April 28, 2017 – Success Requires Action!

Dr. Charles Rothberg
April 28, 2017
Volume 17
Number 16

MLMIC Insurance

Dear Colleagues:

In my view, success for physicians is well within MSSNY’s grasp. But that success won’t come easy.  And success will not result from inaction.  Nor will it result from being too risk averse.

  • We’ll need to work to advocate on behalf our doctors to provide legislative relief, regulatory relief, and administrative simplification.
  • We’ll need to advocate for them and help them to more effectively represent themselves in an ever changing practice environment – more often in the role of employee in a changing workforce.

I am well aware that I have just a one-year term to implement some ideas that I believe are critical going forward.  I intend to build upon the strong foundation provided by my predecessor, Dr. Malcolm Reid, and I expect to provide a bridge to the leadership of president elect Dr. Tom Madejski.  I introduce Three Pillars that make up my platform:

  • Wellness
  • Disparities
  • Engagement

The term “burnout” has become so overused that it risks losing much of its meaning. We learned at a CME program at this year’s HOD and through our Task Force report that it is institutional factors that contribute to ‘burnout’— NOT defective doctors.  Yes, they are exhausted— from the hamster wheel of insurance authorizations, rejections and unfair remuneration for work that has been signed, sealed and delivered.  What is MSSNY doing to alleviate the problem?

MSSNY is currently working on early intervention programs. We must change our focus from intervention to one that places greater emphasis on prevention. We should refer to “Physician Wellness” which is suggestive of the remedy, rather than “burnout,” which refers solely to the symptom.

If we want to survive as a viable society, we must engage NOT ONLY our members, but also non-members, students, health care stakeholders, and the press. If we do not engage, we undermine our own authority. The balance is tricky. When the press asks us for statements, we have to speak decisively, thoughtfully, unambiguously and without timidity. To do so we need to have strong policy positions and abundant discourse on which to rely.  We need to engage by means of all kinds of media – conventional, social media, face to face.  Please do not groan when I sincerely encourage you to sign up for twitter. You might enjoy it! Follow me @MSSNYRothberg and MSSNY@mssnytweet.

Engagement for MSSNY will involve much more than compelling policy, advocacy and effective messaging. It must involve enrichment as well.  However, expanding existing programs such as our CME, our advocacy, newsletters, and especially programs modeled on our successful leadership seminars which engaged over 100 physicians in programs both downstate and in central New York.

We have developed an overly narrow view of disparities – a narrow view that I believe we have outgrown.  Going forward, our solutions must extend beyond just the ethnic. The future must include ALL contributors to adverse health outcomes— gender, LGBTQ, geography, poverty, age and even physician diversity. We need to look beyond how we traditionally view diversity. There are lots of people out there who don’t want to fit a mold. But they do want to feel free to be themselves. They look to us for understanding, not necessarily for advice.

As we are coming to understand, patients with gender identity issues have hated going to the doctor, any doctor. They were afraid, because they thought they might be judged. The people who have been outliers have stepped forward and we should walk beside them and learn how to better treat them in our offices. The objective of the three pillars I have outlined is to chart a path to the future. Other stakeholders are certainly positioning themselves to fill any voids – WE SEE HOW THAT IS WORKING OUT!  We must not allow voids, and where they exist, WE must fill them.

Now that we know better, we must listen better; then we will do better.

A matter that was discussed at the House that is receiving some attention is our decision to develop an unbiased survey through the Bioethics Committee regarding MSSNY’s members’ attitude towards aid-to-the-dying. For now, our policy remains that “physicians should not assist in suicide.”

Results of this survey will be conveyed to the 2018 House of Delegates.

Charles Rothberg, MD
MSSNY President

Please send your comments to comments@mssny.org

Appeals Court Blocks Proposed Anthem-Cigna Merger
In a landmark victory for patients and physicians, a federal appeals court upheld the lower-court ruling that blocked the proposed mega-merger between health insurance giants Cigna and Anthem (the parent of Empire Blue Cross/Blue Shield).   MSSNY worked together with the AMA and several other state medical associations to oppose this proposed merger.  Last fall, then-MSSNY President Dr. Malcolm Reid testified at a public hearing hosted by the New York Department of Financial Services examining this proposed merger.

