a pediatrician from Cooperstown and MSSNY delegate, testified on behalf of MSSNY and addressed the variety of issues challenging communities in rural areas. These include the need for more adequate reimbursement for services provided to Medicaid members; enhanced ability to incentivize physicians to practice in rural areas through increased funding for programs like Doctors Across New York (DANY); innovation through a carefully planned and quality-controlled telemedicine system; understanding how social determinants of health impact communities in order to craft localized solutions; and supporting evidence-based public health measures. Dr. Kjolhede and others also stressed the strong willingness on the behalf of physicians and other stakeholders to work together to improve access to quality care in rural areas.   (AVELLA)

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Physician Advocacy Needed in End of Session Push for Insurance Reforms
With only three weeks remaining until the scheduled end of session, strong advocacy is needed on a variety of insurance related bills that MSSNY is supporting in order to bring about positive reforms to the health insurance system in New York. Physicians are urged to help advocate for the advancement of these reforms and emphasize how important these bills are. 

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 MSSNY strongly supports 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 such as prior authorizations and network participation rules. Insurance companies have been fighting against this fiercely so we must ensure strong grassroots support for this legislation that would put physicians on more even footing with insurers.

The bill has been reported out of the Assembly Health and Codes Committees and awaits a vote in Ways & Means. Its Senate companion is currently in in the Senate Health Committee. Please urge your Assemblymember and Senator to join on as a co-sponsor and support the bill 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 currently on the Senate calendar eligible for a vote and has been reported out of the Assembly Insurance Committee; it currently awaits a vote in the Assembly Codes Committee. Please urge your Assemblymember and Senator to join on as a co-sponsor and support the bill 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 you should be spending with your 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 help physicians in a variety of ways, including reducing prior authorization burdens, updating UR standards and patient protections for prescription drug coverage continuity.

The bill is has been reported out of the Senate Insurance Committee and is on the floor calendar eligible for a vote. Its Assembly companion awaits consideration in the insurance committee. Please urge your Assemblymember and Senator to join on as a co-sponsor and support the bill click here.

Network due process – There is currently a glaring loophole in New York’s laws that allow insurance companies to terminate physicians from their networks by non-renewal without cause or recourse. While they are required to notify physicians when contracts are terminated and physicians are then afforded the opportunity for a hearing, these protections don’t extend to non-renewal. Senator Rivera’s and Assemblymember Lavine’s bill (S.3463/A.2835) would provide physicians with proper due process upon non-renewal and would enhance the current hearing process by allowing the subject of the hearing (the physician) to choose one of the three members of the panel.

The bill is currently eligible for a vote on the Senate Floor. It was recently reported out of the Assembly Codes Committee and will be eligible for a vote in the Assembly next week.  (AVELLA)

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MSSNY Testifies at Single Payor Hearing
MSSNY President Dr. Art Fougner testified at a 13-hour long Assembly-Senate hearing this week (click here) examining legislation (S.3577, Rivera/A.5248, Gottfried) that would create a single payor system in New York State.  Dr. Fougner’s testimony praised the sponsors for their efforts to ensure New Yorkers have coverage for the care they need, as well as the efforts to revise the legislation to address concerns that physicians have raised with the legislation.   These improvements include provisions to reduce prior authorization requirements and additional mechanisms to help physicians more fairly negotiate with a monolithic bureaucratic structure.  MSSNY has a long-standing position in opposition to a single payor insurance system, though many physicians across the State have expressed support for such a system.

Dr. Fougner noted that while there are aspects of such a system that are appealing, such as the potential for administrative simplification, MSSNY remains concerned that the good intentions of the sponsors of this proposal may not be how the NY Health system will ultimately operate, particularly when they must respond to situations where anticipated tax revenues do not meet spending projections. He also noted that continued promotion and expansion of the varied programs to provide health insurance coverage for New York’s uninsured and underinsured is MSSNY’s preferred approach.

There will be more hearings on this issue later in the year.   (AUSTER)

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Efforts to Legalize Recreational Marijuana Continue as Legislature Nears End
Advocates for legalizing the recreational/adult-use of marijuana in New York are strongly pressing members of the New York State Legislature to pass legislation.   A. 1617A/ S 1527A, sponsored by Assembly Majority Leader Crystal Peoples-Stokes and Senator Liz Krueger, which was recently amended, would create the “marijuana regulation and taxation act”.   The amended bill would expunge lower level marijuana convictions reduce the amount of marijuana that can be possessed to three ounces, and tax marijuana at a higher level.  Additionally, the new bill calls for the state to train police to recognize impaired drivers and establishes an Office of Cannabis Management which would oversee the growth, sale and distribution of hemp and medical marijuana as well as recreational/adult-use marijuana.  The Assembly bill is in the Assembly Codes Committee and the Senate bill is in the Senate Finance Committee.  The Medical Society of the State of New York continues to oppose the legalization of recreational marijuana and continues to work with other advocacy groups that oppose this measure.

