MSSNY eNews: August 27, 2021 – Health Care Worker Vaccination Mandate Approved by Key Public Health Committee
Insurance Hassles? We Can Help
As physicians, we know all too well how hassles with insurance companies can get in the way of our first and foremost responsibility and primary concern—taking care of our patients. Each of us attended medical school to learn how to be a physician, not to spend hours of wasted time dealing with denied claims, prior authorizations, and other insurance issues.
MSSNY’s new Director of Physician Payment and Practice, Heather Lopez, is here to help. In the few weeks since she came on board, Heather has already worked to advocate for physicians and patients in disputes with commercial and public payors regarding claim payment and rules limiting the physician-patient relationship and access to quality, affordable care. She works with MSSNY leadership and staff to identify larger problems and trends in claim payment or limits on physician practice that impact patient care.
Under Heather’s direction, the department of Physician Payment and Practice maintains an effective liaison with third party health insurers, administrators, managed care entities and pertinent federal and state agencies on behalf of MSSNY members. She is an expert in Medicare, Medicaid, Workers Compensation, Auto No-Fault, traditional indemnity, and managed care plans and provides education, guidance, and general assistance to MSSNY members with health insurance related issues.
Additionally, Heather analyzes physician complaints and advocates for solutions with insurers and regulators, as well as with both federal and state public payors and identifies trends or common sets of problems faced by physicians and patients that may be subject to solutions through legislative or regulatory action.
Heather comes to MSSNY with a wealth of experience and knowledge in the health care arena. And she’s here to help you—our MSSNY members. Please contact Heather directly at 518.465.8085 X332 | firstname.lastname@example.org with a specific issue—or just to chat about the ways she can help you going forward.
Health Care Worker Vaccination Mandate Approved by Key Public Health Committee
The New York Public Health and Health Planning Council (PHHPC) approved an emergency regulation to be adopted by the NYS Department of Health requiring health care workers in all Article 28 regulated settings – hospitals, nursing homes, clinics, Ambulatory Surgery Centers, dialysis facilities, etc. – to be vaccinated against Covid. This includes physicians and other care providers who may not be employed directly but who provide care at these health care settings (such as a physician with privileges at a hospital or who sees patients at a nursing home). There is an exemption for health care workers for documented medical contraindications, but after objection from various groups including MSSNY, the proposed “religious exemption” to this vaccination requirement was dropped from the regulation.
Based upon the recommendation of MSSNY’s Emergency Preparedness and Infectious Disease Committees, MSSNY President Dr. Joseph Sellers recently issued a statement supporting mandatory vaccination of health care workers as one important step to increase our vaccination rate and reduce the spread of Covid: MSSNY Applauds NYS COVID-19 Vaccination Mandate for Healthcare Workers.
The regulation will require health care workers at hospitals and nursing homes to have a first dose by September 27, and for other Article 28 regulated settings, by October 7. The regulation will be effective for 90 days.
According to the regulation, an acceptable medical exemption to the required vaccine is where a “licensed physician or certified nurse practitioner certifies that immunization with COVID-19 vaccine is detrimental to the health of member of a covered entity’s personnel, based upon a pre-existing health condition”. It further provides “the requirements of this section relating to COVID-19 immunization shall be inapplicable only until such immunization is found no longer to be detrimental to such personnel member’s health.” Furthermore, it instructs these covered health care entities that “the nature and duration of the medical exemption must be stated in the personnel employment medical record, or other appropriate record, and must be in accordance with generally accepted medical standards, (see, for example, the recommendations of the Advisory Committee on Immunization Practices of the U.S. Department of Health and Human Services), and any reasonable accommodation may be granted and must likewise be documented in such record”. regulation will be effective for 90 days.
MSSNY President Discusses COVID Vaccine Confidence and COVID Cases Among Children
Cheddar TV News (8/25) interviewed MSSNY President Joseph R. Sellers, MD, who discussed the rise in COVID-19 cases among children and how schools and parents can handle the coronavirus. Dr. Sellers recommended, “Reach out to your doctor. Talk to them about the safety for your child, about immunization for your child. If parents are hesitant, let’s overcome that hesitancy with some information. Let’s follow the science.” Watch the interview here.
Students Who Have a Bad Experience in Medical School More Likely to Regret Career, Study Finds
Students who said they were mistreated during their first two years of medical school were more likely to report exhaustion and career regret by the time they graduated, according to findings published Aug. 9 in JAMA Network Open.
Researchers used data from the 2014-2016 Association of American Medical Colleges Medical School Year 2 Questionnaire, and another questionnaire completed by the same students during their last year of medical school. Data from 14,126 medical students across 140 U.S. medical schools were included in the analysis.
Overall, nearly 23 percent of respondents reported mistreatment in the first two years of medical school. This group was more likely to report higher levels of exhaustion and disengagement, compared to students who didn’t report a negative experience. Of the group that reported mistreatment, 18.8 percent reported career regret by the time of graduation.
At the same time, students who reported positive learning experiences, such as better interactions with faculty, were more likely to report higher empathy, lower exhaustion scores and lower engagement scores by the time they graduated. Better student-to-student interactions were also tied to a lower chance of reporting career regret during the last year of medical school, the findings showed.
“The findings of this cohort study suggest that medical students who experienced mistreatment and perceived the learning environment less favorably were more likely to develop higher levels of exhaustion and disengagement, lower levels of empathy, and career regret compared with medical students with more positive experiences,” researchers said. “Strategies to improve well-being, empathy, and experience should include approaches to eliminate mistreatment and improve the learning experience.”