Dr. Reid’s testimony emphasized the already very difficult practice environment for physicians in New York State that has become worse in recent years, in part the result of the narrowing of health insurer participating provider networks and increasing pre-authorization burdens, problems which undoubtedly would be made worse had this merger been permitted to move forward.  Indeed, DFS Superintendent Maria Vullo issued a letter that highlighted concerns with the significant market impact the merger would have had if approved.

New York Attorney General Eric Schneiderman, who had joined several AGs across the country in litigation to oppose the proposed merger, issued a statement praising the Appeal’s court’s ruling:

“Today’s decision is a win for consumers in New York and across the country.  We are very pleased that the Court of Appeals agreed with the District Court’s finding that this merger would violate antitrust laws by substantially lessening competition in commercial health insurance markets, likely leading to increased health insurance premiums and reduced quality and innovation.  I again thank my federal and state partners for their work to protect patients and ensure that competition in the health insurance industry remains vibrant across the country.”

To read more click here.                                                                                                      (AUSTER)

Last Weeks of Legislative Session Present Opportunities and Challenges
The legislature returned to session this past Monday after two weeks off following the passage of the state budget.  The last scheduled session day is June 21st. Issues for state lawmakers to address in the remaining weeks of session could include New York City Mayoral control, ethics reform and various MSSNY supported/opposed bills detailed below.   Stay tuned for future emails and go to MSSNY’s website for updates when actions are needed on our priority legislation.

One bill supported by MSSNY, S.3943 (Hannon), was moved through the Senate Health committee this week and has passed the Assembly (see related article).  This bill would provide physicians and other health care practitioners with necessary due process protections where health insurers seek to terminate a physician from its network by failing to renew the physician’s contract.

MSSNY is also working together with several specialty societies to reduce administrative hassles by advancing legislation that would enact several components of the AMA’s Prior Authorization Principles (click here), including:

  • Assuring that a practitioner of the same or similar specialty review health care pre-authorization request on behalf of a health plan before treatment is denied;
  • Require health plan utilization review criteria to be evidence-based and peer reviewed ;
  • Reduce the time frame for reviewing prior authorization requests from 3 business days to 48 hours (and to 24 hours for urgent situations)
  • Assure that a prior authorization, once given, is enduring for the duration of the medication or treatment.
  • Prohibit mid-year prescription formulary changes; and
  • Assure that once a prior authorization is given, it cannot be withdrawn if eligibility is confirmed on the day of the service.

Among the Many Other Bills MSSNY is fighting to achieve:

  • Collective Negotiations (4472, Gottfried /S.3663,Hannon) – would allow independently practicing physicians to collectively negotiate patient care terms with market dominant health insurers under close state supervision.  To send a letter to your legislators click here.
  • Changes Definition of Clinical Peer Reviewer (2539,Gottfried) – Would assure that a physician of the same or similar specialty review health care recommendations on behalf of a health plan before treatment recommendations are denied
  • Improving the Medical Liability Landscape in New York State (4913, Schimminger) – would implement a number of important reforms to the medical liability adjudication system to reduce the exorbitant cost of medical liability insurance.
  • Protecting the Peer-Review Process (2460 Gottfried / S.3661 Hannon) – Would extend the confidentiality provisions relating to discovery of testimony to apply to statements made by any person in attendance at peer-review committee that is a party to an action the subject matter of which was reviewed at such meeting.
  • Raising the purchase age of tobacco products to 21 and regulate e-cigarettes under the Clean Indoor Air Act.

Among the many Bills MSSNY is opposing:

  • Expanding the Medical Liability Lawsuits (3339/S.4080) – would substantially lengthen the statute of limitations for medical malpractice actions and lead to enormous increases in the cost of liability insurance for physicians and hospitals.  If enacted this bill could increase your liability premiums by 15%.  Please send a letter in opposition click here.
  • Expansion of Medical Liability Damages (411/A.1386) – would greatly expand the categories of damages which a plaintiff may recover in a wrongful death action.  Actuarial studies have predicted that this bill could increase liability premiums by over 50%.
  • Prohibiting Ex-Parte Interviews of Plaintiff’s Treating Physician (243/A.1404) – would prohibit a physician’s defense counsel in a medical liability action from conducting an interview with the plaintiff’s treating physician. This bill would present significant issues for physicians in a medical liability action by limiting the opportunity to fully examine the plaintiff’s health condition to evaluate the merit of the plaintiff’s claim.
  • Retail Clinics (A958) – would permit corporate owned “retail clinics” in big box stores
  • Certification of Certified Registered Nurse Anesthetists (CRNAs) (A.442/S.1385) – would provide for the certification by the education department of certified registered nurse anesthetists (CRNAs).  This bill fails to define a scope of practice consistent with existing New York State standards.  Under NYS Health Code (10 NYCRR 700.2), CRNAs are already required to register with the NYS Education Department and are prohibited from practicing nurse anesthesia without meeting specific education and testing requirements.
  • Podiatric scope of practice (1880/ S.4734) – would expand the scope of practice of podiatrists to allow podiatrists to “diagnose, treat, operate or prescribe for cutaneous conditions of the ankle to the level of the distal tibial tuberocity” (knee).(DIVISION OF GOVERNMENTAL AFFAIRS)