Also pending in both houses is A.7467/S.5657, sponsored by Assemblymember Richard Gottfried and Senator Diane Savino, which would greatly expand New York State’s medical program for certifying patients for the use of marijuana.   The bill eliminates “serious condition” and replaces it with “condition” and further expands the list of condition eligible for certification.  The measure also expands the list of practitioners who can certify the patient for the use of marijuana and would authorize “smoking” as a modality of treatment.   The bill is pending in the Assembly Codes Committee and the Senate Health Committee.   (CLANCY, AUSTER)

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Bill to Assess Ways to Improve Physician Loan Repayment Program Passes Both Houses
Senator Rivera and Assemblymember Gottfried’s S.4269/A.5425 has passed both the Senate and Assembly and will be sent to the Governor for signature. The bill, which was supported by MSSNY, will require an assessment of the impact of requiring individual applicants for grants from the Doctors Across New York physician loan repayment and physician practice support programs to use the New York State Grants Gateway.

Doctors Across New York (DANY) is a successful recruitment and retention tool that helps attract physicians to underserved areas across New York. This is achieved by offering loan forgiveness and practice start-up financial support from the state. This year, the application has been moved from the Department of Health to the New York Grants Gateway. The process to obtain a grants gateway account and the method via which applicants access the RFA is more rigorous and difficult than the previous process and there is some fear that this will reduce the number of physicians that are able to take advantage of this program.  MSSNY has been working with the NY Chapter of ACP in advocating for this legislation.

The workgroup established by this legislation will gather information on the results of the new application process and will work to ensure that the number of applicants is not negatively impacted by the increased administrative steps needed to apply.       (AVELLA)

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Varying Proposals to Address Surprise Medical Bills Contain Positive and Concerning Elements
With several US House and Senate leaders releasing bi-partisan proposals to address the issue of “surprise” patient out of network medical bills that could undermine New York’s acclaimed law, physicians are urged to send a letter (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.

Importantly, last week Representative Joe Morelle (D-NY) together with Representative Dr. Phil Roe (R-TN) and Dr. Raul Ruiz (D-CA) released a proposal that seeks to mirror New York’s law, which uses a “baseball arbitration” Independent Dispute Resolution (IDR) system to determine payments for out of network medical care, and uses charge data collected by an independently controlled database as a leading benchmark to guide the IDR.  MSSNY Board of Trustees member Dr. Andrew Kleinman also recently participated in a meeting with the House Doctors Caucus to educate legislators about New York’s approach.

However, several proposals have been advanced that would either require an insurer determined in-network based default rate for out of network surprise medical bills, or create a baseball arbitration system that uses an insurer determined in-network rate as a benchmark.   MSSNY has written to New York’s Congressional delegation praising the approach set forth by Representatives Morelle, Roe and Ruiz, and raising strong concerns with other proposals.

Specifically, New York’s letter raised concerns with the insurance industry’s own notorious history establishing benchmarks for out of network payment, and the history of then-Attorney General Cuomo’s investigation which found that by using a flawed and conflicted database to determine reimbursement rates for out-of-network care, insurers were increasing profits at the expense of patients and physicians.   Moreover, it was noted that New York’s law struck a tenuous balance among various health care stakeholders that protected patients from surprise medical bills and assured that hospital emergency departments had access to needed on-call specialty care.

With so much interest in this issue, there will be likely be Congressional action this year, so physician grassroots advocacy is essential.  (AUSTER)

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Expansion of Scope of Practice Legislation Pending on Senate Calendar For A Vote
There are several bills that are now on the Senate Calendar and ready for a vote that would expand the scope of practice for many providers.  The Medical Society opposes the following measures:

• 5395/A.6185, which is sponsored by Senator Robert Jackson and Assemblymember Gary Pretlow, would inappropriately expand the scope of practice of podiatrists the following ways: by 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 enabling podiatrists to treat wounds that are not contiguous with structures of the foot or ankle.
• 5092/A.3867, sponsored by Senate Health Chair Gustavo Rivera and Assemblymember John McDonald. This 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, without an order from a physician to provide such services.
• 5227/A.6511A, sponsored by Senator Rachel May and Assemblymember Amy Paulin. The bill would allow pharmacists to provide ALL immunizations on the Advisory Committee on Immunizations Practices (ACIP) list recommended for adults, this would more than double the number of immunizations pharmacists would be permitted to provide.
• 4975/A.6486, sponsored by Senator Neil Breslin and Assemblymember John McDonald, would authorize a pharmacist to administer vaccines for hepatitis A, hepatitis B, and human papillomavirus

to adults via a patient or non-patient specific script.