Take a Listen to MSSNY’s Podcast: Virtual CME Offerings at HOD; The COVID-19 Delta Variant; and an Update on MSSNY Lobbying Efforts
Urge Governor to Sign into Law 2 Bills to Assist Patients to Receive Needed Medications
With Governor Hochul taking office this week, this is a good time to contact her office to urge that she sign into law legislation passed at the end of the Legislative Session critical to helping patients to be able to receive the medications they need as well as to ensure greater oversight over pharmacy benefit formulary development practices. A letter or tweet can be sent from here: Urge Gov. Hochul to SIGN two RX bills – Regulating PBMs and Restricting Mid-Year Formulary Changes.
The first bill (A.1396, Gottfried/S.3762, Breslin), will provide greater accountability and transparency of the practices of Pharmacy Benefit Managers (PBMs). The bill was significantly revised from the version that passed the Legislature in 2019, but vetoed, to address concerns raised in your veto message. The bill would require that PBMs be licensed by the Department of Financial Services (DFS) and adhere to standards established by DFS. The bill would also provide for the disclosure of all possible revenue streams and terms and conditions that they place on their networks of pharmacies. MSSNY has supported greater oversight and regulation of PBMs as one manner to address restrictive formularies and excessive prior authorization requirements that interfere with patients obtaining needed medications.
The second bill (A.4668, People-Stokes/S.4111, Breslin), would significantly limit the ability of health insurers to move medications to higher cost-sharing tiers for their prescription drug formularies during a policy year. A substantially similar passed the Assembly and Senate in 2019, but was vetoed. To address concerns raised in the 2019 veto message, the new legislation would prohibit the applicability of a mid-year formulary change for those patients who were on the medication at the beginning of the policy year, or suffer from a condition for which the medication is part of a treatment regimen, for that condition. However, other mid-year formulary changes could still occur.
Better Medicare Alliance Releases Report on Social Determinants of Health
Better Medicare Alliance recently released a report highlighting innovative approaches to addressing social determinants of health for Medicare Advantage (MA) beneficiaries. Conducted by the National Opinion Research Center (NORC) at the University of Chicago on behalf of Better Medicare Alliance’s Center for Innovation in Medicare Advantage, the report found there was a dramatic increase in plan activity to address social needs within MA particularly in the areas of social isolation, transportation, housing, and food.
NORC’s research also showed that barriers to further SDOH innovations remain which include technology limitations, misaligned incentives, and the disconnect between health care systems and social services.
Last Chance to Nominate a Colleague for MSSNY’s Bernstein Award
The Medical Society of the State of New York is accepting nominations for the 2020 Albion O. Bernstein, MD Award. The deadline for applications has been extended to September 7, 2021. This prestigious award is given to:
“…the physician, surgeon or scientist who shall have made the most widely beneficial discovery or developed the most useful method in medicine, surgery or in the prevention of disease in the twelve months prior to December 2020.”
This award was endowed by the late Morris J. Bernstein in memory of his son, a physician who died in an accident while answering a hospital call in November 1940.
The $2,000 award will be presented to the recipient during a MSSNY Council Meeting.
Nominations must be submitted on an official application form and must include the nominator’s narrative description of the significance of the candidate’s achievements as well as the candidate’s curriculum vitae, including a list of publications or other contributions.
To request an application, please contact:
Committee on Continuing Medical Education
Miriam Hardin, PhD, Manager, Continuing Medical Education
Medical Society of the State of New York
99 Washington Avenue, Suite 408
Albany, NY 12210
New NGSMedicare.com Walkthrough and Open Q&A Webinars
NGSMedicare will release a redesigned provider content website that will contain all content that is now available but with an easier and more intuitive look and feel. As they transition to the new site, they are conducting webinars for providers to attend in order to gain an overview of the new provider content website and ask questions about NGSMedicare.com.
Sign up for one of the following webinars to learn about the new provider content website. All times listed are eastern time. The NGSMedicare Crosswalk Reference compares the existing website with the new website.
10 States with Highest COVID-19 Case Increases in Last 2 Weeks
New daily COVID-19 cases in the U.S. have risen 29 percent over the last two weeks, with 47 states and the District of Columbia seeing cases trend upward, according to data tracked by The New York Times.
Case averages were decreasing only in Louisiana, Missouri and Arkansas.
Below are 10 states with the highest 14-day case increase. Data is taken from state and local health agencies and was last updated Aug 24.
14-day change: 352 percent increase
Cases per 100,000 people: 27
14-day change: 160 percent increase
Cases per 100,000 people: 52
14-day change: 128 percent increase
Cases per 100,000 people: 28
14-day change: 105 percent increase
Cases per 100,000 people: 25
14-day change: 98 percent increase
Cases per 100,000 people: 28
14-day change: 86 percent increase
Cases per 100,000 people: 87
14-day change: 82 percent increase
Cases per 100,000 people: 47
14-day change: 78 percent increase
Cases per 100,000 people: 50
14-day change: 77 percent increase
Cases per 100,000 people: 33
14-day change: 77 percent increase
Cases per 100,000 people: 27
–Masson, Becker’s Hospital Review
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Health Research, Inc. (HRI) has a job opening within the AIDS Institute’s Office of the Medical Director for a Public Health Physician II. Please distribute this announcement widely through your networks. Interested individuals can apply for this position through the HRI website.
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