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

Legislation to Repeal Significant Portions of the ACA Could Be Back Before Congress; MSSNY Joins Several Other Organizations to Express Concerns
Multiple media outlets reported this week that the members of House Freedom Caucus agreed to support the American Health Care Act (AHCA) if it incorporated amendments that would permit states to modify specific ACA requirements, including age rating bands, essential health benefits, and continuous coverage incentives.  The amendment was the result of ongoing discussions between Representative Tom MacArthur (R-NJ), co-Chair of the centrist “Tuesday Group” and the House Freedom Caucus.

The AHCA was pulled from Congressional consideration in late March because it had insufficient “yes” votes, including lack of support from the Freedom Caucus.  However, as of this writing it is not known whether this amendment to the AHCA legislation will now produce a majority to support the legislation, or whether it could also pass the US Senate.

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

The AMA sent a letter to Congressional leaders noting that “Nothing in the MacArthur amendment remedies the shortcomings of the underlying bill” and that the AMA remains “deeply concerned that the AHCA would result in millions of Americans losing their current health insurance coverage”.  It is urging physicians to send a letter in opposition to their legislators here: click here.

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

However, it would substantially revise ACA rules that facilitated various subsidized coverage programs for those who make up to 400% FPL ($94,000 for a family of 4).  While the expanded eligibility for Medicaid (up to 138% FPL) would be available through the end of 2019, starting in 2020, such expanded coverage would only be continued for those who had such coverage prior to the end of 2019.  The AHCA would also repeal the tax credits currently provided to help cover cost-sharing amounts for coverage for individuals who earn too much to qualify for Medicaid.  Instead, tax credits of $2,000-$4,500 (depending upon age) would be provided to enable the purchase of health insurance coverage.

Tax credits will be available in full to individuals earning less than $75,000 and households earning less than $150,000, but they will be capped for higher earners.  It appears as if the AHCA would also completely eliminate funding for New York’s Essential Plan, which provides low-cost insurance coverage with little cost-sharing responsibilities for those who make between 138% -200% FPL.

The bill would also repeal several other notable ACA provisions, including the requirement for all individuals to have health insurance coverage, the large employer coverage mandate, the provision to impose a “tanning” tax and a provision that limits the tax deductible treatment for health insurers of executive income that exceeds $500,000.

Please remain alert for further updates.

MSSNY Supports Legislation That Would Raise The Purchasing Age For Tobacco And Restrict E-Cigarettes
The New York State Senate Health Committee advanced two smoking related pieces of legislation this week.  S.3978/A.273 would increase the purchasing age for tobacco products from eighteen to 21 years of age and S.2543/A.516 would include the use of electronic cigarettes or e-cigarettes under the Clean Indoor Air Act.  The Medical Society of the State of New York strongly supports both these measures.  In its statement of support, MSSNY indicated that the best way to reduce the number of people who are addicted to tobacco is to prevent them from starting to smoke.  Addiction to tobacco products occurs relatively quickly once someone begins to smoke.  Once someone becomes addicted to tobacco it is very difficult to quit.  Data suggest the earlier the onset of smoking, the more severe the addiction is likely to be and 90% of all smokers begin before age 20.  Each day, 6,000 children under 18 years of age smoke their first cigarette.

Children most often try their first cigarette with a friend or peer who already smokes.  This bill aims at reducing the number of people who smoke by raising the age requirement to 21. E-cigarettes are not currently defined as a “tobacco product” under the New York S tax law, retailers that sell e-cigarettes do not need a tobacco registration from the Department of Taxation and Finance.