Please urge your legislators to oppose these measures.  Assembly 518-455-4100, and Senate 518-455-2800.    (CLANCY, AUSTER)     

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AMA Opioid Task Force Issued 2019 Report
The AMA Opioid Task Force this week issued an updated report containing recommendations focusing on tangible actions that can help to end the opioid epidemic. In 2014-15, the Task Force issued six recommendations focused on ways in which physicians could take specific actions to help reverse the nation’s opioid epidemic. While there has been   demonstrated progress in each of these areas, it is clear that much more work remains, and policymakers have an increasing role to play. The new recommendations:

1. Remove prior authorization, step therapy and other inappropriate administrative burdens or barriers that delay or deny care for FDA-approved medications used as part of medication-assisted treatment for opioid use disorder.
2. Support assessment, referral and treatment for co-occurring mental health disorders as well as enforce state and federal laws that require insurance parity for mental health and substance use disorders.
3. Remove administrative and other barriers to comprehensive, multimodal, multidisciplinary pain care and rehabilitation programs.
4. Support maternal and child health by increasing access to evidence-based treatment, preserving families, and ensuring that policies are non-punitive.
5. Support reforms in the civil and criminal justice system that help ensure access to high quality, evidence-based care for opioid use disorder, including medication-assisted treatment.

The task force consists of American Medical Association, American Osteopathic Association, and 25 specialty and state medical societies as well as the American Dental Association.   The Medical Society of the State of New York is a member of the task force.    The original task force recommendations, issued in 2015, focused on actions that physicians could take to help end the epidemic and are now regularly being followed by New York physicians:

• Register for and use the state prescription drug monitoring program;
• Enhance education and training on effective, evidence-based treatment;
• Support comprehensive care for patients in pain and those with a substance use disorder;
• Remove stigma. Patients with pain and with a substance use disorder deserve comprehensive care and compassion, not judgment;
• Expand access to naloxone in the community and through co-prescribing; and
• Encourage safe storage and disposal of opioids and all medications. (CLANCY)

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

The number of measles cases in New York State in 2019 has again seen an uptick over the past week.  806 of the 940 confirmed cases nationwide are in New York State. In 2019 there have been 493 confirmed cases in New York City and 313 outside of New York City (254 in Rockland; 37 in Orange; 17 in Westchester; 3 in Sullivan; 1 in Suffolk and 1 in Greene counties) confirmed cases as of May 30^th.  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. https://cme.mssny.org/ . You can also view MSSNY’s latest Medical Matters webinar entitled “What’s Your Diagnosis? Infectious Diseases” which involves a patient with a fever and a rash. Please check these out and keep yourself informed about the growing 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)

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Registration Now Open for Veterans Matters CME Webinar on June 5^th
Register now for MSSNY’s next Veterans Matters webinar June 5^th 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 mhoffman@mssny.org 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.

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pschuh@mssny.org	mauster@mssny.org	pclancy@mssny.org	mavella@mssny.org
charring@mssny.org

eNews

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SURVEY: What are Your Challenges with EHR?
MSSNY, in conjunction with other physician associations, has been working with the New York e-Health Collaborative (NYeC) on ways to reduce the hassles associated with the implementation and use of electric health record (EHR) systems.

To that end, they have developed a survey for physicians to complete gauging the challenges of EHR use, including connecting to and using medical information from your local Regional Health Information Organization (RHIO) to enhance patient care delivery.

Please take just a few minutes to complete the survey here.

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Opioids Prescribed in 1 of 6 ED Visits by Young People
One in six emergency department visits by adolescents and young adults resulted in an opioid prescription, according to a Pediatrics study.

Using 2005 to 2015 data from two national health surveys, researchers examined 47,000 visits to emergency departments and 31,000 visits to outpatient clinics among patients aged 13 to 22. Among the findings:

• Nearly 15% of emergency department visits and 3% of clinic visits resulted in an opioid prescription.
• Opioid prescriptions in the ED decreased slightly over time.
• The prescribing rate surpassed 40% for dental problems in all ages and clavicle fracture in adolescents.

A commentator writes: “This study’s findings reflect many of the unique attributes of health care use by young adults. … Young adults seek care for acute conditions and injuries, chronic conditions, and reproductive care and receive a greater proportion of their care at emergency departments than any age group except for the elderly.”