This opens a loophole for retailers to sell e-cigarettes, even if they are not registered and do not sell traditional tobacco products.  Since there is no registration requirement, there is no way for the Department of Health’s Enforcement Unit to know that they are selling e-cigarettes or conduct compliance checks to ensure that they are not selling to minors. This bill will further require that they register if they sell e-cigarettes. The Medical Society of the State of New York strongly supports both these measures and urges physicians to contact their legislators and urge their support for both bills.  Physicians can send a letter to their legislators by clicking on the link: click here.
(HARRING, CLANCY)                                                 

Legislation Advances to Assure Peer Review Prior to Health Plan Contract Non-Renewal
Legislation (S.3943, Hannon) to assure that a physician has a right to a hearing before their clinical peers before their participation contract with a health insurance company can be non-renewed was reported unanimously from the Senate Health Committee to the Senate floor this week.

MSSNY supports this legislation.  Identical legislation (A.2704, Lavine) recently passed the Assembly.  The purpose of the bill is to address a gap in current law that prohibits a health insurance company from terminating a physician’s contract with a health plan without a written explanation of the reasons for the proposed contract termination and an opportunity for a hearing before clinical peers, but does not apply those rights to situations where the physician’s contract is not renewed.

There have been instances in the last few years where certain health insurance companies have dropped significant numbers of physicians from their networks without providing any recourse to these physicians to challenge these non-renewals.  This legislation would provide important protections to better assure the continuity of the physician-patient treatment relationship.  Physicians can send a letter to their Senator in support of this legislation here (click here).

MSSNY Joins Other Advocacy Organizations to Continue Federal Support for Subsidized Health Insurance Coverage for those below 250% FPL
MSSNY joined several other health care, patient and employer organizations in a press statement (Click here ) this week that encouraged Congress and President Trump to ensure continued funding for health insurance cost-sharing reductions (CSRs) currently provided under the Affordable Care Act, as Congress was negotiating a continuing Budget resolution to prevent a government shutdown.

In particular, the press release highlighted that more than 700,000 New Yorkers benefit from these CSR funds, including those who are enrolled in the State’s Essential Plan (for those earn less than 200% of the FPL), as well as those who earn between 200-250% FPL who receive health insurance coverage through New York’s Health Insurance Exchange.   These subsidized health insurance coverage options could be lost if these CSR subsidies were not continued.  It was reported in several media outlets on Wednesday that the new administration intends to continue to make these subsidy payments (click here)

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

The educational objectives are: 1)  Understand preparedness and response actions of public health and healthcare to a novel pandemic influenza, simulated in full-scale exercise.  2)  Describe two delineated strategies in which public health and office-based physicians would interact in a pandemic influenza.  Additional information or assistance with registration may be obtained by contacting Melissa Hoffman at mhoffman@mssny.org.  

 Medical Matters is a series of CME webinars sponsored by MSSNY’s Committee on Emergency Preparedness and Disaster/Terrorism Response.  

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

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

NYS DOH Announce Free Buprenorphine Training Across New York State
The NYSDOH AIDS Institute announces a Free Buprenorphine Waiver Training for Clinical Providers in various locations throughout the state.  Attached are flyers with further information, including location, online registration and pre-requisite training.  The NYSDOH trainings will be in Monticello (May 6th) click here , Plattsburgh (May 20th) click here, Ithaca (June 3rd)  click here. 

The New York City Department of Health and Mental Hygiene conducts free buprenorphine waiver trainings as well throughout all five boroughs.  For further information, please contact them at buprenorphine@health.nyc.gov. For more information about all upcoming MAT trainings, please visit www.pcssmat.org/mat-basics/mat-waiver-training/.  Should you have any questions, please do not hesitate to contact the department at 1-800-692-8528 or buprenorphine@health.ny.gov. Space is limited to 40 individuals and will fill up so please register fast!

LAST CHANCE TO REGISTER:  Please Join our Running/Walking Team for the CDPHP Workforce Team Challenge
Please join us on May 18th!  MSSNY will be a premium sponsor of the 2017 CDPHP Workforce Team Challenge, a 3.5-mile race for runners and walkers, taking place in Albany on May 18, 2017.  MSSNY members and alliance members are highly encouraged to join with us to participate, either as a runner or a walker.

MSSNY’s sponsorship of the event is part of an ongoing effort to have a visible presence at health-related public events.    As a premium sponsor, MSSNY’s logo will be featured on the official race t-shirt, and MSSNY will be recognized during the race announcements.  In addition, MSSNY will have an exhibit table on Empire State Plaza.

Registration for this event closes May 1, 2017, OR when the cap of 10,000 registrants is reached.  As of today, Friday, April 28, 2017, at 10:00 AM, 9,200 people had already registered.  Please do not wait! 

The race begins at 6:25 PM, at Empire State Plaza, and features a scenic route that traverses Albany’s Washington Park.  The popular event always attracts great crowd support and on-course entertainment.  Sawyer Fredericks, winner of the eighth season of The Voice, will be singing the National Anthem.

Instructions and registration link are available  here.  Please choose “Medical Society of the State of New York” from the team drop-down list.  Registration is $24, and a portion of the registration fees go to this year’s “Charities of Choice,” Boys and Girls Club of Albany and Vanderheyden.   A flyer may be accessed here.  For more information, please contact Miriam Hardin (mhardin@mssny.org).   (HARDIN)

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

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

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Clinicians: MIPS Participation Status Letter
CMS is reviewing claims and letting practices know which clinicians need to take part in the Merit-based Incentive Payment System (MIPS), an important part of the new Quality Payment Program (QPP). In late April through May, you will get a letter from your Medicare Administrative Contractor that processes Medicare Part B claims, providing the participation status of each MIPS clinician associated with your Taxpayer Identification Number (TIN).

Clinicians should participate in MIPS in the 2017 transition year if they:

  • Bill more than $30,000 in Medicare Part B allowed charges a year and
  • Provide care for more than 100 Part B-enrolled Medicare beneficiaries a year

QPP intends to shift reimbursement from the volume of services provided toward a payment system that rewards clinicians for their overall work in delivering the best care for patients. It replaces the Sustainable Growth Rate formula and streamlines the “Legacy Programs” – Physician Quality Reporting System, the Value-based Payment Modifier, and the Medicare Electronic Health Records Incentive Program. During this first year of the program, CMS is committed to working with you to streamline the process as much as possible. Our goal is to further reduce burdensome requirements so that you can deliver the best possible care to patients. Learn more about the Quality Payment Program.

A MSSNY House United Can Never Be Defeated
One of the important messages that came out of the MSSNY’s Annual House of Delegate’s meeting was the powerful force we can play in the legislative process when physicians are united.  While physicians may have differing views on key health issues, it was again demonstrated that respectful dialogue and discussions lead to a productive MSSNY agenda.  The House of Delegate’s meeting has concluded but a lot of work still has to be done.  Various speakers highlighted the importance of contacting your legislators and the role of MSSNYPAC.   We have a lot of work ahead, but if all physicians engage in advocacy and the political process, there is much we can accomplish.  Please join us in these efforts.

Upcoming Veterans Health Care Conference in LI: CME for Primary Care Physicians
MSSNY, the New York State Psychiatric Association, and the National Association of Social Workers New York State Chapter are hosting a two-day conference on Long Island on Friday, May 5 and Saturday, May 6, 2017 at the Clarion Hotel & Conference Center, located at 3845 E Veterans Memorial Hwy, Ronkonkoma, NY 11779.

The conference will consist of interactive seminars and panel discussions focusing on the current and evolving healthcare needs of veterans.The training section is fully subscribed. However, physicians can still attend the conference.,/span>

There is no cost, but separate registration is required for both the trainings and conference. The presentation is part of Veterans Mental Health Training Initiative, which is supported by a grant provided by the New York State Legislature and administered through the New York State Office of Mental Health. 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 each 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

Further information or for assistance in registering for these programs, contact Greg Elperin at gelperin@mssny.org

MLMIC Releases New Risk Management CME Program
As part of MLMIC’s ongoing commitment to help physicians and other healthcare practitioners improve the quality of patient care and reduce potential liability exposure in their practices, a new online risk management CME program, Proactive Risk Management Follow-Up Program VII (Follow-Up VII), has been developed for its policyholders and is now available at policyholders’ secure login at MLMIC.com.