Pediatrics article

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MSSNY Council Notes—May 30. 2019

• MLMIC has filed for a no rate increase and a “claims free” discount with DFS. The decision is expected at the end of June. MLMIC will let MSSNY know immediately when the decision is made and we will inform membership.
• MLMIC has contributed $50,000 to MSSNY’s Physician Wellness Committee, which is chaired by Dr. Charles Rothberg.
• On behalf of MSSNYPAC, Dr. Thomas Lee reported very successful fundraising events in Erie County and Staten Island, and encouraged each county in New York to develop a local fundraising effort to bring new members into MSSNYPAC. Contact Jennifer Wilks at jwilks@mssnypac.org or 518.465.8085 to get started.
• The Medical, Educational and Scientific Foundation of New York (MESF) will run a final Physician Leadership Seminar June 21-22 at the Hyatt Regency in Hauppauge on Long Island. Contact Tom Donohue at tdonoghue@mssny.org for more info.
• 40 MSSNY Delegates and Alternates will attend the annual AMA meeting June 8-12 in Chicago.
• Hayden S. Wool, a partner with Garfunkel Wild, presented “Key Considerations in Informing Ancillary Services through a Group.” He provided an overview of the key regulatory compliance issues related to patient referrals and the performance of ancillary services by Group Practice. The presentation focused on an overview of physician consolidation/service expansion; structural changes; and regulatory compliance issues.
• Onondaga County Medical Society hired Erika Barry as their new executive director.
  

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Westchester Medical Center Locked in Contract Dispute
Empire BlueCross BlueShield has notified its members that Westchester Medical Center Health Network will become out-of-network on June 1 unless the two sides reach an agreement. The health network’s contract with Empire expired April 1, but discussions have continued during a two-month “cooling off” period. “We have a strong desire for Westchester Medical Center to be in-network, but we have to provide affordable products,” Alan Murray, Empire’s CEO, told Crain’s. “That’s a constant balance we’re challenged with.”

The insurer sent a letter describing the potential network changes to members last month; it was obtained this week by The Journal News. The hospitals affected are Westchester Medical Center and Maria Fareri Children’s Hospital in Valhalla; Bon Secours Community Hospital in Port Jervis, Orange County; Good Samaritan Hospital in Suffern, Rockland County; St. Anthony Community Hospital in Warwick, Orange County; and MidHudson Regional Hospital in Poughkeepsie, Dutchess County. The insurer told members that Empire would cover WMCHealth facilities as in-network during emergencies, when services have been previously authorized or where another provider is not within 30 miles of a patient’s home. (Crain’s Health Pulse)

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Some Measles Patients Are Asked Not to Travel by Air
Five states, including New York, have advised people who may have measles that public health officials could stop them from boarding airplanes, the Washington Post reports.

State officials can request that the CDC put measles patients on a Do Not Board List that could prevent them from getting on aircraft. All eight people given the warnings by officials in New York, California, Illinois, Oklahoma and Washington State canceled their flights.

The CDC reported 971 cases of measles in the United States so far this year, the highest number in over a quarter-century an increase of 91 cases in the past week. CDC Director Robert Redfield pleaded with hesitant parents to vaccinate their children, reiterating that measles and other vaccines are safe and do not cause autism. Maine and New Mexico have joined the list of 26 states that have confirmed measles. https://www.cdc.gov/measles/travelers.html; CDC measles outbreak surveillance;  NEJM Journal Watch Infectious Diseases coverage of U.S. measles outbreak in 2019

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Growing Number of Cancer Patients Are Using Electronic Cigarettes
Findings published in a research letter in JAMA Oncology report that “research shows a growing number of cancer patients are using electronic cigarettes.” Investigators found that “e-cigarette use by cancer patients rose from 8.5% in 2014 to nearly 11% in 2017.” The data indicated that “among patients younger than 50, the rate of use rose from 23% in 2014 to 27% in 2017.”

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CDC: Decline of Diagnosed Diabetes in US, Yet Overall Numbers High
Even though “rates of diagnosed diabetes in the United States may finally be declining…overall numbers remain high,” Stephen R. Benoit, MD, and colleagues from the Division of Diabetes Translation, Centers for Disease Control and Prevention (CDC) concluded after analyzing “data for an almost 40-year period (1980-2017) from the National Health Interview Survey.” The findings were published online in BMJ Open Diabetes Research and Care. https://drc.bmj.com/content/7/1/e000657

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Weed Killer May Be Linked to Liver Disease, Study Suggests
An article published online in Clinical Gastroenterology and Hepatology reported that research suggests “the popular weed killer Roundup might be linked to liver disease.” Researchers found that “a group of patients suffering from liver disease had elevated urine levels of glyphosate, the primary weed-killing ingredient in Roundup.” Lead researcher Paul Mills said, “We found those patients who had more severe disease had higher levels of [glyphosate] excretion, which means they had higher levels of exposure, presumably through their diet.”

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Dr. Madejski Debates Legalization of Recreational Marijuana
Immediate Past President Dr. Tom Madejski debates recreational marijuana with author, screenwriter, former editor-in-chief/Publisher at High Times and convicted drug smuggler Richard Stratton on the podcast Morano Whenever. Highlights of the debate will also air this Sunday morning on AM 970 THE ANSWER, which is broadcast in the New York metropolitan area.

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