The topics covered in this program include:

  • the benefits as well as the associated liability risks of using electronic health records (EHRs) in the office practice
  • the proper use of EHR features and the use of EHR data in litigation
  • the key factors considered by plaintiffs’ attorneys when evaluating a potential malpractice claim
  • the areas of risk commonly identified in high exposure liability cases
  • follow-up procedures in the office practice and the liability risks of patient noncompliance
  • recent trends in pediatric claims and the main areas of liability risk in the treatment of pediatric patients

In addition to its educational value, physicians can earn CME credits, ABIM and ABP MOC credits (if appropriate), the applicable premium credit (5%, VAP or ECPIP) and eligibility to participate in the NYS excess medical malpractice insurance program (Section 18 professional liability coverage).  To view the program now, click here to log in.

Should you have any questions regarding this program, please do not hesitate to contact MLMIC’s Risk Management Department at (212) 576-9601, from 9 a.m. – 4:45 p.m., Monday through Friday.

41.6% of Heart Attack Patients Not Taking Meds after Two Years
study in JAMA Cardiology analyzed data on 29,932 Medicare patients ages 66 to 75 who had been hospitalized for a heart attack from 2007 through 2012 and had filled a prescription for either Lipitor or Crestor.

At six months after their discharge from the hospital, 58.9 percent of them were still taking the medicine with high adherence rates. By two years, only 41.6 percent were taking it as directed; many were taking lower dosages than prescribed, and nearly one in five had stopped taking the medicine completely.

The senior author, Dr. Robert S. Rosenson, a professor of medicine at the Icahn School of Medicine at Mt. Sinai, said that failing to take the medicine properly results in greater risk for heart attack, stroke and unstable angina.

“Health care providers have an obligation to educate the patient,” he said. “We need to stress the evidence that supports the therapy. People who continue the medicine have progressively fewer adverse outcomes over time. Once you have a heart attack, this is prevention for the rest of your life.”

MSSNYPAC – The Political Voice of New York’s Physicians
MSSNYPAC Medical Society of New York
More than 100 MSSNYPAC-supporting physicians participated in our Physician Advocacy Roundtable held in Westchester last Friday during MSSNY’s annual House of Delegates meeting.  Senator Terrence Murphy, Assemblyman Andrew Raia, Nassau-Suffolk Hospital Council Chair Kevin Dahill and AMA Trustee Barbara McAneny, MD discussed the importance of physician participation in the development of health care policies affecting the communities we serve, such as implications of a potential ACA repeal, and response to the opioid and heroin addiction epidemic.  To support our work, please join MSSNYPAC at www.mssnypac.org/contributeMSSNYPAC is a force for change in healthcare delivery. 

Malaria May Be More Common In US Than Previously Reported, Study Suggests
The New York Times (4/25) reports in “Global Health” that malaria may be more common in the US than previously reported, according to a new study published in The American Journal of Tropical Medicine and Hygiene. After analyzing hospital discharge records in the Agency for Healthcare Research and Quality’s National Inpatient Sample, researchers concluded there were at least 2,100 cases of malaria each year in the US between 2000 and 2014. The article also points out that the Centers for Disease Control and Prevention estimates that there are around 1,500 to 2,000 cases of malaria each year.

Illegal Cancer Treatments: FDA Warning – Fraudulent Claims of Diagnosis, Treatment, Prevention or Cure
FDA issued warning letters addressed to 14 U.S.-based companies illegally selling more than 65 products that fraudulently claim to prevent, diagnose, treat or cure cancer.

It is a violation of the Federal Food, Drug and Cosmetic Act to market and sell products that claim to prevent, diagnose, treat, mitigate or cure diseases without first demonstrating to the FDA that they are safe and effective for their labeled uses. The illegally sold products cited in the warning letters include a variety of product types, such as pills, topical creams, ointments, oils, drops, syrups, teas and diagnostics (such as thermography devices).

They include products marketed for use by humans or pets that make illegal, unproven claims regarding preventing, reversing or curing cancer, killing/inhibiting cancer cells or tumors, or other similar anti-cancer claims. See the list of illegally sold cancer treatments.

The products are marketed and sold without FDA approval, most commonly on websites and social media platforms. Healthcare professionals and patients are encouraged to report adverse events or side effects related to the use of these products to the FDA’s MedWatch Safety Information and Adverse Event Reporting Program:

  • Complete and submit the report Online: www.fda.gov/MedWatch/report
  • Download form or call 1-800-332-1088 to request a reporting form, then complete and return to the address on the pre-addressed form, or submit by fax to 1-800-FDA-0178 

Do You Want to Comment on Role of Physician-Owned Hospitals?The Fiscal Year (FY) 2018 Hospital Inpatient Prospective Payment System proposed rule released by the Centers for Medicare and Medicaid Services (CMS) on April 14 asks the public to comment on the appropriate role of physician-owned hospitals in the nation’s health care delivery system.  Specifically, the proposed regulation asks about the impact that CMS regulations and the statutory restrictions on these facilities have had on health care delivery and on Medicare beneficiaries.

While there have been longstanding restrictions on physician hospital ownership under the Stark self-referral regulations, these restrictions were tightened with passage of the Affordable Care Act (ACA), which essentially banned the construction of new facilities and placed restrictions on the expansion of already existing physician-owned hospitals.

Representative Sam Johnson (R-TX) recently re-introduced H.R. 1156, the “Patient Access to Higher Quality Health Care Act of 2017,” which would repeal the ACA limits on physician-owned hospitals and allow these facilities to remain competitive.  The legislation is supported by the American Medical Association.

Physician-owned hospitals provide high-quality care and contribute to a competitive health care marketplace.  If allowed to compete on a level playing field, they may play an important role in enhanced care coordination as well as new health care delivery models.

Physicians are encouraged to submit comments to CMS electronically, following the instructions under the “comment now” button, before 5:00 pm ET on June 13, 2017. 

Doctors’ Visas: Bronx Lebanon Filed 213 Applications in 2016
Bronx-Lebanon Hospital Center filed 213 applications for H-1B visas in 2016, second only to Michigan’s William Beaumont Hospital, according to a study published in JAMA last week and reported on by Kaiser Health News. Employers in New York, Michigan and Illinois submitted the most H-1B applications for foreign physicians, causing concern amid President Donald Trump’s call for a review of the visa program. The H-1B visa program allows employers to hire highly skilled professionals from abroad to fill employment gaps in the U.S., typically in high-tech, science, engineering and math jobs. But hospitals use the program as well, often to recruit doctors to serve in rural or underserved urban areas. The number of visas is capped at 85,000 annually.

Review Your Open Payments Data Before it Becomes Available to the Public
CMS will publish the Open Payments Program Year 2016 data and updates to the 2013, 2014, and 2015 program years on June 30, 2017.
Review and dispute for the Program Year 2016 Open Payments data publication began on Saturday, April 1, 2017 and will last until May 15, 2017. Physicians and teaching hospitals must initiate their disputes during this 45-day review period in order for any disputes to be addressed before the June 30th publication.
Physician and teaching hospital review of the data is voluntary, but strongly encouraged. While the opportunity for physicians and teaching hospitals to dispute any data associated with them expires at the end of the calendar year in which the record is published, the disputes must be initiated during this 45-day review and dispute period, ending on May 15th, in order to be reflected in the June 30th publication.

If you have never registered with Open Payments before:
Make sure you have your National Provider Identifier (NPI) number, and State License Number (SLN). Initial registration is a two-step process and should take approximately 30 minutes:

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

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

For users that registered last year but have been inactive for more than 60 days:
The EIDM locks accounts if there is no activity for 60 days or more. To unlock an account, go to the CMS Enterprise Portal, enter your user ID and correctly answer all challenge questions; you’ll then be prompted to enter a new password.

For users that registered last year but have been inactive for more than 180 days:
The EIDM deactivates accounts if there is no activity for 180 days or more. To reinstate an account that has been deactivated, contact the Open Payments Help Desk.

For more information about the registration process, visit the physician and teaching hospital registration page on the Open Payments website.

Submit questions to the Help Desk via email at openpayments@cms.hhs.gov or by calling 1-855-326-8366, Monday through Friday, from 8:30 a.m. to 7:30 p.m. (ET), excluding Federal holidays.


Want to Sell Your Medical Practice? Do You Have Medical Office Space to Sell or Share?
Clineeds is a new online platform designed to help medical providers sell their practice or buy, sell and share medical office space. Listing is FREE! No contracts. No commitments. No fees. Sign up today at http://www.clineeds.com/sign-up

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

Physician Opportunities

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

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

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

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

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

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

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

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

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